Short Description

This track will test the sharing of FHIR MeasureReport resource instances between a submitter (e.g. healthcare provider/EHR) and a recipient (e.g. PHA/STLT) to identify priority situational awareness indicators (e.g., bed counts, staffing levels, availability of supplies, and other aggregate measures). Not required: the data needed, including sources), to calculate prioritized indicators

Long Description

Track Goals:

Provide mission-critical situational awareness information to public health during pandemics, natural disasters, and other preparedness events.

Test standardized and scalable ways of providing high-quality, timely, and on-demand summary data (e.g., bed count, supply inventory, and other sentinel indicator measures) in ways that lessen the strain on both healthcare and public health.

Support both emergency response and ongoing monitoring needs (e.g., chronic disease indicators for community health assessments, small area analyses, etc.).

Assess existing DEQM and/or SANER IGs for scalable approaches that can help calculate the prioritized indicators.

Identify possible additions to USCDI+ (plus).


Test an implementation guide or guides

Related Tracks?

Other Helios Track: 2023 - 01 Helios Accelerator Bulk Data Track

Call for participants

State Tribal Local Territorial (STLT) 

Healthcare Electronic Health Record (EHR) Technology Partners

Track Prerequisites

The data submitter will generate a FHIR MeasureReport Resource and data ideally via native FHIR or via CSV to FHIR conversion

Track Lead(s)

Forrest White

Track Lead Email(s)


Specification Information



US Core 3.1.1 or 4.0.0

QI Core

Measure FHIR IG


CQF Ruler

Clinical Reasoning Framework

Zulip stream



Track Kick off Call

Track Participants

System Roles

Data Submitter: Healthcare provider (one or more EHR vendor & tech partner) organization that possesses desired measure data in their system(s) with the ability to generate a FHIR MeasureReport resource and data AND make it available to QUERY via native FHIR API OR PUSH to an authorized Public Health Authority (PHA/STLT)

Data Recipient: PHA (one or more STLT) with the ability to query and/or receive FHIR MeasureReport resources and data

System Roles

Data Source

The Data Source interacts with the Measure Computer and provides data for it to compute from.

The Data Source can be an HIT/EHR supporting FHIR DSTU2 or R4,


  • Have a sandbox environment containing ONLY test patient data that can be accessed by applications.
  • Support the Argonaut Data Query 1.0.0  (DSTU2) or FHIR US Core Release 3.1.1 or 4.0.0 or 5.0 (R4) Implementation Guide.
  • Load realistic sample data into your system to support the Measure computation for measures used during the Scenarios for this Connectathon (see SANER - Test Data Sets for types of data of interest to include in your sandbox).

Measure Source

The Measure Source reports results for a single facility, results for a collection of facilities, or aggregated data for a region.


  • Be able to produce a MeasureReport resource for one or more PHA measures (e.g. HHS Protect, jurisdiction specific).
  • Load realistic sample data into your system to populate the MeasureReport.
    • These data should be sufficiently distinctive that you can recognize them in a MeasureReport or in someone else's system.  
  • If you're doing the push scenario, have a client that can do a MeasureReport create.

Measure Consumer

The Measure Consumer provides access to aggregated or line-level data gathered from one or more Measure Sources.


  • Be able to ingest a MeasureReport resource for the PHA Measure and store it in your system. 
  • If you're doing the push scenario, have a server that can accept a MeasureReport create.
  • If you're doing the pull scenario, have a client that can initiate a MeasureReport search.

Measure Computer

The Measure Computer is a Measure Source that can evaluate a Computable Measure against a FHIR Server


  • Be able to retrieve a Measure from a Measure Definition Source
  • Be able to parse a Measure and compute against multiple Data Sources (see above)
  • Be able to send a MeasureReport to a MeasureReport Consumer

Measure Definition Source

Measure Definition Source providing (create/update) Measure resources to a Measure Definition Consumer.

Measure Definition Consumer

Measure Definition Consumer accepting new/updated Measure resources to act upon.


  • Be able to read a Measure definition
  • Be able to connect to a FHIR Server containing test patient data
  • Compute the measure from the data in the FHIR Server and report it acting as a Measure Source (see above)

Testing Scenario:


Identify appropriate resources for measurements

Step 1: Identify appropriate resources  for Measure


  • External Source Identifies appropriate resources  to use for Measurement

Precondition: Success Criteria: 

  • See other Scenarios in Public Health Track

Success Criteria:  

  • Data Source has appropriate resources that will identify appropriate resources  of interest that can be retrieved when queried.

Bonus point:


Step 2: Retrieve Measure

Action: Measure Computer (acting through Measure Definition Consumer) requests updated Measure from Measure Definition Source

Precondition: Success Criteria: 

  • An existing or updated Measure is available on the Measure Definition Source

Success Criteria:  

  • The existing Measure has been retrieved by the Measure Computer
  • The Measure can be parsed by the Measure Computer

Bonus point:


Step 3: Compute Measure

Action: Measure Computer requests data from Data Source(s)

Precondition: Success Criteria: 

  • Data Sources have data to request

Success Criteria:  

  • Data is transferred to the Measure Computer
  • The Measure Computer can compute a MeasureReport

Bonus point:


Step 4: Send Measure

Action: Measure Computer (acting through Measure Source) sends data to Measure Consumer

Precondition: Success Criteria: 

  • A MeasureReport Resource has been created

Success Criteria:  

  • MeasureReport is communicated to Measure Consumer
  • MeasureReport contains the Report and the line-level data as requested for computing it

Bonus point:


Automated Measure Computation and Reporting

Action: A provider organization application executes the following actions in appropriate roles in the scenario. 

  1. Application in the role of Measure Definition Consumer retrieves (PULL) a Computable Measure (definition) from a Measure Definition Source
  2. Application in the role of Measure Computer uses the Computable Measure to compute against a FHIR Server
  3. Application in the role of Measure Source creates a MeasureReport based on the Computable Measure, and sends (PUSH) the MeasureReport to Measure Consumer

A public health organization application acts as both a Measure Definition Source and a Measure Consumer

  1. Measure Definition Source supports queries for a Computable Measure
  2. Measure Consumer accepts MeasureReport based on a Computable Measure


  • Measure Definition Source prepopulated with a Computable Measure
  • FHIR Server prepopulated with test data for computing measures

Success Criteria:

  • MeasureReport pushed to the Measure Consumer
  • Computed measurements match known results for the Computable Measure applied to the provided test data

Bonus point:

  • Provide evidence of FHIR Path/CQL calculations

For example, identify the FHIR Patient resources in the MeasureReport that were used to calculate the data.


Security and Privacy Considerations:

TLS and non-TLS endpoints should both be available for testing.

FHIR Servers and Tools

Washington Department of Health / University of Washington -  FHIR Server


Oracle Cerner - FHIR Sandbox - will require registration by January 6, 2023 



Audacious Inquiry - FHIR Server


This query: http://test.sanerproject.org/fhir/MeasureReport/_history?_since=2023-01-14T00:00:00&_pretty=true will get you the measure reports submitted 1-14-2023 or after.



ICF - CQF Ruler FHIR Server


Altarum - SANER FHIR Server


Data Flow Diagrams

Click Image to view 3 slides (scroll down in viewer)

Helios Aggregate Data Track Schedule

Saturday January 14, 2023 and 

Sunday January 15, 2023

Schedule - Will be updated week of January 9, 2023