Da Vinci Risk Adjustment Implementation Guide
2.0.0-ballot - STU2 Ballot

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## Resource Profile: Risk Adjustment Coding Gap MeasureReport

Official URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport | Version: 2.0.0-ballot
Active as of 2023-03-28 | Computable Name: RiskAdjustmentCodingGapMeasureReport
Copyright/Legal: Used by permission of HL7 International - Clinical Quality Information Work Group, all rights reserved Creative Commons License

This profile is based on the MeasureReport to represent a risk adjustment coding gap report.

New Extensions: Annotation and ConfidenceScale

### Mandatory Data Elements and Terminology

The following data-elements must always be present (Mandatory) or must be supported (Must Support). The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each MeasureReport must have:

1. A `MeasureReport.status` element
2. A `MeasureReport.type` element hard coded to “individual”
3. A `MeasureReport.measure` element references a Risk Adjustment Model Measure
4. A `MeasureReport.subject` element references a US Core Patient profile
5. A `MeasureReport.period` element for the clinical evaluation period for which the risk adjustment coding gap report was generated.

Each MeasureReport should have ([Must Support]):

1. Zero to many `MeasureReport.group` element
2. Each `MeasureReport.group` should have a `MeasureReport.group.code` element
3. Each `MeasureReport.group` should have a `MeasureReport.group.suspectType` element
4. Each `MeasureReport.group` should have a `MeasureReport.group.evidenceStatus` element
5. Each `MeasureReport.group` should have a `MeasureReport.group.evidenceStatusDate` element
6. Each `MeasureReport.group` should have a `MeasureReport.group.hierarchicalStatus` element
7. Each `MeasureReport.group` should have zero to many `MeasureReport.evalautedResource` element

Each MeasureReport may have ([Must Support]):

1. Each `MeasureReport.group` may have zero to one `MeasureReport.group.confidenceScale` element
2. Each `MeasureReport.group` may have zero to many `MeasureReport.group.annotation` element

Additional Profile specific implementation guidance:

1. `evaluatedResource` SHALL reference resources using USCore profiles where applicable

The Clinical Data Collection Deadline element, `clinicalDataCollectionDeadline`, was added as an extension to MeasureReport. We are seeking comment from implementers if they intend to use this element when communicating risk adjustment coding gap reports from payers to providers.

Usage:

- Use this Resource Profile: Risk Adjustment Coding Gap Report Bundle
- Refer to this Resource Profile: Risk Adjustment Clinical Evaluation Evidence Task
- Examples for this Resource Profile: MeasureReport/ra-measurereport01-with-annotation, MeasureReport/ra-measurereport01, MeasureReport/ra-measurereport02, MeasureReport/ra-measurereport03... Show 3 more, MeasureReport/ra-measurereport04, MeasureReport/ra-measurereport05 and MeasureReport/ra-measurereport06

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Differential Table
- Key Elements Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from MeasureReport

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport |  | 0..* | MeasureReport | This is a risk adjustment coding gap report.
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
status | S | 1..1 | code | complete | pending | error
type | S | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Fixed Value: individual
measure | S | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S | 1..1 | dateTime | When the report was generated
reporter | S | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start | S | 1..1 | dateTime | Starting time with inclusive boundary
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
group | S | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
code | S | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
stratifier |  |  |  |
code |  | 0..1 | CodeableConcept | What stratifier of the group
evaluatedResource | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
MeasureReport.group.code | example | SampleCMSHCC

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ra-1 | error | MeasureReport.period | 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]).*') |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment coding gap report.
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type | S Σ C | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure | S Σ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S Σ | 1..1 | dateTime | When the report was generated
reporter | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S Σ C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
evaluatedResource | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
MeasureReport.status | required | MeasureReportStatus
MeasureReport.type | required | Fixed Value: individual
MeasureReport.improvementNotation | required | MeasureImprovementNotation
MeasureReport.group.code | example | SampleCMSHCC

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) |
ra-1 | error | MeasureReport.period | 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]).*') |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment coding gap report.
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type | S Σ C | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure | S Σ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S Σ | 1..1 | dateTime | When the report was generated
reporter | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S Σ C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
population |  | 0..* | BackboneElement | The populations in the group
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | 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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value |  | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
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 | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
MeasureReport.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
MeasureReport.status | required | MeasureReportStatus
MeasureReport.type | required | Fixed Value: individual
MeasureReport.improvementNotation | required | MeasureImprovementNotation
MeasureReport.group.code | example | SampleCMSHCC
MeasureReport.group.population.code | extensible | MeasurePopulationType
MeasureReport.group.stratifier.stratum.population.code | extensible | MeasurePopulationType
MeasureReport.evaluatedResource.type | extensible | ResourceType

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ra-1 | error | MeasureReport.period | 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]).*') |

This structure is derived from MeasureReport

Summary

Mandatory: 6 elements (1 nested mandatory element)
Must-Support: 21 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

- Risk Adjustment Model Measure (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-model-measure)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference

Differential View

This structure is derived from MeasureReport

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport |  | 0..* | MeasureReport | This is a risk adjustment coding gap report.
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
status | S | 1..1 | code | complete | pending | error
type | S | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Fixed Value: individual
measure | S | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S | 1..1 | dateTime | When the report was generated
reporter | S | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start | S | 1..1 | dateTime | Starting time with inclusive boundary
end | S | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
group | S | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
code | S | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
stratifier |  |  |  |
code |  | 0..1 | CodeableConcept | What stratifier of the group
evaluatedResource | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
MeasureReport.group.code | example | SampleCMSHCC

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ra-1 | error | MeasureReport.period | 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]).*') |

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment coding gap report.
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type | S Σ C | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure | S Σ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S Σ | 1..1 | dateTime | When the report was generated
reporter | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S Σ C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
evaluatedResource | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
MeasureReport.status | required | MeasureReportStatus
MeasureReport.type | required | Fixed Value: individual
MeasureReport.improvementNotation | required | MeasureImprovementNotation
MeasureReport.group.code | example | SampleCMSHCC

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MeasureReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MeasureReport | 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 | error | MeasureReport | 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 | error | MeasureReport | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MeasureReport | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mrp-1 | error | MeasureReport | Measure Reports used for data collection SHALL NOT communicate group and score information : (type != 'data-collection') or group.exists().not() |
mrp-2 | error | MeasureReport | Stratifiers SHALL be either a single criteria or a set of criteria components : group.stratifier.stratum.all(value.exists() xor component.exists()) |
ra-1 | error | MeasureReport.period | 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]).*') |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MeasureReport | C | 0..* | MeasureReport | This is a risk adjustment coding gap report.
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
clinicalDataCollectionDeadline | S | 0..1 | date | 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 and applies to the early-bird date if incentive were offered. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Additional identifier for the MeasureReport
status | ?!S Σ | 1..1 | code | complete | pending | error Binding: MeasureReportStatus (required): The status of the measure report.
type | S Σ C | 1..1 | code | The type code is fixed to 'individual' for a risk adjustment coding gap report Binding: MeasureReportType (required): The type of the measure report. Fixed Value: individual
measure | S Σ | 1..1 | canonical(Risk Adjustment Model Measure) | This references a measure that represents a risk adjustment model, such as CMS-HCC V24.
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | What individual(s) the report is for
date | S Σ | 1..1 | dateTime | When the report was generated
reporter | S Σ | 1..1 | Reference(US Core Organization Profile) | Organization that generated the MeasureReport
period | S Σ C | 1..1 | Period | Clinical evaluation period during which risk adjusting encounters could be conducted and documented with expectations of submission for risk adjustment purposes. ra-1: Date precision SHALL be at least to day ( YYYY-MM-DD )
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 1..1 | dateTime | Starting time with inclusive boundary
end | S Σ C | 1..1 | dateTime | End time with inclusive boundary, if not ongoing
improvementNotation | ?!Σ | 0..1 | CodeableConcept | increase | decrease Binding: MeasureImprovementNotation (required): Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.
group | S C | 0..* | BackboneElement | A group contains information for a Condition Category. If a patient/member has multiple Condition Categories, there will be multiple group(s) and each group represents a Condition Category.
id | S | 1..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
suspectType | S | 0..1 | CodeableConcept | This is the risk adjustment suspect type for a Condition Category (CC) gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType Binding: Risk Adjustment Suspect Type ValueSet (extensible)
evidenceStatus | S | 0..1 | CodeableConcept | This is evidence status of a Condition Category (CC) coding gap: open-gap|closed-gap|pending. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus Binding: Risk Adjustment Evidence Status ValueSet (extensible)
evidenceStatusDate | S | 0..1 | date | When the evidence status was changed to either closed-gap, open-gap, or pending URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
hierarchicalStatus | S | 0..1 | CodeableConcept | This is to indicate whether hierarchies were applied to a Condition Category (CC), and if applied, whether the Condition Category (CC) is superseded: applied-superseded|applied-not-superseded|not-applied|not-applicable URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus Binding: Risk Adjustment Hierarchical Status ValueSet (extensible)
confidenceScale | S | 0..1 | CodeableConcept | Confidence scale for a coding gap URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale Binding: Confidence Scale Value Set (extensible)
annotation | S | 0..* | (Complex) | Annotation URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | S Σ | 0..1 | CodeableConcept | Condition Category (CC) code for a Risk Adjustment Model Binding: Sample CMS Hierarchical Condition Category (example)
population |  | 0..* | BackboneElement | The populations in the group
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | 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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
value |  | 0..1 | CodeableConcept | The stratum value, e.g. male
component |  | 0..* | BackboneElement | Stratifier component values
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 0..1 | CodeableConcept | initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Binding: MeasurePopulationType (extensible): The type of population (e.g. initial, numerator, denominator, etc.).
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 | S | 0..* | Reference(Resource) | 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 a Condition Category (CC) gap.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
groupReference | S | 0..* | string | This references the MeasureReport.group.id. URL: http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
MeasureReport.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
MeasureReport.status | required | MeasureReportStatus
MeasureReport.type | required | Fixed Value: individual
MeasureReport.improvementNotation | required | MeasureImprovementNotation
MeasureReport.group.code | example | SampleCMSHCC
MeasureReport.group.population.code | extensible | MeasurePopulationType
MeasureReport.group.stratifier.stratum.population.code | extensible | MeasurePopulationType
MeasureReport.evaluatedResource.type | extensible | ResourceType

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ra-1 | error | MeasureReport.period | 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]).*') |

This structure is derived from MeasureReport

Summary

Mandatory: 6 elements (1 nested mandatory element)
Must-Support: 21 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

- Risk Adjustment Model Measure (http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-model-measure)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation
- http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference

Other representations of profile: CSV, Excel, Schematron