HL7 Clinical Quality Information Sept 2014 Chicago WGM Minutes
Attendees:
MON / TUE / WED / THURName / Company / Email / Q3 / Q4 / Q1 / Q4 / Q1 / Q3 / Q4 / Q4
Angela Flanagan / OFMQ /
Angelique Cortez / ONC
Ann Phillips / NQF /
Anne Smith / NCQA / / X / X / X / X / X / X
Atanu Sen / Accenture / / X
Austin Kreisler / Leidos / / X
Aziz Boxwala / Meliorix / / X / X / X
Beau Bannerman / Lantana /
Ben West / Epic /
Benjamin Flessner / Epic /
BJ Wood
Bob Greenes / ASU / Mayo /
Brenda Wood
Brett Marquard / River Rock Associates / / X / X
Bryn Rhodes / Veracity Solutions / / X / X / X
Calvin Beebe / Mayo Clinic / / X / X
Casey Thompson / OFMQ /
Cathy Welsh / Academy of Nutrition Dietics /
Charles Rica / ASIP Sante /
Chethan Makonahalli
Chris Bontempi / McKesson /
Chris Melo / Philips /
Chris Millet / The Lazy Company / / X / X / X / X / X
Claude Nanjo / Cognitive Medical Systems / / X / X / X
Clayton Curtis / VA /
Crystal Kallem / Lantana Consulting Group / / X / X / X / X / X / X / X
Cynthia Barton / OFMQ /
Dan Pollock / CDC / / X
Daniel Antohe / Siemens Healthcare / / X
Daniel Chaput / ONC /
Dave Wade / CSC /
David Booth / HRG /
David Rowed / HL7 - Australia / / X / X / X
David Sundaram-Stukel / Epic /
David Susanto / Accenture /
Dharnaeesh Bommireddypalli /
Donna Quirk / Academy of Nutrition & Dietetics / (?) / X
Emory Fry / Cognitive Medical Systems / / X / X
Eric Larson / NGC / CDC / / X / X / X / X / X
Estelle Noone / HCQIS /
Floyd Eisenberg / iParsimony, LLC / / X / X / X / X / X / X / X / X
Gaye Dolin / IMO / / X / X
Genny Luensman / CDC / NIOSH /
George Cole / Allscripts / / X / X
Guilherme Del Flol / Univ of Utah / / X / X
Hans Anderson / Synechron /
Hector Cariello / Lantana Consulting Group /
Hector Cintron / Accenture / / X / X
Helmut Koenig / Siemens Healthcare /
Howard Strasberg / Wolter Kluwer / / X / X
Jason Kratz / Epic /
Jason Mathews / MITRE / / X / X / X / X
Jeff Brown / Kernodle Clinic / / X / X
Jeffrey Hammer / MITRE /
Joe Kunisch / Memorial Hermann Healthcare /
John Feikema / ONC / not readable
Julia Skapik / ONC / / X / X / X / X / X
Juliet Rubini / Mathematica MPR /
Justin Schirle / Epic /
Keith Boone / GE / / X / X
Ken Kawamoto / University of Utah / / X / X / X
Kendra Hanley / AMA-PCPI /
Kimberly Smuk / AMA-PCPI /
KP Sethi / Lantana Consulting Group / / X / X / X / X
Laura Heerman-Langford / Intermountain Healthcare /
Leslie Tompkins / FDA /
Lindsey Hoggle / Academy of Nutrition Dietics /
Lisa Nelson / Lantana Counsulting Group / / X
Marc Hadley / MITRE /
Maria Moen / Brookdale Senior Living /
Mark Kramer / MITRE / / X / X / X / X / X
Mark Sherfarman / Sherfarman Consulting /
Mark Tucker / Mayo /
Matthew Rohn / ONC /
Michelle Dardis / The Joint Commission /
Mollie Ullman-Cullere / Partners HealthCare /
Patty Craig / Joint Commission / / X / X / X / X / X / X / X / X
Paul Malpiedi / CDC /
Peter Haug / Intermountain Healthcare /
Rick Geimer / Lantana Consulting Group / / X
Rita Altamore / Washington Dept of Health /
Rob Dingwell / MITRE /
Rob Hausam / Hausam Consulting /
Rob McClure / MD Partners / / X / X
Robert Jenders / UCLA / / X / X / X
Rosemary Kennedy / NDNQI / / X / X / X / X / X / X / X
Russell Hamm / Lantana Consulting Group /
Russell Leftwich / Tennessee Dept of Health /
Rute Martins / The Joint Commission /
Sarah Gaunt / Lantana /
Sarah Ryan / MITRE / / X
Stan Rankins / Telligen / / X / X / X / X / X
Stephanie Wilson /
Tessa van Stijn / NICTIZ / / X / X / X / X
Thomson Kuhn / ACP / / X / X / X / X
Varsha Parekh / CAP /
Vaspaan Patel / NCQA / / X / X / X / X
Vinayak Kulkarni / Siemens Healthcare /
Virgnia Riehl / Me /
Walter G. Suarez / Kaiser Permanente / / X / X / X
Yan Heras / Lantana Consulting Group /
Zahid Butt / Medisolv /
14 | Page
HL7 Clinical Quality Information Sept 2014 Chicago WGM Minutes
Time: Monday Q3 and Q4Facilitator / Walter Suarez (Q3)
Crystal Kallem (Q4) / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
· Welcome/Introductions
· Agenda planning
o Review WGM agenda and update as necessary
o Approve Friday, 9/12 meeting minutes
o QRDA Errata Publication Update
o Cancer Registry update
· January 2015 Ballots
o QRDA Category I DSTU Release 3 PSS - approved 9/12 (including SDWG updates)
o CQF-based HQMF Implementation Guide PSS - need review for vote
o Measures Specification Report using FHIR - need review for vote
o Any other Project Scope Statements for January?
· QRDA Category III DSTU Extension
· Updates to 3-Year Plan
Supporting Documents – CQI HL7 wiki agenda, PSS documents
Minutes/Conclusions Reached:
Business Session
· Agenda Planning
o Added a discussion concerning what CQI would present at the combined workgroup meeting on Wed Q2 and at the payer summit
· Conference call minutes
o The committee reviewed meeting minutes from the 9/12 conference call.
Crystal moved to approve and Chris seconded
No further discussion
Opposed: 0; abstentions: 7; approved: 15
· QRDA Errata Publication Update
o CQI is still waiting on John Quinn (HL7) to approve the package.
o Crystal will follow-up.
o The pre-publication document is on CQI’s Document space (http://www.hl7.org/Special/committees/cqi/docs.cfm ) posted for members only.
· Cancer Registry Ballot Update
o Thom Kuhn provided a comment that he is concerned about the harmonization of the cancer registry ballot and the Quality space. The Cancer Registry ballot writers are meeting with Thom later in the week.
o Discussion occurred around the fact that the Cancer Registry was added to Meaningful Use Stage 2 and that it was originally an IHE Profile that has been brought to HL7 for ballot (through the normal ballot cycle and process).
o The group discussed differences between quality and registries.
§ The Cancer Registry ballot is using CCDA and other national standards. But it is not using HQMF or QRDA.
o PHER will reach out to CQI when the Cancer Registry Implementation Guide is ready to review.
January 2015 Ballots
· Project Scope Statements (PSS) must be completed, approved, and submitted to HL7 by Sunday 9/28.
· NIBs must be completed, approved, and submitted to HL7 by Sunday 11/11.
· Ballots will be open from 12/12/14 through 1/12/14.
· QRDA Category I DSTU Release 3 PSS
o This DSTU PSS was approved 9/12 and included SDWG’s updates
o The PSS was sent to TSC to determine how it will be provided to the US Realm Taskforce for review. In addition, Crystal has requested a clarification from the HL7 Process Improvement Committee on how to engage with the US Realm Taskforce.
o The PSS has been sent to DESD for their Monday evening agenda.
· CQF-based HQMF Implementation Guide PSS
o Mark Kramer presented this PSS.
o Marc Hadley sent updates on 9/12 (forwarded by Rosemary on 9/15)
o Project scope: Develop an IG that defines how HQMF R2.1 will be used in combination with CQL and QUICK to define clinical quality measures.
o It is anticipated that this project, while not directly focused on quality reporting, will be relevant to, and may inform, the evolution of the QRDA-based quality reporting set of specifications.
o The ballot will be for comment only in January 2015
o It will be a DSTU ballot in May 2015
Mark moved to approve and Walter seconded
No further discussion
Opposed: 0; abstentions: 0; approved: 18
· Measures Specification Report using FHIR PSS
o Chris discussed this PSS.
o Discussion occurred around FHIR issues that were raised as concern about the CQI Whitepaper and whether or not it was the correct time to attempt to create a FHIR related product.
o This project is being sponsored by the National IT Institute for Healthcare in the Netherlands
o Chris will update the PSS based on discussions and it will be brought back at a later time for vote.
· QRDA Category III DSTU Extension – Release 3
o Work on this project is slated to start in October. More information about this project will be provided at a later time.
Additional Items
· Updates to 3-Year Plan
o CQI did not evaluate it’s 3-Year Plan. It was not due this quarter, so it will be added to either a future call or the January WGM Business meeting.
· Presentation to the combined workgroup meeting on Wed Q2 and the payer summit
o Floyd will make both presentations
o CQI worked with Floyd on what he will present related to CQI activities and the quality space.
Time: Tuesday Q1 – Joint w/ SDWGFacilitator / Walter Suarez / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
· Metadata ballot comments (Keith)
· Measure Specification Report using FHIR (Chris)
· Harmonizing concepts/value sets between CDA (clinical care process & transition) and the quality domain (CDS and measurement)
· Null flavor and QRDA (Floyd)
· Specific ballot comments requiring SDWG input on QUICK & White Paper (if needed)
Supporting Documents: Measure Reporting FHIR PSS
Minutes/Conclusions Reached:
· Reviewed agenda – nothing was added
· Metadata ballot comments (Keith)
o Content should be completed by the end of the WGM
o All issues have been resolved
o CQI needs to finalize reconciliation and approve the pre-publication documentation
o Keith will notify CQI when he is ready for the review
· Measure Specification Report using FHIR PSS (Chris)
o Chris reviewed the updated PSS with both CQI and SD.
o This project is being sponsored by the National IT Institute for Healthcare in the Netherlands
o Concern was raised that this might confuse the US Realm Taskforce and others that it could be used for Meaningful Use or other US programs
o Concerns were raised about the overlap with QRDA and whether it was really necessary to have an International standard and a US Realm standard
o Patty will send Chris The Joint Commission’s core measure aggregate data dictionary and metadata that The Joint Commission and CMS capture about transmitted patient-level quality files.
KP moved to approve with the modifications made during the meeting and Chris seconded
No further discussion
Opposed: 0; abstentions: 1; approved: 37
o The PSS will be sent to FHIR and DESD for approval
· Harmonizing concepts/value sets between CDA (clinical care process & transition) and the quality domain (CDS and measurement)
o Discussion occurred around the following:
§ Alignment may not occur with CCDA specification, but with the clinical record
§ Not sure if CMS would align with CCDA given measure steward issues that have been raised on CMS’ eMIG calls
§ Measure developers would like to see HL7 value sets as they are developing their measures so they can be selected within the Measure Authoring Tool if appropriate
§ The NLM Value Set Authority Center (VSAC) allows measure developers to see each other’s value sets.
§ New functionality will allow commenting on value sets
§ HL7 value sets could be added to VSAC
§ Comments loaded on VSAC would still have to go back to HL7 for review and reconciliation through the normal process.
§ There is an open question about who is the steward of each value set
§ ONC stated that major changes related to the value sets cannot occur during Meaningful Use Stage 2 due to regulatory requirements. However, ONC will review this discussion concerning making HL7 value sets available to measure developers and other items during this discussion for Stage 3.
§ A question was raised if PHINVADS could also be lifted to VSAC so measure developers could also use them.
· Null flavor and QRDA (Floyd)
o Yan brought up the issue of null flavors and their use in quality measures on one of the calls based upon a DSTU ballot comment that was approved for future evaluation
o The discussion concluded:
§ It would be possible to change the RIM, which would require everything to be re-balloted. This would have to go to M&M for approval.
§ We need to look at specific exceptions where a reason for not doing something needs to be tracked instead of providing the general ability for a measure develop to require a clinician to state they didn’t do anything for all elements.
§ Not sure if null flavor is currently included in FHIR resources; however, it can be incorporated by each document as needed and does not have to be included in all FHIR artifacts.