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Committee Approval Date:

CQI approval of PSS: May 8, 2020

TSC approval of PSS: June 29, 2020

CQI approval of IG Proposal: July 10, 2020


Publishing Lead:

Bob Dolin


Contributing or Reviewing Work Groups:

CQI, CDS


FHIR Development Project Insight ID:

Project ID: 1633


Scope of coverage:

This US Realm IG furthers the work of the AHRQ Outcome Measures Framework (OMF) by providing a reproducible framework for formalizing outcome definitions.

Covered in this guide: 

  1. A reproducible method and a formalism for representing condition outcome definitions and criteria, such that the representations can be reused across different use cases.
  2. Description of how the method aligns with the direction the United States is going with quality measurements and decision support, using FHIR, QI-Core, and CQL.
  3. A set of examples, drawn from the Depression domain, that demonstrate the method end to end

Content location:

Content wiki: Outcome Criteria Framework

Github site: Pending

Proposed IG realm and code:

us/outcome-criteria-framework

Maintenance Plan:

Content will be maintained under CQI sponsorship, updated at least as often as required to keep the IG from expiring.

Short Description:

(NOTE: This is a DRAFT description. Ballot content is in early stages of development. A proposed revision to Short Description will be submitted closer to NIB time).

The Outcome Criteria Framework Implementation Guide defines a reproducible method and a formalism for representing condition outcome definitions and criteria, such that the representations can be reused across different use cases.

Long Description:

(NOTE: This is a DRAFT description. Ballot content is in early stages of development. A proposed revision to Long Description will be submitted closer to NIB time).

Learning Health Systems are hampered by differences in condition definitions and criteria across quality measurements, decision support, research, and direct patient care. These differences further add to provider data capture burden, and hamper our ability to reuse data generated in the process of patient care. The Outcome Criteria Framework Implementation Guide defines a defines a reproducible method and a formalism for representing condition outcome definitions and criteria, such that the representations can be reused across different use cases.

The primary target audience for this specification includes developers of structured criteria (e.g. quality measure developers, decision support developers). A secondary target audience is consumers of structured criteria (e.g. so that they better understand how to actualize reuse of criteria). 

Involved parties:

This work is supported by the Office of the Secretary Patient-Centered Outcomes Research Trust Fund under Interagency Agreement 18-596R-18 through Agency for Healthcare Research and Quality contract no. 75Q80119C00005.

Expected implementations:

At a minimum, testing will be done through Connectathons. In addition, OM1 and Elimu Informatics are building a prototype implementation. 

Content sources:

Narrative definitions of outcome criteria are developed as part of technical expert panels. In particular, using the AHRQ Outcome Measures Framework (OMF), expert panels have converged on a core set of outcome definitions and criteria for a number of conditions, including Depression, Asthma, Lung Cancer, Lumbar Spondylolisthesis, and others. These definitions form the basis for the examples in the guide.

Example Scenarios:

(NOTE: This is a DRAFT description. Ballot content is in early stages of development. A proposed revision to Example Scenarios will be submitted closer to NIB time).

A primary scenario supported by this guide is where an expert panel has developed a set of narrative definitions, and wants to formalize those definitions in alignment with EHR and eCQM standards, and they want to do so such that the formal definitions can support quality measurement, clinical decision support, and clinical research use cases. 

IG Relationships:

(NOTE: This is a DRAFT description. Ballot content is in early stages of development. A proposed revision to IG Relationships will be submitted closer to NIB time).

This implementation guide uses US Core profiles and is aligned with FHIR, QI-Core, and CQL. 

Timelines:

Comment-only ballot: May, 2021
STU ballot: Sept, 2021
Real world testing: Through Sept, 2022
Normative ballot: On or after Sept, 2022

FMG Notes

Approved by FMG July 22, 2020 (2020-07-22 FMG Agenda/Minutes)