HL7 Clinical Quality Information September 2013 Cambridge WGM Minutes
(corrected)
Attendees: Updated attendee list on 10/18.
/ Monday / Wednesday / Thursday /Name / Company / Email / Q3 / Q4 / Q2 / Q3 / Q4 / Q1 / Q2 /
Anna Langhans / Accenture - ONC / / x / x / x
Anne Smith / NCQA / / x / x / x / x / x / x
Azanu Sen / Accenture / / x / x
Aziz Boxwala / Meliorix / / x / x / x / x
Ben West / Epic / / x / x / x
Bruce Bray / University of Utah / / x / x / x
Bryn Rhodes / HeD / / x / x / x / x
Chris Millet / NQF / / x / x / x / x / x / x
Christina Knotts / First Databank / / x
Claude Nanjo / Zynx / / x / x
Crystal Kallem / Lantana Consulting Group / / x / x / x / x / x / x / x
David Shields / University of Utah / / x / x
David Sundaram-Stukel / Epic / / x / x / x
David Susanto / Accenture / / x / x / x
Evelyn Gallego / ONC S&I / / x
Floyd Eisenberg / iParsimony, LLC / / x / x / x / x / x / x / x
Fredick Strom / HL7 - Sweden / / x
George Cole / Allscripts / / x / x
Guilherne Delfiol / U of Utah / / x
Hari Nandigam / Partners Healthcare / / x
Howard Strasberg / Wolter Kluwer / / x
Jeff Brown / Kernodel Clinic, Inc / / x
Jennifer Sisto / Accenture / / x
Joe Bormel / ONC / / x / x / x / x / x
John Feikema / ONC / / x
John Quinn / HL7 / CAN / / x
John Robotham / UpDoDate / / x
Julie Crouse / ONC / / x / x / x / x / x
Jyothi Mallampalh / Mathematica / / x / x / x / x / x / x
Karstien Fehre / Medexter / / x / x
Keith Boone / GE / / x / x
Ken Pool / OZ Systems / / x / x
Kensaku Kawamoto / Univ. of Utah / / x
Kimberly Smuk / AMA-PCPI / / x / x / x / x / x
KP Sethi / Lantana Consulting Group / / x / x / x
Leslie Tompkins / FDA/CDRH / / x
Lindsey Hoggle / AND / / x / x / x
Lisa Nelson / LOTS / / x
Majorie Rallins / AMA-PCPI / / x / x / x
Marc Hadley / MITRE / / x / x / x / x
Margarita Sordo / Partners Healthcare / / x / x
Mark Roche / Roche Consulting / / x / x
Martin Rosner / Philips Healthcare / / x / x
Matt Humphrey / Telligen / / x / x
Muhammed Asim / Philips Healthcare / / x / x
Norman ??? / x
Patty Craig / The Joint Commission / / x / x / x / x / x / x
Peter Adlassnig / Medexter / / x
Peter Goldschmdt / World Development Group / / x / x
Peter Haug / Intermountain Healthcare / / x / x
Rita Sachilon / AHIMA / / x / x / x / x / x
Robert Jenders / UCLA / / x
Robert McClure / MD Partners / / x / x
Roberto Rocha / Partners Healthcare / / x / x
Rosemary Kennedy / eCare Informatics / / x / x / x / x / x
Rusty Henry / Cerner / / x / x / x
Sandra Raup / Datuit / / x / x
Stan Huff / Intermountain Healthcare / / x
Taroon Amin / NQF / / x / x
Terrie Reed / FDA/CDRH / / x
Vaspaan Patel / NCQA / / x / x / x / x / x
Victor Lee / Zynx Health / / x
Viet Nauyen / SMS / / x
Vinayak K / Siemens / / x
Visay Shah / JBS International / / x
Walter G. Suarez / Kaiser Permanente / / x / x / x / x
Yan Heras / Lantana Consulting Group / / x
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HL7 Clinical Quality Information September 2013 Cambridge WGM Minutes
(corrected)
Time: Monday Q3Facilitator / Chris Millet / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
1. Introductions
2. Agenda Planning
3. Review CQI WG 3-year Plan
4. Project Updates
5. CQI WG Decision-Making Practices
Supporting Documents – CQI HL7 wiki agenda
Minutes/Conclusions Reached:
· Business Session
o Introductions
o Agenda Planning - Wiki agenda was updated real-time
o Review CQI WG 3 year plan
§ No changes were made
§ Transition of standards
· Need to develop a plan for the transition fairly soon.
· Transition components will include:
o Knowledge transfer from Structured Documents.
o Communication plan to ensure stakeholders are aware to whom they should submit questions.
§ Proposed New Work
· First 4 items are moving forward and quarters at Cambridge have been put aside for each of them
· QRDA Category II and Risk Model Transport are still proposed new work
o Project updates
§ Julie Crouse discussed ONC requests for the quality standards. Further discussion will occur throughout the WG meeting.
o CQI WG Decision-Making Practices
§ Discuss CQI’s Decision-making Process
· Discussed at the Atlanta 2013 WGM and approved; however, the group wanted it to come back at another meeting due to the small number of people involved in the discussion.
· Group reviewed the following changes where the wording changes are in blue italic text:
o A quorum for committee meetings require that two co-chairs and at least three other HL7 CQI members be present, where no single organization or party represents more than one half (50%) of the voting Work Group membership for that meeting.
o Any member present may move to table (defer) major decisions even if quorum is met. Reasons such as missing key stakeholders or supporting information must be documented at the time the motion carries. In accordance with Robert’s Rules of Order, such a motion to table requires a second, is not subject to debate, and shall be voted upon immediately.
· Motion to approve rewording – Walter Suarez, second Anne Smith
o Abstain: 0 Against: 0 For: 16 – motion passes
Time: Monday Q4Facilitator / Walter, Crystal / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
1. Quality White Paper
Supporting Documents – Detailed White Paper Outline was updated on the CQI HL7 website
Minutes/Conclusions Reached:
· Planning initial ballot in Jan 2014 cycle
o Purpose of the ballot is to receive feedback on the Whitepaper to ensure it appropriately reflects the current standards. This will not be a normative artifact or product.
· CQI members have picked which section(s) they want to contribute too; however, others may still join the project as contributors.
· Whitepaper Audiences:
o Policy makers
o Measure developers
o Standard development organizations
o Users of the standards – providers, vendors
· Consumer perspective and experiences on health care quality should be included in discussion concerning the Domain of Quality in Health and Healthcare (section 3) and evaluated to determine if there is a gap with the Standards and Data Models (section 7).
· The name of section 5 was changed from Drivers of Healthcare Quality Measurement to Drivers of Healthcare Quality Measurement and Management
· Group discussed The Intersection of Quality Measurement, Quality Management and Clinical Decision Support and the Drivers of Healthcare Quality Measurement sections in detail and the whitepaper outline and potential references for each section was updated on the website.
Joint with SDWG and CQIWG – SDWG HostingTime: Tues Q1
· Discussion included: Transition of work products from SDWG to CQIWG; QRDA “smoking gun” design; unification of quality reporting, decision support, and transitions
· See SDWG meeting minutes for more information
Joint with EHRWG, CICWG, and CQIWG – EHRWG HostingTime: Tues Q2
· Discussion was related to the EHR Usability project
· Small group discussions occurred during Q3
· See EHRWG meeting minutes for more information
Joint with PCWG and CQIWG – PCWG HostingTime: Tues Lunch
· Discussion was related to the Care Plan and Plan of Care
· See PCWG meeting minutes for more information
CQIWG did not meetTime: Tues Q3
· Some CQIWG members attended the EHRWG meeting for further discussion concerning the EHR Usability project.
· See EHRWG meeting minutes for more information
Joint with SDWG and CQIWG – SDWG HostingTime: Tues Q4
· Discussion included: Questionnaire Demo presented by Martin Rosner and QDM-based HQMF R2 reconciliation
· See SDWG meeting minutes for more information
Time: Wednesday Q2Facilitator / Crystal Kallem / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
1. ONC Initiatives
a. Data Access Framework (DAF)
b. Structured Data Capture (SDC)
2. FDA Unique Device Identifier
Supporting Documents – posted to CQI’ website:
· S&I Framework - DAF Overview presented at Sept 2013 WGM.pptx
· S&I Framework - SDC Overview presented at Sept 2013 WGM.pptx
· FDA - UDI Overview presented at Sept 2013 WGM.pptx
Minutes/Conclusions Reached:
· Evelyn Gallego, ONC, presented Structured Data Capture (SDC)
o SDC is using IHE RFD, IHE RFD-Retrieve Form, and IHE RFD-Submit Form profiles to exchange form/templates, populate the form/template with patient data, and transmit the completed form/template to an external data repository.
o S&I Framework homepage for the project:
http://wiki.siframework.org/Structured+Data+Capture+Initiative
· John Feikema, ONC, presented Data Access Framework (DAF)
o DAF is focused on providing tools to providers to access their patient’s data both within and across organizations.
o Looking to identify, create, and modify standards to solve basic data access issues faced by providers in a modular and substitutable fashion.
o Currently defining use cases for the project.
o They have identified initial candidate standards for each ‘bucket’ within the data access framework.
§ QRDA Category I, II, III is included in Query Results
§ HL7 HQMF is included in Query Structure
o Work will be performed in 2 phases
§ Phase 1 is focused on Local Access via Intra Organization Query
§ Phase 2 is focused on Targeted Access via Inter Organization Query
o S&I Framework homepage for the project: http://wiki.siframework.org/Data+Access+Framework+Homepage
· Terrie Reed, FDA, presented the FDA Unique Device Identifier (UDI)
o FDA will accredit agencies that will be allowed to assign UIDs to devices.
o Manufacturers will submit their assigned UID to FDA’s Globally Unique Device Identification Database (UIDID) along with associated device attributes (Common Product Model).
§ The UIDID will be made publically available at no charge
§ The UDI is to be used by FDA application (MAUDE, Recalls) and external systems (EHRs, Claims, Inventory Systems) as the device ID standard.
o GUDID is not a requirement for hospitals – it is a tool that will provide the following benefits if all stakeholders by in EHRs, Claims, Inventory Systems, Incident Systems, Clinical Maintenance, etc.
o The FDA will be working with ONC to integrate the UDI standard into Meaningful Use Stage 3 and, potentially, other projects.
Time: Wednesday Q3 & Q4Facilitator / Crystal Kallem / Scribe / Patty Craig
Attendee / Name / Affiliation
Attendance sheet for this meeting is at the beginning of this document.
Quorum Requirements Met: Yes
Agenda Topics
1. Identified the agenda for Q3 and Q4 at the beginning of Q3
a. Identify Components which projects need to address
b. Prioritize Components
c. Principals for Standard Selection (to assist Keith Boone)
Supporting Documents – posted to CQI’ website:
· Keith Boone - An Architecture for CDS and Quality Measurement presented at Sept 2013 WGM.pptx
· Bryn Rhodes - Quality Measurement – Clinical Decision Support Harmonization Proposal presented at Sept 2013 WGM.pptx
Minutes/Conclusions Reached:
· The output from Structured Documents Wed. Q1 discussion was discussed (see Structured Documents minutes for more information) and the following diagram was developed.
Quality Improvement (QI) Family of StandardsBusiness / Information / Behavior / Engineering
Conceptual / QI Whitepaper /
QI DAM / Common / QI Functional Requirements / Product List
QI Policy
Platform Independent / QI Logical Model / Metadata / QI Logic Expression / Transparency Principles
Platform Specific / QRDA Category I, QRDA Category III, HQMF R2, HQMF QDM IG, HeD Knowledge Artifact, vMR, CCDA R2? / HeD, Knowledge Artifact, HQMF R2, HQMF QDM IG
· Based upon the above diagram, four projects and one informative paper were identified for the short-term work of CQI and CDS.
· The four projects are:
o Clinical Quality Whitepaper (CQI sponsor)
o Harmonization of Health Quality Artifact Reasoning and Expression Logic (CDS primary sponsor, CQI co-sponsor)
o Harmonization of Health Quality Information Models (CQI primary sponsor)
§ Formally known as the vMR / QDM Harmonization project
o Clinical Quality Common Metadata (CQI primary sponsor)
§ Examples of the common metadata are: subject, provenance, security & privacy, descriptive, exchange of data, object lifecycle, relationships between information