Difference between revisions of "04 January 2018 CQI Conference call Minutes"

Latest revision as of 15:54, 7 January 2019

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DRAFT January 4, 2019 - CQI Conference Call Meeting Minutes

HL7 Clinical Quality Information Workgroup
January 4, 2019 – 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: Juliet
Meeting Scribe: Floyd

January 4, 2019 - CQI Conference Call Attendance

Attendee	Attendee's Organization	Attendee's email	Present
Abdul Malik	Hi3 Solutions	abdulmalik.shakir@hi3solutions.com
Abrar Salam	The Joint Commission	asalam@jointcommission.org
Alex Liu	EPIC	aliu@epic.com
Andrey Soares	U C Denver	andrey.soares@ucdenver.edu	yes
Angela Flanagan	Lantana Consulting Group	angela.flanagan@lantanagroup.com	yes
Ann Phillips	NCQA	phillps@ncqa.org
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
Bob Keyes	Telligen	bkeyes@telligen.com
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
Craig Newman	Altartum	craig.newman@altarum.org	yes
Crystal Kallem	CK Consulting	crystal.kallem@ckconsultingllc.com
Dan Donahue	ESAC	dan.donahue@esacinc.com
David Sundaram-Stukel	EPIC	dsandara@epic.com	yes
Dipti Ghandi	The Joint Commission	dghandi@jointcommission.org	yes
Durwin Day	BCBSA	dday@bsbsil	yes
Eric Askegaard	UHG	eric_askegaard@uhg.com	yes
Floyd Eisenberg	iParsimony, LLC	FEisenberg@iParsimony.com	yes
Fareeda Nazeer	The Joint Commission	fnazeer@jointcommission.org
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
isabel Zaru-Roque	ESAC	isabel.zaru-roque@esacinc.com
James Bradley	Mitre	jhbradley@mitre.org
Jamie Lehner	PCPI	jamie.lehner@thepcpi.org
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	yes
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
Kurt Allen	US Dept of Veterans Affairs	kurta@gjoll.com
Ken Hall	Veradigm Health	kenneth.hall@veradigmhealth.com	yes
Lenel James	BCBSA	lenel.james@bcbsa.org	yes
Linda Michaelsen	Optum	linda.michaelsen@optum.com	yes
Lisa Anderson	The Joint Commission	landerson@jointcommission.org	yes
Lisa Nelson	Life Over Time Solutions, LLC	LisaRNelson@cox.net
Liz Hartley-Sommers	BCBSA	elizabeth.hartley@bcbsla.com	yes
Lizzie Charbonneau	Mitre	lizzie@mitre.org
Lorraine Constable	HL7 Canada	lorraine@constable.ca
Luke Osborne	MITRE	lwosborne@mitre.org
Lynn Perrine	Lantana	lynn.perrine@lantanagroup.org	yes
Matthew Tiller	ESAC	matthew.tiller@esacinc.com	yes
Michael Okeefe	MITRE	mokeefe@mitre.org
Mike Ballie	UHC	michael.ballie@uhc.com	yes
Mike Hunt	Experian	mike.hunt@experian.com
Mia Nievera	The Joint Commission	mnievera@jointcommission.org	yes
Mitra Biglari	The Joint Commission	mbiglari@jointcommission.org
Michelle Mish Turner	UHC	michelle-p-turner@uhc.org	yes
Nancy Whipple	GE	nancy.whipple@ge.com
Nick Radov	UHC	nradov@uhc.org	yes
Pamela Mahan-Rudolph	Memorial	pamela.mahanrudolph@memorialhermann
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
Rob McClure	MD Partners Inc	rmcclure@mdpartners.com
Robert Samples	ESAC Inc	robert.samples@esacinc.com	yes
Rukma Joshi	ESAC Inc	rukma.joshi@esacinc.com
Ryan Clark	NCQA	ryan@ncqa.org	yes
Sam Sayer	Mitre	ssayer@mitre.org
Serafina Versaggi	JP Systems	serafina.versaggi@jpsystems.com	yes
Stan Rankins	Telligen	SRankins@telligen.com	yes
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
Wendy Talbot	NCQA	talbot@ncqa.org	yes
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
Zabrina Gonzaga	Lantana Consulting Group	zabriana.gonzaga@lantanagroup.com

Meeting Minutes

Roll call and agenda review

Secondary use of CDAs from provider EHR or from local-to-provider HIEs for Reporting Quality Measure Information - Attachments Workgroup invited for presentation [Wendy Talbot (NCQA] - NCQA Audit Supplemental Data Presentation
- Questions addressed by the presentation:
  - What is role of primary and supplemental data for quality reporting under HEDIS?
  - What is the NCQA audit process?
  - Why is a C-CDA considered supplemental and how are payers & ACOs audited
  - What is the current and planned NCQA approach for “validating HIE data feeds” with C-CDA in 2019
- See slide deck provided by Wendy Talbot. The primary issue is the need to validate the original source of information. Once a reviewer/auditor has reviewed a specific source, the information can be considered "standard" when checked in subsequent years. If 2 sources are using the same EHR, can the answer work for two different providers. The requirement is to assure the data are coming from the right place within the program. The effort is to assure NCQA is receiving the information expected (provenance, correct fields, etc.). Without validation back to the source causes challenges with reliability and validity of data. Claims are also validated, not just C-CDAs. To avoid receiving information about ordered procedures Vs completed procedures, QDM and/or FHIR profiles can increase eCQM specificity that may help with the need to audit in the future. The auditors also work with plans and vendors to address issues identified.
- C-CDA Attachments Supplemental Guide - This AWG-published HL7 standard and guide includes an entire Chapter 7 on added constraints for C-CDA R2.1 identified by the major US payers, including CMS, UHC and BCBS Plans. These conformance constraints have been proposed and submitted to be part of the HIPAA Attachments rule and are deemed critical to provide key constraints on C-CDA to help ensure better quality and better consistency in document creation. Perhaps some or many of the same constraints would provide comparable value for quality reporting.
- Some health plans capture a lot of information, not only those required for specific measured. Therefore, all the information is passed through a C-CDA.
- C-CDA provenance not necessarily included in files. C-CDA elements allow author, performer, dateTime, recorder but these are not necessarily shared at the data level.
- Sharing of the logs of issues found by NCQA auditors would help with standards reviews. These issues can be shared at the Implementation-a-thon.
- Provenance is not the major problem, it is more an issue of building C-CDAs. Feedback will be very helpful to encourage better implementations. The C-CDA scorecard will not be sufficient. The Examples Task Force provides another path to provide standard examples. C-CDA Scorecard
- NCQA meets with the auditors next week and will bring information for discussion at the San Antonio WGM. The Examples Task Force is also meeting Saturday Evening 1/12/2019 as another venue for reviewing the issues identified.
STU Comment Review (Monthly)
- QRDA Category I R4 - No new comments as of Wednesday, January 2, 2019
- QRDA Category I R5
  - Comment 1699 - indicating 404 error - not a standards question - referred to Webmaster. No vote required.
- QRDA Category I R5.1 - No new comments as of Wednesday, January 2, 2019
- QRDA Category III R2.1 - No new comments as of Wednesday, January 2, 2019
- QDM-based HQMF R1.4 - No new comments as of Wednesday, January 2, 2019
- CQL-based HQMF R2 - No new comments as of Wednesday, January 2, 2019
- CQL-based HQMF R2.1 - No new comments as of Wednesday, January 2, 2019
- CQL-based HQMF R3 - No new comments as of Wednesday, January 2, 2019
- FHIR Tracker Items for Clinical Reasoning:
  - 19855 - Discussed a need for FHIR Measure IG which will require a PSS. To ballot in May or September 2019, we will need to start the process during the San Antonio WGM for approval within 4 weeks prior to the May WGM. Note - this comment was not resolved during the meeting today.
- No new CQI (i.e., measurement-related) FHIR Tracker Items for FHIR Clinical Reasoning as of Wednesday, January 2, 2019

Finalization of CDS and CQI Comments for the HL7 Policy Committee on ONC Draft for Public Comment "Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs" - CDS Workgroup invited for comment review
- email from Bryn Rhodes (12/20/2018 7:17 PM ET) with last set of comment edits (to be attached to agenda announcement)
- The CQI WG reviewed the comments available thus far and had no additions or corrections.
- Floyd Eisenberg moved to submit the comments to the HL7 Policy Committee; Anne Marie Smith seconded. 18 Approve, 0 Opposed, 1 Abstention.
- Final CQI and CDS Comments submitted to the HL7 Policy Committee uploaded to CQI Document Site
Reminder: Sub groups for ballot content refinement reviewed. Meeting information below:
- Sub groups include: Composite scoring (Tuesdays at 1015a ET)
  - CQL-based HQMF Discussion RE: Composite Measures in CQL (call minutes on confluence: Composite Measures in CQL SubGroup) - No updates presented
    - Tuesdays December 18, 2018 and January 8, 2019 from 10:15 to 11:15 AM ET US
    - Webinar http://gotomeet.me/alphora
  - DEQM Project Call Details (no updates presented):
    - First call on Thursday, December 20th, 3 - 4 PM ET and subsequently every Thursday at 3 - 4 PM ET
    - https://www.gotomeet.me/DaVinciTechnical
    - United States: +1 (646) 749-3122
    - Access Code: 255-559-629
    - The recurring call details is available on HL7 website Conference Calls Center
- QUICK (to be scheduled post discussion at the HL7 WGM in San Antonio)
- FHIR measures (time: potentially use second half Friday CQI meetings
Reviewed and updated San Antonio schedule
- Found on confluence here
Confluence is coming!
- Confluence will replace the Wiki for agendas and the HL7 work group page for document posting
- CQI WG members reminded to sign up for an account here
- Draft confluence page available here
Project Updates
- CQI Project Updateslinked to Confluence here - No updates provided
Notifications and Announcements
- Cancel January 11, 2019 meeting due to travel to San Antonio WGM
- Next CQI WG meeting - at San Antonio HL7 WGM
- Balloting Milestones
  - December 7, 2018 – January 7, 2019 – NOTE BALLOT COMMENT DEADLINE January 7, 2019

Meeting Adjourned at: 2:56 PM ET, Friday, January 4, 2019

Difference between revisions of "04 January 2018 CQI Conference call Minutes"

Latest revision as of 15:54, 7 January 2019

DRAFT January 4, 2019 - CQI Conference Call Meeting Minutes

January 4, 2019 - CQI Conference Call Attendance

Meeting Minutes

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@@ Line 2: / Line 2: @@
 [http://wiki.hl7.org/index.php?title=Clinical_Quality_Information Back to CQI Wiki Page]
 <br>
-=='''January 4, 2019''' - CQI Conference Call Meeting Minutes==
+=='''DRAFT''' '''January 4, 2019''' - CQI Conference Call Meeting Minutes==
 HL7 Clinical Quality Information Workgroup
 <br>
-'''January 4, 2019'' – 1-3 PM EDT<br>
+''January 4, 2019'' – 1-3 PM EDT<br>
 Dial in: 770-657-9270 Passcode: 217663<br>
 [https://join.freeconferencecall.com/hl7cqi https://join.freeconferencecall.com/hl7cqi]<br>
@@ Line 35: / Line 35: @@
 | row2cell3 | aliu@epic.com
 | row2cell4 |
+|-
+| row2cell1 | Andrey Soares
+| row2cell2 | U C Denver
+| row2cell3 | andrey.soares@ucdenver.edu
+| row2cell4 | yes
 |-
 | row2cell1 | Angela Flanagan
 | row2cell2 | Lantana Consulting Group
 | row2cell3 | angela.flanagan@lantanagroup.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Ann Phillips
@@ Line 49: / Line 54: @@
 | row2cell2 | NCQA
 | row2cell3 | smith@ncqa.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Ben Ghahhari
@@ Line 59: / Line 64: @@
 | row2cell2 | NCQA
 | row2cell3 | hamlin@ncqa.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Bo Borgnakke
@@ Line 89: / Line 94: @@
 | row2cell2 | ESAC
 | row2cell3 | bryn@databaseconsultinggroup.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Chana West
 | row2cell2 | ESAC Inc
 | row2cell3 | chana.west@esacinc.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Claudia Hall
 | row2cell2 | Mathematica
 | row2cell3 | chall@mathematicampr.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Craig Newman
 | row2cell2 | Altartum
 | row2cell3 | craig.newman@altarum.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Crystal Kallem
@@ Line 119: / Line 124: @@
 | row2cell2 | EPIC
 | row2cell3 | dsandara@epic.com
-| row2cell4 |
+| row2cell4 | yes
+|-
+| row2cell1 | Dipti Ghandi
+| row2cell2 | The Joint Commission
+| row2cell3 | dghandi@jointcommission.org
+| row2cell4 | yes
+|-
+| row2cell1 | Durwin Day
+| row2cell2 | BCBSA
+| row2cell3 | dday@bsbsil
+| row2cell4 | yes
+|-
+| row2cell1 | Eric Askegaard
+| row2cell2 | UHG
+| row2cell3 | eric_askegaard@uhg.com
+| row2cell4 | yes
 |-
 | row1cell1 | Floyd Eisenberg
 | row1cell2 | iParsimony, LLC
 | row1cell3 | FEisenberg@iParsimony.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row1cell1 | Fareeda Nazeer
@@ Line 134: / Line 154: @@
 | row2cell2 | IMO
 | row2cell3 | gdolin@imoonline.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Hafsa Subhan
@@ Line 189: / Line 209: @@
 | row2cell2 | Optum
 | row2cell3 | joseph.quinn@optum.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | John Damore
@@ Line 204: / Line 224: @@
 | row2cell2 | Mathematica
 | row2cell3 | jrubini@mathematicampr.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Kanwarpreet Sethi
 | row2cell2 | Lantana Consulting Group
 | row2cell3 | kp.sethi@lantanagroup.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Kathleen Connor
@@ Line 220: / Line 240: @@
 | row2cell3 | kurta@gjoll.com
 | row2cell4 |
+|-
+| row2cell1 | Ken Hall
+| row2cell2 | Veradigm Health
+| row2cell3 | kenneth.hall@veradigmhealth.com
+| row2cell4 | yes
+|-
+| row2cell1 | Lenel James
+| row2cell2 | BCBSA
+| row2cell3 | lenel.james@bcbsa.org
+| row2cell4 | yes
 |-
 | row2cell1 | Linda Michaelsen
 | row2cell2 | Optum
 | row2cell3 | linda.michaelsen@optum.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Lisa Anderson
@@ Line 235: / Line 265: @@
 | row2cell3 | LisaRNelson@cox.net
 | row2cell4 |
+|-
+| row2cell1 | Liz Hartley-Sommers
+| row2cell2 | BCBSA
+| row2cell3 | elizabeth.hartley@bcbsla.com
+| row2cell4 | yes
 |-
 | row2cell1 | Lizzie Charbonneau
@@ Line 250: / Line 285: @@
 | row2cell3 | lwosborne@mitre.org
 | row2cell4 |
+|-
+| row2cell1 | Lynn Perrine
+| row2cell2 | Lantana
+| row2cell3 | lynn.perrine@lantanagroup.org
+| row2cell4 | yes
 |-
 | row2cell1 | Matthew Tiller
@@ Line 260: / Line 300: @@
 | row2cell3 | mokeefe@mitre.org
 | row2cell4 |
+|-
+| row2cell1 | Mike Ballie
+| row2cell2 | UHC
+| row2cell3 | michael.ballie@uhc.com
+| row2cell4 | yes
 |-
 | row2cell1 | Mike Hunt
@@ Line 269: / Line 314: @@
 | row2cell2 | The Joint Commission
 | row2cell3 | mnievera@jointcommission.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Mitra Biglari
@@ Line 275: / Line 320: @@
 | row2cell3 | mbiglari@jointcommission.org
 | row2cell4 |
+|-
+| row2cell1 | Michelle Mish Turner
+| row2cell2 | UHC
+| row2cell3 | michelle-p-turner@uhc.org
+| row2cell4 | yes
 |-
 | row2cell1 | Nancy Whipple
@@ Line 284: / Line 334: @@
 | row2cell2 | UHC
 | row2cell3 | nradov@uhc.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Pamela Mahan-Rudolph
@@ Line 299: / Line 349: @@
 | row2cell2 | MITRE
 | row2cell3 | pauld@mitre.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Ping Jiang
@@ Line 329: / Line 379: @@
 | row2cell2 | ESAC Inc
 | row2cell3 | robert.samples@esacinc.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Rukma Joshi
@@ Line 339: / Line 389: @@
 | row2cell2 | NCQA
 | row2cell3 | ryan@ncqa.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Sam Sayer
@@ Line 345: / Line 395: @@
 | row2cell3 | ssayer@mitre.org
 | row2cell4 |
+|-
+| row2cell1 | Serafina Versaggi
+| row2cell2 | JP Systems
+| row2cell3 | serafina.versaggi@jpsystems.com
+| row2cell4 | yes
 |-
 | row2cell1 | Stan Rankins
 | row2cell2 | Telligen
 | row2cell3 | SRankins@telligen.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Steve Hufnagel
@@ Line 374: / Line 429: @@
 | row2cell2 | ACP
 | row2cell3 | tkuhn@acponline.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Viet Nguyen
@@ Line 385: / Line 440: @@
 | row2cell3 | walter.g.suarez@kp.org
 | row2cell4 |
+|-
+| row2cell1 | Wendy Talbot
+| row2cell2 | NCQA
+| row2cell3 | talbot@ncqa.org
+| row2cell4 | yes
 |-
 | row2cell1 | Yan Heras
 | row2cell2 | Optimum eHealth
 | row2cell3 | yanheras@gmail.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Yanyan Hu
 | row2cell2 | The Joint Commission
 | row2cell3 | yhu@jointcommission.org
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Zach May
 | row2cell2 | ESAC Inc
 | row2cell3 | zachary.may@esacinc.com
-| row2cell4 |
+| row2cell4 | yes
 |-
 | row2cell1 | Zabrina Gonzaga
@@ Line 410: / Line 470: @@
 *Roll call and agenda review<br>
-* Secondary use of CDAs from provider EHR or from local-to-provider HIEs for Reporting Quality Measure Information - Attachments Workgroup invited for presentation [Wendy Talbot (NCQA]
+* Secondary use of CDAs from provider EHR or from local-to-provider HIEs for Reporting Quality Measure Information - Attachments Workgroup invited for presentation [Wendy Talbot (NCQA] - [http://wiki.hl7.org/index.php?title=File:The_Audit_Supplemental_Data.pptx#file NCQA Audit Supplemental Data Presentation]<br>
-** What is role of primary and supplemental data for quality reporting under HEDIS?
+** Questions addressed by the presentation:
-** What is the NCQA audit process?
+*** What is role of primary and supplemental data for quality reporting under HEDIS?
-** Why is a C-CDA considered supplemental and how are payers & ACOs audited
+*** What is the NCQA audit process?
-** What is the current and planned NCQA approach for “validating HIE data feeds” with C-CDA in 2019
+*** Why is a C-CDA considered supplemental and how are payers & ACOs audited
+*** What is the current and planned NCQA approach for “validating HIE data feeds” with C-CDA in 2019
+** See slide deck provided by Wendy Talbot.  The primary issue is the need to validate the original source of information. Once a reviewer/auditor has reviewed a specific source, the information can be considered "standard" when checked in subsequent years.  If 2 sources are using the same EHR, can the answer work for two different providers.  The requirement is to assure the data are coming from the right place within the program. The effort is to assure NCQA is receiving the information expected (provenance, correct fields, etc.). Without validation back to the source causes challenges with reliability and validity of data. Claims are also validated, not just C-CDAs.  To avoid receiving information about ordered procedures Vs completed procedures, QDM and/or FHIR profiles can increase eCQM specificity that may help with the need to audit in the future.  The auditors also work with plans and vendors to address issues identified. <br>
+** [http://www.hl7.org/implement/standards/product_brief.cfm?product_id=464 C-CDA Attachments Supplemental Guide] - This AWG-published HL7 standard and guide includes an entire Chapter 7 on added constraints for C-CDA R2.1 identified by the major US payers, including CMS, UHC and BCBS Plans.  These conformance constraints have been proposed and submitted to be part of the HIPAA Attachments rule and are deemed critical to provide key constraints on C-CDA to help ensure better quality and better consistency in document creation.  Perhaps some or many of the same constraints would provide comparable value for quality reporting.
+** Some health plans capture a lot of information, not only those required for specific measured. Therefore, all the information is passed through a C-CDA.<br>
+** C-CDA provenance not necessarily included in files. C-CDA elements allow author, performer, dateTime, recorder but these are not necessarily shared at the data level.<br>
+** Sharing of the logs of issues found by NCQA auditors would help with standards reviews. These issues can be shared at the Implementation-a-thon.<br>
+** Provenance is not the major problem, it is more an issue of building C-CDAs. Feedback will be very helpful to encourage better implementations.  The C-CDA scorecard will not be sufficient.  The Examples Task Force provides another path to provide standard examples. [https://sitenv.org/ccda-smart-scorecard/ C-CDA Scorecard]
+** NCQA meets with the auditors next week and will bring information for discussion at the San Antonio WGM. The Examples Task Force is also meeting Saturday Evening 1/12/2019 as another venue for reviewing the issues identified.
 * STU Comment Review (Monthly)
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=198 QRDA Category I R4]
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=198 QRDA Category I R4] - No new comments as of Wednesday, January 2, 2019
-*** No new comments as of Wednesday, January 2, 2019
 ** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=246 QRDA Category I R5]
-*** No new comments as of Wednesday, January 2, 2019
+*** [http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=1699 Comment 1699] - indicating 404 error - not a standards question - referred to Webmaster. No vote required.
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=220 QRDA Category I R5.1]
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=220 QRDA Category I R5.1] - No new comments as of Wednesday, January 2, 2019
-*** No new comments as of Wednesday, January 2, 2019
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=212 QRDA Category III R2.1] - No new comments as of Wednesday, January 2, 2019
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=212 QRDA Category III R2.1]
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=196 QDM-based HQMF R1.4] - No new comments as of Wednesday, January 2, 2019
-*** No new comments as of Wednesday, January 2, 2019
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=210 CQL-based HQMF R2] - No new comments as of Wednesday, January 2, 2019
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=196 QDM-based HQMF R1.4]
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=217 CQL-based HQMF R2.1] - No new comments as of Wednesday, January 2, 2019
-*** No new comments as of Wednesday, January 2, 2019
+** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=230 CQL-based HQMF R3] - No new comments as of Wednesday, January 2, 2019
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=210 CQL-based HQMF R2]
+** FHIR Tracker Items for Clinical Reasoning:
-*** No new comments as of Wednesday, January 2, 2019
+*** [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=19855&start=0 19855] - Discussed a need for FHIR Measure IG which will require a PSS.  To ballot in May or September 2019, we will need to start the process during the San Antonio WGM for approval within 4 weeks prior to the May WGM. Note - this comment was not resolved during the meeting today.
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=217 CQL-based HQMF R2.1]
-*** No new comments as of Wednesday, January 2, 2019
-** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=230 CQL-based HQMF R3]
-*** No new comments as of Wednesday, January 2, 2019
-** No new FHIR Tracker Items for QICore as of Wednesday, January 2, 2019
 ** No new CQI (i.e., measurement-related) FHIR Tracker Items for FHIR Clinical Reasoning as of Wednesday, January 2, 2019
 * Finalization of CDS and CQI Comments for the HL7 Policy Committee on [https://www.healthit.gov/sites/default/files/page/2018-11/Draft%20Strategy%20on%20Reducing%20Regulatory%20and%20Administrative%20Burden%20Relating.pdf ONC Draft for Public Comment "Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs"] - CDS Workgroup invited for comment review
 ** email from Bryn Rhodes (12/20/2018 7:17 PM ET) with last set of comment edits (to be attached to agenda announcement)
+** The CQI WG reviewed the comments available thus far and had no additions or corrections.
-* Reminder: Sub groups for ballot content refinement
+** Floyd Eisenberg moved to submit the comments to the HL7 Policy Committee; Anne Marie Smith seconded. 18 Approve, 0 Opposed, 1 Abstention.
-** Potential sub groups include: Composite scoring (Tuesdays at 1015a ET)
+** Final CQI and CDS Comments submitted to the HL7 Policy Committee uploaded to [http://www.hl7.org/Special/committees/cqi/docs.cfm? CQI Document Site]
-*** CQL-based HQMF Discussion RE: Composite Measures in CQL (call minutes on confluence: [https://confluence.hl7.org/display/CQIWC/CQI+Workgroup+Sub-Workgroup+on+CQL-Based+HQMF+Composite+Measure+Expressions+in+CQL Composite Measures in CQL SubGroup])
+* Reminder: Sub groups for ballot content refinement reviewed.  Meeting information below:
+** Sub groups include: Composite scoring (Tuesdays at 1015a ET)
+*** CQL-based HQMF Discussion RE: Composite Measures in CQL (call minutes on confluence: [https://confluence.hl7.org/display/CQIWC/CQI+Workgroup+Sub-Workgroup+on+CQL-Based+HQMF+Composite+Measure+Expressions+in+CQL Composite Measures in CQL SubGroup]) - No updates presented
 **** Tuesdays December 18, 2018 and January 8, 2019 from 10:15 to 11:15 AM ET US
 **** Webinar [http://gotomeet.me/alphora http://gotomeet.me/alphora]
-*** DEQM Project Call Details:
+*** DEQM Project Call Details (no updates presented):
 **** First call on Thursday, December 20th, 3 - 4 PM ET and subsequently every Thursday at 3 - 4 PM ET
 **** https://www.gotomeet.me/DaVinciTechnical
@@ Line 451: / Line 515: @@
 ** QUICK (to be scheduled post discussion at the HL7 WGM in San Antonio)
 ** FHIR measures (time: potentially use second half Friday CQI meetings
-* Review San Antonio schedule<br>
+* Reviewed and updated San Antonio schedule<br>
 ** Found on confluence [https://confluence.hl7.org/display/CQIWC/Jan+2019+WG%2C+San+Antonio%2C+TX+-+Agenda  here]
 * Confluence is coming!<br>
 ** Confluence will replace the Wiki for agendas and the HL7 work group page for document posting
-** Please sign up for an account [https://jira.hl7.org/secure/Signup!default.jspa here]
+** CQI WG members reminded to sign up for an account [https://jira.hl7.org/secure/Signup!default.jspa here]
 ** Draft confluence page available [https://confluence.hl7.org/pages/viewpage.action?spaceKey=CQIWC&title=Clinical+Quality+Information+WG+%28CQI%29+Home here]
 * Project Updates<br>
-** CQI Project Updates[https://confluence.hl7.org/display/CQIWC/Clinical+Quality+Information+WG+%28CQI%29+Home linked to Confluence here]
+** CQI Project Updates[https://confluence.hl7.org/display/CQIWC/Clinical+Quality+Information+WG+%28CQI%29+Home linked to Confluence here] - No updates provided
 * Notifications and Announcements<br>
 ** Cancel January 11, 2019 meeting due to travel to San Antonio WGM
@@ Line 465: / Line 529: @@
 *** December 7, 2018 – January 7, 2019 – '''NOTE BALLOT COMMENT DEADLINE January 7, 2019'''
-* Meeting Adjourned at:
+* Meeting Adjourned at: 2:56 PM ET, Friday, January 4, 2019