Stream: implementers
Topic: MeasureReport and filtering based on ONC (c)(4) requirements
Kevin Weaver (Jul 30 2018 at 12:25):
Hi folks, I'm looking at the ONC (c)(4) criteria for creating filtered QRDA-III XML files based on a defined set of filters (TIN, NPI, patient age, sex, conditions, etc.). I see the MeasureReport resource (https://www.hl7.org/fhir/measurereport.html) where type is summary which is analogous to a QRDA-III. However, I don't see any search or other parameters there or in (https://www.hl7.org/fhir/measure-operations.html#evaluate-measure) that would allow for filtering by these attributes. There also doesn't seem to be a way to run $evaluate-measureon a List or Group of Patients to generate a summary type MeasureReport, it looks like it only supports filtering on one patient at a time. Is there another way to support this requirement that I might be missing? (CC @Bryn Rhodes )
Bryn Rhodes (Jul 30 2018 at 18:43):
$evaluate-measure supports population level evaluation, either as a summary, or as a ‘subject-list’. In either case the supplemental data and stratifiers are provided in the same way. The use case to search for a measure report based on those criteria those is new. Who are the actors in that case?
Kevin Weaver (Jul 30 2018 at 19:06):
Hey Bryn, I'm mainly getting the use case from 2015 Edition CQM criteria (c)(4), see https://www.healthit.gov/sites/default/files/2015Ed_CCG_c4-CQM-filter.pdf. The requirement is to "filter clinical quality measure (CQM) results at the patient and aggregate levels by each one and any combination of the data listed in (iii)." which are:
(A)Taxpayer Identification Number.
(B) National Provider Identifier.
(C) Provider type in accordance with, at a minimum, the standard specified in § 170.207(r)(1).
(D)Practice site address.
(E) Patient insurance in accordance with the standard specified in § 170.207(s)(1).
(F) Patient age.
(G)Patient sex in accordance with the version of the standard specified in § 170.207(n)(1).
(H)Patient race and ethnicity in accordance with, at a minimum, the version of the standard specified in § 170.207(f)(2).
(I) Patient problem list data in accordance with, at a minimum, the version of the standard specified in § 170.207(a)(4).
Attempting to translate this to FHIR, I don't see a way to generate a MeasureReport based on any arbitrary combination of the above filters, but I may be missing something.
Kevin Weaver (Jul 30 2018 at 19:10):
The idea would be to take the filtered summary type MeasureReport and translate it into a QRDA III XML file per the requirement.
Bryn Rhodes (Jul 31 2018 at 12:33):
The practitioner parameter of the $evaluate-measure operation lets you run the report for a specific practitioner, and we use the QI Core Practitioner profile to specify NPI and/or TIN as well as the specialty for a given practitioner.
Bryn Rhodes (Jul 31 2018 at 12:34):
For the patient-specific data elements listed there (sex, race, ethnicity, payer), those are included as supplemental data elements in the measure definitions and then included in the summary and/or individual reports.
Last updated: Apr 12 2022 at 19:14 UTC
