Date: 5/25/2021

Quarter: Q3

CDS Hosted CQI

Chair: Bryn Rhodes

Scribe: Bryn Rhodes

Agenda

  • Gaps in Care Connectathon Report and Project Update
  • Clinical Reasoning Connectathon Report out and Project Update
  • Review Attribution approach from Connectathon
  • FHIR R5 Review/Prep
  • FHIR Trackers, time allowing

Meeting Minutes

Gaps in Care Connectathon:

  • Integrated agenda with Clinical Reasoning Track
  • Focus on End-to-end Gaps in Care scenario
    • Testing gaps-in-care profiles and $care-gaps operation
    • Changes made as part of reconciliation
    • Reference implementations updated
    • Test care gaps with a variety of measures
    • Demo from the MITRE team on DetectedIssue and GuianceResponse to provide detailed information on detected gaps
  • Less payer participation (likely due to timezone differences), still good participation
  • Able to do more testing compared to January session
  • Used ConMan to record testing results
    • Significant number of scenarios, represents a lot of data entry to support
    • For next time around, might need to set this up ahead of time
    • Discussions with ConMan team on how to better support measure-specific testing
  • Identified issues with:
    • reference implementation
    • authoring issues with content
    • CQF tooling (bundling/packaging issues)
  • Next steps
    • Refine reference implementation

Clinical Reasoning Connectathon:

  • UniFHIR High Level View diagram
    • Diagram depicts submit/collect interactions between both the provider organizations and UniFHIR, as well as UniFHIR and the Line of Business (program-level) services. It's not clear from the diagram whether the intent is to support submission/exchange of individual or summary level data and how that interaction would play out.

Provider Attribution Discussion

  • Focused this cycle on how we can better support communication of the "selective" data requirements to help systems determine applicability of a particular artifact to a given patient. Will define an isSelective extension on DataRequirement to communicate that the data requirement is selective of applicability (and is to be interpreted in combination with other selective data requirements for the artifact)

FHIR R5

  • Generally want to get Knowledge Artifact resources to maturity 4:
    • Library
    • Measure
    • PlanDefinition
    • ActivityDefinition
  • Could potentially take some normative as well, leaving new elements marked as TU
    • Propose that we take Measure normative, marking group.type, group.basis, group.scoring, group.scoringUnit, and group.improvementNotation as TU
    • Also consider MeasureReport
      • Need to consider input parameters (TU)
      • Need to consider "location" (i.e. "where the data originated") (TU)
        • Add element location 0..1 Reference(Organization | Location | Group) Where is the data being reported from
        • Comes up in public health indicators
        • Also has potential usage in quality reporting
    • Library should go normative as well

Ballot Reconciliation

  • FHIR-32079 - Getting issue details... STATUS
  • Note that the FHIRAllTypes is the appropriate value set, since there shouldn't be a limitation on the allowed return types of criteria in a measure. Authoring environments may want to provide user help for selecting basis based on the types available in content IGs used to author the artifact, but the QM IG shouldn't restrict that. Resolution recorded in the tracker

Action Items

  • None