Two breakout sessions scheduled on Saturday, Jan 14, 2023: - 2:00PM - 3:00PM breakout session at Grand Ballroom Salon 1
- 4:00PM - 5:00PM breakout session at Grand Ballroom Salon 1
End to End Scenario Step 1: Coding Gap Generation - (Payer) |
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| Action | Payer calls $ra.coding-gaps operation to create a Risk Adjustment Coding Gap Bundle for a group of patients (use a group of one patient for this testing scenario to demonstrate group) | | Preconditions | Payer Server is pre-populated with Risk Adjustment Coding Gap MeasureReport and resources for supporting evidence | | Success |
Report Annotation Action: - Payer sends the Risk Adjustment Coding Gap Report to Provider
- Provider updates the report with an annotation and post the report back to the Payer
Preconditions: Payer Server is pre-populated with Risk Adjustment Coding Gap MeasureReport and resources for supporting evidence Success Criteria: | Criteria | returns: New RA Coding Gap Bundle
Composition (status: preliminary)
Original DetectedIssue (status: preliminary)
Original Evidence
RA MeasureReport |
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| Setup | Ensure clean test environment
- <DELETE> [base]/Bundle?_timestamp=2022-11-27T11:42:12.848-07:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:14:26.354+00:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:16:18.198+00:00 | | Action | Provider calls $ra.remediate-coding-gaps operation to create a new Risk Adjustment Coding Gap Bundle | | Preconditions | - Original Risk Adjustment Coding Gap Bundle is available on the Provider Server
- Clinical Evaluation DetectedIssue and clinical evaluation evidence are available on the Provider Server
| | Success Criteria | returns New RA Coding Gap Bundle
Existing Composition (status: preliminary)
Existing Original DetectedIsssue (status: preliminary) - for gap closure request scenario
Existing Original Evidence Existing Original DetectedIsssue (status: preliminary)
Existing Original Evidence
Existing RA MeasureReport
Add
Clinical Evaluation DetectedIssue (status: preliminary) - for gap closure request
Clinical Evaluation Evidence | | Bonus Point | Run Step 2 independently - Precondition: have a bundle available to Post that can run step 2 independently
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Step 3: Coding Gap Approve Scenario - (Risk Adjustment Coder) |
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| Setup | Ensure clean test environment:
- <DELETE> [base]/Bundle?_timestamp=2022-11-27T11:42:12.848-07:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:14:26.354+00:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:16:18.198+00:00 | | Action | Risk Adjustment Coder calls $ra.approve-coding-gaps operation to create a new Risk Adjustment Coding Gap Bundle | | Preconditions | The updated Risk Adjustment Coding Gap Bundle is available on the Risk Adjustment Coder Server | | Success Criteria | returns: New Risk Adjustment Coding Gap Bundle
Existing Composition Existing Original DetectedIsssue (status: canceled) - for gap closure request scenario
Existing Original Evidence Existing Original DetectedIsssue (status: final)
Existing Original Evidence Existing MeasureReport
Clinical Evaluation DetectedIssue (status: final) - for gap closure request
Clinical Evaluation Evidence Set DetectedIssue status to canceled/final | | Bonus Point | Run Step 3 independently - Precondition: have a bundle available to Post that can run step 3 independently
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Step 4: Coding Gap Resolution Scenario - (Payer) |
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| Setup | Ensure clean test environment:
- <DELETE> [base]/Bundle?_timestamp=2022-11-27T11:42:12.848-07:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:14:26.354+00:00
- <DELETE> [base]/Bundle?_timestamp=2022-11-30T03:16:18.198+00:00 | | Action | Payer calls $ra.resolve-coding-gaps operation to created a new Risk Adjustment Coding Gap Bundle with the updated RA MeasureReport | | Preconditions | The updated Risk Adjustment Coding Gap Bundle is available on the Payer Server | | Success Criteria | returns: New Risk Adjustment Coding Gap Bundle
Existing Composition (status: final)
Updated RA MeasureReport
Include All
Detected Issues (Original and Clinical Evaluation)
Evidence (Original and Clinical Evaluation)
Set
Composition status to final | | Bonus Point | Run Step 4 independently - Precondition: have a bundle available to Post that can run step 4 independently
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Test Scenarios: https://docs.google.com/spreadsheets/d/1vcVp1KJH4_aERiwy7x-lARmYXR1JlcbniggPyQ6ZgGg/edit#gid=0
"Assisted" Generation Scenario - Risk Adjustment Coding Gap Report
— — — Reference Implementation End Points: Reference Implementation using cqf-ruler /HAPI Novillus Risk Adjustment Server: (require password to access) Touchstone: There are two separate instances of Risk Adjustment validator set up in Touchstone. One points to the STU1 IG and another points to the CI Build which contains the STU2 content in development. Test Scripts: https://touchstone.aegis.net/touchstone/testdefinitions Test Plan: Document Testing Results in the Connectathon Manager Connectathon Manager: : http://conman.clinfhir.com/connectathon.html?event=con32
stu2-b branch: Security and Privacy Considerations: | 
