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What is the purpose of Quality Improvement (QI)-Core and can you explain the relationship between QI-Core, CQL, and the QDM?

QDM and QI Core serve as data models for clinical quality measurement, defining the structure and meaning of clinical data such as laboratory tests and their associated attributes. However, data models alone do not express logic. Clinical Quality Language (CQL) provides the mechanisms to define conditions, comparisons, and temporal relationships among those data elements (for example, determining whether one event occurred after another). Prior versions of QDM (v5.3 and earlier) combined both the data model and the expression language into a single specification.

In the Health Level Seven International® (HL7®) community, the Clinical Quality Improvement and Clinical Decision Support (CDS) Work Groups harmonized efforts to express eCQM (QDM) and CDS artifacts (virtual medical record). The result is an HL7 Fast Healthcare Interoperability Resources® (FHIR®) Implementation Guide, QI-Core, which includes a detailed mapping of QDM concepts. QI-Core-related tooling allows eCQM developers to use it directly to author eCQMs in FHIR. QI-Core specifically builds directly on each FHIR version to assure consistency of eCQM expressions and the evolving method for data interchange and interoperability. The eCQI Resource Center includes further information about FHIR and transition efforts.

  • QDM provides a conceptual model for quality measurement data, supporting consistent expression of clinical concepts across measures.
  • QI Core provides a standardized, FHIR-based representation of quality measurement data for implementation and interoperability.
  • CQL provides a formal, human-readable, and machine-executable language for expressing measure logic using QDM or QI Core data.