Measure
The Measure resource provides the definition of a quality measure.
- Schema
- Usage
- Relationships
- Referenced By
Properties
Name | Required | Type | Description |
---|---|---|---|
url | uri | Canonical identifier for this measure, represented as a URI (globally unique) DetailsAn absolute URI that is used to identify this measure when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this measure is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the measure is stored on different servers. Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found. | |
identifier | Identifier[] | Additional identifier for the measure DetailsA formal identifier that is used to identify this measure when it is represented in other formats, or referenced in a specification, model, design or an instance. Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this measure outside of FHIR, where it is not possible to use the logical URI. | |
version | string | Business version of the measure DetailsThe identifier that is used to identify this version of the measure when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the measure author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts. There may be different measure instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the measure with the format [url]|[version]. | |
name | string | Name for this measure (computer friendly) DetailsA natural language name identifying the measure. This name should be usable as an identifier for the module by machine processing applications such as code generation. The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly. | |
title | string | Name for this measure (human friendly) DetailsA short, descriptive, user-friendly title for the measure. This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc. | |
subtitle | string | Subordinate title of the measure DetailsAn explanatory or alternate title for the measure giving additional information about its content. | |
status | ✓ | code | draft | active | retired | unknown DetailsThe status of this measure. Enables tracking the life-cycle of the content. Allows filtering of measures that are appropriate for use versus not. |
experimental | boolean | For testing purposes, not real usage DetailsA Boolean value to indicate that this measure is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage. Allows filtering of measures that are appropriate for use versus not. | |
subject[x] | CodeableConcept, Reference<Group> | E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device DetailsThe intended subjects for the measure. If this element is not provided, a Patient subject is assumed, but the subject of the measure can be anything. The subject of the measure is critical in interpreting the criteria definitions, as the logic in the measures is evaluated with respect to a particular subject. This corresponds roughly to the notion of a Compartment in that it limits what content is available based on its relationship to the subject. In CQL, this corresponds to the context declaration. | |
date | dateTime | Date last changed DetailsThe date (and optionally time) when the measure was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the measure changes. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the measure. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource. | |
publisher | string | Name of the publisher (organization or individual) DetailsThe name of the organization or individual that published the measure. Usually an organization but may be an individual. The publisher (or steward) of the measure is the organization or individual primarily responsible for the maintenance and upkeep of the measure. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the measure. This item SHOULD be populated unless the information is available from context. | |
contact | ContactDetail[] | Contact details for the publisher DetailsContact details to assist a user in finding and communicating with the publisher. May be a web site, an email address, a telephone number, etc. | |
description | markdown | Natural language description of the measure DetailsA free text natural language description of the measure from a consumer's perspective. This description can be used to capture details such as why the measure was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the measure as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the measure is presumed to be the predominant language in the place the measure was created). | |
useContext | UsageContext[] | The context that the content is intended to support DetailsThe content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate measure instances. When multiple useContexts are specified, there is no expectation that all or any of the contexts apply. | |
jurisdiction | CodeableConcept[] | Intended jurisdiction for measure (if applicable) DetailsA legal or geographic region in which the measure is intended to be used. It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended. | |
purpose | markdown | Why this measure is defined DetailsExplanation of why this measure is needed and why it has been designed as it has. This element does not describe the usage of the measure. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this measure. | |
usage | string | Describes the clinical usage of the measure DetailsA detailed description, from a clinical perspective, of how the measure is used. | |
copyright | markdown | Use and/or publishing restrictions DetailsA copyright statement relating to the measure and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the measure. | |
approvalDate | date | When the measure was approved by publisher DetailsThe date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage. The 'date' element may be more recent than the approval date because of minor changes or editorial corrections. | |
lastReviewDate | date | When the measure was last reviewed DetailsThe date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date. If specified, this date follows the original approval date. | |
effectivePeriod | Period | When the measure is expected to be used DetailsThe period during which the measure content was or is planned to be in active use. The effective period for a measure determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015. | |
topic | CodeableConcept[] | The category of the measure, such as Education, Treatment, Assessment, etc. DetailsDescriptive topics related to the content of the measure. Topics provide a high-level categorization grouping types of measures that can be useful for filtering and searching. | |
author | ContactDetail[] | Who authored the content DetailsAn individiual or organization primarily involved in the creation and maintenance of the content. | |
editor | ContactDetail[] | Who edited the content DetailsAn individual or organization primarily responsible for internal coherence of the content. | |
reviewer | ContactDetail[] | Who reviewed the content DetailsAn individual or organization primarily responsible for review of some aspect of the content. | |
endorser | ContactDetail[] | Who endorsed the content DetailsAn individual or organization responsible for officially endorsing the content for use in some setting. | |
relatedArtifact | RelatedArtifact[] | Additional documentation, citations, etc. DetailsRelated artifacts such as additional documentation, justification, or bibliographic references. Each related artifact is either an attachment, or a reference to another resource, but not both. | |
library | canonical[] | Logic used by the measure DetailsA reference to a Library resource containing the formal logic used by the measure. | |
disclaimer | markdown | Disclaimer for use of the measure or its referenced content DetailsNotices and disclaimers regarding the use of the measure or related to intellectual property (such as code systems) referenced by the measure. | |
scoring | CodeableConcept | proportion | ratio | continuous-variable | cohort DetailsIndicates how the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort. The value set is extensible, allowing additional measure scoring types to be represented. | |
compositeScoring | CodeableConcept | opportunity | all-or-nothing | linear | weighted DetailsIf this is a composite measure, the scoring method used to combine the component measures to determine the composite score. | |
type | CodeableConcept[] | process | outcome | structure | patient-reported-outcome | composite DetailsIndicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization. | |
riskAdjustment | string | How risk adjustment is applied for this measure DetailsA description of the risk adjustment factors that may impact the resulting score for the measure and how they may be accounted for when computing and reporting measure results. Describes the method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow for more useful comparisons. | |
rateAggregation | string | How is rate aggregation performed for this measure DetailsDescribes how to combine the information calculated, based on logic in each of several populations, into one summarized result. The measure rate for an organization or clinician is based upon the entities’ aggregate data and summarizes the performance of the entity over a given time period (e.g., monthly, quarterly, yearly). The aggregated data are derived from the results of a specific measure algorithm and, if appropriate, the application of specific risk adjustment models. Can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). This could be applied to aggregated cohort measure definitions (e.g., CDC's aggregate reporting for TB at the state level). | |
rationale | markdown | Detailed description of why the measure exists DetailsProvides a succinct statement of the need for the measure. Usually includes statements pertaining to importance criterion: impact, gap in care, and evidence. | |
clinicalRecommendationStatement | markdown | Summary of clinical guidelines DetailsProvides a summary of relevant clinical guidelines or other clinical recommendations supporting the measure. | |
improvementNotation | CodeableConcept | increase | decrease DetailsInformation on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range). | |
definition | markdown[] | Defined terms used in the measure documentation DetailsProvides a description of an individual term used within the measure. | |
guidance | markdown | Additional guidance for implementers DetailsAdditional guidance for the measure including how it can be used in a clinical context, and the intent of the measure. | |
group | MeasureGroup[] | Population criteria group DetailsA group of population criteria for the measure. | |
id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
code | CodeableConcept | Meaning of the group DetailsIndicates a meaning for the group. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing groups to be correlated across measures. | |
description | string | Summary description DetailsThe human readable description of this population group. | |
population | MeasureGroupPopulation[] | Population criteria DetailsA population criteria for the measure. | |
id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
code | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation DetailsThe type of population criteria. | |
description | string | The human readable description of this population criteria DetailsThe human readable description of this population criteria. | |
criteria | ✓ | Expression | The criteria that defines this population DetailsAn expression that specifies the criteria for the population, typically the name of an expression in a library. In the case of a continuous-variable or ratio measure, this may be the name of a function that calculates the value of the individual observation for each patient or event in the population. For these types of measures, individual observations are reported as observation resources included in the evaluatedResources bundle for each patient. See the MeasureReport resource or the Quality Reporting topic for more information. |
stratifier | MeasureGroupStratifier[] | Stratifier criteria for the measure DetailsThe stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path. | |
id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
code | CodeableConcept | Meaning of the stratifier DetailsIndicates a meaning for the stratifier. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures. | |
description | string | The human readable description of this stratifier DetailsThe human readable description of this stratifier criteria. | |
criteria | Expression | How the measure should be stratified DetailsAn expression that specifies the criteria for the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element. | |
component | MeasureGroupStratifierComponent[] | Stratifier criteria component for the measure DetailsA component of the stratifier criteria for the measure report, specified as either the name of a valid CQL expression defined within a referenced library or a valid FHIR Resource Path. Stratifiers are defined either as a single criteria, or as a set of component criteria. | |
id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
code | CodeableConcept | Meaning of the stratifier component DetailsIndicates a meaning for the stratifier component. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing stratifiers to be correlated across measures. | |
description | string | The human readable description of this stratifier component DetailsThe human readable description of this stratifier criteria component. | |
criteria | ✓ | Expression | Component of how the measure should be stratified DetailsAn expression that specifies the criteria for this component of the stratifier. This is typically the name of an expression defined within a referenced library, but it may also be a path to a stratifier element. |
supplementalData | MeasureSupplementalData[] | What other data should be reported with the measure DetailsThe supplemental data criteria for the measure report, specified as either the name of a valid CQL expression within a referenced library, or a valid FHIR Resource Path. Note that supplemental data are reported as observations for each patient and included in the evaluatedResources bundle. See the MeasureReport resource or the Quality Reporting topic for more information. | |
id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
code | CodeableConcept | Meaning of the supplemental data DetailsIndicates a meaning for the supplemental data. This can be as simple as a unique identifier, or it can establish meaning in a broader context by drawing from a terminology, allowing supplemental data to be correlated across measures. | |
usage | CodeableConcept[] | supplemental-data | risk-adjustment-factor DetailsAn indicator of the intended usage for the supplemental data element. Supplemental data indicates the data is additional information requested to augment the measure information. Risk adjustment factor indicates the data is additional information used to calculate risk adjustment factors when applying a risk model to the measure calculation. | |
description | string | The human readable description of this supplemental data DetailsThe human readable description of this supplemental data. | |
criteria | ✓ | Expression | Expression describing additional data to be reported DetailsThe criteria for the supplemental data. This is typically the name of a valid expression defined within a referenced library, but it may also be a path to a specific data element. The criteria defines the data to be returned for this element. |
Search Parameters
Name | Type | Description | Expression |
---|---|---|---|
composed-of | reference | What resource is being referenced | Measure.relatedArtifact.where(type = 'composed-of').resource |
context | token | A use context assigned to the measure | Measure.useContext.value as CodeableConcept |
context-quantity | quantity | A quantity- or range-valued use context assigned to the measure | Measure.useContext.value as Quantity | Measure.useContext.value as Range |
context-type | token | A type of use context assigned to the measure | Measure.useContext.code |
date | date | The measure publication date | Measure.date |
depends-on | reference | What resource is being referenced | Measure.relatedArtifact.where(type = 'depends-on').resource | Measure.library |
derived-from | reference | What resource is being referenced | Measure.relatedArtifact.where(type = 'derived-from').resource |
description | string | The description of the measure | Measure.description |
effective | date | The time during which the measure is intended to be in use | Measure.effectivePeriod |
identifier | token | External identifier for the measure | Measure.identifier |
jurisdiction | token | Intended jurisdiction for the measure | Measure.jurisdiction |
name | string | Computationally friendly name of the measure | Measure.name |
predecessor | reference | What resource is being referenced | Measure.relatedArtifact.where(type = 'predecessor').resource |
publisher | string | Name of the publisher of the measure | Measure.publisher |
status | token | The current status of the measure | Measure.status |
successor | reference | What resource is being referenced | Measure.relatedArtifact.where(type = 'successor').resource |
title | string | The human-friendly name of the measure | Measure.title |
topic | token | Topics associated with the measure | Measure.topic |
url | uri | The uri that identifies the measure | Measure.url |
version | token | The business version of the measure | Measure.version |
context-type-quantity | composite | A use context type and quantity- or range-based value assigned to the measure | Measure.useContext |
context-type-value | composite | A use context type and value assigned to the measure | Measure.useContext |
Inherited Properties
Name | Required | Type | Description |
---|---|---|---|
id | string | Logical id of this artifact DetailsThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | |
meta | Meta | Metadata about the resource DetailsThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | |
implicitRules | uri | A set of rules under which this content was created DetailsA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | |
language | code | Language of the resource content DetailsThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | |
text | Narrative | Text summary of the resource, for human interpretation DetailsA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | |
contained | Resource[] | Contained, inline Resources DetailsThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | |
extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | |
modifierExtension | Extension[] | Extensions that cannot be ignored DetailsMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
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.
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 Observation resource, with the exception that the Measure is purely definitional, it contains no actual measurements, only a description of how to calculate a particular measurement or set of measurements.
A Measure is also similar to a clinical document, but as with the relationship to Observation, a Document is specific to a particular subject.