hair:  Viet NguyenYan Heras

Scribe: Phung Matthews
 

Minutes Approved as Presented 


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Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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






Announcement

HL7 Connectathon 28 Sept 13-15 

  • Registration is now available here
  • Early Bird registration August 16th and last day to register is August 30th. 
  • Plan to hold a Risk Adjustment Track!

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 IGContinuous Integration (CI) Build site: https://build.fhir.org/ig/HL7/davinci-ra

Looking to construct the narrative on the IG and moving forward to building it.


Discussion

Continue with business requirement and FHIR analysis discussion:

 continue discussion on whether to use the operation or simple return call for the report. This was brought up at the CQI meeting. Their suggestions were instead of having specific return, have it be generic operation, can be applied for the evaluated measure. 

Added parameters for the Get report operation. 

Not all parameters may be supported by all vendors. Then we can use the overload for the scenarios. Identify the list of parameters for the overload,

These are the parameters for the ones who are submitted. 

The overloads are for the servers to use, due to some parameters being optional. 

Any number of overloads is a call to the same methods or functions but with different sets of parameters

  • example searching for patient- can find it with patient ID, social number, first name or last name. 
  • basically have the same goal but can use different parameters
  • examples of the overload- would be how to call the API with the various parameters

Organization- may be harder to use as parameter since data quality on that is not accurate

For HCC- may need to pull list of codes for patient report as outreach. 

Member Attribution IG may be used to find your list of members. 

Generally, if you are a specialist, you would still need a PCP license to be attributed to the patient. 

If provider wants to pull a report, is there a time where he would pull patients he is not attributed to? Rather than adding which patients to pull report from. Most likely would have a list of patients to pull patient from. 

Which then may mean that practitioner or organization may not be needed as a parameter.

Also need to consider sensitive information shared among other providers. 

May still require NPI to know who is requesting the data. Could we use the log in as identification/credentials? 

Think of other roles that may need to pull risk reports, such as self insured employers and patients.

Use of reportID or measureID to restrict the information on what is on the report.

Other parameters to look for: Model versions (that is active during the clinical period, add to the Model parameter), hcc code (to allow passing multiple HCC codes)

Remove model and version as a parameter, as it would be placed in the results and the provider can filter it on their end/UI. 

also remove evidence status and suspect type- as it should fall under the provider

Can we leave them and not state that the API should support them?



Chat comments

Brent Zenobia to Everyone

Can "practitioner" refer to either an NPI or a TIN?

oh I see, never mind

Brent Zenobia to Everyone

hccModel can't just be the most recent version of the risk adjustment model due to ESRD, PACE, etc. which run a version or two behind the most recent version

Viet Nguyen to Everyone

Would we apply something like the scopes like we do with OAuth?


Connectathon Planning

Review Track Proposal: 2021-09 Da Vinci Risk Adjustment

Discuss Track Schedule







ManagementNext Agenda



Adjournment
adjourned at 3:58PM ET

Attendees

Present

Name

Affiliation


PresentNameAffiliation
PresentNameAffiliation
PresentNameAffiliation
  •  
Stratametrics
  •  
Dale Davidson

  •  
Rachel Foerster

  •  
Kimberly Bradbury
  •  


  •  
Karl EverittEpic
  •  
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 QuinnHSX
  •  
Shawn




  •  
Phranil MethaHealow
  •  
Cigna Evernorth
  •  
Donielle Williams




  •  
MultiCare
  •  
Mariel Brechner

  •  





  •  
BCBST
  •  
Christopher Marchand

  •  
Pranathi K




  •  


  •  
Madhurima DharCozeva
  •  
Vijay Sravani Thotakura




  •  
Availity
  •  
Kira Whitworth

  •  
Angie Finley




  •  
Brent ZenobiaNovillus
  •  
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.

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