ECDS In Brief

The ECDS reporting standard gives health plans a method for collecting and reporting standard electronic clinical data for HEDIS quality measurement and improvement.

The ECDS architecture was designed to help HEDIS implementers understand how technology might improve the efficiency of quality reporting while providing an incentive to connect to a broad array of actionable information from multiple sources.

HEDIS quality measures reported using ECDS inspire innovative use of electronic clinical data to document high-quality patient care.

The ECDS reporting standard represents a step forward in the evolution of HEDIS to accommodate the extensive information available in electronic datasets used for patient care and quality improvement.

Measures that use HEDIS ECDS Reporting Method

Measurement Year 2026

Behavioral health

• Depression Screening and Follow-Up for Adolescents and Adults
• Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
• Depression Remission or Response for Adolescents and Adults
• Unhealthy Alcohol Use Screening and Follow-Up
• Prenatal Depression Screening and Follow-Up
• Postpartum Depression Screening and Follow-Up
• Follow-up Care for Children Prescribed ADHD Medication
• Metabolic Monitoring For Children and Adolescents on Antipsychotics

Preventive screening

• Breast Cancer Screening
• Colorectal Cancer Screening
• Cervical Cancer Screening
• Documented BI-RADS Assessment Mammogram
• Follow-Up After Abnormal Mammogram Assessment
• Lead Screening in Children

Health equity

• Social Needs Screening and Intervention

Immunizations

• Prenatal Immunization Status
• Adult Immunization Status
• Childhood Immunization Status
• Immunization for Adolescents

Management of chronic conditions

• Blood Pressure Control for Patients with Hypertension
• Follow-Up After Acute Care Visits for Asthma
• Statin Therapy for Patients with Diabetes
• Statin Therapy for Patients with Cardiovascular Disease
• Blood Pressure Control for Patients with Diabetes

Types of ECDS Data

Data systems that may be eligible for HEDIS ECDS reporting include, but are not limited to, member eligibility files, EHRs, clinical registries, HIEs, administrative claims systems, electronic laboratory reports (ELR), electronic pharmacy systems, immunization information systems (IIS) and disease/case management registries.

Data sources used for HEDIS ECDS reporting are categorized as follows:

1. Electronic health record (EHR)/personal health record (PHR). Patient records that document a patient’s medical history, treatment plans, radiology and laboratory test results in digital format that can make the information available instantly and securely to authorized users.
2. Health information exchange (HIE)/clinical registry. HIEs and clinical registries eligible for this reporting category include state HIEs, IIS, public health agency systems, regional HIEs (RHIO), Patient-Centered Data Homes™ or other registries developed for research or to support quality improvement and patient safety initiatives. Clinical registries may be sponsored by a government agency, nonprofit organization, health care facility or private company, and decisions regarding use of a registry’s data are the responsibility of the registry’s governing committee.⁴
3. Case management system. A shared database of member information collected through a collaborative process of member assessment, care planning, care coordination or monitoring of a member’s functional status and care experience. Case management systems eligible for this category of ECDS reporting include any system developed to support the organization’s case/disease management activities, including activities performed by delegates.
4. Administrative. Includes data from administrative claim processing systems for all services incurred (paid, suspended, pending, denied) during the period defined by each measure’s participation, as well as member management files, member eligibility and enrollment files, electronic member rosters, internal audit files and member call service databases.

Submit questions about HEDIS ECDS reporting through My NCQA.

ECDS Frequently Asked Questions

See FAQs here.

1. HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).
2. https://www.federalregister.gov/documents/2015/10/16/2015-25597/2015-edition-health-information-technology-health-it-certification-criteria-2015-edition-base
3. https://www.healthit.gov/providers-professionals/health-information-exchange/what-hie
4. https://www.nih.gov/health-information/nih-clinical-research-trials-you/list-registries

Understanding ECDS Measures & the Hybrid Phase out

Get familiar with understanding how ECDS measures support the Digital Transition

The Transformation of HEDIS

NCQA’s vision for the future of measures is the use of digital quality measures (dQMs).  The transition involves a multi-phase approach towards fully automated, interoperable measurement systems. The goal is to eliminate manual processes, enable real-time insights, and align data collection with clinical workflows to reduce administrative burden.

Electronic Clinical Data Systems (ECDS) and Digital Quality Measures (dQM) are related but not synonymous.

Electronic Clinical Data Systems (ECDS)

• A HEDIS^® reporting standard for health plans that collect and submit quality measures
• A structured way to aggregate electronic data for HEDIS reports
• Supports electronic exchange of clinical data

Digital Quality Measure (dQM)

• A standard, interoperable format
• Computer interpretable, fully specified, standards-based (i.e., FHIR-CQL) measure content
• Improves the delivery of specifications and makes it easier to use measure content
• ECDS and traditional HEDIS measures are available as dQMs through Digital Content Services.

Visit the Digital Quality Hub to learn more about NCQA’s Digital Quality Transition.

Hybrid Transition

The shift to digital measurement involves phasing out the Hybrid reporting method, easing manual record retrieval, and advancing towards making quality measures available as FHIR/CQL computable dQMs. Hybrid measures are crucial for organizations’ HEDIS reporting. NCQA plans to phase out Hybrid Reporting by MY2029. By MY2025, eight HEDIS measures will still allow Hybrid reporting. Before phasing out, an ECDS version will be added. Some measures will transition directly to ECDS or revert to Administrative methods, while others will become new ECDS measures.

See the current hybrid transition timeline below.

Replacing the Hybrid measures has been a deliberate process. It starts with developing and testing the new ECDS measure, including parallel testing with the existing hybrid measure to compare results and ensure accuracy. Once validated, the new ECDS measure becomes part of the official HEDIS reporting, integrating into health plan workflows. The final step is retiring the original hybrid measure after successful implementation, fully transitioning to digital reporting to reduce manual processes and enhance efficiency.

During the transition, NCQA evaluates HEDIS data to confirm the ECDS measure meets quality standards, provides benchmark guidance for health plans, and collaborates with standard organizations to address digital feasibility gaps. This phased approach ensures thorough testing, validation, and stakeholder engagement, maintaining data integrity and reporting accuracy throughout.

Visual Pathway for Replacing Hybrid Measures with ECDS:

• Develop the new ECDS measure, implement it, then sunset the original measure.
• Both old and new measures will be in HEDIS simultaneously.

This transition period enables us to:

• Compare performance between original and new measures.
• Provide anticipatory guidance about benchmarks.
• Identify and close digital feasibility gaps through standards engagement.

Understand the Difference in the Reporting Methods in HEDIS

There are some key highlights that are different in the different reporting methods.

HEDIS ECDS Data Collection Considerations

Transition to ECDS Reporting