Retrieve and interpret HEDIS-aligned quality measure data from a health plan's FHIR-based Quality Measure reporting endpoint

In-depth guide

Steps

1. Identify the plan's FHIR R4 base URL and confirm that the server supports the MeasureReport resource and the $evaluate-measure operation by querying the capability statement at the /metadata endpoint.
2. Request the relevant Measure resource by canonical URL or server-local ID; confirm the measure version and the value sets it references are current for the applicable measurement year.
3. Invoke the $evaluate-measure operation with parameters specifying the measurement period start and end dates, the patient or group ID for the population, and the report type (summary for aggregate or individual for patient-level).
4. Parse the returned MeasureReport resource, extracting the group array elements which contain the population counts (initial-population, denominator, numerator, denominator-exclusion) and the calculated rate.
5. Cross-reference the MeasureReport.evaluatedResource references to identify which patient encounters and observations contributed to numerator membership, enabling drill-down audit.
6. Combine MeasureReport data across multiple plans or time periods using the measure canonical URL as the join key to enable cross-plan or longitudinal comparisons.