Skip to end of metadata
Go to start of metadata

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

Hosting: CDS


  • Roll call and Introductions
  • Reviewed Agenda for the week and updated as needed.
  • FHIR Quality Measure IG and DEQM update 
    • Both reconciliation spreadsheets have been posted for several weeks for review.  Some individuals have removed their negative vote(s) based upon their review. 
      • Moved by Bryn Rhodes to approve both May 2019 reconciliation spreadsheets for FHIR Quality Measure IG and DEQM, Seconded by Rob Samples
      • The vote was delayed because some modifications had to be done because of issues with GForge.  They have been non-substantial.
      • Abstain: 0, Opposed: 0, Affirmative: 41
  • FHIR Clinical Practice Guideline (CPG) IG ballot reconciliation and update  [CPG-on-FHIR Update - 2019 Sep.pptx]
    • Work has focused on structuring content and recommendations in different layers of knowledge.
    • Use cases for connectathon tracks include the US CDC opiod prescribing guideline.
    • Ballot reconciliation
      • Good cross-section of HL7 members that voted and most of the votes were related to Enhancements.
      • 33 affirmative (94 comments), 32 negative (33 comments).
      • Comment themes included: separation of concerning, naming (protocol, workflow, etc), methodology documentation, knowledge representation, background discussion, CPG development lifecycle, Evidence/Proven
  • FHIR Evidence-Based Medicine (EBM) update  -  [EBMonFHIR Connectathon Report Out Sept 2019.pptx]
    • Brian Alper provided an update on the project.
      • This is the representation of evidence that would serve as the basis for decision support artifacts and interventions in clinical decision support.
      • Focus is on expansion of the FHIR Evidence Resource and using it in the Connectathon
    • Group Resource Usage Discussion
      • Took about a year to get a stable model before they went to the Connectathon
      • Group Resource has a Group.type and Group.member and FHIR was planning on removing some of the types and members; however, the suggestion is that it instead expanded so that measures can be about something other than people.  For example, a group of procedures, or a group of medications.
        • Bryn will submit a FHIR Tracker to expand modify the definition of GroupResource and add additional types and members
        • Group.characteristic allows for multiple characteristics but they are combined with AND (intersection) and there is no simple method for combining with OR (union)
        • Bryn will submit a FHIR Tracker requesting that instead of characteristics, that either CQL or FHIRPath would be used.
    • QI-Core ballot reconciliation
      • Item #24064
        • Non-elective encounter was really a proxy for a non-elective procedure in the Stroke measures.
        • Any changes with FHIR will not exist until FHIR R5.  Until then we need to come up with a solution for previous versions of FHIR.
        • Concerns that 'routine' and 'elective' are not the same thing.
        • Proposed solution:  If it is an attribute of a procedure, then an extension to support the notion of "elective" procedure.  This may involved a change to the request priority, but this needs to be examined.
        • Lisa will add a follow-up comment to the Tracker to discuss the conversation so far.
        • Once it has been modeled, this will need to be discussed with FHIR-I to add to R5.
        • Item will not be voted upon until the actually modeling has been determined.
      • Item #24304
        • The group agreed the Tracker identifies a problem that must be resolved.  The submitter wants to be involved in the resolution, so the Tracker is on hold.
      • Item #24073
        • It was determined that it is too early to require QUICK.  At some point, this may become a requirement and the QI-Core will be updated at that time.
        • Moved by Yan Heras as Persuasive, per solution entered on the Tracker, Seconded by Juliet Rubini
        • No further discussion
        • Abstain: 3, Opposed: 0, Affirmative: 35
      • Item #24045
        • Moved by Paul Denning as Persuasive, per solution entered on the Tracker, Seconded by Juliet Rubini
        • No further discussion
        • Abstain: 2, Opposed: 0, Affirmative: 34


  • None

Action Items

  • None

Meeting Adjourned:  12:30pm