Fast Healthcare Interoperability Resources® (FHIR®) Tooling and Resources
- Electronic Clinical Quality Measure (eCQM) Related Tools for Use and Evaluation
- CQL-to-ELM Translator: A specification for producing an Expression Logical Model (ELM) file format from Clinical Quality Language (CQL).
- Clinical Quality Framework (CQF) Ruler: An implementation of FHIR®'s Clinical Reasoning Module for processing quality measures and serves as a knowledge artifact repository and clinical decision support service.
- CQL Evaluation Engine: An open-source Java-based evaluation engine capable of evaluating the result of any CQL expression. This tool is now part of the CQL repository.
- CQL Execution Framework: A set of TypeScript/JavaScript libraries that can execute CQL artifacts expressed as JavaScript Object Notation (JSON) ELM.
- FHIR® eCQM Examples: A website containing example eCQMs using FHIR®.
- Measure Authoring Development Integrated Environment (MADiE): MADiE allows users to develop and test measures in an integrated workspace and supports QI-Core profile-informed authoring and testing of FHIR® measures.
- Visual Studio Code: An open-source text editor. The ‘cqframework.cql’ extension supports highlighting, syntax checking, ad-hoc evaluation, test cases, and terminology for CQL and FHIR® model validation. This free text editor environment can be used to facilitate measure evaluation and testing for eCQMs using the open source CQL Evaluation Engine.
- FHIR® Implementation Guides
- FHIR® Implementation Guide Registry: A list of many of the implementation guides defined by the FHIR® community.
- FHIR® Quality Measure Implementation Guide: The intent of the FHIR® Quality Measure Implementation Guide (IG) or QM IG is to provide guidance on the representation of eCQMs using the FHIR® Clinical Reasoning Module, Quality Improvement (QI)-Core IG, and CQL. It provides requirements for the use of measure structure, metadata, definitions, and logic when authoring and evaluating eCQMs.
- Data Exchange for Quality Measures Implementation Guide (DEQM): An HL7® FHIR® IG to support value-based care data exchange. The aim is for DEQM to replace Quality Reporting Document Architecture (QRDA) Category I for individual reporting and QRDA Category III for aggregate reporting.
- Quality Improvement Core (QI-Core) IG: An IG, based on US-Core, that provides the data model for eCQM development and clinical decision support authoring. The aim for QI-Core is to replace QDM as the data model for eCQMs.
- FHIR® Testing Tools
- ClinFHIR®: An open-source tool that provides an educational environment and also allows developers to create or search for FHIR-based resources. This tool helps people learn about FHIR® by visualizing how the parts combine to represent clinical information in a structured and coded manner. It also serves as a development tool with features to build and validate some of the required artifacts, particularly as an aid to learning.
- FHIR® Servers - Public Testing Servers : HL7® provides a list of FHIR® servers publicly available for testing. These are public services provided by volunteers and HL7® makes no representations concerning their safety or reliability.
- Postman: A collaboration platform designed for developing and testing application programming interfaces (APIs). Postman simplifies interactions with FHIR® servers, enabling users to post requests and updates efficiently. It is particularly useful for testing FHIR-based eCQMs during Health Level Seven International® Connectathons.
- CQL Runner: An online platform for ad hoc testing of CQL.
- Inferno: Inferno is an open-source tool for creating, executing, and sharing automated FHIR® conformance tests. Hosted on HealthIT.gov, it offers public services for running select tests, including those for the ONC Health IT Certification Program, and provides flexible tools for local and integrated testing.
- Crucible: A suite of open-source testing tools for FHIR®. It helps the FHIR development community ensure correct FHIR implementations. Crucible can test for conformance to the FHIR standards, score patient records for completeness, generate synthetic patient data, and test SMART on FHIR applications.
- Test Data Tools
- SyntheaTM: An open-source repository that enables the generation of realistic but synthetic patient data and health records, covering every aspect of health care. The resulting data is free from cost, privacy, and security restrictions, enabling research with health information technology data that is otherwise legally or practically unavailable.
- Browse and download synthetic records
- HL7® Downloads: HL7® webpage that contains examples, reference implementations, and other useful resources.
- SyntheaTM: An open-source repository that enables the generation of realistic but synthetic patient data and health records, covering every aspect of health care. The resulting data is free from cost, privacy, and security restrictions, enabling research with health information technology data that is otherwise legally or practically unavailable.
Last Updated: Jun 17, 2025