2023.09.06 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.  

https://www.zoomgov.com/rec/share/95gcJlmtFF11oL52w6MXgZ5z_dUs6QFnq-2pNST51lLcDp-Q6BojeZevXOwnpUKO.ga5ep-aHEH4gtIsA

Passcode: v7jum#b8 

PI24 Feature (EDI impacted) review:

Transplant: Communication and Managing Referrals Dashboard

Business Objective/Description:

• Improve the referral process between dialysis facilities and transplant centers to enhance response and prevent gaps in patient waitlist process for a transplant by utilizing a dashboard.

• 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.

• What will be documented?

  • Dialysis Centers:

    Is/was the patient actually referred to the TXP center (Doctors orders/RN referral)

    1.  Referral date to TXP center (and Name of Center)
    2.  Was the referral received by 
       a.    Fax
       b.    Phone
       c.    Electronic
       d.    Other
    3. Medical records sent (y/n)

    
    Transplant Centers:
    

    1.   Date TXP center acknowledged the referral
    2.  What is the date of the first appointment at the TXP Center
    3.  Outcome of the first appointment at TXP Center
       1. Patient accepted
          1. Testing
          2. Considerations for LRD, LURD, CAD 
       2. Patient rejected
          1. contraindications
             1. medications
             2. weight
             3. smoking
• Only basic work is planned to be done in PI24 (PI24 ends 11/21) 
  
  • There is no development work and no information gathering
  • It consists of only mockups of the screens
• Since this is a new data collection, Nathan requests for more details as they become available
  • DaVita needs to research what data is currently collected internally for transplant referrals so they will be able to send the correct information needed to EQRS
• Per Geraldine - Will the Program/EQRS receive any of the referral information from the transplant centers itself or is all this data coming from the facilities?
  • The transplant facilities will be entering whether they received the referral and their assessment of the individual - whether they were accepted or rejected and why/why not?
  • Will this information be a manual documentation, or will it come from the feed from UNOS that already exists?
    • Historically they have been told the UNOS feed is better, the source of truth 
    • Per Adrienne, we are still early in the PI and the team is just starting to work on this so she will try to get more information for this group
• Per Nathan - Is this going to be a new collection type, a new file or is going to be put into patient demographics?
  • Adrienne will reach out to the ADO and try to get answers to the questions

Portal Reporting: Vaccinations Report - PI24

Business Objective/Description:

• Create a new Quicksight dashboard available within the EQRS application for accessing detailed vaccination data. 
• TBD - workgroup meetings are schedule for gathering requirements.

Updates to 2728 Questions and Answers:

EDI Submitter Program Working Group Questions (as of June, 2023) 

• As far as the timeline, it will largely depend on when those forms are released from PRA
  • Due to no forms yet, there will be the appropriate time allotted for the transition/implementation
  • Question from previous meeting:  If someone already had a 2728 in the old version, would the system save it and be able to finish it in the new version?
    • Yes, that is the plan but once it converts to the new version of the form, you will no longer be able to start a new version of the old form
    • If there are incomplete 2728 forms in the old version, they will not be lost when switching to the new version
    • Per Leah - For supplemental 2728 forms, will those all go over to the new form or will those retain the old form version?
      • Per Adrienne, all the forms including supplemental 2728 forms
      • Per Leah, this may create a different workload for them
• Porsche is still working on the request to begin passing on the information to the community through announcements
  • It is being discussed but a decision has not been made on if they plan to do it or how they will

Updates to Peritonitis Questions and Answers:

• The Program is in talks with the CDC
• There are no updates at this time
• Question from Kathleen - Have the talks with the CDC included how the CDC will actually get the data from EQRS?
  • Yes, the CDC data needs are being discussed
  • Kathleen heard there was a concern on how the CDC will get the data
• Question from Geraldine - Because Peritonitis is up in the air right now, is Peritonitis not a mandatory submission or are they still to submit it even though there are a lot of questions around it?
  • The clinic should continue providing the information, but right now it is NOT being required because of the outstanding questions and clarifications needed around it
  • It's not mandatory for the LDOs to submit data, but the clinics should manually put it in so they can get used to entering this information
  • If there are questions about how it's being calculated or what's required, where should the questions be sent to make sure they are being addressed by the CDC?
    • The questions should not go to the CDC at this time
    • Porsche suggested Geraldine send their questions to her using the meeting invite so that we can capture all the questions

DaVita -

• Nathan was asking if it is possible to bring back the idea of sharing with the EDIs the following after a PI planning session:
  • • What was committed in the PI and presented to the EDIs
    • What was pushed out of uncommitted work into the potential bucket for the next PI
    • Long term Roadmap
  • It would be nice for the EDIs to know what is coming
  • What CMS/the Program is considering
  • Where the backlog items stand
• Porsche will see what she can provide

FMC -

• Kathleen asked if the Program/CMS is open to receiving enhancements suggestions for the system from the EDIs and getting them prioritized and added to a PI?
  • Per Porsche, they do accept enhancements however the Program prioritizes enhancements based on their own set of criteria
  • EDIs are free to suggest enhancements but the prioritization would be handled by the Program internally
  • Suggested enhancements can be sent to: qnetsupport-esrd@cms.hhs.gov

DCI -

• Geraldine asked - Last year the ICD-10 codes were updated (Causes of renal failure) but they were not updated in EQRS
  • Some insurance companies would not pay because they felt the code(s) was not one of the new codes  
  • With October 1st coming up and ICD-10 codes will be updated again -
    • How do we make sure these codes are updates in EQRS? 
    • Per Michael Kennedy, ICD-10 codes that are on the 2728 are only in the system for the 2728 for the onboarding.  We don't track them in any other place
    • The ICD-10 codes are specific to the 2728.  They do it to match the 2728 specifically for the research purposes and the breakdowns (enrollment and entitlement and ssa).  If you need a something specific for insurance and claim purposes, you can do whatever you want

RHA

US Renal 

Next meeting scheduled for: 04 Oct 2023  

Program Working Group Call - changing to monthly cadence.

• The reason for the adjustment to a monthly meeting is to give the Program more time to research and get answers to EDI questions. The Program relies on other teams/groups to get answers and it takes time to hear back from these groups 
• The next meeting will be on Wednesday, 10/4. Moving forward it will be the first Wednesday of each month 
• Arnie will update and send out the meeting invite series