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Difference between revisions of "20 July 2018 CQI Conference Call Minutes"

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***Updates made for Continuous Variable measures
 
***Updates made for Continuous Variable measures
 
***Updates made for Composite measures
 
***Updates made for Composite measures
 +
**** No questions were raised during the review of the Publication Package.
 +
**** Juliet moves to approve the package for publication, Julia Seconds. No further discussion.
 +
**** '''15 Approved, 0 Abstained, 0 Against''
 +
 
**Publication Request for CQL-based HQMF IG
 
**Publication Request for CQL-based HQMF IG
−
*** No questions were raised during the review of the Publication Package.  
+
*** No questions were raised during the review of the Publication Request document.  
 
*** Juliet moves to approve the package for publication, Julia Seconds. No further discussion.
 
*** Juliet moves to approve the package for publication, Julia Seconds. No further discussion.
 
*** '''15 Approved, 0 Abstained, 0 Against'''
 
*** '''15 Approved, 0 Abstained, 0 Against'''

Revision as of 17:18, 20 July 2018

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20 July 2018 - CQI Conference Call Minutes DRAFT

HL7 Clinical Quality Information Workgroup
Friday, July 20, 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: Yan
Meeting Scribe: Patty

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
Anne Smith NCQA smith@ncqa.org
Ben Ghahhari CMS benjamin.ghahhari@cms.hhs.gov
Ben Hamlin NCQA hamlin@ncqa.org
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
Chana West ESAC Inc chana.west@esacinc.com
Claudia Hall Mathematica chall@mathematicampr.org
Dan Donahue ESAC dan.donahue@esacinc.com
Floyd Eisenberg iParsimony, LLC FEisenberg@iParsimony.com
Gay Dolin IMO gdolin@imoonline.com
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
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
Kanwarpreet Sethi Lantana Consulting Group kp.sethi@lantanagroup.com
Kathleen Connor US Dept of Veterans Affairs kathleen_connor@comcast.net
Linda Michaelsen Optum linda.michaelsen@optum.com
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
Myron Finseth Medtronic myron.finseth@medtronic.com
Nick Radov UHC nradov@uhc.org
Pamela Mahan-Rudolph Memorial pamela.mahanrudolph@memorialhermann
Patty Craig The Joint Commission pcraig@jointcommission.org yes
Paul Denning MITRE pauld@mitre.org
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
Viet Nguyen Strata Metrics vietnguyen@stratametrics.com
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
Zach May ESAC Inc zachary.may@esacinc.com


  • Reminder
    • 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


  • Decision regarding CQL-based HQMF IG
    • CQL-based HQMF content for publication
      • Posted since this previous Monday for review
      • Minor updates were made to correct identified issues
      • Updates made for Continuous Variable measures
      • Updates made for Composite measures
        • No questions were raised during the review of the Publication Package.
        • Juliet moves to approve the package for publication, Julia Seconds. No further discussion.
        • '15 Approved, 0 Abstained, 0 Against
    • Publication Request for CQL-based HQMF IG
      • No questions were raised during the review of the Publication Request document.
      • Juliet moves to approve the package for publication, Julia Seconds. No further discussion.
      • 15 Approved, 0 Abstained, 0 Against


  • Clinical Reasoning FHIR Tracker items
    • For details of each tracker item, search the FHIR Tracker Website by tracker item ID:
    • Block Vote Tracker Items:
      • 16807 Does this mean that stratisfier always relates to a value set or boolean? Integers and doublesbooleans are not allowed? - 2018-May Core STU #37 (Bas van den Heuvel) In Person Considered - Question Answered
      • 16819 How does this work in CQL. context Patient is supported the other ones are less clear. - 2018-May Core STU #40 (Bas van den Heuvel) In Person Considered - Question Answered
      • 16839 What context? And why not always populate it ? - 2018-May Core STU #46 (Bas van den Heuvel) In Person Considered - Question Answered
      • 14098 Extend Measure/MeasureReport to better support public health/health system use cases (Carl Leitner) Persuasive
      • 15913 MeasureReport.reporter should not include Group (Lloyd McKenzie) Persuasive
      • 16783 Criteria use a different pattern than is expressed in the dynamic language specification. Suggest to align. - 2018-May Core STU #31 (Bas van den Heuvel) In Person Persuasive
      • 16822 The spec is clear on Patient parsing. For the othber ones tha other part of the spect ofting refer to patient based measurs where subject should be used instead. - 2018-May Core STU #41 (Bas van den Heuvel) In Person Persuasive
      • 16836 How the information enclosed in the supplmentalData element is to be used is unclear form the provided information. - 2018-May Core STU #45 (Bas van den Heuvel) In Person Persuasive
      • 16842 Don't understand how this relates to the previous part of the sentence. Does this assume measures are always profiled ? - 2018-May Core STU #47 (Bas van den Heuvel) In Person Persuasive
      • 16845 How does this element relate to the element purpose or usage or description ? - 2018-May Core STU #48 (Bas van den Heuvel) In Person Persuasive
      • 16847 Probably logic refers to the logic included in the Library object. Refering to the library as logic is not clear. - 2018-May Core STU #49 (Bas van den Heuvel) In Person Persuasive
      • 16803 Multiple InitialPopulations? InitialPopulation consisting of multiple populations? Or is meant just having multiple population fields? - 2018-May Core STU #36 (Bas van den Heuvel) In Person Persuasive with Mod
      • 16811 What about very large populations ? you would have for example 20000 references included in the measure report ? - 2018-May Core STU #38 (Bas van den Heuvel) In Person Persuasive with Mod
      • 16815 Is elm no longer supported? - 2018-May Core STU #39 (Bas van den Heuvel) In Person Persuasive with Mod
      • 16826 Add element on measure resource related to Meaningful Measures domain (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/MMF/General-info-Sub-Page.html) as defined by CMS - 2018-May Core STU #42 (Bas van den Heuvel) In Person Persuasive with Mod
    • Individual tracker items for discussions
      • 17355
      • 16853
      • 16850
      • 16833
      • 16830



Review additional harmonization proposal (late addition) Discuss and vote on whether we need to address any issues about it during the harmonization call. Proposal 1 (Add 1 new code to the HL70287 table (Problem/Goal Action Code) to support unambiguous declaration of use of snapshot mode (not using the action codes at all)) Proposal 2 (Add 1 new code to the HL70206 table (Action Code) to support unambiguous declaration of use of snapshot mode (not using the action codes at all))

    • 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)
    • HL7 FHIR® Implementation Guide: Clinical Quality Framework (CQF on FHIR), Release 1 (PI ID: 1234) (Co-Primary with CDS)
    • HL7 FHIR® Profile: Quality, Release 1 - US Realm (PI ID: 1125)
    • 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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