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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
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
Abrar Salam The Joint Commission
Alex Liu EPIC
Angela Flanagan Lantana Consulting Group yes
Ann Phillips NCQA yes
Anne Smith NCQA yes
Ben Ghahhari CMS
Ben Hamlin NCQA yes
Bo Borgnakke Michigan Shared Services Network
Bob Dieterle Enable Care, LLC
Bob Keyes Telligen
Brett Marquard River Rock Associates
Brian Alper EBSCO
Bryn Rhodes ESAC
Chana West ESAC Inc yes
Claudia Hall Mathematica yes
Crystal Kallem CK Consulting
Dan Donahue ESAC
David Sundaram-Stukel EPIC yes
Floyd Eisenberg iParsimony, LLC
Gay Dolin IMO yes
Hafsa Subhan The Joint Commission
Howard Strasberg Wolters Kluwer
Humberto Mandirola Biocom
iIkka Kunnamo Duodecim jilkkakunnamo@duodecim.fl
isabel Zaru-Roque ESAC yes
James Bradley Mitre
Jamie Lehner PCPI yes
Jeff Schmitz Health eFilings
Jenny Brush ESAC
Joe Kunisch Memorial Hermann
Joe Quinn Optum
John Damore Diameter Health
Julia Skapik Cognitive Medicine yes
Juliet Rubini Mathematica yes
Kanwarpreet Sethi Lantana Consulting Group
Kathleen Connor US Dept of Veterans Affairs
Kurt Allen US Dept of Veterans Affairs yes
Linda Michaelsen Optum yes
Lisa Anderson The Joint Commission
Lisa Nelson Life Over Time Solutions, LLC
Lizzie Charbonneau Mitre
Lorraine Constable HL7 Canada
Luke Osborne MITRE
Matthew Tiller ESAC
Mike Hunt Experian
Mia Nievera The Joint Commission
Mitra Biglari The Joint Commission
Nick Radov UHC
Pamela Mahan-Rudolph Memorial pamela.mahanrudolph@memorialhermann yes
Patty Craig The Joint Commission
Paul Denning MITRE yes
Ping Jiang The Joint Commission
Rathore Garima
Rebeccah Baer NCQA
Rich Boyce
Rob McClure MD Partners Inc yes
Robert Samples ESAC Inc yes
Rukma Joshi ESAC Inc
Ryan Clark NCQA
Sam Sayer Mitre
Stan Rankins Telligen
Steve Hufnagel
Sue Kent CCF
Sweta Ladwa ESAC inc
Thomas Reese U of Utah
Thomson Kuhn ACP yes
Viet Nguyen Strata Metrics
Walter Suarez Kaiser Permanente
Yan Heras Optimum eHealth yes
Yanyan Hu The Joint Commission
Zach May ESAC Inc 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