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* Chair - Floyd Eisenberg, Scribe - Walter Suarez | * Chair - Floyd Eisenberg, Scribe - Walter Suarez | ||
* Discussion: | * Discussion: | ||
+ | <br> | ||
** From the agenda, we had already completed the project planning and PSS review for September ballots, and had coordinated ballot reconciliation for the week. We focused on the following items: | ** From the agenda, we had already completed the project planning and PSS review for September ballots, and had coordinated ballot reconciliation for the week. We focused on the following items: | ||
− | + | <br> | |
− | + | # Floyd and Walter provided a review of the discussion and actions taken during the Steering Division meeting. This was the first meeting under the new Domain Expert structure. CQI is now part of the new Clinical Steering Division (formerly Domain Experts). | |
− | + | <br> | |
− | + | # CQI has received a request from Arden Syntax to consider supporting their request to move from Infrastructure SD to Clinical SD (as they seem to work closely with CDS and, in some cases with CQI. The feeling among the CQI group was that Arden Syntax seems to be much more of an Infrastructure component of HL7 work, rather than a Clinical working group. Thus, we are deciding to not get involved in the request from Arden Syntax. | |
− | + | <br> | |
− | + | # During the Steering Division, we were informed of the need to review and update/approve the WG Mission and Charter. We discussed and updated the Mission and Charter - last updated in 2017. Several changes were made, mainly eliminating the detail listing of projects, which seem to be more appropriately moved to our 3-year workplan. The plan is to submit the revised M&C to the CQI List, and review it with the WG during our upcoming calls, and get it completed and approved in the next few weeks, well before the September deadline. | |
− | + | <br> | |
− | + | # The WG discussed a new issue - how to handle of transition from ED to Inpatient status, when there is an 'observation' period in between. The question is where would that be captured in the current system. We understand that in FHIR this will be addressed. We will do some research and find out with some other people think, and come back to this issue during one of our calls. | |
− | + | <br> | |
− | + | # We reviewed our next meetings. | |
<br> | <br> | ||
Revision as of 08:29, 15 May 2018
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D R A F T - T E M P L A T E for CQI WGM Minutes - Cologne Germany - May 2018
Contents
Attendance - DRAFT ATTENDANCE LOG for the full week May 14-18, 2018
CQI May 2018 Workgroup Meeting Attendance
Attendee | Attendee's Organization | Attendee's email | Mon 14 May Q2 |
Mon 14 May Q3 |
Mon 14 May Q4 |
Tue 15 May Q1 |
Tue 15 May Q2 |
Tue 15 May Q3 |
Tue 15 May Q4 |
Wed 16 May Q1 |
Wed 16 May Q2 |
Wed 16 May Q3 |
Wed 16 May Q4 |
Thu 17 May Q1 |
Thu 17 May Q2 |
Thu 17 May Q3 |
Thu 17 May Q4 |
Abdulmausk Shaker | HI3 | abdumalil.shaker@hi3solutions.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Abrar Salam | The Joint Commission | asalam@jointcommission.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Alex Liu | EPIC | aliu@epic.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Alex Liu | EPIC | aliu@epic.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Amnon Shabo (Shvo) | Philips | amnon.shvo@gmail.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Andrew Gordon | WoltersKluwer | andrew.gordon@wolterskulwer.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Andrew Simms | Cognitive Medical Systems | asimms@cognitivemedical.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Ann Phillips | NCQA | Phillips@ncqa.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Anne Marie Smith | NCQA | smith@ncqa.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Ben Ghahhari | CMS | benjamin.ghahhari@cms.hhs.gov | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Ben Hamlin | NCQA | hamlin@ncqa.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Bryn Rhodes | ESAC | bryn@databaseconsultinggroup.com | X | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Chana West | ESAC Inc | chana.west@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Claudia Hall | Mathematica | chall@mathematicampr.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Dan Donahue | ESAC | dan.donahue@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Floyd Eisenberg | iParsimony, LLC | FEisenberg@iParsimony.com | X | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Gay Dolin | IMO | gdolin@imoonline.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Hafsa Subhan | The Joint Commission | hsubhan@jointcommission.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
iIkka Kunnamo | . | jilkkakunnamo@duodecim.fl | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Jamie Lehner | PCPI | jamie.lehner@thepcpi.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Jenny Brush | ESAC | jennifer.brush@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Joe Quinn | Optum | joseph.quinn@optum.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Juliet Rubini | Mathematica | jrubini@mathematicampr.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Kanwarpreet Sethi | Lantana Consulting Group | kp.sethi@lantanagroup.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Kathleen Connor | . | kathleen_connor@comcast.net | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Linda Michaelsen | Optum | linda.michaelsen@optum.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Lisa Anderson | The Joint Commission | landerson@jointcommission.org | X | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Lorraine Constable | . | lorraine@constable.ca | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Matthew Tiller | ESAC | matthew.tiller@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Mitra Biglari | The Joint Commission | mbiglari@jointcommission.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Pamela Mahan-Rudolph | Memorial Hermann | pamela.mahanrudolph@memorialhermann | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Patty Craig | The Joint Commission | pcraig@jointcommission.org | X | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Paul Denning | MITRE | pauld@mitre.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Ping Jiang | The Joint Commission | pjiang@jointcommission.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Robert Dieterle | Enable Care | rdieterle@enablecare.us | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Robert Samples | ESAC Inc | robert.samples@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Stan Rankins | Telligen | SRankins@telligen.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Sue Kent | CCF | kents@ccf.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Sweta Ladwa | ESAC inc | sweta.ladwa@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Thomson Kuhn | ACP | tkuhn@acponline.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Walter Suarez | Kaiser | walter.g.suarez@kp.org | X | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Yan Heras | Optimum Health | yanheras@gmail.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Yanyan Hu | The Joint Commission | yhu@jointcommission.org | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Zach May | ESAC Inc | zachary.may@esacinc.com | . | . | . | . | . | . | . | . | . | . | . | . | . | . | . |
Monday, May 14, 2018 CQI WGM Minutes
Q1
- No Meeting - HL7 Plenary Session
Q2
- Agenda Topics
- CQI Business Meeting
- Chair - Walter Suarez; Scribe - Floyd Eisenberg
- Discussion:
- Walter reviewed the scope of CQI WG
- Bryn volunteered to act as interim co-chair to support meetings through the week
- Floyd moved to appoint Bryn Rhodes, Patty seconded, Vote - 10 approve, 0 abstain, 0 opposed
- Walter reviewed the agenda for the week - Floyd updated the agenda as we discussed during the call
- Floyd reviewed the new steering committee structure
Q3
- Orders and Observations (OO) hosting CQI
- Agenda Topics
- Use of Observation Resources - Design Patterns
- Order Set and Plan Definitions
- Catalog resource definitions
- Chairs: Lorraine - See OO agenda for attendance
Discussion
- Alerting and Alarms
- Order Catalogue
- FHIR Tracker items
- FHIR Tracker Items
- 15942 – NutritionOrder – consistent modeling of .status Vs .intent with the rest of FHIR – modeling inconsistent with other FHIR resource modeling. Loraine was able to find the modeling now does include the intent metadata element in the STU 4 ballot. It has been harmonized.
- Withdrawn by commenter
- 15943 – NutritionOrder – NutritionOrder modeling - differences with ServiceRequest, MedicationRequest . The use case is the ability or order a specific dietary item. Nutrition order is modeled as the ability to order enteral diet, a nutritional supplement, a parenteral diet, etc. (E.g., oral diet - with types that include multiple diet type) - The NutritionOrder is a work in progress - needs to address a specific nutrient. The idea is to describe a nutrient modifier but the question is how to address "notDoneReason" and also to define a specific nutrient at the exclusion of all others.
- There is always one diet for a patient active at any time, but supplements are different and might be addressed later on. See tracker item: 17164
- Motion to break into 3 tracker items to follow and resolve each independently: Create tracker to harmonize the NutritionOrder to match the Request Pattern and handle NotDoneReason - see tracker item: 17166
- Discuss how to handle boundaries and modeling when adding a supplement to an existing diet - do you entirely replace, or add? See tracker item: 17167
- Motion by Ken McCaslin, second by Floyd Eisenberg - 26 approved, 0 opposed, 3 abstain
- There is always one diet for a patient active at any time, but supplements are different and might be addressed later on. See tracker item: 17164
- 15945 – SupplyRequest modeling (general) and related to blood products (SupplyDelivery, SupplyRequest, and BiologicallyDerivedProducts). This subject is currently under development. Supply request is not the correct resource. This is on Wednesday Q3 Patient care agenda this week.
- Motion: Rob Hausam, Second Richard Esmond: Balloters will connect with project team (see link in FHIR traker)to assure use cases are covered in that material. Vote - 29-0-0
- Immunization - the current modeling provides documentation details about immunization administration or a forecast (immunization recommendation) but not an order - referred to Public Health workgroup for follow up.
- FHIR Tracker Items
- Order Catalogue
- Claude Nanjo discussed work on Order Catalogue - joined forces with Francios Macary - to define the core FHIR resource to represent the catalog for order entry. Proposal - use composition resource and introduce in a future profile a notion of a catalogue entry - to wrap an item as part of a catalog. This discussion is consistent with managing order sets. The connectathon created a catalog and sought to query for a catalog and elements. The Catalogue profile - needs to capture the business content used in the V2 catalogue for lab which is the most complex in V2. Conceptually, the FHIR resources need to capture identified, contributor, version, status publisher, copyright, title, Catalogue entry (identifier, contributor serviceProvider, orderable, version, status status Date Title, ChargeInforation, SpecimenDefinition, SpecimentToLab, Container, Handling, Lab service, ObservationSpecification, Units. Lorraine showed V2 modeling - some of the details are included in the notes here. ---- Richard Esmond suggested there is parallel with Imaging Requests - work with registries to get LOINC identifiers defined - should join with RadLAC - coordinate with II (Imaging Integration). Needs to also address Appropriate Use Criteria and CDS Hooks - to perform, needs to trace all the way along if there is a recommendation to process and order - and track if the order occurred and how it was handled. This discussion addresses the catalogue of what can be ordered.
- Other material addresses order management - fulfillment has not been sufficiently addressed.
- Claude showed examples of the order catalogue content.Link to Order Catalog
- Claude Nanjo discussed work on Order Catalogue - joined forces with Francios Macary - to define the core FHIR resource to represent the catalog for order entry. Proposal - use composition resource and introduce in a future profile a notion of a catalogue entry - to wrap an item as part of a catalog. This discussion is consistent with managing order sets. The connectathon created a catalog and sought to query for a catalog and elements. The Catalogue profile - needs to capture the business content used in the V2 catalogue for lab which is the most complex in V2. Conceptually, the FHIR resources need to capture identified, contributor, version, status publisher, copyright, title, Catalogue entry (identifier, contributor serviceProvider, orderable, version, status status Date Title, ChargeInforation, SpecimenDefinition, SpecimentToLab, Container, Handling, Lab service, ObservationSpecification, Units. Lorraine showed V2 modeling - some of the details are included in the notes here. ---- Richard Esmond suggested there is parallel with Imaging Requests - work with registries to get LOINC identifiers defined - should join with RadLAC - coordinate with II (Imaging Integration). Needs to also address Appropriate Use Criteria and CDS Hooks - to perform, needs to trace all the way along if there is a recommendation to process and order - and track if the order occurred and how it was handled. This discussion addresses the catalogue of what can be ordered.
Q4
- Agenda Topics
- CQI Meeting - Planning for September
- Chairs: Walter Suarez, Scribe: Floyd Eisenberg
Discussion:
- Decision Making Process - due to some edits to the default DMP, the CQI WG reviewed our individual WG addendum and believes that the addendum is still required.
Floyd Eisenberg moved to re-affirm our DMP addendum, Patty Craig seconded - Vote 6-0-0
- Planning for September
- 30-day Medication Reconciliation PSS under consideration. Plan is to review the PSS Wednesday Q2 and consider an STU ballot for September to address an implementation guide to manage publication of data by the EHR and subscription by a data analytic engine for the data, then aggregation and analysis for reporting to a reporting agency. The STU will use 30-day med reconciliation as the example.
- Evidence-based Medicine (EBM) on FHIR (CDS primary) - approved by CDS and CQI - current plan is to ballot for comment only in September. The project facilitator (Brian Alper) will review with Biological Regulated Research (BRR) for potential co-sponsorship (perhaps during this quarter) and then bring modified PSS to CDS and CQI on Wednesday Q2 for review and possible re-vote if needed, then submit to FHIR Management Group and Clinical Domain for approval.
- FHIR Quality for QI Core to ballot in September (Project 1125) and PSS is up-to-date. The work requires publication of QI Core / QUICK STU 3 based on the completed ballot reconciliation from January 2018. Then we need to update to FHIR STU 4 and US FHIR Core STU 4 for the September ballot.
- No known need for new ballots for CQL-based HQMF (CQI managed) or CQL (CDS managed) but both PSS' are current and active
- 30-day Medication Reconciliation PSS under consideration. Plan is to review the PSS Wednesday Q2 and consider an STU ballot for September to address an implementation guide to manage publication of data by the EHR and subscription by a data analytic engine for the data, then aggregation and analysis for reporting to a reporting agency. The STU will use 30-day med reconciliation as the example.
Tuesday, May 15, 2018 CQI WGM Minutes
Q1
- Agenda Topics
- CQI Meeting
- CQI Meeting
- Chair - Floyd Eisenberg, Scribe - Walter Suarez
- Discussion:
- From the agenda, we had already completed the project planning and PSS review for September ballots, and had coordinated ballot reconciliation for the week. We focused on the following items:
- Floyd and Walter provided a review of the discussion and actions taken during the Steering Division meeting. This was the first meeting under the new Domain Expert structure. CQI is now part of the new Clinical Steering Division (formerly Domain Experts).
- CQI has received a request from Arden Syntax to consider supporting their request to move from Infrastructure SD to Clinical SD (as they seem to work closely with CDS and, in some cases with CQI. The feeling among the CQI group was that Arden Syntax seems to be much more of an Infrastructure component of HL7 work, rather than a Clinical working group. Thus, we are deciding to not get involved in the request from Arden Syntax.
- During the Steering Division, we were informed of the need to review and update/approve the WG Mission and Charter. We discussed and updated the Mission and Charter - last updated in 2017. Several changes were made, mainly eliminating the detail listing of projects, which seem to be more appropriately moved to our 3-year workplan. The plan is to submit the revised M&C to the CQI List, and review it with the WG during our upcoming calls, and get it completed and approved in the next few weeks, well before the September deadline.
- The WG discussed a new issue - how to handle of transition from ED to Inpatient status, when there is an 'observation' period in between. The question is where would that be captured in the current system. We understand that in FHIR this will be addressed. We will do some research and find out with some other people think, and come back to this issue during one of our calls.
- We reviewed our next meetings.
Q2
- CQI hosts CDS and FHIR
- Agenda Topics
- CDS Hooks 1.0 ballot reconciliation
- FHIR Clinical Reasoning ballot reconciliation
- Chair - Floyd Eisenberg; Scribe - Walter Suarez
- Discussion:
Q3
- CDS hosts CQI and FHIR
- Agenda Topics
- Use of Observation Resources - Design Patterns
- Order Set and Plan Definitions
- Catalog resource definitions
- Chairs: See CDS Minutes
- Discussion
Q4
- Agenda Topics
- CQI Meeting - CQL-based HQMF Ballot Reconciliation (tentative)
- Chairs: Interim Chair, Scribe: Floyd Eisenberg
- Discussion:
Wednesday, May 16, 2018 CQI WGM Minutes
Q1
- CQI Hosts CIMI and CDS
- Agenda Topics
- Agenda Topics (Tentative)
- Presentation from European clinical sites regarding current activities and needs for standards for CDS and measurement
- CDS KNART Project review (15 minutes)
- CDS Hooks 1.0 Ballot reconciliation
- Intermountain Discussion RE: Pulmonary Embolus CDS content/logic
- QI Core content review with CIMI and future direction
- Chair - Floyd Eisenberg, Scribe - Walter Suarez
- Discussion:
Q2
- CQI hosts CDS
- Agenda Topics (proposed):
- (CQL ballot reconciliation)
- Proposal for Evidence-based Medicine (EBM) on FHIR
- Presentation from European clinical sites regarding current activities and needs for standards for CDS and measurement
- Chair - Walter Suarez; Scribe - Floyd Eisenberg; Scribe
- Discussion:
Q3
- CDS hosts CQI
- Agenda Topics
- FHIR Clinical Reasoning module review
- CQL-based HQMF Ballot Reconciliation
- Chairs: See CDS Minutes
- Discussion
Q4
- CDS hosts CQI and CIMI
- Agenda Topics
- QI Core content review with CIMI and future direction
- CIMI for Quality
- Chairs: See CDS Minutes
- Discussion:
Thursday, May 17, 2018 CQI WGM Minutes
Q1
- No Planned Meeting - Notes from PC meeting
- Agenda Topics
- Chair - n/a, Scribe - n/a
- Discussion: