Clinical Quality Framework

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Effort Co-Sponsors:

• Clinical Quality Information Work Group

Background

The Clinical Quality Framework is a joint effort by the Clinical Decision Support and Clinical Quality Information Work Groups to identify, develop, and harmonize standards that promote integration and reuse between Clinical Decision Support (CDS) and Clinical Quality Measurement (CQM).

The effort began as a public-private initiative sponsored by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator of Health IT (ONC) and has since transitioned to a joint effort within HL7 as the stewards of the specifications involved.

The effort focuses on two primary use cases:

1. Representation and distribution of knowledge artifacts (rules, order sets, documentation templates, measures, etc)
2. . Evaluation of knowledge

Representation

For the knowledge representation use case, artifacts such as rules, order sets, and quality measures are represented using three primary components:

1. Metadata - Structured information about the artifact such as description, usage, evidence, stewardship, and catalog information
2. Patient and Clinical Information - Data models used to represent patient and clinical information within the artifacts
   
   1. Health Quality Information Models Activities (Includes CMS Quality Data Model (QDM) mapping activities to QI Core)
3. Expression Logic - Formal representation of logic involved in the artifact such as rule conditions and quality measure population criteria

Evaluation

The CDS Hooks specification provides the basis for the evaluation use case. The CQF community participates in the CDS Hooks process in pursuit of decision support evaluation use cases.