• Alliance Overview

• Alliance Mission

• Alliance Principles

• Alliance Objectives

• Antitrust

• Alliance Structure

• Alliance Membership and Governance

  • Membership Categories

    • Executive Steering Committee and Workgroups

    • Community Members

    • Government Observers

  • Membership Responsibilities

    • Member Responsibilities for Policy Priorities

    • Member Responsibilities for Technical Tools and Specifications

    • Member Responsibilities to Support Open Standards

    • Other Responsibilities

    • Benefits for Community Membership

  • Decision-Making Process

    • Principles of Consensus

      • Principle One: Seek informed consensus. All members have a responsibility to share and seek input for proposed changes.

    • Procedures of Consensus

      • 1. Consensus does not require perfect agreement.

      • 2. Consensus does not require zero reservations or doubts, but does indicate that there is enough agreement that members are willing to support advancing the recommendation as a “consensus.”

      • 3. As the Alliance facilitator, Leavitt Partners will help declare when a consensus exists.

      • 4. In absence of a Near Consensus, the parties agree to move forward with the following options:

  • Criteria for Adding New Members

  • Process for Adding New Members

• Confidentiality

• Future Updates to Alliance Charter.

Over the past decade, health care data exchange has become more efficient due to increased use of Health Information Exchanges and the rise of tools that support open standards like Fast Healthcare Information Resources (FHIR®). However, many organizations are now finding the ability to objectively assess the quality of that data has not progressed at the same rate. Most organizations are still using traditional database-centric approaches to measure aspects of data quality, including aspects such as accuracy, conformity, and plausibility. This presents significant problems for patient care, safety, public health, clinical research, insurance claims, and administrative costs.

The Patient Information Quality Improvement (PIQI) Alliance is a multi-sector initiative with the goal to define a set of objective criteria and a standard approach to enable consistent quality assessment across the industry.

The PIQI Alliance is dedicated to collaboratively identifying, developing, and advancing tools, dashboards, and metrics that measure the quality of patient data through a consensus-based process. Additionally, we will provide actionable policy recommendations for federal policymakers aimed at improving the quality of patient data.

1. Patient-Centric Approach: The PIQI Alliance will seek to prioritize patient-centric information models, ensuring that data quality assessments are aligned with the evolving needs of patient-oriented care. This approach enhances the accuracy, usability, and interoperability of health care data.

2. Standardization and Uniformity: The PIQI Alliance will support an open-standard framework and taxonomy for health care data quality.

3. Collaboration and Knowledge Sharing: The PIQI Alliance will promote cross-sector collaboration and knowledge sharing among health care providers, health information technology companies, patient advocacy groups, and regulatory bodies. This collaborative effort leverages the expertise of various sector partners to develop and implement the framework.

4. Continuous Improvement: The framework will emphasize ongoing monitoring and evaluation to ensure continuous improvement in data quality. This will include regular progress reports to Executive Steering Committee, data quality assessments, and the adaptation of the framework based on feedback and evolving health care needs.

5. Transparency and Accountability: The PIQI Alliance will promote transparency and accountability in data quality assessments. This will include clear documentation of the assessment logic, criteria, and scoring methods, as well as the involvement of stakeholders in decision-making processes.

The PIQI Alliance has the following objectives:

1. Support a Standards-Based Framework to Assess Current Patient Information Quality. The Alliance will provide consensus-based recommendations from stakeholders on improving assessment criteria to improve quality of patient data to ensure it meets specific criteria for accuracy, conformity, availability, and plausibility.

2. Provide Effective Independent Governance. The Alliance will provide a structure to enable effective consensus-based decision-making, ensuring all members are equally considered, adhering to open standards and collaborative principles.

3. Support Reference Implementation and Industry Standard Simple Assessment Modules. The Alliance will support an open reference implementation as well as executable Simple Assessment Modules (SAMs) that adhere to Apache 2.0 Commons License criteria. Both the reference implementation and SAMs shall stay in sync with any ANSI-based standards that are developed as part of the HL7 open specifications.

4. Use Case Development and Prioritization. The Alliance will support development and prioritization of use cases for leveraging the PIQI framework to improve patient data quality that is exchanged.

5. Provide Ongoing Monitoring and Evaluation. The PIQI Alliance will establish mechanisms for continuous monitoring and evaluation to ensure sustained improvements in patient data quality.

In all PIQI Framework discussions, members must remember that meetings include representatives of companies that compete with one another in the marketplace.  Discussions, plans, consensus arrangement, agreements, strategies, etc., may be unlawful if they relate to any of the following topics:

·       Current or future prices or bidding information

·       Limits on production or product lines

·       Allocating customers or territories

·       Individual company marketing strategies, projections, or assessments

·       Establishing a practice of dealing with customers or suppliers

The Alliance structure will be formed as an informal collaboration, and not registered as a section 501(c) organization under the Internal Revenue Code. 

Further consideration of a formal organization will be subject to decisions of the Members consistent with its governance documents. 

The PIQI Alliance consists of senior representatives of the member companies as well as subject matter experts. All representatives of the Executive Steering Committee and Community Members (described below) will participate in oversight and workflow as well as supply in-kind resources to support the technical implementation of the open standards and reference implementations to measure patient data quality.

The PIQI Alliance will operate by means of an Executive Steering Committee (ESC). The ESC will approve the group’s specific agenda and policy positions, establish goals and objectives, and oversee the overall direction of the Alliance. Workgroups may be created as desired by ESC members to research and address specific issues or questions. This could evolve to more formal communities of practice as the alliance matures. Each Workgroup will be composed of ESC members, Community Members, and Government Observers to ensure diverse perspectives and broad engagement.

Current workgroups are tasked to develop a PIQI evaluation framework for each of the listed use cases:

1. The CARIN IG for BB (CPCDS) workgroup will be developing a PIQI evaluation framework for the claims data model we developed as part of our CARIN IG for Blue Button FHIR IG work.

2. The USCDI workgroup will review the data elements, discuss if there are any unique patterns around SAMs to include in the PIQI framework, and for scoring and whether it is satisfied by USCDI.

Additional workgroups may be added and this structure could evolve into more formal communities of practice as the Alliance matures.

The PIQI Alliance will be made up of key stakeholders, implementers, and experts in patient data quality measurement from a cross-section of the industry as designated by the ESC.

All members hold equal voices and decision-making authority. This ensures a balanced representation of perspectives and expertise in guiding the direction of the PIQI Alliance. In the event of a tie, a neutral convener within the ESC, will hold the tie-breaking vote. Any open standards will be published to HL7. Any actual technical work products (for example, implementations of evaluation profiles, Simple Assessment Modules, or other similar artifacts) will be governed under the Apache 2.0 license.

Final deliverables from the PIQI Alliance will be open source. Consequently, anyone can be a member of the community; there are no special requirements. However, the most important members in this community consist of:

·       Platform or technology owners that provide software to report on patient information quality.

·       Any business entity that use software to ingest or transfer patient information electronically (e.g. payers, providers, labs, research institutions, etc.).

Data quality is a critical issue to reduce fraud, waste, and abuse (FWA) in government-sponsored health plans as well as manage the health and wellness of those members. Feedback from key agencies that are evaluating health care data will ensure PIQI will support all critical use cases for these products.

The PIQI Alliance is an active, collaborative initiative, requiring active participation to collectively advance policy priorities, technical tools, and open, standards-based implementations to improve measurement of patient data quality.

Each member of the ESC has a vote equal to the other members. The members have the right and the responsibility to:

·       Identify and discuss policy priorities,

·       Identify and discuss advocacy strategy as appropriate,

·       Attend, or determine who will attend on its behalf, internal meetings,

·       Attend, or determine who will attend, meetings with external stakeholders, and

·       Govern any external communications.

All policy positions of the Alliance will be determined by consensus.

Each member of the Alliance will contribute in-kind resources to support the maturity of the PIQI Framework, quality rubrics, and other critical implementation tools. The expectations for these resources can be found in the PIQI Alliance GitHub repository:https://github.com/piqiframework/.github/blob/main/piqiFrameworkGovernance.md

Each member of the ESC and Community members must be committed to adhering to the open standards set forth by the PIQI Alliance as well as ensuring the continual improvement of those standards. It is expected that implementations will evolve more quickly (and will, in fact, inform standards improvement). In addition, it is also expected that members of the PIQI Alliance will build value-add capabilities that differentiate their offerings from the “base” standards offered by the PIQI Framework.

In addition to members contributing their staff time and energy, capital (intellectual, political, social), and brand to the Alliance, ESC and Community members agree to participate in the economics of the Alliance to the degree they are able. Economic contributions will generally be tiered based on sector, non-profit/for-profit status, organizational size, and steering committee status. Resources will be provided through membership commitments agreed to by individual members and management (Leavitt Partners).

Management will work with individual members of the Alliance to identify and agree on economic commitments. Management recognizes that organizations are situated differently (for-profit vs. non-profit, large organizations vs. small organizations, etc.) and will work with members accordingly.

Economic contributions can be invoiced on a monthly, quarterly, semi-annual, or annual basis, and will be documented through a membership Letter Agreement between an individual Member organization and management.

Community Members are critical to the success of the PIQI Alliance. Participating as a member also brings several intangible benefits, including:

·       Access to Expertise: You’ll be part of a network of experts committed to patient data quality.

·       Policy Advocacy: Several government entities have expressed interest in the work done by the PIQI Alliance and have participated in workgroups as observers. Members that participate will have an opportunity to work side by side to set quality standards that can be leveraged.

·       Credit for Contributions: Members of the PIQI Alliance are featured at industry conferences including HIMSS, VIVE, and NCQA Forums. In addition, members that create or update materials to support the community are credited for their contributions to assist in their own firm’s marketing efforts.

·       Opportunity for Early Adoption Alliance members have an opportunity to adopt practices before they become part of the standard and allows them to provide feedback for improvement.

The PIQI Alliance, as a community of practice, is a consensus-driven organization. The following principles and procedures will be followed. While each member will have an equal voice, no single organization will have a “veto” in the PIQI Alliance.

The following principles will be followed for all deliverables maintained by the PIQI Alliance:

Principle Two: Consensus is Not Uniform Agreement. Achieving consensus inherently involves a process of give and take amongst members. It is assumed not all members will achieve ideal positions for all proposed changes. This is recognized as normal and acceptable in the process to achieving consensus to advance shared objectives.

Principle Three: Recognize and report minority opinions. As part of the decision process, objections should be noted and acknowledged before decisions are made. This ensures that all voices are heard.

Principle Four: When there is no active objection, consent is implied. This requires careful planning for all changes. For this type of consensus to be effective, it is necessary to allow sufficient time for stakeholders to review proposed decisions before assuming that there are no objections. For more significant issues, more time must be provided to enable discussion within their organizations to consider the impacts. This will provide the framework for all members, regardless of location or other commitments, will have sufficient time to read, digest, and respond to the proposal..

Principle Five: Continuously move toward a productive conclusion. All members have a responsibility to adhere to the shared principles and values of the Alliance. Active collaboration is continuously required. This principle implies the following core goals:

·       An equal opportunity for each member to express its positions and objectives.

·       A desire to collectively engage in a consensus process to build new content and policy together.

·       Professional respect and honest dialogue to foster genuine consideration of proposals, suggestions, and positions put forward by members

Consensus means the group has reached a conclusion the entire group is prepared to endorse. 

In absence of a consensus, Leavitt Partners may declare a “near consensus” which will serve as the new basis from which to work to refine thinking and achieve consensus.

1. Members agree to table the issue

1. Issue may be addressed it at a later date, or

2. Group members may decide the issue is not one that is in scope for the Alliance.

2. In rare cases, a single member who is objecting to a broader, deeper consensus and direction of the Alliance may conclude that the work as evolved in a manner unaligned with the member’s organizational focus. In such rare case, the single member organization may choose to withdraw from the Alliance.

Organizations wishing to join the Alliance will be evaluated by the Executive Steering Committee using the following criteria:

·       Charter: Does the organization agree with the scope and content of the charter?

·       Demonstrated Cross-Organization Collaboration: Is the organization committed to working with, in, and through the Alliance? To what degree do they demonstrate cross-organization collaboration?

·       Consensus: Is the organization committed to a process that makes decisions by consensus?

·       Course: To the degree the Alliance has concrete policy recommendations, principles, or technical implementations that set a course for the future, is the organization aligned/do they agree?

·       Compromise: Does the organization recognize the promise in compromise and willing to commit to an endeavor which necessarily involves compromise?

·       Contribution: Is the organization willing to contribute time, effort, brand, and intellectual, social, and financial capital to the success of the Alliance?

·       Conduct: Is the organization’s conduct and reputation generally one of positive renown such that it will reflect positively (or at least not negatively or distractingly) on the Alliance?

·       Current Collaborators: Do existing Alliance members welcome and approve the new member? If not, why? Are the concerns substantive, stylistic, or other?

Leavitt Partners, with input from Alliance members and working on their behalf, will identify and reach out to potential new members for the Alliance. Prospective members will be screened by Leavitt Partners, based on a preliminary assessment, a conversation about principles, and a discussion about common opportunities. After Leavitt Partners presents their recommendation, new members will be added by consensus of the Alliance. To operationalize this, Leavitt Partners will provide email notification to members and welcome feedback within a specified timeframe, after which consensus is assumed and the new member will be added to the Alliance.

While working on this project, the discussions and interactions of the members are subject to Chatham House rule. This approach is intended to protect the deliberative process for achieving consensus within the Alliance while enabling members to share information about the Alliance with relevant stakeholders and key audiences.

In practice, this means, for those materials which are not intended as open-source or open standards, members are free to share the general themes and conclusions of the Alliance, without conveying the specific details of conversations or deliberations or attributing such to individual Alliance member organizations or individuals.

In contrast, written materials not related to the open standards or frameworks are deemed confidential to Alliance members unless otherwise labeled for public dissemination and use. Such a label will be decided by consensus.

For the Alliance, revisions to the charter will be determined on a consensus basis by all members.