Quality Matters: A Podcast by NCQA

CQL and FHIR: Myths, Misunderstandings and More


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In this episode of Quality Matters, host Andy Reynolds welcomes Bryn Rhodes and Rob Reynolds of Smile Digital Health to unravel two foundational, yet widely misunderstood, technologies in health care: Clinical Quality Language (CQL) and Fast Healthcare Interoperability Resources (FHIR). With decades of leadership in health care standards, Bryn and Rob share hard-earned insights, persistent misconceptions and what the future holds for digital transformation in such areas as clinical reasoning and quality measurement.

Listen to this episode to discover:

  • Why CQL and FHIR Are Often Misunderstood and Why That Matters: CQL enables knowledge and logic sharing, while FHIR facilitates data exchange. Together, they empower precise and scalable healthcare interventions.
  • CQL’s Human Readability is More Than a Feature; It’s a Gateway:  Learn how CQL’s intuitive language design bridges clinical and technical teams, reduces errors in translation and is already proving to be a strong match for AI-based tools and systems.
  • Why FHIR Alone Doesn’t Guarantee Interoperability: Hear why true interoperability requires coordinated expectations between parties, including common terminology and agreed use cases.
  • Business Strategy Meets Standards Adoption: Learn why treating interoperability as a strategic imperative (not just compliance) can unlock innovation, lower costs and drive better population health outcomes.
  • CQL Engine News: NCQA Chief Technology Officer Ed Yurcisin updates the quality community on the role of CQL engines, why no engine covers all use cases and how NCQA’s open-source engine is moving the industry forward.

This conversation is a must-listen for health care leaders, B2B strategists and informatics professionals navigating digital transformation. It’s packed with actionable ideas, tech-forward insights and a human-centered approach to quality’s future. 


Key Quote:

“I’m delighted you’re hearing FHIR and CQL used together because that wasn’t always the case. People in the past used them separately and thought these things are completely distinct. 

Both of them have their power and bring the value separately, but you need both of them to achieve greater value. If you have FHIR, you have the ability to share the data. We can express questions. ‘What about this, about the data?’ We can do that in a shared, interoperable way with CQL.

But if the data isn’t interoperable, the ability to share questions doesn’t do much because you can’t get the data that those questions are about. So hearing people talk about those things in the same sentence, that’s fantastic. That’s exactly where we need to be.“

 -Rob Reynolds
 

Time Stamps:

(02:00) The Relationship Between FHIR and CQL

(08:20) Common Misconceptions About CQL and FHIR

(12:57) NCQA's Commitment to CQL

(17:40) Advice for Adopting CQL and FHIR


Dive Deeper:

Episode 18 of Quality Matters with Ed Yurcisin

Episode 19 of Quality Matters with Ed Yurcisin

Connect with Rob Reynolds

Connect with Bryn Rhodes

...more
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