1. 1 HQMF Update Nov 7, 2013

2. 2 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5

3. 3 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 The first international standard for the formal representation of clinical quality measure metadata, data elements, and logic Metadata o Standardized measure types o Standardized populations o Standardized performance calculations Data elements o Tied to HL7 RIM Logic o Broad and expressive, but unconstrained

4. 4 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 HQMF R1 chapter added to Blueprint for the CMS Measures Management System Metadata o Clarification and cross-CMS alignment Data elements o Defined Race, Ethnicity, Sex, Payer supplemental data elements Logic o Revised human-readable representation

5. 5 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 Metadata o Minor updates Data elements o Aligned with QDM o Aligned with Consolidated CDA and QRDA templates Logic o Constrained based on MAT implementation

6. 6 Quality Data Type QDS NQF QDMPattern Library Quality Data Type Pattern eMeasure Pattern Quality Data Type Type Quality Data Type Pattern Quality Data Element Vocabulary Binding Quality Data Element QDS Element Quality Data Element Data Criteria Population Criteria Denominator Numerator Initial Patient Population CDA Template CDA Template Library QDM-based HQMF R1 (MU2)

7. 7 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 Metadata o Differentiation of person- vs. event-based measures o Blueprint updated to describe performance calculations for Ratio and Continuous Variable measures Data elements o Updated based on Dec 2012 QDM Logic o … continued on next slide …

8. 8 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 Logic o Constrained based on HL7 IG o Simplified XML o Named logic sub-trees o Expanded expressivity Additional logic operators (e.g. XOR) Occurrence indicators Expression language for complex calculations o Expanded measure support Risk-adjusted Outcome measures Ratio measures Continuous Variable measures o Computable measure logic

9. 9 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 Break HQMF R2 into discrete “modules” (to set the stage for CDS alignment): o Metadata layer o Data layer o Expression layer Metadata layer o Support for Composite measures Data layer o ~ HQMF R2 Expression layer o ~ HQMF R2

10. 10 HQMF Progression [2010] HQMF R1 [2011] eMIG-enhanced HQMF R1 [2012] QDM-based HQMF R1 + MAT (=MU2) [TBD] HQMF R2.1 [2013] HQMF R2 (and QDM-based HQMF R2) [TBD] HQMF R2.5 Metadata layer o Modified based on alignment with CDS standards Data layer o Modified based on alignment with CDS standards Expression layer o Modified based on alignment with CDS standards

11. 11 Thank you! Questions?