Add a section "Submit Data and Collect Data for Multiple Measures" to describe how the changes described below are used.

Update http://hl7.org/fhir/us/davinci-deqm/2023Jan/StructureDefinition-datax-measurereport-deqm.html to allow an extension (0..*) for MeasureReport.measure to identify the set of measures to be used . If the data exchange is for a single measure, this extension is not used and the measure is referenced; if the data exchange is for multiple measures, the measure reference is not used, and the extension is used (to satisfy the 1..1 for MeasureReport.measure).

Support multiple ways to identify the set of measures:
1. references to individual Measure resources
2. code which matches Measure.topic
3. reference to a CQFM Quality Program Library ( http://hl7.org/fhir/us/cqfmeasures/2023Jan/StructureDefinition-quality-program-cqfm.html )
4. Other?

Specify how the same data needed for multiple measures can be included exactly once in the data exchange (collect, submit, of bulk submit); specify which elements must match to be considered identical (e.g., resourceType and id). Identical data transferred multiple times in the exchange is permitted (but discouraged), and the receiving system can decide how to handle the duplicates.

Define one or more extensions to use within MeasureReport.measure as described above

Consider adding Measure/$deqm.data-requirements that supports multiple measures (i.e., URL: [base]/Measure/$data-requirements, without [id] required by the R4 operation).

Add or update CapabilityStatements as appropriate.