Calculates HEDIS-style quality measures from FHIR data including denominator/numerator/exclusion logic, measure rates, gap-to-goal analysis, and non-compliant patient identification. Use when asked to calculate quality measures, HEDIS rates, quality dashboard, star rating, measure compliance, or CMS quality scores.
Use when a clinician or quality team needs formal HEDIS/CMS quality measure calculations with denominator/numerator logic, benchmark comparison, and actionable gap lists.
fhir_search to build the denominator population from Condition/Patient resources per measure specificationfhir_search to identify and remove excluded patients (hospice, ESRD, bilateral mastectomy, etc.)fhir_search to query numerator evidence: Observation (lab results), Procedure (screenings), DiagnosticReport (imaging)fhir_search(resourceType="Condition", queryParams="code=http://snomed.info/sct|44054006,http://snomed.info/sct|46635009&clinical-status=active&_count=500")
fhir_search(resourceType="Observation", queryParams="code=http://loinc.org|4548-4&date=ge[measurement-year-start]&_sort=-date&_count=500")
fhir_search(resourceType="DiagnosticReport", queryParams="code=http://loinc.org|24606-6&date=ge[27-months-ago]&_count=500")