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


  • Roll call and Introductions
  • Reviewed Agenda for this meeting and updated as needed.
  • CQL Tracker Items
    • Next CDS call will go over and vote on the clarification and errata Tracker items listed below:
      • #1703 - clarify expand semantics
      • #1704 - Decimal predecessor/successor semantics
      • #1705 - Combine in the presence of nulls
      • #1706 - Inconsistent width semantics
      • #1707 - Count for Intervals#1707 - Count for Intervals
      • #1708 - Expand uses width, not count
      • #1709 - Collapse uses width, not count
      • #1710 - Code equivalence for post-coordinated expressions
      • #1716 - Context
        • Clarify and expand support for non-patient-based and population context
        • Proposed disposition:
          • Allowed contexts are specified by the data model info (informal content)
          • Context relationships are defined as part of the data model info (informal content)
          • No default context (move default context to IG
          • Context null
            • Queries execute at the highest level, no context filtering is performed
      • #1717 - Shared Test Suites
        • Test suites should be shared between FHIRPath and CQL
        • Test suites should be harmonized and shared between CQL implementations
        • Proposed disposition:
          • Incorporate FHIRPath tests from the normative spec
          • Ensure the published test suite applies correctly in the various implementations
    • Ratio Comparison (#1680) discussion:
      • Straight forward - compare two ratios (e.g., 7 IU/mL or less)
      • Less clear - ratio expressed as a decimal will provide the opposite answer (e.g., HAI greater than 1:20, .25)
      • Proposed disposition:
        • Provide the rationale for not supporting ratio comparison directly, citing these examples and the obvious patient safety ramifications
        • Suggest ratio comparison must be done explicitly
      • An alternative disposition would be to define a "titer" type that supported the titer comparison behavior
      • Vote:
        • Paul Denning moved to accept proposed disposition above (and not alternative disposition) , Stan Huff seconded
        • No further discussion
        • Abstain: 0, Opposed: 0, Affirmative: 28
  • DeQM open ballot items
    • #18557 - Clarify use case - DeQM #1
    • Disposition is Persuasive and agreed by the submitter
    • Non-substantive - explanatory text will be added to the documentation
      • Bas van den Henvel motioned to accept, Floyd seconded
      • No further discussion
      • Abstain: 0, Opposed: 0, Affirmative: 26
  • No further discussion concerning QUICK was needed - see discussion during previous quarters today
  • Ballots in May
    • QI Core - will not go to ballot in May, maybe Sept or next January
    • CQL-based HQMF IG known issues
    • CQL will be balloted
    • QDM-based HQMF IG Withdraw
    • FHIR Measure IG (if content ready)
    • CDS: Documentation Templates and Rules (DaVinci)
    • DeQM addendums
  • Ballots in Sept or later
    • Representing Clinical Guidelines in September
    • QRDA for 2020 data collection (September or later)
    • EBM on FHIR (September or later)
  • No plans for ballot
    • Guideline Appropriate Order (GAO)
  • Updated Montreal draft agenda
    • Meeting room invitations will be sent out by Patty based on draft agenda
    • Floyd is reaching out to OO and PC to see if they want invite us in Montreal


  • No CQI conference call this Friday (1/18)

Action Items

  • Juliet will send out new Friday meetings links for FreeConference Call - includes both web and phone updates
  • Juliet will send out new co-chair meeting links for FreeConference Call - includes both web and phone updates 

Meeting Adjourned:   4:43pm