Agenda / Minutes of 10:00 - 11:00 AM (CDT US) White Paper Update Call

Measurement Data Element Structure for EHR Extraction: White Paper Update Call 30 April 2008 11:00-12:00 CDT US

Attendance:

• Floyd Eisenberg (Siemens Healthcare)
• Jason Colquitt (Greenway Medical)
• Jody Logan (HL7 Member, Oregon Health Sciences University)
• Sheila Teasdale (HIMSS Member, American Medical Association, Collaborative for Performance Measure Integration with EHRS)
• Vassil Peytchev (EPIC)
• Chad Bennett (Iowa Foundation for Medical Care)
• Penelope Solis (American Heart Association, sponsor)

Current Version of White Paper: April 26, 2008

• Review Sections, Status, Assign Tasks
  • Establish clear goals for white paper - Updates incorporated - Pele Yu
  • List Stakeholders - Requires Update
  • Identify Specific Use Cases
    • Review Public Health Use Case - Ana Estelrich, Sarah Knoop, Sondra Renly
    • Quality / Patient Safety Use Case added - Floyd - For review / comment by all
    • Research Use Case Required - Draft to be created by Jason Colquitt, Floyd Eisenberg
  • Identify Specific Quality Measures - Chad Bennett, Patty Craig
    • AMI-3 Joint Commission - ACEI/ARB at Discharge for Patients with AMI
    • Diabetes measure - update required from The Joint Commission
    • Specific measures from provider organization - Evaluation to be performed by Judy Logan
  • Identify Value Sets for each measure - Chad, Patty Craig, others?
    • Standards, terminologies
    • Consider standards for specifications into which value sets fit for this use case
    • Incorporate measures into draft Collaborative XML schema
      • It is reasonable to keep the measure in one XML file and the codes in a separate XML file. The measure XML should have a component that incorporates include statements to point to the XML file containing the codes. The XML file containing the codes, for this round would represent the value set registry which would be transported with the measure XML. An alternative would be to refer to an XDS value set registry which is not currently in scope for a profile for this year. The code (value set) XML could be one for all measures, one for subsets of related measures, or individual per measure. The include statements can refer to codes represented in various value set XML files. In the absence of a registry, all value set XML files would need to be transported to the receiving end to represent the registry locally.
      • Vassil Peytchev provided a sample XML file using the current Collaborative XML schema to show a measure with included value sets. - Vassil Peytchev.zip Zip File Sample Measure
      • The current Collaborative XML model requires some work to align with HL7 v3.0 components to allow interoperability with CCD which is used by EHRs today. Required effort and timing to be determined after status review by Vassil Peytchev and Delanae Heldt (American Medical Association, a cosponor of the Collaboartive).
      • Creating an XSLT for a generic transform would allow the measure XML to be represented in template form making it human readable. The XSLT will allow creation of a human readable measure specification that combines the measure XML that incorporate 'include' statements referring to one or more value set XML files.
      • Long term, Structured Document Architecture (SDA - now in HL7 informative ballot) can be used next year in a profile to convert the XML structure into SDA and provide a basic link to vocabulary. QRDA is a subset of SDA and currently only addressing patient-level reporting, not the measure itself.
  • Consider tool to enable creation of schema - EHRVA input - Jacob Reider, Floyd Eisenberg
  • Identify value of implementing future profile related to this white paper for each stakeholder - TBD
  • Challenges with using ITI-SVS in current state - Ana Estelrich with input from Sarah Knoop, Sondra Renly
    • Terminologies (CTS as a standard – requires flat list of codes. Terminology needs to be simple. To use more complex terminologies, may require additional work on CTS).
    • Value set may be defined extensionally (a list) or intensionally (e.g., all children of a term in a hierarchy). For this effort only extensionally defined values will be listed.
    • etc.
• Challenges
  • Review of current Collaborative XML schema by Delane Heldt (AMA) and Vassil Peytchev to determine timing and value of HL7 v3.0 work on the current version
  • Timing and input of 2 measures (Joint Commission) and 1 or 2 additional from ambulatory gastroenterology (Judy Logan)
  • Potential for creation of a simple measure creation tool in existing timeframe to enable creation of a measure XML by measure developers without XML background
• Next Steps (as outlined through the minutes):
  • The Joint Commission and Iowa Foundation for Medical Care, with input from the Intermountain Health Care to work on identification of value sets for two measures
  • Floyd has provided a link to the - Vassil Peytchev.zip sample XML created by Vassil on this wiki
  • Jason will develop a draft of a research use case for the introductory portion of the white paper, for collaboration with Floyd
  • Floyd will follow up regarding the potential for a measure entry tool
  • Floyd with coordinate with Judy Logan regarding other potential measures from Gastroenterology specialty groups
  • Follow up call for the QRPH Technical Committee planned for 1-3 PM CDT 1 May 2008.