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  1. FHIR Specification Feedback
  2. FHIR-35922

Reference to composites should address content as entity and not limit to patient

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Quality Measures (FHIR)
    • 2.1.0 [deprecated]
    • Clinical Quality Information
    • Composite Measure Scoring mapping
    • Composites
    • Sections 5.1 All-or-Nothing; Section 5.2 Opportunity Scoring; Section 5.3 Patient-level Linear Combination
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      Agree with recommendation. 

      1. Add the new text (in red) to the paragraphs directly above https://build.fhir.org/ig/HL7/cqf-measures/composite-measures.html#all-or-nothing-scoring :

      Architecturally, environments that are already capable of calculating measures using the measure scoring methods already described in this implementation guide can readily consume composite measure specifications that use the first approach (individual-based) but would require additional support in order to calculate component-based measures. Specifically, completely generic support for component-based calculation methods would require that an environment be able to evaluate CQL logic in the Population context. However, by restricting composite calculation support to those methods specified by this implementation guide, environments can calculate composites by operating on the results of individual-level scores.  It is important to note that each scoring method should work for any subject for which the measure is developed - e.g patient or encounter.

      2. Add a ballot question to solicit examples of composite measures that use a subject other than patient.

      3. Change all references of "patient level linear scoring" to "subject level linear scoring"

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      Agree with recommendation.  1. Add the new text (in red) to the paragraphs directly above https://build.fhir.org/ig/HL7/cqf-measures/composite-measures.html#all-or-nothing-scoring : Architecturally, environments that are already capable of calculating measures using the measure scoring methods already described in this implementation guide can readily consume composite measure specifications that use the first approach (individual-based) but would require additional support in order to calculate component-based measures. Specifically, completely generic support for component-based calculation methods would require that an environment be able to evaluate CQL logic in the Population context. However, by restricting composite calculation support to those methods specified by this implementation guide, environments can calculate composites by operating on the results of individual-level scores.  It is important to note that each scoring method should work for any subject for which the measure is developed - e.g patient or encounter. 2. Add a ballot question to solicit examples of composite measures that use a subject other than patient. 3. Change all references of "patient level linear scoring" to "subject level linear scoring"
    • Juliet Rubini/Matt Tiller: 14-0-0
    • Clarification
    • Compatible, substantive

    Description

      The composite measure scoring methods are well stated and the diagrams very helpful. However, each uses as patient as the entity in the example. And, the section 5.3 Patient-level Linear Combination Scoring specifically references patient. Each scoring method should work for any entity for which the measure is developed - patient, encounter, etc. So the descriptions should add reference to entity-related all-or-nothing, entity-related Opportunity, and Entity-Level Linear Combination Scoring. The scoring methods will still work. The IG should allow users to understand that any entity may be used.

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            bryn.rhodes Bryn Rhodes
            feisenberg Floyd Eisenberg
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