MeasureReport

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

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	Additional identifier for the MeasureReport Details 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. 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.
status	✓	code	complete | pending | error Details The MeasureReport status. No data will be available until the MeasureReport status is complete. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
type	✓	code	individual | subject-list | summary | data-collection Details 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. 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.
measure	✓	canonical	What measure was calculated Details A reference to the Measure that was calculated to produce this report.
subject		Reference< Patient | Practitioner | PractitionerRole | Location | Device | RelatedPerson | Group >	What individual(s) the report is for Details Optional subject identifying the individual or individuals the report is for.
date		dateTime	When the report was generated Details The date this measure report was generated.
reporter		Reference< Practitioner | PractitionerRole | Location | Organization >	Who is reporting the data Details The individual, location, or organization that is reporting the data.
period	✓	Period	What period the report covers Details The reporting period for which the report was calculated.
improvementNotation		CodeableConcept	increase | decrease Details Whether improvement in the measure is noted by an increase or decrease in the measure score. 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.
group		MeasureReportGroup[]	Measure results for each group Details The results of the calculation, one for each population group in the measure.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
code		CodeableConcept	Meaning of the group Details The meaning of the population group as defined in the measure definition.
population		MeasureReportGroupPopulation[]	The populations in the group Details The populations that make up the population group, one for each type of population appropriate for the measure.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
code		CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Details The type of the population.
count		integer	Size of the population Details The number of members of the population.
subjectResults		Reference<List>	For subject-list reports, the subject results in this population Details This element refers to a List of subject level MeasureReport resources, one for each subject in this population.
measureScore		Quantity	What score this group achieved Details 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.
stratifier		MeasureReportGroupStratifier[]	Stratification results Details When a measure includes multiple stratifiers, there will be a stratifier group for each stratifier defined by the measure.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
code		CodeableConcept[]	What stratifier of the group Details The meaning of this stratifier, as defined in the measure definition.
stratum		MeasureReportGroupStratifierStratum[]	Stratum results, one for each unique value, or set of values, in the stratifier, or stratifier components Details 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.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
value		CodeableConcept	The stratum value, e.g. male Details 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.
component		MeasureReportGroupStratifierStratumComponent[]	Stratifier component values Details A stratifier component value.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
code	✓	CodeableConcept	What stratifier component of the group Details The code for the stratum component value.
value	✓	CodeableConcept	The stratum component value, e.g. male Details The stratum component value.
population		MeasureReportGroupStratifierStratumPopulation[]	Population results in this stratum Details The populations that make up the stratum, one for each type of population appropriate to the measure.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
code		CodeableConcept	initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation Details The type of the population.
count		integer	Size of the population Details The number of members of the population in this stratum.
subjectResults		Reference<List>	For subject-list reports, the subject results in this population Details This element refers to a List of subject level MeasureReport resources, one for each subject in this population in this stratum.
measureScore		Quantity	What score this stratum achieved Details 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.
evaluatedResource		Reference<Resource>[]	What data was used to calculate the measure score Details A reference to a Bundle containing the Resources that were used in the calculation of this measure.

Search Parameters

Name	Type	Description	Expression
date	date	The date of the measure report	MeasureReport.date
evaluated-resource	reference	An evaluated resource referenced by the measure report	MeasureReport.evaluatedResource
identifier	token	External identifier of the measure report to be returned	MeasureReport.identifier
measure	reference	The measure to return measure report results for	MeasureReport.measure
patient	reference	The identity of a patient to search for individual measure report results for	MeasureReport.subject.where(resolve() is Patient)
period	date	The period of the measure report	MeasureReport.period
reporter	reference	The reporter to return measure report results for	MeasureReport.reporter
status	token	The status of the measure report	MeasureReport.status
subject	reference	The identity of a subject to search for individual measure report results for	MeasureReport.subject

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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.
language		code	Language of the resource content Details The base language in which the resource is written. 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).
text		Narrative	Text summary of the resource, for human interpretation Details 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. 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.
contained		Resource[]	Contained, inline Resources Details 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. 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.
extension		Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the resource. 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored Details 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). 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.

Usage

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

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

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

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

Relationships

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

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