type: resource-definitionsresource: MeasureReport

MeasureReport Definitions

MeasureReport

Results of a measure evaluation

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

Cardinality: 0..*

Constraints: mrp-2 | error | Stratifiers SHALL be either a single criteria element or a set of criteria components | group.stratifier.stratum.all(value.exists() xor component.exists()); mrp-1 | error | Measure Reports used for data collection SHALL NOT communicate group and score information | (type != 'data-exchange') or group.exists().not()

Mappings: rim=Observation[classCode=OBS, moodCode=EVN]; w5=clinical.general

MeasureReport.identifier

Additional identifier for the MeasureReport

Definition: A formal identifier that is used to identify this MeasureReport when it is represented in other formats or referenced in a specification, model, design or an instance.

Requirements: Allows externally provided and/or usable business identifiers to be easily associated with the module.

Cardinality: 0..*

Type: Identifier

Summary: true

Mappings: w5=FiveWs.identifier; rim=id

MeasureReport.category

The category of measure report instance this is (example codes include deqm, ra, vbp)

Definition: The category of measure report instance this is such as Data Exchange for Quality Measures (DEQM), Risk Adjustment, or Value-Based Performance.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measurereport-category

Mappings: rim=methodCode

MeasureReport.messages

Evaluation messages

Definition: A reference to an OperationOutcome that contains any information, warning, and/or error messages that were generated while processing an operation such as $evaluate.

Comments: Operation processing often generates information, warning, or error messages that don't necessarily stop processing (so would not result in an OperationOutcome as the overall result of the operation) but still need to be communicated as part of the result. This element allows for these messages to be included as a reference to an OperationOutcome resource (typically included as a contained resource in the result of the operation).

Cardinality: 0..1

Type: Reference(OperationOutcome)

MeasureReport.status

complete | pending | error

Definition: The MeasureReport status. No data will be available until the MeasureReport status is complete.

Comments: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Cardinality: 1..1

Type: code

Binding: required:measure-report-status

Summary: true

Is Modifier: true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)

Mappings: w5=FiveWs.status; rim=status

MeasureReport.type

individual | subject-list | summary | data-exchange

Definition: The type of measure report. This may be an individual report, which provides the score for the measure for an individual member of the population; a subject-listing, which returns the list of members that meet the various criteria in the measure; a summary report, which returns a population count for each of the criteria in the measure; or a data-collection, which enables the MeasureReport to be used to exchange the data-of-interest for a quality measure.

Comments: Data-exchange reports are used only to communicate data-of-interest for a measure. They do not necessarily include all the data for a particular subject or population, but they may.

Conditions: mrp-1

Cardinality: 1..1

Type: code

Binding: required:measure-report-type

Summary: true

Mappings: w5=FiveWs.class; rim=methodCode

MeasureReport.dataUpdateType

incremental | snapshot

Definition: Indicates whether the data submitted in a data-exchange report represents a snapshot or incremental update. A snapshot update replaces all previously submitted data for the receiver, whereas an incremental update represents only updated and/or changed data and should be applied as a differential update to the existing submitted data for the receiver.

Comments: This element only applies to Data-collection reports used to communicate the data-of-interest for a measure

Requirements: Allows receiving systems to support incremental exchange of data, reducing overall bandwidth requirements.

Cardinality: 0..1

Type: code

Binding: required:submit-data-update-type

Summary: true

Is Modifier: true (Reason: This element determines whether the data in a data-exchange measure report is a snapshot or incremental update and is required in order to correctly apply the data update to a receiving system)

Mappings: rim=N/A

MeasureReport.measure

What measure was calculated

Definition: A reference to the Measure that was calculated to produce this report.

Cardinality: 0..1

Type: canonical

Summary: true

Mappings: w5=FiveWs.what[x]; rim=outboundRelationship[typeCode=INST]/target[classCode=OBS, moodCode=DEFN]

MeasureReport.subject

What individual(s) the report is for

Definition: Optional subject identifying the individual or individuals the report is for.

Cardinality: 0..1

Type: Reference(CareTeam, Device, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson)

Summary: true

Mappings: w5=FiveWs.subject; rim=participation[typeCode=SBJ]

MeasureReport.date

When the measure report was generated

Definition: The date this measure report was generated.

Cardinality: 0..1

Type: dateTime

Summary: true

Mappings: w5=FiveWs.recorded; rim=participation[typeCode=AUT].time

MeasureReport.reporter

Who is reporting the data

Definition: The individual or organization that is reporting the data.

Cardinality: 0..1

Type: Reference(Practitioner, PractitionerRole, Organization)

Summary: true

Mappings: w5=FiveWs.source; rim=participation[typeCode=PRF]

MeasureReport.reportingVendor

What vendor prepared the data

Definition: A reference to the vendor who queried the data, calculated results and/or generated the report. The ‘reporting vendor’ is intended to represent the submitting entity when it is not the same as the reporting entity. This extension is used when the Receiver is interested in getting vendor information in the report.

Cardinality: 0..1

Type: Reference(Organization)

Mappings: rim=participation[typeCode=PRF]

MeasureReport.location

Where the reported data is from

Definition: A reference to the location for which the data is being reported.

Cardinality: 0..*

Type: Reference(Location)

Mappings: rim=participation[typeCode=PRF]

MeasureReport.period

What period the report covers

Definition: The reporting period for which the report was calculated.

Cardinality: 1..1

Type: Period

Summary: true

Mappings: rim=effectiveTime

MeasureReport.inputParameters

What parameters were provided to the report

Definition: A reference to a Parameters resource (typically represented using a contained resource) that represents any input parameters that were provided to the operation that generated the report. If the input parameter includes stratifiers, then the MeasureReport SHALL include the input parameters.

Comments: Whenever an operation returns a MeasureReport, the IN parameters from that operation can be returned to the caller of the operation using MeasureReport.inputParameters. Operations include but are not limited to $evaluate-measure, $care-gaps, $data-requirements, and $collect-data. The inputParameters can also be used in a MeasureReport used to define a test case (i.e., not as a result of an operation).

Cardinality: 0..1

Type: Reference(Parameters)

Mappings: rim=N/A

MeasureReport.group

Measure results for each group

Definition: The results of the calculation, one for each population group in the measure. A MeasureReport SHALL have a group element corresponding to each group element defined in the Measure being reported.

Conditions: mrp-2, mrp-1

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.linkId

Pointer to specific group from Measure

Definition: The group from the Measure that corresponds to this group in the MeasureReport resource. This element SHALL be populated based on the corresponding element in the Measure being reported.

Comments: Note that in previous versions of FHIR, the id element was used to determine corresponding groups between Measure and MeasureReport. Systems MAY support this for backwards-compatibility.

Cardinality: 0..1

Type: string

Mappings: rim=.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id

MeasureReport.group.title

Title of a group. Note- this value is copied from this element in Measure

Definition: Indicates the title for of the group.

Cardinality: 0..1

Type: string

MeasureReport.group.calculatedDate

The date the Measure Report was calculated

Definition: The date the Measure Report was calculated.

Cardinality: 0..1

Type: dateTime

Mappings: rim=participation[typeCode=AUT].time

MeasureReport.group.code

Meaning of the group

Definition: The meaning of the population group as defined in the measure definition. This element SHALL be populated with at least the codings in the code of the corresponding group in the Measure being reported.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:measure-group-example

Summary: true

Mappings: rim=code

MeasureReport.group.description

Summary description

Definition: The human readable description of this population group. This element SHOULD be populated based on the description of the corresponding group in the Measure being reported.

Cardinality: 0..1

Type: markdown

Mappings: rim=.text

MeasureReport.group.type

process | outcome | structure | patient-reported-outcome

Definition: Indicates whether the measure is used to examine a process, an outcome over time, a patient-reported outcome, or a structure measure such as utilization.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measure-type

Summary: true

Mappings: rim=.methodCode { the aspect of what the measure applies to }

MeasureReport.group.subject

What individual(s) the report is for

Definition: Optional subject identifying the individual or individuals the report is for.

Cardinality: 0..1

Type: Reference(CareTeam, Device, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson)

Summary: true

Mappings: w5=FiveWs.subject; rim=participation[typeCode=SBJ]

MeasureReport.group.scoring

What scoring method (e.g. proportion, ratio, continuous-variable)

Definition: Indicates 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. It is expected to be the same as the scoring element on the referenced Measure.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measure-scoring

Summary: true

Is Modifier: true (Reason: Scoring determines what method was used to calculate the measure score and is required for correct interpretation of the score)

Mappings: rim=methodCode

MeasureReport.group.improvementNotation

increase | decrease

Definition: Whether improvement in the measure is noted by an increase or decrease in the measure score. Exercise caution when using any values besides increase or decrease for improvementNotation.

Comments: This element is typically defined by the measure, but reproduced here to ensure the measure score can be interpreted. The element is labeled as a modifier because it changes the interpretation of the reported measure score. Note also that a MeasureReport instance includes the improvementNotation as defined by the Measure being reported. It is duplicated in the MeasureReport because it is a critical aspect of interpreting the measure score but it is not intended to reflect whether the measure report is an increase or decrease. It helps interpret if the measure score is an increase or decrease, I.e., moving in the direction of the desired outcome. This element SHALL be populated based on the improvementNotation element of the corresponding group in the Measure being reported.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measure-improvement-notation

Summary: true

Is Modifier: true (Reason: Improvement notation determines how to interpret the measure score (i.e. whether an increase is an improvement))

Mappings: rim=interpretationCode

MeasureReport.group.improvementNotationGuidance

Explanation of improvement notation

Definition: Narrative text to explain the improvement notation and how to interpret it.

Comments: This element allows explanation to the improvementNotation be provided. In some cases, additional guidance is required to clearly communicate measure intent around improvement notation. For example, a measure looking at Ceasarean-section births may have an improvement notation of “decrease”, but it is critical to be able to communicate that a measure score of 0 is not the intent.

Cardinality: 0..1

Type: markdown

Summary: true

Is Modifier: false

Mappings: rim=interpretationCode

MeasureReport.group.population

The populations in the group

Definition: The populations that make up the population group, one for each type of population appropriate for the measure. Each group in the MeasureReport SHALL have populations as defined in the corresponding group of the Measure being reported.

Cardinality: 0..*

Type: BackboneElement

Constraints: mrp-3 | error | The count and countQuantity elements SHALL be mutually exclusive | count.exists() xor countQuantity.exists()

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.population.linkId

Pointer to specific population from Measure

Definition: The population from the Measure that corresponds to this population in the MeasureReport resource. This element SHALL be populated based on the corresponding element in the Measure being reported.

Comments: Note that in previous versions of FHIR, the id element was used to determine corresponding populations between Measure and MeasureReport. Systems MAY support this for backwards-compatibility.

Cardinality: 0..1

Type: string

Mappings: rim=.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id

MeasureReport.group.population.title

Title of a group. Note- this value is copied from this element in Measure

Definition: Indicates the title for of the group's population.

Cardinality: 0..1

Type: string

MeasureReport.group.population.code

Definition: The type of the population. This element SHALL be populated with at least the codings in the code element of the corresponding population in the Measure group being reported.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measure-population

Summary: true

Mappings: rim=code

MeasureReport.group.population.description

The human readable description of this population criteria

Definition: The human readable description of this population criteria. This element SHOULD be populated based on the description element of the corresponding population in the Measure group being reported.

Cardinality: 0..1

Type: markdown

Mappings: rim=.text

MeasureReport.group.population.count

Size of the population

Definition: The number of members of the population.

Conditions: mrp-3

Cardinality: 0..1

Type: integer

Mappings: rim=value

MeasureReport.group.population.countQuantity

Size of the population as a quantity

Definition: The number of members of the population, specified as a quantity to support identifying units, as well as to support some composite measure calculation use cases where the resulting count of the population is a decimal value.

Conditions: mrp-3

Cardinality: 0..1

Type: Quantity

Mappings: rim=value

MeasureReport.group.population.subjectResults

For subject-list reports, the subject results in this population

Definition: This element refers to a List of individual level MeasureReport resources, one for each subject in this population.

Cardinality: 0..1

Type: Reference(List)

Mappings: rim=outboundRelationship[typeCode=SBJ]

MeasureReport.group.population.subjectReport

For subject-list reports, references to the individual reports for subjects in this population

Definition: A reference to an individual level MeasureReport resource for a member of the population.

Comments: This element SHALL NOT be used with subjectResults. Either systems provide results as a List of MeasureReport, or as references to individual MeasureReports. Note that using this element introduces a constraint on the size of the subject-list MeasureReport; implementations would be free to return a TOO-COSTLY response if a request is made for a subject-list report with too many subjects.

Cardinality: 0..*

Type: Reference(MeasureReport)

Mappings: rim=outboundRelationship[typeCode=SBJ]

MeasureReport.group.population.subjects

What individual(s) in the population

Definition: Optional Group identifying the individuals that make up the population.

Comments: Note that this element can only be used for summary and subject-list reports where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group resource SHALL be an actual (as opposed to a definitional) group.

Cardinality: 0..1

Type: Reference(Group)

Mappings: w5=FiveWs.subject; rim=participation[typeCode=SBJ]

MeasureReport.group.measureScore[x]

What score this group achieved

Definition: The measure score for this population group, calculated as appropriate for the measure type and scoring method, and based on the contents of the populations defined in the group.

Cardinality: 0..1

Type: Quantity, dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio

Summary: true

Mappings: rim=value

MeasureReport.group.stratifier

Stratification results

Definition: The stratification results for this measure group, calculated as defined by the stratifier element of the measure being reported. Each group in the MeasureReport SHALL have stratifiers as defined in the corresponding group of the Measure being reported.

Conditions: mrp-2

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.stratifier.linkId

Pointer to specific stratifier from Measure

Definition: The stratifier from the Measure that corresponds to this stratifier in the MeasureReport resource. This element SHALL be populated based on the corresponding element in the Measure being reported.

Comments: Note that in previous versions of FHIR, the id element was used to determine corresponding stratifiers between Measure and MeasureReport. Systems MAY support this as well as linkId for backwards-compatibility.

Cardinality: 0..1

Type: string

Mappings: rim=.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id

MeasureReport.group.stratifier.title

Title of a group's stratifier. Note- this value is copied from this element in Measure

Definition: Indicates the title for of the group's stratifier.

Cardinality: 0..1

Type: string

MeasureReport.group.stratifier.code

What stratifier of the group

Definition: The meaning of this stratifier, as defined in the measure definition. This element SHALL be populated with at least the codings in the code element of the corresponding stratifier in the Measure group being reported.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:measure-stratifier-example

Mappings: rim=code

MeasureReport.group.stratifier.description

The human readable description of this stratifier

Definition: The human readable description of this stratifier criteria. This element SHOULD be populated with the description element of the corresponding stratifier in the Measure group being reported.

Conditions: mea-1

Cardinality: 0..1

Type: markdown

Mappings: rim=.text

MeasureReport.group.stratifier.stratum

Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components

Definition: This element contains the results for a single stratum within the stratifier. For example, when stratifying on administrative gender, there will be four strata, one for each possible gender value.

Conditions: mrp-2

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.stratifier.stratum.value[x]

The stratum value, e.g. male

Definition: The value for this stratum, expressed as a CodeableConcept. When defining stratifiers on complex values, the value must be rendered such that the value for each stratum within the stratifier is unique.

Conditions: mrp-2

Cardinality: 0..1

Type: CodeableConcept, boolean, Quantity, Range, Reference

Binding: example:measurereport-stratifier-value-example

Mappings: rim=outboundRelationship[typeCode=COMP].value

MeasureReport.group.stratifier.stratum.component

Stratifier component values

Definition: A stratifier component value.

Conditions: mrp-2

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.stratifier.stratum.component.linkId

Pointer to specific stratifier component from Measure

Definition: The stratifier component from the Measure that corresponds to this stratifier component in the MeasureReport resource. This element SHALL be populated based on the corresponding element in the Measure being reported.

Cardinality: 0..1

Type: string

Mappings: rim=.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id

MeasureReport.group.stratifier.stratum.component.code

What stratifier component of the group

Definition: The code for the stratum component value. This element SHALL be populated with at least the codings in the code element of the corresponding component of the stratifier being reported.

Cardinality: 1..1

Type: CodeableConcept

Binding: example:measure-stratifier-example

Mappings: rim=code

MeasureReport.group.stratifier.stratum.component.description

The human readable description of this stratifier component

Definition: The human readable description of this stratifier criteria component. This element MAY be populated with the description of the corresponding component of the stratifier being reported.

Cardinality: 0..1

Type: markdown

Mappings: rim=.text

MeasureReport.group.stratifier.stratum.component.value[x]

The stratum component value, e.g. male

Definition: The stratum component value.

Cardinality: 1..1

Type: CodeableConcept, boolean, Quantity, Range, Reference

Binding: example:measurereport-stratifier-value-example

Mappings: rim=outboundRelationship[typeCode=COMP].value

MeasureReport.group.stratifier.stratum.population

Population results in this stratum

Definition: The populations that make up the stratum, one for each type of population appropriate to the measure. For each stratifier, systems MAY provide population breakdowns in addition to the stratified scores.

Cardinality: 0..*

Type: BackboneElement

Constraints: mrp-4 | error | The count and countQuantity elements for a statum population SHALL be mutually exclusive | count.exists() xor countQuantity.exists()

Mappings: rim=outboundRelationship[typeCode=COMP]

MeasureReport.group.stratifier.stratum.population.linkId

Pointer to specific population from Measure

Definition: The population from the Measure that corresponds to this population in the MeasureReport resource. This element SHALL be populated with the linkId corresponding to the population being reported.

Cardinality: 0..1

Type: string

Mappings: rim=.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id

MeasureReport.group.stratifier.stratum.population.code

Definition: The type of the population. This element SHALL be populated with at least the codings in the code element of the corresponding population being reported.

Cardinality: 0..1

Type: CodeableConcept

Binding: extensible:measure-population

Mappings: rim=code

MeasureReport.group.stratifier.stratum.population.count

Size of the population

Definition: The number of members of the population in this stratum.

Conditions: mrp-4

Cardinality: 0..1

Type: integer

Mappings: rim=value

MeasureReport.group.stratifier.stratum.population.countQuantity

Size of the population as a quantity

Definition: The number of members of the population in this stratum, specified as a quantity to support identifying units, as well as to support some composite measure calculation use cases where the resulting count of the population is a decimal value.

Conditions: mrp-4

Cardinality: 0..1

Type: Quantity

Mappings: rim=value

MeasureReport.group.stratifier.stratum.population.subjectResults

For subject-list reports, the subject results in this population

Definition: This element refers to a List of individual level MeasureReport resources, one for each subject in this population in this stratum.

Cardinality: 0..1

Type: Reference(List)

Mappings: rim=outboundRelationship[typeCode=SBJ]

MeasureReport.group.stratifier.stratum.population.subjectReport

For subject-list reports, a subject result in this population

Definition: A reference to an individual level MeasureReport resource for a member of the population.

Comments: This element SHALL NOT be used in with subjectResults, either systems provide results as a List of MeasureReport, or as references to individual MeasureReports. Note that using this element introduces a constraint on the size of the subject-list MeasureReport; implementations would be free to return a TOO-COSTLY response if a request is made for a subject-list report with too many subjects.

Cardinality: 0..*

Type: Reference(MeasureReport)

Mappings: rim=outboundRelationship[typeCode=SBJ]

MeasureReport.group.stratifier.stratum.population.subjects

What individual(s) in the population

Definition: Optional Group identifying the individuals that make up the population.

Comments: Note that this element can only be used for summary and subject-list reports where the basis is of the same type as the populations (e.g. a Patient-based measure, rather than an Encounter-based measure). In addition, the referenced Group SHALL be an actual (as opposed to a definitional) group.

Cardinality: 0..1

Type: Reference(Group)

Mappings: w5=FiveWs.subject; rim=participation[typeCode=SBJ]

MeasureReport.group.stratifier.stratum.measureScore[x]

What score this stratum achieved

Definition: The measure score for this stratum, calculated as appropriate for the measure type and scoring method, and based on only the members of this stratum.

Cardinality: 0..1

Type: Quantity, dateTime, CodeableConcept, Period, Range, Duration, boolean, Ratio

Mappings: rim=value

MeasureReport.supplementalData

Additional information collected for the report

Definition: A reference to a Resource that represents additional information collected for the report. If the value of the supplemental data is not a Resource (i.e. evaluating the supplementalData expression for this case in the measure results in a value that is not a FHIR Resource), it is reported as a reference to a contained Observation resource.

Comments: For individual measure reports, the supplementalData elements represent the direct result of evaluating the supplementalData expression for the subject of the report. For summary reports, supplementalData is reported as references to contained Observation resources that represent the number of times each value appeared as a supplementalData result for members of the population.

Cardinality: 0..*

Type: Reference(Resource)

Mappings: rim=.targetObservation

MeasureReport.evaluatedResource

What data was used to calculate the measure score

Definition: Evaluated resources are used to capture what data was involved in the calculation of a measure. This usage is only allowed for individual reports to ensure that the size of the MeasureReport resource is bounded.

Comments: Evaluated resources are only reported for individual reports.

Cardinality: 0..*

Type: Reference(Resource)

Mappings: rim=.targetObservation