Release 5
Clinical ReasoningThis page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions 
. Page versions: R5 R4B R4 R3
| Clinical Quality Information Work Group | Maturity Level: 4 | Trial Use | Security Category: Anonymous | Compartments: No defined compartments |
The Measure resource provides the definition of a quality measure.
The Measure resource represents a structured, computable definition of a health-related measure such as a clinical quality measure, public health indicator, or population analytics measure. A quality measure is a quantitative tool to assess the performance of an individual or organization with respect to a specified process or outcome via the measurement of actions, processes, or outcomes of clinical care. Quality measures are often derived from clinical guidelines and are designed to determine whether the appropriate care has been provided given a set of clinical criteria and an evidence base.
Note that the Measure itself does not typically contain any logic; rather a Library resource is referenced that contains the logic required by the measure, and the various expression elements, such as population criteria, reference named expressions within that library (or libraries). In addition, if the Measure references multiple libraries, then any expression references within the resource must be qualified with the name of the library that contains the referenced expression.
This resource is a definition resource from a FHIR workflow perspective - see Workflow, specifically Definition.
For a detailed discussion of how to use the Measure and MeasureReport resources, refer to the Quality Reporting topic.
The Measure resource describes a specific quality measure, or population analytic, providing the structure of the measure in terms of the calculation elements (the populations involved). The Group resource is also capable of describing a population, however, the complexity involved in specifying the criteria in the general case requires the use of a high-level query language such as Clinical Quality Language (CQL). As such, the Measure resource defines only the top-level populations and references expressions for the actual criteria. These expressions are typically provided using a Library resource containing CQL or ELM expressions. In addition, the individual members of a population may be cases such as encounters or procedures and in these cases, the Group resource would be unable to represent the population characteristics accurately.
A Measure is also similar to an ObservationDefinition resource, in that it is purely definitional, it contains no actual measurements, only a description of how to calculate a particular measurement or set of measurements. Measure is different from ObservationDefinition in that Measure is intended to provide a computable specification.
A Measure is also similar to a clinical document, but as with the relationship to Observation, a Document is specific to a particular subject.
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Measure | TU | DomainResource | A quality measure definition + Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation + Rule: Stratifier SHALL be either a single criteria or a set of criteria components Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension Interfaces Implemented: MetadataResource | |
  url | ΣC | 0..1 | uri | Canonical identifier for this measure, represented as a URI (globally unique) + Warning: URL should not contain | or # - these characters make processing canonical references problematic |
 identifier | Σ | 0..* | Identifier | Additional identifier for the measure |
| version | Σ | 0..1 | string | Business version of the measure |
  versionAlgorithm[x] | Σ | 0..1 | How to compare versions Binding: Version Algorithm (Extensible) | |
 versionAlgorithmString | string | |||
 versionAlgorithmCoding | Coding | |||
| name | ΣC | 0..1 | string | Name for this measure (computer friendly) |
| title | ΣT | 0..1 | string | Name for this measure (human friendly) |
| subtitle | T | 0..1 | string | Subordinate title of the measure |
| status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (Required) |
| experimental | Σ | 0..1 | boolean | For testing purposes, not real usage |
| subject[x] | 0..1 | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Participant Resource Types (Extensible) | ||
| subjectCodeableConcept | CodeableConcept | |||
 subjectReference | Reference(Group) | |||
| basis | Σ | 0..1 | code | Population basis Binding: All FHIR Types (Required) |
| date | Σ | 0..1 | dateTime | Date last changed |
| publisher | ΣT | 0..1 | string | Name of the publisher/steward (organization or individual) |
| contact | Σ | 0..* | ContactDetail | Contact details for the publisher |
| description | ΣT | 0..1 | markdown | Natural language description of the measure |
| useContext | Σ | 0..* | UsageContext | The context that the content is intended to support |
| jurisdiction | ΣXD | 0..* | CodeableConcept | Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (Extensible) |
| purpose | T | 0..1 | markdown | Why this measure is defined |
| usage | T | 0..1 | markdown | Describes the clinical usage of the measure |
| copyright | T | 0..1 | markdown | Use and/or publishing restrictions |
| copyrightLabel | T | 0..1 | string | Copyright holder and year(s) |
| approvalDate | 0..1 | date | When the measure was approved by publisher | |
| lastReviewDate | 0..1 | date | When the measure was last reviewed by the publisher | |
| effectivePeriod | Σ | 0..1 | Period | When the measure is expected to be used |
| topic | XD | 0..* | CodeableConcept | The category of the measure, such as Education, Treatment, Assessment, etc Binding: Definition Topic (Example) |
| 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 | 0..* | canonical(Library) | Logic used by the measure | |
| disclaimer | Σ | 0..1 | markdown | Disclaimer for use of the measure or its referenced content |
| scoring | Σ | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (Extensible) |
| scoringUnit | Σ | 0..1 | CodeableConcept | What units? Binding: Measure Scoring Unit (Example) |
| compositeScoring | Σ | 0..1 | CodeableConcept | opportunity | all-or-nothing | linear | weighted Binding: Composite Measure Scoring (Extensible) |
| type | Σ | 0..* | CodeableConcept | process | outcome | structure | patient-reported-outcome | composite Binding: Measure Type (Extensible) |
| riskAdjustment | Σ | 0..1 | markdown | How risk adjustment is applied for this measure |
| rateAggregation | Σ | 0..1 | markdown | 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 | Σ | 0..1 | CodeableConcept | increase | decrease Binding: Measure Improvement Notation (Required) |
 term | 0..* | BackboneElement | Defined terms used in the measure documentation | |
| code | 0..1 | CodeableConcept | What term? Binding: Measure Definition Example (Example) | |
| definition | 0..1 | markdown | Meaning of the term | |
| guidance | ΣXD | 0..1 | markdown | Additional guidance for implementers (deprecated) |
| group | C | 0..* | BackboneElement | Population criteria group |
| linkId | C | 0..1 | string | Unique id for group in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the group Binding: Measure Group Example (Example) | |
| description | 0..1 | markdown | Summary description | |
| type | Σ | 0..* | CodeableConcept | process | outcome | structure | patient-reported-outcome | composite Binding: Measure Type (Extensible) |
| subject[x] | 0..1 | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Participant Resource Types (Extensible) | ||
| subjectCodeableConcept | CodeableConcept | |||
| subjectReference | Reference(Group) | |||
| basis | Σ | 0..1 | code | Population basis Binding: All FHIR Types (Required) |
| scoring | Σ | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (Extensible) |
| scoringUnit | Σ | 0..1 | CodeableConcept | What units? Binding: Measure Scoring Unit (Example) |
| rateAggregation | Σ | 0..1 | markdown | How is rate aggregation performed for this measure |
| improvementNotation | Σ | 0..1 | CodeableConcept | increase | decrease Binding: Measure Improvement Notation (Required) |
| library | 0..* | canonical(Library) | Logic used by the measure group | |
| population | 0..* | BackboneElement | Population criteria | |
| linkId | C | 0..1 | string | Unique id for population in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: Measure Population Type (Extensible) | |
| description | 0..1 | markdown | The human readable description of this population criteria | |
| criteria | 0..1 | Expression | The criteria that defines this population | |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| inputPopulationId | 0..1 | string | Which population | |
| aggregateMethod | 0..1 | CodeableConcept | Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) Binding: Measure Aggregate Method (Extensible) | |
 stratifier | C | 0..* | BackboneElement | Stratifier criteria for the measure |
 linkId | C | 0..1 | string | Unique id for stratifier in measure + Warning: Link ids should be 255 characters or less |
| code | C | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Example (Example) |
| description | C | 0..1 | markdown | The human readable description of this stratifier |
| criteria | C | 0..1 | Expression | How the measure should be stratified |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| component | C | 0..* | BackboneElement | Stratifier criteria component for the measure |
| linkId | C | 0..1 | string | Unique id for stratifier component in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Example (Example) | |
| description | 0..1 | markdown | The human readable description of this stratifier component | |
| criteria | 0..1 | Expression | Component of how the measure should be stratified | |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| supplementalData | 0..* | BackboneElement | What other data should be reported with the measure | |
| linkId | C | 0..1 | string | Unique id for supplementalData in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the supplemental data Binding: Measure Supplemental Data Example (Example) | |
| usage | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: Measure Data Usage (Extensible) | |
| description | 0..1 | markdown | The human readable description of this supplemental data | |
| criteria | 1..1 | Expression | Expression describing additional data to be reported | |
| Documentation for this format |
See the Extensions for this resource
UML Diagram (Legend)
XML Template
<Measure xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <url value="[uri]"/><!-- 0..1 Canonical identifier for this measure, represented as a URI (globally unique) --> <identifier><!-- 0..* Identifier Additional identifier for the measure --></identifier> <version value="[string]"/><!-- 0..1 Business version of the measure --> <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]> <name value="[string]"/><!-- I 0..1 Name for this measure (computer friendly) --> <title value="[string]"/><!-- 0..1 Name for this measure (human friendly) --> <subtitle value="[string]"/><!-- 0..1 Subordinate title of the measure --> <status value="[code]"/><!-- 1..1 draft | active | retired | unknown --> <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage --> <subject[x]><!-- 0..1 CodeableConcept|Reference(Group) E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device --></subject[x]> <basis value="[code]"/><!-- 0..1 Population basis --> <date value="[dateTime]"/><!-- 0..1 Date last changed --> <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) --> <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact> <description value="[markdown]"/><!-- 0..1 Natural language description of the measure --> <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext> <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for measure (if applicable) --></jurisdiction> <purpose value="[markdown]"/><!-- 0..1 Why this measure is defined --> <usage value="[markdown]"/><!-- 0..1 Describes the clinical usage of the measure --> <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions --> <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) --> <approvalDate value="[date]"/><!-- 0..1 When the measure was approved by publisher --> <lastReviewDate value="[date]"/><!-- 0..1 When the measure was last reviewed by the publisher --> <effectivePeriod><!-- 0..1 Period When the measure is expected to be used --></effectivePeriod> <topic><!-- 0..* CodeableConcept The category of the measure, such as Education, Treatment, Assessment, etc --></topic> <author><!-- 0..* ContactDetail Who authored the content --></author> <editor><!-- 0..* ContactDetail Who edited the content --></editor> <reviewer><!-- 0..* ContactDetail Who reviewed the content --></reviewer> <endorser><!-- 0..* ContactDetail Who endorsed the content --></endorser> <relatedArtifact><!-- 0..* RelatedArtifact Additional documentation, citations, etc --></relatedArtifact> <library><!-- 0..* canonical(Library) Logic used by the measure --></library> <disclaimer value="[markdown]"/><!-- 0..1 Disclaimer for use of the measure or its referenced content --> <scoring><!-- 0..1 CodeableConcept proportion | ratio | continuous-variable | cohort
JSON Template
{
"resourceType" : "Measure",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"url" : "<uri>", // Canonical identifier for this measure, represented as a URI (globally unique)
"identifier" : [{ Identifier }], // Additional identifier for the measure
"version" : "<string>", // Business version of the measure
// versionAlgorithm[x]: How to compare versions. One of these 2:
"versionAlgorithmString" : "<string>",
"versionAlgorithmCoding" : { Coding },
"name" : "<string>", // I Name for this measure (computer friendly)
"title" : "<string>", // Name for this measure (human friendly)
"subtitle" : "<string>", // Subordinate title of the measure
"status" : "<code>", // R! draft | active | retired | unknown
"experimental" : <boolean>, // For testing purposes, not real usage
// subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"basis" : "<code>", // Population basis
"date" : "<dateTime>", // Date last changed
"publisher" : "<string>", // Name of the publisher/steward (organization or individual)
"contact" : [{ ContactDetail }], // Contact details for the publisher
"description" : "<markdown>", // Natural language description of the measure
"useContext" : [{ UsageContext }], // The context that the content is intended to support
"jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for measure (if applicable)
"purpose" : "<markdown>", // Why this measure is defined
"usage" : "<markdown>", // Describes the clinical usage of the measure
"copyright" : "<markdown>", // Use and/or publishing restrictions
"copyrightLabel" : "<string>", // Copyright holder and year(s)
"approvalDate" : "<date>", // When the measure was approved by publisher
"lastReviewDate" : "<date>", // When the measure was last reviewed by the publisher
"effectivePeriod" : { Period }, // When the measure is expected to be used
"topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc
"author" : [{ ContactDetail }], // Who authored the content
"editor" : [{ ContactDetail }], // Who edited the content
"reviewer" : [{ ContactDetail }], // Who reviewed the content
"endorser" : [{ ContactDetail }], // Who endorsed the content
"relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc
"library" : ["<canonical(Library)>"], // Logic used by the measure
"disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
"scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
"scoringUnit" : { CodeableConcept }, // What units?
"compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
"type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
"riskAdjustment" : "<markdown>", // How risk adjustment is applied for this measure
"rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
"rationale" : "<markdown>", // Detailed description of why the measure exists
"clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
"improvementNotation" : { CodeableConcept }, // increase | decrease
"term" : [{ // Defined terms used in the measure documentation
"code" : { CodeableConcept }, // What term?
"definition" : "<markdown>" // Meaning of the term
}],
"guidance" : "<markdown>", // Additional guidance for implementers (deprecated)
"group" : [{ // I Population criteria group
"linkId" : "<string>", // Unique id for group in measure
"code" : { CodeableConcept }, // Meaning of the group
"description" : "<markdown>", // Summary description
"type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
// subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"basis" : "<code>", // Population basis
"scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
"scoringUnit" : { CodeableConcept }, // What units?
"rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
"improvementNotation" : { CodeableConcept }, // increase | decrease
"library" : ["<canonical(Library)>"], // Logic used by the measure group
"population" : [{ // Population criteria
"linkId" : "<string>", // Unique id for population in measure
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"description" : "<markdown>", // The human readable description of this population criteria
"criteria" : { Expression }, // The criteria that defines this population
"groupDefinition" : { Reference(Group) }, // A group resource that defines this population
"inputPopulationId" : "<string>", // Which population
"aggregateMethod" : { CodeableConcept } // Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
}],
"stratifier" : [{ // I Stratifier criteria for the measure
"linkId" : "<string>", // Unique id for stratifier in measure
"code" : { CodeableConcept }, // I Meaning of the stratifier
"description" : "<markdown>", // I The human readable description of this stratifier
"criteria" : { Expression }, // I How the measure should be stratified
"groupDefinition" : { Reference(Group) }, // A group resource that defines this population
"component" : [{ // I Stratifier criteria component for the measure
"linkId" : "<string>", // Unique id for stratifier component in measure
"code" : { CodeableConcept }, // Meaning of the stratifier component
"description" : "<markdown>", // The human readable description of this stratifier component
"criteria" : { Expression }, // Component of how the measure should be stratified
"groupDefinition" : { Reference(Group) } // A group resource that defines this population
}]
}]
}],
"supplementalData" : [{ // What other data should be reported with the measure
"linkId" : "<string>", // Unique id for supplementalData in measure
"code" : { CodeableConcept }, // Meaning of the supplemental data
"usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
"description" : "<markdown>", // The human readable description of this supplemental data
"criteria" : { Expression } // R! Expression describing additional data to be reported
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes from both R4 and R4B
| Measure | |
| Measure.versionAlgorithm[x] |
|
| Measure.subject[x] |
|
| Measure.basis |
|
| Measure.usage |
|
| Measure.copyrightLabel |
|
| Measure.scoring |
|
| Measure.scoringUnit |
|
| Measure.riskAdjustment |
|
| Measure.rateAggregation |
|
| Measure.term |
|
| Measure.term.code |
|
| Measure.term.definition |
|
| Measure.group.linkId |
|
| Measure.group.description |
|
| Measure.group.type |
|
| Measure.group.subject[x] |
|
| Measure.group.basis |
|
| Measure.group.scoring |
|
| Measure.group.scoringUnit |
|
| Measure.group.rateAggregation |
|
| Measure.group.improvementNotation |
|
| Measure.group.library |
|
| Measure.group.population.linkId |
|
| Measure.group.population.description |
|
| Measure.group.population.criteria |
|
| Measure.group.population.groupDefinition |
|
| Measure.group.population.inputPopulationId |
|
| Measure.group.population.aggregateMethod |
|
| Measure.group.stratifier.linkId |
|
| Measure.group.stratifier.description |
|
| Measure.group.stratifier.groupDefinition |
|
| Measure.group.stratifier.component.linkId |
|
| Measure.group.stratifier.component.description |
|
| Measure.group.stratifier.component.criteria |
|
| Measure.group.stratifier.component.groupDefinition |
|
| Measure.supplementalData.linkId |
|
| Measure.supplementalData.description |
|
| Measure.definition |
|
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Measure | TU | DomainResource | A quality measure definition + Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation + Rule: Stratifier SHALL be either a single criteria or a set of criteria components Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension Interfaces Implemented: MetadataResource | |
| url | ΣC | 0..1 | uri | Canonical identifier for this measure, represented as a URI (globally unique) + Warning: URL should not contain | or # - these characters make processing canonical references problematic |
| identifier | Σ | 0..* | Identifier | Additional identifier for the measure |
| version | Σ | 0..1 | string | Business version of the measure |
| versionAlgorithm[x] | Σ | 0..1 | How to compare versions Binding: Version Algorithm (Extensible) | |
| versionAlgorithmString | string | |||
| versionAlgorithmCoding | Coding | |||
| name | ΣC | 0..1 | string | Name for this measure (computer friendly) |
| title | ΣT | 0..1 | string | Name for this measure (human friendly) |
| subtitle | T | 0..1 | string | Subordinate title of the measure |
| status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (Required) |
| experimental | Σ | 0..1 | boolean | For testing purposes, not real usage |
| subject[x] | 0..1 | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Participant Resource Types (Extensible) | ||
| subjectCodeableConcept | CodeableConcept | |||
| subjectReference | Reference(Group) | |||
| basis | Σ | 0..1 | code | Population basis Binding: All FHIR Types (Required) |
| date | Σ | 0..1 | dateTime | Date last changed |
| publisher | ΣT | 0..1 | string | Name of the publisher/steward (organization or individual) |
| contact | Σ | 0..* | ContactDetail | Contact details for the publisher |
| description | ΣT | 0..1 | markdown | Natural language description of the measure |
| useContext | Σ | 0..* | UsageContext | The context that the content is intended to support |
| jurisdiction | ΣXD | 0..* | CodeableConcept | Intended jurisdiction for measure (if applicable) Binding: Jurisdiction ValueSet (Extensible) |
| purpose | T | 0..1 | markdown | Why this measure is defined |
| usage | T | 0..1 | markdown | Describes the clinical usage of the measure |
| copyright | T | 0..1 | markdown | Use and/or publishing restrictions |
| copyrightLabel | T | 0..1 | string | Copyright holder and year(s) |
| approvalDate | 0..1 | date | When the measure was approved by publisher | |
| lastReviewDate | 0..1 | date | When the measure was last reviewed by the publisher | |
| effectivePeriod | Σ | 0..1 | Period | When the measure is expected to be used |
| topic | XD | 0..* | CodeableConcept | The category of the measure, such as Education, Treatment, Assessment, etc Binding: Definition Topic (Example) |
| 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 | 0..* | canonical(Library) | Logic used by the measure | |
| disclaimer | Σ | 0..1 | markdown | Disclaimer for use of the measure or its referenced content |
| scoring | Σ | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (Extensible) |
| scoringUnit | Σ | 0..1 | CodeableConcept | What units? Binding: Measure Scoring Unit (Example) |
| compositeScoring | Σ | 0..1 | CodeableConcept | opportunity | all-or-nothing | linear | weighted Binding: Composite Measure Scoring (Extensible) |
| type | Σ | 0..* | CodeableConcept | process | outcome | structure | patient-reported-outcome | composite Binding: Measure Type (Extensible) |
| riskAdjustment | Σ | 0..1 | markdown | How risk adjustment is applied for this measure |
| rateAggregation | Σ | 0..1 | markdown | 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 | Σ | 0..1 | CodeableConcept | increase | decrease Binding: Measure Improvement Notation (Required) |
| term | 0..* | BackboneElement | Defined terms used in the measure documentation | |
| code | 0..1 | CodeableConcept | What term? Binding: Measure Definition Example (Example) | |
| definition | 0..1 | markdown | Meaning of the term | |
| guidance | ΣXD | 0..1 | markdown | Additional guidance for implementers (deprecated) |
| group | C | 0..* | BackboneElement | Population criteria group |
| linkId | C | 0..1 | string | Unique id for group in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the group Binding: Measure Group Example (Example) | |
| description | 0..1 | markdown | Summary description | |
| type | Σ | 0..* | CodeableConcept | process | outcome | structure | patient-reported-outcome | composite Binding: Measure Type (Extensible) |
| subject[x] | 0..1 | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device Binding: Participant Resource Types (Extensible) | ||
| subjectCodeableConcept | CodeableConcept | |||
| subjectReference | Reference(Group) | |||
| basis | Σ | 0..1 | code | Population basis Binding: All FHIR Types (Required) |
| scoring | Σ | 0..1 | CodeableConcept | proportion | ratio | continuous-variable | cohort Binding: MeasureScoring (Extensible) |
| scoringUnit | Σ | 0..1 | CodeableConcept | What units? Binding: Measure Scoring Unit (Example) |
| rateAggregation | Σ | 0..1 | markdown | How is rate aggregation performed for this measure |
| improvementNotation | Σ | 0..1 | CodeableConcept | increase | decrease Binding: Measure Improvement Notation (Required) |
| library | 0..* | canonical(Library) | Logic used by the measure group | |
| population | 0..* | BackboneElement | Population criteria | |
| linkId | C | 0..1 | string | Unique id for population in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: Measure Population Type (Extensible) | |
| description | 0..1 | markdown | The human readable description of this population criteria | |
| criteria | 0..1 | Expression | The criteria that defines this population | |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| inputPopulationId | 0..1 | string | Which population | |
| aggregateMethod | 0..1 | CodeableConcept | Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count) Binding: Measure Aggregate Method (Extensible) | |
| stratifier | C | 0..* | BackboneElement | Stratifier criteria for the measure |
| linkId | C | 0..1 | string | Unique id for stratifier in measure + Warning: Link ids should be 255 characters or less |
| code | C | 0..1 | CodeableConcept | Meaning of the stratifier Binding: Measure Stratifier Example (Example) |
| description | C | 0..1 | markdown | The human readable description of this stratifier |
| criteria | C | 0..1 | Expression | How the measure should be stratified |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| component | C | 0..* | BackboneElement | Stratifier criteria component for the measure |
| linkId | C | 0..1 | string | Unique id for stratifier component in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the stratifier component Binding: Measure Stratifier Example (Example) | |
| description | 0..1 | markdown | The human readable description of this stratifier component | |
| criteria | 0..1 | Expression | Component of how the measure should be stratified | |
| groupDefinition | 0..1 | Reference(Group) | A group resource that defines this population | |
| supplementalData | 0..* | BackboneElement | What other data should be reported with the measure | |
| linkId | C | 0..1 | string | Unique id for supplementalData in measure + Warning: Link ids should be 255 characters or less |
| code | 0..1 | CodeableConcept | Meaning of the supplemental data Binding: Measure Supplemental Data Example (Example) | |
| usage | 0..* | CodeableConcept | supplemental-data | risk-adjustment-factor Binding: Measure Data Usage (Extensible) | |
| description | 0..1 | markdown | The human readable description of this supplemental data | |
| criteria | 1..1 | Expression | Expression describing additional data to be reported | |
| Documentation for this format |
See the Extensions for this resource
XML Template
<Measure xmlns="http://hl7.org/fhir">
JSON Template
{
"resourceType" : "Measure",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"url" : "<uri>", // Canonical identifier for this measure, represented as a URI (globally unique)
"identifier" : [{ Identifier }], // Additional identifier for the measure
"version" : "<string>", // Business version of the measure
// versionAlgorithm[x]: How to compare versions. One of these 2:
"versionAlgorithmString" : "<string>",
"versionAlgorithmCoding" : { Coding },
"name" : "<string>", // I Name for this measure (computer friendly)
"title" : "<string>", // Name for this measure (human friendly)
"subtitle" : "<string>", // Subordinate title of the measure
"status" : "<code>", // R! draft | active | retired | unknown
"experimental" : <boolean>, // For testing purposes, not real usage
// subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"basis" : "<code>", // Population basis
"date" : "<dateTime>", // Date last changed
"publisher" : "<string>", // Name of the publisher/steward (organization or individual)
"contact" : [{ ContactDetail }], // Contact details for the publisher
"description" : "<markdown>", // Natural language description of the measure
"useContext" : [{ UsageContext }], // The context that the content is intended to support
"jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for measure (if applicable)
"purpose" : "<markdown>", // Why this measure is defined
"usage" : "<markdown>", // Describes the clinical usage of the measure
"copyright" : "<markdown>", // Use and/or publishing restrictions
"copyrightLabel" : "<string>", // Copyright holder and year(s)
"approvalDate" : "<date>", // When the measure was approved by publisher
"lastReviewDate" : "<date>", // When the measure was last reviewed by the publisher
"effectivePeriod" : { Period }, // When the measure is expected to be used
"topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc
"author" : [{ ContactDetail }], // Who authored the content
"editor" : [{ ContactDetail }], // Who edited the content
"reviewer" : [{ ContactDetail }], // Who reviewed the content
"endorser" : [{ ContactDetail }], // Who endorsed the content
"relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc
"library" : ["<canonical(Library)>"], // Logic used by the measure
"disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
"scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
"scoringUnit" : { CodeableConcept }, // What units?
"compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
"type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
"riskAdjustment" : "<markdown>", // How risk adjustment is applied for this measure
"rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
"rationale" : "<markdown>", // Detailed description of why the measure exists
"clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
"improvementNotation" : { CodeableConcept }, // increase | decrease
"term" : [{ // Defined terms used in the measure documentation
"code" : { CodeableConcept }, // What term?
"definition" : "<markdown>" // Meaning of the term
}],
"guidance" : "<markdown>", // Additional guidance for implementers (deprecated)
"group" : [{ // I Population criteria group
"linkId" : "<string>", // Unique id for group in measure
"code" : { CodeableConcept }, // Meaning of the group
"description" : "<markdown>", // Summary description
"type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
// subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"basis" : "<code>", // Population basis
"scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
"scoringUnit" : { CodeableConcept }, // What units?
"rateAggregation" : "<markdown>", // How is rate aggregation performed for this measure
"improvementNotation" : { CodeableConcept }, // increase | decrease
"library" : ["<canonical(Library)>"], // Logic used by the measure group
"population" : [{ // Population criteria
"linkId" : "<string>", // Unique id for population in measure
"code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
"description" : "<markdown>", // The human readable description of this population criteria
"criteria" : { Expression }, // The criteria that defines this population
"groupDefinition" : { Reference(Group) }, // A group resource that defines this population
"inputPopulationId" : "<string>", // Which population
"aggregateMethod" : { CodeableConcept } // Aggregation method for a measure score (e.g. sum, average, median, minimum, maximum, count)
}],
"stratifier" : [{ // I Stratifier criteria for the measure
"linkId" : "<string>", // Unique id for stratifier in measure
"code" : { CodeableConcept }, // I Meaning of the stratifier
"description" : "<markdown>", // I The human readable description of this stratifier
"criteria" : { Expression }, // I How the measure should be stratified
"groupDefinition" : { Reference(Group) }, // A group resource that defines this population
"component" : [{ // I Stratifier criteria component for the measure
"linkId" : "<string>", // Unique id for stratifier component in measure
"code" : { CodeableConcept }, // Meaning of the stratifier component
"description" : "<markdown>", // The human readable description of this stratifier component
"criteria" : { Expression }, // Component of how the measure should be stratified
"groupDefinition" : { Reference(Group) } // A group resource that defines this population
}]
}]
}],
"supplementalData" : [{ // What other data should be reported with the measure
"linkId" : "<string>", // Unique id for supplementalData in measure
"code" : { CodeableConcept }, // Meaning of the supplemental data
"usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
"description" : "<markdown>", // The human readable description of this supplemental data
"criteria" : { Expression } // R! Expression describing additional data to be reported
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes from both R4 and R4B
| Measure | |
| Measure.versionAlgorithm[x] |
|
| Measure.subject[x] |
|
| Measure.basis |
|
| Measure.usage |
|
| Measure.copyrightLabel |
|
| Measure.scoring |
|
| Measure.scoringUnit |
|
| Measure.riskAdjustment |
|
| Measure.rateAggregation |
|
| Measure.term |
|
| Measure.term.code |
|
| Measure.term.definition |
|
| Measure.group.linkId |
|
| Measure.group.description |
|
| Measure.group.type |
|
| Measure.group.subject[x] |
|
| Measure.group.basis |
|
| Measure.group.scoring |
|
| Measure.group.scoringUnit |
|
| Measure.group.rateAggregation |
|
| Measure.group.improvementNotation |
|
| Measure.group.library |
|
| Measure.group.population.linkId |
|
| Measure.group.population.description |
|
| Measure.group.population.criteria |
|
| Measure.group.population.groupDefinition |
|
| Measure.group.population.inputPopulationId |
|
| Measure.group.population.aggregateMethod |
|
| Measure.group.stratifier.linkId |
|
| Measure.group.stratifier.description |
|
| Measure.group.stratifier.groupDefinition |
|
| Measure.group.stratifier.component.linkId |
|
| Measure.group.stratifier.component.description |
|
| Measure.group.stratifier.component.criteria |
|
| Measure.group.stratifier.component.groupDefinition |
|
| Measure.supplementalData.linkId |
|
| Measure.supplementalData.description |
|
| Measure.definition |
|
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)
Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) , the spreadsheet version & the dependency analysis
| Path | ValueSet | Type | Documentation |
|---|---|---|---|
| Measure.versionAlgorithm[x] | VersionAlgorithm | Extensible | Indicates the mechanism used to compare versions to determine which is more current. |
| Measure.status | PublicationStatus | Required | The lifecycle status of an artifact. |
| Measure.subject[x] | ParticipantResourceTypes | Extensible | All Resource Types that represent participant resources |
| Measure.basis | FHIRTypes (a valid code from All FHIR Types) | Required | All FHIR types |
| Measure.jurisdiction | JurisdictionValueSet | Extensible | This value set defines a base set of codes for country, country subdivision and region for indicating where a resource is intended to be used. Note: The codes for countries and country subdivisions are taken from ISO 3166 |
| Measure.topic | DefinitionTopic | Example | High-level categorization of the definition, used for searching, sorting, and filtering. |
| Measure.scoring | MeasureScoring | Extensible | The scoring type of the measure. |
| Measure.scoringUnit | MeasureScoringUnit | Example | This is an example value set illustrating some typical scoring units used in quality measure specifications. |
| Measure.compositeScoring | CompositeMeasureScoring | Extensible | The composite scoring method of the measure. |
| Measure.type | MeasureType | Extensible | The type of measure (includes codes from 2.16.840.1.113883.1.11.20368). |
| Measure.improvementNotation | 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.term.code | MeasureDefinitionExample | Example | Example Measure Definitions for the Measure Resource. |
| Measure.group.code | MeasureGroupExample | Example | Example Measure Groups for the Measure Resource. |
| Measure.group.type | MeasureType | Extensible | The type of measure (includes codes from 2.16.840.1.113883.1.11.20368). |
| Measure.group.subject[x] | ParticipantResourceTypes | Extensible | All Resource Types that represent participant resources |
| Measure.group.basis | FHIRTypes (a valid code from All FHIR Types) | Required | All FHIR types |
| Measure.group.scoring | MeasureScoring | Extensible | The scoring type of the measure. |
| Measure.group.scoringUnit | MeasureScoringUnit | Example | This is an example value set illustrating some typical scoring units used in quality measure specifications. |
| Measure.group.improvementNotation | 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.group.population.code | MeasurePopulationType | Extensible | The type of population. |
| Measure.group.population.aggregateMethod | MeasureAggregateMethod | Extensible | Aggregation method for a measure (e.g. sum, average, median, minimum, maximum, count) |
| Measure.group.stratifier.code | MeasureStratifierExample | Example | Identifier subgroups in a population for measuring purposes. |
| Measure.group.stratifier.component.code | MeasureStratifierExample | Example | Identifier subgroups in a population for measuring purposes. |
| Measure.supplementalData.code | MeasureSupplementalDataExample | Example | Supplemental data in a population for measuring purposes. |
| Measure.supplementalData.usage | MeasureDataUsage | Extensible | The intended usage for supplemental data elements in the measure. |
| UniqueKey | Level | Location | Description | Expression |
 cnl-0 | Warning | (base) | Name should be usable as an identifier for the module by machine processing applications such as code generation | name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$') |
| mea-1 | Rule | (base) | Stratifier SHALL be either a single criteria or a set of criteria components | group.stratifier.all((code | description | criteria).exists() xor component.exists()) |
| cnl-1 | Warning | Measure.url | URL should not contain | or # - these characters make processing canonical references problematic | exists() implies matches('^[^|# ]+$') |
| mea-2 | Warning | Measure.group.linkId | Link ids should be 255 characters or less | $this.length() <= 255 |
| mea-3 | Warning | Measure.group.population.linkId | Link ids should be 255 characters or less | $this.length() <= 255 |
| mea-4 | Warning | Measure.group.stratifier.linkId | Link ids should be 255 characters or less | $this.length() <= 255 |
| mea-5 | Warning | Measure.group.stratifier.component.linkId | Link ids should be 255 characters or less | $this.length() <= 255 |
| mea-6 | Warning | Measure.supplementalData.linkId | Link ids should be 255 characters or less | $this.length() <= 255 |
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 |
| composed-of | reference | What resource is being referenced | Measure.relatedArtifact.where(type='composed-of').resource (Any) | 6 Resources |
| context | token | A use context assigned to the measure | (Measure.useContext.value.ofType(CodeableConcept)) | 30 Resources |
| context-quantity | quantity | A quantity- or range-valued use context assigned to the measure | (Measure.useContext.value.ofType(Quantity)) | (Measure.useContext.value.ofType(Range)) | 30 Resources |
| context-type | token | A type of use context assigned to the measure | Measure.useContext.code | 30 Resources |
| context-type-quantity | composite | A use context type and quantity- or range-based value assigned to the measure | On Measure.useContext: context-type: code context-quantity: value.ofType(Quantity) | value.ofType(Range) | 30 Resources |
| context-type-value | composite | A use context type and value assigned to the measure | On Measure.useContext: context-type: code context: value.ofType(CodeableConcept) | 30 Resources |
| date | date | The measure publication date | Measure.date | 30 Resources |
| depends-on | reference | What resource is being referenced | Measure.relatedArtifact.where(type='depends-on').resource | Measure.library (Library, Any) | 6 Resources |
| derived-from | reference | What resource is being referenced | Measure.relatedArtifact.where(type='derived-from').resource (Any) | 10 Resources |
| description | string | The description of the measure | Measure.description | 28 Resources |
| effective | date | The time during which the measure is intended to be in use | Measure.effectivePeriod | 12 Resources |
| identifier | token | External identifier for the measure | Measure.identifier | 34 Resources |
| jurisdiction | token | Intended jurisdiction for the measure | Measure.jurisdiction | 26 Resources |
| name | string | Computationally friendly name of the measure | Measure.name | 26 Resources |
| predecessor | reference | What resource is being referenced | Measure.relatedArtifact.where(type='predecessor').resource (Any) | 10 Resources |
| publisher | string | Name of the publisher of the measure | Measure.publisher | 30 Resources |
| status | token | The current status of the measure | Measure.status | 35 Resources |
| successor | reference | What resource is being referenced | Measure.relatedArtifact.where(type='successor').resource (Any) | 6 Resources |
| title | string | The human-friendly name of the measure | Measure.title | 27 Resources |
| topic | token | Topics associated with the measure | Measure.topic | 10 Resources |
| url | uri | The uri that identifies the measure | Measure.url | 34 Resources |
| version | token | The business version of the measure | Measure.version | 30 Resources |
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0 generated on Sun, Mar 26, 2023 15:25+1100.
Links: Search |
Version History |
Contents |
Glossary |
QA |
Compare to R4 |
Compare to R4B |
|
Propose a change