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14.18 Resource MeasureReport - Content

Clinical Quality Information icon Work GroupMaturity Level: 4 Trial UseSecurity Category: Business Compartments: Group, Patient

The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.

14.18.1 Scope and Usage

The MeasureReport resource represents the results of calculating a measure for a specific subject or group of subjects. The $evaluate operation of the Measure resource is defined to return a MeasureReport. The resource can represent three different levels of report: individual, subject-list, and summary.

The resource draws requirements from the HL7 CDA R2 Implementation Guide: Quality Reporting Document Architecture - Category 1 (QRDA I) Release 1 STU5.3 (US Realm) and the HL7 Implementation Guide for CDA Release 2: Quality Reporting Document Architecture - Category III (QRDA III), Release 1 implementation guides.

An individual MeasureReport contains information about a specific subject and typically includes references to the relevant data used to generate the report. A subject-list MeasureReport reports on a list of subjects and provides a List resource that contains references to individual-level reports for each subject being reported. A summary MeasureReport reports on a group of subjects and contains population counts and the calculated score as defined by the Measure. Finally, data-collection reports are used to communicate the data of interest, so no scoring or other calculated information is expected.

For a detailed discussion of how to use the Measure and MeasureReport resources, refer to the Quality Reporting topic.

Note to Balloters: A new countQuantity element is added in this ballot. The CQI Work Group is seeking reviewers and implementers feedback on these two options addressing the need to support decimal-valued count.

  1. Option 1: generalize the count element itself (i.e. change the count element to a Quantity, a breaking change)
  2. Option 2: keep the approach of defining a new countQuantity element to maintain backwards compatibility

14.18.2 Boundaries and Relationships

Although the MeasureReport is conceptually an Observation, there is enough specific information required to support the quality reporting use case to warrant a separate resource.

The resource is differentiated from a general-purpose query result because it communicates specific information related to quality measurement evaluation that would be difficult to convey generally without imposing some other structure on top of the general results.

14.18.3 References to this Resource

  • Resource References: itself

14.18.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. MeasureReport TU DomainResource Results of a measure evaluation
+ Rule: Measure Reports used for data collection SHALL NOT communicate group and score information
+ Rule: Stratifiers SHALL be either a single criteria element or a set of criteria components

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier Additional identifier for the MeasureReport

... category 0..1 CodeableConcept The category of measure report instance this is (example codes include deqm, ra, vbp)
Binding: Measure Report Category VS (Extensible)
... messages 0..1 Reference(OperationOutcome) Evaluation messages
... type ΣC 1..1 code individual | subject-list | summary | data-exchange
Binding: Measure Report Type (Required)
... dataUpdateType ?!Σ 0..1 code incremental | snapshot
Binding: Submit Data Update Type (Required)
... measure Σ 0..1 canonical(Measure) What measure was calculated
... subject Σ 0..1 Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) What individual(s) the report is for
... date Σ 0..1 dateTime When the measure report was generated
... reporter Σ 0..1 Reference(Practitioner | PractitionerRole | Organization) Who is reporting the data
... reportingVendor 0..1 Reference(Organization) What vendor prepared the data
... location 0..* Reference(Location) Where the reported data is from

... period Σ 1..1 Period What period the report covers
... inputParameters 0..1 Reference(Parameters) What parameters were provided to the report
... scoring ?!Σ 0..1 CodeableConcept What scoring method (e.g. proportion, ratio, continuous-variable)
Binding: Measure Scoring icon (Extensible)
... improvementNotation ?!ΣXD 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation icon (Required)
... group C 0..* BackboneElement Measure results for each group

.... linkId 0..1 string Pointer to specific group from Measure
.... calculatedDate 0..1 dateTime The date the Measure Report was calculated
.... code Σ 0..1 CodeableConcept Meaning of the group
Binding: Measure Group Example (Example)
.... description 0..1 markdown Summary description
.... subject Σ 0..1 Reference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson) What individual(s) the report is for
.... scoring ?!Σ 0..1 CodeableConcept What scoring method (e.g. proportion, ratio, continuous-variable)
Binding: Measure Scoring icon (Extensible)
.... improvementNotation ?!Σ 0..1 CodeableConcept increase | decrease
Binding: MeasureImprovementNotation icon (Extensible)
.... improvementNotationGuidance Σ 0..1 markdown Explanation of improvement notation
.... population C 0..* BackboneElement The populations in the group
+ Rule: The count and countQuantity elements SHALL be mutually exclusive

..... linkId 0..1 string Pointer to specific population from Measure
..... code Σ 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType icon (Extensible)
..... description 0..1 markdown The human readable description of this population criteria
..... count C 0..1 integer Size of the population
..... countQuantity CTU 0..1 Quantity Size of the population as a quantity
..... subjectResults 0..1 Reference(List) For subject-list reports, the subject results in this population
..... subjectReport 0..* Reference(MeasureReport) For subject-list reports, references to the individual reports for subjects in this population

..... subjects 0..1 Reference(Group) What individual(s) in the population
.... measureScore[x] Σ 0..1 What score this group achieved
..... measureScoreQuantity Quantity
..... measureScoreDateTime dateTime
..... measureScoreCodeableConcept CodeableConcept
..... measureScorePeriod Period
..... measureScoreRange Range
..... measureScoreDuration Duration
..... measureScoreBoolean boolean
.... stratifier C 0..* BackboneElement Stratification results

..... linkId 0..1 string Pointer to specific stratifier from Measure
..... code 0..1 CodeableConcept What stratifier of the group
Binding: Measure Stratifier Example (Example)
..... description 0..1 markdown The human readable description of this stratifier
..... stratum C 0..* BackboneElement Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components

...... value[x] C 0..1 The stratum value, e.g. male
Binding: Measure Report Stratifier Value Example (Example)
....... valueCodeableConcept CodeableConcept
....... valueBoolean boolean
....... valueQuantity Quantity
....... valueRange Range
....... valueReference Reference()
...... component C 0..* BackboneElement Stratifier component values

....... linkId 0..1 string Pointer to specific stratifier component from Measure
....... code 1..1 CodeableConcept What stratifier component of the group
Binding: Measure Stratifier Example (Example)
....... description 0..1 markdown The human readable description of this stratifier component
....... value[x] 1..1 The stratum component value, e.g. male
Binding: Measure Report Stratifier Value Example (Example)
........ valueCodeableConcept CodeableConcept
........ valueBoolean boolean
........ valueQuantity Quantity
........ valueRange Range
........ valueReference Reference()
...... population C 0..* BackboneElement Population results in this stratum
+ Rule: The count and countQuantity elements for a statum population SHALL be mutually exclusive

....... linkId 0..1 string Pointer to specific population from Measure
....... code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
Binding: MeasurePopulationType icon (Extensible)
....... count C 0..1 integer Size of the population
....... countQuantity CTU 0..1 Quantity Size of the population as a quantity
....... subjectResults 0..1 Reference(List) For subject-list reports, the subject results in this population
....... subjectReport 0..* Reference(MeasureReport) For subject-list reports, a subject result in this population

....... subjects 0..1 Reference(Group) What individual(s) in the population
...... measureScore[x] 0..1 What score this stratum achieved
....... measureScoreQuantity Quantity
....... measureScoreDateTime dateTime
....... measureScoreCodeableConcept CodeableConcept
....... measureScorePeriod Period
....... measureScoreRange Range
....... measureScoreDuration Duration
....... measureScoreBoolean boolean
... supplementalData 0..* Reference(Any) Additional information collected for the report

... evaluatedResource 0..* Reference(Any) What data was used to calculate the measure score


doco Documentation for this format icon

See the Extensions for this resource

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

14.18.4.1 Terminology Bindings

Path ValueSet Type Documentation
MeasureReport.category MeasureReportCategory (a valid code from Measure Report Category CS) Extensible

Measure report categories
MeasureReport.status MeasureReportStatus Required

The status of the measure report.
MeasureReport.type MeasureReportType Required

The type of the measure report.
MeasureReport.dataUpdateType SubmitDataUpdateType Required

Concepts for how a measure report consumer and receiver coordinate data exchange updates. The choices are snapshot or incremental updates
MeasureReport.scoring MeasureScoring icon Extensible

The scoring type of the measure.
MeasureReport.improvementNotation MeasureImprovementNotation icon 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.
MeasureReport.group.code MeasureGroupExample Example

Example Measure Groups for the Measure Resource.
MeasureReport.group.scoring MeasureScoring icon Extensible

The scoring type of the measure.
MeasureReport.group.improvementNotation MeasureImprovementNotation icon Extensible

Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
MeasureReport.group.population.code MeasurePopulationType icon Extensible

The type of population.
MeasureReport.group.stratifier.code MeasureStratifierExample Example

Identifier subgroups in a population for measuring purposes.
MeasureReport.group.stratifier.stratum.value[x] MeasureReportStratifierValueExample Example

Example Measure Stratification Value for MeasureReports Resource.
MeasureReport.group.stratifier.stratum.component.code MeasureStratifierExample Example

Identifier subgroups in a population for measuring purposes.
MeasureReport.group.stratifier.stratum.component.value[x] MeasureReportStratifierValueExample Example

Example Measure Stratification Value for MeasureReports Resource.
MeasureReport.group.stratifier.stratum.population.code MeasurePopulationType icon Extensible

The type of population.

14.18.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img mrp-1Rule (base)Measure Reports used for data collection SHALL NOT communicate group and score information(type != 'data-exchange') or group.exists().not()
img mrp-2Rule (base)Stratifiers SHALL be either a single criteria element or a set of criteria componentsgroup.stratifier.stratum.all(value.exists() xor component.exists())
img mrp-3Rule MeasureReport.group.populationThe count and countQuantity elements SHALL be mutually exclusivecount.exists() xor countQuantity.exists()
img mrp-4Rule MeasureReport.group.stratifier.stratum.populationThe count and countQuantity elements for a statum population SHALL be mutually exclusivecount.exists() xor countQuantity.exists()

14.18.5 MeasureReport Search

Although the MeasureReport resource does define search parameters, it is up to the individual measure evaluation service whether historical records of measure evaluation requests are preserved. A service might not support searching on MeasureReports at all, or it may support searching only for a pre-defined expiration period. The search parameters are defined to provide consumers with a consistent interface to searching if it is available for a specific service implementation. In any case, services should detail the support they do provide using a CapabilityStatement.

14.18.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
date date The date of the measure report MeasureReport.date 26 Resources
evaluated-resource reference An evaluated resource referenced by the measure report MeasureReport.evaluatedResource
(Any)
identifier token External identifier of the measure report to be returned MeasureReport.identifier 65 Resources
location reference The location to return measure report results for MeasureReport.location
(Location)
measure reference The measure to return measure report results for MeasureReport.measure
(Measure)
patient reference The identity of a patient to search for individual measure report results for MeasureReport.subject.where(resolve() is Patient)
(Patient)		 65 Resources
period date The period of the measure report MeasureReport.period
reporter reference The reporter to return measure report results for MeasureReport.reporter
(Practitioner, Organization, PractitionerRole)
status token The status of the measure report MeasureReport.status
subject reference The identity of a subject to search for individual measure report results for MeasureReport.subject
(Practitioner, Group, Organization, CareTeam, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson, Location)