Clinical Quality Framework

1. Clinical Quality Framework All Hands Meeting September 25, 2014 11am-12:30pm ET cqframework.info

2. Logistics • As a reminder, please mute your phone when you are not talking to the group. • When speaking, please say your name before making your comment. • You can ask questions by unmuting or by using the “Chat” feature on the web meeting. To find the “Chat” feature, look for the “Chat” bubble at the top of the meeting window. • Send your “chat” to All Panelists in order to ensure the comments are addressed publicly. • This meeting is being recorded. • Should you need to take another call, please leave the meeting and rejoin (i.e., please do not put the meeting line on hold). From S&I Framework to Participants: Could you please explain how the terminologies are used in this instance? All Panelists CQF Wiki: cqframework.info 2

3. Agenda CQF Wiki: cqframework.info 3

4. Welcome • Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Use Cases, Project Charter, and General Information are posted on cqframework.info • Input requested on Quality Improvement and Clinical Knowledge (QUICK) data model concrete/leaf clinical statement types: https://docs.google.com/spreadsheets/d/1QiiNdtTeD17vbEQn9bzXLMaBY1A30c6FEyt-qsIB0cw/edit?usp=sharing Place feedback in spreadsheet or contact aziz.boxwala@meliorix.com by September 22, 2014 • QIDAM pre-publication draft is readyfor review • Cypress 2.5 was released on September 25, 2014 http://projectcypress.org CQF Wiki: cqframework.info 4 QIDAM=Quality Improvement Domain Analysis Model

5. Welcome • Clinical Quality Framework (CQF) All Hands meetings are held weekly on Thursdays from 11am to 12:30pm ET • https://siframework1.webex.com/siframework1/onstage/g.php?t=a&d=666535029 • Dial In: +1-650-479-3208 • Access code: 666 535 029 • CQF QUICK Data Model meetings are held weekly on Wednesdays from 1 to 2pm ET • http://fuze.me/24308131 • Dial In: +1-770-657-9270 • Participant passcode: 6870541 • CQF Clinical Quality Language meetings are held weekly on Wednesdays from 11am to 12pm ET • https://global.gotomeeting.com/meeting/join/554237525 • Dial In: +1-770-657-9270 • Participant passcode: 6870541 CQF Wiki: cqframework.info 5

6. WelcomeNotional Project Timeline Mar 2014: Pre-Discovery - Call for participation Apr-Jun 2014: Discovery - Charter, use case, and functional requirements development May 2014-Nov 2015: Implementation – Standards development and review Jun 2014-Nov 2015: Pilots Dec 2015: Evaluation Mar 2014 May 2014 Jul 2014 Sep 2015 Nov 2015 … Use Case Kick-off Initiative End Use Case Consensus Kick-off (3/21) Pilot Kick-off Pre-Discovery, Call for Participation Discovery Charter, Use Cases, Functional Requirements Implementation Standards Development and Review Pilot Evaluation CDS=Clinical Decision Support CQL=Clinical Quality Language DSTU=Draft Standard for Trial Use FHIR=Fast Healthcare Interoperability Resources HQMF=Health Quality Measures Format IG=Implementation Guide KAS=Knowledge Artifact Specification QUICK=Quality Improvement and Clinical Knowledge Use Case Pilots Technology Evaluations

7. WelcomeStandards Reconciling ballot comments CQM-Specific Standards Common Metadata Standard CDS-Specific Standards Reconciling ballot comments Common Data Model Standard (QUICK) Common Expression Logic Standard (CQL) CDS=Clinical Decision Support CQL=Clinical Quality Language CQM=Clinical Quality Measurement QUICK=Quality Improvement and Clinical Knowledge CQF Wiki: cqframework.info 7

8. Prioritization of Concrete/Leaf Clinical Statement Types Aziz Boxwala, CQF Subject Matter Expert CQF Wiki: cqframework.info 8

9. HL7 Update Ken Kawamoto, CQF Co-Coordinator CQF Wiki: cqframework.info 9

10. HL7 Update: Clinical Quality Language (CQL) Bryn Rhodes, CQF Subject Matter Expert CQF Wiki: cqframework.info 11

11. HL7 Update: CQLCQL Ballot Summary 91.5% Affirmative CQF Wiki: cqframework.info 11 Vote Summary

12. HL7 Update: CQLCQL Ballot Summary Neg-Mj: Negative Vote with Reason - Major Neg-Mi: Negative Vote with Reason- Minor A-C: Affirm Vote with Comment A-Q: Affirm Vote with Question A-S: Affirmative Vote with Comment -Suggestion A-T: Affirm Vote with Comment - Typo CQF Wiki: cqframework.info 12 Comment Summary

13. HL7 Update: CQLCQL Ballot Summary CQF Wiki: cqframework.info 13 Major Comment Categories • Audience • General concerns over the intended audience of the various sections • Clarity • Suggestions and requests for clarification • Data Model • Concerns about the relative coupling of CQL/QUICK • Syntax • Comments about complexity and/or expressivity of the syntax • Timing • Comments relating to temporal comparisons and support • Examples • Requests for more or better examples • Questions/Comments/Errata

14. HL7 Update: CQLCQL Ballot Summary CQF Wiki: cqframework.info 14 Disposition Summary

15. HL7 Update: CQLCQL Ballot Summary CQF Wiki: cqframework.info 15 Reconciliation Summary

16. HL7 Update: Quality Improvement and Clinical Knowledge (QUICK) Aziz Boxwala, CQF Subject Matter Expert Claude Nanjo, CQF Subject Matter Expert CQF Wiki: cqframework.info 16

17. HL7 Update: QUICKQUICK Ballot Summary CQF Wiki: cqframework.info 17 Vote Distribution

18. HL7 Update: QUICKQUICK Ballot Summary A-C: Affirm Vote with Comment A-Q: Affirm Vote with Question A-S: Affirmative Vote with Comment -Suggestion A-T: Affirm Vote with Comment - Typo Neg-Mj: Negative Vote with Reason - Major Neg-Mi: Negative Vote with Reason- Minor CQF Wiki: cqframework.info 18 Comment Distribution

19. HL7 Update: QUICKQUICK Ballot Summary CQF Wiki: cqframework.info 19 Comment Summary • Relationship to other standards • FHIR • v3 • Model scope • Statements about entities other than patients (e.g., nurse staffing ratios) • Model design and naming issues • Clarification • Occurrence versus unknown occurrence versus non-occurrence • Act versus observable (particularly with results) • Better documentation • Typos

20. HL7 Update: QUICKQUICK Ballot Summary CQF Wiki: cqframework.info 20 Plan • Have tentative ballot resolutions completed this week • Work with commenters over the next week • Aim for votes/block-votes in second half of October

21. Pilot Update Bridget Blake, CQF Project Manager Pilot Leads CQF Wiki: cqframework.info 21

22. Pilot Update CQF Wiki: cqframework.info 22 Pilot leads are finalizing pilot summaries Pilot leads will work with designated subject matter experts to engage the pilot teams and move the pilot forward Pilot discussions will be part of each week’s All Hands meeting; pilot teams can provide updates and get community input during All Hands meetings Pilots can share information regarding individual pilot meetings and progress via the cqframework.info pilot pages Initial pilot feedback will be provided to the QUICK and CQL teams by early December 2014, in preparation for the QUICK and CQL DSTU ballots

23. Pilot Update CQF Wiki: cqframework.info 23

24. Next Steps • Review QUICK data model concrete/leaf clinical statement types https://docs.google.com/spreadsheets/d/1QiiNdtTeD17vbEQn9bzXLMaBY1A30c6FEyt-qsIB0cw/edit?usp=sharing • Review the QIDAM pre-publication draft • Engage in workgroups (www.cqframework.info) • Pilots • Pilots Sub-Team Lead Peggy Tsai • Individual Pilot Leads or Bridget Blake • QUICK Data Model • Claude Nanjo, Aziz Boxwala • Clinical Quality Language • Bryn Rhodes • Join us for the next Clinical Quality Framework meeting on October 2 from 11am to 12:30pm ET CQF Wiki: cqframework.info 24

25. Questions and Discussion cqframework.info CQF Wiki: cqframework.info 25