20 July 2018 CQI Conference Call Minutes

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

20 July 2018 - CQI Conference Call Minutes

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	yes
Alex Liu	Epic	aliu@epic.com	yes
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	yes
Chana West	ESAC Inc	chana.west@esacinc.com	yes
Claudia Hall	Mathematica	chall@mathematicampr.org	yes
Dan Donahue	ESAC	dan.donahue@esacinc.com
David Sundarum-Stukel	Epic	dsundara@epic.com	yes
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	yes
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	yes
Lisa Nelson	Life Over Time Solutions, LLC	LisaRNelson@cox.net
Lizzie Charbonneau	Mitre	lizzie@mitre.org	yes
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	yes
Mitra Biglari	The Joint Commission	mbiglari@jointcommission.org
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	yes
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
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
  • 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, Claudia Seconds. No further discussion.
      • 15 Approved, 0 Abstained, 0 Against
  • [http://www.hl7.org/documentcenter/public/wg/cqi/HL7_Publication_Request_CQL-based_HQMF_PIC-1142_2018July-20.docx Publication Request
    • Based upon discussion the following updates were made:
      • Implementation and Case Studies section to include the MAT, Bonnie, and used for eCQM publication on eCQI Resource Center
      • Parent Standard section CQL R1.1 to R1.2
      • Updated Vote numbers
    • Bryn moves to approve the package for publication, Juliet 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 #1 Tracker Items:
    • Note: There are items in the block vote that were requested for in person review; however, the individual has not responded. Only Persuasive items are being included from this individual. Given the time remaining to complete review of FHIR Tracker items, CQI agreed to include these items within the vote.
      • 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
    • Bryn moves to approve the Block Vote #1 as specified, Myron Seconds. No further discussion.
    • 15 Approved, 1 Abstained, 0 Against
  • Individual tracker items discussed during the call:
    • 17355
      • Minor discussion occurred.
      • The proposed resolution is Persuasive.
      • Bryn moves to approve this tracker item as specified, Patty Seconds. No further discussion.
      • 16 Approved, 0 Abstained, 0 Against
    • 16853
      • Individual requested an in person review; however, they have not been available.
      • The proposed resolution is Persuasive.
      • Bryn moves to approve this tracker item as specified, Paul Seconds. No further discussion.
      • 16 Approved, 0 Abstained, 0 Against
    • 16850
      • The proposed resolution is Persuasive and the documentation will be updated to include appropriate wording.
      • Bryn moves to approve this tracker item as specified, Paul Seconds. No further discussion.
      • 16 Approved, 0 Abstained, 0 Against
    • 16833
      • The proposed resolution is Persuasive.
      • Bryn moves to approve this tracker item as specified, Paul Seconds. No further discussion.
      • 16 Approved, 0 Abstained, 0 Against
    • 16830
      • Discussion concerning Ratio measures occurred and it was agreed to change the original resolution from 'Not Persuasive' to 'Considered for Future Use'.
      • The proposed resolution is Considered for Future Use.
      • Bryn moves to approve this tracker item as specified, Juliet Seconds. No further discussion.
      • 16 Approved, 0 Abstained, 0 Against

• 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 either harmonization proposals.
    • Bryn moves that CQI is satisfied with both proposals, Patty Seconds. No further discussion.
    • 16 Approved, 0 Abstained, 0 Against
    • Yan will notify HL7 that CQI has reviewed all of the proposals and are satisfied. CQI will not be calling into the Harmonization call.

• Notification of new CMS Notice for Proposed Rulemaking (NPRM) - Physician Fee Schedule - also available at Federal Register unpublished version
  • Consider review and comment by CQI WG
    • Thom commented that this NPRM is very similar to the IPPS NPRM in those areas CQI are interested in.
  • For reference: Location for HL7 final comments to CMS regarding IPPS NPRM - specifically note eCQM section includes CQI WG recommendations.

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)
    • Project meetings for FHIR Exchange for Data for Quality Measures: Thursdays, 3-4 PM ET https://global.gotomeeting.com/join/465572589 Dial in: United States: +1 (646) 749-3129; Access Code: 465-572-589; Australia: +61 2 9087 3604; Canada: +1 (647) 497-9391; Netherlands: +31 207 941 377
  • Gaps in Care (PI ID: 1427)

• Co-sponsored Project Updates
  • 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 27, 2018

Meeting adjourned: 2:18pm ET