Will add text to clarify improvementNotation in the base specification (measureReport - NEW Tracker) in DEQM in general to the effect that: A measure report instance includes the improvementNotation as defined by the measure being reported. It is duplicated in the measure report because it is a critical aspect of interpreting the measure score but it is not intended to reflect whether the measure report is an increase or decrease. It help interpret if the measure score is an increase or decrease, I.e., moving in the direction of the desired outcome.