QRDA Category I: Ballot Development

Transcription

1 QRDA Category I: Ballot Development HL7 Structured Documents Sub Workgroup for Developing the QRDA I Ballot for May Telecom: Participant Code: Web: Meeting ID:

2 Meeting Information When: Every Thursday, February 23rd March 29th 4:30ET 5:30ET For Today: Telecom: , Participant Code: Web: Meeting ID: A Webinar will be in place for the remainder of the meetings 2

3 Welcome PURPOSE Communicate Meeting Information Review Timelines Provide Background Begin Design Consideration Discussions Next Steps TIME AGENDA 10 min Meeting Information 5 min Timelines 5 min Review Project Scope statement 10 min QRDA vs emeasure review 15 min Review High -level Proposed Changes 10 min Begin Design Consideration Discussions 5 min Next Steps 3

4 Meeting Information: Invite to be Sent QRDA Ballot Development Meeting Meeting Time for QRDA Ballot Development This Webinar is held on the following dates: Mar 1, 4:30 PM - 5:30 PM EST Mar 8, 4:30 PM - 5:30 PM EST Mar 15, 4:30 PM - 5:30 PM EST Mar 22, 4:30 PM - 5:30 PM EST Mar 29, 4:30 PM - 5:30 PM EST Register Now at: Once registered you will receive an confirming your registration with information you need to join the Webinar. System Requirements PC-based attendees Required: Windows 7, Vista, XP or 2003 Server Macintosh -based attendees Required: Mac OS X 10.5 or newer 4

5 Meeting Information: Note and Notices Notes and Notices and changes will be sent through Structured Document Work Group Listserv HL7 Membership not required Listserv sign-up: You can use this interface to subscribe or unsubscribe to any of HL7's public lists, or to change your subscription settings Structured Documents: 5

6 Meeting Information: QRDA Wiki Meeting Notes and developing IG drafts will also be posted on the QRDA Wiki: Or from HL7 homepage: Commonly-accessed Information > Find a Resource > HL7 Wiki Infrastructure Topic Groups > Structured Documents UV Realm CDA Impl. Guides > Quality Reporting Document Architecture 6

7 High-level Timelines Task Timeframe QRDA and QDM-based QRDA Content development January 3 March 30, Ballot period April 9 May 7, Ballot reconciliation May 8 June 22, Finalize and publish June 22 - July 13, 7

8 Project Scope Statement Review Project Scope Statement 8

9 Introduction QRDA Category I is for communicating individual patient data. QRDA Category I is an HL7 Draft Standard for Trial Use (DSTU) Published in April

10 QRDA vs. emeasure HQMF Standard emeasures QRDA Standard QRDA IGs QRDA Instances 10

11 Templated CDA Many different kinds of documents. A bucket of reusable templates. QRDA Cat I QRDA Cat I A CDA document using CCD templates plus others A CDA document using CCD templates CCD Demographics CDA Allergies.... Family History Social History Vital Signs Medications Problems Payer Chief Complaint Mode of Transport Discharge Diagnosis Surgical Finding Discharge Diet New template 11

12 Coupling Between emeasure and QRDA National Quality Forum (NQF) NQF Quality Data Model (QDM) Pattern Library Instantiate (e.g., vocabulary binding) emeasure Data Criteria Quality Data Element Quality Data Element Quality Data Type Quality Data Type Pattern Pattern QDS Element QDS Quality Element Data Element QDS Quality Data Type Quality Data Type Type Quality Data Type Pattern Pattern Pattern Pattern Population Criteria Denominator CDA Template Library QRDA Template Numerator Initial Patient Population QRDA Template QRDA Template 12

13 Coupling Between emeasure and QRDA 13

14 QRDA Category I Design Considerations 14

15 Proposed Changes to QRDA Cat I DSTU 2 Parts to the Implementation Guide: 1) Framework for QRDA Cat I: Updates Define underspecified concepts Simplify Sections Simplify and Clarify Method of referencing emeasures 2) QDM approach to QRDA Describe methodology for dynamic population of QRDA I Define QRDA patterns for every QDM HQMF pattern 15

16 Proposed Changes to QRDA Cat I DSTU Determine if Consolidated US Realm header can be re-used Participants: Revisit header participant scenarios (e.g. use of Informant and Custodian) Simplify the sections Measure Section: List of emeasures being reporting on Reporting Parameters: Period for which data are being reported Patient Data: Data elements Reference the emeasure(s) version specific identifier 16

17 Proposed Changes How many QRDA IGs? Single QRDA IG, where sender dynamically populates, based on the specific measures being reported against. This requires that data elements include date/time stamps. 17

18 Issues Send a QRDA for which patient(s)? What if no patients meet the criteria? How many data to send? What if there are no data? How many QRDA Implementation Guides should there be? 18

19 Scenarios SBP > 170 over the past 18mo Send all BPs? Send most recent abnormal? Send just the abnormal? What if none are abnormal? Active diagnosis of DM Send entire problem list? Send only DM if present? What about other problems (e.g. AIDS)? 19

20 Recommendations Scoop and Filter a QRDA Cat I contains EHR data sufficient to satisfy emeasure requirements. Which patients? Send a QRDA Category 1 document for only those patients that meet the IPP criteria. Filter out patients based on regulatory guidance (e.g. Submit only for Medicare beneficiaries ) What if there are no patients? No QRDA Cat I is sent. (An aggregate report would indicate zero patients in IPP). 20

21 Recommendations How many data? Smoking gun send the conclusive evidence. Include data criteria, stratification variables, supplemental data elements, measure observations (and stuff that is required in CDA Header) What if there are no data? The data element will not be sent: Absence of evidence is evidence of absence 21

22 Next Steps This week: We will send out the webinar meeting on SDWG list-serv Participants must sign-up for the SDWG list-serv Participants must sign up for the webinar Will be the same for each meeting only need to sign up once Next Week: Continue with Design Consideration Discussion Propose and Discuss Header Design 22

23 Thank you! Contact Crystal Kallem: Gaye Dolin: 23