2023.03.22 EQRS Program Working Group Meeting

 Ticket CS1737244 – Resolved – Enhancement Request: EQRS Warning Messages (recording 13:22 - 20:04) 

• Nathan asking for clarification: The ticket below was opened and I found the response very odd. It seems to me like this wasn’t even added to the EQRS Backlog, which is the response I expected. When I sent the ticket, I did not expect this would be a high priority. I did expect though it would be added as a backlog item since updating the verbiage seems like low hanging fruit.  Any details you can share on if the backlog process has changed or there are new criteria for recommendations being added to the backlog.
  • Per Lisa: I thought this was agreed to when the EDI physicians’ set the ranges. I could have sworn we used this verbiage because it was recommended. I thought it was normal, valid, out of range. We were trying to have ranges that were valid for dialysis patients that might not have normal values, but also have values that no one should ever have. 
• Ticket information: The following warning messages need their description updated to align with the new Updated Warning Ranges. I'd also recommend the verbiage be updated to clarify it is outside the warning range. Calling the range "valid" can be misleading since there are many valid values that are outside the warning range. Warning ID Current Warning Description Updated Warning Range 12502 Kt/V is not in the valid range (0.50 - 2.50). 1-3 12602 Kt/V is not in the valid range (0.50 - 6.00). 1-3 12330 Serum Albumin is not in the valid range (1.00 - 5.50) 2.5-5.5 12528 Post-Dialysis Weight is not in the valid range (32.0 - 318.0). 70-700 lbs or 32-318 kg 12533 Height is not in the valid range (48.0 - 82.0 in or 122.0 - 208.0 cm) 36.0 - 82.0 in or 91.0 - 208.0 cm 12320 Uncorrected Calcium is not in the valid range (0.1 - 20.0). 5-15 I'd also request it is validated EQRS is triggering off the new warning range for each of these and not the old one that is still in the message description.

  • Nathan's request was not to change the ranges themselves or any coding. It is to update the verbiage of the existing Error/Warning messages, so they are more aligned with the ranges that were implemented. Recommendation to standardize the verbiage

  • Nathan is not questioning the naming of the valid ranges or change the ranges or add any logic
  • Per Nathan, this request is not a super high priority
  • The EQRS HCD team may be looking at doing some work making sure there is some consistency across the system; could be something they could put on their backlog
  • Lisa will take this back to the HCD team to make sure the warnings are consistent with the ranges that are set up and come up with some verbiage that would be consistent and acceptable across all of them (Action Item Lisa)

DaVita

• Vaccination Data - Has the data transformation of the historical data happened?
  • More information is coming but the transformation is being targeted to happen next Monday, 3/27 6pm to 6am
  • Lisa is asking to hold off on pushing any vaccination data into the system during this timeframe
• Depression Screening module - Is it still the case where it just listed all patients and didn't apply any exclusions?
  • Will the Depression module only be asking for results for patients that are over the age of 12 and have been there for more than 90 days? (those type of major exclusions)
  • Per Lisa, the current depression module is based more on QIP needs.  She will need to ask Ahmar to understand what the expected behavior is. (Action Item Lisa)
  • Nathan is trying to understand what to expect in that module from a patient reporting perspective; they have some clinics that have reached out to DaVita with some concerns
• Nathan asked if Lisa is planning on sharing with the group what came out of the PI22 Planning session?
  • Lisa will see about getting something together to share with the group at the next meeting

FKC

• Kathleen has questions about the Peritonitis requirements regarding what is being asked; she will put them together and send over to EQRS (Action Item Kathleen Complete 3/30.  Lisa answered Kathleens questions))
• Question about Accretions in EQRS - Kathleen has been told there is something wrong with Accretions and it's on the backlog to be addressed but would like to raise it as a high priority
  • It is not allowing them either admit patients correctly or submit clinical data correctly
  • They are getting a lot of near match errors that don't make sense because the existing record matches exactly with what they have in their internal system
  • Also getting error code 20,002 and its an exact match error; prevents admissions and clinical data submissions
  • She confirmed with Nancy, Accretions are causing problems with the transplant data/the wait listed data - becoming a growing problem
  • Lisa is not aware of any issues with transplant.  She will go back and talk to Nancy and discuss the issue; they will see if they can change the priority for one of the upcoming PIs
  • Kathleen will provide information as needed

DCI

• Geraldine - Peritonitis - Is there an accommodation for Peritonitis without a culture result at all?
  • Per Vlad - based on the documentation, "yes".
    • There is a question: "Did the patient have PD Effluent culture? Answer "yes" or "no"
    • If "no" you do not need to add any culture information
• Geraldine - Vlad ran some queries for them and what they found when they downloaded the discharge date and reason and the reason is "death", it closes the admission in EQRS but it doesn't trigger a 2746
  • It's not on the dashboard; the clinic is not aware that they have to complete it
  • They are told the workaround is to remove the end date and end admission of death; go into the intial demographic screen add it there and that will trigger the 2746
    • DCI's facilities do not enter the death information in because its already downloaded that the admission is ended in death
    • They have had a bunch of 2746s last year that were not done in EQRS and they had to go back and force them to trigger the 2746 so it showed up on the dashboard so the clinic can enter it
    • Has anyone on the call had this issue?
      • Per Kathleen - FKC has not experienced this issue with FKC data
  • Lisa has requested for Geraldine to submit this ticket so it can be researched and see if there is anything else that needs to be done (Action Item Geraldine)

RHA

US Renal