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HL7 Quality Reporting Document Architecture DSTU CDA Release 2, US Realm HL7 September 2008 WGM (Vancouver, BC, Canada) Pele Yu, MD MS FAAP.

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Presentation on theme: "HL7 Quality Reporting Document Architecture DSTU CDA Release 2, US Realm HL7 September 2008 WGM (Vancouver, BC, Canada) Pele Yu, MD MS FAAP."— Presentation transcript:

1 HL7 Quality Reporting Document Architecture DSTU CDA Release 2, US Realm HL7 September 2008 WGM (Vancouver, BC, Canada) Pele Yu, MD MS FAAP

2 To develop an electronic data standard for exchange of patient-level quality measurement data between healthcare information systems. Quality Reporting Document Architecture

3 Paper Medical Records Electronic Health Records Proprietary data formats Status Quo in Quality Measure Reporting Data Entry 100% manual process: data abstraction and data mining Prepare data for analysis Requestors of Quality Data Quality Improvement Organizations Accrediting Organizations, Medical Societies, The Alliance Payers Key-boarding or manual entry Feedback to clinicians Complete? QRDA Point of Care clinicians Future of Quality Measure Reporting

4 Coordination with Related Efforts Measure Development eMeasure Specification Aggregators, Requestors ok? The Collaborative eMeasure specification NQF, NCQA, AMA, APQ.... Measure definition HIMSS IHE: Multi-party choreography using HL7 messages, services AHIC, HITSP Use Cases QRDA feedback Data Elements for Quality HITEP

5 QRDA Project History Phase 1: September 07 – January 08 –Proof of concept, use CDA for quality reporting HAI reports for CDC (SDTC) SDTC interest in CDA based non-clinical reporting documents – Structured Documents Architecture (SDA) –Domain Analysis –Requirements Analysis Phase 2: May 2008 to present –DSTU Ballot –QRDA Implementation Guideline for 2 Pediatric Measures (CHCA) –QRDA Reporting Categories (MedAllies) NHIN Trial Implementation demonstration project in NY Summary patient record exchange using CDA

6 QRDA Draft Standard 2008 Category 1 – Patient-Level Reports –For DSTU Ballot Category 2 – Summary Reports –Informational, for Comments Category 3 – Calculated Reports –Informational, for Comments

7 QRDA Category 1 Specifications Header –Header US Realm Unique CDA template ID, LOINC code, and Title –Participants Target a single patient Author one or more entities (person, organization, device) Informant one reporting entity (person, organization) Custodian one custodian (person, organization) Legal Authenticator one legal authenticator (person, organization) Body –One body –One or more sections, subsections (Measure Set, Measure) Section –Measure Set Section (measure set name, version, OID, description) –Measure Section (measure name, version, OID, description) –Reporting Parameters Section (applicable reporting period) –Patient Data Section (Re-use of CCD and CDA, if applicable)

8 QRDA Specifications – RIM Constructs Header –Header US Realm Unique CDA template ID, LOINC code, and Title –Participants Target a single patient Author one or more entities (person, organization, device) Informant one reporting entity (person, organization) Custodian one custodian (person, organization) Legal Authenticator one legal authenticator (person, organization) Body –One body –One or more sections, subsections (Measure Set, Measure) Section –Measure Set Section (measure set name, version, OID, description) –Measure Section (measure name, version, OID, description) –Reporting Parameters Section (applicable reporting period) –Patient Data Section (Re-use of CCD and CDA, if applicable) QRDA Phase 1

9 QRDA Deliverable Implementation Guides for QRDA Category 1 Pediatric Measures –VON Neonatal Admission Hypothermia Measure Outcome measure –CHCA Body Mass Index (BMI) Process measure Rationale –Few data points, well-defined –Pilot potential –Pediatric measures on NQF Roadmap –Relevant to project stakeholder (CHCA)

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12 Implication of DSTU QRDA is feasible –RIM adaptable –CDA adaptable –Strong HL7 support –Industry awareness achieved Ready for industry use –HITSP –IHE –Pilot efforts Barriers for adoption and progress –Lack of continuity in effort –Lack of formal project management structure

13 Next Steps QRDA DSTU Ballot reconciliation next few months –Resolve issues without substantive change and publish DSTU, or –Resolve issues w/ substantive changes, then re-ballot –Implications QRDA Phase 3 –Funding for future development to refine DSTU leading to Normative Standard Category 1 DSTU Category 2 and 3 include in next ballot cycle/s, if enough work is done (MedAllies, etc) –Create solid links with industry Harmonize efforts (IHE, Collaborative, JCAHO, HEDIS, etc) Engage vendors and MDOs –Pilot and demonstration projects Vendors, hospitals, QIOs


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