Steps

Review the dQM specifications published at the eCQI Resource Center and the companion HL7 FHIR profiles developed by CMS to understand which measures have been translated from eCQM/QRDA to FHIR-based dQM format.
Configure your EHR or data platform to expose patient data through a FHIR R4 endpoint, ensuring the FHIR resources (Encounter, Condition, Observation, Procedure, MedicationRequest) are populated with the coded values required by the target dQM logic.
Use a CQL (Clinical Quality Language) engine that supports FHIR as its data model to evaluate the measure logic against live FHIR data, producing numerator and denominator membership for each patient.
Package the FHIR-based measure report as a MeasureReport resource and validate it against the applicable FHIR dQM profile before submission.
Submit the MeasureReport through whatever FHIR API endpoint the receiving program (for example, a CMS quality reporting program or an ACO aggregator) has designated, using the $submit-data operation or a direct FHIR POST as specified.
Monitor for OperationOutcome responses that indicate acceptance or rejection and retain the transaction IDs for reconciliation.

Known gotchas

dQM measure logic expressed in FHIR/CQL may differ from the eCQM/QDM logic for the same measure; a patient who meets criteria in the QRDA version may not meet criteria in the FHIR dQM version due to value set or timing differences.
FHIR-based dQM submission is not yet universally required for all CMS quality programs as of 2026; confirm with the specific program (IQR, MSSP, MIPS) whether FHIR submission is accepted or mandatory for the applicable performance year.
CQL engine implementations vary in their support for FHIR version-specific features; test your evaluation results against the reference test cases published alongside each dQM specification to detect engine-level discrepancies.

Generate and submit a QRDA Category III aggregate eCQM report for CMS MIPS quality reporting

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

hl7.org · 6 steps · unrated

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Implement CMS digital quality measure (dQM) reporting using FHIR-based data extraction as the next evolution beyond QRDA submission

Steps

Known gotchas

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