License

dQMGrid proposes three standard, permissive licenses — one for each kind of material — chosen to be as clean as possible and to match what the surrounding standards and open-source communities already use. The licensor is MDinteractive, owner and steward of the project.

Proposed — not yet in effect

No dQMGrid material has been released under these licenses yet. Because CMS’s direction may shape dQMGrid’s open-source strategy, the exact model and licenses will be finalized after our upcoming discussions with CMS. Open licenses such as Apache 2.0 and Creative Commons cannot be withdrawn once granted, so we are deciding before granting any. Until then, dQMGrid material remains © MDinteractive and is not yet openly licensed.

Material	License	In short
Calculator core, conformance harness, test decks	Apache License 2.0	Use, modify and distribute, including commercially; keep the notices; includes a patent grant
Rule artifacts — CodeSystem fragments, ConceptMaps, derivation and profile-declaration rules	CC0 1.0	Dedicated to the public domain; no conditions
Documentation, this site, the EHR cookbook and recipes	CC BY 4.0	Share and adapt for any purpose, including commercially, with attribution

Why these three

Code — Apache 2.0. The standard choice for open-source software in health interoperability: the HAPI FHIR server, MITRE’s fqm-execution and the Clinical Quality Framework’s CQL tooling that dQMGrid builds on are all Apache-licensed. Its express patent grant matters for software that organizations run in production.

Rule artifacts — CC0. dQMGrid’s rules are FHIR content, and FHIR content is customarily published without conditions: HL7 publishes the FHIR specification under CC0, and the CMS dQM measure content dQMGrid runs is itself published under CC0. Rules exist to be copied into every implementation that needs them, so they carry no conditions at all. A signature on a rule set is a separate thing, and is not affected by the license — see the open-source model.

Documentation — CC BY 4.0. The common license for open-source documentation and the most permissive Creative Commons license that still credits contributors. Some major open-source publishers license their documentation under CC BY-SA, which also requires adaptations to carry the same license; dQMGrid uses CC BY without that condition, so the cookbook can be reused anywhere.

Measure content is not ours

dQMGrid runs measure packages published by CMS and its measure developers through the eCQI Resource Center, and value sets maintained in the Value Set Authority Center (VSAC), which has its own terms of use. dQMGrid’s manifest discloses every change made to a package so it would load; it does not relicense the package.

Release timing

No material is openly licensed yet. The documentation and cookbook are readable now, and will be published under the confirmed license once the licensing is finalized after our upcoming discussions with CMS. The calculator core, conformance harness, test decks and rule artifacts are planned for public release with the first release. Until then the repository is available to CMS on request.

Trademarks

“dQMGrid” and the dQMGrid logo identify this project and are owned by MDinteractive. The licenses above cover code and content, not the name or logo: you may say your product uses or is built on dQMGrid, but not in a way that suggests it is the dQMGrid project or is endorsed by it. A trademark policy will be published with the governance charter.

Third-party components

dQMGrid builds on open-source components under their own licenses, including the HAPI FHIR server and Clinical Reasoning module, MITRE’s fqm-execution and deqm-test-server, the HL7 FHIR Validator and the Clinical Quality Framework’s CQL tooling. Their notices are carried in the repository.