Virtual WGM 2020-05-21 Minutes

Chair: Bryn Rhodes

Scribe: Howard Strasberg

Discussion items

• Consider a vote to support removal of support for prior version of FHIR (DSTU2 and STU3) from the DTR PSS and the DTR IG.
  
  • Deferred; Robert Dieterle was not on the call
• CQL Ballot Reconciliation
  • https://docs.google.com/presentation/d/1Op9_ih-DAEk_APPrAc_wdyFX7Tx6ZTtZ37pHVduQXbo/edit?usp=sharing

  • T	Key	Summary	Assignee	Reporter	P	Status	Resolution	Created	Updated	Due

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  • vast majority of comments were affirmative
  • 61 in block vote 1 - mostly minor changes
  • 7 in block vote 2
  • 7 for teleconference with proposed resolutions
  • 14 no resolution yet
  • Discussion
    • FHIR-27061 - Getting issue details... STATUS
      • day vs 'd'
      • month vs 'mo'
    • FHIR-27062 - Getting issue details... STATUS
      • age in years versus annums
      • use calendar durations in CQL; don't use UCUM for calendar
      • week vs 'wk'
      • no UCUM units for calendar durations
      • a calendar month is not a definite quantity
      • a calendar week is not a definite quantity because of leap seconds
      • Bryn will review measures for this discrepancy
      • resolved on the call - see JIRA for details
    • FHIR-27067 - Getting issue details... STATUS
      • resolved on the call - see JIRA for details
    • FHIR-27073 - Getting issue details... STATUS
      • resolved on the call - see JIRA for details
    • FHIR-27439 - Getting issue details... STATUS
      • lack of production ready tooling
      • Atom plug-in is available
      • AHRQ CDS Connect
      • see community projects page
        • https://github.com/cqframework/clinical_quality_language/wiki/Community-Projects
      • resolved on the call - see JIRA for details
• Extension for CQL 1.3 STU (on the grounds that it is needed to support reporting through 2021 for measures written using this version of the specification)
  • CQL STU3 Extension Request
  • STU expiring in September, but currently being used in eCQM reporting through 2021
  • Proposal is to submit an STU extension request through the end of 2021 (2 year extension)
  • Motion to extend STU for 2 years: Howard Strasberg / Patty Craig.  Approved 12/0/0.
• CPG-on-FHIR Update - Bryn
  • completed reconciliation except for one item
  • lots of work applying comments and profiles
  • bindings
    • strength of recommendation
    • quality of evidence
    • GRADE is an example, but there are many others
    • cannot require GRADE
    • can you flag the top level recommendations of different systems?  
      • not reliably, since different criteria would be used
    • individual implementations could specify specific systems
    • discussion of example versus preferred binding
      • consensus formed around it being an example
      • when you create an instance, you have to make a selection
• EBM-on-FHIR Update - Brian Alper
  • COVID-19 Knowledge Accelerator (COKA) project
    • extension of EBM-on-FHIR
    • goal: establish FHIR standards for various aspects about evidence about COVID-19
    • a primary effort was on the Citation resource
    • although there's a concept of relatedArtifact, the large volume of citations to be shared and de-duplicated required a different approach
    • citation managers - demonstrate they can send, receive data in this format
    • EvidenceReport resource
      • purpose - transmit combinations of data; it's a composition
      • use cases
        • classification - citation is about treatment, a certain type of study, about human Covid-19 disease
        • search results - list of search results
        • resource compilation - contains one or more other FHIR resources
        • structured text
      • divided into sections
    • Connectathon report
      • 9 people, 7 orgs, 5 countries
      • simplified the Citation resource, which still has 90-100 elements
        • made a contributorship element
      • processed 4933 citation resources
      • drafted and EvidenceReport resource
      • citation managers
        • PICO Portal
        • DistillerSR
      • discovered issues
        • maintaining actual instances while the standard is still being defined
        • handling extensions
    • this week - hoping to create a repository with 100K citations
    • Citation resource
      • unique identifiers and related identifiers
      • journal identifiers
      • variance of titles and abstracts with translations
      • alternate versions (e.g. print, electronic)
      • elements specific to MEDLINE and PubMed
      • additional definition details were added in accordance with a recent CDS call
      • always open to feedback
    • Evidence and EvidenceVariable resources took more than a year to develop stable models
    • Citation and EvidenceReport were developed in 2-3 weeks!
• Next calls
  • CQI hosts CDS Fri 5/22 1 PM ET
  • CDS WG call Wed 5/27 12 PM ET