CQL and FHIR: Myths, Misunderstandings and More
Clinical Quality Language and Fast Healthcare Interoperability Resources are technology standards that have existed for years.
But myths and misconceptions about CQL and FHIR persist.

Experts from Smile Digital Health help us distinguish fact from fiction.
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About The Guests
In addition to being Director of Standards Strategy for Smile Digital Health, Bryn Rhodes a co-chair of the HL7 Clinical Decision Support Work Group, and editor of HL7 Clinical Quality Language and the FHIR Clinical Reasoning module.
Smile Digital Health Vice President of Clinical Reasoning Rob Reynolds is an experienced entrepreneur whose decades of experience in the software field span consulting, manufacturing, financial and medical software. He is also the technical lead of the Health Level 7 (HL7) Da Vinci Risk Adjustment Use Case.
Episode Description
In this episode of Quality Matters, host Andy Reynolds welcomes Bryn Rhodes and Rob Reynolds of Smile Digital Health to unravel two foundational, yet widely misunderstood, technologies in health care: Clinical Quality Language (CQL) and Fast Healthcare Interoperability Resources (FHIR). With decades of leadership in health care standards, Bryn and Rob share hard-earned insights, persistent misconceptions and what the future holds for digital transformation in such areas as clinical reasoning and quality measurement.
Listen to this episode to discover:
- Why CQL and FHIR Are Often Misunderstood and Why That Matters: CQL enables knowledge and logic sharing, while FHIR facilitates data exchange. Together, they empower precise and scalable healthcare interventions.
- CQL’s Human Readability is More Than a Feature; It’s a Gateway:  Learn how CQL’s intuitive language design bridges clinical and technical teams, reduces errors in translation and is already proving to be a strong match for AI-based tools and systems.
- Why FHIR Alone Doesn’t Guarantee Interoperability: Hear why true interoperability requires coordinated expectations between parties, including common terminology and agreed use cases.
- Business Strategy Meets Standards Adoption: Learn why treating interoperability as a strategic imperative (not just compliance) can unlock innovation, lower costs and drive better population health outcomes.
- CQL Engine News: NCQA Chief Technology Officer Ed Yurcisin updates the quality community on the role of CQL engines, why no engine covers all use cases and how NCQA’s open-source engine is moving the industry forward.
This conversation is a must-listen for health care leaders, B2B strategists and informatics professionals navigating digital transformation. It’s packed with actionable ideas, tech-forward insights and a human-centered approach to quality’s future.
Both of them have their power and bring the value separately, but you need both of them to achieve greater value. If you have FHIR, you have the ability to share the data. We can express questions. ‘What about this, about the data?’ We can do that in a shared, interoperable way with CQL.Â
But if the data isn’t interoperable, the ability to share questions doesn’t do much because you can’t get the data that those questions are about. So hearing people talk about those things in the same sentence, that’s fantastic. That’s exactly where we need to be.
Timestamps
(02:00) The Relationship Between FHIR and CQL
(08:20) Common Misconceptions About CQL and FHIR
(12:57) NCQA’s Commitment to CQL
(17:40) Advice for Adopting CQL and FHIR