Stewardship

Who maintains dQMGrid

dQMGrid is owned and stewarded by MDinteractive, a United States–based health information technology company. MDinteractive funds the project’s development, maintains the code and the rule library, holds the dQMGrid name and logo, and offers commercial support and signing alongside the free, open-source project.

We say this plainly because an open project should be clear about who is behind it. Owning the project does not mean controlling what you can do with it: the proposed licenses are permissive — Apache 2.0 for code, a public-domain dedication (CC0) for rules, CC BY for documentation — and signing is open to any qualified signer. Final licensing will be confirmed after our upcoming discussions with CMS. See License and the open-source model.

The project and the company

dQMGrid follows a familiar pattern in open-source health interoperability: an open project, and a company that maintains it and sells services around it. The two have distinct roles.

The dQMGrid project — open source	MDinteractive — commercial
The calculator framework, conformance harness and validator integration	Hosted and managed dQMGrid instances
The rule library, organized by data source	Support and service-level agreements
Published and fault-injected test decks	EHR integration and onboarding of new platforms
Downloadable implementations and deployment automation — container image and a scalable deployment model	Signing rule sets, as the default qualified signer
This site, the EHR cookbook and recipes	Operating a reference instance, for CMS or others

Everything in the left column is free to use under the project’s licenses and runs without MDinteractive. Anything that needs infrastructure, an ongoing service commitment or a signer’s accountability is in the right column.

dQMGrid implements standards; it does not set them. The FHIR, CQL, QI-Core and DEQM specifications belong to HL7, and the measures belong to CMS and its measure developers. dQMGrid reports what it finds upstream to them.

Why MDinteractive built it

MDinteractive has reported Medicare quality as a CMS Qualified Registry since 2010, for 44+ ACOs and thousands of clinicians. A registry sees every way real data fails a measure, because it has to reconcile dozens of EHRs, billing systems, QRDA files and FHIR endpoints into a single submission — with live FHIR connections to 15 EHR platforms.

That work produced the problem dQMGrid addresses. Our own production calculator carries one extractor per EHR platform and one hand-written implementation per measure per year. Every registry builds the same thing privately. dQMGrid is our attempt to build it once, in the open, on the measures CMS publishes.

Our production results are themselves validated against a Cypress-certified QRDA Category I calculation path, which is how dQMGrid’s prototype results can be checked against a known baseline. See Validating results.

How to work with the project

Contribute. Recipes, EHR notes and rule proposals are welcome from anyone. See How to contribute.

Become a facility partner. dQMGrid’s first hospital data source needs inpatient encounter, medication-administration and discharge data — and a facility willing to work with us on it. If your organization is interested, we would like to hear from you.

Become a signer. We expect qualified reviewers beyond MDinteractive to sign rule sets. The qualification criteria arrive with the governance charter at the first release.

Operate or adopt it. Registries, ACOs, facilities and EHR vendors interested in running dQMGrid, or in commercial support and signing, can contact MDinteractive.