The Standard

The Official Blog of Health Level Seven® International


The Use of HL7 FHIR and CQL By Measure Developers

[fa icon="calendar'] Dec 11, 2019 12:38:04 PM / by Jamie Lehner, MBA, CAPM posted in FHIR, interoperability, CMS, Clinical Quality Language, Quality Data Model, Data Exchange for Qualitiy Measures, QI Core, clinical decision support, Value Set Authority Center, Measure Authoring Tool

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Since the fall of 2017, electronic Clinical Quality Measures (eCQMs) logic has been written using Clinical Quality Language (CQL). With the introduction of CQL, the eCQMs included in the CMS federal programs had to be translated from Quality Data Model (QDM)-based expression logic to CQL.

Though CQL provides more flexibility in expressing measure criteria within the logic that allows measure developers to include greater specificity and precision within the measure requirements, this did not result in a direct translation process, as new attributes and timings were made available. What this means is that clinical workflow and input are perhaps more important because CQL is able to convey these nuances, whereas the QDM-based logic expressions were limited. CQL can also be used to develop Clinical Decision Support (CDS) rules and can reuse logic from measures in those CDS rules.

When composing measures using the CQL syntax, the QDM is still used in conjunction with CQL as the means to characterize required data elements within the measure logic. This conceptual model defines what type of clinical data is needed to satisfy the measure requirements. Therefore, the QDM is still very much a part of electronically specified measures, which is incorporated into the logic definitions written using CQL.

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