2021.08.06 EQRS EDI Submission Testing - Meeting

Phase 3 Testing Timeline

• 07/12/2021 - Phase 3 (Clinical Codes/2728) live in production.
• 07/12/2021 - 09/01/2021 - Resubmission of Clinical Data Files (September to December).
• Timeline
  • Encourage everyone to complete large data submissions prior to the closure of the clinical data
  • Allows us to react to any large data submissions early in the process

• Currently working a few tickets with Yvette and team that came in
• Plan to get answers and responses to the tickets Friday/Saturday
• Working with the users/individuals on any issues regarding data clean up
• Validations are doing what they should be doing
• Continuing to monitor the data and statistics from Lakshmi's team
• Also working on patient mapping as needed
• Finished researching an email that Vlad (DCI) sent to him regarding patient merge
  • Michael and Olga are working on it

EDI 2020 DATA SUBMISSIONS

• Researching an issue back from 7/28 - DaVita had about six hundred 99999 errors
  • Related to Patient Demographics from 2021 reporting from Sarah and Christie
  • Traced back an issue in the patient admissions process
  • Due to lack of logging, unable to determine the root cause
  • May add some stack tracing to the microservices in order to see the exceptions being created
  • Question - Has the data been resubmitted?
    • Zac was not on the call to answer
    • Sarah will reach out to Zac and get an answer
• Independent 2020 Data Submission's (manual data entry in the UI)
  • Comment from Diana at NCC - have a downward trend as the facilities are entering their data
  • In good shape
  • Suggestion to put the Independent 2020 Data Submission information on the Public space
  • Looking at the chart, the color coding is week by week
  • The chart represents missing records not patients

DaVita - 

• Wrapping up their batch submissions today
• Field teammates will be taking over full control of the manual entries - focusing on November and December starting next week through the rest of the submission's
• Not done with manual submissions, still going on at this time
• For Manual submissions have roughly 3500 range for December; not sure how many left for November

FKC -

• As mentioned last week, pretty much done with batch submissions
• Focusing on manual entry - about 2000 patients for October, November and December
  • This is a high number, therefore goes back to what Vlad brought up regarding the no clinical data flag
  • They send EQRS the file and they get no feedback that it errors out or has been rejected 
  • EQRS is not accepting it; not populating in the single user interface
  • Causing thousands of their patients to show with missing data even though they submitted something
  • Per Yvette, a story has been created on their board to look into it
  • FKC will try to handle it manually but hoping to get it fixed for 2021 data
• Submitted Depression data
  • Looked at patients that their depression data was rejected
  • Some of the clinics that were certified in 2020 are closed
  • They either closed in 2020 or closed in 2021
  • When you go into the UI and select the clinical depression module, there is a pop up that says "this clinic was not certified during the assessment period" except it was
  • Question - On the clinical depression module, is it only going to allow you to submit data for clinics that are open and certified as of the Submission Date?
    • Yvette will look into this. She thinks in EQRS, the validation was removed prior to go live or shortly after
    • A request may have come from the QIP side to just accept the data even though it doesn't meet the criteria for the measure
    • The original intent was to not allow if a facility or patient didn't meet the criteria for the measure, not to accept the data
    • Michael requested that Yvette include him so he can assist in researching

DCI -

• Progressing well.  They have about 60 patients with clinical records that still need to be processed
• Received the same issues that FKC encountered above
  • No data getting through and,
  • Clinics that are closed, they would get the error message for depression
• Scott will talk to Lisa and Ahmar on what they can provide for the Kt/V topic
  • 12309 Patient is not receiving Hemodialysis at the selected facility as of the Phosphorus Date entered.
    
  • 12328 Patient is not receiving Hemodialysis at the selected facility as of the Uncorrected Calcium Date entered.
    
    • The codes above are currently errors.  There was discussion on making these codes warnings instead of errors
    • Ahmar will need to take back to Delia and other folks
    • Per Lisa this may be a result of allowing lab work to be submitted from hospitalizations b/c if they're submitting the data from the hospitalization the patients not in the clinic
    • Per Vlad - this is very low priority, there are only two cases
    • If outside the admission module start and end date, they will not report the data

NRAA -  

• As of Monday, 8/2, NRAA had about 24,000 patients that were still outstanding according to the NCC report
• Pushing their submitters to work harder and faster, making progress, but still have quite a ways to go
• CS1374543 (INC0190662) -  No Acks or Deferred Responses from EDSM/EQRS since Aug 2, 2021 10:15:50 AM PDT
  • Impacted NRAA in not being able to get files in
  • The issues has been remedied and now submitting again
  • Question - What was the root cause of the outage?
  • Appears to be something with credentials
  • CMS/ISG from the start time that was captured in the email starting around Monday to when the issue was report, all involved people trying to determine the root cause have found nothing in the logs
  • Credentialing seemed to resolve the issue on Thursday
  • This was not an "outage" because there were other submissions that came in from other EDIs throughout the day
  • NRAA may not be coming in through the same "front door" that the other users may be coming in
  • Today all EDI submitters use the same URL to send in their submissions  to EQRS
  • Regarding Credentialing, Yvette was able to use NRAA's Client ID and secret to generate a one hour token on her side emulating what NRAA would have done to get a submission into the system and all checked out fine
  • Continue to monitor to see if it happens again
  • Future enhancement would be to implement monitoring to help in troubleshooting and determining root cause
  • Monitoring for the absence of data may not be successful b/c NRAA may have a period there there is no data

• REMINDER: if need to email the help desk, using the following email address: 

qnetsupport-esrd@hcqis.org with URGENT in front of subject line

• Question from DaVita -  Is there anything regarding 2021 Clinical Submissions that can be shared?
  • Ahmar - currently in discussions but there are no definite dates at this time
  • At the tail end of discussions and need approvals from leadership
  • Hopefully will get approvals for clinical closure dates by next Friday, 8/13 
  • Requested by NRAA (Howard) to have some collaboration.  If recommendations and dates have been made, to share with the people  that are going to be living with those dates
  • Per Ahmar - the EDIs will be given enough time and not at liberty to share at this point
  • Howard is requesting who are the folks not allowing the information to be shared to the EDIs
  • Grace Snyder or Tim Jackson may be the leadership to speak to