About CDQ (Care Data Quality)

CDQ (Care Data Quality) checks a health system’s patient data against structured, evidence-backed care pathways and shows, patient by patient, which steps were missed, late or too early: missed labs, overdue follow-ups, lapsed medications and unordered referrals. Care teams can act before these become readmissions, adverse events, or missed quality bonuses.

The Problem

Health systems have evidence-based guidelines for nearly every chronic condition. What they lack is a systematic way to check every patient against those guidelines at once. Labs go unordered. Referrals fall through. Post-discharge follow-ups are missed. HEDIS gaps accumulate silently — and by the time a gap surfaces, it may already be a readmission, a missed quality bonus, or an adverse outcome.

What CDQ Does

CDQ (Care Data Quality) is a clinical pathway engine. You send it patient event data, by uploading a file or through the API, and it checks every patient against every pathway they qualify for.

For each upload or API call, CDQ:

Enrolls patients in the pathways whose criteria they meet: ICD-10 diagnoses, medications, lab results, age, sex, insurance, or events such as a hospital or ED discharge
Checks each step against its time window, measured from the pathway’s trigger (a diagnosis, discharge or procedure date)
Reports deviations when a required step is missed, late or too early, and lists the steps not due yet
Ranks deviations by clinical severity (critical / high / moderate / low)
Recommends next steps when a result calls for one (for example a high lab value), without changing anything automatically
Traces every step to the guideline section and HEDIS measure behind it

Why Health Systems Need It

Pain Point	CDQ Solution
HEDIS measure gaps (HBD, CBP, KED, EED, COL-E, BCS-E, TRC-HF…)	Structured pathways mapped to each measure; run checks as often as you like during the measurement year, while gaps can still be closed
CMS readmission penalties (HRRP — HF, PNA, surgical)	Dedicated 30-day transitions of care pathways with day-by-day step tracking from discharge
Care coordination across specialists	Every patient is checked against every pathway at once, so a patient with diabetes and CKD is followed on both
High-ED-utilizer costs	Frequent ED Utilizer pathway enrolls patients with 3 or more ED visits in 90 days
Medication therapy gaps (statins, GDMT for HF, anticoagulation for AFib)	Medication steps flag missing prescriptions, ranked by severity
Behavioral health integration	Co-occurring condition pathways (Diabetes + Depression, Anxiety, OUD-MOUD) with collaborative care step sequences
Manual reporting burden	Results by patient, pathway and step, ready to download as CSV

How It Works

flowchart TD
    A["Your data: upload a file or call the API"] --> B["Enrollment: the pathways each patient qualifies for"]
    B --> C["Each step checked against its time window"]
    C --> D["Deviations ranked by severity"]
    C --> E["Recommendations from abnormal results"]
    D --> F["Results, patient pages and CSV downloads"]
    E --> F
    F --> G["Care team follows up"]
    style A fill:#dbeafe,stroke:#1a3a5c,color:#1a3a5c
    style C fill:#f0f3f8,stroke:#1a3a5c,color:#1a3a5c
    style D fill:#fef3c7,stroke:#92400e,color:#92400e
    style E fill:#f0f3f8,stroke:#2d7dd2,color:#1a3a5c
    style G fill:#dcfce7,stroke:#166534,color:#166534

40 pre-built pathways across three clinical tiers:

Tier 1 High-Impact Core (12) — Diabetes, Hypertension, Heart Failure, CKD, Colorectal Cancer Screening, Breast Cancer Screening, HF Transitions of Care, MDD, AFib, Dyslipidemia, Annual Wellness Visit, Adult Annual Preventive Visit
Tier 2 Population Health Expansion (14) — Cervical Cancer, Lung Cancer LDCT, COPD, Asthma, Obesity, Tobacco Cessation, Pneumonia TOC, Post-Surgical TOC, Adult Immunizations, OUD-MOUD, SDOH Screening, Prediabetes, SNF-to-Home, Hypertension Screening
Tier 3 Complex & Specialty (14) — Well-Child/Pediatric, Alcohol Use Disorder, Joint Replacement, Bariatric Surgery, Colonoscopy, Cardiac Catheterization, Gynecologic Surgery, Cataract Surgery, Frequent ED Utilizer, Anxiety, Complex Care/High-Risk, Advance Care Planning, Maternal/Prenatal, Comorbid Diabetes+Depression

Platform Features

Customisable Pathways

Build your own pathways, and change steps, codes and timing, without software releases (Custom Pathways, HEDIS + Custom and Explorer plans, once paid)
Choose which library pathways you run (up to 10 on Custom Pathways and HEDIS + Custom)
Every change goes through review: see what changed since the last approval, then approve or reject it. Changes and approvals are kept in an audit log.

Evidence Traceability

Every step linked to a specific guideline section (e.g., ADA 2025 §6.1, KDIGO 2024 §2.2, ACC/AHA 2022 §7) and HEDIS/CMS measure
Evidence links shown on each pathway’s page

Recommendations

Results that call for action appear as recommendations (e.g., BNP > 400 → urgent cardiology referral), for each patient and as a CSV
Nothing changes automatically: a recommendation never enrolls a patient or creates a deviation

Severity-Ranked Results

Deviations listed most severe first: patient, pathway, step, expected date, date done and days off
A page for each patient shows every pathway, step by step

Reporting

Download deviations, step results and recommendations as CSV
Usage and plan on the Billing page

Integration Model

CDQ works from data you already have, sent one of two ways:

Way in	What you send	Best for
File upload	CSV, TSV, JSON or Excel, up to 3 GB or 10 million rows	Regular extracts from an EHR, claims or a data warehouse
JSON API	The same fields, with an API key (API guide)	Automated, scheduled checks

Data	Used For
Diagnoses (ICD-10)	Enrollment criteria
Lab results and vital signs, with values	Step completion, and recommendations from abnormal results
Medications (RxNorm or NDC)	Medication steps and prescribing gaps
Procedures and visits (CPT, encounter types)	Visit and procedure steps
Hospital and ED discharges	Triggers for transitions-of-care pathways

Patient data is evaluated in memory and never written to disk; an idle upload is discarded after an hour. Only aggregate counts are kept.

What This Is Not

CDQ is not a clinical decision support tool that pops up alerts during the clinical encounter. It is a population-level deviation detection system — it works between encounters, at the care coordinator and quality team level, to ensure patients who have drifted from the care pathway are identified and re-engaged before adverse events occur.

Request a CDQ Demo →

CDQ (Care Data Quality) — Built on evidence. Designed for operational reality.