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Clinical Quality Measure Testing Procedure

The Office of the National Coordinator continues to post updates to the approved Test Method for the ONC Health Information Technology Certification Program. On Friday March 26, 2016, ONC released an updated version of the ONC-Approved Test Procedure for testing of Electronic clinical quality measures [§170.314(c)(1) – (c)(4)]. The latest version of the Quality Measures Testing Procedure can be found at Test Procedure for §170.314(c) Electronic Clinical Quality Measures. The 2015 edition is now published, delete edition reference so that it is not necessary to update on a regular basis.

Questions may be directed to ONC's Office of Certification via email.

Test Data

The Cypress patient test data consists of:

  • Synthetic patients designed to interact with and provide measure steward approved, gold standard expected results for the Electronic Clinical Quality Measures (eCQMs) selected for CMS quality reporting programs for Eligible Clinicians and Eligible Professionals (EP/EC), and for Eligible Hospital (EH) and Critical Access Hospitals (CAH). Cypress test patients are developed to cover at least 95% of possible eCQM logic pathways.

These standardized set of patient test data will be used as the primary evaluation mechanism for Electronic Health Record (EHR) vendor performance on clinical quality measure implementations via the Cypress software. It has not been designed to be an exhaustive test of all logical elements. Instead, the patient test data has been designed instead to provide a simplified and standardized representation of common population information for a eCQM software implementation to process and accurately calculate results.

Cypress v6 Release

Cypress v6 is now available for certification testing of the electronic clinical quality measures (eCQMs) are updated for calendar year 2021 and 2022 reporting. Cypress 6.2.2 is the latest Cypress v6 release for use in the ONC certification program

Cypress v6 User Guide

Cypress v6 can be used for certification testing of electronic clinical quality measures (eCQMs) updated for calendar year 2021 reporting. The Cypress v6 User Guide can be found here.


The Standards Implementation & Testing Environment is a centralized set of tools designed to assist the implementers of Health Information Technology standards required for certification of Electronic Health Record (EHR) technology, and in general, enable interoperable health information exchange. SITE is divided into sandboxes, one for each supported standard.

Electronic Clinical Quality Measure Logic and Implementation Guidance

An updated document detailing the electronic Clinical Quality Measure Logic is publicly available.

2015 Edition Final Rule

The 2015 Edition Health IT Certification Criteria (2015 Edition) builds on past rulemakings to facilitate greater interoperability for several clinical health information purposes and enables health information exchange through new and enhanced certification criteria, standards, and implementation specifications. Taking into account public comments received on the 2015 Proposed Rule, the final rule continues to focus on the establishment of an interoperable nationwide health information infrastructure. Learn more by clicking here.

JIRA Bug Tracking System

JIRA is used by CMS and ONC to track issues or bugs associated with the electronic Clinical Quality Measures (eCQM). Access to the JIRA-Clinical Quality Measure Feedback System is available here . For assistance using the JIRA system, the JIRA-Clinical Quality Measure Feedback System Instructions are available.

eCQI Resource Center

The eCQI Resource Center is the one-stop shop for the most current resources to support Electronic Clinical Quality Improvement.