Quality Priorities

April 26, 2007

MINUTES
Kidney Care Quality Alliance Steering Committee
April 26, 2007
Conference Call

Attendees
ANNA                                                                       Gail Wick
ASPN                                                                        Barbara Fivush
DaVita                                                                       Kent Thiry
FMC                                                                          Ray Hakim
NKF                                                                          Dolph Chianchiano
National Partnership for Women & Families      Deven McGraw
RPA                                                                          Allen Nissenson

KCP                                                                          Linda Keegan
Facilitator/Administrative Arm Patton Boggs   Kathy Lester, Julie Black

Summary
The KCQA will copyright the Phase I measures submitted to the NQF and clearly indicate that the Alliance will provide open access to use of the measures. The Steering Committee agreed to explore working with the Physician Consortium for the next phase of measure development, including establishing ground rules and work group membership.

Review and Approval of Minutes 
The members approved the minutes from the March 6, 2007, meeting.

Update on NQF Measure Submission
NQF has requested feedback about the measure submission form.   Staff described the tenor of process as cooperative. The next step is for the NQF to organize a Steering Committee and Technical Advisory Panel that will review the measures. Steering Committee members can email Ms. Lester to request a copy of the KCQA measures.

Discussion of Copyright for Phase I Measures
Because the Consortium and KCQA measures were not identical, copyrighting the measures jointly is a moot question. As requested, staff reported on the basic legal principles related to copyrighting measures.  The members discussed that a copyright would give KCQA control of modifications to the measures and that KCQA would still be able to provide open access to the measures through free licenses. The Steering Committee agreed unanimously to copyright the measures with clear indication that KCQA will provide open access.

Discussion of KCQA Steering Committee Call with the Consortium
Steering Committee members who participated in the teleconference with the Consortium described the discussion of a possible collaboration. During the call, Consortium representatives told the group that the Consortium does not have immediate plans to establish an ESRD work group, although the Consortium has a CKD work group that is expected to finalize measures this summer.

Several members raised questions regarding the Consortium’s model of collaboration, citing communications lapses with previous cooperative efforts with the KCQA as well as with regard to other Consortium work groups and the kidney community. Steering Committee members also expressed concern about philosophical differences that might not be able to be resolved, especially those related to developing outcome measures.

Those members who participated in the call with the Consortium noted that during the call the Consortium representatives assured them that a cooperative process would be smooth and include working with an AMA methodological team. One Consortium representative also noted the Consortium’s good track record of working with specialty groups during the call. Steering Committee members stated that the Consortium agreed to include the entire community in an ESRD work group and to develop facility measures along side physician measures. Steering Committee members also discussed the role of the Consortium in the development of CPT-2 codes and how helpful they could be in the implementation of potential measures.

The group discussed engaging with the Consortium to clarify procedures and ground rules for a joint venture. Members suggested developing an exit strategy should the project fail to align with the ground rules or if philosophical differences cannot be resolved.

The Steering Committee expressed a willingness to work jointly with the Consortium for the development of Phase II measures, provided both organizations can agree on a set of ground rules. Addressing implementation issues related to the starter set of measures will remain independent, given that both organizations developed separate sets of measures. The members noted that the timeline for KCQA work groups was developed under the assumption that the Alliance was moving forward independently. The group agreed to give the joint process 4-6 months, based upon Lou Diamond’s statement that this would be an appropriate amount of time.

Discussion of Next Steps
Ms. Lester will communicate the Steering Committee’s plan to collaborate to develop adult clinical measures to the AMA Consortium. Staff will draft a set of ground rules for collaboration with the Consortium. The next Steering Committee meeting is on May 8, 11:00 a.m.-12:00 p.m.