Starting with fully specified HEDIS 2018 specs for
Colorectal, Cervical and Breast Cancer Screening
Terminology challenges
Don’t have all the value sets needed for eligibility, so had to comment out those sections
Single Value Sets vs Grouping Value Sets
For example, Cervical Cytology has a value set for CPT, HCPCS, and LOINC
Current approach defines a Grouping value set that is the union of all 3
Seeking EHR feedback on whether that’s easier or harder than keeping them separate and unioning the result in the measure
Working through applying to a population
In a payer scenario, start with an eligible population
Potentially need different versions of the measure
One to run on the provider, which gathers data
One to run on the aggregate set, which stratifies by program
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Decision Support Evaluation
Phillips Healthcare working on expanding capabilities for evaluation of an ActivityDefinition
Additional functionality to help enable testing in isolation
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Outcomes
MiHIN was able to successfully evaluate BCS measure definition against the test data set
Using CQL Runner, we were able to successfully evaluate the BCS measure definition, with the engine accessing the Apelon terminology server to retrieve value set expansions
Lantana was able to install a local CQF Ruler and evaluate CDC Opioid Guidance with it
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Recommendations
There are a lot of moving parts in the stack, need better testing and isolation of the components
Overall need better preparation, measure specs weren’t fully available until a week before the connectathon, so we were still troubleshooting measure evaluation
Need two different flavors of the measure specifications, at least for the payer calculation scenario, one for the provider that is focused on a single EHR/provider information, and another that is focused on aggregate data and stratifies by program