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September Ballot Implementation Guide and Reference Implementation Guide Tasks Tracking Spreadsheet

Please note:  The following are working notes from the Gaps in Care Implementation Guide creation team.  Please don’t consider data on this page as representing anything that will be ultimately contained in the GIC Implementation Guide.  When the GIC IG initial work becomes available, we will add a link both here and in the User Case as we do for all Da Vinci IG’s

Decisions about the path forward for the Gaps In Care IG

  1. Gaps in Care will be part of DEQM
    1. Uses Individual Measure Report
  2. Do Ballot Reconciliation on DEQM
  3. Publish DEQM
  4. Update DEQM to HL7 IG Template
  5. Initial GIC work in Trifolia on FHIR
  6. Cut and paste from Trifolia into DEQM main branch
  7. Prep for Quality Review
  8. Prep for Ballot - August 10th

Existing Gaps in Care Operation Parameters which will be extended

Gaps In Care $care-gaps Operation and Profiles

Needs to add to DEQM to Support Gaps in Care

--add to Home/Introduction Page to incorporate  Gaps in Care - few paragraphs

  - add to 1.3 How to Read this Guide

  - add  1.5.2 Gaps in Care as a reporting scenario and possibility update 1.4

              Figure 1-4 – add Gaps In Care Report to bottom of left hand block

--add to Framework

    Review General if changes are needed

    Add new subtab for Gaps In Care

      - High level description

      - Use Cases

      - How it interacts with other scenarios in DEQM

      - Operation description and use

-Add Example Use Case?

    Should we use existing or new one

??Add Gap in Care under example Colorectal Screening/MRP

       Think about how you would do this for VTE (?future)??

--Add under FHIR Artifacts

     Operations Subtab for  $care-gaps Operation

     Under Profiles - DEQM GIC Detect Issue

                                DEQM GIC Bundle

                               DEQM GIC Composition

-    Bundle Type of Composition that is document is for the report recipient - to make narrative report

           ---- entry for each patient

           ----- subject for each measure

                                DEQM GIC Group?

--Capability statement – updates by Eric


Outstanding issues

New Terminology – LOINC for Bundle/Gaps in Care Report

--How Gaps in Care Works with ATR (Member Attribution

--how to handle Bulk Data?  Future

Future Consideration

Quality Measure IG update for Measure Resource – relevant data expression.  If not balloted in September, add an extension here

               -Background  section is shared by Quality Measure IG and DEQM

      --- relevantResources and rules in Measure Resource



A new $ Care_Gaps Operation within DEQM- will generate a report with a summary list of patients

This will be a:

A computable representation

Could generate and render a narrative display

The Care_Gaps operation collects and returns a list of patients, where, with respect to a positive proportion measure, The patient IS in the denominator and IS NOT in the numerator and with respect to a negative proportion measure that the patient IS in the denominator and IS in the numerator.

Current definition in the spec:

The care-gaps operation is used to determine gaps-in-care based on the results of quality measures. The patient is in the denominator and is not in the numerator.

Example - Positive Proportion Measure = Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

Example – Negative (aka: inverse) Proportion Measure = Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)


"Subject-List Reporting" or "List Reporting"

"Submit data" operation which can be done using group

Can connect the two Patient list and submit data as a bundle and process could be automated which could be just the relevant resources

Need also to communicate if there is a valid reason the patient is (one of the above) eg payer didn’t have exclusion data

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