HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 7.0.2 - US Realm

DESCRIPTION

The QI Core Implementation Guide defines a set of FHIR profiles with extensions and bindings needed to create interoperable, quality-focused applications. The profiles in this implementation guide derive from and extend the US Core profiles to provide a common foundation for building, sharing, and evaluating knowledge artifacts across quality improvement efforts in the US Realm.

As an HL7 FHIR Implementation Guide, changes to this specification are managed by the sponsoring workgroup, Clinical Quality Information, and incorporated as part of the standard balloting process. The current roadmap follows closely behind the base FHIR roadmap, and the US Core Implementation Guide.

This STU update to the QI-Core profiles incorporates updates to the US-Core profiles, version 7.0, specifically updating the Must Support items and US Core Data for Interoperability (USCDI) version 4. Continued work progresses for profile authoring. This QI-Core 7.0.0 Update also includes updates to managing actions that did not occur for a reason, and updated mapping from Quality Data Model (QDM) version 5.6 to QI-Core.

See the specification at http://hl7.org/fhir/us/qicore/STU7.0.2.

Submit Specification Feedback here.

 

ALTERNATIVE NAMES

HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 7.0.2 - US Realm may also go by the following names or acronyms:

BENEFITS

• Encourages consistent access and use of data for clinical quality applications, across organizations and between healthcare systems
• Provides guidance for consistent use of vocabularies and value sets
• Standardizes the requirements for data servers and data consumers (clients) that exchange quality-related clinical data needed for calculation of quality measures and decision support

IMPLEMENTATIONS/CASE STUDIES

• Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC)
• National Committee for Quality Assurance (NCQA) (Draft HEDIS measure guidance)

DEVELOPMENT BACKGROUND

This Implementation Guide originated as a U.S. Realm Specification with support from the Clinical Quality Framework (CQF) initiative, which was a public-private partnership sponsored by the Centers for Medicare & Medicaid Services (CMS) and the U.S. Office of the National Coordinator (ONC) to harmonize standards for clinical decision support and electronic clinical quality measurement. The Clinical Quality Framework effort transitioned to HL7's Clinical Quality Information (CQI) and Clinical Decision Support (CDS) Work Groups in 2016. The HL7 CQI Work Group maintains this Implementation Guide, co-sponsored by the Clinical Decision Support (CDS) HL7 Work Group to inform electronic clinical quality improvement (i.e., measurement and decision support). This Quality Improvement Core (QICore) Implementation Guide is intended to be usable for multiple use cases across domains, and much of the content is likely to be usable outside the U.S. Realm.

In the U.S. Realm, the common reference model for electronic clinical quality measures (eCQMs) is the Quality Data Model (QDM). For clinical decision support, a common reference model is the HL7 Virtual Medical Record for Clinical Decision Support(vMR). Decision support and quality measures are closely related, and can be viewed as "two sides of the same coin". Specifically, decision support provides guidance for clinical best practices, and quality measures assess whether clinical best practices have been followed. It therefore makes intuitive sense to use the same common reference model for both types of applications.

This project is part of an effort to align the HL7 Product Family in the area of health quality improvement. The goal is to have a single logical data model (QUICK), as well as a single logical processing language (CQL), for CDS and clinical quality measurement (CQM). This alignment will lessen the cost and complexity for product developers and vendors, reduce the learning curve, and consolidate efforts to maintain multiple standards.

 

RELATED DOCUMENTS

HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 7.0.2 - US Realm

STU DOCUMENTS

	HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 1.6 - US Realm See the standard at http://hl7.org/fhir/us/qicore/STU6.	(Submit Feedback on STU)
	HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 7 US Realm See the standard at http://hl7.org/fhir/us/qicore/STU7.	(Submit Feedback on STU)
	HL7 FHIR® Profile: Quality, Release 1 STU Release 4.1.1 - US Realm See the standard at http://hl7.org/fhir/us/qicore/STU4.1.1.	Expiration Feb 2026
	HL7 FHIR® Profile: Quality, Release 1 STU Release 5 - US Realm See the standard at http://hl7.org/fhir/us/qicore/STU5/.	Expiration Apr 2025
	HL7 FHIR® Profile: Quality, Release 1 STU Release 3 - US Realm Please see the resource detail for link and download instructions.	Expiration Jul 2022
	HL7 FHIR® Profile: Quality, Release 1 STU Release 4 - US Realm Please see the resource detail for link and download instructions.	Expiration Mar 2022
	HL7 FHIR® Profile: Quality, Release 1 STU Release 2 - US Realm Please see the resource detail for link and download instructions.	Expiration Dec 2019
	HL7 FHIR® Profile: Quality, Release 1 DSTU - US Realm Please see the resource detail for link and download instructions.	Expiration Sep 2017

ADDITIONAL DETAILS

The 4.1 STU update to the QI-Core profiles incorporated updates to the US-Core profiles, version 3.1.1, specifically updating the Must Support items. The new tooling creates a new tab in the Description section and that provides duplicate content to the previous QUICK/QI-Core Authoring tab. Therefore, the QUICK tab has been retired. Continued work progresses for profile authoring. This QI-Core 4.1 Update also includes mapping from Quality Data Model (QDM) version 5.6 to QI-Core.

Click here for the 4.1.1 Errata Letter.

Click here for the 7.0.1 Errata Letter. 

Click here for the 7.0.2 Errata Letter. 

 

TOPICS

• Clinical Quality
• Decision Support

BALLOT TYPE

• STU

STATUS DATE

2025-06-12

RESPONSIBLE WORK GROUPS

STAKEHOLDERS

• Clinical and Public Health Laboratories
• Clinical Decision Support Systems Vendors
• EHR, PHR Vendors
• Emergency Services Providers
• Health Care IT Vendors
• Healthcare Institutions
• HIS Vendors
• Immunization Registries
• Lab Vendors
• Payors
• Quality Reporting Agencies
• Regulatory Agency
• Standards Development Organizations (SDOs)

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm