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.
Does PD suspension require a modality switch? (Recording jump to 01:51 - 03:28)
In general, the answer is Yes. However, there are occasional patients with enough “endogenous residual function” that may be able to sustain a period of no dialysis. The same is true on hemodialysis.
EQRS Feature Updates/Discussion
Porsche
What’s the minimum timeframe to be considered “suspended” where there is no modality change? (Recording jump to 03:29 - 09:11)
There is no defined period for this outcome. However, in previous discussions it was determined that if the patient was not back on PD by day 50 after the diagnosis of peritonitis, it would be considered a modality change.
The EDIs have a meeting with the CDC and Porsche suggest this be brought up at the next meeting. It may take some time before Porsche can get an answer from the CDC
EQRS Feature Updates/Discussion
Porsche/Nathan
2728 Formatting (Recording jump to 09:12 - 31:47)
2728 timeline and email
Has the 2728 timeline shifted?
Per Porsche, the timeline as of now has not shifted; let look 30 days out
Nathan mentioned it is disappointing to here because as mentioned with the race and ethnicity stuff, they cannot do any of the coding
Formatting updates/print limitations
Formatting updates are in progress
Per Nathan, there are opportunities to enhance the accuracy of the form; he suggests the whole document be reviewed for consistency (field numbers, verbiage, etc)
Nathan pointed out that in order to print, the user has to put in a patient signature date even when you just save
This may be an issue. The validation on Save may need to be removed. Anitha will look into this (Action Item Anitha)
Nathan's printed version is not selecting the race today. Is it because the new options are not in prod preview? He can select race but when go to print it, it is not selected
Per Anitha, this is because the new options are not applied yet. This will be addressed when race changes are implemented 2 weeks before go live; if the changes are put in prod preview before, it would break all the other submissions
Geraldine noticed some causes that are not on the new 2728 form, specifically the acute renal failure. Also noticed two new ones that were added; one of them not in it's complete ICD code form
Were these meant to be left out on purpose?
Per Anitha she will talk to Geraldine offline and review the discrepancies (Action Item Anitha)
Updated Technical Documents
An email was sent out earlier today (3/6) withe the updated technical documents
Race and Ethnicity update decisions/clarifications
Race and Ethnicity updates for the new 2728 are not in place yet because it will cause the current production data to break
The Race and Ethnicity will be the last thing they will implement before going live
Goal is to complete all the user testing for all of the 2728 changes except the race and ethnicity
2 weeks before user testing is supposed to complete, EQRS will deliver the race and ethnicity changes and then EDIs can test in prod preview
Until EQRS tells the EDIs the options, the EDIs cannot do anything
DaVita needs time to go through requirements, legal, compliance review, develop and test
Per Porsche the options are not changing. The options are as they are on the form
Nathan - there are 12 new options, and they cannot do any coding if they don't know the codes
Adrienne will make sure the EDIs have the correct documentation the EDIs need to move forward (Action Item Adrienne)
The ADO will have the race/ethnicity documentation by April 9th.
Question from Geraldine - originally only the Federal Registered tribes were listed. That was going to change and include the State Registered tribes. Has that happened?
Per Michael Kennedy - This is under review. Need to look at the Federal and State list to see what is currently in EQRS
Leah Skrien - When looking at the enrolled principal tribe and country boxes that open, the CMS instructions say that if they select native Hawaiian or other Pacific Islander to complete the name of the enrolled principal tribe. Historically it has been to fill out the country for that question.
This needs to be taken into account when the logic is being built
Per Anitha, the new 2728 will have whatever the mapping that the 2023 version of the 2728 is requiring
Leah Skrien - Nephrologist Signature question - There is an extension for the nephrologist being able to sign the form that it's supposed to be signed within 45 days. If they have transferred it's extended to 75 days. Is CMS going to provide during training, some clarification around this as far as what this means as far as overall due date for the form? What happens if it is out of 45 days? Porsche will take back to the team (Action Item Porsche)
ProdPreview emergency downtime and relationship to Prod
Why have there been no emergency downtimes in Production but there have been a number in Prod Preview?
The changes needed for Prod Preview were not required for Production
Adrienne will work with the team on the language used in the communications sent out to the user community to minimize any confusion
2744 Fix Status
Per Michael, they fixed the other discontinue issue
There is still on scenario he is looking into with the counts
Geraldine will send Michael an example where it is not counting
EQRS Feature Updates/Discussion
Porsche/Adrienne
Features selected for PI26:
CMS 2728 #17 Primary Cause of Renal Failure – dropdown function (Recording jump to 31:48 - 32:57)
Request to have a drop-down function to select the exact cause
The drop down shows the cause but not the code
Both the cause and code will be added together to the drop down
EQRS capability for facilities to download their DFCC preview period reports each quarter (Recording jump to 33:02 - 34:13)
EQRS team will create functionality within EQRS for facilities to download their DFCC preview period reports each quarter.
Is DFCC different than the patient lists?
DFCC and Patient lists are separate
Now the team is working on the preview period report
Exploration Enabler: Capture the Nursing Home Start Date & End Date to populate within EQRS (Recording jump to 34:20 - 36:42)
The Nursing Home Start Date is currently an optional field that is updated via UI or EDSM. The Nursing Home Start Date and End Date will become required fields in EQRS. This data is needed as a requirement on the Network contract. A data source needs to be identified and validated. When available this data will be stored in EQRS and will be locked down meaning that the fields are not editable. If the data is not available for a patient, then the fields will be editable via the UI and EDSM. There needs to be the ability to store historical Nursing Home Start and End Dates for the patient but only the most recent dates need to be displayed via the UI.
Geraldine request - for the nursing home part if they could give them a bit of a description because there are many different places where patients stay; they need to know whether its a nursing home or a long-term care facility (Action Item Porsche)
Expanding the description of what they are considering to be nursing home would be helpful
EQRS is doing research this PI to see if they can find a source for the data
Nothing is being implemented at the moment this is an enabler for PI26
Form 2728 Updates - Downstream Changes and Mappings(Recording jump to 36:55 - 40:40)
Update column names and mappings for legacy data in support of updates made for the 2023 version of ESRD forms.
The column names are updates that need to be done internally; no impact to the EDIs
Modify relevant labels and fields (e.g. change "Gender" to "Sex at Birth") in the downstream reports and data warehouse outputs of EQRS to reflect the latest changes to the 2023 versions of ESRD forms and re-map race/ethnicity designations in support of form updates to ensure that legacy ESRD data displays correctly in the updated interface and for reporting purposes.
These are backend/behind the scenes updates needed to be done
Geraldine asked - If the 2728s were started but not submitted prior to May 6th, they would still be able to complete the old version? Anything after that would always be the new version
Per Anitha the answer is Yes
Manage Access and My Profile Redesign (Recording jump to 40:43 - 43:25)
TheManage Accesspages(My Applications | My Access | Request Access (with tool tips) | Pending Requests | Manage User List), along with theProfile Information pageare used by all of our EQRS customers.
Based on previousdiscovery researchconducted by the QIP HCD team in 2021 and unsolicited feedback received from the user community, there's an opportunity to improve the User Experience of the tasks performed in these areas, such as:
requesting roles and managing one's own access
as an SO, managing other users, their roles, and requests
viewing/maintaining profile information
This could entail:
adding helpful descriptions or instructions to provide users more context and guidance
redesigning entire flows to be more seamless and intuitive
restructuring the layout of these pages to be more user-friendly and appealing
Note: This HCD enabler could require a phased approach, as each page of the Manage Access section of EQRS is used for a variety of tasks by various users and would require multiple interview and testing plans for the different user types.
The goal of this feature is for every role to have some sort of landing page/dashboard making it more user friendly when entering the application
Personnel Module Redesign (Recording jump to 43:26 - 44:27)
The Personnel module is a section of EQRS where users at dialysis facilities can add/remove staff that work at their organization and add/update/remove roles and additional details.
Currently, most users are not updating or using this information because they have no personal need for it and/or do not understand the business requirements for their responsibility of keeping this information up to date. Moreover, the UX/UI of the current version is unclear and confusing to use.
Currently, a user lands on the My Access page upon signing into EQRS. The HCD team identified a need for a true homepage experience that can serve as the launching point for users to complete their tasks and as a source of up-to-date information and alerts.
The proposed solution is to have EQRS and QIP users land on a "personalized" homepage relevant to the selected org and respective roles/purview.
Currently, a user must initiate a blind search with many search criteria options and cannot filter the search results to drill down. The new method of viewing and finding patient record(s) will provide users a full list of active patients upon entering the "Patients" page. Users can then filter by name, SSN, facility, MBI, DOB, etc. to drill down on the patient(s) they need to find. The new list would also have additional columns of data that are useful for users (active/inactive, facility they are admitted to, etc.)
Geraldine suggests that it would be nice to be able to just type in the UPI number for the patient search instead of having to go in and physically having to add all the details of that patient again
Adrienne will pass this suggestion off to Lizzie. (Action Item Adrienne)
After discussion with the team, this suggestion will not be added to the backlog at this time (3/8)
Reports: Vascular Access Report (Recording jump to 46:44 - 47:06)
Facility dialysis providers and Dialysis corporations use vascular access data for a number of patient care initiatives and quality improvement in their facility and corporation. ESRD Network organizations use vascular access data as part of their mission in the Social Security Act to maintain the patient registry and ensure a standard of care in the ESRD Program. The implementation of vascular access reporting and dashboards in the EQRS system will allow the users at the scope and role to perform the tasks necessary for their initiatives. This is not a QIP report, and will not mimic the algorithm or outcomes, but a real-time view into the facility, state, Network and national numbers to see which patients have which type of vascular access.
Role Consolidation: Deprecate Unnecessary Roles (Recording jump to 47:07 - 51:58)
Address and deprecate unnecessary roles in EQRS and QIP.
Consolidate overlapping/duplicative roles across Portal and QIP within EQRS. Individual facility users, LDO's, CMS and its representatives need to have appropriate access to EQRS to have the ability to view data and reports, as well as have the ability to submit, review and finalize inquiries.
Question from Nathan - Should they wait until all of the role consolidation is done before they try to proceed with any mass removal of all their roles?
Adrienne suggested to move forward with what the EDIs intended
Nathan mentioned they were waiting for EQRS on mass removal of roles
It was being tested using Kathleen's roles or was that put on hold?
Adrienne will take this back to the EQRS team for more information. She is asking for a few weeks to get an answer
This particular task is still on the backlog. The goal is to prioritize this work for PI27.
For the consolidation, Nathan suggested to make sure now that we are adding DFCC to the system to include the roles functionalities when assessing need consolidation roles, management, etc
Geraldine - She and Vlad were not able to make the last role call. Is there going to be a follow up?
It has to do with consolidation of the roles in EQRS when you go in and put personnel in
Adrienne will have Yvette reach out to Geraldine to discuss (Action Item Adrienne)
Open Forum
EDIs
DaVita -(Recording jump to 55:39 - 58:55)
Nathan has a ticket open that is being looked into. Since last week he has been getting emails that look like EQRS role requests and appear to be fake
Janet Hutchinson mentioned she gets the same type of emails when someone is needing a new or different role in pre prod
These are pre prod roles being created for testing in lower environments
Michael will have them take out Nathan's email so he won't get those type of emails anymore
FMC
DCI - (Recording jump to 52:13 - 53:55)
Geraldine - Would they consider adding a new end for an admission for suspended?
Porsche will take this back to her team internally. (Action Item Porsche)
RHA
US Renal
Innovative Renal Care
Administrative Reminders
Porsche
If any Production issues are encountered, please submit a Helpdesk ticket. This will allow the EQRS team to better track the issue and progress.
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)
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