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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