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14.15 14.18 Resource MeasureReport - Content

Clinical Quality Information Work Group Maturity Level : 2   Trial Use Security Category : Business Compartments : Patient

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

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

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

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

Note that this resource is a special case of the more general notion of a query evaluation result. However, because the general case requires the ability to represent arbitrary content, this resource uses a simple indicator structure to describe population sizes for each population type defined in the measure. The intent is to be able to represent the more general case as well, either by generalizing this resource, or by making this structure a profile of a more general resource, and we are actively seeking comments about what approaches might be taken to achieve that aim.

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

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

No resources refer to this resource directly.

This resource does not implement any patterns.

Structure

Name Flags Card. Type Description & Constraints doco
. . MeasureReport I TU DomainResource Results of a measure evaluation
+ Rule: Measure Reports used for data collection SHALL NOT communicate group and score information
+ Rule: Stratifiers SHALL be either a single criteria or a set of criteria components
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Additional identifier for the MeasureReport
. . . status ?! Σ 1..1 code complete | pending | error
MeasureReportStatus ( Required )
. . . type Σ I 1..1 code individual | subject-list | summary | data-collection
MeasureReportType ( Required )
. . . measure Σ 1..1 canonical ( Measure ) What measure was calculated
. . . subject Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group ) What individual(s) the report is for
. . . date Σ 0..1 dateTime When the report was generated
. . . reporter Σ 0..1 Reference ( Practitioner | PractitionerRole | Location | Organization ) Who is reporting the data
. . . period Σ 1..1 Period What period the report covers
. . . improvementNotation ?! Σ 0..1 CodeableConcept increase | decrease
MeasureImprovementNotation ( Required )
. . . group I 0..* BackboneElement Measure results for each group
. . . . code Σ 0..1 CodeableConcept Meaning of the group
. . . . population 0..* BackboneElement The populations in the group
. . . . . code Σ 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . count 0..1 integer Size of the population
. . . . . subjectResults 0..1 Reference ( List ) For subject-list reports, the subject results in this population
. . . . measureScore Σ 0..1 Quantity What score this group achieved
. . . . stratifier 0..* BackboneElement Stratification results
. . . . . code 0..* CodeableConcept What stratifier of the group
. . . . . stratum 0..* BackboneElement Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
. . . . . . value 0..1 CodeableConcept The stratum value, e.g. male
. . . . . . component 0..* BackboneElement Stratifier component values
. . . . . . . code 1..1 CodeableConcept What stratifier component of the group
. . . . . . . value 1..1 CodeableConcept The stratum component value, e.g. male
. . . . . . population 0..* BackboneElement Population results in this stratum
. . . . . . . code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . . . count 0..1 integer Size of the population
. . . . . . . subjectResults 0..1 Reference ( List ) For subject-list reports, the subject results in this population
. . . . . . measureScore 0..1 Quantity What score this stratum achieved
. . . evaluatedResource 0..* Reference ( Any ) What data was used to calculate the measure score

doco Documentation for this format

UML Diagram ( Legend )

MeasureReport ( DomainResource ) 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 identifier : Identifier [0..*] The MeasureReport status. No data will be available until the MeasureReport status is complete (this element modifies the meaning of other elements) status : code [1..1] « The status of the measure report. (Strength=Required) MeasureReportStatus ! » 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 type : code [1..1] « The type of the measure report. (Strength=Required) MeasureReportType ! » A reference to the Measure that was calculated to produce this report measure : canonical [1..1] « Measure » Optional subject identifying the individual or individuals the report is for subject : Reference [0..1] « Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group » The date this measure report was generated date : dateTime [0..1] The individual, location, or organization that is reporting the data reporter : Reference [0..1] « Practitioner | PractitionerRole | Location | Organization » The reporting period for which the report was calculated period : Period [1..1] Whether improvement in the measure is noted by an increase or decrease in the measure score (this element modifies the meaning of other elements) improvementNotation : CodeableConcept [0..1] « Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. (Strength=Required) MeasureImprovementNotation ! » A reference to a Bundle containing the Resources that were used in the calculation of this measure evaluatedResource : Reference [0..*] « Any » Group The meaning of the population group as defined in the measure definition code : CodeableConcept [0..1] 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 measureScore : Quantity [0..1] Population The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population count : integer [0..1] This element refers to a List of subject level MeasureReport resources, one for each subject in this population subjectResults : Reference [0..1] « List » Stratifier The meaning of this stratifier, as defined in the measure definition code : CodeableConcept [0..*] StratifierGroup 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 value : CodeableConcept [0..1] 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 measureScore : Quantity [0..1] Component The code for the stratum component value code : CodeableConcept [1..1] The stratum component value value : CodeableConcept [1..1] StratifierGroupPopulation The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population in this stratum count : integer [0..1] This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum subjectResults : Reference [0..1] « List » The populations that make up the population group, one for each type of population appropriate for the measure population [0..*] A stratifier component value component [0..*] The populations that make up the stratum, one for each type of population appropriate to the measure population [0..*] 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 stratum [0..*] When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure stratifier [0..*] The results of the calculation, one for each population group in the measure group [0..*]

XML Template

<MeasureReport xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Additional identifier for the MeasureReport --></identifier>
 <status value="[code]"/><!-- 1..1 complete | pending | error -->
 <type value="[code]"/><!-- ?? 1..1 individual | subject-list | summary | data-collection -->
 <measure><!-- 1..1 canonical(Measure) What measure was calculated --></measure>
 <|
   </subject>

 <subject><!-- 0..1 Reference(Device|Group|Location|Patient|Practitioner|
   PractitionerRole|RelatedPerson) What individual(s) the report is for --></subject>
 <date value="[dateTime]"/><!-- 0..1 When the report was generated -->
 <|
   </reporter>

 <reporter><!-- 0..1 Reference(Location|Organization|Practitioner|
   PractitionerRole) Who is reporting the data --></reporter>
 <period><!-- 1..1 Period What period the report covers --></period>
 <improvementNotation><!-- 0..1 CodeableConcept increase | decrease --></improvementNotation>
 <group>  <!-- ?? 0..* Measure results for each group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <population>  <!-- 0..* The populations in the group -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <count value="[integer]"/><!-- 0..1 Size of the population -->
   <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>
  </population>
  <measureScore><!-- 0..1 Quantity What score this group achieved --></measureScore>
  <stratifier>  <!-- 0..* Stratification results -->
   <code><!-- 0..* CodeableConcept What stratifier of the group --></code>
   <stratum>  <!-- 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components -->
    <value><!-- 0..1 CodeableConcept The stratum value, e.g. male --></value>
    <component>  <!-- 0..* Stratifier component values -->
     <code><!-- 1..1 CodeableConcept What stratifier component of the group --></code>
     <value><!-- 1..1 CodeableConcept The stratum component value, e.g. male --></value>
    </component>
    <population>  <!-- 0..* Population results in this stratum -->
     <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
     <count value="[integer]"/><!-- 0..1 Size of the population -->
     <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>
    </population>
    <measureScore><!-- 0..1 Quantity What score this stratum achieved --></measureScore>
   </stratum>
  </stratifier>
 </group>
 <evaluatedResource><!-- 0..* Reference(Any) What data was used to calculate the measure score --></evaluatedResource>
</MeasureReport>

JSON Template

{doco
  "resourceType" : "MeasureReport",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
  "status" : "<code>", // R!  complete | pending | error
  "type" : "<code>", // C? R!  individual | subject-list | summary | data-collection
  "measure" : { canonical(Measure) }, // R!  What measure was calculated
  "|
   

  "subject" : { Reference(Device|Group|Location|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // What individual(s) the report is for
  "date" : "<dateTime>", // When the report was generated
  "|
   

  "reporter" : { Reference(Location|Organization|Practitioner|
   PractitionerRole) }, // Who is reporting the data
  "period" : { Period }, // R!  What period the report covers
  "improvementNotation" : { CodeableConcept }, // increase | decrease
  "group" : [{ // C? Measure results for each group
    "code" : { CodeableConcept }, // Meaning of the group
    "population" : [{ // The populations in the group
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "count" : <integer>, // Size of the population
      "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
    }],
    "measureScore" : { Quantity }, // What score this group achieved
    "stratifier" : [{ // Stratification results
      "code" : [{ CodeableConcept }], // What stratifier of the group
      "stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        "value" : { CodeableConcept }, // The stratum value, e.g. male
        "component" : [{ // Stratifier component values
          "code" : { CodeableConcept }, // R!  What stratifier component of the group
          "value" : { CodeableConcept } // R!  The stratum component value, e.g. male
        }],
        "population" : [{ // Population results in this stratum
          "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          "count" : <integer>, // Size of the population
          "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
        }],
        "measureScore" : { Quantity } // What score this stratum achieved
      }]
    }]
  }],
  "evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:MeasureReport;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MeasureReport.identifier [ Identifier ], ... ; # 0..* Additional identifier for the MeasureReport
  fhir:MeasureReport.status [ code ]; # 1..1 complete | pending | error
  fhir:MeasureReport.type [ code ]; # 1..1 individual | subject-list | summary | data-collection
  fhir:MeasureReport.measure [ canonical(Measure) ]; # 1..1 What measure was calculated
  fhir:

  fhir:MeasureReport.subject [ Reference(Device|Group|Location|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 What individual(s) the report is for

  fhir:MeasureReport.date [ dateTime ]; # 0..1 When the report was generated
  fhir:

  fhir:MeasureReport.reporter [ Reference(Location|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who is reporting the data

  fhir:MeasureReport.period [ Period ]; # 1..1 What period the report covers
  fhir:MeasureReport.improvementNotation [ CodeableConcept ]; # 0..1 increase | decrease
  fhir:MeasureReport.group [ # 0..* Measure results for each group
    fhir:MeasureReport.group.code [ CodeableConcept ]; # 0..1 Meaning of the group
    fhir:MeasureReport.group.population [ # 0..* The populations in the group
      fhir:MeasureReport.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:MeasureReport.group.population.count [ integer ]; # 0..1 Size of the population
      fhir:MeasureReport.group.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population
    ], ...;
    fhir:MeasureReport.group.measureScore [ Quantity ]; # 0..1 What score this group achieved
    fhir:MeasureReport.group.stratifier [ # 0..* Stratification results
      fhir:MeasureReport.group.stratifier.code [ CodeableConcept ], ... ; # 0..* What stratifier of the group
      fhir:MeasureReport.group.stratifier.stratum [ # 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        fhir:MeasureReport.group.stratifier.stratum.value [ CodeableConcept ]; # 0..1 The stratum value, e.g. male
        fhir:MeasureReport.group.stratifier.stratum.component [ # 0..* Stratifier component values
          fhir:MeasureReport.group.stratifier.stratum.component.code [ CodeableConcept ]; # 1..1 What stratifier component of the group
          fhir:MeasureReport.group.stratifier.stratum.component.value [ CodeableConcept ]; # 1..1 The stratum component value, e.g. male
        ], ...;
        fhir:MeasureReport.group.stratifier.stratum.population [ # 0..* Population results in this stratum
          fhir:MeasureReport.group.stratifier.stratum.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          fhir:MeasureReport.group.stratifier.stratum.population.count [ integer ]; # 0..1 Size of the population
          fhir:MeasureReport.group.stratifier.stratum.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population
        ], ...;
        fhir:MeasureReport.group.stratifier.stratum.measureScore [ Quantity ]; # 0..1 What score this stratum achieved
      ], ...;
    ], ...;
  ], ...;
  fhir:MeasureReport.evaluatedResource [ Reference(Any) ], ... ; # 0..* What data was used to calculate the measure score
]

Changes since R3

MeasureReport
MeasureReport.identifier Max Cardinality changed from 1 to * MeasureReport.status
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-status to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.0 to http://hl7.org/fhir/ValueSet/measure-report-status|4.1.0
MeasureReport.type
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-type to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.0 MeasureReport.measure Type changed from Reference(Measure) to canonical(Measure) MeasureReport.subject Added Element MeasureReport.reporter Added Element MeasureReport.improvementNotation Added Element MeasureReport.group.code Added Element MeasureReport.group.population.code Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population" MeasureReport.group.population.subjectResults Added Element MeasureReport.group.measureScore Type changed from decimal to Quantity MeasureReport.group.stratifier.code Added Element MeasureReport.group.stratifier.stratum.value Min Cardinality changed from 1 to 0 Type changed from string to CodeableConcept MeasureReport.group.stratifier.stratum.component Added Element MeasureReport.group.stratifier.stratum.component.code Added Mandatory Element MeasureReport.group.stratifier.stratum.component.value Added Mandatory Element http://hl7.org/fhir/ValueSet/measure-report-type|4.1.0
MeasureReport.group.stratifier.stratum.population.code MeasureReport.improvementNotation
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population" MeasureReport.group.stratifier.stratum.population.subjectResults Added Element MeasureReport.group.stratifier.stratum.measureScore Type changed value set from decimal http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.0 to Quantity MeasureReport.evaluatedResource Added Element MeasureReport.patient deleted MeasureReport.reportingOrganization deleted MeasureReport.group.identifier deleted MeasureReport.group.population.identifier deleted MeasureReport.group.population.patients deleted MeasureReport.group.stratifier.identifier deleted MeasureReport.group.stratifier.stratum.population.identifier deleted MeasureReport.group.stratifier.stratum.population.patients deleted MeasureReport.evaluatedResources deleted http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.1.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . MeasureReport I TU DomainResource Results of a measure evaluation
+ Rule: Measure Reports used for data collection SHALL NOT communicate group and score information
+ Rule: Stratifiers SHALL be either a single criteria or a set of criteria components
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Additional identifier for the MeasureReport
. . . status ?! Σ 1..1 code complete | pending | error
MeasureReportStatus ( Required )
. . . type Σ I 1..1 code individual | subject-list | summary | data-collection
MeasureReportType ( Required )
. . . measure Σ 1..1 canonical ( Measure ) What measure was calculated
. . . subject Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group ) What individual(s) the report is for
. . . date Σ 0..1 dateTime When the report was generated
. . . reporter Σ 0..1 Reference ( Practitioner | PractitionerRole | Location | Organization ) Who is reporting the data
. . . period Σ 1..1 Period What period the report covers
. . . improvementNotation ?! Σ 0..1 CodeableConcept increase | decrease
MeasureImprovementNotation ( Required )
. . . group I 0..* BackboneElement Measure results for each group
. . . . code Σ 0..1 CodeableConcept Meaning of the group
. . . . population 0..* BackboneElement The populations in the group
. . . . . code Σ 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . count 0..1 integer Size of the population
. . . . . subjectResults 0..1 Reference ( List ) For subject-list reports, the subject results in this population
. . . . measureScore Σ 0..1 Quantity What score this group achieved
. . . . stratifier 0..* BackboneElement Stratification results
. . . . . code 0..* CodeableConcept What stratifier of the group
. . . . . stratum 0..* BackboneElement Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
. . . . . . value 0..1 CodeableConcept The stratum value, e.g. male
. . . . . . component 0..* BackboneElement Stratifier component values
. . . . . . . code 1..1 CodeableConcept What stratifier component of the group
. . . . . . . value 1..1 CodeableConcept The stratum component value, e.g. male
. . . . . . population 0..* BackboneElement Population results in this stratum
. . . . . . . code 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
MeasurePopulationType ( Extensible )
. . . . . . . count 0..1 integer Size of the population
. . . . . . . subjectResults 0..1 Reference ( List ) For subject-list reports, the subject results in this population
. . . . . . measureScore 0..1 Quantity What score this stratum achieved
. . . evaluatedResource 0..* Reference ( Any ) What data was used to calculate the measure score

doco Documentation for this format

UML Diagram ( Legend )

MeasureReport ( DomainResource ) 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 identifier : Identifier [0..*] The MeasureReport status. No data will be available until the MeasureReport status is complete (this element modifies the meaning of other elements) status : code [1..1] « The status of the measure report. (Strength=Required) MeasureReportStatus ! » 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 type : code [1..1] « The type of the measure report. (Strength=Required) MeasureReportType ! » A reference to the Measure that was calculated to produce this report measure : canonical [1..1] « Measure » Optional subject identifying the individual or individuals the report is for subject : Reference [0..1] « Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group » The date this measure report was generated date : dateTime [0..1] The individual, location, or organization that is reporting the data reporter : Reference [0..1] « Practitioner | PractitionerRole | Location | Organization » The reporting period for which the report was calculated period : Period [1..1] Whether improvement in the measure is noted by an increase or decrease in the measure score (this element modifies the meaning of other elements) improvementNotation : CodeableConcept [0..1] « Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. (Strength=Required) MeasureImprovementNotation ! » A reference to a Bundle containing the Resources that were used in the calculation of this measure evaluatedResource : Reference [0..*] « Any » Group The meaning of the population group as defined in the measure definition code : CodeableConcept [0..1] 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 measureScore : Quantity [0..1] Population The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population count : integer [0..1] This element refers to a List of subject level MeasureReport resources, one for each subject in this population subjectResults : Reference [0..1] « List » Stratifier The meaning of this stratifier, as defined in the measure definition code : CodeableConcept [0..*] StratifierGroup 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 value : CodeableConcept [0..1] 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 measureScore : Quantity [0..1] Component The code for the stratum component value code : CodeableConcept [1..1] The stratum component value value : CodeableConcept [1..1] StratifierGroupPopulation The type of the population code : CodeableConcept [0..1] « The type of population (e.g. initial, numerator, denominator, etc.). (Strength=Extensible) MeasurePopulationType + » The number of members of the population in this stratum count : integer [0..1] This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum subjectResults : Reference [0..1] « List » The populations that make up the population group, one for each type of population appropriate for the measure population [0..*] A stratifier component value component [0..*] The populations that make up the stratum, one for each type of population appropriate to the measure population [0..*] 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 stratum [0..*] When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure stratifier [0..*] The results of the calculation, one for each population group in the measure group [0..*]

XML Template

<MeasureReport xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Additional identifier for the MeasureReport --></identifier>
 <status value="[code]"/><!-- 1..1 complete | pending | error -->
 <type value="[code]"/><!-- ?? 1..1 individual | subject-list | summary | data-collection -->
 <measure><!-- 1..1 canonical(Measure) What measure was calculated --></measure>
 <|
   </subject>

 <subject><!-- 0..1 Reference(Device|Group|Location|Patient|Practitioner|
   PractitionerRole|RelatedPerson) What individual(s) the report is for --></subject>
 <date value="[dateTime]"/><!-- 0..1 When the report was generated -->
 <|
   </reporter>

 <reporter><!-- 0..1 Reference(Location|Organization|Practitioner|
   PractitionerRole) Who is reporting the data --></reporter>
 <period><!-- 1..1 Period What period the report covers --></period>
 <improvementNotation><!-- 0..1 CodeableConcept increase | decrease --></improvementNotation>
 <group>  <!-- ?? 0..* Measure results for each group -->
  <code><!-- 0..1 CodeableConcept Meaning of the group --></code>
  <population>  <!-- 0..* The populations in the group -->
   <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
   <count value="[integer]"/><!-- 0..1 Size of the population -->
   <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>
  </population>
  <measureScore><!-- 0..1 Quantity What score this group achieved --></measureScore>
  <stratifier>  <!-- 0..* Stratification results -->
   <code><!-- 0..* CodeableConcept What stratifier of the group --></code>
   <stratum>  <!-- 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components -->
    <value><!-- 0..1 CodeableConcept The stratum value, e.g. male --></value>
    <component>  <!-- 0..* Stratifier component values -->
     <code><!-- 1..1 CodeableConcept What stratifier component of the group --></code>
     <value><!-- 1..1 CodeableConcept The stratum component value, e.g. male --></value>
    </component>
    <population>  <!-- 0..* Population results in this stratum -->
     <code><!-- 0..1 CodeableConcept initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation --></code>
     <count value="[integer]"/><!-- 0..1 Size of the population -->
     <subjectResults><!-- 0..1 Reference(List) For subject-list reports, the subject results in this population --></subjectResults>
    </population>
    <measureScore><!-- 0..1 Quantity What score this stratum achieved --></measureScore>
   </stratum>
  </stratifier>
 </group>
 <evaluatedResource><!-- 0..* Reference(Any) What data was used to calculate the measure score --></evaluatedResource>
</MeasureReport>

JSON Template

{doco
  "resourceType" : "MeasureReport",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Additional identifier for the MeasureReport
  "status" : "<code>", // R!  complete | pending | error
  "type" : "<code>", // C? R!  individual | subject-list | summary | data-collection
  "measure" : { canonical(Measure) }, // R!  What measure was calculated
  "|
   

  "subject" : { Reference(Device|Group|Location|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // What individual(s) the report is for
  "date" : "<dateTime>", // When the report was generated
  "|
   

  "reporter" : { Reference(Location|Organization|Practitioner|
   PractitionerRole) }, // Who is reporting the data
  "period" : { Period }, // R!  What period the report covers
  "improvementNotation" : { CodeableConcept }, // increase | decrease
  "group" : [{ // C? Measure results for each group
    "code" : { CodeableConcept }, // Meaning of the group
    "population" : [{ // The populations in the group
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "count" : <integer>, // Size of the population
      "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
    }],
    "measureScore" : { Quantity }, // What score this group achieved
    "stratifier" : [{ // Stratification results
      "code" : [{ CodeableConcept }], // What stratifier of the group
      "stratum" : [{ // Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        "value" : { CodeableConcept }, // The stratum value, e.g. male
        "component" : [{ // Stratifier component values
          "code" : { CodeableConcept }, // R!  What stratifier component of the group
          "value" : { CodeableConcept } // R!  The stratum component value, e.g. male
        }],
        "population" : [{ // Population results in this stratum
          "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          "count" : <integer>, // Size of the population
          "subjectResults" : { Reference(List) } // For subject-list reports, the subject results in this population
        }],
        "measureScore" : { Quantity } // What score this stratum achieved
      }]
    }]
  }],
  "evaluatedResource" : [{ Reference(Any) }] // What data was used to calculate the measure score
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:MeasureReport;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MeasureReport.identifier [ Identifier ], ... ; # 0..* Additional identifier for the MeasureReport
  fhir:MeasureReport.status [ code ]; # 1..1 complete | pending | error
  fhir:MeasureReport.type [ code ]; # 1..1 individual | subject-list | summary | data-collection
  fhir:MeasureReport.measure [ canonical(Measure) ]; # 1..1 What measure was calculated
  fhir:

  fhir:MeasureReport.subject [ Reference(Device|Group|Location|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 What individual(s) the report is for

  fhir:MeasureReport.date [ dateTime ]; # 0..1 When the report was generated
  fhir:

  fhir:MeasureReport.reporter [ Reference(Location|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who is reporting the data

  fhir:MeasureReport.period [ Period ]; # 1..1 What period the report covers
  fhir:MeasureReport.improvementNotation [ CodeableConcept ]; # 0..1 increase | decrease
  fhir:MeasureReport.group [ # 0..* Measure results for each group
    fhir:MeasureReport.group.code [ CodeableConcept ]; # 0..1 Meaning of the group
    fhir:MeasureReport.group.population [ # 0..* The populations in the group
      fhir:MeasureReport.group.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      fhir:MeasureReport.group.population.count [ integer ]; # 0..1 Size of the population
      fhir:MeasureReport.group.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population
    ], ...;
    fhir:MeasureReport.group.measureScore [ Quantity ]; # 0..1 What score this group achieved
    fhir:MeasureReport.group.stratifier [ # 0..* Stratification results
      fhir:MeasureReport.group.stratifier.code [ CodeableConcept ], ... ; # 0..* What stratifier of the group
      fhir:MeasureReport.group.stratifier.stratum [ # 0..* Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components
        fhir:MeasureReport.group.stratifier.stratum.value [ CodeableConcept ]; # 0..1 The stratum value, e.g. male
        fhir:MeasureReport.group.stratifier.stratum.component [ # 0..* Stratifier component values
          fhir:MeasureReport.group.stratifier.stratum.component.code [ CodeableConcept ]; # 1..1 What stratifier component of the group
          fhir:MeasureReport.group.stratifier.stratum.component.value [ CodeableConcept ]; # 1..1 The stratum component value, e.g. male
        ], ...;
        fhir:MeasureReport.group.stratifier.stratum.population [ # 0..* Population results in this stratum
          fhir:MeasureReport.group.stratifier.stratum.population.code [ CodeableConcept ]; # 0..1 initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
          fhir:MeasureReport.group.stratifier.stratum.population.count [ integer ]; # 0..1 Size of the population
          fhir:MeasureReport.group.stratifier.stratum.population.subjectResults [ Reference(List) ]; # 0..1 For subject-list reports, the subject results in this population
        ], ...;
        fhir:MeasureReport.group.stratifier.stratum.measureScore [ Quantity ]; # 0..1 What score this stratum achieved
      ], ...;
    ], ...;
  ], ...;
  fhir:MeasureReport.evaluatedResource [ Reference(Any) ], ... ; # 0..* What data was used to calculate the measure score
]

Changes since Release 3

MeasureReport
MeasureReport.identifier Max Cardinality changed from 1 to * MeasureReport.status
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-status to http://hl7.org/fhir/ValueSet/measure-report-status|4.0.0 to http://hl7.org/fhir/ValueSet/measure-report-status|4.1.0
MeasureReport.type
  • Change value set from http://hl7.org/fhir/ValueSet/measure-report-type to http://hl7.org/fhir/ValueSet/measure-report-type|4.0.0 MeasureReport.measure Type changed from Reference(Measure) to canonical(Measure) MeasureReport.subject Added Element MeasureReport.reporter Added Element MeasureReport.improvementNotation Added Element MeasureReport.group.code Added Element MeasureReport.group.population.code Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population" MeasureReport.group.population.subjectResults Added Element MeasureReport.group.measureScore Type changed from decimal to Quantity MeasureReport.group.stratifier.code Added Element MeasureReport.group.stratifier.stratum.value Min Cardinality changed from 1 to 0 Type changed from string to CodeableConcept MeasureReport.group.stratifier.stratum.component Added Element MeasureReport.group.stratifier.stratum.component.code Added Mandatory Element MeasureReport.group.stratifier.stratum.component.value Added Mandatory Element http://hl7.org/fhir/ValueSet/measure-report-type|4.1.0
MeasureReport.group.stratifier.stratum.population.code MeasureReport.improvementNotation
  • Change code system for extensibly bound codes from "http://hl7.org/fhir/measure-population" to "http://terminology.hl7.org/CodeSystem/measure-population" MeasureReport.group.stratifier.stratum.population.subjectResults Added Element MeasureReport.group.stratifier.stratum.measureScore Type changed value set from decimal http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.0.0 to Quantity MeasureReport.evaluatedResource Added Element MeasureReport.patient deleted MeasureReport.reportingOrganization deleted MeasureReport.group.identifier deleted MeasureReport.group.population.identifier deleted MeasureReport.group.population.patients deleted MeasureReport.group.stratifier.identifier deleted MeasureReport.group.stratifier.stratum.population.identifier deleted MeasureReport.group.stratifier.stratum.population.patients deleted MeasureReport.evaluatedResources deleted http://hl7.org/fhir/ValueSet/measure-improvement-notation|4.1.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 3 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Path Definition Type Reference
MeasureReport.status The status of the measure report. Required MeasureReportStatus
MeasureReport.type The type of the measure report. Required MeasureReportType
MeasureReport.improvementNotation Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue. Required MeasureImprovementNotation
MeasureReport.group.population.code
MeasureReport.group.stratifier.stratum.population.code
The type of population (e.g. initial, numerator, denominator, etc.). Extensible MeasurePopulationType

id Level Location Description Expression
mrp-1 Rule (base) Measure Reports used for data collection SHALL NOT communicate group and score information (type != 'data-collection') or group.exists().not()
mrp-2 Rule (base) Stratifiers SHALL be either a single criteria or a set of criteria components group.stratifier.stratum.all(value.exists() xor component.exists())

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

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

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