Quality Measures Glossary

• Telligen’s FHIR Quality Measures Engine performs quality measure processing at patient-level, practitioner-level, and population-level. The engine evaluates quality measure logic by Clinical quality language (CQL) evaluation. It also performs Data Exchange for Quality Measures (DEQM) Operations such as $submit-data paving the way for real-time API based data submissions. It comes with built-in FHIR-based clinical data repository, exposing a FHIR-compliant REST API.  

Measure Developer

• Measure developers, as directed by the measure steward, are responsible for the development, implementation, and maintenance of measures. Measure developers create, edit, and submit measures to a designated steward. CMS contracts with organizations to develop measure
• Measure developers submit measures to their assigned stewards for approval. It is also the responsibility of the measure developer to circulate their measure content for feedback and to collaborate on potential measure changes suggested by other authors or other entities.

Measure Steward

• CMS defines measure steward as an individual or organization that owns a measure and is responsible for maintaining the measure. Measure stewards may also be measure developers. Measure stewards are the ongoing point of contact for others interested in a given measure. CMS is the steward for most measures developed under contract for CMS. Stewards have permission to approve, reject, and publish measures their assigned measure developer creates and submits. Measure stewards provide overall coordination and management of the measures created by measure developers under a specific program or for a specific purpose. Stewards are responsible for approving measure content and may withdraw measures from approval.

Measure Authoring (vb)

• Primary Measure CQL (FHIR)
• Supplemental CQL libraries
• Test Cases

Measure Translation (vb)

• ELM translation
• Measure Library resource bundles (QMIG STU3)

• Knowledge Repository
• Terminology Server
• Clinical Data Repository
• Reporting System
• Receiving System

• Code Systems
• Codes
• Value sets

electronic Clinical Quality Measure

• a subset of dQMs
• use data specifically from EHRs

digital Quality Measures

• dQMs use data from an array of electronic sources—EHRs, claims data, registries, case management systems, health information exchanges, wearable devices, patient experience surveys, and more

Quality Data Model

• For use by measure developers creating measures using clinicl quality language (CQL)
• The audience includes all stakeholders responsible for translating and developing clinical quality measures into electronic specifications.
• Scope: The method for describing individual data elements within a measure that can be expressed using CQL to specify measure criteria

• Provides the ability to express logic that is human readable yet structured enough for electronically processing a query

• This implementation guide (IG) provides mapping from QDM datatypes and attributes to QI-Core profiles and elements

• This IG describes an approach to representing electronic Clinical Quality Measures (eCQMs) using the FHIR Clinical Reasoning Module and Clinical Quality Language (CQL) in the US Realm

Clinical Quality Information Workgroup

• The Measure Authoring Tool (MAT) is a web-based tool that allows measure developers to author eCQMs using either the Clinical Quality Language (CQL) and the Quality Data Model (QDM) or Fast Healthcare Interoperability Resources® (FHIR®). The MAT provides the capability to express complex measure logic and export measures in several formats.
• Using the tool, authors create Clinical Quality Language (CQL) expressions, which have the conceptual portion of the Quality Data Model (QDM) as their foundation.

• The Value Set Authority Center (VSAC) is provided by the U.S. National Library of Medicine in collaboration with the Office of the National Coordinator (ONC) (NLM) for Health Information Technology and CMS.
• The VSAC provides downloadable access to previously created value sets and is actively incorporating new value sets for other use cases, new measures, and for updating existing measures

• CMS

• The CMS CBE endorses quality measures through a transparent, consensus-based process that incorporates feedback from diverse groups of stakeholders to foster health care quality improvement. the CMS CBE endorses measures only if they pass measure evaluation criteria1: importance to measure and report, scientific acceptability of measure properties, feasibility, usability and use, and related and competing measures.
• To the extent feasible, CMS uses CMS CBE-endorsed measures in CMS public reporting and value-based purchasing programs. However, measure developers do not necessarily submit all measures to the CMS CBE for endorsement. CMS will consider non-endorsed measures if they meet necessary criteria.  

• Starting March 2023 – this private nonprofit applied science and technology development company will review CMS quality measures for endorsement.