QI-Core – Quality Improvement Core

Quality Improvement Core (QI-Core) is a Health Level Seven International® (HL7®) implementation guide that defines a set of Fast Healthcare Interoperability Resources® (FHIR) profiles that support successful creation of interoperable and quality-focused applications including Electronic Clinical Quality Measures (eCQMs) and Clinical Decision Support (CDS) artifacts. US Core profiles are used as a foundation when designing QI-Core profiles. US Core is a set of profiles that define minimum constraints on FHIR resources to ensure interoperability within the US health care system, ultimately improving ease in sharing and understanding health information.

Health Care Quality: Benefits of QI-Core Alignment with US Core

Standardization and Interoperability

QI-Core is designed to standardize the capture, reporting, and comparison of health care quality metrics across various providers and systems. By aligning with US Core, QI-Core facilitates interoperability, allowing different health care organizations to more easily share and compare data. This interoperability is essential for effective communication among health information systems, enabling better tracking and reporting of health care quality, which ultimately leads to improved patient outcomes.

Patient-Centric Focus

Both QI-Core and US Core prioritize patient care by providing a unified framework that helps health care organizations incorporate quality measures into patient care processes. This integration has the potential to decrease implementer burden and allow health care providers to concentrate on delivering high-quality care, thereby enhancing the overall patient experience.

Data-Driven Decision Making

With QI-Core based on US Core, health care organizations can make better decisions using reliable primary clinical data to identify areas for improvement, track progress over time, and make data-driven decisions that enhance care quality.

Transition to Value-Based Care

The alignment of QI-Core with US Core supports the shift towards value-based care, where patient outcomes and care effectiveness are central to reimbursement rather than the number of services provided.

Both QI-Core and US Core enhance health care by establishing clear standards, facilitating effective data sharing, and offering practical tools that enable organizations to assess and improve the quality of care they deliver. QI-Core’s alignment with US Core makes these processes even more effective.

From QDM to QI-Core: Advancing FHIR-Based Measures

QI-Core is a pivotal component of the ongoing harmonization efforts aimed to align specification development for quality measures, particularly eCQMs and CDS artifacts. The profiles in this implementation guide derive from and extend the US Core profiles to provide a common foundation for the creation, sharing, and evaluation of knowledge artifacts that support quality improvement efforts in the US.

QI-Core replaces the Quality Data Model (QDM) as the conceptual framework for constructing quality measures. It introduces identifies specific FHIR-based categories, datatypes, and attributes that facilitate this process. Each QI-Core version includes guidance on authoring and retrieving data for measurement and CDS artifact usage. Each version also provides mapping between the conceptual data model used for eCQMs in CMS programs (QDM version 5.6), and the respective version of QI-Core.

Measure Authoring Tools

To assist measure authors in using QI-Core and Clinical Quality Language (CQL), the Measure Authoring Development Integrated Environment (MADiE) tool is available. This tool streamlines the process of authoring measures, ensuring adherence to the standards set forth by QI-Core. Visit the MADiE webpage for more information.

Measure authors use the National Library of Medicine (NLM) Value Set Authoring Center (VSAC) to define the sets of codes (i.e.: value sets) used in measure logic to identify patient populations of interest. Visit the NLM VSAC Help page for more information.

QI-Core Updates

The integration with US Core is essential for ensuring measures and CDS artifacts use data that maintains consistent meaning during routine data capture and sharing (interoperability). The Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator for Health Information Technology (ONC) defines requirements by publishing the United States Core Data for Interoperability (USCDI) versions. Each QI-Core version builds upon the newest US Core version, which is based upon the current USCDI version. For example, QI-Core 6.0 builds upon US Core version 6.1.0, which incorporates USCDI version 3, required for clinical vendor certification effective January 2026.