Use FHIR $evaluate-measure with a data-collection MeasureReport to decouple data submission from measure scoring in a distributed DEQM reporting workflow

In-depth guide

Steps

1. At the data source (e.g., EHR), POST /Measure/{id}/$collect-data to retrieve a data-collection MeasureReport and supporting clinical resources for each patient in the reporting period
2. POST /Measure/{id}/$submit-data to the aggregator (e.g., payer or HIE), submitting the data-collection MeasureReport and associated resources; the aggregator stores the data without scoring
3. At a later time, the aggregator invokes POST /Measure/{id}/$evaluate-measure using the stored data to calculate the final scored MeasureReport, with reportType=individual or population
4. The aggregator returns or stores the resulting evaluated MeasureReport; the data source can query /MeasureReport?measure={canonical}&subject={patient} to retrieve the final score
5. Implement data freshness checks by comparing the evaluatedResource lastUpdated timestamps in the scored MeasureReport against the submission date to detect stale data