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FHIR IG Statistics: StructureDefinition/cqfm-improvementNotation

Packagehl7.fhir.us.cqfmeasures
Resource TypeStructureDefinition
Idcqfm-improvementNotation
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/cqfmeasures/http://hl7.org/fhir/us/cqfmeasures/STU5/StructureDefinition-cqfm-improvementNotation.html
URLhttp://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation
Version4.0.0
Statusactive
Date2024-11-04T20:11:26+00:00
NameCQFMImprovementNotation
TitleCQFM Improvement Notation
Realmus
Authorityhl7
DescriptionInformation on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range). **Additional Guidance: improvementNotation** `Reference range` with definition of score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality to the improvement notation value set. Please provide comments on this additional code and if there are other codes needed in this value set. Please provide comments on this additional code and if there are other codes needed in the improvement notation value set. If an additional code is added to the improvement notation (like normative reference range as suggested), where is guidance about the reference range best included in the specification for implementer use? Some suggestions include: the guidance field, the rate aggregation field or adding an extension to improvementNotation to add text.
Purpose**Purpose** Measure consumers and implementers must be able to determine how to interpret a measure score.
TypeExtension
Kindcomplex-type

Resources that use this resource

StructureDefinition
computable-measure-cqfmCQFM Computable Measure
publishable-measure-cqfmCQFM Publishable Measure

Resources that this resource uses

ValueSet
measure-improvement-notationMeasureImprovementNotation

Examples of Use for Extension

ResourceVersion
example.fhir.uv.mycontentig#current:Measure/HRExampleCVMeasureR4
example.fhir.uv.mycontentig#current:Measure/HRExampleCohortMeasureR4
example.fhir.uv.mycontentig#current:Measure/HRExampleProportionMeasureR4
example.fhir.uv.mycontentig#current:Measure/HRExampleRatioMeasureR4
gov.healthit.ecqi.ecqms#current:Measure/CMS0334FHIRPCCesareanBirthR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1017FHIRHHFIR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1028FHIRPCSevereOBCompsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS104FHIRSTKDCAntithromboticR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1056CTClinicalFHIRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1074FHIRCTIQRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS108FHIRVTEProphylaxisR4
gov.healthit.ecqi.ecqms#current:Measure/CMS117FHIRChildhoodImmunizationStatusR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1206FHIRCTOQRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1218FHIRHHRFR4
gov.healthit.ecqi.ecqms#current:Measure/CMS122FHIRDiabetesAssessGreaterThan9PercentR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1244FHIRECATHOQRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS124FHIRCervicalCancerScreeningR4
gov.healthit.ecqi.ecqms#current:Measure/CMS125FHIRBreastCancerScreeningR4
gov.healthit.ecqi.ecqms#current:Measure/CMS1264FHIRECATREHQRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS128FHIRAntidepressantMedManagementR4
gov.healthit.ecqi.ecqms#current:Measure/CMS130FHIRColorectalCancerScreeningR4
gov.healthit.ecqi.ecqms#current:Measure/CMS133FHIRCataracts2040BCVAwithin90DaysR4
gov.healthit.ecqi.ecqms#current:Measure/CMS135FHIRHFACEIorARBorARNIforLVSDR4
gov.healthit.ecqi.ecqms#current:Measure/CMS142FHIRDRCommunicationWithPhysicianManagingDiabetesR4
gov.healthit.ecqi.ecqms#current:Measure/CMS143FHIRPOAGOpticNerveEvaluationR4
gov.healthit.ecqi.ecqms#current:Measure/CMS144FHIRHFBetaBlockerTherapyforLVSDR4
gov.healthit.ecqi.ecqms#current:Measure/CMS145FHIRCADBetaBlockerTherapyPriorMIorLVSDR4
gov.healthit.ecqi.ecqms#current:Measure/CMS146FHIRAppropriateTestingforPharyngitisR4
gov.healthit.ecqi.ecqms#current:Measure/CMS149FHIRDementiaCognitiveAssessmentR4
gov.healthit.ecqi.ecqms#current:Measure/CMS155FHIRWeightAssessandCounselforKidsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS159FHIRDepressionRemissionatTwelveMonthsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS165FHIRControllingHighBloodPressureR4
gov.healthit.ecqi.ecqms#current:Measure/CMS190VTEProphylaxisICUFHIRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS22FHIRPCSBPScreeningFollowUpR4
gov.healthit.ecqi.ecqms#current:Measure/CMS2FHIRPCSDepressionScreenAndFollowUpR4
gov.healthit.ecqi.ecqms#current:Measure/CMS349FHIRHIVScreeningR4
gov.healthit.ecqi.ecqms#current:Measure/CMS506FHIRSafeUseofOpioidsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS50FHIRCRLReceiptofSpecialistReportR4
gov.healthit.ecqi.ecqms#current:Measure/CMS56FHIRFunctionalStatusAssessmentforTotalHipReplacementR4
gov.healthit.ecqi.ecqms#current:Measure/CMS645FHIRBoneDensityProstateCancerAndrogenDeprivationTherapyR4
gov.healthit.ecqi.ecqms#current:Measure/CMS646FHIRIntravesicalBacillusCalmetteGuerinForBladderCancerR4
gov.healthit.ecqi.ecqms#current:Measure/CMS68FHIRDocumentationofCurrentMedicationsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS69FHIRPCSBMIScreenAndFollowUpR4
gov.healthit.ecqi.ecqms#current:Measure/CMS71FHIRSTKAnticoagAFFlutterR4
gov.healthit.ecqi.ecqms#current:Measure/CMS72FHIRSTKAntithromboticDay2R4
gov.healthit.ecqi.ecqms#current:Measure/CMS74FHIRPrimaryCariesPreventionasOfferedbyDentistsR4
gov.healthit.ecqi.ecqms#current:Measure/CMS75FHIRChildrenWhoHaveDentalDecayOrCavitiesR4
gov.healthit.ecqi.ecqms#current:Measure/CMS771FHIRUrinarySymptomScoreChangeBenignProstaticHyperplasiaR4
gov.healthit.ecqi.ecqms#current:Measure/CMS816FHIRHHHypoR4
gov.healthit.ecqi.ecqms#current:Measure/CMS819FHIRHHORAER4
gov.healthit.ecqi.ecqms#current:Measure/CMS826FHIRHHPIR4
gov.healthit.ecqi.ecqms#current:Measure/CMS832HHAKIFHIRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS871HHHyperFHIRR4
gov.healthit.ecqi.ecqms#current:Measure/CMS986FHIRMalnutritionScoreR4
gov.healthit.ecqi.ecqms#current:Measure/CMS996FHIRAptTxforSTEMIR4
gov.healthit.ecqi.ecqms#current:Measure/CMSFHIR844HybridHospitalWideMortalityR4
gov.healthit.ecqi.ecqms#current:Measure/OncologyPainIntensityQuantifiedFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/DischargedonAntithromboticTherapyFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/HIVScreeningFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/HospitalHarmHyperglycemiainHospitalizedPatientsFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/HybridHospitalWideMortalityFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/PrimaryCariesPreventionasOfferedbyDentistsFHIRR4
gov.healthit.ecqi.ecqms.subset#current:Measure/SevereObstetricComplicationsFHIRR4
hl7.fhir.us.cqfmeasures#5.0.0:Measure/MultiRateExample-FHIRR4
smart.who.int.hiv#current:Measure/HIVIND11R4
smart.who.int.hiv#current:Measure/HIVIND12R4
smart.who.int.hiv#current:Measure/HIVIND13R4
smart.who.int.hiv#current:Measure/HIVIND14R4
smart.who.int.hiv#current:Measure/HIVIND15R4
smart.who.int.hiv#current:Measure/HIVIND16R4
smart.who.int.hiv#current:Measure/HIVIND18R4
smart.who.int.hiv#current:Measure/HIVIND19R4
smart.who.int.hiv#current:Measure/HIVIND2R4
smart.who.int.hiv#current:Measure/HIVIND20R4
smart.who.int.hiv#current:Measure/HIVIND21R4
smart.who.int.hiv#current:Measure/HIVIND22R4
smart.who.int.hiv#current:Measure/HIVIND24R4
smart.who.int.hiv#current:Measure/HIVIND25R4
smart.who.int.hiv#current:Measure/HIVIND27R4
smart.who.int.hiv#current:Measure/HIVIND28R4
smart.who.int.hiv#current:Measure/HIVIND29R4
smart.who.int.hiv#current:Measure/HIVIND3R4
smart.who.int.hiv#current:Measure/HIVIND30R4
smart.who.int.hiv#current:Measure/HIVIND31R4
smart.who.int.hiv#current:Measure/HIVIND32R4
smart.who.int.hiv#current:Measure/HIVIND33R4
smart.who.int.hiv#current:Measure/HIVIND34R4
smart.who.int.hiv#current:Measure/HIVIND35R4
smart.who.int.hiv#current:Measure/HIVIND37R4
smart.who.int.hiv#current:Measure/HIVIND38R4
smart.who.int.hiv#current:Measure/HIVIND39R4
smart.who.int.hiv#current:Measure/HIVIND4R4
smart.who.int.hiv#current:Measure/HIVIND40R4
smart.who.int.hiv#current:Measure/HIVIND41R4
smart.who.int.hiv#current:Measure/HIVIND42R4
smart.who.int.hiv#current:Measure/HIVIND43R4
smart.who.int.hiv#current:Measure/HIVIND44R4
smart.who.int.hiv#current:Measure/HIVIND45R4
smart.who.int.hiv#current:Measure/HIVIND46R4
smart.who.int.hiv#current:Measure/HIVIND47R4
smart.who.int.hiv#current:Measure/HIVIND48R4
smart.who.int.hiv#current:Measure/HIVIND49R4
smart.who.int.hiv#current:Measure/HIVIND5R4
smart.who.int.hiv#current:Measure/HIVIND50R4
smart.who.int.hiv#current:Measure/HIVIND51R4
smart.who.int.hiv#current:Measure/HIVIND52R4
smart.who.int.hiv#current:Measure/HIVIND53R4
smart.who.int.hiv#current:Measure/HIVIND54R4
smart.who.int.hiv#current:Measure/HIVIND55R4
smart.who.int.hiv#current:Measure/HIVIND56R4
smart.who.int.hiv#current:Measure/HIVIND57R4
smart.who.int.hiv#current:Measure/HIVIND58R4
smart.who.int.hiv#current:Measure/HIVIND59R4
smart.who.int.hiv#current:Measure/HIVIND6R4
smart.who.int.hiv#current:Measure/HIVIND60R4
smart.who.int.hiv#current:Measure/HIVIND61R4
smart.who.int.hiv#current:Measure/HIVIND62R4
smart.who.int.hiv#current:Measure/HIVIND63R4
smart.who.int.hiv#current:Measure/HIVIND64R4
smart.who.int.hiv#current:Measure/HIVIND65R4
smart.who.int.hiv#current:Measure/HIVIND66R4
smart.who.int.hiv#current:Measure/HIVIND67R4
smart.who.int.hiv#current:Measure/HIVIND68R4
smart.who.int.hiv#current:Measure/HIVIND69R4
smart.who.int.hiv#current:Measure/HIVIND7R4
smart.who.int.hiv#current:Measure/HIVIND70R4
smart.who.int.hiv#current:Measure/HIVIND71R4
smart.who.int.hiv#current:Measure/HIVIND72R4
smart.who.int.hiv#current:Measure/HIVIND73R4
smart.who.int.hiv#current:Measure/HIVIND74R4
smart.who.int.hiv#current:Measure/HIVIND75R4
smart.who.int.hiv#current:Measure/HIVIND76R4
smart.who.int.hiv#current:Measure/HIVIND77R4
smart.who.int.hiv#current:Measure/HIVIND78R4
smart.who.int.hiv#current:Measure/HIVIND79R4
smart.who.int.hiv#current:Measure/HIVIND8R4
smart.who.int.hiv#current:Measure/HIVIND80R4
smart.who.int.hiv#current:Measure/HIVIND81R4
smart.who.int.hiv#current:Measure/HIVIND82R4
smart.who.int.hiv#current:Measure/HIVIND83R4
smart.who.int.hiv#current:Measure/HIVIND84R4
smart.who.int.hiv#current:Measure/HIVIND85R4
smart.who.int.hiv#current:Measure/HIVIND86R4
smart.who.int.hiv#current:Measure/HIVIND87R4
smart.who.int.hiv#current:Measure/HIVIND88R4
smart.who.int.hiv#current:Measure/HIVIND89R4
smart.who.int.hiv#current:Measure/HIVIND9R4
smart.who.int.hiv#current:Measure/HIVIND90R4
smart.who.int.hiv#current:Measure/HIVIND91R4
smart.who.int.hiv#current:Measure/HIVIND92R4
smart.who.int.hiv#current:Measure/HIVIND93R4
smart.who.int.hiv#current:Measure/HIVIND94R4
smart.who.int.hiv#current:Measure/HIVIND95R4
smart.who.int.hiv#current:Measure/HIVIND96R4

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: StructureDefinition cqfm-improvementNotation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..1Extensionincrease | decrease
... url 1..1uri"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"
... value[x] 0..1CodeableConceptValue of extension
Binding: MeasureImprovementNotation (required): Indicates how to interpret the calculated score of the measure


doco Documentation for this format

Source

{
  "resourceType": "StructureDefinition",
  "id": "cqfm-improvementNotation",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cqi"
    }
  ],
  "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
  "version": "4.0.0",
  "name": "CQFMImprovementNotation",
  "title": "CQFM Improvement Notation",
  "status": "active",
  "experimental": false,
  "date": "2024-11-04T20:11:26+00:00",
  "publisher": "HL7 International / Clinical Quality Information",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/cqi"
        }
      ]
    }
  ],
  "description": "Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).\n\n**Additional Guidance: improvementNotation**\n\n`Reference range` with definition of score within a defined interval (or a “passing score” over or under a certain threshold) indicates better quality to the improvement notation value set. Please provide comments on this additional code and if there are other codes needed in this value set.\n\nPlease provide comments on this additional code and if there are other codes needed in the improvement notation value set.\n\nIf an additional code is added to the improvement notation (like normative reference range as suggested), where is guidance about the reference range best included in the specification for implementer use?  Some suggestions include: the guidance field, the rate aggregation field or adding an extension to improvementNotation to add text.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "purpose": "**Purpose**\n\nMeasure consumers and implementers must be able to determine how to interpret a measure score.",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "complex-type",
  "abstract": false,
  "context": [
    {
      "type": "element",
      "expression": "Measure.group"
    }
  ],
  "type": "Extension",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation": "constraint",
  "snapshot": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "increase | decrease",
        "definition": "Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "condition": [
          "ele-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false
      },
      {
        "id": "Extension.id",
        "path": "Extension.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "definition": "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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "representation": [
          "xmlAttr"
        ],
        "short": "identifies the meaning of the extension",
        "definition": "Source of the definition for the extension code - a logical name or a URL.",
        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "uri"
          }
        ],
        "fixedUri": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Value of extension",
        "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "binding": {
          "strength": "required",
          "description": "Indicates how to interpret the calculated score of the measure",
          "valueSet": "http://terminology.hl7.org/ValueSet/measure-improvement-notation"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "increase | decrease",
        "definition": "Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "type": [
          {
            "code": "uri"
          }
        ],
        "fixedUri": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation"
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "Indicates how to interpret the calculated score of the measure",
          "valueSet": "http://terminology.hl7.org/ValueSet/measure-improvement-notation"
        }
      }
    ]
  }
}