CQM Attestation Measure - Quality Measure Implementation Guide v3.0.0-ballot

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 3.0.0-ballot 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

Resource Profile: CQM Attestation Measure

Official URL: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-attestationmeasure	Version: 3.0.0-ballot	Highlight text changes?
Standards status: Trial-use	Maturity Level: 4	Computable Name: CQMAttestationMeasure
Other Identifiers: OID:2.16.840.1.113883.4.642.40.61.42.3

The CQM Attestation Measure Profile describes an attestation scoring measure.

Usages:

Examples for this Profile: EXMPromotingInteroperabilityMeasure

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Measure	C	0..*	Measure(4.0.1)	A quality measure definition Constraints: mea-0, mea-1
Measure.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Measure.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
Measure.status	This element is a modifier element. This element is included in summaries.	1..1	code	draft \| active \| retired \| unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
Measure.scoring	This element must be supported. This element is included in summaries.	0..1	CodeableConcept	proportion \| ratio \| continuous-variable \| cohort Binding: MeasureScoring (extensible): The scoring type of the measure. Required Pattern: `{ "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "attestation" } ] }`
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Measure.status	Base	required	PublicationStatus	📍4.0.1	FHIR Std.
Measure.scoring	Base	extensible	MeasureScoring	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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	Measure.implicitRules, Measure.modifierExtension, Measure.status, Measure.scoring	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	Measure.modifierExtension	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())`

This structure is derived from Measure

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Measure		0..*	Measure(4.0.1)	A quality measure definition
Measure.scoring	This element must be supported.	0..1	CodeableConcept	proportion \| ratio \| continuous-variable \| cohort Required Pattern: `{ "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "attestation" } ] }`
Documentation for this format

Description & Constraints Filter:

Measure C 0..* Measure(4.0.1) A quality measure definition
Constraints: mea-0, mea-1

Measure.id This element is included in summaries. 0..1 id Logical id of this artifact

Measure.meta This element is included in summaries. 0..1 Meta Metadata about the resource

Measure.implicitRules This element is a modifier element. This element is included in summaries. 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

Measure.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

Measure.contained 0..* Resource Contained, inline Resources

Measure.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Constraints: ext-1

Measure.url This element is included in summaries. 0..1 uri Canonical identifier for this measure, represented as a URI (globally unique)

Measure.identifier This element is included in summaries. 0..* Identifier Additional identifier for the measure

Measure.version This element is included in summaries. 0..1 string Business version of the measure

Measure.name This element is included in summaries. C 0..1 string Name for this measure (computer friendly)

Measure.title This element is included in summaries. 0..1 string Name for this measure (human friendly)

Measure.subtitle 0..1 string Subordinate title of the measure

Measure.status This element is a modifier element. This element is included in summaries. 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (required): The lifecycle status of an artifact.

Measure.experimental This element is included in summaries. 0..1 boolean For testing purposes, not real usage

Measure.subject[x] 0..1 E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device
Binding: SubjectType (extensible): The possible types of subjects for a measure (E.g. Patient, Practitioner, Organization, Location, etc.).

Measure.subject[x].subjectCodeableConcept CodeableConcept

Measure.subject[x].subjectReference Reference(Group)

Measure.date This element is included in summaries. 0..1 dateTime Date last changed

Measure.publisher This element is included in summaries. 0..1 string Name of the publisher (organization or individual)

Measure.contact This element is included in summaries. 0..* ContactDetail Contact details for the publisher

Measure.description This element is included in summaries. 0..1 markdown Natural language description of the measure

Measure.useContext This element is included in summaries. 0..* UsageContext The context that the content is intended to support

Measure.jurisdiction This element is included in summaries. 0..* CodeableConcept Intended jurisdiction for measure (if applicable)
Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.

Measure.purpose 0..1 markdown Why this measure is defined

Measure.usage 0..1 string Describes the clinical usage of the measure

Measure.copyright 0..1 markdown Use and/or publishing restrictions

Measure.approvalDate 0..1 date When the measure was approved by publisher

Measure.lastReviewDate 0..1 date When the measure was last reviewed

Measure.effectivePeriod This element is included in summaries. 0..1 Period When the measure is expected to be used

Measure.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.

Measure.author 0..* ContactDetail Who authored the content

Measure.editor 0..* ContactDetail Who edited the content

Measure.reviewer 0..* ContactDetail Who reviewed the content

Measure.endorser 0..* ContactDetail Who endorsed the content

Measure.relatedArtifact 0..* RelatedArtifact Additional documentation, citations, etc.

Measure.library 0..* canonical(Library) Logic used by the measure

Measure.disclaimer This element is included in summaries. 0..1 markdown Disclaimer for use of the measure or its referenced content

scoring

0..1

CodeableConcept

proportion | ratio | continuous-variable | cohort
Binding: MeasureScoring (extensible): The scoring type of the measure.
Required Pattern:

{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
      "code" : "attestation"
    }
  ]
}

Measure.compositeScoring This element is included in summaries. 0..1 CodeableConcept opportunity | all-or-nothing | linear | weighted
Binding: CompositeMeasureScoring (extensible): The composite scoring method of the measure.

Measure.type This element is included in summaries. 0..* CodeableConcept process | outcome | structure | patient-reported-outcome | composite
Binding: MeasureType (extensible): The type of measure (includes codes from 2.16.840.1.113883.1.11.20368).

Measure.riskAdjustment This element is included in summaries. 0..1 string How risk adjustment is applied for this measure

Measure.rateAggregation This element is included in summaries. 0..1 string How is rate aggregation performed for this measure

Measure.rationale This element is included in summaries. 0..1 markdown Detailed description of why the measure exists

Measure.clinicalRecommendationStatement This element is included in summaries. 0..1 markdown Summary of clinical guidelines

Measure.improvementNotation This element is included in summaries. 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

Measure.definition This element is included in summaries. 0..* markdown Defined terms used in the measure documentation

Measure.guidance This element is included in summaries. 0..1 markdown Additional guidance for implementers

Measure.group 0..* BackboneElement Population criteria group

Measure.group.id 0..1 string Unique id for inter-element referencing

Measure.group.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.group.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1

Measure.group.code 0..1 CodeableConcept Meaning of the group

Measure.group.description 0..1 string Summary description

Measure.group.population 0..* BackboneElement Population criteria

Measure.group.population.id 0..1 string Unique id for inter-element referencing

Measure.group.population.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.group.population.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1

Measure.group.population.description 0..1 string The human readable description of this population criteria

Measure.group.population.criteria 1..1 Expression The criteria that defines this population

Measure.group.stratifier 0..* BackboneElement Stratifier criteria for the measure

Measure.group.stratifier.id 0..1 string Unique id for inter-element referencing

Measure.group.stratifier.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.group.stratifier.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1

Measure.group.stratifier.code 0..1 CodeableConcept Meaning of the stratifier

Measure.group.stratifier.description 0..1 string The human readable description of this stratifier

Measure.group.stratifier.criteria 0..1 Expression How the measure should be stratified

Measure.group.stratifier.component 0..* BackboneElement Stratifier criteria component for the measure

Measure.group.stratifier.component.id 0..1 string Unique id for inter-element referencing

Measure.group.stratifier.component.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.group.stratifier.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1

Measure.group.stratifier.component.code 0..1 CodeableConcept Meaning of the stratifier component

Measure.group.stratifier.component.description 0..1 string The human readable description of this stratifier component

Measure.group.stratifier.component.criteria 1..1 Expression Component of how the measure should be stratified

Measure.supplementalData 0..* BackboneElement What other data should be reported with the measure

Measure.supplementalData.id 0..1 string Unique id for inter-element referencing

Measure.supplementalData.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1

Measure.supplementalData.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1

Measure.supplementalData.code 0..1 CodeableConcept Meaning of the supplemental data

Measure.supplementalData.usage 0..* CodeableConcept supplemental-data | risk-adjustment-factor
Binding: MeasureDataUsage (extensible): The intended usage for supplemental data elements in the measure.

Measure.supplementalData.description 0..1 string The human readable description of this supplemental data

Measure.supplementalData.criteria 1..1 Expression Expression describing additional data to be reported

Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Measure.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Measure.status	Base	required	PublicationStatus	📍4.0.1	FHIR Std.
Measure.subject[x]	Base	extensible	Subject type	📍4.0.1	FHIR Std.
Measure.jurisdiction	Base	extensible	Jurisdiction	📍4.0.1	FHIR Std.
Measure.topic	Base	example	DefinitionTopic	📍4.0.1	FHIR Std.
Measure.scoring	Base	extensible	MeasureScoring	📍4.0.1	FHIR Std.
Measure.compositeScoring	Base	extensible	CompositeMeasureScoring	📍4.0.1	FHIR Std.
Measure.type	Base	extensible	MeasureType	📍4.0.1	FHIR Std.
Measure.improvementNotation	Base	required	MeasureImprovementNotation	📍4.0.1	FHIR Std.
Measure.group.population.code	Base	extensible	MeasurePopulationType	📍4.0.1	FHIR Std.
Measure.supplementalData.usage	Base	extensible	MeasureDataUsage	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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	Measure.meta, Measure.implicitRules, Measure.language, Measure.text, Measure.extension, Measure.modifierExtension, Measure.url, Measure.identifier, Measure.version, Measure.name, Measure.title, Measure.subtitle, Measure.status, Measure.experimental, Measure.subject[x], Measure.date, Measure.publisher, Measure.contact, Measure.description, Measure.useContext, Measure.jurisdiction, Measure.purpose, Measure.usage, Measure.copyright, Measure.approvalDate, Measure.lastReviewDate, Measure.effectivePeriod, Measure.topic, Measure.author, Measure.editor, Measure.reviewer, Measure.endorser, Measure.relatedArtifact, Measure.library, Measure.disclaimer, Measure.scoring, Measure.compositeScoring, Measure.type, Measure.riskAdjustment, Measure.rateAggregation, Measure.rationale, Measure.clinicalRecommendationStatement, Measure.improvementNotation, Measure.definition, Measure.guidance, Measure.group, Measure.group.extension, Measure.group.modifierExtension, Measure.group.code, Measure.group.description, Measure.group.population, Measure.group.population.extension, Measure.group.population.modifierExtension, Measure.group.population.code, Measure.group.population.description, Measure.group.population.criteria, Measure.group.stratifier, Measure.group.stratifier.extension, Measure.group.stratifier.modifierExtension, Measure.group.stratifier.code, Measure.group.stratifier.description, Measure.group.stratifier.criteria, Measure.group.stratifier.component, Measure.group.stratifier.component.extension, Measure.group.stratifier.component.modifierExtension, Measure.group.stratifier.component.code, Measure.group.stratifier.component.description, Measure.group.stratifier.component.criteria, Measure.supplementalData, Measure.supplementalData.extension, Measure.supplementalData.modifierExtension, Measure.supplementalData.code, Measure.supplementalData.usage, Measure.supplementalData.description, Measure.supplementalData.criteria	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	Measure.extension, Measure.modifierExtension, Measure.group.extension, Measure.group.modifierExtension, Measure.group.population.extension, Measure.group.population.modifierExtension, Measure.group.stratifier.extension, Measure.group.stratifier.modifierExtension, Measure.group.stratifier.component.extension, Measure.group.stratifier.component.modifierExtension, Measure.supplementalData.extension, Measure.supplementalData.modifierExtension	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())`

This structure is derived from Measure

Summary

Must-Support: 1 element

Maturity: 4

Key Elements View

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Measure	C	0..*	Measure(4.0.1)	A quality measure definition Constraints: mea-0, mea-1
Measure.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Measure.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
Measure.status	This element is a modifier element. This element is included in summaries.	1..1	code	draft \| active \| retired \| unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
Measure.scoring	This element must be supported. This element is included in summaries.	0..1	CodeableConcept	proportion \| ratio \| continuous-variable \| cohort Binding: MeasureScoring (extensible): The scoring type of the measure. Required Pattern: `{ "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "attestation" } ] }`
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Measure.status	Base	required	PublicationStatus	📍4.0.1	FHIR Std.
Measure.scoring	Base	extensible	MeasureScoring	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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	Measure.implicitRules, Measure.modifierExtension, Measure.status, Measure.scoring	All FHIR elements must have a @value or children	`hasValue() or (children().count() > id.count())`
ext-1	error	Measure.modifierExtension	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())`

Differential View

This structure is derived from Measure

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Measure		0..*	Measure(4.0.1)	A quality measure definition
Measure.scoring	This element must be supported.	0..1	CodeableConcept	proportion \| ratio \| continuous-variable \| cohort Required Pattern: `{ "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "attestation" } ] }`
Documentation for this format

Snapshot ViewView