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type: resourceresource: Measure

Measure

Introduction

Scope and Usage

The Measure resource represents a structured, potentially 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. Different measure types will contain different population criteria. Some measures may contain multiple rates. Measures can also specify stratifications to subdivide the measure population and/or supplemental data to communicate additional information about a population.

The data of interest for a measure is described as a set of data requirements, and include the specific data type, as well as any constraints. If the measure is specified computably, this information may be inferred by static analysis of the logic used to defined the population criteria. This capability is exposed via the $data-requirements operation.

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.

Boundaries and Relationships

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, however a FHIR Document is specific to a particular subject, whereas the Measure resource is definitional.

Background and Context

Provides additional detail on exactly how the resource is to be used

StructureDefinition

Elements (Simplified)

Mappings

Operations

Full Operations

Resource Packs

list-Measure-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir">
  <id value="Measure-packs"/>
  <status value="current"/>
  <mode value="working"/>
</List>

Search Parameters

Full Search Parameters

Examples

Full Examples

Mapping Exceptions

measure-definition-mapping-exceptions.xml

Divergent Elements

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.

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 element to indicate where the current master source of the resource can be found. | resource=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.

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 element to indicate where the current master source of the resource can be found.

Unknown does not represent 'other' - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | resource=Allows filtering of measures that are appropriate for use versus not.

See guidance around (not) making local changes to elements here.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.). | resource=It may be possible for the measure to be used in jurisdictions other than those for which it was originally designed or intended.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)

See guidance around (not) making local changes to elements here.

Unmapped Elements

measure-fivews-mapping-exceptions.xml

Unmapped Elements