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Submit Quality MeasuresSender Onboarding
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Michigan Health Information Network Shared ServicesMarty Woodruff – Director, Production and Operations
Megan Herbst – Onboarding CoordinatorLindsey Weeks – Onboarding Coordinator
Copyright© 2015 - Michigan Health Information Network Shared Services
Agenda• Scope Information• Prerequisites• Submitting Quality Measures• Onboarding Steps• Onboarding Process• Meaningful Use: Quality Measures• Overview
• Currently Supported Quality Measures• Currently Supported Quality Formats• QRDA Category 1 Files• QRDA Category 3 Files
• Transport Options• Direct• REST API
• Requirements For Go-Live• Summary and Next Steps• Additional Resources
2Copyright© 2015 - Michigan Health Information Network Shared Services
Scope Information
• Clinical Quality Measures (CQMs): measures of quality generated in clinical settings by using clinically-gathered information such as lab results, vital signs, etc.
• Clinical Quality Measurement Recovery and Repository (CQMRR) service: enables providers to submit, view, analyze, and act upon electronic CQMs for:• Medicaid / Meaningful Use attestation• Non-Medicaid providers wishing to take advantage of
electronic CQMs for Clinical Quality Improvement
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Prerequisites
• Participating organizations should begin two parallel onboarding tracks simultaneously:• Legal: Obtain, review, and execute legal agreements• Technical: Establish technical transport and test
• Legal agreements for first-time onboarding consist of a Trusted Data Sharing Organization Agreement and the first Use Case Agreement• Data Sharing Agreements: http
://mihin.org/about-mihin/resources/mihin-legal-document-templates/
NOTE: The type of Data Sharing Agreement will depend on the specific relationship you are seeking with MiHIN. For help picking the correct legal document and to initiate legal onboarding, contact [email protected]
• Exchange-Access Clinical Quality Measures Use Case Agreement: http://mihin.org/wp-content/uploads/2013/07/MIHIN-UCA-Exchange-Access-Clinical-Quality-Measures-PUBLISHED-v12-09-30-15.docx
• For onboarding additional Use Cases after the first, only a new Use Case Agreement is required
4Copyright© 2015 - Michigan Health Information Network Shared Services
VPN/REST API
VPN/REST API
Convert to Desired Format
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Submitting Quality Measures
MIDIGATE®
“Catch, Detach, Dispatch”
Trusted Data Sharing
Organization
Validate
Store
Quality Check
Quality Score
Validate Sender NPI
Senders
Eligible/Critical Access Hospitals
Eligible Providers
Patients Reporting Layer
Reports, Dashboards,Comparisons,
Mining
Medicaid
Data Warehouse
Quality Portals
QRDA
QRDA
Quality Data Mart
QRDA QRDA
Health Provider Directory
RE
ST
AP
I
Direct Secure Message
Onboarding Steps• Express interest in onboarding Use Case• Kick-off meeting
• Exchange contact information• Distribute Use Case Summary and other information• Present onboarding overview
• Legal onboarding: receive, review, and execute legal documents• Trusted Data Sharing Organization Agreement• Use Case Agreement(s)
• Technical onboarding: exchange required technical documents (can occur simultaneously with legal onboarding)• Use Case Implementation Guide• Establish transport method/connectivity (e.g. via Direct or VPN)• Test transport• Test submission mechanism• Verify data quality
• Legal document check – confirm documents are fully executed• Go live into production
6Copyright© 2015 - Michigan Health Information Network Shared Services
Onboarding Process
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Meaningful Use: Quality Measures
• Submit Quality Measures Use Case supports 2013 release of Meaningful Use (MU) measures:• Eligible Professionals must submit at least 9 of 64 provider
measures• Eligible Hospitals and Critical Access Hospitals must
submit at least 16 of 29 hospital measures• All submitters must submit measures from at least 3 of 6
quality measure domains
• Participation in this Use Case will result in MU credit
Copyright 2015 - Michigan Health Information Network 8
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Currently Supported Quality Measures
Description Meaningful Use Clinical Quality Measures, 2013 release
Purpose Clinical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided by eligible professionals, eligible hospitals and critical access hospitals (CAHs) within our health care system.
Hospital Measures 29 Measures
Provider Measures 64 Measures
Source Link http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures.html
Other Requirements
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Currently Supported Quality Formats
Description Clinical Quality Measures
Purpose To establish quality metrics of health care providers
HL7 Standard C-CDA QRDA Category 1 files, C-CDA QRDA Category 3 files
Transport Method REST API via Virtual Private Network (VPN)Direct Secure Messaging (DSM) • HISP must be EHNAC-DTAAP accredited by February 2015
Implementation Guide http://mihin.org/about-mihin/resources/use-cases-in-production/
Other Requirements National Provider Identifier (NPI) must be listed
Copyright© 2015 - Michigan Health Information Network Shared Services
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QRDA Category 1 Files
Description Individual patient level data for one or more measuresThis format qualifies for Meaningful Use clinical quality measure requirements
Purpose These measures have not been calculated by measure criteria
HL7 Standard C-CDA QRDA Category 1 Files
Transport Method REST API via Virtual Private Network (VPN)Direct Secure Messaging (DSM) • HISP must be EHNAC-DTAAP accredited
Implementation Guide http://mihin.org/about-mihin/resources/use-cases-in-production/http://www.hl7.org/implement/standards/product_brief.cfm?product_id=35
Other Requirements National Provider Identifier (NPI) must be listed
Copyright© 2015 - Michigan Health Information Network Shared Services
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QRDA Category 3 Files
Description Aggregate population level data for one or more measuresThis format qualifies for Meaningful Use clinical quality measure requirements
Purpose These measures have been calculated by measure criteria
HL7 Standard C-CDA QRDA Category 3 Files
Transport Method REST API via Virtual Private Network (VPN)Direct Secure Messaging (DSM) • HISP must be EHNAC-DTAAP accredited by February 2015
Implementation Guide http://mihin.org/about-mihin/resources/use-cases-in-production/http://www.hl7.org/implement/standards/product_brief.cfm?product_id=286
Other Requirements National Provider Identifier (NPI) must be listed
Copyright© 2015 - Michigan Health Information Network Shared Services
Establishing Transport and Testing: Transport Option 1 - Direct
• MiHIN requires exchange of non-production messages to confirm connectivity prior to Go-Live
• Sender attaches QRDA file(s) to Direct Secure Message and sends to MIDIGATE™ inbox at MiHIN (e.g. [email protected])• Sender’s Direct Secure Messaging (DSM) HISP must be
EHNAC-DTAAP accredited (DirectTrust)• If sender does not have compliant Direct account, MiHIN can
provide Direct accounts for small annual fee ([email protected]) • MiHIN performs validations and transformations on XML document
received from sender (specific to given collection, case insensitive)• MiHIN sends acknowledgement to Direct message senders
(eventually including content scoring)
13Copyright© 2015 - Michigan Health Information Network Shared Services
Establishing Transport and Testing: Transport Option 2 - REST API
• MiHIN requires exchange of non-production messages to confirm connectivity prior to Go-Live
• Sender transmits QRDA file to MiHIN via REST API• Every request must declare content type to be application/xml
and must be authenticated• MiHIN performs validations and transformations on XML document
received from sender (specific to given collection, case insensitive)• An HTTP 200 OK response means message has been accepted
into system • Response will have JSON body that contains validation errors, if
any, along with additional metadata• See API Guide for more information
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Sample Acknowledgement Message
Copyright 2015 - Michigan Health Information Network 15
Subject: MiHIN MIDIGATE ACK
{“score”:80,“validation”:[{“name”:“cda-2014”,“weight”:20,“errors”:”},{“name”:“schematron-2014”,“weight”:60, “errors”,”},{“name”:“dynamic-npi-check”,“weight”:20,“errors”:“Invalid npi: FakeNPI”}],“trackingId”: “55d33e1a128302563e7c80d8”}
Attachments:
Requirements For Go-Live
• Test transport (Direct or REST)• Finalize required documentation
• Execute legal documents• Complete transport document
• Coordinate “go-live” production schedule• Go-live should be scheduled a minimum of one week in
advance of requested date • Schedule via “[email protected]”
16Copyright© 2015 - Michigan Health Information Network Shared Services
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Summary and Next Steps
Task MiHIN
Trusted Data Sharing
Organization (TDSO)
Determine date/time for next check point X X
Exchange and execute legal agreements X X
Send “care package” X
Send completed transport document X
Establish connectivity X
Coordinate testing X
Go-Live X X
Copyright© 2015 - Michigan Health Information Network Shared Services
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Additional Resources
• For all support issues:
[email protected] • For more information:
www.mihin.org • Contact information:
Marty Woodruff Lindsey Weeks Megan HerbstDirector, Prod/OPS Onboarding Coordinator Onboarding Coordinator
[email protected] [email protected] [email protected]
517-937-2088 517-588-8373 586-549-1674
Copyright© 2015 - Michigan Health Information Network Shared Services
Production SupportSeverity 1 Severity 2 Severity 3 Severity 4
Description Critical Impact/System Down: Business critical software is down or critical interface has failed. The issue is impacting all production systems, causing all QO’s or other organization’s ability to function to be unusable.
Significant Business Impact: Software component severely restricted. Entire organization is unable to continue business functions, causing all communications and transfer of messages to be halted.
Partial Failure or Downtime: Program is usable and less significant features unavailable. The service is online, though may not be working as intended or may not currently be working as intended or may not currently be accessible, though other systems are currently available.
Minimal Business: A non-critical software component is malfunctioning, causing minimal impact, or a test system is down.
Example Example: All messages to and from MiHIN are unable to be sent AND received, let alone tracked.
Example: MiHIN cannot communicate (send or receive) messages between single or multiple QOs, but can still successfully communicate with other organizations.
Example: Messages are lost in transit, messages can be received but NOT transmitted
Example: Additional feature requested
Initiation Method Phone (517)336-1430 & Email to [email protected]
Phone (517)336-1430 & Email to [email protected]
Help Desk- [email protected] Help Desk- [email protected]
Initial Response Within 2 hours Within 2 hours 1 business day 1 business day
Resolution Goal 24 hours 24 hours 3 business days 7 business days
Copyright© 2015 - Michigan Health Information Network Shared Services
