HL7 Clinical Quality Information Workgroup Minutes

HL7 Clinical Quality Information Workgroup Minutes

Friday, November 17, 2017– 1-3 PM EDT

Dial in:770-657-9270 Passcode: 217663

CQI Co-chairs:Patty Craig, Floyd Eisenberg, Walter Suarez, KPSethi,Yan Heras

Meeting Chair: Yan

Meeting Scribe: Floyd

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1. Roll Call

1. Roll call
2. Business Updates– 5 min
3. Additions / modifications to the agenda - none
4. Decision made to cancel 24 November 2017 meeting (day after Thanksgiving)
5. Update that Harmonization Meetings are November 28 and 29, 2017
6. QRDA Category I STU 5 Publication Review and Decision (posted to CQI Members-only document site 12 Nov 2017 -
7. Yan Heras reviewed the changes to the publication and presented the publication request for review by the Workgroup. There were no questions regarding the publication version of QRDA Category I STU 5 as posted to the members site on 12 November 2017.

Motion to approve the publication version and the publication request

1. Motion – Floyd Eisenberg
2. Second – Gay Dolin
3. Opposed – None, Abstain – None, 13 Approved

1. Harmonization Request Final Proposals
2. Add observation to ActEncounterCode value set (OID: 2.16.840.1.113883.1.11.13955) value set (as OBSENC). The proposal uploaded to the CQI WG document site was modified based on input from the Patient Care Workgroup. The changes more clearly indicate that the “Observation” status is not merely watching the patient after Emergency Department discharge until the patient can be picked up for transport home. The WG agreed that a change to the Medicare reference would help with the explanation.
3. Add Measure Observation to measure structure components
4. The two harmonization proposals were reviewed with the Workgroup. Motion to approve the 2 harmonization requests including changing the quote from Medicare.
5. Motion – Floyd Eisenberg
6. Second – Gay Dolin
7. Opposed – None, Abstain – None, 15 Approved
8. Recap – Project Scope Statement (ID 1234) – FHIR-based Quality Framework (CQF on FHIR), also known as Clinical Reasoning

The FHIR Management Group requested clarification of which project scope statement led to the FHIR Clinical Reasoning Module effort in STU 3.0. PSS 1234, CQF on FHIR is the project. The last PSS approval was 2016. There was an update to the PSS approved by the CDS and CQI WGs, US Realm Task Force, FHIR Management (February 2017) but it was withdrawn due to questions about CDS Hooks intellectual property issues. The TSC is reviewing that version of the PSS for approval. The WG was asked today to review that PSS since some of the dates for deliverables are in the past. The dates do include past dates for work that has been completed since the PSS is ongoing. It also includes future dates. The challenge is that the updated PSS title was changed to “HL7 FHIR Implementation Guide: CDS Hooks Release 1” and that title does not address the Clinical Reasoning module that is also covered by the PSS 1234.

1. The CQI WG was not comfortable changing the name of the PSS to include the Clinical Reasoning component with review by the CDS WG.
2. Plan – Review the PSS ‘as is’ with the TSC on Monday, November 20. If there are concerns about the name, then request consideration of conditional approval pending review with the CDS WG to change the name of the PSS.

1. Notification: QRDA Category III 2018 CMS Guide public comment period ends today (17 November 2017).
2. CQIProject Updates – No Updates to any of the following:
3. HL7 CDA® Release 2 Implementation Guide: Quality Reporting Document Architecture Category I (QRDA I) Release 1, STU Release 4 - US Realm (PI ID: 210)
4. HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture (QRDA III), Release 1 - US Realm (PI ID: 896)
5. HL7 Version 3 Standard: Representation of the Health Quality Measures Format (eMeasure), Release 1 (PI ID: 508)
6. HL7 Version 3 Implementation Guide: Quality Data Model (QDM)-based Health Quality Measure Format (HQMF), Release 1 - US Realm (PI ID: 756)
7. HL7 Version 3 Implementation Guide: Clinical Quality Language (CQL)-based Health Quality Measure Format (HQMF), Release 1 - US Realm (PI ID: 1142)
8. HL7 FHIR® Implementation Guide: Clinical Quality Framework (CQF on FHIR), Release 1 (PI ID: 1234)(Co-Primary with CDS)
9. HL7 FHIR® Profile: Quality, Release 1 - US Realm (PI ID: 1125)
10. HL7 CDA® R2 Implementation Guide: Supplemental QRDA Clinical Quality Data Sharing User Guide, Release 1 (PI ID: 1215)
11. Co-sponsored ProjectUpdates (5 min)
12. HL7 Cross-Paradigm Specification: Clinical Quality Language, Release 1 (PI ID: 1108)(CDS Primary, CQI co-sponsor)
13. HL7 Cross-Paradigm Specification: CIMI Logical Models, Release 1 (PI ID: 1253) (CIMI Primary, CQI co-sponsor)
14. HL7 Cross Paradigm Specification: Neutral Mapping Notation, R1 (Project 1237 –FluentPath- AligningFHIRPathwith CQL --- co-sponsoring with CDS, ITS <primary>, FHIR)
15. CrossParadigmIG Medical Device Interoperability (PSS:CrossParadigm_IG_Medical_Device_interoperability.v.4.docx)
16. CompositeKNARTInvestigation(PSS:1336)
17. CrossParadigm_Storyboard_Artifact_Payer_Value_Based_Care(PSS: 1347)
18. Clinical Decision Support Big Picture Implementation Guide (PI ID: tbd) (Arden Syntax Primary, CQI and CDS co-sponsor)
19. FHIR Public Health Electronic Case Reporting (eCR) (PI ID: tbd) CQI and CDS co-sponsor with CIMI as an interested party)
20. US FHIR Core Updates PSS (PI ID: 1265) (US FHIR Primary, CQI and CDS co-sponsor with CIMI as an interested party)
21. Reminders:

General January 2018 Ballot Deadlines NIB Submission Deadline – November 12, 2017

1. Final date to sign up for ballot pools – December 21, 2017
2. HL7 January Ballot open for comment – December 22 – January 22, 2017
3. General Ballot Schedule
4. References:

FHIR-Related Deadlines

1. FHIR Tracker submissions for US FHIR Core – October 1, 2017
2. Deadline for HL7 FHIRConnectathonSubmission to FMG – October 18, 2017
3. Deadline to submit to FMG of plans to submit FHIR IGs – October 25, 2017
4. Deadline for Notice for Intent to Ballot if balloting implementation guides – November 12, 2017
5. Changes to FHIR normative content (upload FHIR tracker issues) – November 15, 2017
6. Complete ballot reconciliation of prior ballots – December 3, 2017
7. Substantive ChangeFreeze for FHIRCore– December 10, 2017
8. Final FHIR Content Freeze (Including IGs) – December 17, 2017
9. Ballot opens – December 22, 2017 – January 22, 2018
10. FHIR Schedule References:

Other Important Upcoming Date

1. Harmonization(applies to all versions of HL7 – v2, v3, FHIR, also submit FHIR requests to FMG)
2. Initial Proposals– November3, 2017
3. Final Proposals – November 24, 2017
4. Harmonization Meeting – November28-29, 2017
5. Harmonization References:
6. HL7 WG meeting in New Orleans – January 27 – February 2, 2018
7. Next CQI Workgroup Call: December 1, 2017

The meeting adjourned at 2:00pm ET. The next CQI WG call is scheduled will be on December 1, 2017.

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