Smile Clinical Quality Intelligence Suite

SMILE'S CLINICAL QUALITY INTELLIGENCE SUITE

Smile CQIS closes the gap by transforming aligned, computable data into real-time intelligence that payers and providers can rely on. By executing standards-based logic directly on computable data, our solution delivers accurate, explainable insight that surfaces care gaps, population trends, and quality signals at the moment they matter, supporting operational, clinical, and quality decisions in real time.

Rather than treating intelligence as an end state, Payers now have an always-available capability to embed quality into everyday operational workflows.

Quality improvement modernization occurs in stages and Smile is with you every step of the way—for today’s needs and tomorrow’s challenges.

Learn how to do more with your data with FHIR open standards and CQL (Clinical Quality Language).

BENEFITS OF THE SMILE'S CQIS

Action clinical data insights with FHIR-native data models and CQL logic.

- Reduce quality measurement cycles from years into minutes, saving operational costs.

- Continuously monitor quality measurements, boosting quality scores and reducing administrator burden.

- Proven real-world Digital HEDIS® measure transformation, aligned with NCQA.

- Identify and close care gaps prospectively, improving care outcomes.

- Deliver Clinical Decision Support at the point of care, reducing provider burden.

Smile dQM - Prepare For Today

Start by choosing the platform that drives proactive quality measures to enhance care, streamline operations and increase profits.

Elevate and streamline your quality reporting workflows.
Care Gaps Management - Prepare For The Future

By integrating the power of the Smile FHIR-based Health Data Platform and CQL, you can achieve real-time identification of care gaps and close them with evidence-based recommendations to deliver better patient outcomes.

Scale clinical intelligence with FHIR and CQL.
KALM (Knowledge Authoring Lifecycle Management) Services

With Smile’s AI-accelerated KALM Services, complex clinical policy documents (like narrative PDFs) are transformed into human-readable computable formats. By accelerating the policy authoring process, our clients are streamlining and automating processes like prior authorization, clinical reasoning and quality measures.

KALM Services use a deterministic approach with AI to ensure transparency, audibility and reliability.
The Strategic Path to Digital Quality

Most Payers assume their data is “good enough”; until assessments or audits reveal costly inconsistencies and missed opportunities. The Smile Data Quality Playbook introduces a new and practical framework for US Payers, mapping out how to strategically invest in digital quality transformation today to, accelerate modernization, mitigate risk, and lay the groundwork for a sustainable, data-driven future.