Glossary

The Quality Data Implementation (QDI) User Group is a group of volunteer members who use the Quality Data Model (QDM) and Fast Healthcare Interoperability Resources® (FHIR®)-related standards. The group seeks to understand data capture and use with respect to workflow in health information technology implementations such that measure requests for data are feasible and provide accurate, comprehensive, and reliable data for evaluation. The data model efforts support the electronic clinical quality improvement landscape and the evolving transition from the QDM to the FHIR model (Quality Improvement Core) for authoring electronic clinical quality measures and digital quality measures. The QDI User Group meets at 3:00 p.m. ET on the third Wednesday of every month.

The Quality Data Model (QDM) is a conceptual information model defining principal concepts (classes) of information, their related attributes, and their relationships. The Model provides a standardized way to express what needs to be retrieved from electronic records to enable quality performance measurement. The QDM is the current structure for electronically representing quality measure concepts for stakeholders involved in electronic quality measure development and reporting.

The Quality Data Model (QDM) Known Issues provides identified issues relative to working with the QDM. Many of these issues originated as tickets in the ONC Project Tracking System (Jira) QDM Issue Tracker project and all were discussed by the Quality Data Implementation Group.

The Health Level Seven International® (HL7®) Quality Improvement Core (QI-Core) Implementation Guide (IG) defines a set of Fast Healthcare Interoperability Resources® (FHIR®) profiles with extensions and bindings needed to create interoperable, quality-focused applications. The profiles in this IG derive from and extend the US Core profiles to provide a common foundation for building, sharing, and evaluating knowledge artifacts across quality improvement efforts in the US Realm.

The sponsoring HL7 workgroup, Clinical Quality Information (CQI), manages changes to this FHIR IG, which are incorporated as part of the standard balloting process. The current roadmap follows closely behind the base FHIR roadmap and the US Core IG. The CQI Workgroup will continue to ballot QI-Core versions annually; each annual QI-Core version will build on the respective US Core version which, in turn, addresses updated versions of USCDI (US Core Roadmap). 

To assist measure developers and implementers in the transition from QDM-based eCQMs to FHIR-based eCQMs, CQI developed the QDM to QI-Core Mapping. Each version of the QI-Core publication updates details related to applicable specifications.

The Quality Payment Program (QPP) Developer Tools allow industry developers, who build software for participating clinicians, to integrate their software directly with CMS applications and data. Available tools include Submissions Application Programming Interface (API), Submissions Developer Preview environment, Measures, Activities, Benchmarks Repository, and Quality Reporting Document Architecture III Conversion Tool Open Source Package. These include documentation for reporting eCQMs. Additionally, there is information on submitting data through the CMS Web Interface and developer documentation on the Eligibility API.

The Quality Payment Program (QPP) Resource Library is the one-stop shop for all QPP resources. It provides educational materials supporting clinicians’ participation in QPP. All QPP webinar resources, including slides, transcripts and recordings from recent presentations, can be found on the QPP Webinar Library. Measure specifications and benchmarks are located within the Full Resource Library section of the QPP Resource Library.

The Quality Reporting Document Architecture (QRDA) is a standard document format for the exchange of electronic clinical quality measure data.

The Quality Reporting Document Architecture (QRDA) III Converter tool converts QRDA III files to the Quality Payment Program (QPP) JavaScript Object Notation format for QPP data submission. The tool can also be used to test whether the QPP system can consume QRDA III files and allows you to see whether the files comply with the CMS QRDA III Implementation Guide for the performance period and be successfully submitted to QPP.

Quality Reporting Document Architecture (QRDA) Known Issues provide implementation information for QRDA Implementation Guides or supporting documents with known technical issues for which a solution is under development but may not be published. This includes issues such as discrepancies between conformance assertions and message text, non-critical conformance assertion errors, and typographical errors.

A qualitative assessment uses approaches such as focus groups, in-depth interviews, detailed behavioral observations, or analysis of written or spoken text, typically to gain an understanding of motivations or opinions.

A Quality Data Model (QDM) attribute provides specific details about a QDM data element. QDM version 5.6 includes only datatype-specific attributes, i.e., metadata, or information about each QDM datatype the electronic clinical quality measure (eCQM) developer may use in eCQM expressions to provide necessary details for calculation.

A Quality Data Model (QDM) category consists of a single clinical concept identified by a value set. A category is the highest level of definition for a QDM element. The QDM currently contains 22 categories. Some examples of categories are Medication, Procedure, Condition/Diagnosis/Problem, Communication, and Encounter.

A Quality Data Model (QDM) data element encapsulates a certain category with an associated datatype. It is a discrete unit of information used in quality measurement to describe part of the clinical care process, including a clinical entity and its context of use. It can include criteria for any relevant metadata about a clinical or administrative concept relevant to quality measurement. A QDM data element provides an unambiguous definition and enables consistent capture and use of data for quality measurement. The measure developer may define for any given measure and reuse when they require the same information for another measure. Reuse encourages standardization of quality measures and reduces the generation of additional software requirements for every new measure.

A Quality Data Model (QDM) datatype is the context in which each category is used to describe a part of the clinical care process. Examples of QDM datatypes include "Medication, Active" and "Medication, Administered" as applied to the QDM Medication category.

Quality Data Model (QDM) entities represent concepts used to specify details about the actor (or performer) of any QDM datatype. An electronic clinical quality measure can use the entities to provide further information required for an individual or organization actor to meet the measure's criteria.

A quality measure is a standard for measuring the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of health care services (§931). Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148, 124 Stat. 119 (2010). https://www.govinfo.gov/content/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

The Quality Measure Implementation Guide (IG), or QM IG, is intended to provide guidance on the representation of quality measures including electronic clinical quality measures (eCQMs) using Fast Healthcare Interoperability Resources® (FHIR®) Clinical Reasoning Module. It provides requirements for eCQM structure, metadata, definitions, and logic for use when authoring, packaging and evaluating quality measures.

Established by CMS, QualityNet provides health care quality improvement news, resources, data reporting tools, and applications used by measured entities and others. QualityNet, the one-stop shop for CMS quality programs, provides information on quality data reporting programs associated with the Hospital Inpatient Quality Reporting Program and other hospital inpatient quality programs, Hospital Outpatient Quality Reporting Program, Ambulatory Surgical Center Quality Reporting Program, Inpatient Psychiatric Facility Quality Reporting Program, Prospective Payment System-Exempt Cancer Hospital Quality Reporting Program, and End-Stage Renal Disease Quality Incentive Program. CMS encourages interested parties, advocates, and others to register for email notifications to receive information on enhancements and new releases, timelines or process/policy modifications, and alerts about applications and initiatives. The CMS Hospital Quality Reporting program notification and discussion lists are available for signup on QualityNet.

A quantitative assessment uses numerically based methods, typically supported by statistical analyses, to show relationships between independent and dependent variables to facilitate description, prediction, and establishing of causal relationships.