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20 July 2018 CQI Conference Call Minutes

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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 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
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
    • Publication Request for CQL-based HQMF IG
      • 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 package for publication, Myron Seconds. No further discussion.
      • 15 Approved, 1 Abstained, 0 Against
    • 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


  • 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
    • 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 (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