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

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| row2cell2 | ESAC Inc
 
| row2cell2 | ESAC Inc
 
| row2cell3 | chana.west@esacinc.com  
 
| row2cell3 | chana.west@esacinc.com  
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| row2cell4 |  
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| row2cell4 | yes
 
|-
 
|-
 
| row2cell1 | Claudia Hall
 
| row2cell1 | Claudia Hall
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| row2cell3 | mokeefe@mitre.org
 
| row2cell3 | mokeefe@mitre.org
 
| row2cell4 |  
 
| row2cell4 |  
 +
|-
 +
| row2cell1 | Mike Ballie
 +
| row2cell2 | UHC
 +
| row2cell3 | michael.ballie@uhc.com
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| row2cell4 | yes
 
|-
 
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| row2cell1 | Mike Hunt
 
| row2cell1 | Mike Hunt
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* 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>
 
* 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>
−
Questions addressed by the presentation:
+
** Questions addressed by the presentation:
−
** What is role of primary and supplemental data for quality reporting under HEDIS?
+
*** What is role of primary and supplemental data for quality reporting under HEDIS?
−
** What is the NCQA audit process?
+
*** What is the NCQA audit process?
−
** Why is a C-CDA considered supplemental and how are payers & ACOs audited
+
*** 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
+
*** 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>
 
** 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>
 
** 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>
 
** 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>
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** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=198 QRDA Category I R4] - No new comments as of Wednesday, January 2, 2019
 
** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=198 QRDA Category I R4] - No new comments as of Wednesday, January 2, 2019
 
** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=246 QRDA Category I R5]
 
** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=246 QRDA Category I R5]
−
*** Comment 1699 - indicating 404 error - not a standards question - referred to Webmaster. No vote required.
+
*** [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] - No new comments as of Wednesday, January 2, 2019
 
** [http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=220 QRDA Category I R5.1] - 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] - No new comments as of Wednesday, January 2, 2019
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** [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=230 CQL-based HQMF R3] - No new comments as of Wednesday, January 2, 2019
 
** FHIR Tracker Items for Clinical Reasoning:
 
** FHIR Tracker Items for Clinical Reasoning:
−
*** [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.
+
*** [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.
 
** No new CQI (i.e., measurement-related) FHIR Tracker Items for FHIR Clinical Reasoning 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
  
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** The CQI WG reviewed the comments available thus far and had no additions or corrections.
 
** 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.
 
** 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 [http://www.hl7.org/Special/committees/cqi/docs.cfm? CQI Document Site]
 
* Reminder: Sub groups for ballot content refinement reviewed.  Meeting information below:
 
* Reminder: Sub groups for ballot content refinement reviewed.  Meeting information below:
−
** Potential sub groups include: Composite scoring (Tuesdays at 1015a ET)
+
** 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
 
*** 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
 
**** Tuesdays December 18, 2018 and January 8, 2019 from 10:15 to 11:15 AM ET US

Latest revision as of 15:54, 7 January 2019

Back to CQI Agenda and Minutes Page
Back to CQI Wiki Page

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)
    • 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
  • 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
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