description: '[MeasureReport](http://hl7.org/fhir/R4/measurereport.html) is used as an organizer for both data exchange for measure and for measure reporting. Three profiles on the MeasureReport resource are defined in this guide to delineate these different uses. The **DEQM Summary MeasureReport Profile** defined here is used when a measure is reported to an aggregator for a group of subjects. It contains all of the data that is relevant to generate the report including the measure outcome and is similar to a QRDA Category 3 report. Unlike the [DEQM Individual MeasureReport Profile](StructureDefinition-deqm-individualmeasurereport.html), the report is typically transacted as a single MeasureReport report.'
package_name: hl7.fhir.uv.deqm
derivation: constraint
name: DEQMSummaryMeasureReportProfile
type: MeasureReport
elements:
  evaluatedResource: {mustSupport: false, index: 58}
  date: {short: 'When the report was generated. Note: The language in R5 was changed to calculated.  We are clarifying that intent.', mustSupport: true, index: 19}
  group:
    constraint:
      deqm-4: {human: 'If the measure scoring is specified on the group and the scoring type is ''proportion'', ''ratio'' or ''continuous-variable'' then the groupImprovementNotation element is required.', severity: error, expression: '(extension(''http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring'').exists().anyTrue() and extension(''http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring'').value.coding.code in (''proportion'' | ''ratio'' | ''continuous-variable'')).anyTrue() implies extension(''http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation'').exists()'}
      deqm-6: {human: If the measure scoring type is 'proportion' then the measureScore SHALL be a numerical value between 0 and 1, severity: error, expression: '((%resource.extension(''http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring'').value.coding.code contains ''proportion'').anyTrue() or extension(''http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring'').value.coding.code contains ''proportion'').anyTrue() implies (measureScore.value >= 0.0 and measureScore.value <= 1.0)'}
    mustSupport: true
    array: true
    min: 1
    index: 25
    elements:
      id: {mustSupport: true, index: 26}
      extension:
        type: Extension
        short: Unique id of the group from the measure.
        mustSupport: true
        url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId
        index: 27
        slicing:
          slices:
            linkId:
              match: {}
              schema: {type: Extension, short: Unique id of the group from the measure., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId', index: 27}
              min: 1
              max: 1
            scoring:
              match: {}
              schema: {short: proportion | ratio | continuous-variable | cohort | composite | attestation, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring', index: 28}
              min: 0
              max: 1
            cqm-compositeScoring:
              match: {}
              schema: {type: Extension, short: 'How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort', mustSupport: true, url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring', index: 29}
              min: 0
              max: 1
            calculatedDate:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate', index: 30}
              min: 0
              max: 1
            improvementNotation:
              match: {}
              schema: {short: increase | decrease, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation', index: 31}
              min: 0
              max: 1
            description:
              match: {}
              schema: {type: Extension, short: Description of the group, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', index: 32}
              min: 0
              max: 1
      code: {mustSupport: true, index: 33}
      population:
        constraint:
          deqm-8: {human: 'The population must either have a count (integer) or a countQuantity (quantity), but not both.', severity: error, expression: 'extension(''http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity'').exists() xor count.exists()'}
        mustSupport: true
        index: 34
        extensions:
          linkId: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId', min: 1, max: 1, type: Extension, short: Unique id for group.population from the measure., mustSupport: true, index: 35}
          countQuantity: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity', min: 0, max: 1, short: Count as a Quantity, type: Extension, mustSupport: true, index: 36}
          description: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', min: 0, max: 1, type: Extension, short: Description of the population, mustSupport: true, index: 37}
        elements:
          extension:
            type: Extension
            short: Unique id for group.population from the measure.
            mustSupport: true
            url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId
            index: 35
            slicing:
              slices:
                linkId:
                  match: {}
                  schema: {type: Extension, short: Unique id for group.population from the measure., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.population.linkId', index: 35}
                  min: 1
                  max: 1
                countQuantity:
                  match: {}
                  schema: {short: Count as a Quantity, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity', index: 36}
                  min: 0
                  max: 1
                description:
                  match: {}
                  schema: {type: Extension, short: Description of the population, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', index: 37}
                  min: 0
                  max: 1
          code: {mustSupport: true, index: 38}
          count: {mustSupport: true, index: 39}
          subjectResults: {mustSupport: false, index: 40}
        required: [code]
      measureScore:
        mustSupport: true
        index: 41
        extensions:
          alternateScoreType: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType', min: 0, max: 1, type: Extension, mustSupport: true, index: 42}
        elements:
          extension:
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
            index: 42
            slicing:
              slices:
                alternateScoreType:
                  match: {}
                  schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType', index: 42}
                  min: 0
                  max: 1
      stratifier:
        constraint:
          deqm-7: {human: 'If group.stratifier exists, then either group.stratifier.code or the group.stratifier.stratum.component.code is present, but not both', severity: error, expression: code.exists() xor stratum.component.exists()}
        mustSupport: true
        index: 43
        extensions:
          linkId: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId', min: 1, max: 1, type: Extension, short: Unique id for group.stratifier from the measure., mustSupport: true, index: 44}
          description: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', min: 0, max: 1, type: Extension, short: Description of the stratifier, mustSupport: true, index: 45}
        elements:
          extension:
            type: Extension
            short: Unique id for group.stratifier from the measure.
            mustSupport: true
            url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId
            index: 44
            slicing:
              slices:
                linkId:
                  match: {}
                  schema: {type: Extension, short: Unique id for group.stratifier from the measure., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.linkId', index: 44}
                  min: 1
                  max: 1
                description:
                  match: {}
                  schema: {type: Extension, short: Description of the stratifier, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', index: 45}
                  min: 0
                  max: 1
          code: {mustSupport: true, index: 46}
          stratum:
            mustSupport: true
            index: 47
            elements:
              value: {mustSupport: true, index: 48}
              component:
                extensions:
                  linkId: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId', min: 1, max: 1, type: Extension, short: Unique id for group.stratifier.component from the measure., mustSupport: true, index: 49}
                elements:
                  extension:
                    type: Extension
                    short: Unique id for group.stratifier.component from the measure.
                    mustSupport: true
                    url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId
                    index: 49
                    slicing:
                      slices:
                        linkId:
                          match: {}
                          schema: {type: Extension, short: Unique id for group.stratifier.component from the measure., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.component.linkId', index: 49}
                          min: 1
                          max: 1
              population:
                constraint:
                  deqm-9: {human: 'The stratum population must either have a count (integer) or a countQuantity (quantity), but not both.', severity: error, expression: 'extension(''http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity'').exists() xor count.exists()'}
                mustSupport: true
                index: 50
                extensions:
                  linkId: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId', min: 1, max: 1, type: Extension, short: Unique id for group.stratifier.population from the measure., mustSupport: true, index: 51}
                  countQuantity: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity', min: 0, max: 1, type: Extension, mustSupport: true, index: 52}
                elements:
                  extension:
                    type: Extension
                    short: Unique id for group.stratifier.population from the measure.
                    mustSupport: true
                    url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId
                    index: 51
                    slicing:
                      slices:
                        linkId:
                          match: {}
                          schema: {type: Extension, short: Unique id for group.stratifier.population from the measure., mustSupport: true, url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.stratifier.stratum.population.linkId', index: 51}
                          min: 1
                          max: 1
                        countQuantity:
                          match: {}
                          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-countQuantity', index: 52}
                          min: 0
                          max: 1
                  code: {mustSupport: true, index: 53}
                  count: {mustSupport: true, index: 54}
                  subjectResults: {mustSupport: false, index: 55}
                required: [count, code]
              measureScore:
                mustSupport: true
                index: 56
                extensions:
                  alternateScoreType: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType', min: 0, max: 1, type: Extension, mustSupport: true, index: 57}
                elements:
                  extension:
                    type: Extension
                    mustSupport: true
                    url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType
                    index: 57
                    slicing:
                      slices:
                        alternateScoreType:
                          match: {}
                          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-alternateScoreType', index: 57}
                          min: 0
                          max: 1
    extensions:
      linkId: {url: 'http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.group.linkId', min: 1, max: 1, type: Extension, short: Unique id of the group from the measure., mustSupport: true, index: 27}
      scoring: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring', min: 0, max: 1, short: proportion | ratio | continuous-variable | cohort | composite | attestation, type: Extension, mustSupport: true, index: 28}
      cqm-compositeScoring: {url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-compositeScoring', min: 0, max: 1, type: Extension, short: 'How the calculation is performed for the measure, including proportion, ratio, continuous-variable, and cohort', mustSupport: true, index: 29}
      calculatedDate: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-calculatedDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 30}
      improvementNotation: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-groupImprovementNotation', min: 0, max: 1, short: increase | decrease, type: Extension, mustSupport: true, index: 31}
      description: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', min: 0, max: 1, type: Extension, short: Description of the group, mustSupport: true, index: 32}
  type:
    type: code
    pattern: {type: Code, value: summary}
    mustSupport: true
    index: 16
  measure:
    constraint:
      deqm-0: {human: Canonical URL SHALL contain a version., severity: error, expression: '%resource.measure.toString().contains(''|'') and %resource.measure.substring(%resource.measure.toString().indexOf(''|'') + 1).length() > 0'}
    short: What measure and version was calculated
    type: canonical
    mustSupport: true
    index: 17
  extension:
    type: Extension
    url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram
    index: 0
    slicing:
      slices:
        vendor:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor', index: 7}
          min: 0
          max: 1
        category:
          match: {}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-category', index: 1}
          min: 0
          max: 1
        reportingProgram:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram', index: 0}
          min: 0
          max: 1
        limitations:
          match: {}
          schema: {type: Extension, short: 'identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport.', mustSupport: true, url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations', index: 13}
          min: 0
          max: 1
        supplementalData:
          match: {}
          schema:
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
            index: 3
            elements:
              value[x]:
                extensions:
                  criteriaReference: {url: 'http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference', min: 0, max: 1, type: Extension, mustSupport: true, index: 4}
                  description: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', min: 0, max: 1, type: Extension, short: Description of the supplemental data, mustSupport: true, index: 5}
                elements:
                  extension:
                    type: Extension
                    mustSupport: true
                    url: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
                    index: 4
                    slicing:
                      slices:
                        criteriaReference:
                          match: {}
                          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference', index: 4}
                          min: 0
                          max: 1
                        description:
                          match: {}
                          schema: {type: Extension, short: Description of the supplemental data, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', index: 5}
                          min: 0
                          max: 1
        trendingIssues:
          match: {}
          schema: {type: Extension, short: 'identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport.', mustSupport: true, url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues', index: 14}
          min: 0
          max: 1
        cehrt:
          match: {}
          schema:
            type: Extension
            short: CMS EHR Certification ID
            url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
            index: 9
            elements:
              valueIdentifier:
                type: Identifier
                pattern:
                  type: Identifier
                  value: {system: 'urn:oid:2.16.840.1.113883.3.2074.1'}
                index: 10
            required: [valueIdentifier]
        inputParameters:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/StructureDefinition/cqf-inputParameters', index: 2}
          min: 0
          max: 1
        scoring:
          match: {}
          schema: {short: proportion | ratio | continuous-variable | cohort | composite | attestation, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring', index: 6}
          min: 0
          max: 1
        software:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem', index: 11}
          min: 0
        location:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation', index: 8}
          min: 0
        message:
          match: {}
          schema: {type: Extension, url: 'http://hl7.org/fhir/StructureDefinition/cqf-messages', index: 12}
          min: 0
          max: 1
  reporter:
    short: Who is reporting the data. The reporter is the entity fulfilling the reporting requirement.
    refers: ['http://hl7.org/fhir/StructureDefinition/Organization', 'http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole']
    type: Reference
    mustSupport: true
    index: 20
  status:
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/ValueSet/measure-report-status'}
    mustSupport: true
    index: 15
  period:
    type: Period
    constraint:
      deqm-1: {human: Date precision SHALL be at least to day ( YYYY-MM-DD ), severity: error, expression: start.toString().length()>9 and end.toString().length()>9}
    mustSupport: true
    index: 21
    elements:
      start: {mustSupport: true, index: 22}
      end: {mustSupport: true, index: 23}
    required: [start, end]
  improvementNotation: {mustSupport: true, index: 24}
  subject:
    short: What group the report is for.
    refers: ['http://hl7.org/fhir/StructureDefinition/Group']
    type: Reference
    mustSupport: false
    index: 18
package_version: 1.0.0-ballot
extensions:
  vendor: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingVendor', min: 0, max: 1, type: Extension, index: 7}
  category: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-category', min: 0, max: 1, type: Extension, mustSupport: true, index: 1}
  reportingProgram: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-reportingProgram', min: 0, max: 1, type: Extension, index: 0}
  limitations: {url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-limitations', min: 0, max: 1, type: Extension, short: 'identifies what limitations should be noted, including potential selection biases and confounding factors when interpreting indicator results or comparing results across the country. If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport.', mustSupport: true, index: 13}
  supplementalData:
    url: http://hl7.org/fhir/5.0/StructureDefinition/extension-MeasureReport.supplementalData
    type: Extension
    mustSupport: true
    index: 3
    elements:
      value[x]:
        extensions:
          criteriaReference: {url: 'http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference', min: 0, max: 1, type: Extension, mustSupport: true, index: 4}
          description: {url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', min: 0, max: 1, type: Extension, short: Description of the supplemental data, mustSupport: true, index: 5}
        elements:
          extension:
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference
            index: 4
            slicing:
              slices:
                criteriaReference:
                  match: {}
                  schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/cqf-criteriaReference', index: 4}
                  min: 0
                  max: 1
                description:
                  match: {}
                  schema: {type: Extension, short: Description of the supplemental data, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/measurereport-populationDescription', index: 5}
                  min: 0
                  max: 1
  trendingIssues: {url: 'http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-trendingIssues', min: 0, max: 1, type: Extension, short: 'identifies what issues might affect the interpretation of trending results, including changes in geographic coverage, data quality, coding standards and classification changes (for example, a new ICD standard). If the extension is present in the Measure, then it SHALL be in the MeasureReport (MustSupport) and SHALL at least contain a copy of the content from the Measure. It is permissible to add content to the extensions in the MeasureReport.', mustSupport: true, index: 14}
  cehrt:
    url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-certificationIdentifier
    type: Extension
    short: CMS EHR Certification ID
    index: 9
    elements:
      valueIdentifier:
        type: Identifier
        pattern:
          type: Identifier
          value: {system: 'urn:oid:2.16.840.1.113883.3.2074.1'}
        index: 10
    required: [valueIdentifier]
  inputParameters: {url: 'http://hl7.org/fhir/StructureDefinition/cqf-inputParameters', min: 0, max: 1, type: Extension, index: 2}
  scoring: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-measureScoring', min: 0, max: 1, short: proportion | ratio | continuous-variable | cohort | composite | attestation, type: Extension, mustSupport: true, index: 6}
  software: {url: 'http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem', min: 0, type: Extension, index: 11}
  location: {url: 'http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-dataLocation', min: 0, type: Extension, index: 8}
  message: {url: 'http://hl7.org/fhir/StructureDefinition/cqf-messages', min: 0, max: 1, type: Extension, index: 12}
class: profile
kind: resource
url: http://hl7.org/fhir/uv/deqm/StructureDefinition/deqm-summarymeasurereport
base: http://hl7.org/fhir/StructureDefinition/MeasureReport
version: 1.0.0-ballot
required: [reporter, group, date, period]