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HRSA UDS+ FHIR IG Repository.
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HIV Linkage to Care and Manual Status Update Codes for eCQMs #61

Open rmccarthy-ath opened 4 months ago

rmccarthy-ath commented 4 months ago

Related to the clinical quality measures there are a lot of scenarios where clinicians may want to set a status for a patient (satisfied, excluded, etc.) based on clinical information that is available to them, but may not be available as a piece of data. For example, patients carrying paper documents, documentation from other countries, or self-reported information (in situations where that is acceptable in the measures). In some of these cases, we have workflows that allow clinicians to set the status "manually".

For many eQCMs the related values sets provide a clear choice for how to "code back" that kind of satisfaction so that it can be included in a UDS+ submission, but in some cases there isn't an obvious choice. The HIV Linkage to Care measure is a good example. It does not have an associated eCQM, so there is no value set to work from. Taking this as an example, then, do you have any guidance about what HRSA would expect to see in terms of a code or codes that would satisfy the HIV Linkage to Care measure? This isn't to suggest that HRSA needs to be in the business of building value sets, but hypothetically if you wanted to assess the care being delivered to the population of newly-diagnosed HIV patients you would want to have some way to define that, which would inform that data that we communicate to HRSA (this assumes that HRSA would use the HIV Linkage to Care measure as a primary tool for this kind of research).

anthonygalba commented 3 months ago

I would add the Dental Sealants measure as another example to this as it's based on an unreleased eCQM specification and some value sets that were never published. As well as IVD, as that measure hasn't been updated since 2019 and I know there are new codes that have been created since then that should qualify.

If HRSA is expecting standard codes as part of UDS+, I'd strongly recommend they do actually get into the business of creating value sets, or at least working with CMS and the measure authors to publish new full eCQMs and value sets for these measures. Without a solid base specification, I fear that you will end up with wildly different implementations of these data elements across vendors / organizations which will lead to data too wildly different to reconcile.

nbashyam commented 2 months ago

Forwarding to the HRSA team.

nbashyam commented 2 months ago

Here is specific guidance for various measures that exists outside of eCQMs: Dental Sealants Value Sets: https://bphc.hrsa.gov/sites/default/files/bphc/data-reporting/uds-dental-sealants-measure-handout.pdf For HIV Linkage measure and the IVD the HRSA team is still looking into it.