hair: Viet Nguyen, Yan Heras
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) |
---|---|---|---|
Management | Review ANSI Anti-Trust Policy | ||
Announcement | HL7 Connectathon 28 Sept 13-15
| Please visit the connectathon page for videos on FHIR 101 and how to read an IG. Our first track for the Sept Connectathon, please let us know who will be joining for testing. | |
Risk Adjustment IG | Continuous Integration (CI) Build site: https://build.fhir.org/ig/HL7/davinci-ra | The CI build is now available. There are several placeholders within it as it would be added as we continue to build it. Under artifacts profiles, there are a couple examples, you may review and provide feedback. MeasureReport profile
Measure profile- MeasureReport is required to link to measure profile, can be used to include risk adjustment model and version Glossary- we do have some definitions on it that is pulled from the confluence pages. If you are interested in writing a paragraph or content, let us know, we appreciate the help and feedback. | |
Discussion | Continue with business requirement and FHIR analysis discussion:
| Operation is where the server plays an active role in responding. For phase 1, we are not expecting the server to have an algorithm to generate the HCC gaps. It would be more for querying and getting a report back. What we need is similar to what the ATR IG includes, ie specify what API to use. Add number of API to pass the information, get evidence status as parameters and specify it as the API. Resources are managed by using the CRUD actions. Sometimes it is more effective to Execute. Risk adjustment API call- when it is made, the precompiled information will be returned in some manner. Depending on granularity of the response, may need to use some JSON to get the report. To define the specs- need to determine whether if it should an operation or query. Current- running risk model reports are not being pulled when requested but instead is already ran and stored to be retrieved. Possibly have periodic batch updates in near real time. When getting back the report as CRUD, you just get the measure report and references but not actual information within the reference Must support- meaning the system has to be able to understand the process and be able to use it -and may not mean that you have to return the information Risk adjustment model is complex and trying to determine whether we really need to have operations for phase 1, since with operations will need to be able to grab content which we do not have access since the algorithm is black box on the payer side. If we do operations, we need to create sample of data and have a tool to pull the report. But the return of the bundle, it may be necessary. If we do _include in the query, the result can be a bundle with other resources. If adding operations, may need to add other parameters to use, such as evidence. | |
Connectathon Planning | Review Track Proposal: 2021-09 Da Vinci Risk Adjustment Discuss Track Schedule | See notes above- will continue to work through what is needed. Email Yan and Linda if you are planning on attending so we can start planning. | |
Management | Next Agenda | Review connectathon template for the track | |
Adjournment | adjourned at 3:58PM ET |
Attendees
Present | Name | Affiliation | Present | Name | Affiliation | Present | Name | Affiliation | ||
---|---|---|---|---|---|---|---|---|---|---|
Stratametrics | Dale Davidson | Rachel Foerster | ||||||||
Karl Everitt | Epic | Tim McNeil | ||||||||
BCBS Alabama | Thomson Kuhn | Leah Hannum | ||||||||
Providence St. Joseph | Patty Craig | Dave Foster | ||||||||
Peter Muir | Nick Radov | Bryan Briegel | ||||||||
Optum | William Harty | Preston Lee | ||||||||
Brian Murta | Centene | Deidre Sacra | Gary Dickinson | |||||||
POCP | Jay Baker | Rob Reynolds | ||||||||
POCP | Joseph Quinn | HSX | Shawn | |||||||
Phranil Metha | Healow | Cigna Evernorth | Donielle Williams | |||||||
MultiCare | Mariel Brechner | |||||||||
BCBST | Christopher Marchand | Pranathi K | ||||||||
Madhurima Dhar | Cozeva | Vijay Sravani Thotakura | ||||||||
Availity | Kira Whitworth | Angie Finley | ||||||||
Brent Zenobia | Novillus | Travis Hendrix | Eric Liu | |||||||
Optum | Zahid Butt | Kim Faison | ||||||||
Frank | Khushwinder Singh | Tushar Shah |
Action items
- Re-evaluate the name of this use case as "Risk Adjustment" does not define the payment aspect of the primary focus. Need to discuss with CQI WG as well.
- Add to Phase 2 - Ability to remove and provide a reason for status change. e.g. the patient no longer has the condition.