2 November 2018 CQI Conference call Minutes

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November 2, 2018 - CQI Conference Call Meeting Minutes

HL7 Clinical Quality Information Workgroup
November 2, 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: Juliet
Meeting Scribe: Yan

November 2nd 2018 - 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
Angela Flanagan	Lantana Consulting Group	angela.flanagan@lantanagroup.com	yes
Ann Phillips	NCQA	phillps@ncqa.org	yes
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
Chana West	ESAC Inc	chana.west@esacinc.com	yes
Claudia Hall	Mathematica	chall@mathematicampr.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
Floyd Eisenberg	iParsimony, LLC	FEisenberg@iParsimony.com
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	yes
James Bradley	Mitre	jhbradley@mitre.org
Jamie Lehner	PCPI	jamie.lehner@thepcpi.org	yes
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	yes
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
Kurt Allen	US Dept of Veterans Affairs	kurta@gjoll.com	yes
Linda Michaelsen	Optum	linda.michaelsen@optum.com	yes
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
Nick Radov	UHC	nradov@uhc.org
Pamela Mahan-Rudolph	Memorial	pamela.mahanrudolph@memorialhermann	yes
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	yes
Robert Samples	ESAC Inc	robert.samples@esacinc.com	yes
Rukma Joshi	ESAC Inc	rukma.joshi@esacinc.com
Ryan Clark	NCQA	ryan@ncqa.org
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
Zach May	ESAC Inc	zachary.may@esacinc.com	yes

Meeting Minutes

• Roll call and agenda review
  • Juliet reminded the group that the FHIR Data Exchange for Quality Measures ballot reconciliation is deferred to next week
• Review changes to the Harmonization Proposal and vote required - Rob McClure
  • Topic - Improvement notation - minor modification required by Harmonization group
  • Initial submission completed 10/25; Final submission due 11/6 (since changes were requested after harmonization review of our initial submission, we will need to approve the changes and meet the final submission deadline)
  • Rob walked through the changes made to the harmonization proposal that was approved by the CQI WG last Friday based on requests from the Harmonization group. Please see the Updated Harmonization Proposal with Track Changes for detailed changes made to the initial harmonization proposal approved by the CQI WG. All changes made are shown in track changes.
  • Rob restated the the codes we are requesting to be added to the ObservationValue Code System. There are no changes from what was approved by the CQI WG last Friday.
  • Rob talked about the changes to harmonization proposal about the Value Set Addition section. Refer to the updated harmonization proposal with track changes for details.
  • Rob expects the harmonization proposal to be approved at the harmonization meeting with these changes made (Next harmonization meeting 11/8)
  • Juliet asked why it is necessary to change from Code to Codable Concept? Rob explained that Code carries nothing, you don't know what code system it is from and nothing. Code carries all meanings in the code itself. Code is schema bound, and we are telling people you cannot change it. By moving from Code to Codable Concept, we are no longer schema bound and we are able to change. It gives more freedom, it does give more baggage to implementer, but allow us to be free to do things that we are currently doing.
  • Rob reviewed the two related FHIR tracker items to this harmonization proposal #19445 and #19446 and requested a vote.
    • FHIR Tracker #19445
      • Rob made a motion to accept as Persuasive with Mod/Anne Smith seconded
      • Approve/Oppose/Abstain: 20/0/0
    • FHIR Tracker #19446
      • Rob clarified the resolution: 1) Change datatype of improvementNotation in Measure and MeasureReport from Code to CodeableConcept with a Required binding to the existing value set. 2) Once the proposed harmonization to code system ObervationValue to represent measurement improvement notation is completed, then update the value set definition for value set "measure improvement notation" to be "all descendents of abstract code "_MeasurementImprovementNotation" in ObservationValue code system.
      • Rob made a motion to accept as Persuasive with Mod/Anne Smith seconded
      • Approve/Oppose/Abstain: 20/0/0
  • Rob made motion to approve and accept the changes to the harmonization proposal and submit it to Harmonization/Anne Smith seconded
    • • Approve/Oppose/Abstain: 20/0/0
  • Rob will accept all the track changes that are approved today for the harmonization proposal and submit by the Final Harmonization Proposal deadline.

• QRDA Category I STU 5.1
  • Yan reminded the group that the QRDA I STU 5.1 Update is currently in the two weeks member review period. The plan is to bring it back to the CQI WG meeting next Friday for a vote to submit to HL7 for publication
  • QRDA Category I STU 5.1 Update Comment Page

• Juliet noted that the regular STU comments review during the first CQI call of the month is deferred to the next call.

• Confluence is coming!
  • Confluence will replace the Wiki for agendas and the HL7 work group page for document posting
    • Please sign up for an account here
    • Draft confluence page available here
  • CQI Project Updates Confluence Page
  • Confluence link

• Gay Dolin gave a quick update about the code system discrepancy issue she brought up in the CQI WG call two weeks ago (document type is expected to be LOINC codes in C-CDA, but eCQMs have specified the value set using SNOMED codes for communication). Gay already entered an ONC JIRA item, Mathematica team is currently investigating. Floyd is also following up with the issue.

• CQI Project Updates (no updates are provided to the projects during today's call)
  • 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) - Currently performing ballot reconciliation from September 2018 ballot
  • Gaps in Care (PI ID: 1427)
• Co-sponsored Project Updates (no updates are provided to the projects during today's call)
  • 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)
• Balloting Milestones
  • October 14, 2018 – PSS deadline (submit to Steering Division and Project Management Office) - DEADLINE HAS PASSED
  • October 28, 2018 – Notice for Intent to Ballot (NIB) Deadline
    • NIB for Gaps in Care is postponed at this point.
  • November 5 – December 6 – Sign up period to be included in a ballot consensus group
  • November 11, 2018 – Preview of artifacts and topics to be included in the ballot with CQI
  • November 18, 2018 – Preview and content deadline (V3)
  • November 25, 2018 – Final content available for CQI WG review [consistent with FHIR Core Substantive Change Freeze (must have completed ballot reconciliation if applicable)
  • December 1, 2018 – Final CQI approval of content and submission (consistent with FHIR code freeze and QA, V3 Final content due dates)
  • December 7, 2018 – January 7, 2019 – January ballot open for voting
• Harmonization
  • October 25, 2018 – Initial Harmonization Proposal Deadline
  • November 6, 2018 – Final Harmonization Proposal Deadline
  • November 8 – Harmonization meeting
• Meeting adjourned at 1:47ET. Next CQI WG meeting will be on Nov. 9th, 2018