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Chair:  Yan Heras

Scribe: Paul Denning

Dial-in number (US): Dial-in number (US): (712) 451-0740
Access code: 449751#
International dial-in numbers: https://fccdl.in/i/hl7cqiwg 

Join the online meeting: https://join.freeconferencecall.com/hl7cqiwg

Attendees

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AttendeeAttendee's OrganizationAttendee's emailPresent

Abdul Malik

Hi3 Solutions

abdulmalik.shakir@hi3solutions.com


Abdullah RafiqiESAC

abdullah.rafiqi@esacinc.com

yes

Alex Liu

EPIC

aliu@epic.com


Andrea Pitkus

-

apitkus@gmail.com


Andrews KanterIMO Healthakanter@imohealth.com

Andrey Soares

U C Denver

andrey.soares@ucdenver.edu


Angela Flanagan

Lantana Consulting Group

angela.flanagan@lantanagroup.com


Angie GlosteinCerner

angie.glostein@cerner.com


Ann Phillips

NCQA

phillps@ncqa.org


Anne Smith

NCQA

smith@ncqa.org


Apurva Dharia

ESAC

apurva.dharia@esacinc.com


Ashish DeshpandeOM1

adeshpande@om1.com


Ben Ghahhari

CMS

benjamin.ghahhari@cms.hhs.gov


Ben Hamlin

NCQA

hamlin@ncqa.org

yes

Bo Borgnakke

Michigan Shared Services Network

borgnakke@mihin.org


Bob Dieterle

Enable Care, LLC

rdieterle@enablecare.us


Bob DolinElimu

bdolin@elimu.io


Bob Keyes

Telligen

bkeyes@telligen.com


Brett Marquard

River Rock Associates

brett@riverockassociates.com


Brian Alper

EBSCO

balper@ebsco.com


Bryn Rhodes

ESAC

bryn@databaseconsultinggroup.com

yes

Casey Thompson


casey@govhealth.com  


Celine LefebvreAMA

celine.lefebvre@ama-assn.org


Chana West

CDQ Solutions

cwest@cdq-solutions.com


Chelsea King ArthurSemantic Bitschelsea.kingarthur@semanticbits.comyes

Chris Moesel

MITRE

cmoesel@mitre.org


Claude Nanjo


cnanjo@gmail.com


Claudia Hall

Mathematica

chall@mathematicampr.org

yes

Courtney Breece

 Inovalon

cbreece@inovalon.com 


Craig Newman

Altartum

craig.newman@altarum.org


Crystal Kallem

CK Consulting

crystal.kallem@ckconsultingllc.com


Cynthia BartonCognitive Medicalcbarton@cognitivemedical.com

Dan Donahue

ESAC

dan.donahue@esacinc.com


Dani CookeOM1

dcooke@om1.com


Daryl Chertcoff 

HLN Consulting

daryl@hln.com


David Sundaram-Stukel

EPIC

dsandara@epic.com


Deb HallMeditechdhall@meditech.com

Dipti Ghandi

The Joint Commission

dghandi@jointcommission.org


Durwin Day

BCBSA

dday@bsbsil


Elise BerlinerAHRQ

elise.berliner@ahrq.hhs.gov


Eric Askegaard

UHG

eric_askegaard@uhg.com


Eric HaasHealth eData

eric@healthedatainc.com


Eric Sullivan

Inovalon

yesesullivan@inovalon.com


Fareeda Nazeer

The Joint Commission

fnazeer@jointcommission.org


Floyd Eisenberg

iParsimony, LLC

FEisenberg@iParsimony.com

yes
Galen HamannVAgalen.hamann@va.gov

Gay Dolin

Namaste Informatics

gdolin@namasteinformatics.com

yes
Gayathri JayawardenaESACgayathri.jayawardena@esacinc.comyes
Genny LuensmanCDCgluensman@cdc.gov

Glen Raley

Humana

graley@humana.com


Hafsa Subhan

The Joint Commission

hsubhan@jointcommission.org


Heather McComasAMAHeather.McComas@ama-assn.org

Heather Patrick

CDC

htx7@cdc.gov


Howard Strasberg

Wolters Kluwer

howard.strasberg@wolterskluwer.com


Humberto Mandirola

Biocom

hmandirola@biocom.com


iIkka Kunnamo

Duodecim

jilkkakunnamo@duodecim.fl


isabel Zaru-Roque

ESAC

isabel.zaru-roque@esacinc.com


James Bradley

Mitre

jhbradley@mitre.org


Jamie Lehner

PCPI

jamie.lehner@thepcpi.org


Jana Malinowski

Cerner

cerjkm@cerner.com


Javier Espina

Philips

javier.espina@philips.com


Jeff Schmitz

Health eFilings

jschmitz@healthefilings.com


Jeff Smith

UHC

jeffery_s_smith@uhc.com


Jen Seeman

ESAC

jennifer.seeman@esacinc.com

yes

Jenny Brush

ESAC

jennifer.brush@esacinc.com


Jerry Goodnough


Jessica Ordoyne

Dynamic Health

jordoyne@dynamichealthit.com


Jim ShalabyElimu

jshalaby@elimu.io


Jimmy Newton
jimmynewton@gmail.com
Joe BormelCognitive Medicinejbormel@cognitivemedicine.comyes

Joe Kunisch

Memorial Hermann

kunisch@memorialhermann.org


Joe Quinn

Optum

joseph.quinn@optum.com


John Damore

Diameter Health

jdamore@diameterhealth.com


John Loonsk


john.loonsk@cgifederal.com


Jonathan LaDeauMeditechjladeau@meditech.com

Julia Skapik




Juliet Rubini

Mathematica

jrubini@mathematicampr.com


K ZapataDiameter Healthkzapata@diameterhealth.com

Kathleen Connor

US Dept of Veterans Affairs

kathleen_connor@comcast.net


Kathy CarsonSemanticBitskathy.carson@semanticbits.comyes

Ken Hall

Veradigm Health

kenneth.hall@veradigmhealth.com


Kurt Allen

US Dept of Veterans Affairs

kurta@gjoll.com


Latasha EstradaSemanticBitslatasha.estrada@semanticbits.com

Laura

CDC

lconn@cdc.gov


Lenel James

BCBSA

lenel.james@bcbsa.org


Leslie SmartHumana

lsmart3@humana.com


Linda Michaelsen

Optum

linda.michaelsen@optum.com

yes

Lisa Anderson

NCQA

landerson@ncqa.org

yes

Lisa Nelson

Life Over Time Solutions, LLC

LisaRNelson@cox.net


Liz Hartley-Sommers

BCBSA

elizabeth.hartley@bcbsla.com


Lorraine Constable

HL7 Canada

lorraine@constable.ca


Luke Osborne

MITRE

lwosborne@mitre.org


Lyn LibertyMeditechlliberty@meditech.comyes

Lynn Perrine

Lantana

lynn.perrine@lantanagroup.org

yes

Marc Hallez

The Joint Commission

mhallez@jointcommission.org

yes

Mark Taylor


mark.taylor@readycomputing.com


Matt Elrod Max MD

elrod@max.md


Matt Hardman

Cerner

matt.hardman@cerner.com


Matthew Dugal

Dynamic Health

mdugal@dynamichealthit.com


Matthew Tiller

ESAC

matthew.tiller@esacinc.com

yes

May Terry

Mitre

mayt@mitre.org


Mia Nievera

The Joint Commission

mnievera@jointcommission.org

yes

Michael O'Keefe

MITRE

mokeefe@mitre.org


Michelle LeavyOM1

mleavy@om1.com


Michelle MillerCerner

michelle.m.miller@cerner.com


Michelle Mish Turner

UHC

michelle-p-turner@uhc.org


Mike Ballie

UHC

michael.ballie@uhc.com


Mike Hunt

Experian

mike.hunt@experian.com


Mitra Biglari

The Joint Commission

mbiglari@jointcommission.org

yes

Nancy Whipple

GE

nancy.whipple@ge.com


Nathan Bunker


nbunker@immregistries.org


Nick Radov

UHC

nradov@uhc.org


Pamela Mahan-Rudolph

Memorial

pamela.mahanrudolph@memorialhermann.org 


Patty Craig

The Joint Commission

pcraig@jointcommission.org

yes

Paul Denning

MITRE

pauld@mitre.org

yes
Peter EmmanuelElimu

pemmanuel@elimu.io


Peter Muir


peter@pjmConsultingLlc.com

yes

Ping Jiang

The Joint Commission

pjiang@jointcommission.org

yes
Piper RanalloAAN pranallo@aan.com yes

Rathore Garima


rathore.garima1@gmail.com


Rebeccah Baer

NCQA

baer@ncqa.org


Rhonda Schwartz

ESAC Inc

rhonda.schwartz@esacinc.com


Ricardo Quintano

Philips

ricardo.quintano@philips.com


Rich Boyce


codehop.dev@gmail.com


Rinku MasterNCQA

master@ncqa.org


Rob McClure

MD Partners Inc

rmcclure@mdpartners.com

yes

Robert Samples

ESAC Inc

robert.samples@esacinc.com

yes
Ron Chee


Rukma Joshi

ESAC Inc

rukma.joshi@esacinc.com


Ryan Clark

NCQA

ryan@ncqa.org


Ryan Weber


ryan.weber@uhc.com


Sam Sayer

MITRE

ssayer@mitre.org


Scott FradkinFlexionsfradkin@flexion.usyes
Serhii IlinSemanticBitsserhii.ilin@semanticbits.com

Serafina Versaggi

JP Systems

serafina.versaggi@jpsystems.com


Shannon Cerf


Sharon Peters


Stan Rankins

Telligen

SRankins@telligen.com

yes

Steve Hufnagel


steve.hufnagel.hl7@gmail.com


Sue Kent

CCF

kents@ccf.org


Sweta Ladwa

ESAC inc

sweta.ladwa@esacinc.com


Tammy KuschelAcustafT.kuschel@acustaf.com

Thomas Reese

U of Utah

thomas.reese@hsc.utah.edu


Thomson Kuhn

ACP

tkuhn@acponline.org

yes
Tom StrassnerMITRE

tsrassner@mitre.org


Traci Psihas

ESAC Inc 

traci.psihas@esacinc.com


Viet Nguyen

Strata Metrics

vietnguyen@stratametrics.com

yes

Walter Suarez

Kaiser Permanente

walter.g.suarez@kp.org


Wendy Talbot

NCQA

talbot@ncqa.org


Yan Heras

Optimum eHealth

yanheras@gmail.com

yes

Yanyan Hu

The Joint Commission

yhu@jointcommission.org

yes

Zabrina Gonzaga 

Lantana Consulting 

zabriana.gonzaga@lantanagroup.com


Meeting Minutes

Meeting Minutes


Agenda Outline

Agenda Item

Minutes
1Announcements 
  • Virtual Connect-a-thon dates: Wednesday May 13, Thursday May 14, and Friday May 15
  • CQI will be one of the early adopters to switch to Zoom for weekly meetings - stay tuned 
  • Ballot opened on April 10th: 
    • HL7 Cross-Paradigm Specification: Clinical Quality Language, Release 1 (Jira Specification = "Clinical Quality Language")
    • HL7 FHIR Guidance: Quality Reporting, Release 1 - US Realm (Jira Specification = "US FHIR Guidance - Quality Reporting")
      Ballot comments for both CQL and FHIR Guidance are to be submitted using HL7 JIRA.  Voters must still upload the Spreadsheet for each ballot.  The spreadsheet must either contain the JIRA Tracker #s or all of the information.  Each comment in the spreadsheet must also contain the Vote.
Yan reviewed the agenda.
2Quality Measure Reporting White Paper 
3

FHIR Quality Measure IG

Quality Measure IG Jira Issues Filter

Review the diagrams that related to the following issues (only issues remaining for a vote):

  • 25501 In Figure 3-9, shouldn't the patient that gets into the Measure Population also get into the Initial Population?
  • 25551 Revise the Calculation flow for Proportion Measures
  • 26342 Harmonize population terminology

Summary of findings, diagram proposals and proposed update to eCQM measure component definitions available at CQI Workgroup Quality Project Subgroup Agenda/Minutes 21 April 2020.

Discussion of Tuesday sub-group call

process flow diagrams

(see attachments to this page)

Measure component flow - HL7 - FINAL 24April2020.pptx

OutcomeFlow__Proportion_version_04212020.vsdx

OutcomeFlow_CV_Version_04212020.vsdx

proportion measures

continuous variable measures

Diagrams emailed from Ping to Floyd on 21 Apr

Numerator Exclusions stay in final denomintor

FHIR-26655 - Getting issue details... STATUS  examined value set

Existing value set is extensible

Discussion about codes used in HQMF and QRDA; new terms (DENIN, etc.) are not to be used in HQMF or QRDA.

New harmonization process to get content into HL7 code systems. Rob McClure will help when new process is ready.

Bryn: just add to FHIR base spec?

Rob: That is what people have been doing, but not what UTG process will do.

Will be worked offline.

New code system for the extended codes to use in the value set

see http://hl7.org/fhir/R4/valueset-measure-population.html

http://hl7.org/fhir/R4/codesystem-measure-population.html

Why a hierarchy?

Need to document on Jira issue the reasons for not using a hierarchy.

Confusing discussion about "inclusion" being either the first step/filter or what is left at the end (i.e., what is included) ... for CV measure

Chart pull metaphor

Patty discussed TJC waterfall to allow interactive examination of exclusions

Need to be clear that measures do not need to have every box in the diagram (e.g., numerator exclusions are rarely used).

FHIR-25501 - Getting issue details... STATUS in-person Javier, not on call (not voted)


FHIR-25551 - Getting issue details... STATUS Mia Nievera in-person

vote

Motion/Second: for-against-abstain 

Rob Samples/Floyd Eisenberg: 28-0-1


FHIR-26342 - Getting issue details... STATUS

HL7 cannot directly influence Bonnie or CMS Blueprint and related CMS documents

Vote:

Motion/Second: for-against-abstain 

Rob McClure/Floyd Eisenberg: 28-0-1

(discussion ended 2:15pm ET)

4

DEQM IG

Da Vinci DEQM Trackers for upcoming DEQM calls Zulip stream 

No issues for discussion today. (Three issues remaining as of now, will be brought to the CQI when the proposed resolutions are ready) 


5Clinical Reasoning Measure and MeasureReport Resources (FHIR Resources owned by CQI)

CQI Core Tracker Block Vote spreadsheet

  • This block vote contains many of the outstanding trackers for the Measure and MeasureReport resources. Specifically, these trackers cover many of the proposed changes resulting from the Quality Measure and Data Exchange for Quality Measures Implementation Guides.
  • The following JIRA filter lists the issues:
    • project = FHIR AND Specification = "FHIR Core (FHIR) [FHIR-core]" AND "Work Group" = "Clinical Quality Information [cqi]" AND status = triaged AND Grouping = Block-Vote-1 ORDER BY priority DESC, updated DESC

Individual issue that is Ready for Vote:

  • Measure Resource
    • FHIR-26844 Examples are missing links to libraries (Bryn Rhodes)  Persuasive
    • FHIR-26655 Clarify "inclusion" nature of population criteria in Measure and MeasureReport (Bryn Rhodes) Persuasive with Modification
  • MeasureReport Resource

(start 2:15pm ET)

https://jira.hl7.org/browse/FHIR-20692
https://jira.hl7.org/browse/FHIR-20699
https://jira.hl7.org/browse/FHIR-20712
https://jira.hl7.org/browse/FHIR-20719
https://jira.hl7.org/browse/FHIR-20804
https://jira.hl7.org/browse/FHIR-21299
https://jira.hl7.org/browse/FHIR-21637
https://jira.hl7.org/browse/FHIR-21638
https://jira.hl7.org/browse/FHIR-24623
https://jira.hl7.org/browse/FHIR-24624
https://jira.hl7.org/browse/FHIR-24625
https://jira.hl7.org/browse/FHIR-24626
https://jira.hl7.org/browse/FHIR-24627
https://jira.hl7.org/browse/FHIR-24628
https://jira.hl7.org/browse/FHIR-24629
https://jira.hl7.org/browse/FHIR-24630
https://jira.hl7.org/browse/FHIR-25283
https://jira.hl7.org/browse/FHIR-25718
https://jira.hl7.org/browse/FHIR-25737
https://jira.hl7.org/browse/FHIR-26647
https://jira.hl7.org/browse/FHIR-26675
https://jira.hl7.org/browse/FHIR-26681
https://jira.hl7.org/browse/FHIR-26695

Block Vote:

Motion/Second: for-against-abstain 

Floyd Eisenberg/Bryn Rhodes: 28-0-1

(end 2:20pm)

6

QI-Core 

QI-Core IG Jira Issues Filter

FHIR-26592 - Naming of QUICK vs QI-Core Logical View TRIAGED   (change QUICK logical view name to QI-Core logical view)

FHIR-26656 - New measure component details and definitions

FHIR-26829 - Consideration for Medication List for patient-reported medications


7QRDA

QRDA I STU5.2 STU Comments http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=283

QRDA I STU 5.2 Errata update planning

QRDA I STU5.1 STU Comments http://www.hl7.org/dstucomments/showdetail.cfm?dstuid=220

(start 2:20pm)

1958 example was not updated

Vote:

Motion/Second: for-against-abstain 

Matthew Tiller/Floyd Eisenberg: 25-0-2


1957 diagnosis attribute with 3 components in QDM 5.5 was not reflected in QRDA spec; do not use Encounter Diagnosis template

Parent template is C-CDA, so no change there.

Vote:

Motion/Second : For-Against-Abstain

Matthew Tiller/Floyd: 21-0-2 (For-Against-Abstain)


1953

Vote:

Motion/Second : For-Against-Abstain

Matthew Tiller/Floyd: 21-0-2 (For-Against-Abstain)


1952

QDM attribute should be Route, not Frequency

Vote:

Motion/Second : For-Against-Abstain

Matthew Tiller/Floyd: 21-0-2 (For-Against-Abstain)


1951 correct extension

Vote:

Motion/Second : For-Against-Abstain

Matthew Tiller/Floyd: 21-0-2 (For-Against-Abstain)


1950

Vote:

Motion/Second : For-Against-Abstain

Matthew Tiller/Jenn Seeman: 21-0-2 (For-Against-Abstain)


1949

Using author template, so author participation is SHALL NOT (inherited

Trifolia tooling issue - says "required" for SHALL NOT

Vote:

Motion/Second : For-Against-Abstain

Floyd Eisenberg/Jenn Seeman: 20-0-2 (For-Against-Abstain)


1943

Vote:

Motion/Second : For-Against-Abstain

Floyd Eisenberg/Matt Tiller: 20-0-2


1939

should be relevantDatetime in note

Motion/Second : For-Against-Abstain

Floyd Eisenberg/Matt Tiller: 20-0-2


1940

mutually exclusive either low/high for relevantPeriod or (low or value for point in time

nullFlavor

More discussion needed.

Ask Cypress developers,

Not exclude nullflavor for datetime

(did not vote)



8

Gaps in Care 

Project confluence page

Gaps in Care Meetings and Minutes

Gaps In Care Supporting Materials


9Depression Outcomes Project

Outcome Criteria Framework Implementation Guide

PSS was approved on April 10th.

Status update about getting PSS approved through HL7. 


10CQL 

Normative ballot is now open - balloting period April 10th - May 11th

Ballot site: https://cql.hl7.org/2020May/index.html


11SANER Project

Discuss COVID-19 project managed by Patient Administration WG (uses FHIR Measure and Measure Report): 

Project Page for Situation Awareness for Novel Epidemic Response FHIR IG


12

Decision Making Practices -

Changes to the eVoting section

Review and seek WG feedback for the proposed changes to the eVoting section of the Decision Making Practices (DMPs)

(2:58pm)

Yan presented the issues about when to end eVote.

13Working Group Meetings

May WGM Cancelled - review agenda for potential need for combined calls with other WGs as initially planned for the face-to-face meeting —  WGM Agenda/Minutes San Antonio May 2020 - DRAFT

Planned list of joint meetings from cancelled May WGM to consider for joint conference calls:

NOTE - HL7 will be sending out information for Co-chairs to be able to invite each other's WGs to joint calls (similar to the invitation system used for the WGMs). If we identify joint calls we want and potential content for such sessions, your co-chairs will know which WGs to invite.

  • Orders and Observations (CQI, CIMI, CDS) – Monday Q3 Also Observation Media DocumentReport/DiagnosticReport
  • CDS and FHIR Infrastructure (CQI, CDS, FHIR I) –
  • EHR WG – Usability, Podiatry, Wound Assessment Template FHIR IG
  • Patient Care (elective procedures, Principal Vs Primary Diagnosis) (Vocab, CIMI, Structured Documents, Orders and Observation, CQI)
  • CDS, CQI and CIMI (FHIR profiles for CDS and CQI – QUICK/QI-Core)
  • CDS and CQI – MedicationKnowledge, Potential Drug/Drug Interactions, EBM-on-FHIR, Clinical Trials Research, CQL
  • Learning Health Systems – Care Team DAM

CQI needs to determine if we need to convene the requested face-to-face joint meetings as conference calls.

Co-chairs will discuss and bring to the next call:

  • Orders and Observations (CQI, CIMI, CDS) – Monday Q3
    • Topics:  Observation Media DocumentReport/DiagnosticReport
  • CDS and FHIR Infrastructure (CQI, CDS, FHIR I)
    • Topics:
  • Patient Care
    • Topics:  elective procedures, Principal Vs Primary Diagnosis
    • Workgroups: Vocab, CIMI, Structured Documents, Orders and Observation, CQI)
  • CDS, CQI and CIMI
    • Topics: FHIR profiles for CDS and CQI – QUICK/QI-Core
  • CDS and CQI –
    • Topics:  MedicationKnowledge, Potential Drug/Drug Interactions, EBM-on-FHIR, Clinical Trials Research, CQL
  • Learning Health Systems
    • Topics: Care Team DAM
    • This invitation is sent by LHS and they typically drive the topics for discussion.
  • EHR WG
    • Topics: Usability, Podiatry, Wound Assessment Template FHIR IG
    • These invitations are sent by EHR and they typically drive the topics for discussion.
  • EHR WG - Mega Report
    • Multiple workgroup discussion
    • They have sent a suggestion for when to meet.

14Connect-a-thons

Virtual Connectathon May 13 - 15

2020-05 Clinical Reasoning Track Confluence Page 

2020-05 Da Vinci Gaps in Care Track Confluence Page


15Project Updates

Review of current projects - found on home page here.

Reminder:

  1. CQI FHIR Quality Measure Project Subgroup calls:
    1. Call Information: 
  2. DEQM / DaVinci calls: 
  3. Gaps in Care DaVinci calls: 
  4. Cross Workgroups Project WG (now managing US Core balloting) - Considering new PSS for metadata for Apps: Marketplace Product Packaging and Metadata


16Balloting timeline

Balloting schedule (confirm on HL7 Calendars):

Approvals for May 2020 Ballot Cycle

  • October 4, 2019 - PSS deadline
  • January 5, 2020 - TSC approval for all PSS for May 2020 Ballot Cycle (requires approval by sponsors, co-sponsors, Steering Division, and Management Group, and other groups such as Architectural Review Board if indicated
  • Harmonization initial proposals due February 20, 2020
  • NIBs due March 1, 2020
  • Harmonization final proposals due March 5, 2020
  • Initial ballot content March 15, 2020
  • Harmonization meeting March 19, 2020
  • Reconciliation Deadline and Ballot Preview Period March 22, 2020
  • WG approval of final content - March 29, 2020
  • Final ballot content April 5, 2020
  • Ballot sign up March 9 - April 9, 2020
  • Ballots open for voting April 10 - May 11, 2020 (ballots will go on as planned even without WGM)

    PSS Deadline Dates for Future Ballots
    September 2020 Ballot Cycle
    April 19, 2020
    TSC Approval of the PSS
    July 5, 2020
    NIB Deadline

    January 2021 Ballot Cycle


    June 5, 2020
    Submit Work Group Approved PSS to the PMO
    August 23, 2020
    TSC Approval of the PSS
    November 1, 2020
    NIB Deadline
    May 2021 Ballot Cycle
    October 9, 2020
    Submit Work Group Approved PSS to the PMO
    December 18, 2020
    TSC Approval of the PSS
    TBD
    NIB Deadline...................................



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