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Chair:  Viet Nguyen , Yan Heras , Gay DolinGini McGlothin

Scribe: Phung Matthews
 

Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



HL7 Da Vinci Education and FHIR Implementation Event

October 27-29, 2020

The Da Vinci Education & FHIR Implementation Event will focus on how the Implementation Guides (IGs) address the final rules, including burden reduction and quality measures

Open registration - click here

General education to Da Vinci Use Case as well as presentation from CMS/ONC on final rules

Early Bird registration- October 21th, 2020

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Attribution Resource


 Need for an Attribution Resource.pptx  - Linda M. 

  • Came up from FHIR Connectathon (Sept 2020) and how it is linked from the provider but cannot equate what they are responsible for
  • Example- if I have Diabetes, the patient may attribute some measure to an endocrinologist instead of all to a primary care
  • Inside Patient- may need practitioner role
  • Care Gap operation- has JIRA ticket to remove practitioner and organization because you actually use the ATR resource instead
  • There are several elements that can be related to attribution
  • Discussion on having it as a group resource - can be built out to have characteristics, can introduce profiles specific to use case, for more complex can use extension to provide specific expression. 
    • group can have 2 things
      • group as a definition for members with characteristics
      • group as not having characteristics
  • http://build.fhir.org/ig/HL7/davinci-atr/StructureDefinition-atr-group.html  example of attribution group

    • not a definition and has no characteristics, instead more of an extension
    • can have attribute provider (ext-attributedProvider) on the member
    • can query by single or multiple NPI or TAX ID
      • works with ACO models
    • can members be attributed to more than one NPI or TAX ID-  but one patient specific to one plan for a period of time
  • Question then is
    • can one patient be attributed to one provider for some things and then attributed to another provider for another things
    • if patient is on different contract then must be a different group
    • however can have multiple providers for patient - ie specialty care programs to be assigned for a patient, contract related specific to bundles or contract related to patient care but these programs can only attribute one patient to one provider
    • http://build.fhir.org/ig/HL7/davinci-atr/spec.html (Section 4.2.4)

    • for the coverageReference in group attribution- provide reason on why they are attributed to provider
  • can have implied set of requirements based on health plans
  • elements for measure, topic, program and condition- may all be included under contract
  • right now the group attribution in CPC can be used but will need to change its characteristics to include the elements of measure, topic, program and condition
  • Further discussion next week as Dragon is also available
  • Note in chat- 

    For CPC+, it's all patients that provider saw whether CMS is the payer or not. 



DEQM/GIC IG Ballot reconciliation

Can check the JIRA dashboard to see which JIRA tickets are being worked on -DaVinci Gaps in Care / DEQM STU2 Balloting Dashboard 

Lots of comments in the narrative description of the Gaps in Care- will be combining it as a group- will provide a working document that everyone can edit or provide feedback

JIRA tickets

FHIR-28496  - not clear on the return parameter- does it return one bundle or many?

  • If we always make it a parament then we are defeating the purpose of bundles, 
  • is a base spec questions- can you support multiple cardinalities directly- (Bryn will take the question and ask)

FHIR-29015 - 

will be not related as it is out of scope for DEQM/GIC

FHIR-28968- no examples of input parameters

will add a section as an example to use different parameters (similar to measure operation evaluate measure)

FHIR-28970 - example of GIC multiple bundle- what input parameter were used to generate output 

challenges- not one to one mapping on results and parameters, there could be many options to generate it

FHIR-28972

update to state measurement period to be the period the report is related 










ManagementNext Agendacontinue ballot reconciliation
Adjournment
Adjourned at 03:14PM ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval
Meeting Presentation MaterialsGaps in Care_meeting_10152020.pptx


Action items


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Attendees

Present

Name

Affiliation

  •  
Stratametrics
  •  
BCBS AL
  •  
Optum
  •  
Namaste Informatics
  •  

  •  
Providence St. Joseph
  •  
NCQA
  •  
Chris JohnsonBCBS AL
  •  
BCBS AL
  •  
Dave FosterEdifecs
  •  
Veradigm
  •  
BCBSM
  •  
Humana
  •  
Cigna
  •  
Cigna
  •  
Kamal TayalDrFirst
  •  
Leslie SmartHumana
  •  
Edifecs
  •  
Health Project Partners
  •  
Carradora
  •  

  •  

  •  
Centene
  •  
MITRE
  •  
Optum
  •  
Optum
  •  
Availity
  •  
BCBS FL
  •  
Tom WillisMoxe Health
  •  
Express Scripts
  •  
Cindy MonarchBCBSM
  •  

  •  
Cigna
  •  
Cigna
  •  
Diameter Health
  •  
Andrea KentCoverMyMeds
  •  
Bob HarringtonAllscripts
  •  
Anthem
  •  
Independent Health
  •  
eClinicalWorks
  •  
ZeOmega
  •  
UHC
  •  
Epic
  •  
Bart CarlsonAzuba Health
  •  
Edward CastagnaAltarum
  •  
Cigna
  •  
Humana
  •  
Rachel Foerster & Associates
  •  
UHC
  •  
Sandy BeggsIBC
  •  
Optum
  •  
BCBST
  •  
Sutter Health
  •  
Chuck GalliIBC
  •  
iParsimony
  •  
Mettle
  •  
WPS Health Solutions
  •  
eClinicalWorks
  •  
Dani Hochleutner
  •  
ZeOmega
  •  
Christopher MarchandDiameter Health
  •  
Joe Bormel
  •  
BCBSM
  •  
ZeOmega
  •  
Regence
  •  
Epic
  •  
ZeOmega
  •  
Edifecs
  •  
Tibco
  •  
Brian Pearson
  •  
Laurie Darst
  •  
Tom Grannan
  •  
Ezequiel Morales
  •  
Paul DenningMITRE
  •  
Bob Dieterle

Present

Name

Affiliation
  •  
SachinZeOmega
  •  
Intersystems
  •  
Douglas Ansel
  •  
Joseph Bormei
  •  
Dynamic Health IT
  •  
Beverly BucktaPfizer
  •  
Jason RankinAthenahealth
  •  
Kenneth Salyards
  •  
NCQA
  •  
Dynamic Health IT
  •  
Telligen
  •  
IBX
  •  
Tanya MorganCigna
  •  
Adrianna Preston-SicariAthenahealth
  •  
Denise
  •  

  •  
Kate BeckHealthfirst
  •  
Jim AdamsonArkansas Blue Cross
  •  
Madhav GoneHealthfirst
  •  
Mrugen MehtaeClinicalWorks
  •  
Tonya HaneyBlue Cross MN
  •  
Vishnu
  •  
Ping JiangJoint Commission
  •  
Database Consulting Group
  •  
AMA
  •  
Providence St. Joseph
  •  

  •  
Brittany NoonanDiameter Health
  •  
Interpro
  •  
Availity
  •  
Cambia
  •  
Jim McKinleyAlabama Medicaid
  •  
Express Scripts

Anthem
  •  
Laura Bright
  •  
Patty Craig
  •  
Pharmacy HIT
  •  
Meenakshi Grandhi
  •  
Michael Fasulo
  •  

  •  
Mitra Biglari
  •  
Gayathri JayawardenaESAC
  •  
Janice KarinMA HEalth Data
  •  
Jennifer SeemanESAC
  •  
Robert SamplesESAC
  •  
Abdullah RafiqiESAC
  •  
Carie HammondAEGIS
  •  
Dipti GandhiJoint Commission
  •  
Anna TaylorMulticare
  •  
Matthew TillerESAC
  •  
Corey SpearsInfor
  •  
Nagesh BashyamDrajer
  •  
Rob Reynolds
  •  
Scott Fradkin
  •  
David DeGandiCambia
  •  
Yanyan HuJoint Commission
  •  
Cody Danielshak Epic
  •  
Healow
  •  

  •  
Tina Borders
  •  
Bill Lakenan
  •  
Jeffrey Danford
  •  
Rose AlmonteMITRE
  •  
Tommi Rainey
  •  
Phung Matthews
  •  
Rakesh Mathew
  •  
Rob
  •  
Sudheen Kumar
  •  

  •  

  •  
Bart CarlsonAzuba
  •  
POCP
  •  
Green Room Technologies
  •  
Aegis
  •  
Mary Winter
  •  
Nirvish Shah
  •  
Bridget BlakeMITRE
  •  
Selene Mullen
  •  
Brody Brodock