QRPH Technical Committee Minutes 2008-05-01

Agenda for QRPH Technical Committee Conference Call 2008-05-01

Attendance

• Chris Carr (RSNA)
• Jason Colquitt (Co-Chair, Greenway Medical Systems)
• Patty Craig (HIMSS, The Joint Commission)
• Floyd Eisenberg (Co-Chair, Siemens)
• Michael Ellwood (American Academy of Physician Assistants)
• Andrew Hamilton (Alliance of Chicago Community Health Services)
• Jan Orton (Intermountain Healthcare)
• Jacob Reider (Misys)
• Harry Solomon (GE)
• Mick Talley (University Bank)
• Feliciano (Pele) Yu (Pediatric Alliance)

Minutes

• Roundtable Updates from Attendees
  • Harry Solomon will be working on a project with the American College of Cardiology for the next version of their registry to transition to standards based data submission. This project will align nicely with possible 2009 efforts in QRPH to align with specialty-based performance and measurement related registries. It also will enhance content related registry interactions now in profile development in Patient Care Coordination for immunization and oncology Registries.
  • Jason Colquitt has also worked with a rheumatology registry project managed by Greenway Medical Systems and Outcome Science using the RFD profile from ITI. RFD allow pre-population of information yet will still require QED (PCC Profile) to obtain additional information.
  • Jan Orton (Intermountain Healthcare) joined the group to participate in the value set and measurement components of the Performance Measure Data Element Structured for EHR Extraction white paper.
• Update on status of three planned initiatives (reference: April_29_-_QRPH_Planning_Discussion):
  • Performance Measure Data Element Structured for EHR Extraction White Paper
    • Current version 26 April
      • Minutes of the last subgroup call on this white paper 30 April 2008: Agenda_/_Minutes_of_10:00_-_11:00_AM_(CDT_US)_White_Paper_Update_Call
      • Two measures are noted but only one is listed. The Joint Commission (per Patty Craig) has suggested a new outpatient measure OP3 - Median time totransfer to another facility for acute coronary intervention. This measure includes the emergency department record, the outpatient record, fibrinolytic treatments, time, and containdications. The group agreed with including this measure as the second to include.
      • The measures chosen are admittedly relatively simple in comparison to measures involving different medication regimens (e.g., the surgical prophylaxis measures and community acquired pneumonia measures). The information gained from work on these simpler measures will inform needs for more complex measures. The white paper will need to include language to indicate that we acknowledge future recommendations future plans for more complex measures.
      • A subgroup of Jan Orton (Intermountain Healthcare), Patty Craig (The Joint Commission) and Chad Bennett (Iowa Foundation for Medical Care) and others interested in participating will coordinate the two selected measures to identify value sets and work on compiling the measures into an XML format (see next item). A sample spreadsheet was started during the QRPH March face-to-face meeting to identify the abstracter guidelines for the first measure (AMI3). AMI3 Draft Specification Spreadsheet
      • The work of the Collaborative for Performance Measure Integration with EHRS (the Collaborative) was presented. The Collaborative created an XML model for measure specifications. This model XML is in draft form and will be updated in June 2008. Vassil Peytchev (EPIC, ITI Technical Committtee) has created a draft model (zip file) of the AMI3 measure in that format. Details of these discussions can be found in the 30 April call link: Agenda_/_Minutes_of_10:00_-_11:00_AM_(CDT_US)_White_Paper_Update_Call. Although not a current 'standard', the Collaborative XML format is the closest model available for informing the white paper effort. Challenges are to be addressed in the white paper:
        • Acknowledge that the Collaborative effort is specific to ambulatory measures. The efforts through this white paper will test the model for inpatient and outpatient measures, enabling enhancements.
        • Acknowledge that updates to the Collaborative effort will enhance the white paper effort through the comment period and the white paper effort will conversely inform the Collaborative effort for their fall 2008 release.
    • There is possibility for creation of a data entry tool to be used by a quality measure developer such that measure developers do not need to understand XML. Funding from EHRVA is under consideration for a quick turnaround on a draft model that can possibly be incorporated into the white paper and subsequently be available for open source modification. More will be available in future meetings. The current version of the proposal is available for review.
  • Care Management White Paper: Due to HL7 Care Plan evaluation work required, consider making this an 18 month or 2 year white paper.
    • The work effort for Care Management has been limited and will take coordination and understanding of HL7 Care Plan models in the Patient Care Workgroup. As such the committee discussed recommending to the QRPH Planning Committee that the white paper be modified to an extended white paper, allowing more time for development.
    • The committee voted and passed unanimously to refer to the QRPH Planning Committee that the Care Management white paper timeline be extended. A suggestion was made also to change the name to Care Management Content, and remove the word infrastructure since the subject is not a technical infrastructure requirement.
  • Drug Safety Profile: Requires ICSR mapping to CDA for inclusion in the profile. Options are rapid recruitment of volunteer members for post-market surveillance activities or limitation to clinical trial reporting. Some followup planned during HL7 with FDA and others.
    • Discussions are planned for early next week, during HL7 meetings with FDA and Pharmaceutical representatives to determine the feasiblity of post-market surveillance work with ICSR in this cycle.
• Next Steps
  • Performance Measure Data Element Structured for EHR Extraction White Paper:
    • Per TC discussion as above
    • Solicitation for review of existing content in the white paper and submission of suggestions, modifications to Floyd Eisenberg
  • Care Management White Paper Decision
    • Per TC vote - Recommendation to QRPH Planning Committee to extend the timeline for the white paper.
  • Drug Safety Content actions
    • Per TC discussion as above, pending discussions next week at HL7
  • A draft agenda for the May face-to-face meeting is available online. Recommendation and suggestions are welcome.
  • IHE is moving to Google Groups for list serves. An email will be send to all participants on May 2. Please respond to this email as you will individually need to sign up for the groups to be able to receive further notifications.

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