HQMF - Health Quality Measure Format

Health Quality Measure Format (HQMF) is a standards-based representation of quality measures as electronic documents. It is developed by Health Level Seven International (HL7) an American National Standards Institute (ANSI) accredited standards development organization. HQMF defines the information necessary to compute a quality measure and result value.

An HQMF document is written in Extensible Markup Language (XML) and contains a header and the measure body.

  1. The HQMF Header (measure details) identifies and classifies the document and provides important metadata about the measure such as general descriptions, numerator and denominator statements, measure steward, measure type and measure scoring, as well as information about whether the measure is endorsed by the National Quality Forum (NQF).
  2. The HQMF Body contains eCQM chapters (e.g., population criteria, data criteria, supplemental data, and risk adjustment variables). The body includes two sections, Population Criteria and Data Criteria.

a. The Population Criteria defines the sections of measure logic (e.g., denominator, numerator, exclusions, etc.) and how these sections are applied to proportion, continuous variable, and ratio measures. This section allows expression of measures of processes and outcomes focused on either individual patients or on encounters or defined episodes of care.

b. The Data Criteria section further explains the information used in the logic, including time references and value sets or direct referenced codes to explicitly define the data used in the Population Criteria section. 

The use of HQMF provides for quality measure consistency and unambiguous interpretation. Improvements in the latest version of this standard provide the capability for more efficient automated processing of HQMF-encoded electronic clinical quality measures (eCQMs) by health IT systems.

Find the HQMF standard

The HQMF normative version (R1) was published in July 2017 and is available for download. HQMF R1 is the base standard used for defining eCQM structure.  This version provides a simplified structure and clearer execution model over previous HQMF releases.  The HL7 Version 3 Standard Representation of  HQMF R1 defines sections in ways that are easier for health IT systems to parse and execute. This release provides the capability for more efficient automated processing of HQMF-encoded eCQMs. 

Clinical Quality Language (CQL) based HQMF is replacing the Quality Data Model (QDM) based HQMF logic expression for use in eCQMs for 2019 reporting/performance. CQL does not replace the data descriptions in the QDM. 

Previous HQMF standards

Review the Implementation Guides (IG) which define how to implement the HQMF standard using the Quality Data Model (QDM). The QDM-based HQMF IG references QDM 4.3 and the Clinical Quality Language (CQL)-based HQMF IG references QDM 5.3.

  • HL7 Version 3 Implementation Guide: QDM-HQMF, Release 1– US Realm HL7 Draft Standard for Trial Use Release 1.4.
    This IG references an earlier version of HQMF, the Standard for Trial Use version 2.1 as the base standard for use with QDM-based eCQMs that use the QDM version 4.3. This version of QDM includes the QDM data model and QDM-based logic expressions. This version is the basis for eCQMs published through May 2017 for the 2018 performance period.
  • HL7 Version 3 Implementation Guide: CQL-based HQMF, Release 1 – US Realm HL7 Standard for Trial Use Release 2.1. This IG references HQMF R1, the normative version published in July 2017. The IG further defines how to implement the standard using QDM 5.3. QDM 5.3 is an updated version of the QDM data model and it contains no logic expression concepts. The IG incorporates CQL as the basis for logic expressions used in the eCQMs. This version is the basis for eCQMs developed with CQL expression language.

Find additional related documents, case studies, and guides on the HL7 website.  

Get Involved

There is not a formal HQMF user group at this time, although there are active standards communities where HQMF is discussed and reviewed.

The HL7 Clinical Quality Information Work Group wiki serves as a collaborative workspace for the development of technology standards in support of measuring and improving health, health care, and health care quality.  All users have edit rights to be able to submit edits, add comments, and concerns. Items on the Wiki are a work in progress and subject to change.

Seek Help and Provide Feedback

Post technical questions and comments related to the new HQMF normative standard can be posted to the ONC JIRA QDM Issue Tracker

Last Updated: April 19, 2018