2023.06.14 EQRS Program Working Group Meeting

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. 

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PI23 Features that impact the EDIs

• Content for Public Portal
  • Business Objective/Description:

Content for Public Portal is a proof of concept that the new Content Management System can be used to host the content, training, updates, news from MyCROWNWeb site. The moving of content will take place in a future PI and there will be notification/communication about the move way in advance. Other types of helpful content will also be identified.

• • • A proof of concept 
    • EQRS has a content management system and will start bringing content over to the public portal

• Emergency Module: Development of MVP for KCER Community
  • Business Objective/Description:

Modernize and improve the process by which dialysis facilities, transplant centers, LDOs and networks share vital information in an emergency scenario in order to support the ability of CMS, Kidney Community Emergency Response (KCER), and the Networks to respond and support dialysis facilities and patients. 

Create a new modernized electronic process for collecting emergency situational status information that can be utilized not only by networks and LDO's but can also be submitted directly by individual facilities.  Collect additional information from affected entities when appropriate to aid in the emergency response and provide an aggregated report of the information collected that gives KCER, the networks and CMS a clear understanding of the situation on the ground without any need to copy and paste information from one place to another or to look for it in multiple places.

• • • Working on the MVP of the module to standardize what facilities were reporting to networks on the ESSRs and what some of LDOs were reporting

• Exploration Enabler: Role Consolidation - EQRS HARP Roles
  • Business Objective/Description:

Consolidate overlapping roles across Portal and QIP within EQRS. All roles necessary for appropriate UI access must exist in HARP/EQRS. Individual facility users, LDO's, CMS and its representatives need to have appropriate access to EQRS to have the ability of viewing data and reports, as well as have the ability to submit, review and finalize inquiries.

• • • Working on getting the roles consolidated across Portal and QIP to make it a little easier for the community
    • A working group will be established to gather feedback on which roles make sense to consolidate

• Exploration Enabler: Transplant: Communication and Managing Referrals
  • Business Objective/Description:

Improve documentation of the referral process between dialysis facilities and transplant centers to enhance response and prevent gaps in patient waitlist process for a transplant. Provides documentation and tracking of dialysis referral to a transplant center and the transplant centers' response as to if the patient was accepted to the transplant program or not along with the reasons for rejection and any testing necessary following acceptance.

• • • Worked on getting the editor role for transplant centers; getting a dashboard for the dialysis facilities so they can see information about their patients getting on the wait list
    • Also working on a similar dashboard for the transplant centers to be able to see information about their patients that was not getting communicated as well as it could have
    • These mentioned above should help to resolve some of the issues that were happening with patients thinking they were on the waitlist but really weren't or if a patient moves and the transplant center is now aware of
    • EQRS ADO is starting to do enabler work about the referral process
    • Hoping to resolve any communication issues within the process
    • Geraldine -
      • In EQRS under the Transplant list, are only those that fall under the categories of Active, Temporarily Inactive or Removed from the List, listed?
        • Per Chris Brown - only patients on the waitlist or have been removed from the waitlist are on the dashboard report
        • The ones being evaluated or expressed interest are not on the list because the data you see is coming from UNOS and UNOS doesn't know about the patients until they get on the waitlist
      • If a facility finds that the list is not correct, who are they supposed to contact in order to get the adjustment made?
        • Per Chris Brown - the transplant center because the transplant center is the one that enters that data into UNOS; data is fed to EQRS on a weekly basis, its not real time
      • Will the information in the transplant section eventually transition over to be in the individual patient information also?
        • Per Lisa - not sure there is a plan for that transition of information
      • If a patient is transplanted and is not listed in the clinic at all, will they still appear in that list even though they are not active in that facility anymore?
        • Per Chris, No, they have to be admitted to the facility to show on that list
      • Because we started entering patients who are in support of transplant to EQRS, would that patient show up on the list as being transplanted even though they are an active patient in that clinic right now receiving dialysis in support of transplant?
        • Per Chris, not sure but they would be admitted to that facility so he believes they probably would show up on that dashboard with being removed for transplant
        • Per Michael K, he will look into it.  The system treats those as transient treatments so they probably would not show up since we treat those as transient admissions until a resolution is determined
          • The dashboard treats dialysis and supportive and transplant admissions as a transient, so they should not show up as prevalent.  They shouldn't show up for those lists of patients
      • Lisa asked why Geraldine thinks it would be beneficial for the information that in the dashboard to eventually get a tide to the patient?
        • Per Geraldine, they have done some things in their own database in order to update the waitlist and that kind of information.  She was wondering if there were future plans in EQRS something being downloaded from the clinic level into a patient's chart about where they were at in their process of being evaluated
        • Per Lisa - we are seeing the information that comes from the transplant centers to UNOS and from UNOS to EQRS as the gold standard
          • There is no expectation for the facilities to enter anything about transplant or waitlist
          • We will be looking into the referral process; some of the information that the EDIs are collecting as the patient is going through referral prior to getting on the waitlist maybe something we are looking for the EDIs to enter in the future
• Updates to Form 2728
  • Business Objective/Description:

Update the 2728 form that is used to collect information about patient deaths. Update Form 2728 (ESRD Medicare Entitlement form) Section A-E UI and Batch functionality to support 2023 version of Form 2728

• • • Unfortunately, for a short period of time the new form went out on the website but it was not the correct form
    • It has been pulled back and the old form is up on the website
    • There is no timeframe when the new form will be out on the website
    • In the next Program Working Group call we will go over the new form
    • Kathleen would like to know if any documentation has been started such as the XSD, XML and timeline for the patient information?
      • Per Adrienne - that is being worked on for this PI; the goal is by the end of this PI to have enough documentation so the EDIs can get started with the XMLs, XSDs, etc.
      • When is the end of PI23?  It is 8/22/23
    • Leah Skrien  - manual data entry of the 2728 form would open around the same time as EDI?
      • Per Adrienne - Correct but to be clear - at the end of this PI the team will have the documentation needed for the EDIs to start coding on their side. Providing the documentation is not the same as the 2728 being live in production in the UI/ready to submit via EDSM. This will occur in early PI24. 
      • Chris Brown - Are there any steps that can be taken to prevent the possibility of the form being released and used either by hand, on paper, etc in the facilities before EQRS is ready to accept those new fields?
        • Per Lisa - unfortunately there is no way to prevent that
        • From a legal perspective, when OMB releases it, the facilities are expected to begin using the new version and not use the old version anymore
• Exploration Enabler - Identify and Propose EQRS Notifications and Alerts Options for CMS Consideration
  • Business Objective/Description:

This enabler will provide a Gap Analysis of what legacy systems used for data updates and discrepancy and how previous Notifications and Alerts modules in CW and REMIS provided reconciliation. This feature will also research and provide CMS recommendations on what possible changes between those systems and EQRS can use, or if there are other opportunities to get "notification-like" data on specific patient identity fields and other information that was previously used by the ESRD community.

Research the CROWNWeb Notifications and REMIS alerts to determine the data quality points that can be used for EQRS, what is no longer viable with one system, and where EQRS can utilize source of truth systems like EDB and UNOS to update data points automatically for ESRD patients.

• Accretions - Improve Mapping of Accretions to Facility and Network Action Lists
  • Business Objective/Description:

This feature will correct the ESRD Patient Registry Accretions process for CMS, ESRD Networks, and ESRD Facilities by correcting and enhancing the ability to properly map inbound ESRD and UNOS Accretions to the queue of the correct facility or network in EQRS vs. CMS. This will allow them to be reviewed and processed in the action list and worked by the appropriate people in a more efficient and timely manner. 

CMS will have the ADO create and implement facility crosswalk capabilities to map Hospital CCNs (xx00xx) to EQRS Transplant Facility CCNs (xx98xx) to correctly route accretions received from UNOS, EDB, and claims to the correct facility or network queue and reduce the number of accretions that are only visible in the CMS queue. An additional goal is to assist CMS in identifying a strategy for clean-up of the current CMS queue and provide suggestions and recommendations for ongoing management of the national CMS queue for accretions. 

Next meeting scheduled for: 28 Jun 2023