2024.1.10 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.

Program Working Group Meeting Recording 01102024.mp4

Status on:

2728 rollout (Jump to recording 03:42 - 34:13 for more details)

• The Program Working Group call meeting series has been updated to be every two weeks for the remainder of Q1
• This will help to facilitate a smooth rollout for all parties involved
• The EQRS ECOT has a communication plan that is currently with leadership for approval
• Release of some of the communications to take place soon; starting with the news flash to give the community a heads up about all the changes that will take place as a result of the updated 2728 form
• It is just to bring awareness the updates to the new 2728 form have been approved but it does not imply EQRS is ready to implement at the time.  
• Anitha (Product Owner for 2728 updates) Prod Preview Timeline
  • This is a high-level rough estimate only
  • Deliver documentation (WSDs, Sample XML and validations - 1/22/24
  • Deploy 2728 changes to Prod Preview - week of 1/22/24
  • Users can perform testing in Prod Preview - 1/29/24
  • Race changes - won't take place until go-live (first 2 weeks in April they will be deployed to Prod Preview for User to perform testing)
  • One week to fix any issues encountered during testing of race changes
  • Go-live sometime in early May
  • Go-Live includes everything: new form, new race, ethnicity, gender, pronouns
  • Nathan raised the question -
    • EQRS thinks the concerns they raised of having to update all of their systems the industry assessment that was shared that shows the vast majority of the industry doesn't collect the vast majority of this new information, can all be done in less than 4 months?
    • Porsche - What we are doing is starting with the standard 3 months' timeline
    • The ask is to work as diligently as possible to get close to this timeline
    • We can look at opportunities to extend the timeline
  • Nathan has expressed that he cannot get their internal systems updated in 3 months; they follow a software lifecycle and need to look at planning, requirements, development, QA and testing which can take months and months in advance
  • Mitzi - Did DaVita not set aside capacity to do it and now you have to wait until you can block off periods of time for capacity? 
    • Does it take DaVita that long to make their coding changes and test them and get them out appropriately?
    • Nathan does not control the system so when certain changes (for example, Gender Identity and pronouns) are asked to be changed/updated, it has to go through a process along with all the other "asks".  They get weighed and prioritized with all the other "asks".
  • Kathleen pointed out that the 2728 form was not finalized. They did not know what was coming until 11/30.  Kathleen did not want to have resources begin work on something that may be useless. Also be a part of nurses and clinician's workflow that had not point.  She did let the entire organization know the 2728 changes will be coming
  • One thing that was not discussed at all is how did this affect patient demographic files? Concerns were raised how some of the new fields would be out into that file
  • Porsche mentioned we moved to have the Program Call meetings more frequently so issues and concerns can be address sooner.
    • Right now, we are not even at the documentation piece
    • Everyone should discuss with their teams the updates and begin the work as needed
    • Let's get from January through March and as it gets closer to April 1, discuss the flexibility and timeline then
  • EQRS can share on 1/22 documentation on how the 2728 updates will impact patient demographics
    • The team is finishing up the work and want to make sure the documentation is complete
    • Nathan pointed out that the 2728 updates are getting a lot of attention across all of DaVita's companies
      • But they can't do what EQRS/CMS wants them to do until they get complete documentation on 1/22
  • Vlad suggested in order to eliminate some stress is to make the new fields optional
    • This is a discussion to be done as it gets closer to Go-Live
    • It would help to have a prioritized list of what were drop dead items vs things that there may be flexibility on for a longer period of time
  • With the documentation coming out on 1/22, EDIs should review the documentation and bring their concerns and issues to the 1/24 Program Working Group meeting
  • Question from Nathan - With the technical documentation, instead of having just the fields updated or added, can it actually be a review of the existing documentation? Historically, fields may be added/updated but the existing fields that were not changed are not reviewed again.
    • EQRS will make sure the EDIs have completed and updated documentation on 1/22.  Any questions from the documentation can be discussed at the 1/24 Program Working Group call

DaVita (Jump to recording 40:15 - 53:38 for more details)

• • Patient DFCC files 
    • Is there any plan to put facility level files in there or would they still get those through dialysisdata.org
      • Per Adrienne - for now it will remain the same, but it is on the EQRS backlog to put the facility level files in there too. We'll see if it is picked up in PI26
  • Peritonitis Update?
    • Per Porsche - it is still being discussed
  • Tribe updates status?
    • Per Michael - he has been working with Nancy and Olga; the final list will be taken to the workgroup for final approval
  • CKCC folks that oversee that program for DaVita have been struggling to get data, the patient level files
    • There have been discussions with CMII about this; they are trying to understand what patients are included, what data points, etc
    • What keeps coming up is EQRS and a connection with getting the data from there
    • Is there anything the Program can share? Have they been hearing anything about this?
      • Porsche has not heard anything about EQRS and CKCC
      • Per Mitzi, the Program did get a request from CMMI folks to have access to EQRS in order to generate patient lists
    • Vlad/Nathan mentioned patients who didn't start at DaVita, we can't see their 2728 data to know if it was optimal start or what it should have been, who's included in that measure, data points, etc
    • Mitzi will look back in her: history of related conversations and discuss with Porsche next steps
  • Has there been any discussions of all the existing fields among the features/modules in EQRS and their usefulness and need to continue to exist? Because DaVita rarely has ever removed anything from EQRS
    • Per Porsche - This is something we can look into such as performing a field audit or requirements audit

FMC (Jump to recording 53:41 - 54:51 for more details)

• • Obviously, we are still waiting for the finalization of the 2746; after today's discussion and input on the 2728 updates, we still need to keep in mind the same effort and timeline will be needed for the 2746 as well
  • Kathleen opened a ticket back in November and has not had any work done on the ticket.  Who can Kathleen reach out to?  
    • Send the ticket number to Michael and he will look into it

DCI (Jump to recording 34:14 - 39:59 for more details)

• • Telehealth visits - 
    • The network wanted DCI to modify some records in EQRS and make them telehealth visits for their home patients, but the visit was not telehealth and the physician was not telehealth
    • The network sent Geraldine information on a telehealth visit on a completely different date than their home visit which wasn't with their physician
    • Is it just general telehealth visits the patient might have had with a family doctor because the nephrologists was physically in the clinic when we did our visit, so they asked the clinic not to modify the EQRS record
    • Geraldine is inquiring about this telehealth visit information that the network is receiving
      • Per Janet Hutchinson - the specific codes for claims data would be included in the telemedicine documentation and in the spec document for that quality improvement project
      • EDIs have never been told there's an expectation that is a patient had a telehealth visit that we know nothing about and gets build through Medicare and it comes up on a claim that we have a responsibility to enter into EQRS
      • This is a CMS decision
      • Porsche request Geraldine to send her a right up of the issue and she will work with the COR to get this resolved

RHA 

US Renal 

Innovative Renal Care (Jump to recording 55:30 - 58:24 for more details)

• • Laura - Is the MedRec Yes/No update in place yet?
    • It went in effect with the January 2024 Clinical Month
    • The MedRec question is required all the time.  If the answer is "Yes" then the other 3 fields are also required (date, clinician type and the name)
    • If sent for any 2023 data, it will error
    • Only in effect for January 2024
    • December and November 2023 files should not include that MedRec question

Administrative Reminders

• If any Production issues are encountered, please submit a Helpdesk ticket.  This will allow the EQRS team to better track the issue and progress.
  • Service Center: 866-288-8912 or qnetsupport-esrd@cms.hhs.gov. 
• CMS will refresh data in the EQRS Prod Preview environment on the first Sunday of every month. The planned schedule is below.

• • Sun, 03 Dec 2023
  • Sun, 07 Jan 2024
  • Sun, 04 Feb 2024
  • Sun, 03 Mar 2024
  • Sun, 07 Apr 2024
  • Sun, 05 May 2024
  • Sun, 02 Jun 2024
  • Sun, 07 Jul 2024
  • Sun, 04 Aug 2024
  • Sun, 01 Sep 2024

• • If there are any issues with the scheduled date(s) please notify the team by the Friday before that Sunday when the refresh of data is scheduled to take place
  • If there are any issues encountered with the refresh on Sunday, it will be moved to Monday (next day)

• Next meeting scheduled for: 24 Jan 2024  

• The Program has decided to change the frequency of the Program Working Group meeting from a monthly call, back to a bi-weekly call during the implementation of the 2728 updates (January – March 2024).  This will allow the EDIs to be more engaged, more aware of the progress and to provide their feedback during the 2728 updates.