Open-source dQM calculation for real EHR data
The challenge, and our answer
Section titled “The challenge, and our answer”The challenge
Published dQMs pass on synthetic test patients but, on real exports, often return a plausible rate with no error — certified EHRs export US Core, and the measures read QI-Core. Every reporter bridges that gap privately.
Our answer
dQMGrid builds that bridge once, in the open: versioned rules for each EHR make real exports readable, the published measures run unchanged, and every patient not counted is accounted for.
Measured on real data
Section titled “Measured on real data”How it works
Section titled “How it works”The calculator
Loads the published packages as published, conforms real data, evaluates on two open engines, and produces standard FHIR MeasureReports.
The rules
Versioned FHIR artifacts that make each EHR’s export readable — organized by data source, so one signed rule reaches every site on that product.
The account
For every patient not counted: the empty retrieve, the missing element, the source and who owns the fix.
Built for the full converted set
Section titled “Built for the full converted set”Four measures run today against every published test case; ten in the first release, including the 2026 Shared Savings Program ACO measures; then the full converted set of about 70. We show phases, not dates: the pace depends on funding and partners.
Coverage: all 74 dQMs
Every published package, its population basis and scoring, and its status — including the ten first-release measures.
Roadmap
What is built, what is designed but not yet built, and what is planned.
Savings model
What solving each EHR problem once, for the whole country, could avoid — with every assumption adjustable.
Who it is for
Section titled “Who it is for”Providers and facilities
Calculate from your own export, inside your own boundary.
ACOs and registries
Report in FHIR without waiting for every vendor to be conformant.
EHR vendors
A precise, reproducible record of what to fix at the source.
CMS
A neutral reference instance and a channel back to measure stewards.
Open source, stewarded by MDinteractive
Section titled “Open source, stewarded by MDinteractive”Everything that computes a result is intended to be open. MDinteractive owns and maintains the project, and offers hosting, support and signing as separate services. The exact open-source model and licensing will be finalized after our upcoming discussions with CMS.
The open-source model
What is open, what is offered as a service, and why the line is drawn at the signature.
License
Proposed: Apache 2.0 for code, CC0 for rules, CC BY 4.0 for documentation. Not yet in effect.
Governance
How decisions and signing work today, and the charter planned for the first release.
The EHR cookbook
Section titled “The EHR cookbook”Practical notes from real integrations
How 14 EHRs behave over FHIR, step-by-step recipes for getting measure data out of them, and how to submit your own.