CMS FHIR Quality Measure Development IG, published by Centers for Medicare & Medicaid Services (CMS). This guide is not an authorized publication; it is the continuous build for version 0.8.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cms-qmd/ and changes regularly. See the Directory of published versions

Allergies

FHIR defines the AllergyIntolerance resource to represent allergies and intolerances for a patient. US Quality Core defines the US Quality Core AllergyIntolerance profile, which derives from US Core AllergyIntolerance, requires patient, and adds the resolutionAge extension.

Authoring patterns for allergies and intolerances are documented in AllergyIntolerance in the US CQL implementation guide, covering onset and abatement, along with worked examples for contrast dye, egg, and nut allergies. This page records only what differs for quality measurement; see the Pattern Index for the full list of available patterns.

For AllergyIntolerance, see also modifier elements, search parameters, and cross-version considerations in that guide.

NOTE: Retrieves in the US CQL patterns are written against the US Core model ([USCore.AllergyIntolerance]). In CMS dQMs they are written against US Quality Core ([USQualityCore.AllergyIntolerance]). The element-level guidance is otherwise the same. The shared definitions in USCoreElements — All Allergies and Intolerances, Active Confirmed Allergies and Intolerances, and their variants — retrieve US Core-conformant instances, so measures requiring US Quality Core conformance should retrieve against US Quality Core directly.

Current Allergies

See Current allergies.

Quality measures are evaluated retrospectively, against the data that exists at the time of evaluation rather than during the measurement period. Because isActive() tests the current clinicalStatus, it should not be used to establish that an allergy was active during the measurement period. Use the prevalence interval instead, as described in Onset, abatement, and prevalence interval; prevalenceInterval() accounts for resolutionAge as well as abatement.

No Known Allergies

See No known allergies.

USCoreElements distinguishes No Known Allergies (Confirmed) from No Known Allergies (Not Asked); a measure asserting that a patient has no known allergies should use the confirmed form. Both definitions test isActive(), so the retrospective consideration above applies to them.

Verified Allergies

See Clinical and verification status.

Measure logic should use the verification-status functions defined in FHIRCommon — isVerified() and verified(), along with isConfirmed(), isUnconfirmed(), isRefuted(), and their list-valued forms — rather than re-declaring them locally. QICoreCommon’s verified() is deprecated in favor of the FHIRCommon function; see the Refactored Index.