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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
Measure/AlaraCTClinicalFHIRR4
Measure/AntidepressantMedicationManagementFHIRR4
Measure/AppropriateDXAScansForWomenUnder65FHIRR4
Measure/AppropriateTestingforPharyngitisFHIRR4
Measure/AppropriateTreatmentforUpperRespiratoryInfectionURIFHIRR4
Measure/BoneDensityProstateCancerAndrogenDeprivationTherapyFHIRR4
Measure/BreastCancerScreeningFHIRR4
Measure/CADBetaBlockerTherapyPriorMIorLVSDFHIRR4
Measure/CMS1017HHFIFHIRR4
Measure/CMS1028FHIRPCSevereOBCompsR4
Measure/CMS104FHIRSTKDCAntithromboticR4
Measure/CMS1074AlaraCTIQRFHIRR4
Measure/CMS108VTEProphylaxisFHIRR4
Measure/CMS1206ALARACTOQRFHIRR4
Measure/CMS1218HHRFFHIRR4
Measure/CMS1244ECCQHOQRFHIRR4
Measure/CMS1264ECCQREHQRFHIRR4
Measure/CMS190VTEProphylaxisICUFHIRR4
Measure/CMS334FHIRPCCesareanBirthR4
Measure/CMS506FHIRSafeUseofOpioidsR4
Measure/CMS71FHIRSTKAnticoagAFFlutterR4
Measure/CMS72FHIRSTKAntithromboticDay2R4
Measure/CMS816HHHypoFHIRR4
Measure/CMS819HHORAEFHIRR4
Measure/CMS826HHPIFHIRR4
Measure/CMS832HHAKIFHIRR4
Measure/CMS871HHHyperFHIRR4
Measure/CMS996FHIRAptTxforSTEMIR4
Measure/CMSFHIR529HybridHospitalWideReadmissionR4
Measure/CMSFHIR844HybridHospitalWideMortalityR4
Measure/CRLReceiptofSpecialistReportFHIRR4
Measure/Cataracts2040BCVAwithin90DaysFHIRR4
Measure/CervicalCancerScreeningFHIRR4
Measure/ChildandAdolescentMajorDepressiveDisorderMDDSuicideRiskAssessmentFHIRR4
Measure/ChildhoodImmunizationStatusFHIRR4
Measure/ChildrenWhoHaveDentalDecayOrCavitiesFHIRR4
Measure/ChlamydiaScreeninginWomenFHIRR4
Measure/ColonCancerScreeningFHIRR4
Measure/ControllingHighBloodPressureFHIRR4
Measure/DRCommunicationWithPhysicianManagingDiabetesFHIRR4
Measure/DementiaCognitiveAssessmentFHIRR4
Measure/DepressionRemissionatTwelveMonthsFHIRR4
Measure/DiabetesEyeExamFHIRR4
Measure/DiabetesGlycemicStatusAssessmentGreaterThan9PercentFHIRR4
Measure/DischargedonAntithromboticTherapyFHIRR4
Measure/DocumentationofCurrentMedicationsFHIRR4
Measure/FallsScreeningForFutureFallRiskFHIRR4
Measure/FollowUpCareforChildrenPrescribedADHDMedicationADDFHIRR4
Measure/FunctionalStatusAssessmentforTotalHipReplacementFHIRR4
Measure/FunctionalStatusAssessmentsforHeartFailureFHIRR4
Measure/HFACEIorARBorARNIforLVSDFHIRR4
Measure/HFBetaBlockerTherapyforLVSDFHIRR4
Measure/HIVIND11R4
Measure/HIVIND12R4
Measure/HIVIND13R4
Measure/HIVIND14R4
Measure/HIVIND15R4
Measure/HIVIND16R4
Measure/HIVIND18R4
Measure/HIVIND19R4
Measure/HIVIND2R4
Measure/HIVIND20R4
Measure/HIVIND21R4
Measure/HIVIND22R4
Measure/HIVIND24R4
Measure/HIVIND25R4
Measure/HIVIND27R4
Measure/HIVIND28R4
Measure/HIVIND29R4
Measure/HIVIND3R4
Measure/HIVIND30R4
Measure/HIVIND31R4
Measure/HIVIND32R4
Measure/HIVIND33R4
Measure/HIVIND34R4
Measure/HIVIND35R4
Measure/HIVIND37R4
Measure/HIVIND38R4
Measure/HIVIND39R4
Measure/HIVIND4R4
Measure/HIVIND40R4
Measure/HIVIND41R4
Measure/HIVIND42R4
Measure/HIVIND43R4
Measure/HIVIND44R4
Measure/HIVIND45R4
Measure/HIVIND46R4
Measure/HIVIND47R4
Measure/HIVIND48R4
Measure/HIVIND49R4
Measure/HIVIND5R4
Measure/HIVIND50R4
Measure/HIVIND51R4
Measure/HIVIND52R4
Measure/HIVIND53R4
Measure/HIVIND54R4
Measure/HIVIND55R4
Measure/HIVIND56R4
Measure/HIVIND57R4
Measure/HIVIND58R4
Measure/HIVIND59R4
Measure/HIVIND6R4
Measure/HIVIND60R4
Measure/HIVIND61R4
Measure/HIVIND62R4
Measure/HIVIND63R4
Measure/HIVIND64R4
Measure/HIVIND65R4
Measure/HIVIND66R4
Measure/HIVIND67R4
Measure/HIVIND68R4
Measure/HIVIND69R4
Measure/HIVIND7R4
Measure/HIVIND70R4
Measure/HIVIND71R4
Measure/HIVIND72R4
Measure/HIVIND73R4
Measure/HIVIND74R4
Measure/HIVIND75R4
Measure/HIVIND76R4
Measure/HIVIND77R4
Measure/HIVIND78R4
Measure/HIVIND79R4
Measure/HIVIND8R4
Measure/HIVIND80R4
Measure/HIVIND81R4
Measure/HIVIND82R4
Measure/HIVIND83R4
Measure/HIVIND84R4
Measure/HIVIND85R4
Measure/HIVIND86R4
Measure/HIVIND87R4
Measure/HIVIND88R4
Measure/HIVIND89R4
Measure/HIVIND9R4
Measure/HIVIND90R4
Measure/HIVIND91R4
Measure/HIVIND92R4
Measure/HIVIND93R4
Measure/HIVIND94R4
Measure/HIVIND95R4
Measure/HIVIND96R4
Measure/HIVRetentionFHIRR4
Measure/HIVSTITestingFHIRR4
Measure/HIVScreeningFHIRR4
Measure/HIVScreeningFHIRR4
Measure/HIVViralSuppressionFHIRR4
Measure/HospitalHarmHyperglycemiainHospitalizedPatientsFHIRR4
Measure/HybridHospitalWideMortalityFHIRR4
Measure/InitiationandEngagementofSubstanceUseDisorderTreatmentFHIRR4
Measure/IntravesicalBacillusCalmetteGuerinForBladderCancerFHIRR4
Measure/KidneyHealthEvaluationFHIRR4
Measure/MultiRateExample-FHIRR4
Measure/OncologyPainIntensityQuantifiedFHIRR4
Measure/PCSBMIScreenAndFollowUpFHIRR4
Measure/PCSBPScreeningFollowUpFHIRR4
Measure/PCSDepressionScreenAndFollowUpFHIRR4
Measure/POAGOpticNerveEvaluationFHIRR4
Measure/PreventiveCareAndTobaccoUseScreeningAndCessationInterventionFHIRR4
Measure/PrimaryCariesPreventionasOfferedbyDentistsFHIRR4
Measure/PrimaryCariesPreventionasOfferedbyDentistsFHIRR4
Measure/ProstateCaAvoidanceBoneScanOveruseFHIRR4
Measure/SevereObstetricComplicationsFHIRR4
Measure/StatinTherapyforthePreventionandTreatmentofCardiovascularDiseaseFHIRR4
Measure/UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIRR4
Measure/UseofHighRiskMedicationsintheElderlyFHIRR4
Measure/WeightAssessmentandCounselingforNutritionandPhysicalActivityforChildrenandAdolescentsFHIRR4

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"
        }
      }
    ]
  }
}