QDM - Quality Data Model

The value set Binding Parameter Specification (BPS) is generated by the National Library of Medicine (NLM) as part of the Value Set Authority Center’s (VSAC) Downloadable Resources. The BPS details the usage of value sets by electronic clinical quality measures (eCQMs), the binding of value sets to Quality Data Model (QDM) categories, and the value sets object identifiers (OIDs) used to create grouping value sets. It also lists other select value set metadata, allowing eCQM implementers and vendors to use the BPS to track versions and other parameters of the value sets for each eCQM release. Users can access the BPS metadata file for any released set of CMS eCQM value set files through the NLM's VSAC Downloadable Resources. Access requires a free Unified Medical Language System (UMLS) license.

The CQMCommonQDM Library (formerly known as the Global Common Library) is a shared, standardized library of Clinical Quality Language (CQL) functions and expressions built on the Quality Data Model (QDM). It provides reusable logic that can be referenced by multiple electronic clinical quality measures (eCQMs), eliminating the need for each measure to independently implement common functionality.

The library helps eCQM developers to:

• Reuse common logic across multiple measures
• Promote consistency and alignment in measure specifications
• Reduce duplication of code and logic
• Improve consistency and reliability across CMS eCQMs

Rather than defining commonly used logic within every individual measure, eCQMs reference the CQMCommonQDM library to leverage centrally maintained functions and expressions. This approach improves maintainability by allowing common logic enhancements or corrections to be made in a single shared library rather than across numerous individual measure libraries.

The CQMCommonQDM library, along with its CQL source and generated Expression Logic Model (ELM) files, is published with the annual eCQM release and is available from the eCQI Resource Center under the eCQMs section for each CMS reporting program (for example, Eligible Clinician eCQMs). It is also included as part of the published measure packages for measures that reference the library.

The eCQM Data Element Repository (DERep) provides clarification, definitions, and clinical context for the data elements associated with electronic clinical quality measures (eCQMs) used in CMS quality reporting and incentive programs. This resource is designed to help implementers accurately interpret and apply eCQM data requirements within health IT systems. The information presented in the DERep is derived from eCQM specifications, the Quality Data Model (QDM), and the Value Set Authority Center (VSAC). Each eCQM data element includes details about its associated value set or direct reference code (DRC), the relevant QDM datatype, and applicable QDM attributes.

This Health Level Seven International® (HL7®) Clinical Quality Language (CQL)-Health Quality Measure Format (HQMF) Implementation Guide (IG) defines an approach to using CQL with the Quality Data Model (QDM) and HQMF to define electronic clinical quality measures (eCQMs). The IG describes the use of CQL to express the logic and the US Domain conceptual data model, QDM, to express the individual data types and their attributes for an eCQM detailed using the HQMF standard.

Measure Authoring Development Integrated Environment (MADiE) is a software tool that makes creating and testing electronic clinical quality measures (eCQMs)/digital quality measures (dQMs) easier by combining both steps in one application.

MADiE allows eCQM developers to author eCQMs using Quality Improvement (QI)-Core, the Quality Data Model (QDM), and Fast Healthcare Interoperability Resources® (FHIR®) to test and verify eCQM behavior. MADiE helps eCQM developers execute eCQM logic against the constructed test cases to provide users with information to evaluate if the eCQM logic aligns with the intent of the eCQM.

The Office of the National Coordinator for Health Information Technology (ONC) Project Tracking System uses Jira, a project management and issue-tracking platform developed by Atlassian.

This system provides a centralized and transparent platform for users to log, track, and discuss issues with subject matter experts across a broad range of topics including: Hybrid Measures, CQL, Cypress, eCQMs, MADiE, QDM, QRDA, and USCDI+ Quality (FHIR/dQM projects coming soon). CMS uses the system throughout the development, implementation, and maintenance stages of the measure lifecycle.

A 90-day account deactivation policy is enforced for users who have not logged into the system for 90 consecutive days or longer.

The Quality Data Implementation (QDI) User Group is a group of volunteer members who use the Quality Data Model (QDM) and/or 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) 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 Quality Data Model (QDM)-based Clinical Quality Language (CQL) Style Guide provides standardized expressions of electronic clinical quality measure (eCQM) concepts across eCQMs and defines a uniform “look and feel” to eCQM logic. The QDM-based CQL Style Guide focuses on a set of common best practices that have been implemented across QDM-based eCQMs in CMS quality reporting programs. The QDM-based CQL Style Guide also promotes the use of consistent language within the framework of CQL, including libraries, aliases, definitions, and functions, and provides guidance on other conventions, such as operator precedence. eCQM stewards or developers who are developing or specifying eCQMs for potential inclusion in CMS reporting programs should follow these best practices.