Quality Measure Implementation Guide (STU5)
5.0.0 - release United States of America flag

Quality Measure Implementation Guide (STU5), published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 5.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Resource Profile: CQFM Ratio Measure

Official URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/ratio-measure-cqfm Version: 4.0.0
Active as of 2024-10-11 Computable Name: CQFMRatioMeasure

The CQFM Ratio Measure Profile describes a ratio scoring measure.

For more information on the usage of this profile, refer to the [profiles] and [packaging] pages.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CQFMComputableMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 0..* CQFMComputableMeasure A quality measure definition
... scoring S 0..1 CodeableConcept ratio
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ratio
... group SC 1..* BackboneElement Population criteria group
cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
.... Slices for extension Content/Rules for all slices
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed

.... Slices for population SC 4..8 BackboneElement Population criteria
Slice: Unordered, Open by value:code
..... population:initialPopulation S 1..2 BackboneElement Initial Population
...... Slices for extension Content/Rules for all slices
....... populationBasis 0..1 code Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population

...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: initial-population
..... population:denominator S 1..1 BackboneElement Denominator
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator
..... population:denominatorExclusion S 0..1 BackboneElement Denominator Exclusion
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator-exclusion
..... population:numerator S 1..1 BackboneElement Numerator
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator
..... population:numeratorExclusion S 0..1 BackboneElement Numerator Exclusion
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator-exclusion
..... population:measureObservation S 0..2 BackboneElement Measure Observation
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
....... aggregateMethod S 1..1 code Aggregate with
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod
Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)

...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: measure-observation

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
cmp-13errorMeasure.groupRatio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQFMComputableMeasure A quality measure definition
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
... scoring SΣC 0..1 CodeableConcept ratio
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ratio
... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
... group SC 1..* BackboneElement Population criteria group
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
.... Slices for extension Content/Rules for all slices
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


..... component S 0..* RelatedArtifact What artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the group
.... description S 0..1 string Summary description
.... Slices for population SC 4..8 BackboneElement Population criteria
Slice: Unordered, Open by value:code
..... population:All Slices Content/Rules for all slices
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.

...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:initialPopulation S 1..2 BackboneElement Initial Population
...... Slices for extension Content/Rules for all slices
....... populationBasis 0..1 code Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: initial-population
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:denominator S 1..1 BackboneElement Denominator
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:denominatorExclusion S 0..1 BackboneElement Denominator Exclusion
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator-exclusion
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:numerator S 1..1 BackboneElement Numerator
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:numeratorExclusion S 0..1 BackboneElement Numerator Exclusion
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator-exclusion
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:measureObservation S 0..2 BackboneElement Measure Observation
...... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
....... aggregateMethod S 1..1 code Aggregate with
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod
Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)


...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: measure-observation
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
..... Slices for extension Content/Rules for all slices
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept Meaning of the stratifier
..... description S 0..1 string The human readable description of this stratifier
..... component S 0..* BackboneElement Stratifier criteria component for the measure
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept Meaning of the stratifier component
...... description S 0..1 string The human readable description of this stratifier component
...... criteria 1..1 Expression Component of how the measure should be stratified
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the supplemental data
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


.... description S 0..1 string The human readable description of this supplemental data
.... criteria 1..1 Expression Expression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type
from this IG
Measure.scoringextensiblePattern: ratio
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:initialPopulation.codeextensiblePattern: initial-population
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:denominator.codeextensiblePattern: denominator
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:denominatorExclusion.codeextensiblePattern: denominator-exclusion
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:numerator.codeextensiblePattern: numerator
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:numeratorExclusion.codeextensiblePattern: numerator-exclusion
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:measureObservation.codeextensiblePattern: measure-observation
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-13errorMeasure.groupRatio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())
NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure SC 0..* CQFMComputableMeasure A quality measure definition
mea-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
mea-1: Stratifier SHALL be either a single criteria or a set of criteria components
cmp-1: Population basis must be specified at the root, or on each group
cmp-2: Scoring must either be specified at the root, or on each group
cmp-3: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-4: Improvement notation must be specified for scoring types other than cohort
cmp-5: If type is specified at the root, it may not be specified on any group
cmp-6: If riskAdjustment is specified at the root, it may not be specified on any group
cmp-7: If rateAggregation is specified at the root, it may not be specified on any group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


.... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
.... effectiveDataRequirements S 0..1 canonical(CRMI Module Definition Library) Effective required data for evaluation
URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
.... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... url Σ 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)
... identifier Σ 0..* Identifier Additional identifier for the measure
... version Σ 0..1 string Business version of the measure
... name ΣC 0..1 string Name for this measure (computer friendly)
... title Σ 0..1 string Name for this measure (human friendly)
... subtitle 0..1 string Subordinate title of the measure
... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

... experimental Σ 0..1 boolean For testing purposes, not real usage
... subject[x] S 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: Subject Type Value Set (extensible)
.... subjectCodeableConcept CodeableConcept
.... subjectReference Reference(Group)
... date Σ 0..1 dateTime Date last changed
... publisher Σ 0..1 string Name of the publisher (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher
... description Σ 0..1 markdown Natural language description of the measure
... useContext Σ 0..* UsageContext The context that the content is intended to support
... jurisdiction Σ 0..* CodeableConcept Intended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.


... purpose 0..1 markdown Why this measure is defined
... usage 0..1 string Describes the clinical usage of the measure
... copyright 0..1 markdown Use and/or publishing restrictions
... approvalDate 0..1 date When the measure was approved by publisher
... lastReviewDate 0..1 date When the measure was last reviewed
... effectivePeriod Σ 0..1 Period When the measure is expected to be used
... topic 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc.
Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.


... author 0..* ContactDetail Who authored the content
... editor 0..* ContactDetail Who edited the content
... reviewer 0..* ContactDetail Who reviewed the content
... endorser 0..* ContactDetail Who endorsed the content
... relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc.
... library S 0..1 canonical(CRMI Computable Library) Logic used by the measure
... disclaimer Σ 0..1 markdown Disclaimer for use of the measure or its referenced content
... scoring SΣC 0..1 CodeableConcept ratio
Binding: Measure Scoring (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ratio
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... compositeScoring Σ 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.

... type SΣC 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).


... riskAdjustment ΣC 0..1 string How risk adjustment is applied for this measure
... rateAggregation ΣC 0..1 string How is rate aggregation performed for this measure
... rationale Σ 0..1 markdown Detailed description of why the measure exists
... clinicalRecommendationStatement Σ 0..1 markdown Summary of clinical guidelines
... improvementNotation SΣC 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required)
... definition Σ 0..* markdown Defined terms used in the measure documentation
... guidance Σ 0..1 markdown Additional guidance for implementers
... group SC 1..* BackboneElement Population criteria group
cmp-8: Scoring unit may only be specified at the root if the scoring is also specified at the root
cmp-9: Improvement notation must be specified for scoring types other than cohort
cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... populationBasis SC 0..1 code What type of population
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed


..... scoringUnit SC 0..1 CodeableConcept What units?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit
..... scoringPrecision 0..1 positiveInt Number of decimal places
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringPrecision
..... compositeScoring S 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-compositeScoring
Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed


..... component S 0..* RelatedArtifact What artifact
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-component
..... type C 0..* CodeableConcept process | outcome | structure | patient-reported-outcome
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type
Binding: MeasureType (extensible): Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.


..... riskAdjustment C 0..1 string How risk adjustment is applied for this measure
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment
..... rateAggregation C 0..1 string How is rate aggregation performed for this measure
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation
..... improvementNotation SC 0..1 CodeableConcept increase | decrease
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the group
.... description S 0..1 string Summary description
.... Slices for population SC 4..8 BackboneElement Population criteria
Slice: Unordered, Open by value:code
..... population:All Slices Content/Rules for all slices
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.

...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:initialPopulation S 1..2 BackboneElement Initial Population
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... populationBasis 0..1 code Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population


...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: initial-population
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:denominator S 1..1 BackboneElement Denominator
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:denominatorExclusion S 0..1 BackboneElement Denominator Exclusion
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator-exclusion
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:numerator S 1..1 BackboneElement Numerator
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:numeratorExclusion S 0..1 BackboneElement Numerator Exclusion
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: numerator-exclusion
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
..... population:measureObservation S 0..2 BackboneElement Measure Observation
...... id 0..1 string Unique id for inter-element referencing
...... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
....... aggregateMethod S 1..1 code Aggregate with
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-aggregateMethod
Binding: Measure Aggregate Method (preferred): Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count)


...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType (extensible): The type of population.


Required Pattern: At least the following
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: measure-observation
........ display 0..1 string Representation defined by the system
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... description S 0..1 string The human readable description of this population criteria
...... criteria 1..1 Expression The criteria that defines this population
.... stratifier S 0..* BackboneElement Stratifier criteria for the measure
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... appliesTo 0..* CodeableConcept Which population does this stratifier apply to?
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo
Binding: MeasurePopulationType (extensible): Indicates the population


..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code S 0..1 CodeableConcept Meaning of the stratifier
..... description S 0..1 string The human readable description of this stratifier
..... criteria 0..1 Expression How the measure should be stratified
..... component S 0..* BackboneElement Stratifier criteria component for the measure
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 0..1 CodeableConcept Meaning of the stratifier component
...... description S 0..1 string The human readable description of this stratifier component
...... criteria 1..1 Expression Component of how the measure should be stratified
... supplementalData S 0..* BackboneElement What other data should be reported with the measure
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..1 CodeableConcept Meaning of the supplemental data
.... usage S 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.


.... description S 0..1 string The human readable description of this supplemental data
.... criteria 1..1 Expression Expression describing additional data to be reported

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Measure.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Measure.statusrequiredPublicationStatus
http://hl7.org/fhir/ValueSet/publication-status|4.0.1
from the FHIR Standard
Measure.subject[x]extensibleSubjectTypeValueSet
http://hl7.org/fhir/us/cqfmeasures/ValueSet/subject-type
from this IG
Measure.jurisdictionextensibleJurisdiction ValueSet
http://hl7.org/fhir/ValueSet/jurisdiction
from the FHIR Standard
Measure.topicexampleDefinitionTopic
http://hl7.org/fhir/ValueSet/definition-topic
from the FHIR Standard
Measure.scoringextensiblePattern: ratio
http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoringextensibleCompositeMeasureScoring
http://hl7.org/fhir/ValueSet/composite-measure-scoring
from the FHIR Standard
Measure.typeextensibleMeasureType
http://hl7.org/fhir/ValueSet/measure-type
from the FHIR Standard
Measure.improvementNotationrequiredMeasureImprovementNotation
http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.codeextensibleMeasurePopulationType
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:initialPopulation.codeextensiblePattern: initial-population
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:denominator.codeextensiblePattern: denominator
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:denominatorExclusion.codeextensiblePattern: denominator-exclusion
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:numerator.codeextensiblePattern: numerator
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:numeratorExclusion.codeextensiblePattern: numerator-exclusion
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.group.population:measureObservation.codeextensiblePattern: measure-observation
http://hl7.org/fhir/ValueSet/measure-population
from the FHIR Standard
Measure.supplementalData.usageextensibleMeasureDataUsage
http://hl7.org/fhir/ValueSet/measure-data-usage
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cmp-1errorMeasurePopulation basis must be specified at the root, or on each group
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis').exists()).allTrue()
cmp-2errorMeasureScoring must either be specified at the root, or on each group
: scoring.exists() xor (group.exists() and group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()).allTrue())
cmp-3errorMeasureScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies scoring.exists()
cmp-4errorMeasureImprovement notation must be specified for scoring types other than cohort
: (scoring.exists() and (scoring.coding.code.contains('proportion') or scoring.coding.code.contains('ratio') or scoring.coding.code.contains('continuous-variable') or scoring.coding.code.contains('composite')) and improvementNotation.exists()) xor (group.exists() and group.select((extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and (extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('proportion') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('ratio') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('continuous-variable') or extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code.contains('composite')) and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists())).allTrue()) xor (scoring.exists() and scoring.coding.code.contains('cohort'))
cmp-5errorMeasureIf type is specified at the root, it may not be specified on any group
: type.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type').exists()).allFalse()
cmp-6errorMeasureIf riskAdjustment is specified at the root, it may not be specified on any group
: riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-riskAdjustment').exists()).allFalse()
cmp-7errorMeasureIf rateAggregation is specified at the root, it may not be specified on any group
: rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation').exists()).allFalse()
cmp-8errorMeasure.groupScoring unit may only be specified at the root if the scoring is also specified at the root
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoringUnit').exists() implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists()
cmp-9errorMeasure.groupImprovement notation must be specified for scoring types other than cohort
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation').exists()
cmp-13errorMeasure.groupRatio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
: extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').exists() and extension('http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring').value.coding.code contains 'ratio' implies population.select(code.coding.where(system = 'http://terminology.hl7.org/CodeSystem/measure-population').code in ('initial-population' | 'numerator' | 'denominator' | 'denominator-exclusion' | 'measure-observation' | 'numerator-exclusion')).allTrue()
dom-2errorMeasureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMeasureIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMeasureIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorMeasureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMeasureA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mea-0warningMeasureName should be usable as an identifier for the module by machine processing applications such as code generation
: name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
mea-1errorMeasureStratifier SHALL be either a single criteria or a set of criteria components
: group.stratifier.all((code | description | criteria).exists() xor component.exists())

This structure is derived from CQFMComputableMeasure

Summary

Mandatory: 7 elements(4 nested mandatory elements)
Must-Support: 22 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Measure.group.population

Differential View

This structure is derived from CQFMComputableMeasure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Measure 0..* CQFMComputableMeasure A quality measure definition
... scoring S 0..1 CodeableConcept ratio
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-scoring
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: ratio
... group SC 1..* BackboneElement Population criteria group
cmp-13: Ratio measures may not have other than initial population, denominator, numerator, denominator-exclusion, numerator-exclusion, and measure-observation criteria
.... Slices for extension Content/Rules for all slices
..... scoring SC 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring
Binding: Measure Scoring (extensible): How the measure calculation is performed

.... Slices for population SC 4..8 BackboneElement Population criteria
Slice: Unordered, Open by value:code
..... population:initialPopulation S 1..2 BackboneElement Initial Population
...... Slices for extension Content/Rules for all slices
....... populationBasis 0..1 code Allows the populationBasis for that population to be overridden. If not present, the populationBasis of the measure (or group) is used. If present, it specifies the population basis for all the expressions that use it as the initial population in the ratio measure.
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis
Binding: FHIRAllTypes (required): The type of elements in the population

...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: initial-population
..... population:denominator S 1..1 BackboneElement Denominator
...... Slices for extension Content/Rules for all slices
....... criteriaReference S 0..1 string Which criteria
URL: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-criteriaReference
...... code S 1..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Required Pattern: At least the following
....... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
........ system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/measure-population
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: denominator
..... population:denominatorExclusion S 0..1 BackboneElement Denominator Exclusion
...... Slices for extension Content/Rules for all slices
....... criteriaReference S