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CQF Presents at AMIA Symposium November 16
Monday November 16, 2015 10:30am-12pm PT 
American Medical Informatics Association (AMIA) Annual Symposium, San Francisco, CA
Didactic Panel S25: The Clinical Quality Framework Initiative to Harmonize Decision Support and Quality Measurement Standards: Defined Standards, Pilot Results, and Moving Beyond Quality Improvement
K. Kawamoto, University of Utah; M. Hadley, MITRE Corporation; T. Oniki, Intermountain Healthcare; J. Skapik, Office of the National Coordinator for Health IT 
The Clinical Quality Framework (CQF) is a public-private partnership sponsored by the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) to create a harmonized set of standards for clinical decision support (CDS) and electronic clinical quality measurement (eCQM). At AMIA 2014, experts presented preliminary results from the first year of this multi-year initiative. In this panel, CQF leaders will describe the standards developed, including the HL7 Clinical Quality Language standard for logical expression, the HL7 FHIR Quality Profiles for data exchange, the HL7 Quality Improvement and Clinical Knowledge model for logical inferencing, and several implementation guides leveraging these foundational standards. The panelists will then present findings from pilot deployments of the standards in various clinical domains ranging from cardiology to radiology, preventive care, infectious diseases, and oncology. The panelists will also describe partnerships with relevant initiatives beyond the quality domain, including the ONC Data Access Framework initiative, the Health Services Platform Consortium (HSPC), and the Clinical Information Modeling Initiative (CIMI). The slides are attached here.
Cypress Release Schedule Discussion with eCQM Community
ONC & CMS invite the EHRA and the CQM Community to help define the priority and timing of the next Cypress Release. The Cypress Release planned for December was to include support for the most recent Implementation Guides (IGs), both the HL7 QRDA IG Errata for 2014, and the CMS 2015 QRDA Combined IG. ONC/CMS have decided to delay support for the CMS 2015 QRDA Combined IG as more time is required to make the additional QRDA constraints compatible across the Cypress certification and CMS submission processes. The goal is to ensure that certified EHRs produce a QRDA document that will meet CMS submission requirements. ONC/CMS ask for the community’s help in determining the best path forward.
Please join us from 4-5 pm EST on November 18, 2014, for a Cypress webinar session to discuss the timing and need for IG support as vendors plan for EHR certification in 2015. Registration link:https://www4.gotomeeting.com/register/644219839.
Original Plan: Cypress v2.6 December 2014 Release:
  • Upgrade to the HL7 Quality Reporting Data Standards (QRDA) Errata for 2014 from the previous HL7 Base QRDA IG from July 2012.
    • “Optional Validation Utility” for vendors to check compliance of QRDA documents for the CMS 2015 Combined QRDA Implementation Guide.

    General References

    The following is a list of useful artifacts for the community.

    N/A
    Artifact NameDescription
    Data Access Framework S&I InitiativeDAF Home
    Structured Data Capture S&I InitiativeSDC Home
    FHIRhttp://www.hl7.org/implement/standards/fhir/
    eCQI Resource Centerhttps://ecqi.healthit.gov/
    FHIR Clinical Reasoning Modulehttp://hl7.org/fhir/2016Sep/clinicalreasoning-module.htmlHealth eDecisions S&I Initiative (closed)
    HL7 Clinical Decision Support Work Grouphttps://www.hl7.org/Special/committees/dss/index.cfm
    HL7 Clinical Quality Information WGhttp://www.hl7.org/Special/committees/cqi/index.cfm
    HL7 Structured Documents Work Grouphttp://www.hl7.org/special/Committees/structure/index.cfm
    Query Health S&I InitiativeN/A
    Health eDecisions Initiative (closed)N/A

    More Information

    eCQI Resource Center is Here
    The Electronic Clinical Quality Improvement (eCQI) Resource Center launched the week of February 2, 2015. This web-based tool will provide:

    • Centralized One-Stop-Shop location for electronic quality resources
    • List of electronic clinical quality measures and their specifications
    • Links to tools for measure development, testing, and certification

    The intent of the resource center is to provide a central repository for eCQI resources in an effort to reduce burden for the eCQI community and improve user experience by connecting related activities and streamlining the process for obtaining guidance and feedback. Please note that eCQI Resource Center will be enhanced in a phased approach. 

    eCQM Testing Tool Cypress Latest Release
    Cypress version 2.6, a testing and certification tool for electronic clinical quality measures, was released on January 22, 2015. The latest version can be downloaded from http://projectcypress.org/. Cypress v2.6 requires a fresh install of Cypress due to breaking changes in the QRDA Errata release. The upgrade to HL7 2014 QRDA Errata release is necessary to align with CMS submission systems for 2015 that also comply with the new errata release.

    What’s New in the Cypress v2.6 Release*:
    •HL7 QRDA Errata IG for 2014 
    –Support for the 2014 Errata Update to the HL7 Implementation Guide for CDA® Release2: Quality Reporting Document Architecture – Category I and Category III.
    •Cypress V2.6 Measure Bundle
    –Measure Bundle v2.6 includes updated patients. Measure Bundle v2.6 will be the only option available to the Cypress user for testing.

    *Allows for a 90-day window for vendors to upgrade to Cypress v2.6. Cypress v2.5.1 and Cypress v2.4.1 will continue to be available for vendors to complete their existing test cycles before needing to upgrade.

    Detailed release notes can be found here. Please send feedback about the Cypress eCQM certification releases and future enhancements to talk@projectcypress.org.

    Quality Data Model 4.1.2 Released
    The Quality Data Model (QDM) describes clinical concepts in a standardized format to enable electronic clinical quality measurement. Quality Data Model specification, version 4.1.2 was released on January 14, 2015. Support for the 4.1.2 changes were made in the Measure Authoring Tool (MAT) v4.1.0. 

    QDM 4.1.2 contains the following changes: 

    –Removal of the anatomical approach site attribute from all Physical Examdatatypes
    –Removal of the method attribute from Procedure, Intolerancedatatype
    –Clarification of the meaning of start datetime and stop datetime in all Orderdatatypes
    –Clarification regarding where quantity-based temporal comparisons can and cannot be used

    CQF Profiles are Available as Part of the Continuous Build of FHIR
    To see the profiles:

    • Go to http://hl7-fhir.github.io/
    • Click on Clinical Resources
    • Click on the resource name
    • Click on the Packages tab
    • Click on a CQF package
    • Click on the profile name

    Initiative Contacts

    Co-CoordinatorKen Kawamoto kensaku.kawamoto@utah.edu Co-CoordinatorFloyd Eisenberg floyd.eisenberg@esacinc.com ONC LeadJulia Skapik julia.skapik@hhs.gov Standards Development SMEBryn Rhodes bryn@databaseconsultinggroup.com Project SupportSwapna Bhatiaswapna.bhatia@esacinc.comCMS SponsorMinet Javellana minet.javellana@cms.hhs.gov Use Case Sub-Team Co-LeadJulie Scherer jscherer@motivemi.com Use Case Sub-Team Co-LeadCatherine Staes catherine.staes@hsc.utah.edu HL7 CDS Work Group LiaisonHoward Strasberg howard.strasberg@wolterskluwer.com HL7 CQI Work Group LiaisonWalter Suarez walter.g.suarez@kp.org Chlamydia Screening Pilot Point of ContactJohanna Goderre johanna.goderrejones@hhs.gov Ischemic Vascular Disease: Use of Aspirin or Other Antithrombotic Pilot Point of ContactJulie Scherer jscherer@motivemi.com Radiology Appropriateness of Use Pilot Point of ContactTom Conti tconti@acrselect.org Breast Cancer Decision SupportChad Armstrongchad.armstrong@evinance.com