1. FHIR Implementation Guide for Data Exchange for Quality Measures
CQI – Da Vinci
FHIR Implementation Guide for Data Exchange for Quality Measures
Project Update
Viet Nguyen | Linda Michaelsen
Robert Dieterle| Bryn Rhodes | Eric Haas
June 29, 2018

2. Summary from PSS
Payers and providers need common exchange process to share the data required to complete quality measures.
This PSS focuses on both the standard for exchange and the specific use case of medication reconciliation attestation and the underlying process from which the attestation is created that support information for transitions of care, and care management plans involving medication changes.
Proof of 30 day medication reconciliations is increasingly required for value based care incentives. Providers and care coordinators face the challenge of collecting accurate and complete patient medication records across care settings.
Today’s manual and ad hoc processes are costly and will not scale.

3. Status Update
FHIR resources and profiles for general measures identified.
FHIR operations for general measures outlined
FHIR resources and profiles for MRP use case drafted (90% complete)
FHIR operations for MRP use case drafted (50% complete)
Draft Implementation Guide started

4. Base Resources for Quality Measures
Library
(canonical)
Measure CQL
Measure
MeasureReport
6/27/18

5. Measure/[id]/$submit-data
Operations
1. Retrieve measure data requirements
Query Measure/[id]/$datarequirements
Provider System
Payer System
Return data requirements
2. Push measure data from Provider to Payer
On event, POST
Measure/[id]/$submit-data
Payer System
Provider System
3. Retrieve measure data from Provider by Payer
Query Measure/[id]/$collect-data
Provider System
Payer System
Return Operation Response with
MeasureReport and evaluated resources

6. Publish-Subscribe - TBD
4. Payer subscribes to measure on Provider system (Definition in progress)
Subscribe to Measure/[id]
Provider System
Payer System
On event, Post Measure/[id]/$submit-data

7. Next Steps/To-Do Finalize draft of high level operations
Finalize draft of MRP profiles
Finalize draft of MRP operation/operation outcome definition
Define components of IG to support STU3
Floyd to confirm with TSC the need for 1 or 2 NIB (STU3 and R4 IG versions)
Add narrative information to Draft IG and complete IG
IG Proposal template due to FMG 7/11
NIB submission review at CQI meeting 7/6
IG Ballot Submission mid-August
Review QI Core profiles may also be appropriate for MRP use case

8. FHIR Gap Analysis for MRP Use Case - Draft
Double-click on chart to see other resources/profiles (tabbed worksheets)