Blog

Sharalee is the senior director of population health at Vatica Health.

As the healthcare industry evolves toward value-based care, digital quality measurement has emerged as both an operational necessity and a strategic differentiator. Traditional HEDIS workflows, reliant on manual abstraction and fragmented data, are rapidly giving way to digital ecosystems built on interoperability, standardization and precision. 

In 2025, Digital Quality Measures (DQMs) represents more than a technological upgrade — it’s a fundamental shift in how healthcare organizations define, measure and deliver quality. 

From paper to precision: the shift to digital quality 

For decades, quality reporting has relied on retrospective chart reviews and claims-based approximations. But as highlighted at the recent NCQA Health Innovation Summit 2025, that era is ending. DQMs use structured, standards-based data sourced directly from electronic health records, health information exchanges and other interoperable systems. 

This shift eliminates manual abstraction, reduces reporting lag and improves data accuracy at the source. As NCQA emphasizes, digital quality “requires precision and governance.” Success depends not just on technology but also on deliberate investments in data capture, validation and clinical context alignment. 

By leveraging frameworks like HL7® FHIR®, USCDI, and the HEDIS® Core Implementation Guide, organizations can harmonize data across disparate systems, creating a single, trusted source of truth for quality performance. 

Why digital quality is becoming the industry standard

1. Interoperability and real-time measurement 

Digital quality enables continuous performance tracking, rather than annual measurement cycles. The CMS Quality Payment Program and NCQA’s Digital Measurement Framework both signal an industry-wide expectation that organizations move toward interoperable, FHIR-based reporting that supports real-time feedback and transparency (CMS, 2024; NCQA, 2023). 

This level of visibility enhances data flow between payers, providers and patients. This drives faster care gap closure, supports proactive patient engagement and aligns with health equity goals that rely on timely, accurate data across populations.

2. Governance, accuracy and accountability 

Digital transformation is not just about automation — it’s about re-engineering quality programs for data integrity and governance. As the NCQA session underscored, “accuracy is not optional.” In digital environments, even minor coding or URI mismatches can invalidate entire measure sets. 

Healthcare organizations leading in digital quality are investing in governance frameworks that emphasize structured data capture, validation pipelines and audit-ready transparency, ensuring every measure reported accurately reflects the care delivered.

3. Sustainability and scalability in value-based models 

Digital quality directly supports the scalability and sustainability of value-based care. By enabling population-level computation and bulk FHIR data exchange, organizations can evolve from static measurement to dynamic care pathway design. 

This evolution allows ACOs, health plans and provider groups to manage performance across multiple contracts, reduce administrative overhead and reinvest savings into preventive care and equity initiatives. 

In short, digital quality provides the infrastructure to scale value-based care efficiently and equitably. 

Building the digital quality future 

The future of quality isn’t about simply digitizing HEDIS — it’s about creating a resilient, intelligent and interoperable quality ecosystem. 

Leaders should focus on: 

• Investing in clinical data governance frameworks that ensure accuracy and compliance. 

• Collaborating in digital quality communities like the HL7 Da Vinci and Digital Quality Implementation Collaborative (DQIC) to shape next-generation standards. 

• Designing for scalability, ensuring platforms can support both real-time feedback and longitudinal population health analytics. 

Organizations that embrace digital quality today will define the benchmarks for value-based care tomorrow — achieving not only compliance but also operational excellence, equity, and measurable outcomes at scale. As the industry advances toward digital quality measurement, Vatica is continuously evolving its technology and data infrastructure to meet these standards and help our customers transition seamlessly. 

How Vatica Is enabling the digital quality future 

As Vatica Health integrates its leading risk adjustment platform with Cozeva’s advanced digital quality and population health capabilities, the combined solution is uniquely positioned to help clients operationalize this digital transformation. Together, Vatica and Cozeva provide: 

• Unified risk + quality platform: Seamlessly connects provider workflows, clinical data and measure computation in one interoperable system built on FHIR and other national standards. 

• Real-time quality insights: Enables continuous tracking and closure of care gaps directly at the point of care — not months after claims are processed. 

• Validated clinical data exchange: Supports end-to-end data governance and audit readiness, ensuring that quality reporting reflects accurate, compliant and validated information. 

• Scalable population health analytics: Delivers actionable insights across contracts, helping health plans, ACOs and provider groups improve outcomes and financial performance in value-based models. 

These capabilities align directly with the push by CMS and NCQA toward interoperable, digital-first quality measurement and real time population management. By uniting deep clinical expertise with a powerful technology platform, Vatica Health is not only preparing clients for the digital quality era — it’s already helping them thrive in it. 

References 

1. Centers for Medicare & Medicaid Services (CMS). Quality Payment Program: Digital Quality Measure Roadmap. 2024. https://qpp.cms.gov/ 
2. National Committee for Quality Assurance (NCQA). From Paper to Practice: The Digital Transformation of Quality Measures in Action. Presented at the NCQA Health Innovation Summit, October 2025 
3. Office of the National Coordinator for Health Information Technology (ONC). United States Core Data for Interoperability (USCDI) Version 5. 2024.