Quality Measure Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.1-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-cqm/ and changes regularly. See the Directory of published versions

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Resource Profile: CQM Computable Measure

The CQM Computable Measure Profile describes minimum expectations for a computable electronic Quality Measure (QM), including the use of a computable library. For more information on the usage of this profile, refer to the Profiles and Packaging pages in this implementation guide. Implementations SHOULD support using the id elements of group, population, stratifier, and supplementalData as a backwards-compatible mechanism for linking between Measure and MeasureReport

Usages:

• Derived from this Profile: CQM Cohort Measure, CQM Composite Measure, CQM Continuous Variable Measure, CQM Proportion Measure and CQM Ratio Measure
• Examples for this Profile: BCSComponent, CCSComponent, EXM108, EXM124... Show 13 more, EXM125, EXM130, EXM146, EXM55, MeasureEXM, EXMRatioMeasure, HBPComponent, MultiRateExample, PVSComponent, TSCComponent, Terminology_FHIR, MeasureAgeStratifiedExample and PublishableMeasureEXM
• CapabilityStatements using this Profile: CQF Measures Shareable Measure Repository Capability Statement

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
usage	S	0..1	string	Describes the clinical usage of the measure
library	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SΣC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type	SΣC	0..*	CodeableConcept	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
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
improvementNotation	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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
population	S	0..*	BackboneElement	Population criteria
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
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
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 From the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 From the FHIR Standard
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If 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-4	error	Measure	If 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-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name 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-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())
popBasis-1	error	Measure.extension:populationBasis, Measure.group.extension:populationBasis	If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. : value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())

This structure is derived from Measure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
Slices for extension				Content/Rules for all slices
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
subject[x]	S	0..1	CodeableConcept, Reference(Group)	E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
usage	S	0..1	string	Describes the clinical usage of the measure
library	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type	SΣC	0..*	CodeableConcept	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure
improvementNotation	SC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	S	0..*	BackboneElement	Population criteria
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
code	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
description	S	0..1	string	The human readable description of this population criteria
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension				Content/Rules for all slices
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier component
supplementalData	S	0..*	BackboneElement	What other data should be reported with the measure
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor
description	S	0..1	string	The human readable description of this supplemental data
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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	S	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	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
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	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
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	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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
population	S	0..*	BackboneElement	Population criteria
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
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
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Measure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 From the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1 From the FHIR Standard
Measure.topic	example	DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic|4.0.1 From the FHIR Standard
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://hl7.org/fhir/ValueSet/composite-measure-scoring|4.0.1 From the FHIR Standard
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 From the FHIR Standard
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If 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-4	error	Measure	If 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-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name 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-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())
popBasis-1	error	Measure.extension:populationBasis, Measure.group.extension:populationBasis	If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. : value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())

This structure is derived from Measure

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 36 elements

Structures

This structure refers to these other structures:

• CRMI Computable Library (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
• http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId

Maturity: 4

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
subject[x]	S	0..1		E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
usage	S	0..1	string	Describes the clinical usage of the measure
library	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SΣC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type	SΣC	0..*	CodeableConcept	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
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
improvementNotation	SΣC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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
population	S	0..*	BackboneElement	Population criteria
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
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
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 From the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 From the FHIR Standard
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If 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-4	error	Measure	If 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-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name 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-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())
popBasis-1	error	Measure.extension:populationBasis, Measure.group.extension:populationBasis	If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. : value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())

Differential View

This structure is derived from Measure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
Slices for extension				Content/Rules for all slices
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
subject[x]	S	0..1	CodeableConcept, Reference(Group)	E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Subject Type Value Set (extensible)
usage	S	0..1	string	Describes the clinical usage of the measure
library	S	0..1	canonical(CRMI Computable Library)	Logic used by the measure
scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
type	SΣC	0..*	CodeableConcept	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure
rateAggregation	C	0..1	string	How is rate aggregation performed for this measure
improvementNotation	SC	0..1	CodeableConcept	increase | decrease Binding: MeasureImprovementNotation (required)
group	SC	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure
code	S	0..1	CodeableConcept	Meaning of the group
description	S	0..1	string	Summary description
population	S	0..*	BackboneElement	Population criteria
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
code	S	0..1	CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
description	S	0..1	string	The human readable description of this population criteria
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
Slices for extension				Content/Rules for all slices
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier
component	S	0..*	BackboneElement	Stratifier criteria component for the measure
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
description	S	0..1	string	The human readable description of this stratifier component
supplementalData	S	0..*	BackboneElement	What other data should be reported with the measure
Slices for extension				Content/Rules for all slices
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
code	S	0..1	CodeableConcept	Meaning of the supplemental data
usage	S	0..*	CodeableConcept	supplemental-data | risk-adjustment-factor
description	S	0..1	string	The human readable description of this supplemental data
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Measure	SC	0..*	Measure	A quality measure definition Constraints: mea-0, mea-1, comp-1, comp-2, comp-3, comp-4, comp-5, comp-6, comp-7
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:populationBasis	SC	0..*	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:effectiveDataRequirements	S	0..1	canonical(CRMI Module Definition Library)	Effective required data for evaluation URL: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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	S	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	proportion | ratio | continuous-variable | cohort Binding: Measure Scoring (extensible)
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	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. Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
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	0..*	BackboneElement	Population criteria group Constraints: comp-8, comp-9
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
extension:populationBasis	SC	0..1	code, DataRequirement	What type of population URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis Binding: FHIRAllTypes (required): The type of elements in the population Constraints: popBasis-1
extension:scoring	SC	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring Binding: Measure Scoring (extensible): How the measure calculation is performed
extension:scoringUnit	SC	0..1	CodeableConcept	What units? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
extension:scoringPrecision		0..1	positiveInt	Number of decimal places URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
extension:compositeScoring	S	0..1	CodeableConcept	proportion | ratio | continuous-variable | cohort URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring Binding: CompositeMeasureScoring (extensible): How the composite measure calculation is performed
extension:component	S	0..*	RelatedArtifact	What artifact URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
extension:type	C	0..*	CodeableConcept	Extension URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type Binding: ObservationMeasureType (extensible): Indicates the type of quality measure based on the observation value.
extension:riskAdjustment	C	0..1	string	How risk adjustment is applied for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
extension:rateAggregation	C	0..1	string	How is rate aggregation performed for this measure URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
extension:improvementNotation	SC	0..1	CodeableConcept	increase | decrease URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-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
population	S	0..*	BackboneElement	Population criteria
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
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
stratifier	S	0..*	BackboneElement	Stratifier criteria for the measure
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:appliesTo		0..*	CodeableConcept	Which population does this stratifier apply to? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo Binding: MeasurePopulationType (extensible): Indicates the population
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	0..1	CodeableConcept	Meaning of the stratifier component Binding: Measure Stratifier Type (preferred)
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:linkId	S	1..1	string	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
extension:valueSet		0..1	canonical(ValueSet)	What stratum values? URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Measure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Measure.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.0.1 From the FHIR Standard
Measure.subject[x]	extensible	SubjectTypeValueSet http://hl7.org/fhir/uv/cqm/ValueSet/subject-type From this IG
Measure.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction|4.0.1 From the FHIR Standard
Measure.topic	example	DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic|4.0.1 From the FHIR Standard
Measure.scoring	extensible	MeasureScoring http://terminology.hl7.org/ValueSet/measure-scoring
Measure.compositeScoring	extensible	CompositeMeasureScoring http://hl7.org/fhir/ValueSet/composite-measure-scoring|4.0.1 From the FHIR Standard
Measure.type	extensible	ObservationMeasureType http://terminology.hl7.org/ValueSet/v3-ObservationMeasureType
Measure.improvementNotation	required	MeasureImprovementNotation http://terminology.hl7.org/ValueSet/measure-improvement-notation
Measure.group.population.code	extensible	MeasurePopulationType http://hl7.org/fhir/ValueSet/measure-population|4.0.1 From the FHIR Standard
Measure.group.stratifier.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.group.stratifier.component.code	preferred	MeasureStratifierType(a valid code from Measure Stratifier Type Codes) http://terminology.hl7.org/ValueSet/measure-stratifier-type From this IG
Measure.supplementalData.usage	extensible	MeasureDataUsage http://hl7.org/fhir/ValueSet/measure-data-usage|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
comp-1	error	Measure	Population basis must be specified at the root, or on each group : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists() or group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis').exists()).allTrue()
comp-2	error	Measure	Scoring is required. It must be specified on the root only, or on every group, and it cannot be on both. : (scoring.exists() and group.extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').empty()) xor (scoring.empty() and group.all(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()))
comp-3	error	Measure	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies scoring.exists()
comp-4	error	Measure	If scoring is specified on the root and the scoring type is 'proportion','ratio', or 'continuous-variable' then the improvementNotation element is required on the root. : scoring.exists() and (scoring.coding.code in ('proportion' | 'ratio' | 'continuous-variable')) implies improvementNotation.exists()
comp-5	error	Measure	If type is specified at the root, it may not be specified on any group : type.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type').exists()).allFalse()
comp-6	error	Measure	If riskAdjustment is specified at the root, it may not be specified on any group : riskAdjustment.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment').exists()).allFalse()
comp-7	error	Measure	If rateAggregation is specified at the root, it may not be specified on any group : rateAggregation.exists() implies group.select(extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation').exists()).allFalse()
comp-8	error	Measure.group	Scoring unit may only be specified at the root if the scoring is also specified at the root : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit').exists() implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists()
comp-9	error	Measure.group	If scoring is specified on the group and the scoring type is 'proportion', 'ratio', or 'continuous-variable' then the improvementNotation element is required. : extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').exists() and extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring').value.coding.code in ('proportion' | 'ratio' | 'continuous-variable') implies extension('http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation').exists()
dom-2	error	Measure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Measure	If 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-4	error	Measure	If 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-5	error	Measure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Measure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mea-0	warning	Measure	Name 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-1	error	Measure	Stratifier SHALL be either a single criteria or a set of criteria components : group.stratifier.all((code | description | criteria).exists() xor component.exists())
popBasis-1	error	Measure.extension:populationBasis, Measure.group.extension:populationBasis	If DataRequirement.type is present, it may only contain the elements 'profile' and 'codeFilter'. : value.exists() and value.is(DataRequirement) implies ( value.as(DataRequirement).type.exists() and value.as(DataRequirement).limit.empty() and value.as(DataRequirement).sort.empty() and value.as(DataRequirement).dateFilter.empty() and value.as(DataRequirement).subject.empty() and value.as(DataRequirement).mustSupport.empty())

This structure is derived from Measure

Summary

Mandatory: 0 element(5 nested mandatory elements)
Must-Support: 36 elements

Structures

This structure refers to these other structures:

• CRMI Computable Library (http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringUnit
• http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoringPrecision
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-scoring
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-component
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-type
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-riskAdjustment
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-rateAggregation
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-improvementNotation
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-appliesTo
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.linkId
• http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-valueSet
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.stratifier.component.linkId
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId

Maturity: 4