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Publication Request

Publication Request

1. Published Name of the Standard for which request is being made

HL7 Version 3 Implementation Guide: Clinical Quality Language (CQL)-based Health Quality Measure Format (HQMF), Release 1 - STU 3 US Realm

2. Standards Material/Document

STU Extension

3. Date of Request

Jul 10, 2020

4. Use Period

5. Reason for extension, timeline, and actions

This version of CQL-based HQMF is used for electronic clinical quality measures (eCQMs) being implemented for reporting in calendar year 2020. Implementers may need to refer to this version which uses CMS Quality Data Model version 5.4 through early summer 2021.

6. Original Publication Date

Aug 03, 2018

7. End date of the current STU period

Aug 03, 2020

8. Length of the requested extension

one year

9. Review Process

10. HL7 Work Group making this request and date

CQI WG - July 10, 2020

10a. Requesting WG Date

Jul 10, 2020

11. URL of approval minutes

12. HL7 Product Management Group

This is a V3 implementation guide, not CDA or FHIR or V2.

12a. Management Group Date of Approval

13. URL of approval minutes

14. Is the artifact ready for final publication?


15. If not ready, please describe remaining steps.

Extension only - no change

16. Tool name used to produce the machine processable artifacts in the IG


17. The name of the “IG artifact” within the context of the above mentioned tool.


18. Balloted Name of the standard for which request is being made

19. Requested name for published standard

20. If CMET, list IDs balloted


21. Project Insight Number


22. Document Realm

US Realm

23. Ballot cycle in which the document was successfully balloted

May 2019

24. Results of that ballot (following reconciliation activities):

24. Results of that ballot (following reconciliation activities):

(not needed for errata, STU extension, or unballoted STU update)

25. Affirmative

26. Negative

27. Abstentions

28. Not Returned

29. Total in ballot pool

30. Date on which final document/standards material was supplied to HQ

31. URL of publication material/ SVN repository

32. Publishing Facilitator

Bryn Rhodes

33. Special Publication Instructions

34. URL of ballot reconciliation document

35. Has the Work Group posted its consideration of all comments received in its reconciliation document on the ballot desktop?

36. Substantive Changes Since Last Ballot?

37. Product Brief Reviewed By

CQI Workgroup

38. Date Product Brief Reviewed

Jul 10, 2020

39. Has the Product Brief changed?


Product Brief

Product Brief

40. Family


41. Section

Implementation Guides

42. Topic

Clinical Quality

43. Please Describe the Topic

44. Product Type

Implementation Guide

45. Parent standard

HL7 v3, reference to CQL

46. Parent Standard Status


47. Update/replace standard

Extension request only

48. Common name/search keyword

49. Description



These are categories of potential users, implementers, or other interested parties such as those that are indicated on the Project Scope Statement under “Stakeholders/Vendors/Providers”. Select those that are applicable, or suggest others:

50. Stakeholders

Quality Reporting Agencies, Regulatory Agency

51. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, HIS

52. Providers

Clinical and Public Health Laboratories Local and State Departments of Health Healthcare Institutions (hospitals, long term care, home care, mental health)

53. Benefits

Retains the Quality Data Model (QDM) for the expression of eCQM data requirements. This data model is familiar to measure developers and has been widely implemented for quality reporting by the Centers for Medicare and Medicaid Services (CMS) in the US.
STU 3 includes a 3rd volume that includes templates for each of the QDM concepts that have been constrained specifically for use with CQL.
Replaces the logic portion of the QDM with CQL. The logic expression capabilities of QDM are limited and, as a result, some measures have provided supplemental information in the form of narrative guidance to completely specify the desired calculation. The more powerful and expressive CQL enables the expression of more complex logic than was previously possible using the previous QDM logic alone

54. Implementations/Case Studies

Implemented in Measure Authoring Tool and Bonnie
Used for the published eCQMs that are on the eCQI Resource Center
Piloted as part of the Clinical Quality Framework S&I Initiative, for details see:
Tested with measure developers and implementers from September 2016 and ongoing to identify best practices and appropriate content.

55. Development Background

The STU 4 includes balloted changes that guide how to implement CQL within the HQMF structure, including a new Terminology section and vocabulary management. Changes include the use of direct referenced codes rather than require value sets for all data elements. Volume 3 also provides updated HL7 V3 templates to address each QDM version 5.5 concept as specifically designed for use with CQL. The CQI WG reviewed all ballot content as well as all reconciliation to ensure all those who use the CQL-based HQMF STU standard have the most current information. The new STU 3 version also provides greater specificity about how to manage composite measures.