2021.08.25 EQRS Program Working Group Meeting

• Telemedicine
  • The past two weeks the ADO team has added telemedicine usage tracking to the EQRS application

• "Edit Treatment Information" page - a Telemedicine check box (optional) will be available to check the check box to indicate that the user is using the telemedicine
• Under "Treatment information" section the Telemedicine field will display "Yes"
• Under Facilities>Services Information page>Additional Services (Optional) - added a Telemedicine check box if the facility is providing the telemedicine service
• To search on Telemedicine facilities - Go to Search page under Advanced Search>Additional services>Click on Telemedicine check box>Submit
• DCI (Vlad) - Why is it in the Treatment page? It is not in the right place to put Telemedicine
  • Per Lisa -  it was put on there so the user would not have to constantly re-enter it with the clinical data; more of a one time entry
  • Vlad -  how would it be handled if patient is doing telemedicine one month then goes into the clinic the next few months, then back to telemedicine.  How would this scenario be handled?
  • Concern the program/ISG did not ask the EDI's
  • Vlad suggest telemedicine should have been place in the clinical data section so it can be documented how many telemedicine contacts a patient had during a certain time
  • A treatment is really an order
  • It needs to be documented if its secured or not
  • Per Lisa - this suggestion will be looked at for future enhancements
  • Telemedicine is primarily for patients who are doing home therapy
  • Suggest to make the definition clearer and have the EOCT get the definition out
• FKC (Kathleen)
  • What is the expectation of checking and unchecking the Telemedicine check box?
  • If the patient goes back and forth between Telemedicine and not doing Telemedicine, is the expectation to constantly go back and forth in updating the treatment record?
    • Per Lisa - no, it would be for the predominance of whatever they did for the month.  If for the month they predominately checked in through Telemedicine, then you would check the Telemedicine checkbox
    • Lisa will take the multiple scenarios presented, back to ISG/ADO and revisit the telemedicine definition and check box
• Leah Skrien asked if there are other things tied to treatment?  
  • Per Lisa - she cannot tell her at this time if there will be anything else tied to treatment 
  • Nathan asked when and how can they get an answer to Leah's question
    • Lisa will have the other PO's put together something explaining if anything is tied to treatment and bring to the next meeting (Action Item)
• Telemedicine - XSD change
  
  • Under modality in the XSD, there is an XSD element added with a name "telemedicine"
  • This is an optional field so if no value is provided, the telemedicine value will default to "false"
  • It it optional to include the tags at all
  • Recommended that the above scenario (without the tags) be tested in prod preview
  • When will the updated data dictionary, xml examples and XSD documentation be available?
    • They will be provided once the production date has been determined
    • Therefore, EDIs will not be told how to implement this until it is actually in production
    • Concerned is that the EDI developers need time to get this into their systems
    • The expectation of CMS is to have the facilities manually enter the ~90,000+patients through the single user interface
    • It was pointed out that the EDIs have electronic submission in order to remove the burden of manual entry as much as possible
    • Per Lisa, this is a requirement in the network contract and the networks will gather the data, one way or another.  This is an easier option than them contacting each and every facility
• Telemedicine - Data Dictionary
  • A new role is added
  • Keynote type is modality 
  • The element is telemedicine
  • Field type is Boolean
  • It is not a required field
  • As far as the description, it is optional and if not provided by default the value will be "false"; (listed values are True or false)
  • Field is used to identify patients using telemedicine services for the treatment of dialysis facilities
  • Added a new column called "Notes' to identify that telemedicine is the only new field added. The new column is being used as an indicator that it is new
  • Rather than duplicate column C in the data dictionary, suggested to have the "Notes" column be used as an "as of" date field to indicate the production date of the new field (i.e. Telemedicine) 
  • The definition for "Telemedicine" will be further clarified when Lisa takes the feedback to the team (Action Item)

• Other topics to discuss at these meetings?
  • Review Roadmaps; PI information
    • The roadmap was presented to the group at the 7/28 meeting
    • The Program offered as PI's are coming up, we would do shallow dives, bring the features to review and make comments
    • This is a work in progress and trying to incorporate the EDIs more as well as their view points
    • Started a new contract and some some of the things had to be put in EQRS while we were in procurement and those could not be discussed
    • We are working in being as transparent as we can and moving forward in trying to incorporate the EDIs
    • We need to move forward and ISG/Program will take the concerns of the EDIs of not being included in being able to provide input before something is implemented into the system as a lessons learned.  Moving forward we will try to have the EDI's more engaged and include them after shallow dives
  • Timelines
  • When can the EDIs expect details - technical documentation
  • After a shallow dive is completed, make sure anything we need to include for the EDI Submitter's gets included on the agenda
• Question from Vlad - Was the fix for the transplant citizenship issue and the clinical data check box deployed last night? (8/24)
  • Per Scott the fix for code 13510 related to citizenship status was deployed the evening of 8/24
  • The clinical data check box issue was not deployed.  It was rescheduled for Thursday, 8/26
• Question from Rachelle Caruthers - Was Lisa able to speak to leadership about the method of delivering the healthcare personnel flu data?  Are they open to alternate methods rather than putting that into NHSN?
  • Lisa has not had the chance to ask leadership 

Next meeting scheduled for 08 Sep 2021