Da Vinci Risk Adjustment Implementation Guide
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## Resource Profile: RiskAdjustmentCodingGapMeasureReport - Detailed Descriptions

Active as of 2023-03-28

Definitions for the ra-measurereport resource profile.

- Differential Elements Table
- Key Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here.

1. MeasureReport
Definition | This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model. The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.
2. MeasureReport.extension:clinicalDataCollectionDeadline
SliceName | clinicalDataCollectionDeadline
Control | 0..1
Type | Extension(RAClinicalDataCollectionDeadline) (Extension Type: date)
Must Support | true
3. MeasureReport.status
Must Support | true
4. MeasureReport.type
Must Support | true
Fixed Value | individual
5. MeasureReport.measure
Type | canonical(RiskAdjustmentModelMeasure|Measure)
Must Support | true
6. MeasureReport.subject
Control | 10..1
Type | Reference(USCorePatientProfile|Patient|Practitioner|PractitionerRole|Location|Device|RelatedPerson|Group)
Must Support | true
7. MeasureReport.date
Definition | This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency. The date this measure report was generated.
Control | 10..1
Must Support | true
8. MeasureReport.reporter
Definition | Organization that generated the MeasureReport The individual, location, or organization that is reporting the data.
Control | 10..1
Type | Reference(USCoreOrganizationProfile|Practitioner|PractitionerRole|Location|Organization)
Must Support | true
9. MeasureReport.period
Control | This element is affected by the following invariants: ra-1
Must Support | true
Invariants | Defined on this element ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (: start.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*') and end.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*'))
10. MeasureReport.period.start
Control | 1..1
Must Support | true
11. MeasureReport.period.end
Control | 1..1
Must Support | true
12. MeasureReport.group
Definition | Condition Categories and detailed information for the coding gap. The results of the calculation, one for each population group in the measure.
Must Support | true
13. MeasureReport.group.id
Control | 10..1
Must Support | true
14. MeasureReport.group.extension:suspectType
SliceName | suspectType
Control | 0..1
Type | Extension(RASuspectType) (Extension Type: CodeableConcept)
Must Support | true
15. MeasureReport.group.extension:evidenceStatus
SliceName | evidenceStatus
Control | 0..1
Type | Extension(EvidenceStatus) (Extension Type: CodeableConcept)
Must Support | true
16. MeasureReport.group.extension:evidenceStatusDate
SliceName | evidenceStatusDate
Control | 0..1
Type | Extension(RAClinicalEvidenceStatusDate) (Extension Type: date)
Must Support | true
17. MeasureReport.group.extension:hierarchicalStatus
SliceName | hierarchicalStatus
Control | 0..1
Type | Extension(HierarchicalStatus) (Extension Type: CodeableConcept)
Must Support | true
18. MeasureReport.group.extension:confidenceScale
SliceName | confidenceScale
Control | 0..1
Type | Extension(ConfidenceScale) (Extension Type: CodeableConcept)
Must Support | true
19. MeasureReport.group.extension:annotation
SliceName | annotation
Control | 0..*
Type | Extension(Annotation) (Complex Extension)
Must Support | true
20. MeasureReport.group.code
Definition | Condition Category (CC) code for a Risk Adjustment Model. The meaning of the population group as defined in the measure definition.
Binding | For example codes, see Sample CMS Hierarchical Condition Category For codes, see (unbound)
Must Support | true
21. MeasureReport.group.stratifier
Control | 0..?
22. MeasureReport.group.stratifier.code
Control | 0..1*
23. MeasureReport.evaluatedResource
Definition | An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap. A reference to a Bundle containing the Resources that were used in the calculation of this measure.
Must Support | true
24. MeasureReport.evaluatedResource.extension:groupReference
SliceName | groupReference
Definition | This id references the `MeasureReport.group.id`, which allows linking a supporting resource to a specific Condition Categories coding gap.
Control | 0..*
Type | Extension(GroupReference) (Extension Type: string)
Must Support | true

Guidance on how to interpret the contents of this table can be found here.

1. MeasureReport
Definition | This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model. The MeasureReport resource contains the results of the calculation of a measure; and optionally a reference to the resources involved in that calculation.
Control | 0..*
Summary | false
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists()) mrp-1: Measure Reports used for data collection SHALL NOT communicate group and score information (: (type != 'data-collection') or group.exists().not()) mrp-2: Stratifiers SHALL be either a single criteria or a set of criteria components (: group.stratifier.stratum.all(value.exists() xor component.exists()))
2. MeasureReport.implicitRules
Definition | A 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.
Control | 0..1
Type | uri
Is Modifier | true
Summary | true
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. MeasureReport.extension:clinicalDataCollectionDeadline
SliceName | clinicalDataCollectionDeadline
Definition | This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RAClinicalDataCollectionDeadline) (Extension Type: date)
Must Support | true
Comments | This is an extension to represent the clinical data collection deadline
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
4. MeasureReport.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. MeasureReport.status
Definition | The MeasureReport status. No data will be available until the MeasureReport status is complete.
Control | 1..1
Binding | The codes SHALL be taken from MeasureReportStatus The status of the measure report.
Type | code
Is Modifier | true
Must Support | true
Summary | true
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. MeasureReport.type
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.
Control | 1..1 This element is affected by the following invariants: mrp-1
Binding | The codes SHALL be taken from MeasureReportType The type of the measure report.
Type | code
Must Support | true
Summary | true
Comments | Data-collection 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.
Fixed Value | individual
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. MeasureReport.measure
Definition | A reference to the Measure that was calculated to produce this report.
Control | 1..1
Type | canonical(RiskAdjustmentModelMeasure|Measure)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
8. MeasureReport.subject
Definition | Optional subject identifying the individual or individuals the report is for.
Control | 10..1
Type | Reference(USCorePatientProfile|Patient|Practitioner|PractitionerRole|Location|Device|RelatedPerson|Group)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. MeasureReport.date
Definition | This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency. The date this measure report was generated.
Control | 10..1
Type | dateTime
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. MeasureReport.reporter
Definition | Organization that generated the MeasureReport The individual, location, or organization that is reporting the data.
Control | 10..1
Type | Reference(USCoreOrganizationProfile|Practitioner|PractitionerRole|Location|Organization)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. MeasureReport.period
Definition | The reporting period for which the report was calculated.
Control | 1..1 This element is affected by the following invariants: ra-1
Type | Period
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (: start.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*') and end.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*'))
12. MeasureReport.period.start
Definition | The start of the period. The boundary is inclusive.
Control | 10..1 This element is affected by the following invariants: per-1
Type | dateTime
Must Support | true
Summary | true
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. MeasureReport.period.end
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Control | 10..1 This element is affected by the following invariants: per-1
Type | dateTime
Must Support | true
Summary | true
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. MeasureReport.improvementNotation
Definition | Whether improvement in the measure is noted by an increase or decrease in the measure score.
Control | 0..1
Binding | The codes SHALL be taken from MeasureImprovementNotation Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
Type | CodeableConcept
Is Modifier | true
Summary | true
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. MeasureReport.group
Definition | Condition Categories and detailed information for the coding gap. The results of the calculation, one for each population group in the measure.
Control | 0..* This element is affected by the following invariants: mrp-1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. MeasureReport.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 10..1
Type | string
Must Support | true
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
17. MeasureReport.group.extension:suspectType
SliceName | suspectType
Definition | Risk adjustment suspect type, whether the Condition Category (CC) gap is historic, suspected or net new
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RASuspectType) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension is to represent risk adjustment suspect type
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. MeasureReport.group.extension:evidenceStatus
SliceName | evidenceStatus
Definition | Condition Category gap evidence status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(EvidenceStatus) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, or pending.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
19. MeasureReport.group.extension:evidenceStatusDate
SliceName | evidenceStatusDate
Definition | When the evidence status changed to either closed-gap, open-gap, or pending.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RAClinicalEvidenceStatusDate) (Extension Type: date)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
20. MeasureReport.group.extension:hierarchicalStatus
SliceName | hierarchicalStatus
Definition | Hierarchies applied to a Condition Category (CC) status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(HierarchicalStatus) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
21. MeasureReport.group.extension:confidenceScale
SliceName | confidenceScale
Definition | Coding gap confidence scale
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ConfidenceScale) (Extension Type: CodeableConcept)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
22. MeasureReport.group.extension:annotation
SliceName | annotation
Definition | Annotation May 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.
Control | This element is affected by the following invariants: ele-1
Type | Extension(Annotation) (Complex Extension)
Must Support | true
Invariants | Defined on this element ele-1: (: ) ext-1: (: )
23. MeasureReport.group.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
24. MeasureReport.group.code
Definition | Condition Category (CC) code for a Risk Adjustment Model. The meaning of the population group as defined in the measure definition.
Control | 0..1
Binding | For example codes, see Sample CMS Hierarchical Condition Category For codes, see (unbound)
Type | CodeableConcept
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. MeasureReport.evaluatedResource
Definition | An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap. A reference to a Bundle containing the Resources that were used in the calculation of this measure.
Control | 0..*
Type | Reference(Resource)
Must Support | true
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. MeasureReport.evaluatedResource.extension:groupReference
SliceName | groupReference
Definition | This id references the `MeasureReport.group.id`, which allows linking a supporting resource to a specific Condition Categories coding gap.
Control | 0..*
Type | Extension(GroupReference) (Extension Type: string)
Must Support | true
Summary | false
Comments | This is an extension to reference a Condition Category (CC).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())

Guidance on how to interpret the contents of this table can be found here.

1. MeasureReport
Definition | This is a risk adjustment coding gap report of a patient/member using a specific version of a particular Risk Adjustment model.
Control | 0..*
Summary | false
2. MeasureReport.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Summary | true
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. MeasureReport.meta
Definition | The 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.
Control | 0..1
Type | Meta
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. MeasureReport.implicitRules
Definition | A 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.
Control | 0..1
Type | uri
Is Modifier | true
Summary | true
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. MeasureReport.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages A human language
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Summary | false
Comments | 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).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. MeasureReport.text
Definition | A 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.
Control | 0..1
Type | Narrative
Summary | false
Alternate Names | narrative, html, xhtml, display
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. MeasureReport.contained
Definition | These 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.
Control | 0..*
Type | Resource
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
Comments | 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.
8. MeasureReport.extension
Definition | An Extension
Control | 0..*
Type | Extension
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on MeasureReport.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
9. MeasureReport.extension:clinicalDataCollectionDeadline
SliceName | clinicalDataCollectionDeadline
Definition | This is the deadline by which the providers must have all claims data to the payers to count for risk adjustment for a clinical evaluation period. This date is set by the Payer.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RAClinicalDataCollectionDeadline) (Extension Type: date)
Must Support | true
Comments | This is an extension to represent the clinical data collection deadline
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. MeasureReport.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. MeasureReport.identifier
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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Summary | true
Requirements | Allows externally provided and/or usable business identifiers to be easily associated with the module.
Comments | Typically, this is used for identifiers that can go in an HL7 V3 II data type - e.g. to identify this {{title}} outside of FHIR, where the logical URL is not possible to use.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. MeasureReport.status
Definition | The MeasureReport status. No data will be available until the MeasureReport status is complete.
Control | 1..1
Binding | The codes SHALL be taken from MeasureReportStatus The status of the measure report
Type | code
Is Modifier | true
Must Support | true
Summary | true
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. MeasureReport.type
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.
Control | 1..1 This element is affected by the following invariants: mrp-1
Binding | The codes SHALL be taken from MeasureReportType The type of the measure report
Type | code
Must Support | true
Summary | true
Comments | Data-collection 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.
Fixed Value | individual
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. MeasureReport.measure
Definition | A reference to the Measure that was calculated to produce this report.
Control | 1..1
Type | canonical(RiskAdjustmentModelMeasure)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. MeasureReport.subject
Definition | Optional subject identifying the individual or individuals the report is for.
Control | 1..1
Type | Reference(USCorePatientProfile)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. MeasureReport.date
Definition | This is the date when the risk adjustment coding gap reports were generated by payers' back end systems such as legacy system, FHIR server, risk adjustment engine. For example, a payer may generate risk adjustment coding gap reports for members quarterly or at a different frequency.
Control | 1..1
Type | dateTime
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. MeasureReport.reporter
Definition | Organization that generated the MeasureReport
Control | 1..1
Type | Reference(USCoreOrganizationProfile)
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. MeasureReport.period
Definition | The reporting period for which the report was calculated.
Control | 1..1 This element is affected by the following invariants: ra-1
Type | Period
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD ) (: start.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*') and end.value.matches('^([0-9]{4})(-)(1[0-2]|0[1-9])-(3[01]|0[1-9]|[12][0-9]).*'))
19. MeasureReport.period.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
20. MeasureReport.period.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on MeasureReport.period.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
21. MeasureReport.period.start
Definition | The start of the period. The boundary is inclusive.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Must Support | true
Summary | true
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. MeasureReport.period.end
Definition | The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Must Support | true
Summary | true
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. MeasureReport.improvementNotation
Definition | Whether improvement in the measure is noted by an increase or decrease in the measure score.
Control | 0..1
Binding | The codes SHALL be taken from MeasureImprovementNotation Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue
Type | CodeableConcept
Is Modifier | true
Summary | true
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. MeasureReport.group
Definition | Condition Categories and detailed information for the coding gap.
Control | 0..* This element is affected by the following invariants: mrp-1
Type | BackboneElement
Must Support | true
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. MeasureReport.group.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 1..1
Type | string
Must Support | true
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
26. MeasureReport.group.extension
Definition | An Extension
Control | 0..*
Type | Extension
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on MeasureReport.group.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
27. MeasureReport.group.extension:suspectType
SliceName | suspectType
Definition | Risk adjustment suspect type, whether the Condition Category (CC) gap is historic, suspected or net new
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RASuspectType) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension is to represent risk adjustment suspect type
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. MeasureReport.group.extension:evidenceStatus
SliceName | evidenceStatus
Definition | Condition Category gap evidence status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(EvidenceStatus) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension represents evidence status of a Condition Category (CC) coding gap, whether there is evidence that supports a Condition Category (CC) coding gap is closed-gap, open-gap, or pending.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
29. MeasureReport.group.extension:evidenceStatusDate
SliceName | evidenceStatusDate
Definition | When the evidence status changed to either closed-gap, open-gap, or pending.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(RAClinicalEvidenceStatusDate) (Extension Type: date)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. MeasureReport.group.extension:hierarchicalStatus
SliceName | hierarchicalStatus
Definition | Hierarchies applied to a Condition Category (CC) status
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(HierarchicalStatus) (Extension Type: CodeableConcept)
Must Support | true
Comments | This extension hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
31. MeasureReport.group.extension:confidenceScale
SliceName | confidenceScale
Definition | Coding gap confidence scale
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ConfidenceScale) (Extension Type: CodeableConcept)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
32. MeasureReport.group.extension:annotation
SliceName | annotation
Definition | Annotation
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Annotation) (Complex Extension)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
33. MeasureReport.group.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
34. MeasureReport.group.code
Definition | Condition Category (CC) code for a Risk Adjustment Model.
Control | 0..1
Binding | For example codes, see Sample CMS Hierarchical Condition Category
Type | CodeableConcept
Must Support | true
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. MeasureReport.group.population
Definition | The populations that make up the population group, one for each type of population appropriate for the measure.
Control | 0..*
Type | BackboneElement
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. MeasureReport.group.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
37. MeasureReport.group.population.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
38. MeasureReport.group.population.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
39. MeasureReport.group.population.code
Definition | The type of the population.
Control | 0..1
Binding | The codes SHALL be taken from MeasurePopulationType; other codes may be used where these codes are not suitable The type of population (e.g. initial, numerator, denominator, etc.)
Type | CodeableConcept
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. MeasureReport.group.population.count
Definition | The number of members of the population.
Control | 0..1
Type | integer
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. MeasureReport.group.population.subjectResults
Definition | This element refers to a List of subject level MeasureReport resources, one for each subject in this population.
Control | 0..1
Type | Reference(List)
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. MeasureReport.group.measureScore
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.
Control | 0..1
Type | Quantity
Summary | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
43. MeasureReport.group.stratifier
Definition | When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.
Control | 0..*
Type | BackboneElement
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. MeasureReport.group.stratifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
45. MeasureReport.group.stratifier.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
46. MeasureReport.group.stratifier.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
47. MeasureReport.group.stratifier.code
Definition | The meaning of this stratifier, as defined in the measure definition.
Control | 0..1
Type | CodeableConcept
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. MeasureReport.group.stratifier.stratum
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.
Control | 0..*
Type | BackboneElement
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. MeasureReport.group.stratifier.stratum.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
50. MeasureReport.group.stratifier.stratum.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
51. MeasureReport.group.stratifier.stratum.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
52. MeasureReport.group.stratifier.stratum.value
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.
Control | 0..1
Type | CodeableConcept
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. MeasureReport.group.stratifier.stratum.component
Definition | A stratifier component value.
Control | 0..*
Type | BackboneElement
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. MeasureReport.group.stratifier.stratum.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
55. MeasureReport.group.stratifier.stratum.component.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
56. MeasureReport.group.stratifier.stratum.component.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
57. MeasureReport.group.stratifier.stratum.component.code
Definition | The code for the stratum component value.
Control | 1..1
Type | CodeableConcept
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. MeasureReport.group.stratifier.stratum.component.value
Definition | The stratum component value.
Control | 1..1
Type | CodeableConcept
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. MeasureReport.group.stratifier.stratum.population
Definition | The populations that make up the stratum, one for each type of population appropriate to the measure.
Control | 0..*
Type | BackboneElement
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. MeasureReport.group.stratifier.stratum.population.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
61. MeasureReport.group.stratifier.stratum.population.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
62. MeasureReport.group.stratifier.stratum.population.modifierExtension
Definition | May 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).
Control | 0..*
Type | Extension
Is Modifier | true
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
63. MeasureReport.group.stratifier.stratum.population.code
Definition | The type of the population.
Control | 0..1
Binding | The codes SHALL be taken from MeasurePopulationType; other codes may be used where these codes are not suitable The type of population (e.g. initial, numerator, denominator, etc.)
Type | CodeableConcept
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. MeasureReport.group.stratifier.stratum.population.count
Definition | The number of members of the population in this stratum.
Control | 0..1
Type | integer
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. MeasureReport.group.stratifier.stratum.population.subjectResults
Definition | This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.
Control | 0..1
Type | Reference(List)
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. MeasureReport.group.stratifier.stratum.measureScore
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.
Control | 0..1
Type | Quantity
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. MeasureReport.evaluatedResource
Definition | An evaluated resource is any data a clinician would need to independently arrive at the clinical inference that a Condition Category (CC) listed on a Risk Adjustment Coding Gap Report could be present for a patient. Risk adjusted evaluated resources may include practitioners, encounters, diagnoses, medications, labs, or any other clinical evidence that the suspecting algorithm may have used as supporting evidence to infer the presence of an Condition Category (CC) gap.
Control | 0..*
Type | Reference(Resource)
Must Support | true
Summary | false
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. MeasureReport.evaluatedResource.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
Summary | false
69. MeasureReport.evaluatedResource.extension
Definition | May 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.
Control | 0..*
Type | Extension
Summary | false
Alternate Names | extensions, user content
Comments | 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on MeasureReport.evaluatedResource.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
70. MeasureReport.evaluatedResource.extension:groupReference
SliceName | groupReference
Definition | This id references the `MeasureReport.group.id`, which allows linking a supporting resource to a specific Condition Categories coding gap.
Control | 0..*
Type | Extension(GroupReference) (Extension Type: string)
Must Support | true
Summary | false
Comments | This is an extension to reference a Condition Category (CC).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
71. MeasureReport.evaluatedResource.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Summary | true
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. MeasureReport.evaluatedResource.type
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Control | 0..1
Binding | The codes SHALL be taken from ResourceType; other codes may be used where these codes are not suitable Aa resource (or, for logical models, the URI of the logical model)
Type | uri
Summary | true
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. MeasureReport.evaluatedResource.identifier
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. MeasureReport.evaluatedResource.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Control | 0..1
Type | string
Summary | true
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))