Quality Planning Committee Minutes 2007-11-05 06

Quality Domain Planning Committee Agenda

Nov 5-6, 2007, RSNA Building, Oakbrook IL

Activity	Discussion Summary
Introduction and Review of New IHE Governance	New IHE governance review provided by Chris Carr. New information will be posted to this wiki site with respect to the Quality Domain as it becomes available.
Recap - Overview of ONC Quality Use Case, 2007 PEQD Effort	For context, the workflow diagrams of the ONC Quality Use Case ([1]) were reviewed with the Planning Committee. The gaps with respect to the PEQD framework were reviewed. Primary gaps exist in (a) the measure definition from measure developers, (b) the analyzer and aggregator function and (c) in the patient-level data submission.
Quality Reporting Document Architecture (QRDA) - Liora Alschuler, Pele Yu	The QRDA is in the process of review by HL7 Structured Documents with expectation of a ballot in May 2008. Briefly, QRDA is a constraint on CDA specific to quality reporting. It is likely that QRDA may be approved as a standard within the Quality Domain profile timeline for 2008, but approval in that timeline is not guaranteed.
Review Brief Profile Proposals by Planning Committee	Individual Profile Summaries: Structured Quality Measure Validation and Aggregation; Structured Quality Measure Definition and Import; Receive & Forward Proxy Actor; Proposed Work Item: Imaging Structured Reporting - Creation and Transmission; Electronic Exchange of Patient Care Coordination Data Using the Omaha System; a Terminology That Supports Clinical Practice
PC Selects "Short List" of Profiles, Effort & Feasibility Analysis	PC evaluation grid available at the following link from the ftp site: [2]
Structured Quality Measure Validation and Aggregation	Disposition: The validation component is a requirement of the Framework. It is a subsequent step to submission of the patient-level quality information, aggregation and analysis of that information, and re-send of the analyzed/aggregated information to the care provider (individual or organizational) for confirmation and/or correction of components of the report. The validation step is therefore deferred until 2009 work effort. The aggregation component is manageable with constraint on Medical Summary (as defined by HITSP in constructs to be published by December 2007 (C38), having completed comment resolution). The component is also managed with QRDA, but there is no definite assurance of formal approval by HL7 in May 2008. One option for the PC include creation of a constrained Medical Summary identical to the HITSP component and structure of QRDA such that the profile completion is independent of HL7 approval timelines. To be considered is identification of the time and editor required for creation of the profile. The PC identified this portion of the proposal as second in priority to Structured Quality Measure Definition and Import.
Structured Quality Measure Definition and Import	Disposition:
Receive & Forward Proxy Actor	Disposition: The Quality PC identified the proposal as a benefit for the management of documents for the analyzer / aggregator. It is also required to manage the needs of biosurveillance as requested by HITSP as "Publish and Subscribe" to the ITI Planning Committee in 2006. The ITI Planning Committee has in 2007 referred a combination of two Publish and Subscribe propsals to the ITI Technical Committee. The Quality PC therefore, referred the "Receive & Forward Proxy Actor" to the ITI Technical Committee for incorporation into the Publish and Subscribe proposal process. Subsequent to the closure of the Quality PC meeting, the Publish and Subscribe proposal was presented to the ITI Technical Committee and will be included in a white paper regarding Publish and Subscribe. The Quality Technical Committee will review and make a decision dependent on the outcome of the ITI Technical Committee decision.
Proposed Work Item: Imaging Structured Reporting - Creation and Transmission	Disposition: The Quality PC identified that a structured imaging report could clearly provide structured data elements required for quality measures, and also for future clinical decision support management concurrently and retrospectively. The proposal indicated a set of 180 identified data elements to include within the structure. The request is best managed as a constraint of Medical Summary which is best managed by coordination with the Cardiology, Radiology and PCC Domains specific to individual provider communication about an individual patient. The output will clearly benefit quality measurement; however, the constrained Medical Summary is best managed by the other Domains.
Electronic Exchange of Patient Care Coordination Data Using the Omaha System; a Terminology That Supports Clinical Practice	Disposition: The proposal has also been submitted to the PCC Planning Committee. The Quality PC suggested the proposal addressed a broader requirement for continuity of care based on terminology, in this case the request is specific to the Omaha system. The PC referred the proposal to the PCC Nursing Terminology Subcommittee for management.