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Date

Attendees

Name
Adrienne Adkinsx
Adrienne Rayx

Ahmar Wazir


Anitha Chintalapatix
Anne McDermott
Arnie Esparterox
Branon Barrettx
Cheri Jerger
Chris Brownx
Chris Mario
Curt Phillips
Danita Patel
Deb Wilsonx
Dianna Christensenx
Erin Wolfe
Hari Krishna
Heather Moore
Howard Thomas
Janet Hutchinson
Jason Clemx
Jay Vancil
Jennifer Baileyx
Julie Alvarezx
Justin Garcia
Kathleen Prewittx
Kelly Llewellynx
Lakshmi Eriginenix
Leah Skien
Lisa Rees
Melissa Fieldhousex
Michael Kennedyx
Nathan Muzosx
Ozlem Tasel
Pandu Muddanax
Revathy Ramakrishna
Sarah Filling
Scott Laughlinx
Seema Sreenivas
Shalon Quinnx
Shamim Almamun
Steve Goodman
Vladimir Ladikx
Yvette Brownx
Zac Cohen
Zachary Serlethx




Agenda

ItemsWho
Meeting RecordingArnie

This session will be recorded for the purpose of documenting the meeting minutes and action items. If there are any objections to the recording of this session, please make it known now. Absence of an objection to the meeting being recorded will count as consent to recording this meeting.

https://us06web.zoom.us/rec/share/QY26rar8km5yzXUsUefStCTQ4jf3U1ic7d4YShAf_cvYG2s5kXybptssJKxrDY24.vh_ncrLABWh1ZD4B Passcode: @7*gBQ?K 

PI Feature Update Shalon

Parathyroid Hormone (PTH) and Vitamin D - Overview/Discussion

  • This came from a Congressional request, office of legislation has asked to include it in EQRS
  • Planning to have active by 7/31/22
  • Still in development so would like to get input from the EDIs
  • PTH used to be in CrownWeb
  • Development is just starting so at this time not sure what it will look like; looking to ISG to assist
  • This was brought to the EDI attention know to allow enough time for their planning an development time
  • Michael Kennedy will be working with Shalon's team to build out the enabler
  • The sooner CMS/ISG can provide the "What" to the EDIs the better.  They need time to reach out to their customer base to understand if this is something they are getting from their labs today, if they are collecting in their EMR systems, if they have to do something different in their workflows
  • Vlad's/Nathan's recommendations/scenarios on what should be involved (listen to recording at 16:41 - 30:01) 
    • They already have calcium, phosphorus and corrected calcium which is already in EQRS
    • Need to add PTH; which may be a big problem
    • PTH has different essays that cannot be compared to each other or not easily compared to each other
    • The EDIs may use different essays which will produce drastically different values
    • Need to figure out what essays to be used in the industry and how to document them
    • If there is a need for comparison, how to actually compare them
    • Regarding medication, PTH can be controlled by 3 types of medication - 1) Spine (Vitamin D medication or VGRA vitamin D receptor antagonist, Hectoral, Zempral, Cynicalset)
    • DCI may already document these medications; they were submitted to EQRS at one point
    • Medication 2 - Cosimametix (generic - synacalsic); parsabef 
    • Medication 3 - phosphate binders; a very diverse type of medication
      • If decide to include phosphate binders into reporting in EQRS, need to figure out if people actually document them in the system
      • This is a medication that can be prescribed by nephrologist and primary care physicians
      • If they need to be documented, how will we document them because there is a huge variety of them
    • Per Nathan, agrees with Vlad and need to understand what is the intent of what the data will be used for
PI Feature UpdateYvette

Admission in support of Transplant questions (listen to recording at 30:11 - 47:31)

Nov 30 2021 EQRS System Demo Questions_Suggestions_010722.docx

Resources and References - EQRS Communications Hub - HCQIS Confluence (cms.gov)

If admission reason is New to ESRD (because first episode is transplant), can the Admit Reason be Dialysis in Support of Transplant?

  • This is not really related to the feature that we implemented in this PI, however, the rules for all of the admission reasons and discharge reasons is attached to that feature - admission and supportive transplant
  • The current rules did not change
  • Information has been posted on the public confluence page (see link above)

Can you you share the validation errors?

  • There are not any new validation errors for this feature, so the existing validation would apply here
  • Information has been posted on the public confluence page (see link above)
  • If there is a new election, how can there not be new validations?
    • The current validation rules for admissions for what admission can be after another, and what discharge can go after a reason, the validation is the same
    •  There are no new error codes
    • In this feature had to create a new discharge reason code
  • Rules are posted at the bottom of the feature page (see link above)

Will this data appear on the Patient Events report and in the patient population, and will there be an indicator that this is a temporary admission?

  • This feature uses the dialysis and supportive transplant admission reason and patients who have been admitted with that admission reason do appear on the patient events report
  • Patients who have been discharged with the new discharge reason do not appear on that report because there was no requirement to do so
    • If this is something needed, will need to speak to Lisa about getting it added

Which facility will trigger the 2746?

  • The 2746 form will be triggered by the facility who actually enters the death
  • There was no requirement to restrict that for this feature, to only the transplant facility
  • It will work like it does today, any facility that enters the death, the form will trigger
  • If somebody reports dialysis and supportive transplant, the system is designed so that it doesn't automatically discharge the patient from the transplant unit, right? Yes
  • If a dialysis facility enters a discharge reason of death, what is the transplant unit supposed to discharge the patient at?
    • This question will have to be answered by the Program (action item Lisa)
    • If the dialysis clinic puts in the death, does the system automatically do something for the transplant record or vice versa
      • Per Yvette, it will not automatically do anything for the transplant record today
      • If the Program says a specific Unit should put in the death, does it also then trigger an automatic action so that the other provider doesn't have to go in and do anything?

Are there limitations on the modalities that are related to the support of transplant admission? This could improve data quality, so they should be added.

  • Right now currently there are no limits on the modalities
  • Per Nathan, we should consider some secondary prompts, pop ups to the user

Change the verbiage of the label "Depression status" to "Screening status"

  • No answer at this time, Lisa still taking back to the Program
  • Shalon is working with someone  to review the questions

Change the verbiage to the history modal link from "Depressed patients details" to 'Submitted patient details"

  • No answer at this time, Lisa still taking back to the Program
  • Shalon is working with someone  to review the questions
EQRS Update Michael Kennedy

EQRS Tasks - Where are we today? (listen to recording at 47:36 - 1:00:15)

  • UNOS was deployed 1/6; updated in the schema, in the tables and is now in prod
    • The UI looks good, new fields are showing and no secondary records and sorts correctly
    • The extra fields - active status, candidate status (subgroup of active); descriptions have been added
    • From the system demo, iteration demos and working with stakeholders
      • Provided a description for the listing centers - added to backlog for an enhancement
      • Expanding that coverage tab and the waitlist to facilities and EDI users
    • Sent Janet Hutchinson the updated schemas, table that had new data added for the data feed and then subsequent patient matching in the actual waitlist
    • Michael and Olga matched an extra 100,000 patients (from 65-70% to over 90%)
    • Suggestion from Nathan to Dianna Christensen that this would be a great opportunity as the report is updated with the new fields and logic to go through a more collaborative process to discuss timing and planning so everyone is prepared
    • What kind of user interface?  Was there something new developed?
      • There were enhancements to the current UI that the networks can see
      • This will be available in the future
  • Claims problems
    • All of the erroneously processed claims cleaned up
    • No one was incorrectly terminated
    • A plan is in place to make sure moving forward the appropriate people are terminated or people are not terminated inappropriately and then to modernize that source so that those are processed correctly going forward
    • The production data is now clean
    • Question from Chris Brown - Are the claims in EQRS only fee for service claims or Medicare advantage information included?
      • Per Michael - it's not just fee for service
      • Some patients are MAPD, if they have the right HMO flag and being pulled in correctly
      • We do have the Part A and B and inpatient and outpatient
  • Clinical Data
    • Some of the reports received were very confusing after the October outage, log4j updates, etc
    • Actively cleaning up the data and scenarios; January of 2021 has been cleaned up
    • As soon as 2021 data is cleaned up, Michael will let everyone know
    • Once everything  is cleaned up, a report will be run to review any errors, etc in plenty of time to meet the end of February deadline
  • 2744 Reports back in progress
    • Plans to go out end of January, beginning of February
    • Providing the beginning of service; beginning of the survey period, the additions, the losses and the end of the survey period
    • Every 2744 will be able to see exactly the list of patients and what is causing those numbers to be in that bucket on the form
  • Corporate Role is back in progress
    • EDB lockdown is starting back in progress
    • Cleaning up the production data
    • The data that has been removed from on the NCC report will be added back
EDI Submitter's Progress (upcoming feature development)EDIs

DaVita

  • Vaccinations, data dictionary, feedback and planning -
    • Vaccinations are in a holding pattern right now for CMS, since it was agreed to begin/resume work in Q1
    • Data Dictionary will be reviewed when vaccinations work is picked back up and will incorporate Nathans feedback at that time
    • Nathan would like any support that can be given to the group in getting answers from the program side to the questions mentioned in previous email regarding vaccinations
  • Nathan brought to the groups attention the reporting of overall completion for 2021 data submissions and the error analysis
    • Per Scott, the reporting will be available starting next week from Dianna Christensen
    • This will cover the EDIs and the UI based facilities

FKC

  • Kathleen wanted a follow up on the last name "Null" issue
    • Per Yvette, the fix is planned to go out next week, possibly in the Thursday, 1/13 release

DCI

  • Michael was able to answer all the questions Vlad had

NRAA

  • Michael was able to answer all the questions Kelly had
GeneralScott

Action Items:

  • The 2746 form will be triggered by the facility who actually enters the death.  If a dialysis facility enters a discharge reason of death, what is the transplant unit supposed to discharge the patient at? Lisa Rees 
  • Request from Chris - display/capture EQRS rule updates or "hot-fix"/non major release dates that can be shared with the EDI Submitters that may impact their ability to correct/update patient data
    • Scott will research a way to be able to identify a feature that a rule update or "hot-fix" impacts, so the EDI Submitters are aware of the change Scott Laughlin
  • Question from Nathan - With the turn of year, it's also time for annual attestations
    • As part of the process the EDIs usually gets a weekly report of the status of the ICHCAPS attestations
    • This report has come from different contracting groups
    • Per Janet Lea Hutchinson - this is not something the NCC has provided
    • Per Scott - we will need to get back to Nathan on this Scott Laughlin
  • Request from Yvette to Nathan and Vlad to send an email to Lisa with what the proper wording should be for the questions they brought attention to in the meeting.  It will need to be approved by the program before Yvette can make any changes to the verbiage (Nathan and Vlad)
  • Scott will discuss revisiting the DaVita effective date and date of death issue with Lisa Scott Laughlin 



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