Minutes: HL7 Clinical Quality Information Workgroup

October 16, 2015

CQI Co-chairs: Patty Craig, Floyd Eisenberg, Walter Suarez, Crystal Kallem, Chris Millet

Meeting Chair:Chris

Meeting Scribe:Crystal

Agenda

  1. Roll call

Crystal Kallem / Lantana Consulting Group /
Floyd Eisenberg / iParsimony /
Ann Phillips / NQF /
KP Sethi / Lantana Consulting Group /
Bob Jones / The Lazy Company /
Chris Markle / ESAC /
Deidre Sacra
Julia Skapik / ONC /
Juliet Rubini / Mathematica
Justin Schirle / Epic /
Tammy Kuschel / McKesson /
Sarah Ryan /
Stan Rankins / Telligen /
Mark Hadley / MITRE /
Jason Mathews / MITRE /
Yan Heras / Lantana Consulting Group /
Cynthia Barton / Lantana Consulting Group /
Gaye Dolin / IMO /
Mark Kramer / MITRE /
Karl Poterack / Mayo /
Vaspaan Patel / NCQA /
Jae Kim / ESAC /
Ashley McCrea / ESAC /
Richard Asmund
Stan Rankins / Telligen /
Nadia Ramey / ESAC /
Kimberly Smuk / AMA /
  1. Business Updates
  2. Debrief from HL7 WGM
  3. A new project scope statement for the quality exchange white paper was approved at the WGM. Moving it through the US Realm Task Force and TSC for approval.
  4. Discussions with CIMI to ensure that various workgroups are aware of the work that is going on with CIMI (Clinical Information Modeling Initiative) which is a new workgroup within HL7.
  5. FHIR Quality Profile (QI Core)
  6. In spite of the decision made by the committee last week to incorporate QUICK into the FHIR Quality Profile (aka QI Core) via the DSTU update process, Floyd proposed that the committee reconsider balloting QUICK as an independent DSTU in January.
  7. The FHIRQI-Core Quality Profile is based off of resources with FHIR which has been balloted and published this year.
  8. The challenge is that FHIR has published v2.0, but are striving for v2.1. Additionally QUICK is current not a DSTU Standard. It was included as an informative addendum in the QI-Core FHIR Profiles ballot but removed due to negative comments from the community about its purpose.
  9. QUICK already exists as an HL7 project which would allow the committee to take it forward for ballot as DSTU in the upcoming ballot cycle.
  10. FHIR is pushing V2.1 back to the May ballot cycle, so V2.0 would be valid in January. This would be a good reason to move forward with QUICK because FHIR would be stable during the January ballot cycle.
  11. The input from a QUICK ballot in January would provide valuable input to FHIR 2.1.
  12. Concerns raised that if we do a DSTU update to publish QUICK with QI Core, there could be concern that adding QUICK would be a substantive change, thus requiring a ballot anyway. Then it could be too late to make the upcoming ballot cycle.
  13. The last time these artifacts were balloted, we balloted QI CORE as DSTU with QUICK as an informative artifact/addendum to the QI Core Profiles. Before publishing QI CORE, the project team removed QUICK as an informative artifact based on a ballot comments.
  14. Some felt that the QUICK model should be a logical model that stands alone – an independent artifact. The original intent was to have an independent data model. Having it stand as an independent artifact would make it more comprehensive to clinicians and allow a staged approach to the overall product. Input to QUICK would inform FHIR QI Core profiles.
  15. Others felt QUICK couldn’t/shouldn’t stand independent. That it will present more challenges when synchronizing with FHIR. It’s believed that we should continue to focus on profiles and ballot the profiles with QUICK being a derivative of the profiles.
  16. Currently QUICK is reverse engineered/derived from the QI-Core FHIR Profiles. Some members raised the issue that balloting QUICK as a separate DSTU from the already published QI-Core DSTU would cause confusion and be a source of redundancy. Any changes/comments against QUICK cannot be implemented without making changes to the QI-Core FHIR profiles anyway. This raises the question whether QUICK and the QI-Core FHIR profiles should be separated in the first place.
  17. Mark H. moved to ballot QUICK as a DSTU 1.0 and simultaneously ballot QI CORE as DSTU 1.1. Julia seconded the motion. Discussion:
  18. KP cautioned that QUICK and QI CORE would have different versions, causing confusion and more challenges with alignment.
  19. Mark K. asked if QI CORE could be considered a reference implementation of QUICK instead of a standard by itself. His reasoning was that QUICK and QI-Core are different representations of the same model and hence only one combined “package” should be balloted and made DSTU.
  20. After lengthy discussion, Mark Hadley withdrew the motion.
  21. Floyd moved to overturn the decision made last week (to conduct a DSTU update to the FHIR Quality Profile and include QUICK); and instead proceed with a single DSTU ballot that includes both the FHIR QI-Core Quality Profile and QUICK. Ann Phillips seconded.

Vote: 1 abstention; 0 against; 24 approved

  1. QRDA Category I DSTU R3 Update – PSS Review
  2. Chris made updates to the PSS to conduct a DSTU update. He will send the draft to the committee to review during next week’s call.
  3. Ballot comment Resolution – FHIR eCQM – Block vote scheduled for 10/23
  4. The FHIR eCQM team will be sending a block vote to the listserv later today for 1 week review.
  5. The committee will conduct the block vote next week.
  6. Informational:
  7. PSS deadline for the January Ballot Cycle is October 18
  8. NIB deadline for the January Ballot Cycle is October 25
  9. NIB to CQI listserve by Monday, October 19, 2015
  10. Harmonization Calls:
  11. Initial Proposals Due October 25
  12. Final Proposals Due November 8
  13. Harmonization Calls: November 10 and 12 (13th reserved for overflow day)
  14. Next Call Friday, October 23, 2015. Meeting adjourned at 3:00 pm ET.