Skip to end of metadata
Go to start of metadata

Quarter:  1 (Hosting CQI & CIMI)

Chair:  Bryn Rhodes

Scribe:  Robert Jenders

Discussion

  1. QUICK
    1. Claude Nanjo provided a "quick" update on recent activity involving the QUICK ("QUality Improvement Clinical Knowledge") data model [QUICK Update WGM Sept 2019.pptx].  QUICK serves as a logical model for data referenced in knowledge artifacts represented in standards managed by the CDS and CQI WGs.  QUICK is a logical view of data derived from QI Core that in turn is based on a specific version of FHIR (STU3, R4, eventually R5), meaning that there are different logical views that are QUICK.  Ultimately the goal is to use the QUICK Logical Model to refer to data in a knowledge representation formalism, e.g., CQL.  CQL is the authoring view of the data which then is processed in ELM (the execution layer), at which a FHIR-to-QUICK translation occurs in order to derive the FHIR payload.
    2. Open discussion and questions have followed.  US CMS has not made a decision yet when a transition from the use of QDM to QUICK in eMeasures although this is anticipated.  Some raised the issue that QUICK might be an unnecessary layer in the representation of eMeasures.  On the other hand, QUICK is linked to a specific version of FHIR through computable mappings.
    3. Motion:  QUICK should be explored as the method of interacting with FHIR measures, particularly with regard to measure authoring and tools.  Moved Skapik, second Kawamoto.  Discussion:  The purpose of QUICK was to replace QDM as a data model.  The goal of the motion is to provide guidance to tool developers and others to ensure that appropriate tools are developed.  A number of work group members described the importance of testing in this regard.  Vote:  38/0/2.


Quarter:  2 (Hosted by CQI; see their minutes as primary documentation)

Chair:  Floyd Eisenberg

Scribe:  Robert Jenders

Discussion

  1. Bryn Rhodes provided updates on several activities [CPG-on-FHIR Update - 2019 Sep.pptx].
    1. FHIR Quality Measure IG:  Issue resolution in progress.  Motion:  Approve ballot reconciliation spreadsheet for this + DEQM reconciliation spreadsheet.  Moved Rhodes, second Samples.  Vote:  41/0/0.
    2. CPG on FHIR:  Work has focused on structuring content and recommendations in different layers of knowledge (from L1 = narrative to L2 = semi-structured/human readable to L3 = structured = machine-readable to L4 = executable in a specific implementation environment).  Work product = IG.  Use cases (for connectathon tracks, etc) include the US CDC opioid prescribing guideline; CKD management; HIV screening; WHO antenatal guidelines; CDC anthrax exposure prophylaxis and HBV decision support.  9/2019 ballot:  Aff 33 (94 comments), neg 32 (33 comments).  Themes underlying these comments, and possible reconciliation involving these, were reviewed.
  2. EBM on FHIR
    1. Brian Alper reviewed recent work on Evidence-Based Medicine on FHIR (EBMonFHIR) project [EBMonFHIR Connectathon Report Out Sept 2019.pptx].  This is the representation of evidence that would serve as the basis for decision support artifacts and interventions in clinical decision support.  This focused on expansion of the FHIR Evidence resource and its use in the connectathon.  
    2. Extended discussion of different aspects of "group" in this context, particularly where a group may not be the conventional group of patients but instead would be a group of information resources that serve as the evidence.
  3. QICore Ballot Reconciliation
    1. Issues discussed in turn, with resolutions entered directly in the gforge tracker.
    2. Issue 24304:  Consensus was that this was persuasive, but it was not formally resolved.  
    3. Issue 24073:  Found persuasive.  QUICK is not (yet) required.  Yan Heras moved, Rubini second.  Vote:  35/0/3.
    4. Issue 24045:  Found persuasive–example does not align with its anchor.  Denning moved, Rubini second.  Vote:  34/0/2.


Quarter:  3 (Hosting Pharmacy, CQI and BR&R)

Chair:  Bryn Rhodes

Scribe:  Robert Jenders

Discussion

  1. PDDI CDS IG (Potential Drug-Drug Interaction) 
    1. Richard Boyce reviewed the background of and recent activity in this project [update-to-HL7-CDS-and-Pharm-WGs-09182019.pptx].  Goal:  Explain how to use CQL, FHIR and CDS Hooks to provide context-sensitive CDS at the time of drug ordering/prescribing.
    2. Comment-only ballot 9/2018 => http://hl7.org/fhir/uv/pddi/2018Sep/index.html
    3. Facilitated by developments in CDS Hooks:  order-select and order-signed.
    4. Plan:  Further revision of draft IG, with the goal of balloting in 5/2020 (comment-only).
  2. FHIR MedicationKnowledge Resource
    1. https://www.hl7.org/fhir/medicationknowledge.html
    2. Background and recent activity reviewed by the Pharmacy WG.
    3. Key attribute for implementing CDS:  ClinicalUseIssue = indication, contraindication, interaction, etc.
    4. Intended to provide information about a medication–clinical, cost, etc.
  3. Biomedical Research & Regulation WG:  Interaction with CDS-related FHIR Resources
    1. Hugh Glover reviewed their model of this area and posed questions about the best way to use these resources (e.g., PlanDefinition).
  4. Sydney Agenda Planning
    1. PDDI IG:  NIB for comment-only ballot.
    2. No new PSS.
    3. Consensus:  Because the Sydney meeting is shifted one day into the future during the week of the WGM and no plenary will be held, the easiest solution is to shift all (Arden, CDS and CQI) work group meetings one day into the future from their conventional schedule, preserving the schedule of joint meetings during the Atlanta WGM.
      1. Arden Syntax WG will meet all day Tuesday.
      2. CDS WG will meet all day Wednesday and Thursday.


Quarter:  4 No meeting