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Standards Summary - dQM

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A diagram illustrating how digital quality measurement (dQM) data flows between clinicians, hospitals, and the Centers for Medicare & Medicaid Services (CMS). On the left, icons represent an eligible clinician at the top and a hospital at the bottom. Both send dQM data toward a central CMS building icon. Eligible clinicians transmit DEQM Summary Measure Reports to CMS. Hospitals transmit DEQM Individual Measure Reports to CMS. Arrows between CMS and both the clinician and hospital show bidirectional data ex

 

Digital quality measure (dQM) standards are critical to data consistency, validity, and interoperability. Standards, in the context of health information technology, refer to agreed-upon methods and terminology for connecting systems such as file formats for electronic documents, messages, and related health care data elements. Standards pertain to data transport, data format and structure, and the meanings of codes and terms. See the Interoperability Standards Platform for more information about eCQI standards and initiatives. Learn about how CMS is transitioning from eCQMs to dQMs for quality reporting programs.

 
Key standards for electronic transmission of health information used to support dQMs:

Clinical Quality Language (CQL) – expression language used to communicate specific data to be retrieved, and logic needed to evaluate dQMs. The machine-readable Expression Logical Model (ELM) is a representation of the CQL.

Fast Healthcare Interoperability Resources® (FHIR®) - a key standard for use for exchanging health care information electronically.

Data Exchange for Quality Measures (DEQM) - DEQM Implementation Guide provides a framework that defines conformance profiles and guidance to enable the exchange of quality information and quality measure reporting.

Quality Improvement Core Implementation Guide (QI-Core) - Defines a set of FHIR profiles with extensions and bindings to create interoperable, quality-focused applications with and support for quality improvement data within healthcare systems in the US Realm used in the creation of dQMs and CDS artifacts.

FHIR Quality Measure Implementation Guide (QM IG) - defines conformance profiles and guidance for quality measures using the FHIR Clinical Reasoning Module, including requirements for data retrieval and analysis.

Health Terminology Standards

Numerous organizations develop and maintain standard terminologies. The National Library of Medicine’s (NLM) Unified Medical Language System® Metathesaurus is a large biomedical thesaurus organized by concept, or meaning, and it links synonyms to the concept from nearly 200 different terminologies. However, dQMs use only a handful of these terminologies, e.g., SNOMED CT, CPT, and RxNorm. NLM’s Value Set Authority Center (VSAC) is the official source of value sets used in CMS programs.

Last Updated: Oct 06, 2026

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