Submit Quality Measures
Sender Onboarding
Michigan Health Information Network Shared Services
Marty Woodruff – Director, Production and Operations
Megan Herbst – Onboarding Coordinator
Lindsey Weeks – Onboarding Coordinator
Copyright© 2015 - Michigan Health Information Network Shared Services
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Agenda
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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
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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
Copyright 2015 - Michigan Health Information Network
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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/mihinlegal-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
legal@mihin.org
• Exchange-Access Clinical Quality Measures Use Case Agreement:
http://mihin.org/wp-content/uploads/2013/07/MIHIN-UCA-ExchangeAccess-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
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Submitting Quality Measures
Quality Data Mart
Patients
Senders
Eligible
Providers
Reporting Layer
Reports,
Dashboards,
Comparisons,
Mining
Trusted Data
Sharing
Organization
Convert to
Desired
Format
Quality Portals
VPN/REST API
Quality Score
Q
R
D
A
Eligible/Critical
Access Hospitals
Medicaid
Data
Warehouse
Quality Check
VPN/REST API
“Catch, Detach, Dispatch”
Store
Q
R
D
A
Validate
REST API
MIDIGATE®
inbox@direct.mihin.org
Q
R
D
A
Q
R
D
A
Validate Sender
NPI
Health Provider Directory
Copyright 2015 Michigan Health Information Network Shared Services
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Onboarding Steps
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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)
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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
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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
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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-andGuidance/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
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QRDA Category 1 Files
Description
Individual patient level data for one or more measures
This 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 measures
This 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
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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. cat1@direct.mihin.org)
• 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 (help@mihin.org)
• 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)
Copyright© 2015 - Michigan Health Information Network Shared Services
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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
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:
Copyright 2015 - Michigan Health Information Network
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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 “help@mihin.org”
Copyright© 2015 - Michigan Health Information Network Shared Services
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Summary and Next Steps
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
Task
Send completed transport document
X
Establish connectivity
X
Coordinate testing
X
Go-Live
X
Copyright© 2015 - Michigan Health Information Network Shared Services
X
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Additional Resources
• For all support issues:
help@mihin.org
• For more information:
www.mihin.org
• Contact information:
Marty Woodruff
Lindsey Weeks
Megan Herbst
Director, Prod/OPS
Onboarding Coordinator
Onboarding Coordinator
Marty.woodruff@mihin.org Lindsey.weeks@mihin.org
Megan.herbst@mihin.org
517-937-2088
586-549-1674
517-588-8373
Copyright© 2015 - Michigan Health Information Network Shared Services
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Production Support
Severity 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 help@mihin.org
Phone (517)336-1430 &
Email to help@mihin.org
Help Desk- help@mihin.org
Help Desk- help@mihin.org
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