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13 July 2018 CQI Conference Call Minutes

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13 July 2018 - CQI Conference Call Minutes

HL7 Clinical Quality Information Workgroup
Friday, July 13, 2018 – 1-3 PM EDT
Dial in: 770-657-9270 Passcode: 217663
https://join.freeconferencecall.com/hl7cqi
CQI Co-chairs: Patty Craig, Floyd Eisenberg, Juliet Rubini, KP Sethi, Yan Heras
Meeting Chair: Floyd
Meeting Scribe: KP

Agenda

  • Roll call
Attendee Attendee's Organization Attendee's email Present
Abdul Malik Hi3 Solutions abdulmalik.shakir@hi3solutions.com
Abrar Salam The Joint Commission asalam@jointcommission.org
Angela Flanagan Lantana Consulting Group angela.flanagan@lantanagroup.com
Ann Phillips NCQA phillps@ncqa.org yes
Anne Smith NCQA smith@ncqa.org yes
Ben Ghahhari CMS benjamin.ghahhari@cms.hhs.gov
Ben Hamlin NCQA hamlin@ncqa.org yes
Bo Borgnakke Michigan Shared Services Network borgnakke@mihin.org
Bob Dieterle Enable Care, LLC rdieterle@enablecare.us
Brett Marquard River Rock Associates brett@riverockassociates.com
Brian Alper EBSCO balper@ebsco.com
Bryn Rhodes ESAC bryn@databaseconsultinggroup.com yes
Chana West ESAC Inc chana.west@esacinc.com yes
Claudia Hall Mathematica chall@mathematicampr.org yes
Dan Donahue ESAC dan.donahue@esacinc.com
Floyd Eisenberg iParsimony, LLC FEisenberg@iParsimony.com yes
Gay Dolin IMO gdolin@imoonline.com yes
Hafsa Subhan The Joint Commission hsubhan@jointcommission.org
Howard Strasberg Wolters Kluwer howard.strasberg@wolterskluwer.com
Humberto Mandirola Biocom hmandirola@biocom.com
iIkka Kunnamo Duodecim jilkkakunnamo@duodecim.fl
James Bradley Mitre jhbradley@mitre.org
Jamie Lehner PCPI jamie.lehner@thepcpi.org yes
Jeff Schmitz Health eFilings jschmitz@healthefilings.com
Jenny Brush ESAC jennifer.brush@esacinc.com
Joe Kunisch Memorial Hermann kunisch@memorialhermann.org
Joe Quinn Optum joseph.quinn@optum.com
John Damore Diameter Health jdamore@diameterhealth.com
Julia Skapik Cognitive Medicine jskapik@cognitivemedicine.com
Juliet Rubini Mathematica jrubini@mathematicampr.com yes
Kanwarpreet Sethi Lantana Consulting Group kp.sethi@lantanagroup.com yes
Kathleen Connor US Dept of Veterans Affairs kathleen_connor@comcast.net
Linda Michaelsen Optum linda.michaelsen@optum.com yes
Lisa Anderson The Joint Commission landerson@jointcommission.org
Lisa Nelson Life Over Time Solutions, LLC LisaRNelson@cox.net
Lizzie Charbonneau Mitre lizzie@mitre.org
Lorraine Constable HL7 Canada lorraine@constable.ca
Luke Osborne MITRE lwosborne@mitre.org
Matthew Tiller ESAC matthew.tiller@esacinc.com
Mike Hunt Experian mike.hunt@experian.com
Mia Nievera The Joint Commission mnievera@jointcommission.org
Mitra Biglari The Joint Commission mbiglari@jointcommission.org yes
Myron Finseth Medtronic myron.finseth@medtronic.com yes
Nick Radov UHC nradov@uhc.org
Pamela Mahan-Rudolph Memorial pamela.mahanrudolph@memorialhermann yes
Patty Craig The Joint Commission pcraig@jointcommission.org
Paul Denning MITRE pauld@mitre.org yes
Ping Jiang The Joint Commission pjiang@jointcommission.org
Rathore Garima rathore.garima1@gmail.com
Rebeccah Baer NCQA baer@ncqa.org
Rich Boyce codehop.dev@gmail.com
Robert Samples ESAC Inc robert.samples@esacinc.com
Rukma Joshi ESAC Inc rukma.joshi@esacinc.com
Sam Sayer Mitre ssayer@mitre.org
Stan Rankins Telligen SRankins@telligen.com
Steve Hufnagel steve.hufnagel.hl7@gmail.com
Sue Kent CCF kents@ccf.org
Sweta Ladwa ESAC inc sweta.ladwa@esacinc.com
Thomas Reese U of Utah thomas.reese@hsc.utah.edu
Thomson Kuhn ACP tkuhn@acponline.org yes
Viet Nguyen Strata Metrics vietnguyen@stratametrics.com yes
Walter Suarez Kaiser Permanente walter.g.suarez@kp.org
Yan Heras Optimum eHealth yanheras@gmail.com yes
Yanyan Hu The Joint Commission yhu@jointcommission.org yes
Zach May ESAC Inc zachary.may@esacinc.com yes


  • Reminder
    • CQI July 6 Call was cancelled
    • Planned ballots for September 2018:
      • Project 1234 - FHIR Clinical Reasoning - current PSS is valid, does not require Notice for Intent to Ballot as it is part of FHIR STU 4
      • (Project ID 1429) - FHIR IG for Exchange of Data for Quality Measures - still needs NIB


  • Update review for FHIR Exchange of Data for Quality Measures
    • Viet gave a quick review of the project. See slides posted on CQI documents page for complete updates.
    • Viet and Bryn went over the Operations Definitions defined in the project. The operation definitions are posted on the FHIR website with a link.
    • Framework is meant to handle any standard - so will there be additional profiles to handle requirements specific to other organizations.
    • Goal is to have as much of that shared among all orgs. If we have done the framework correctly then they should be able to use the core as is without requiring change to how that happens.
    • It would be appropriate to update the IG if there are operations that are needed for reporting.
    • FMG was concerned about not wanting to see an IG come through for every measure. This IG should address the generic framework and provide some use cases as an example.
    • This is based on STU 4 and will mimic what we expect in R4. Will ask FHIR core how to make it backwards compatible for R3. Versioning is going to be a challenge as STU 2 and Argonaut is so well supported.
    • Viet will make confluence page available and encourages folks to join call. Information provided below:


  • Project meetings for FHIR Exchange for Data for Quality Measures:


  • Notice for Intent to Ballot (NIB) for FHIR Exchange of Data for Quality Measures
    • Floyd went over the NIB for FHIR Exchange of Data for QUality Measures with Viet.
    • Project has approvals from FMG, US Realm and Clinical Steering. TSC will review and (hopefully) approve next week.
    • No questions were raised during the review of the NIB.
    • KP moves to approve the NIB, Viet Seconds. No further discussion.
    • 17 Approved, 0 Abstained, 0 Against


  • Review CQL-based HQMF content for publication (Link to publication version documents sent to CQI Workgroup on Monday, July 9, 2018)
    • Will get a draft out monday at the latest and will seek approval following friday.
    • Primary questions related to comment 87 and 88 around continuous variable measure support
    • Some conformance language was added to address these comments' cconcern.
    • Changed referencing in the measure populations to use IDs so its unique
    • similarly changed referencing of included CQL files to be unique by using a URI and then extension of the CQL file.
    • these are the differences b/w draft shared before to now
    • There were a couple of resolutions that were handled differently in the IG than what was voted on the ballot spreadsheet. We should vote on that change to the spreadsheet resolution.
    • Motion by Bryn and KP Seconded to reopen Comment 53 and 99 for resolution.
      • 18 Approved, 0 abstain, 0 against
    • Comment 53: Changed disposition to not persuasive with mod, as the production examples are now dated compared to the changes introduced in the IG.
      • KP makes the motion to approve the updated disposition, Bryn Seconded.
      • 18 Approved, 0 abstain, 0 against
    • Comment 99: Changed disposition to Considered for future use because no current example exists but will add one when we have a clinically relevant one.
      • Bryn Moved, Paul seconded.
      • 18 Approved, 0 abstain, 0 against
    • Paul made the motion to reopen comments 87 and 88. Bryn seconded.
      • 18 Approved, 0 abstain, 0 against
      • Both 87 and 88 dispositions are changed to Persuasive with Mod. See updated spreadsheet for modified dispositions.
      • Bryn moved to approve the modified dispositions. Paul Seconded.
      • 17 Approved, 0 abstain, 0 against
    • Juliet made the motion to approve the ballot spreadsheet with the updates discussed today. Gaye seconded.
      • 17 Approved, 0 abstain, 0 against


  • Review Harmonization Items under consideration
    • Need to review the harmonization proposals and vote to approve that the CQI group has no comments/concerns.
    • Floyd discussed the proposals posted for this harmonization cycle.
    • No concerns were brought up on the call
    • Floyd asked if the group was comfortable stating that we have no concerns with the proposals and will not be joining.
      • Juliet made the motion that we're satisfied with the proposals. KP Seconded.
      • 17 Approved, 0 abstain, 0 against



  • Suggested modifications to CQI WG Mission and Charter Uploaded to CQI Document Site
    • Minor modifications were recommended which are posted in the document as tracked changes on the documents page. On approval Floyd will send a final update.
    • Mostly stylistic changes so will go to TSC right away.
      • KP makes the motion to approve the changes. Bryn seconded.
      • 16 Approved, 0 abstain, 0 against


  • Project Updates
  • CQI Project Updates
    • HL7 CDA® Release 2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I) Release 1, STU Release 4 - US Realm (PI ID: 210)
    • HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture (QRDA III), Release 1 - US Realm (PI ID: 896)
    • HL7 Version 3 Standard: Representation of the Health Quality Measures Format (eMeasure), Release 1 (PI ID: 508)
    • HL7 Version 3 Implementation Guide: Quality Data Model (QDM)-based Health Quality Measure Format (HQMF), Release 1 - US Realm (PI ID: 756)
    • HL7 Version 3 Implementation Guide: Clinical Quality Language (CQL)-based Health Quality Measure Format (HQMF), Release 1 - US Realm (PI ID: 1142)
      • does not need any management group approvals since doesnot have FHIR or CDA content.
    • HL7 FHIR® Implementation Guide: Clinical Quality Framework (CQF on FHIR), Release 1 (PI ID: 1234) (Co-Primary with CDS)
      • We need to include the Measure Report and Measure Resource in the R4 ballot. no disagreements from the group.
      • Bryn moved that we include the Clinical Reasoning IG in the FHIR R4 ballot. Juliet Seconded.
      • 16 Approved, 0 abstain, 0 against
      • Still some ballot resolutions that are left to go. Will put FHIR tracker items on the agenda to get through them.
    • HL7 FHIR® Profile: Quality, Release 1 - US Realm (PI ID: 1125)
      • Submitted for publication. has gone to FMG before going to TSC. Questions popped up about errors but they do not affect implementability.
    • HL7 CDA® R2 Implementation Guide: Supplemental QRDA Clinical Quality Data Sharing User Guide, Release 1 (PI ID: 1215)
    • FHIR IG for Exchange of Data for Quality Measures (PI ID: 1429)
    • Gaps in Care (PI ID: 1427)
  • Co-sponsored Project Updates (5 min)
    • HL7 Cross-Paradigm Specification: Clinical Quality Language, Release 1 (PI ID: 1108) (CDS Primary, CQI co-sponsor)
    • HL7 Cross-Paradigm Specification: CIMI Logical Models, Release 1 (PI ID: 1253) (CIMI Primary, CQI co-sponsor)
    • HL7 Cross Paradigm Specification: Neutral Mapping Notation, R1 (Project 1237 – FluentPath - Aligning FHIRPath with CQL --- co-sponsoring with CDS, ITS <primary>, FHIR)
    • CrossParadigm IG Medical Device Interoperability (PSS: CrossParadigm_IG_Medical_Device_interoperability.v.4.docx)
    • Composite KNART Investigation (PSS: 1336)
    • CrossParadigm_Storyboard_Artifact_Payer_Value_Based_Care(PSS: 1347)
    • Clinical Decision Support Big Picture Implementation Guide (PI ID: tbd) (Arden Syntax Primary, CQI and CDS co-sponsor)
    • FHIR Public Health Electronic Case Reporting (eCR) (PI ID: tbd) CQI and CDS co-sponsor with CIMI as an interested party)
    • US FHIR Core Updates PSS (PI ID: 1265) (US FHIR Primary, CQI and CDS co-sponsor with CIMI as an interested party)
    • Evidence-Based Medicine on FHIR (CDS sponsor, CQI co-sponsor) EBM on FHIR Project Initiation Tasks (Project ID 1422)
  • Notifications
  • New Project Scope Statements - May 27, 2018
  • Harmonization
    • Initial proposals due - June 22, 2018
    • Final proposals due - July 20, 2018
    • Harmonization meeting - July 25 and 26, 2018
  • Notification for Intent to Ballot deadline - July 15, 2018
  • Initial Content Deadline - July 4, 2018
  • Reconciliation Content Deadline - August 3, 2018
  • Final ballot content due - August 19, 2018
  • Ballot opens – August 24, 2018 – September 24, 2018
  • WGM – September 29 - October 5, 2018 (Baltimore, MD)
  • Next CQI Workgroup Call: July 20, 2018
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