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Date: February 5, 2020

Quarter: 1

Discussion items


Clinical Steering Division Update

PSS considerations for Sept 2020 (Baltimore)

Workgroup Health


Action items

Quarter: 2

Discussion items

Note - for Wednesday Q2 (February 5) CQI hosted but attendees entered their presence on the CDS attendance record as this was a combined meeting: 2020-FEB CDS WGM Attendance 


Clinical Steering Division Update

PSS considerations for Sept 2020 (Baltimore)

Did not have a steering division update.

What are the next steps with VMR and DSS. 
Need Ken's input to make a decision.

Review slides for CQL normativeBryn

Reviewed summary of issues related to CQL.  FHIRPath is normative and published

Errata review revealed several (about 20) Errata comments in CQL that need to be resolved, mostly related to UCUM and calendar duration timing.  

Review MedicationRequestIntervalsBrynPosted to Zulip CQL stream.  Solution proposed by Bryn will avoid including recursion in new version of CQL.

QI Core ChangesBrynCovered a basic overview of 'not done' profiles in QI-Core.  Mark suggested to allow a list of codes in addition to a value set for reasons not done.   Recommendation to update fields to 0..0 for elements that should not be present.  

Action items

Quarter: 3

Discussion items


Session Hosted by CDS - See CDS WG minutes for details. 2020-02-05 Q3 CDS WGM Minutes. Highlights noted here.

Joint w/ CQI and FHIR-I

  • CDS Hooks Project Update, connectathon report out, sandbox update, 1.1 roadmap
Isaac Vetter

Patient View hook has reached the highest maturity level.  10 to possibly 100 distiinct implementers.  Reviewed the number and types of comments, many around User ID.  Many more for a block vote.  Resolve remainder over the next couple of months.  

CDS Hooks Argonaut Project- hooks to meet PAMA requirements being published

SMART Web Messaging- PSS for CDS SMART Messaging is not yet created.  Discussed co-sponsoring by CDS.  

Dennis provided a connectathon review-  5 participants, worked on 1.0 scenarios.  Cerner and Epic were both able to integrate with two patient-view services.  

Link to Slides:

Discussed the need for override reasons for CDS services.  Prepping to test this in San Antonio.  

  • FHIRcast update - STU2
Isaac Vetter


Introduction and overview of FHIRcast specification

Reviewed 2020 Roadmap: Work on STU 2 specification using Websockets, Deploy, Direction for image measurement exchange

Resolve about 100 comments from Feb Ballot

  • Infobutton-on-FHIR

Brief overview of Infobutton- provides contextualized information to clinician (ex. patient has asthma, infobutton will deliver info from knowledge repositories).  

Reviewed Confluence page describing InfoButton vs. CDS Hooks and when to use which.  CDS Hooks vs. InfoButton: Which should I use?

Participants were requested to review and provide comments

  • FHIR Clinical Reasoning

TSC is looking for resources that are going normative in R5.  We don't have any ready for normative, however we can push to maturity level 4, if not level 5:  planDefinition, library, measure, measureReport, ActivityDefenition, DetectedIssue, EventDefenition, RequestGroup, RiskAssessment

Action items

Quarter: 4

Discussion items


Patient Care hosted this quarter. Highlights noted here. See PC minutes for details.

PC resources addressed for Quality

  • Elective Procedure 24014
  • Principal Vs Primary Diagnosis 
  • Principal Vs Primary Procedure 22786 and 24014

The workgroup reviewed these items.  24014 relates to a resource owned by another workgroup that was not represented here.  22786 was closed as non-persuasive several months ago.  This needs to be logged with OO to evaluate the binding to the value set.  Stan suggested this is not a value set issue (elective is not orthogonal to priority).  Original commenter needs to resubmit additional JIRA tickets.  

Change is scope of DEQM PSS: PSS - Data Exchange for Quality Measures - FHIR IGBryn

Gave an overview of the need for Gaps in Care and seeking PC approval of change in scope.  Need additional profiles, extensions, etc. in DEQM.  

PC and CDS each had quorum and voted successfully to approve the changes to the DEQM PSS and remain as co-sponsors - see PC minutes for voting details.

Action items