Commure “FHIRs” It Up at the HL7 Connectathon

Zach Smith

By Zach Smith, Engineering Manager

In September, the Clinical Reasoning team at Commure had the opportunity to virtually participate in the HL7 ⓇFHIR ⓇConnectathon for the first time. The FHIR Connectathons are a great way to join forces with other members of the industry to share knowledge and test conformance to the FHIR specification and implementation guides. The Connectathons are also beneficial for the spec writers at HL7, to get feedback and advance the maturity of their specifications. I, along with my colleagues Elise, Emily, and Pascal, participated in the Clinical Reasoning track.

As a FHIR-native platform for healthcare software development, Commure’s offerings in the clinical reasoning space (a CQL Engine, distributed measure evaluation engine, and clinical decision support (CDS) APIs) are all heavily streamlined to work with FHIR. While this works well for cutting-edge use cases, there are vast amounts of clinical knowledge artifacts in the ecosystem operating on legacy data models, such as QDM. A key example of these legacy artifacts can be seen in the CMS eCQM Library, which still uses QDM.

An interesting breakout session during the Connectathon gave us the opportunity to talk to industry leaders about the transition from QDM to QI Core (a FHIR profile specifically focused on clinical quality), mappings from the legacy data model, as well as a commitment from CMS that they will move forward with transitioning their measures to QI Core. While this transition won’t happen overnight, it’s encouraging to see such a key stakeholder in the industry embracing modern, open standards for healthcare quality.

Another major component of Connectathons is conformance testing. This gave the Clinical Reasoning team an opportunity to put the software we’ve worked hard on to the test. Our CQL engine, the heart of our clinical reasoning platform, took center stage. We were able to successfully execute the majority of the provided Connectathon libraries against our engine and verify the results.

Additionally, with the help of one of the Connectathon facilitators, we tested conformance of our Data Exchange solution, a key component of our distributed measure evaluation engine. Demonstrating implementation conformance is critical to advancing the maturity level of the specification. We tested the conformance of our $data-requirements operation implementation, and suggested improvements to the APIs of other operations, including $collect-data, and $evaluate-measure.

If you’re passionate about moving the industry forward towards open, interoperable standards for healthcare data and clinical quality, I encourage you to participate in future Connectathons! These events are crucial for the HL7 team to improve the maturity of their specifications, and are a great way to get inspired by learning what other smart folks in the industry are hacking on.

Commure is designed to help developers build the next generation of healthcare applications. Anyone working in this area should check out Commure’s FHIR-native developer platform. And if you’re interested in working at the intersection of healthcare, programming language theory, and distributed data processing like I am, consider joining the team!

Zach Smith, Engineering Manager

HL7®and FHIR®are registered trademarks of Health Level Seven International (HL7) and their use does not constitute endorsement by HL7.

Originally published at on October 8, 2020.




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