Now Available: Quality Data Model (QDM) v5.5 Publication for 2021 Reporting/Performance Period

The Centers for Medicare & Medicaid Services has published the Quality Data Model (QDM) version 5.5. The QDM has been aligned with the emerging standard Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR). Support for these features and modifications will be implemented in the production version of the Measure Authoring Tool (MAT) to be released by Fall 2019. Electronic clinical quality measures (eCQMs) produced using the QDM v5.5 publication are anticipated for the 2021 reporting/performance period, whereas eCQMs produced using QDM v5.4 are for the 2020 reporting/performance period.

The QDM v5.5 contains these changes from QDM v5.4:

• Added a new QDM item, called Entities, including Patient, Care Partner, Practitioner and Organization to allow greater expressivity in requesting information about performer-type attributes
• Added QDM datatype Related Person
• Added performer-type attributes to each of the existing QDM datatypes. Based on the context of the QDM datatype, a performer may be referenced as performer, requester, participant, sender, recipient, prescriber or dispenser (note that sender, recipient, prescriber and dispenser existed in QDM 5.4)
• Added priority attribute to Encounter, Order, Encounter, Performed, Procedure, Order and Procedure, Performed
• Added status dateTime to Care Goal to allow timing of care plan updates in measures
• Modified Encounter, Performed diagnosis attribute to reference two components: diagnosis (code) and a new item, present on admission indicator
• Modify timing options:
  • Add Relevant Period timing to Assessment, Performed
  • Add Relevant dateTime to Adverse Event; Assessment, Performed; Device Applied; Diagnostic Study, Performed; Immunization, Administered; Intervention, Performed; Laboratory Test, Performed; Medication, Active; Medication, Administered; Medication, Dispensed; Medication, Order; Physical Exam, Performed; Procedure, Performed; Substance, Administered
  • Change Communication, Performed timing to directly reference sent dateTime and received dateTime
• Prescriber.id and dispenser.id were modified to prescriber and dispenser to allow eCQMs to take advantage of new QDM Entities to specify additional information about performers of actions consistently
• Changed Immunization, Administered timing attribute to Relevant period and retained author dateTime for negation rationale
• Clarified timing statement for Encounter, Performed diagnosis attribute 
• Clarified description of timing for negation rationale attributes
• Removed all QDM data flow attributes (source, recorder, health record field)
• Removed QDM datatype Provider Characteristic
• Removed the ordinality and principal diagnosis attributes; added rank as an attribute to Encounter, Performed as a component of diagnosis and to Procedure, Performed, Procedure, Order and Procedure, Recommended. Rank, represented as an integer, defines the principal diagnosis as the encounter diagnosis with a rank of 1; similarly, it defines a principal procedure as a procedure with a rank of 1

The QDM will continue to evolve based on stakeholder input and feedback from the QDM User Group.

Additional Information

To join the QDM User Group, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center Events page.

If you have questions about QDM, contact the ESAC, Inc. QDM team at the ONC Project Tracking System (JIRA) QDM project.

Current and past versions of the QDM, QDM User Group meeting information, and Clinical Quality Language (CQL) resources are found on the eCQI Resource Center