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SMILE dQM SOLUTION


Drives proactive quality measures to enhance care, streamline operations and increase profits.

WHAT IT DOES

Modernizing the quality measures process supports value-based care outcomes while managing costs. Smile makes this possible with its dQM (digital Quality Measures) solution—powered by a FHIR-native Health Data Platform and CQL (Clinical Quality Language) engine.

HEDIS Measures for Payers

HEDIS (Healthcare Effectiveness Data and Information Set), created by the NCQA ( National Committee for Quality Assurance), is utilized by over 90% of health plans in the U.S. The goal of HEDIS evaluations is to assess care quality, drive improvements, and enable informed patient choices. 

MIPS Measures for Providers

MIPS (Merit-Based Incentive Payment System) is a framework of digital quality measures developed by the CMS (Center for Medicare and Medicaid Services). Its goal is to support value-based payment models, ensuring that healthcare providers are recognized for delivering high-quality care to patients and populations.

ECOSYSTEM TRANSFORMATION WITH KNOWLEDGE PAYERS AND PROVIDERS CAN TRUST

High quality care that can be scaled across populations requires strong partnerships between payers and providers and how their technologies connect. Smile’s dQM is an enterprise-level, scalable solution that runs proactive quality improvement analytics, while also streamlining internal processes to reduce cost, burden, and delays.

For both payers and providers, Smile dQM turns your weeks-long process of manually generating and submitting measurements into only minutes by leveraging open standards in FHIR and CQL.

Current State
With Smile
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Blue Hedis

KEY FEATURES OF SMILE'S dQM FOR PAYERS AND PROVIDERS

Our dQM solution is powered by our FHIR and CQL engine to standardize and modernize quality measure calculations, reporting, and submission, so payers and providers can enhance care and increase profits.

  • All-in-One Measure Support
  • Intuitive & Easy-to-use Tool
  • Manage Population Health
  • Knowledge Authoring
  • Continuous Care Quality Improvement

All-in-One Measure Support

License NCQA Digital Content Services HEDIS Measures and CMS QPP MIPS measures, and also supportstate, regional, and custom measures all with one dQM evaluation tool. This single plug-and-play tool provides maximum flexibility to evaluate measures across diverse populations.

Intuitive & Easy-to-use Tool

Our CQL engine analyzes data and evaluates quality measures automatically, with the click of a button. This automation reduces effort and errors, and frees up your resources to focus on enhancing patient care. 

Manage Population Health

Our high performance engine implements quality improvement at scale, with results for 1 million patients with 250,000,000 FHIR resources in <1 hour with 100ms latency per patient per quality measure.

Knowledge Authoring

Being the experts in CQL, Smile can author non-HEDIS custom quality measures to synthesize clinical knowledge and support new business initiatives including risk adjustments and predictive analytics.

Continuous Care Quality Improvement

Continuous measure evaluation turns retrospective care delivery into prospective care management, supporting earlier care intervention and better population health management.

WHY CHOOSE SMILE'S dQM?

Real-Time Quality Improvement

Transition from retrospective care evaluation to proactive care management with continuous measure evaluation.
Automation and Accuracy

Minimize manual data entry with automated measure evaluation, ensuring more accurate and timely insights.
Flexible and Configurable

Using FHIR open standards, and CQL for knowledge authoring, allows you to configure and scale measures for diverse populations and care settings.

Ready to Transform Your Quality Life-cycle and Lead the Industry?

Get in Touch