HL7 Clinical Quality Information Workgroup 
CQI Co-chairs: Patty Craig, Floyd Eisenberg, KP Sethi, Juliet Rubini, Yan Heras 
Meeting Chair: Floyd Eisenberg
Meeting Scribe: KP Sethi

CQI Hosted CDS and FHIR Infrastructure


  • Roll call and Introductions
  • Clinical Practice Guidelines on FHIR (led by Bryn) - see slides for detailed information
    • Slide presentation by Bryn: Representation of Clinical Practice Guideline Recommendations on FHIR
    • Overview: focus on leaves ... if-then part of guidelines
    • Set of profiles + set of exemplars
    • Bryn provided an outline of the IG - similar to DEQM - provides overview of where this work fits
    • 4 Examples + Use cases are included, there's a project page, github and draft IG posted. 
    • Targeting a September ballot, based on FHIR R4. 
  • EBM-on-FHIR Update (no slides)
    • Detailed report out on Wed Q1
    • 2 resource: comparative evidence resource + cohort group resource
    • Organized around a population element. Has an intended cohort - intended to include "this" type of people
    • Will connect to the CPG on FHIR guidelines. the evidence from EBG will connect to clinical guidelines/recommendations in CPG.
    • Considering an informational ballot in September for the new resources in EBM on FHIR 
  • Cohort definitions: (slides by Bryn)
    • Review requirements for Cohort Definition from different perspectives for Quality Measurement/Decision Support, Medication Knowledge, EBM on FHIR
    • Will look at Group resource which intended for cohort definitions
    • Group Resource: defined collection of entities that may be discussed or acted upon collectively. 
    • Actual vs Definitional - Definitional describes characteristics to include patients, Actual is a reference to actual patient ids
    • Value Reference - should this be a URI so we can use a value set to define the characteristics?
    • To test this... suggest that project define some sample cohorts to test that the resource can do what you need the cohorts to be able to do. 
    • Population resource: Being able to assign (to an indication, contraindication, or undesirable effects) a population based on Age, Gender, Race, and health status. 
    • Seems like some expression logic is needed to connect populations/cohorts
    • Next Steps: understand from each perspective how the cohort definitions will be used. 
    • Continued discussion. plan to meet again in a month to discuss updates. EBM on FHIR has several examples that can be used. Will be following up on the CDS/CQI WG calls
  • FHIR Measure IG Recon:
    • 238 comments, 219 affirmative, 19 negatives, 
    • balloted at the same time as CQL based HQMF and got a lot of positive feedback
    • Overall result: passed
  • CQL Ballot Recon:
    • 147 comments, 103 affirmative, 44 negs. Most of the affirmatives are suggestions
    • Doesn't seem like too bad in the negatives. Bryn feels positive this will not be difficult to resolve. 
    • Overall result: passed
  • FHIR Path:
    • 127 comments, 102 affirmative, 25 negative. Normative ballot.  
    • 100 dispositions in block comments, 10-15 in-person, rest will be dispositioned at some point. 
  • CQL based HQMF:
    • 35 comments. lots of overlap with CQL and FHIR Measure IG. 
  • Clinical Reasoning Track Report out (Slides by Bryn) - originally was Q3 topic, but moved up because we had time. 
    • Tested DEQM scenarios 
      • Med Recon, Colorectal Cancer etc. 
    • Lots of participants
    • Tested submit data - question about planned approach of using batch
    • Worked on Blood Pressure Measure - highlighted need to expose profiles rather than direct resources
    • QUICK Draft 3.0.0 - model that would be used within decision support
    • Analytics Track - participants offered to work together on importing QI-Core profiles and the screening cancer data set into BigQuery
    • See Slides for detailed report out. 


  • None

Action Items

  • None

Meeting Adjourned:   12:25 PM