Measure - FHIR Resource (r4)
This Measure Resource uses the FHIR API standard for access and structure.
Validate an Measure FHIR Resource (r4)
Measure Attributes
AttributeField is listTypeDescription
Description: Canonical identifier for this measure, represented as a URI (globally unique)
FHIR Version: r4
Attribute Type : uri
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"url": Learn more about the (Measure) url FHIR attribute
Description: Additional identifier for the measure
FHIR Version: r4
Attribute Type : Identifier
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"identifier": [
{
"use": "official",
"value": "exclusive-breastfeeding-measure"
}
]Learn more about the (Measure) identifier FHIR attribute
Description: Business version of the measure
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"version": "4.0.1"Learn more about the (Measure) version FHIR attribute
Description: C? Name for this measure (computer friendly)
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"name": Learn more about the (Measure) name FHIR attribute
Description: Name for this measure (human friendly)
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"title": "Exclusive Breastfeeding Measure"Learn more about the (Measure) title FHIR attribute
Description: Subordinate title of the measure
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subtitle": Learn more about the (Measure) subtitle FHIR attribute
Description: draft | active | retired | unknown
FHIR Version: r4
Attribute Type : code
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"status": "active"Learn more about the (Measure) status FHIR attribute
Description: For testing purposes, not real usage
FHIR Version: r4
Attribute Type : boolean
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"experimental": Learn more about the (Measure) experimental FHIR attribute
Description:
FHIR Version: r4
Attribute Type : Reference
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"subject[x]": Learn more about the (Measure) subject[x] FHIR attribute
Description: Date last changed
FHIR Version: r4
Attribute Type : dateTime
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"date": "2015-03-08"Learn more about the (Measure) date FHIR attribute
Description: Name of the publisher (organization or individual)
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"publisher": Learn more about the (Measure) publisher FHIR attribute
Description: Contact details for the publisher
FHIR Version: r4
Attribute Type : ContactDetail
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"contact": Learn more about the (Measure) contact FHIR attribute
Description: Natural language description of the measure
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"description": "Exclusive breastfeeding measure of outcomes for exclusive breastmilk feeding of newborns."Learn more about the (Measure) description FHIR attribute
Description: The context that the content is intended to support
FHIR Version: r4
Attribute Type : UsageContext
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"useContext": Learn more about the (Measure) useContext FHIR attribute
Description: Intended jurisdiction for measure (if applicable)
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"jurisdiction": Learn more about the (Measure) jurisdiction FHIR attribute
Description: Why this measure is defined
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"purpose": "Measure of newborns who were fed breast milk only since birth"Learn more about the (Measure) purpose FHIR attribute
Description: Describes the clinical usage of the measure
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"usage": Learn more about the (Measure) usage FHIR attribute
Description: Use and/or publishing restrictions
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"copyright": Learn more about the (Measure) copyright FHIR attribute
Description: When the measure was approved by publisher
FHIR Version: r4
Attribute Type : date
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"approvalDate": Learn more about the (Measure) approvalDate FHIR attribute
Description: When the measure was last reviewed
FHIR Version: r4
Attribute Type : date
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"lastReviewDate": Learn more about the (Measure) lastReviewDate FHIR attribute
Description: When the measure is expected to be used
FHIR Version: r4
Attribute Type : Period
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"effectivePeriod": Learn more about the (Measure) effectivePeriod FHIR attribute
Description: The category of the measure, such as Education, Treatment, Assessment, etc.
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"topic": [
{
"text": "Exclusive Breastfeeding"
}
]Learn more about the (Measure) topic FHIR attribute
Description: Who authored the content
FHIR Version: r4
Attribute Type : ContactDetail
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"author": Learn more about the (Measure) author FHIR attribute
Description: Who edited the content
FHIR Version: r4
Attribute Type : ContactDetail
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"editor": Learn more about the (Measure) editor FHIR attribute
Description: Who reviewed the content
FHIR Version: r4
Attribute Type : ContactDetail
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"reviewer": Learn more about the (Measure) reviewer FHIR attribute
Description: Who endorsed the content
FHIR Version: r4
Attribute Type : ContactDetail
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"endorser": Learn more about the (Measure) endorser FHIR attribute
Description: Additional documentation, citations, etc.
FHIR Version: r4
Attribute Type : RelatedArtifact
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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"
}
]Learn more about the (Measure) relatedArtifact FHIR attribute
Description: Logic used by the measure
FHIR Version: r4
Attribute Type : canonical(Library)
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"library": [
"Library/library-exclusive-breastfeeding-cqm-logic"
]Learn more about the (Measure) library FHIR attribute
Description: Disclaimer for use of the measure or its referenced content
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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."Learn more about the (Measure) disclaimer FHIR attribute
Description: proportion | ratio | continuous-variable | cohort
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"scoring": {
"coding": [
{
"code": "proportion"
}
]
}Learn more about the (Measure) scoring FHIR attribute
Description: opportunity | all-or-nothing | linear | weighted
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"compositeScoring": Learn more about the (Measure) compositeScoring FHIR attribute
Description: process | outcome | structure | patient-reported-outcome | composite
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"type": [
{
"coding": [
{
"code": "process"
}
]
}
]Learn more about the (Measure) type FHIR attribute
Description: How risk adjustment is applied for this measure
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"riskAdjustment": Learn more about the (Measure) riskAdjustment FHIR attribute
Description: How is rate aggregation performed for this measure
FHIR Version: r4
Attribute Type : string
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"rateAggregation": Learn more about the (Measure) rateAggregation FHIR attribute
Description: Detailed description of why the measure exists
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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."Learn more about the (Measure) rationale FHIR attribute
Description: Summary of clinical guidelines
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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."Learn more about the (Measure) clinicalRecommendationStatement FHIR attribute
Description: increase | decrease
FHIR Version: r4
Attribute Type : CodeableConcept
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"improvementNotation": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code": "increase"
}
]
}Learn more about the (Measure) improvementNotation FHIR attribute
Description: Defined terms used in the measure documentation
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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"
]Learn more about the (Measure) definition FHIR attribute
Description: Additional guidance for implementers
FHIR Version: r4
Attribute Type : markdown
Required: N/A
Countability: Singleton
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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."Learn more about the (Measure) guidance FHIR attribute
Description: Population criteria group
FHIR Version: r4
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"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"
}
}
]
}
]Learn more about the (Measure) group FHIR attribute
Description: What other data should be reported with the measure
FHIR Version: r4
Attribute Type : Data Type
Required: N/A
Countability: Array
Flags: N/A
Terminology bindings: N/A
Requirements: N/A
Comments: N/A
Example:
"supplementalData": Learn more about the (Measure) supplementalData FHIR attribute
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 Parameter | Field Type | Resource Fields Searched |
|---|---|---|
composed-of | reference | relatedArtifact.where |
context | text | useContext.value |
context-quantity | quantity | useContext.value |
context-type | text | useContext.code |
context-type-quantity | composite | useContext |
context-type-value | composite | useContext |
date | date | date |
depends-on | reference | relatedArtifact.where |
derived-from | reference | relatedArtifact.where |
description | text | description |
effective | date | effectivePeriod |
identifier | text | identifier |
jurisdiction | text | jurisdiction |
name | text | name |
predecessor | reference | relatedArtifact.where |
publisher | text | publisher |
status | text | status |
successor | reference | relatedArtifact.where |
title | text | title |
topic | text | topic |
url | uri | url |
version | text | version |
