2021-01 Da Vinci Gaps in Care/Member Attribution

System Roles (Gaps in Care)

• Client - A system submitting a request for gaps in care results.
• Server- A system receiving a request for gaps in care results and returning a care gaps response in the form of a Care Gaps report.
• Knowledge Repository - A system that supports searching and retrieval of measure artifacts
• Terminology Service - A system that supports searching and retrieval of measure-related terminology

Systems capable of playing these roles should implement the exchange and reporting scenarios as described in the Data Exchange for Quality Measures implementation guide.

The CQF Ruler, a reference implementation of FHIR Clinical Reasoning based on the HAPI FHIR Server is available to either play the Consumer or Receiver, or to help guide and test implementations in preparation for the track.

A test instance of the CQF Ruler is available here: https://gic-sandbox.alphora.com.  This testing instance is subject to change throughout the event.

Scenario: End-to-End Gaps in Care Reporting

Action: A Client calls the $care-gaps operation using the Colorectal Cancer Screening measure and receives the gaps in care report from the Server. The Client uses the $collect-data or $submit-data operation to gather data-of-interest that would close the open gap and submit to the Server. The Client then calls the $care-gaps operation again for the Colorectal Cancer Screening measure using the same set of in parameters. The Client uses the $submit-data operation to send the summary measure report

Precondition: The Server knows the patient and has appropriate measure data for the patient to produce gaps in care report. The Server supports measure calculations for the measure of interest and is able to generate summary report

Success Criteria: The end to end is successful

Bonus point: Run for additional measure(s)

TestScript(s):

Scenario: Test the updated GIC profiles/operation incorporating changes applied from the DEQM IG September 2020 ballot reconciliation

Action: A Client calls the $care-gaps operation to request a gaps in care report from the Server, using various combinations of the $care-gaps in parameters

Precondition: The Server knows the patient and has appropriate measure data for the patient to produce gaps in care report. 

Success Criteria:  The Client receives the gaps in care report as expected based on the in parameters provided to the $care-gaps operation and successfully processes the data

Bonus point: 

TestScript(s):

Scenario: Test the use of ATR IG to attribute members when create a gaps in care report

Action: A Client calls the $care-gaps operation for a specific Group from the Server. The Server gets a pre-configured Group. The Server returns gaps in care report for the Group, which shows open and/or closed gaps for each patient in the Group for the Colorectal Cancer Screening measure.

Precondition: Group is pre-configured on both Gaps in Care Server and Member Attribution Server. 

Success Criteria: The gaps in care Client receives gaps in care report for the Group

Bonus point: Using Bulk data to test the scenario

TestScript(s): All testing materials can be accessed from the DA Vinci Gaps in care GitHub Repository: https://github.com/dbcg/davinci-gic. These testing materials are subject to change throughout the event.

Security and Privacy Considerations: The scenarios and reference implementations here run using open (i.e. unsecured) connections. Systems SHALL NOT use PHI in any form, or data derived directly from PHI.