Measure - FHIR Resource (r4)


This Measure Resource uses the FHIR API standard for access and structure.

Validate an Measure FHIR Resource (r4)



Resource Attributes

AttributeField is listTypeDescription
approvalDatefalsedate# When the measure was approved by publisher
authortrueContactDetail# Who authored the content
clinicalRecommendationStatementfalsemarkdown# Summary of clinical guidelines
compositeScoringfalseCodeableConcept# opportunity | all-or-nothing | linear | weighted
contacttrueContactDetail# Contact details for the publisher
copyrightfalsemarkdown# Use and/or publishing restrictions
datefalsedateTime# Date last changed
definitiontruemarkdown# Defined terms used in the measure documentation
descriptionfalsemarkdown# Natural language description of the measure
disclaimerfalsemarkdown# Disclaimer for use of the measure or its referenced content
editortrueContactDetail# Who edited the content
effectivePeriodfalsePeriod# When the measure is expected to be used
endorsertrueContactDetail# Who endorsed the content
experimentalfalseboolean# For testing purposes, not real usage
grouptrueData Type# Population criteria group
guidancefalsemarkdown# Additional guidance for implementers
identifiertrueIdentifier# Additional identifier for the measure
improvementNotationfalseCodeableConcept# increase | decrease
jurisdictiontrueCodeableConcept# Intended jurisdiction for measure (if applicable)
lastReviewDatefalsedate# When the measure was last reviewed
librarytruecanonical(Library)# Logic used by the measure
namefalsestring# C? Name for this measure (computer friendly)
publisherfalsestring# Name of the publisher (organization or individual)
purposefalsemarkdown# Why this measure is defined
rateAggregationfalsestring# How is rate aggregation performed for this measure
rationalefalsemarkdown# Detailed description of why the measure exists
relatedArtifacttrueRelatedArtifact# Additional documentation, citations, etc.
reviewertrueContactDetail# Who reviewed the content
riskAdjustmentfalsestring# How risk adjustment is applied for this measure
scoringfalseCodeableConcept# proportion | ratio | continuous-variable | cohort
statusfalsecode# draft | active | retired | unknown
subject[x]falseReference#undefined
subtitlefalsestring# Subordinate title of the measure
supplementalDatatrueData Type# What other data should be reported with the measure
titlefalsestring# Name for this measure (human friendly)
topictrueCodeableConcept# The category of the measure, such as Education, Treatment, Assessment, etc.
typetrueCodeableConcept# process | outcome | structure | patient-reported-outcome | composite
urlfalseuri# Canonical identifier for this measure, represented as a URI (globally unique)
usagefalsestring# Describes the clinical usage of the measure
useContexttrueUsageContext# The context that the content is intended to support
versionfalsestring# Business version of the measure

Measure Example

{
  "resourceType": "Measure",
  "id": "measure-exclusive-breastfeeding",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"grid dict\"><tr><td><b>Id: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">Measure/measure-exclusive-breastfeeding</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Identifier: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>value: </b><span>exclusive-breastfeeding-measure</span></td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Title: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive Breastfeeding Measure</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Status: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">active</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Description: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Purpose: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Topic: </b></td></tr><tr><td style=\"padding-right: 25px;\"><span style=\"padding-left: 25px;\"><b>text: </b><span>Exclusive Breastfeeding</span><br/></span></td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Library: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>reference: </b><span>Library/library-exclusive-breastfeeding-cqm-logic</span></td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Type: </b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\">outcome</td></tr></table><p/><table class=\"grid dict\"><tr><td><b>Group:</b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>Population Group 1</span><br/></span></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>initial-population</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>initial-population-1-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>InitialPopulation1</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>denominator</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>denominator-1-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Denominator1</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>denominator-exclusion</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>denominator-exclusions-1-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>DenominatorExclusions1</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>numerator</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>numerator-1-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Numerator1</span></p></td></tr></table><table class=\"grid dict\"><tr><td><b>Group:</b></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>Population Group 2</span><br/></span></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>initial-population</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>initial-population-2-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>InitialPopulation2</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>denominator</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>denominator-2-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Denominator2</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>denominator-exclusion</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>denominator-exclusions-2-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>DenominatorExclusions2</span></p></td></tr><tr><td style=\"padding-left: 25px; padding-right: 25px;\"><b>Population:</b><br/><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>type:</b><span>numerator</span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>Identifier:</b><br/><span style=\"padding-left: 25px;\"><b>value: </b><span>numerator-2-identifier</span><br/></span></p><p style=\"margin-bottom: 5px; padding-left: 25px;\"><b>criteria: </b><span>Numerator2</span></p></td></tr></table></div>"
  },
  "identifier": [
    {
      "use": "official",
      "value": "exclusive-breastfeeding-measure"
    }
  ],
  "version": "4.0.1",
  "title": "Exclusive Breastfeeding Measure",
  "status": "active",
  "date": "2015-03-08",
  "description": "Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns.",
  "purpose": "Measure of newborns who were fed breast milk only since birth",
  "topic": [
    {
      "text": "Exclusive Breastfeeding"
    }
  ],
  "relatedArtifact": [
    {
      "type": "documentation",
      "citation": "American Academy of Pediatrics. (2005). Section on Breastfeeding. Policy Statement:Breastfeeding and the Use of Human Milk. Pediatrics.115:496-506."
    },
    {
      "type": "documentation",
      "citation": "American College of Obstetricians and Gynecologists. (Feb. 2007). Committee on Obstetric Practice and Committee on Health Care for Underserved Women. Breastfeeding: Maternal and Infant Aspects. ACOG Committee Opinion 361."
    },
    {
      "type": "documentation",
      "citation": "California Department of Public Health. (2006). Genetic Disease Branch. California In-Hospital Breastfeeding as Indicated on the Newborn Screening Test Form, Statewide, County and Hospital of Occurrence: Available at: http://www.cdph.ca.gov/data/statistics/Pages/BreastfeedingStatistics.aspx."
    },
    {
      "type": "documentation",
      "citation": "Centers for Disease Control and Prevention. (Aug 3, 2007). Breastfeeding trends and updated national health objectives for exclusive breastfeeding--United States birth years 2000-2004. MMWR - Morbidity & Mortality Weekly Report. 56(30):760-3."
    },
    {
      "type": "documentation",
      "citation": "Centers for Disease Control and Prevention. (2014). Division of Nutrition, Physical Activity and Obesity. Breastfeeding Report Card. Available at: http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf"
    },
    {
      "type": "documentation",
      "citation": "Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: US Department of Health and Human Services. Available at: http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf"
    },
    {
      "type": "documentation",
      "citation": "Kramer, M.S. & Kakuma, R. (2002).Optimal duration of exclusive breastfeeding. [107 refs] Cochrane Database of Systematic Reviews. (1):CD003517."
    },
    {
      "type": "documentation",
      "citation": "Petrova, A., Hegyi, T., & Mehta, R. (2007). Maternal race/ethnicity and one-month exclusive breastfeeding in association with the in-hospital feeding modality. Breastfeeding Medicine. 2(2):92-8."
    },
    {
      "type": "documentation",
      "citation": "Shealy, K.R., Li, R., Benton-Davis, S., & Grummer-Strawn, L.M. (2005).The CDC guide to breastfeeding interventions. Atlanta, GA: US Department of Health and Human Services, CDC. Available at: http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf."
    },
    {
      "type": "documentation",
      "citation": "Taveras, E.M., Li, R., Grummer-Strawn, L., Richardson, M., Marshall, R., Rego, V.H., Miroshnik, I., & Lieu, T.A. (2004). Opinions and practices of clinicians associated with continuation of exclusive breastfeeding. Pediatrics. 113(4):e283-90."
    },
    {
      "type": "documentation",
      "citation": "US Department of Health and Human Services. (2007). Healthy People 2010 Midcourse Review. Washington, DC: US Department of Health and Human Services. Available at: http://www.healthypeople.gov/2010/data/midcourse/?visit=1."
    },
    {
      "type": "documentation",
      "citation": "World Health Organization. (1991). Indicators for assessing breastfeeding practices. Geneva, Switzerland: World Health Organization. Available at: http://whqlibdoc.who.int/hq/1991/WHO_CDD_SER_91.14.pdf?ua=1."
    },
    {
      "type": "predecessor",
      "resource": "Measure/measure-predecessor-example"
    },
    {
      "type": "derived-from",
      "resource": "Measure/measure-predecessor-example"
    }
  ],
  "library": [
    "Library/library-exclusive-breastfeeding-cqm-logic"
  ],
  "disclaimer": "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.",
  "scoring": {
    "coding": [
      {
        "code": "proportion"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "code": "process"
        }
      ]
    }
  ],
  "rationale": "Exclusive breast milk feeding for the first 6 months of neonatal life has long been the expressed goal of World Health Organization (WHO), Department of Health and Human Services (DHHS), American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG). ACOG has recently reiterated its position (ACOG, 2007). A recent Cochrane review substantiates the benefits (Kramer et al., 2002). Much evidence has now focused on the prenatal and intrapartum period as critical for the success of exclusive (or any) BF (Centers for Disease Control and Prevention [CDC], 2007; Petrova et al., 2007; Shealy et al., 2005; Taveras et al., 2004). Exclusive breast milk feeding rate during birth hospital stay has been calculated by the California Department of Public Health for the last several years using newborn genetic disease testing data. Healthy People 2010 and the CDC have also been active in promoting this goal.",
  "clinicalRecommendationStatement": "Exclusive breast milk feeding for the first 6 months of neonatal life can result in numerous long-term health benefits for both mother and newborn and is recommended by a number of national and international organizations. Evidence suggests that the prenatal and intrapartum period is critical for the success of exclusive (or any) breast feeding. Therefore, it is recommended that newborns are fed breast milk only from birth to discharge.",
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase"
      }
    ]
  },
  "definition": [
    "Gestational age is calculated using the ACOG ReVITALize guidelines with Estimated Due Date (EDD) http://www.acog.org/about_acog/acog_departments/patient_safety_and_quality_improvement/~/media/departments/patient%20safety%20and%20quality%20improvement/201213issuesandrationale-gestationalageterm.pdf. The exam used needs to be the most recent exam associated with this pregnancy"
  ],
  "guidance": "A discharge to a designated cancer center or children's hospital should be captured as a discharge to an acute care facility. It is acceptable to calculate Gestational Age using the American College of Obstetricians and Gynecologists ReVITALize guidelines, which define Gestational Age as calculated using the best obstetrical Estimated Due Date (EDD) based on the formula: Gestational Age= (280-(EDD-Reference Date))/7 where Reference Date is the date on which you are trying to determine gestational age. For PC-05, Reference Date is the Birth Date. Note however that the calculation may yield a non-whole number and gestational age should be rounded off to the nearest completed week. For example, an infant born on the 5th day of the 36th week (35 weeks and 5/7 days) is at a gestational age of 35 weeks, not 36 weeks.",
  "group": [
    {
      "id": "PopulationGroup1",
      "population": [
        {
          "code": {
            "coding": [
              {
                "code": "initial-population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "InitialPopulation1"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "Denominator1"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "denominator-exclusions"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "DenominatorExclusions1"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "Numerator1"
          }
        }
      ]
    },
    {
      "id": "PopulationGroup2",
      "population": [
        {
          "code": {
            "coding": [
              {
                "code": "initial-population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "InitialPopulation2"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "Denominator2"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "denominator-exclusion"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "DenominatorExclusions2"
          }
        },
        {
          "code": {
            "coding": [
              {
                "code": "numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql",
            "expression": "Numerator2"
          }
        }
      ]
    }
  ]
}

Measure Structure

{
  "resourceType" : "Measure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this measure, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the measure
  "version" : "<string>", // Business version of the measure
  "name" : "<string>", // C? Name for this measure (computer friendly)
  "title" : "<string>", // Name for this measure (human friendly)
  "subtitle" : "<string>", // Subordinate title of the measure
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  // subject[x]: E.g. Patient, Practitioner, RelatedPerson, Organization, Location, Device. One of these 2:
  "subjectCodeableConcept" : { CodeableConcept },
  "subjectReference" : { Reference(Group) },
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the measure
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for measure (if applicable)
  "purpose" : "<markdown>", // Why this measure is defined
  "usage" : "<string>", // Describes the clinical usage of the measure
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "approvalDate" : "<date>", // When the measure was approved by publisher
  "lastReviewDate" : "<date>", // When the measure was last reviewed
  "effectivePeriod" : { Period }, // When the measure is expected to be used
  "topic" : [{ CodeableConcept }], // The category of the measure, such as Education, Treatment, Assessment, etc.
  "author" : [{ ContactDetail }], // Who authored the content
  "editor" : [{ ContactDetail }], // Who edited the content
  "reviewer" : [{ ContactDetail }], // Who reviewed the content
  "endorser" : [{ ContactDetail }], // Who endorsed the content
  "relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations, etc.
  "library" : [{ canonical(Library) }], // Logic used by the measure
  "disclaimer" : "<markdown>", // Disclaimer for use of the measure or its referenced content
  "scoring" : { CodeableConcept }, // proportion | ratio | continuous-variable | cohort
  "compositeScoring" : { CodeableConcept }, // opportunity | all-or-nothing | linear | weighted
  "type" : [{ CodeableConcept }], // process | outcome | structure | patient-reported-outcome | composite
  "riskAdjustment" : "<string>", // How risk adjustment is applied for this measure
  "rateAggregation" : "<string>", // How is rate aggregation performed for this measure
  "rationale" : "<markdown>", // Detailed description of why the measure exists
  "clinicalRecommendationStatement" : "<markdown>", // Summary of clinical guidelines
  "improvementNotation" : { CodeableConcept }, // increase | decrease
  "definition" : ["<markdown>"], // Defined terms used in the measure documentation
  "guidance" : "<markdown>", // Additional guidance for implementers
  "group" : [{ // Population criteria group
    "code" : { CodeableConcept }, // Meaning of the group
    "description" : "<string>", // Summary description
    "population" : [{ // Population criteria
      "code" : { CodeableConcept }, // initial-population | numerator | numerator-exclusion | denominator | denominator-exclusion | denominator-exception | measure-population | measure-population-exclusion | measure-observation
      "description" : "<string>", // The human readable description of this population criteria
      "criteria" : { Expression } // R!  The criteria that defines this population
    }],
    "stratifier" : [{ // Stratifier criteria for the measure
      "code" : { CodeableConcept }, // Meaning of the stratifier
      "description" : "<string>", // The human readable description of this stratifier
      "criteria" : { Expression }, // How the measure should be stratified
      "component" : [{ // Stratifier criteria component for the measure
        "code" : { CodeableConcept }, // Meaning of the stratifier component
        "description" : "<string>", // The human readable description of this stratifier component
        "criteria" : { Expression } // R!  Component of how the measure should be stratified
      }]
    }]
  }],
  "supplementalData" : [{ // What other data should be reported with the measure
    "code" : { CodeableConcept }, // Meaning of the supplemental data
    "usage" : [{ CodeableConcept }], // supplemental-data | risk-adjustment-factor
    "description" : "<string>", // The human readable description of this supplemental data
    "criteria" : { Expression } // R!  Expression describing additional data to be reported
  }]
}

Measure Search Parameters

The following search parameters can be used to query Measure resources. Just submit them like so:

https://api.1up.health/fhir/r4/Measure?query-param=queryvalue
Search ParameterField TypeResource Fields Searched
composed-ofreferencerelatedArtifact.where
contexttextuseContext.value
context-quantityquantityuseContext.value
context-typetextuseContext.code
context-type-quantitycompositeuseContext
context-type-valuecompositeuseContext
datedatedate
depends-onreferencerelatedArtifact.where
derived-fromreferencerelatedArtifact.where
descriptiontextdescription
effectivedateeffectivePeriod
identifiertextidentifier
jurisdictiontextjurisdiction
nametextname
predecessorreferencerelatedArtifact.where
publishertextpublisher
statustextstatus
successorreferencerelatedArtifact.where
titletexttitle
topictexttopic
urluriurl
versiontextversion