Glossary

Account — The part of an dQMGrid run that records, for every patient the measure did not count, which retrieve came back empty, which element was missing, its data source, and who owns the fix.

Bias report — The difference between a measure’s result in reporting mode and in quality-improvement mode, per measure and per data source: every patient whose population membership depended on an unsigned derivation or inference.

Bulk Data — The FHIR Bulk Data Access specification (Flat FHIR). A certified EHR exposes it through $export, returning NDJSON files. The _since parameter returns only resources changed after a given time.

CQL — Clinical Quality Language, the HL7 standard language in which dQM logic is written.

DEQM — Data Exchange for Quality Measures, an HL7 implementation guide. dQMGrid uses a DEQM server in front of fqm-execution.

Derivation — A rule that fills a missing element from another element present in the same resource, such as an onset date from a recorded date. Counts in reporting mode only when signed.

dQM — Digital quality measure. A quality measure published as a FHIR measure package with CQL logic, written against QI-Core.

eCQM — Electronic clinical quality measure. About 70 have been converted to dQMs.

ELM — Expression Logical Model, the compiled form of CQL that engines execute.

Inference — A rule that adds meaning the source did not assert, such as mapping a site’s local radiology order text to a LOINC code. Counts in reporting mode only when signed.

Manifest — The record of every change made to a published package so that it would load. It travels with every result.

MeasureReport — The standard FHIR resource that carries a measure’s populations and score.

QI-Core — Quality Improvement Core, the FHIR profiles dQMs retrieve data by.

Quality-improvement mode — Counts every rule’s output, each one marked, so a site can find closable gaps.

Repair — A rule that re-expresses a fact the source already asserted, in the form the measure reads — such as relabeling a code’s system. Counts in reporting mode.

Reporting mode — Counts only what the source already coded, plus repairs and signed rules.

Retrieve — A CQL statement that fetches data of a given type and profile. An empty retrieve is the most common reason a real export scores zero.

Signing — A named, qualified reviewer accepting a derivation or inference so that it counts in a reported result. See Rules and signing.

Tier — The scope of a rule: standards (follows from the specifications), vendor (one EHR product), or site (one organization’s build of it).

US Core — The FHIR profiles that certified EHRs are tested against and export.