1. Clinical Quality Framework cqframework.info All Hands Meeting July 24, 2014 11am-12:30pm ET

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. 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 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).

3. Agenda TopicPresenter WelcomeBridget Blake, CQF Project Manager Clinical Quality Expression Language Status Update and Discussion Bryn Rhodes, CQF Expression Language Sub-Team Lead QUICK Data Model Status Update and Discussion Aziz Boxwala, CQF Data Model Sub-Team Co-Lead Claude Nanjo, CQF Data Model Sub-Team Co-Lead HL7 Ballot ProcessKensaku Kawamoto, CQF Co-Coordinator Next StepsKensaku Kawamoto, CQF Co-Coordinator Questions and Technical DiscussionKensaku Kawamoto, CQF Co-Coordinator 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.infocqframework.info 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 4

5. Welcome Notional Project Timeline 5 Kick-off (3/21) Pre-Discovery, Call for Participation May 2014Sep 2015 Discovery Initiative End Mar 2014Nov 2015Jul 2014 Implementation Pilot Charter, Use Cases, Functional Requirements Standards Development and Review Use Case Pilots Technology Evaluations Use Case Kick-off Use Case Consensus Pilot Kick-off Evaluation … 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 DateMilestone 4/11/14Charter Finalization 4/18-4/30/14Initial Logical Model Development 4/25/14Use Case Selection 5/1/14Proposed Harmonized Logical Model Approach 6/30/14Pilot Planning Begins 7/3/14Use Case Finalized 7/30/14Narrow Slices of Draft Specifications Ready for Pilots 8/3/14Standards (Incorporating Initial Pilot Feedback) Submitted for HL7 Ballot 8/18/14Pilot Implementation Begins

6. Welcome Standards CQF Wiki: cqframework.info 6 CQM-Specific Standards CDS-Specific Standards Common Metadata Standard Common Data Model Standard (QUICK) Common Data Model Standard (QUICK) Common Expression Logic Standard (CQL) CDS=Clinical Decision Support CQL=Clinical Quality Language CQM=Clinical Quality Measurement QUICK=Quality Information and Clinical Knowledge

7. Clinical Quality Expression Language Status Update and Discussion Bryn Rhodes, CQF Expression Language Sub-Team Lead CQF Wiki: cqframework.info 7

8. Clinical Quality Expression Language Status Update and Discussion Current Status CQF Wiki: cqframework.info 8

9. Clinical Quality Expression Language Status Update and Discussion Discussion CQF Wiki: cqframework.info 9 The biggest outstanding issues are: –Handling precision-based comparisons for datetimes –Solidifying library scope, reference, and definition issues –Defining data model definition and reference –Solidifying/Defining valueset issues

10. QUICK Data Model Status Update and Discussion Aziz Boxwala, Data Model Sub-Team Lead Claude Nanjo, Data Model Sub-Team Lead CQF Wiki: cqframework.info 10

11. QUICK Data Model Status Update and Discussion Activities performed this week CQF Wiki: cqframework.info 11 FHIR=Fast Healthcare Interoperability Resources QIDAM=Quality Information Domain Analysis Model QUICK=Quality Information and Clinical Knowledge Alignment of QUICK prioritized concepts with FHIR Review of attribute placement in hierarchy Preparation of Ballot Overview material –https://docs.google.com/document/d/1N54SGKg6bKKe7oy- Adun88xTznYpe43PoLDXWAuQry4/edit#https://docs.google.com/document/d/1N54SGKg6bKKe7oy- Adun88xTznYpe43PoLDXWAuQry4/edit# Discussion of extension approach for QUICK –Preliminary thoughts can be found here: –https://docs.google.com/document/d/1w6tE3qQ4oIz3GVm3ab8C UNtLCZCMwaWTVh8ZjaWWROU/edit#https://docs.google.com/document/d/1w6tE3qQ4oIz3GVm3ab8C UNtLCZCMwaWTVh8ZjaWWROU/edit#

12. QUICK Data Model Status Update and Discussion Discussion CQF Wiki: cqframework.info 12 To join the HL7 Clinical Decision Support (CDS) and Clinical Quality Information (CQI) listservs –Access the HL7 homepage –Select Listserv on the bottom menu –Select Subscribe to list services at the upper right of the page –Click on the listserv name (e.g., Clinical Decision Support) –Select Join Select Listserv Select Subscribe to list services

13. Health Level 7 International (HL7) Ballot Process Ken Kawamoto, CQF Co-Coordinator CQF Wiki: cqframework.info 13

14. HL7 Ballot Process Types of HL7 Ballots There are four basic types of ballots –O – Comment -only –I – Informative –D – Draft Standard for Trial Use Trial period 12-24 months –N – Normative Standards may be “Universal” or “Realm-specific” (e.g., US- specific) CQF will be balloting for September 2014: –Clinical Quality Language (CQL) – Comment-only, US Realm –Quality Improvement and Clinical Knowledge (QUICK) Logical Model – Comment-only, US Realm Note: Letter designations are used at the ballot site to indicate ballot level Note: Letter designations are used at the ballot site to indicate ballot level CQF Wiki: cqframework.info 14

15. HL7 Ballot Process Types of Ballots: Ballot Type Summary Ballot TypeIntent For CommentTo gather input from members wide audience on viability & clarity of proposed specification. Seeking: Constructive comments. InformativeA non-normative specification intended for general publication. Seeking: Review and validation of content not yet intended to be normative. DSTUA DSTU is a draft standard for validating the standard during the 12-24 month DSTU period. Seeking: Objective assessment of viability of implementation of proposed standard. NormativeThe normative, validated standard. Seeking: Approval as an American National Standard (ANS). CQF Wiki: cqframework.info 15

16. HL7 Ballot Process Types of Ballots: Ballot Type Summary (Cont.) Ballot TypeBallot Pool QuorumApproval For CommentN/A InformativeN/A60% DSTU10 registered HL7 members 60% Normative60% of registered HL7 voters 75% CQF Wiki: cqframework.info 16

17. HL7 Ballot Process Overview of Comment-Only Ballot An HL7 Work Group submits and proposes content for Comment- Only review The intent is to gather input from members outside of the Work Group on the viability and clarity of the proposed content The review of proposed content does not seek a vote, per se, but will capture all comments CQF Wiki: cqframework.info 17

18. HL7 Ballot Process Participation in Comment-Only Ballot Members enroll in the review group via the HL7 Ballot Desktop –The enrollment period ends one week prior to the review closing date –Ballot pool sign-up begins July 7 and ends August 1 Nonmembers may also enroll, and this is encouraged –Nonmembers must register their intent with HL7 during the stated enrollment period by mail, telephone, or email We will also collect CQF community comments for submission by the CQF team There is no minimum review group At the close of the comment-only review period the responsible Work Group shall consider all comments with the intent of improving the quality and clarity of the submitted content before submission to a subsequent ballot. The Work Group shall post the results of their consideration of the comments submitted to the HL7 Ballot Desktop Note: A Comment-only Ballot does not require reconciliation CQF Wiki: cqframework.info 18

19. HL7 Ballot Process The Ballot Desktop http://www.hl7.org/ctl.cfm?action=ballots.home Objectives –Learn how to join in a ballot pool –Learn how to navigate the ballot desktop CQF Wiki: cqframework.info 19

20. HL7 Ballot Process Locating the Ballot Desktop CQF Wiki: cqframework.info 20

21. HL7 Ballot Process Desktop Home Page When you link to the ballot desktop members should log in at the home page using your HL7 User ID and Password. CQF Wiki: cqframework.info 21

22. HL7 Ballot Process Navigate to the Ballot Page Appendix CQF Wiki: cqframework.info 22

23. HL7 Ballot Process Join the Ballot Pools Appendix CQF Wiki: cqframework.info 23

24. Next Steps Engage in workgroups (www.cqframework.info)www.cqframework.info Pilots Pilot Sub-Team Lead Peggy TsaiPeggy Tsai Individual Pilot Leads or Bridget BlakeBridget Blake QUICK Data Model Claude Nanjo, Aziz BoxwalaClaude NanjoAziz Boxwala Clinical Quality Language Bryn Rhodes Join us for the next Clinical Quality Framework meeting on July 31 from 11am to 12:30pm ET CQF Wiki: cqframework.info 24

25. Questions and Technical Discussion NameE-Mail Marc Hadley, Co-Coordinatormhadley@mitre.org Ken Kawamoto, Co-Coordinatorkensaku.kawamoto@utah.edu Bridget Blake, Project Managerbridget@mitre.org cqframework.info CQF Wiki: cqframework.info 25