Date: 5/24/2021
Quarter: Q3
Vocab Hosted CDS and CQI
Agenda brought forward by CQI and CDS
Previous topics for update discussion May 2021:
- PresentOnAdmission value set (code system exists but not value set)
- Vocabulary Profiles (Shareable, Computable, Executable, Publishable)
- Measure Terminology Service
- Specifically approach to including inactive codes from an authoring perspective
- Quality Program Release (Binding Parameters Specification)
- Expectations with use of Unified Terminology Governance (UTG) - what are considerations for CQI/CDS for upcoming change requests - Bring new requirements for vocabulary changes to this session.
Meeting Minutes
- See Vocab's meeting agenda and minutes for detail information.
- CPG value set profiles moving to core
- Clinical Practice Guidelines (CPG) - The FHIR Clinical Guidelines Implementation Guide (CPG IG) provides a means of creating a computable representation of a narrative clinical guideline that is faithful to guideline intent and supports the derivation of downstream capabilities such as cognitive and decision support, quality measures, case reporting, and documentation templates that direct clinical documentation in support of determining guideline compliance.
- The CPG Plan describes what treatments, test, consults and other interventions need done to address a particular clinical concern (e.g., a disease or condition, recovery from a procedure, prevention including secondary and tertiary prevention, contingencies for possible complications), in the case of the CPG, the concerns as scoped by the guideline and its recommendations. The Plan in the CPG context, is scoped to all patients in a cohort as defined by the eligibility criteria and the patient-specific plan is manifested as a Care Plan.
- A matrix showing the usage of the CPG value sets would assist with the understanding of why and how they are needed.
- Discussion: Can a value set need to have multiple Knowledge Representation Framing?
- The phrase "executable" is meant to be FHIR server executable.
- Composable value sets is meant to restrict the way that the value set instance communicates.
- Shareable value sets - could have both a narrative and a compose. This is not a preferred method of defining a value set.
- Discussion: Can a value set need to have multiple Knowledge Representation Framing?
- Clinical Practice Guidelines (CPG) - The FHIR Clinical Guidelines Implementation Guide (CPG IG) provides a means of creating a computable representation of a narrative clinical guideline that is faithful to guideline intent and supports the derivation of downstream capabilities such as cognitive and decision support, quality measures, case reporting, and documentation templates that direct clinical documentation in support of determining guideline compliance.
FHIR-32635 - Add knowledge extensions to ShareableValueSet
- Rob is willing to accept this request; however, wants the matrix to be created.
- Others in the Vocab workgroup are not as sure that this should be done.
- FHIR-32624 - Add manifest, expansion, and includeDraft parameters to the $expand
- Consider adding parameters for manifest, expansion, and includeDraft to the $expand operation definition, as defined in the extension of the $exapand operation in the QM IG: http://hl7.org/fhir/us/cqfmeasures/2021May/OperationDefinition-ValueSet-expand.html
- Will have a June 18th meeting during CQI's Friday meeting.
- There are additional FHIR Trackers related to this request. Bryn will link them together.
- Present on Admission (POA):
- CodeSystem-presentOnAdmission
- valueset-ex-diagnosis-on-admission
- Encounter-diagnosisPresentOnAdmission
Discussion: FHIR-32378 - Create QICorePresentOnAdmission value set
FHIR-31395 - Incorporate ValueSet Profiles Defined in CPG into Core TRIAGED and VSD Profile Project Documents
Next STEPS from Vocab minutes:
- See their minutes.
Action Items
- Bryn to create a matrix of the CPG value sets and explain how and why they exists.
- Bryn to link his FHIR Trackers related to FHIR-32624 to this ticket.
- Paul to work with Mark to ensure that the meta data, etc is correct in the proposed value set. note: QI Core cannot be in the name of the value set.
- Paul to reach out to the Financial Management Workgroup (Mary Kay) to see if they want to keep binding to the example or the new on that is being created.
- ExplanationOfBenefit.diagnosis.onAdmission (CodeableConcept / Example)
- Claim.diagnosis.onAdmission (CodeableConcept / Example)