Quality Measure FHIR IG Proposal

FHIR Quality Measure Implementation Guide

Owning work group name

Clinical Quality Information

Committee Approval Date:

2019-02-08

Contributing or Reviewing Work Groups

Clinical Decision Support

FHIR Development Project Insight ID

PIID 1499

Scope of coverage

The scope of the Implementation Guide is the specification of clinical quality measures, including patient-based and non-patient-based, process measures, outcome measures, structure measures, and composite measures. The scope does not include the creation of profiles for the representation of data involved in the measures.

The scope is intended to be universal (i.e. nothing in the IG should restrict its usage to the U.S. Realm).

IG Purpose

This implementation guide will provide additional profiles and guidance to enable the use of FHIR to specify quality measures utilizing the core functionality provided by the FHIR base specification as well as any extensions needed. These profiles will involve extensions and/or constraints specific to the various types of measures, and where appropriate, will provide feedback to the core Measure resource.

Content location

This work will build on functionality that was started as part of connectathon testing and preparation, so there is already an established repository as part of the Clinical Quality Framework initiative github organization:

https://github.com/cqframework/cqf-measures

Proposed IG realm and code

Realm: US Code: ECQM

NOTE: The IG is not intended to be US Realm specific, but we recognize that without international participation we cannot claim Universal realm. We are actively seeking international participation for this reason.

Maintenance Plan

There are many stakeholders with a need for the ability to represent measure specifications in the FHIR space including payers, quality reporting vendors and agencies, and quality assurance organizations. Many of these organizations are active members of the Clinical Quality Information Work Group, and so the Work Group is committed to producing and maintaining this guidance.

Short Description

Provides profiles and guidance for the representation of clinical quality measures in FHIR and Clincal Quality Language (CQL).

Long Description

This Implementation Guide defines an approach to using the FHIR Measure resource and Clinical Quality Language (CQL) to define and share clinical quality measure specifications. The IG defines profiles for proportion, ratio, continuous variable, and composite measures, and provides guidance and conformance requirements regarding the use of Clinical Quality Language to reliably express and evaluate the measures.

Involved parties

NCQA Medisolv MITRE TJC Mathematica ESAC

Expected implementations

NCQA Medisolve MITRE

Content sources

Health Quality Measures Format CQL-Based HQMF Implementation Guide

Example Scenarios

Full set of examples from the CQL-Based HQMF Implementation Guide Example content from previous connectathons, including CMS130, 124, and 127 Other potential examples illustrating the sharing of content between decision support and quality measurement

IG Relationships

Not a specific dependency, but Data Exchange for Quality Measures will make use of measures authored according to the guidance developed in this IG. It's not clear at this time whether there is a need for an explicit dependency (DEQM has already been using measure content developed without this IG in place).

Timelines

Given that most of the content already exists, we plan to have the content feature complete by 2/17, and ready for review/approval by CQI on 3/10.

When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org