2022.03.11 EQRS EDI Touchpoint Status 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://us06web.zoom.us/rec/share/rEN_aKo17DC98y4ggq54FJH0Eczj3YnE6rNvBKrWPByVMwZHWJYyqMV46KRDmB6v.j6x6OOpn6_Cx4seR Passcode: rh7h$qb1 

2021 Data Submission Error Trend report status

Recording for this discussion: 1:00 - 12:13 

• The EDIs would like to have the report sent to them on Friday's even if it's not the close of the month
• For Clinical Compliance, the report was run for last weekend and there is great progress; 2021 numbers are looking better
• In the upper 90 percentile for the whole country

Admissions and Discharges status

• While we knew EDSM could strip away a discharge, it looked like in the UI people could do the same
• Michael tested it and there are scenarios that should not be allowed to occur
• These scenarios have been possible since go-live
• Michael's team is working on the fix now and any data related issues
  • More than one open admit
  • Overlapping admit dates was possible
  • Reasons for admit and discharge was not required
• Question from Leah - when looking at the potential fix would it be to prevent them from being able to do that or would it be to insert the system discharge?
  • Per Michael, it would be to prevent that going forward
  • A partial fix went in last night, 3/10
• Extracts for QIP and 5 Star have not been run yet due to the extension.  The fix will be in place before the extract is run again
• There will be no rework or need to regenerate the 2744s for those that are balanced and correct

UNOS update

• Michael will have Olga start this weekend and truncate the UNOS waitlist table and then repopulate it with the data feed so that it removed those weird records and then it should show some improvement
• Since it is being run over the weekend (Friday and Saturday), you may not see UNOS waitlist data while it is being recreated from the current database

Prod Preview User Role update

Recording for this discussion: 12:18 - 15:08 

• Turns out there was an EQRS system issue in the prod preview environment for a few users that has lost their access to prod preview
• Scenario: If you do not log into prod preview for 60 days your user roles will be removed
• Under normal circumstances the EQRS system would start sending the user emails reminding them to login starting at 50 days, 52 days, etc
• Everyone's email address in prod preview had an issue with them so if you did not receive an email you were affected by this issue
• As a result, if you lost your access to prod preview during this time, EQRS will get your access back to you
• A resolution will be done on the backend, giving access back to those who lost their access
• Let Scott or Michael know if your access has been revoked
• EQRS is planning is planning on doing the correction at the beginning of PI18 (~mid April) aligning with the schedule for the vaccinations module

Vaccinations

Recording for this discussion: 15:32 - 28:23

• User Guide Feedback
  • The Vaccination User Guide was sent out via email last week
  • Hayley is open to any feedback from the EDIs
  • Question from Steve Goodman - When will the data dictionary be updated?
    • Per Yvette, the XSD, data dictionary, data mapping, etc will be provided around 4/12 
  • Question from Nathan/Kathleen - If a patient receives the flu vaccine at DaVita, they administer it, and then they transferred to FKC and they tell the FKC clinic they got their flu vaccine at DaVita, do both clinics report it?
    • Per Yvette, when DaVita reports the vaccine information and that patient is transferred to FKC, for example, FKC would be able to see that vaccine information in the system, it will not be hidden from FKC 
    • FKC would be able to see that DaVita reported the vaccine and it was given on a certain date
    • If the patient gives FKC the information, for example, the patient tells FKC they already received the vaccine on X date, it's going to overlap the vaccine information unless FKC is reporting a different date, then it will add the vaccine information
    • If it is the same date and same vaccine, it will override, similar to the patient attributes information
    • Kathleen pointed out this seems problematic, if flu is something being measured, because DaVita would lose their credit for having administered the vaccine and it goes to FKC who didn't administer the vaccine but who recorded it
    • Per Yvette there were no requirements for this module to capture who reported the information. What they wanted to do was to make sure the patients were getting vaccines and to be able to capture that data
    • EQRS does not capture if the information came from DaVita or FKC (in the example above)
    • Per Vlad, one way to deal with this is to give the EDIs visibility, receive a weekly report with all vaccinations for active DCI patients
      • Per Yvette, reports are coming at a later module
      • Per Nathan, long term is to get access to the CDR so reporting is not an issue. Data will be available and EDIs can choose how to use it; it would be nice to have vaccination data available to the EDIs and not have to rely on a third party to send it to the EDIs
    • Regarding the example above and override of the vaccine information, Nathan asked if the dates need to be exact? 
      • For example, a patient says they received it on 1/1 but the clinic comes and says they got it the 1st week in January and the FKC person types in the 3rd of January
      • Yvette thinks it will add the new date, but needs to verify (Action Item)

Data Migration

Recording for this discussion: 29:17 - 38:51

• Currently, vaccination data comes in through the clinical module every month and there is no way to go into the clinical module and request to see all of the vaccination data for patient X.  
• You would need to go into the Manage Patient Clinical Values page and select the clinical month to review then search for a particular patient, then go down to the vaccination section to see what they received, then change the month to see what was entered for a particular month
• In the Clinical module there is no way to see the patient X received 3 pneumococcal vaccines within X period
• In the new vaccination module, you can see a full list of every vaccine that the patient had over a period of time
• In relation to the migration - The plan is to still migrate the latest vaccination data for a patient 
  • When the migration is done, any data that is currently in clinical will remain
  • The user would still be able to go back into the Clinical module and see the data for previous months prior to going live
  • Data would still exist from the beginning of time
  • Per Janet (NCC) the problem is that the PPSV23 vaccination is required 3 times in a patients lifespan; 1 and then a booster 5 years later and then again after age 65 if they were not over 65 when they got one of the previous ones
  • That's a problem b/c it won't be trackable unless it's captured somewhere and the facilities, the patients, the network's won't see that information; they won't be able to look it up any better after the vaccination module then they can now
  • Per Yvette, today, any of the past data you can't do it today.  You still can't come in the Clinical module and see.  Going forward, you will be able to but there's not a good way to be able to migrate that information without having it just be a mess; there would be duplicate information 
  • Nathan has concerns the data will not be usable until we get through 2023
    • Per Janet, for the pneumococcal PPSV23, the data until those boosters and over 65 get entered, it's not going to be able to be used with the QIA so that's going to have to get redesigned and that will be up to CMS 

Let the group know whether the Vaccinations User Guide was enough for your teams to get started with understanding your timeline for readiness? Provide a rough timeline when you think you will be ready.

DaVita

• Per Nathan, the Vaccination Users Guide is a good starting point but having the data dictionary, XML examples, XSD is really what they need to finalize and what they coded is the right behavior, error codes, etc
• DaVita thinks they can get started with creating requirements, it's still hard to finalize development
• If the data dictionary, xml examples, XSD won't be available until mid April, DaVita is looking at a June/July timeframe for testing

FKC

• Kathleen echo's what Nathan mentioned above.  The Vaccination Users Guide gives them an idea, but not really a concrete pathway
• A more deep dive and conversations with the IT team are needed to get a solid timeline

DCI

• DCI has practically all the data that EQRS requires already collecting in their system with the exception of  severe adverse reaction that needs to be tightened up
• A June/July timeframe will be reasonable for DCI
• Question from Vlad - If a patient comes in and this week we give them both flu and pneumonia vaccine, how would they be submitted?
  • Per Yvette, you would be able to submit both for the patient (pneumonia and flu)
  • Nathan asked how is the xml structured?
    • Per Yvette, we don't have an xml at this time
    • But the plan is for the user to be able to submit multiple vaccines in your file
    • Question from Howard - Does it mean there would be multiple vaccinations on a single clinical record for that patient?
      • Per Yvette, on a single vaccine, yes; for example, you would have the patient information and then multiple vaccine records

NRAA

• Howard has similar thoughts to what Nathan mentioned
• A June/July timeframe is tentatively reasonable for NRAA; closer to July given the number of systems NRAA has to deal with
• NRAA has not done details requirements development yet; getting the XML examples will help to talk to their developers

• The public EDI website (confluence page) has been redesigned for better organization and access to EDI documentation/information.  Links below:
  • Electronic Data Interface Submitters
  • EQRS and EDI Development Alignment Process
• REMINDER: For any issues encountered, send an email to the help desk using the following email address:  qnetsupport-esrd@hcqis.org with "URGENT" in front of subject line for urgent matters
• CCSQ Support Central - https://cmsqualitysupport.servicenowservices.com/ccsq_support_central
• EDI Data Submission records that are outstanding - EDI 2021 Data Submissions
• Independent 2021 Data Submission records that are outstanding - Independent 2021 Data Submissions