Digital quality measures (dQMs) provide a digital format for HEDIS®1 measures—the kind of measures that organizations have used and reported to NCQA since the early 1990’s. NCQA dQMs are quality measures published as a self-contained downloadable package that includes the technical specifications provided in both human-readable documentation and computable specifications (i.e., computer-readable code).
Advantages of dQMs include:
- Easier transfer of measures into your IT system.
For years, people who work for health plans have been required to transform human-readable, narrative descriptions of HEDIS measures, into a format their own IT systems could interpret. NCQA providing the digital quality measure code means quality measures are now more readily implemented in a highly consistent manner. - Less interpretation, recoding and human error.
Since NCQA publishes the measure computer code, people who work for health plans are no longer required to interpret the measure intent from the narrative, which substantially reduces the chance of human error in the process. Certification and validation of measures can now focus on the accuracy of measure implementation, rather than on the correctness of measure coding. - Harmonization with industry standards.
NCQA dQMs are closely aligned with interoperability and data exchange standards so the measures are much easier to deploy, enabling knowledge to be readily shared across the entire continuum of care. NCQA dQM specifications are expressed using the Clinical Quality Language (CQL) standard for representing a clinical quality measure as an electronic document and Fast Healthcare Interoperability Resources (FHIR). These standards enable better exchange of quality information and align with federal regulations supporting interoperability.
Quality measurement is evolving to become more patient-focused and more significant in supporting quality improvement. Advancements in digital data and measurement standards have made this possible. Producing digital quality measures is an important part of NCQA’s commitment to improve the quality of health care and a key step to fully enabling a digital quality ecosystem.
dQM Frequently Asked Questions
How are the HEDIS dQMs obtained?
The latest release of HEDIS dQMs is available in the NCQA Store. The HEDIS dQMs are provided as a package of files and include an implementation guide.
Is use of FHIR/CQL required to implement HEDIS dQMs?
While all HEDIS dQMs are specified using FHIR/CQL, measure implementers may reference the provided code and translate it to their desired language. Currently, any measure translation from FHIR/CQL to other languages would be manual.
What resources are available to assist with implementation of FHIR/CQL measures?
To assist customers, NCQA has a demo video on how to download and implement open source tooling to support using the HEDIS dQMs. Below are links to the open-source reference engine for running FHIR/CQL measures.
- CQL Execution Engine v2.1.0 (https://github.com/cqframework/cql-execution).
- CQL Exec FHIR v1.5.0 (https://github.com/cqframework/cql-exec-fhir).
NCQA used this Javascript engine to test our measures. The reference implementation contains information and code for executing CQL artifacts as JSON ELM. For execution of the measure, the patientSource should point to the individual patients who will be iterated through, one at a time. The codeService should point to the JSON value sets. Refer to each project for implementation guidance.
When will all HEDIS measures be digital?
NCQA has developed a roadmap to provide nearly all HEDIS measure specifications in a digital format over the next 5 years. For more details on this roadmap, please refer to Episode 11 of the Future of HEDIS webinar series (‘Better Data, Better Measures, Better Care’). NCQA will use various methods including webinars, blogs and public comment to post updates and announcements about the transition of HEDIS to all digital.
How are data collection and coding practices impacted by using dQMs?
NCQA dQMs already use standard codes and terminology to define the key data necessary to generate reliable quality knowledge. The use of interoperability standards for the quality measurement specifications reduces measurement burden by facilitating the exchange of information between systems. The ability to exchange information seamlessly between health care entities and relying on standard digital data will improve the value of measure results, ensuring the right information gets to the right place when it is most useful for care improvement.
Does using HEDIS dQMs impact requirements for measure certification?
Currently, all organizations that use NCQA measures for HEDIS reporting or in a commercial product or service, must be certified for all measures used, including those offered in the dQM format. For more information, please see NCQA’s Measure Certification Program.
1HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).