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CMS Interoperability Rule and Impact of COVID-19

[fa icon="calendar'] Sep 8, 2020 1:16:05 PM / by Shobhit Saran posted in FHIR, interoperability, health IT, Payers, CMS, Da Vinci, ONC, CARIN Alliance, payer data exchange, USCDI

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The Centers for Medicare & Medicaid Services (CMS) released the much-awaited Interoperability & Patient Access Rule in early March this year. This rule establishes policies that aim to break down barriers in the health system across the US for better patient engagement. Government bodies are taking significant efforts for governments-sponsored health plans to adopt interoperability to make healthcare system efficient. Multiple initiatives by the Department of Health and Human Services (HHS) and its CMS and Office of the National Coordinator for Health Information Technology (ONC) aim to improve care-coordination and member experience. CMS had proposed the Interoperability & Patient Access Rule to support regulations of the MyHealthEData initiative, with implementation timelines to drive programs such as BlueButton, BlueButton 2.0 and Data at the Point of Care.

In the times of pandemic, healthcare organizations have realized the importance of having access to data for better care coordination and efficient care delivery. With seamless data access, organizations can:

  • Share health data of beneficiaries with different care teams
  • Identify high-risk population and implement preventive actions to control risk
  • Leverage tele-health with access to patient historical health data
  • Take timely decisions on emergency treatments based on patient medication history
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Summer 2020 CTO Tooling Update

[fa icon="calendar'] Sep 3, 2020 3:09:20 PM / by Wayne Kubick posted in FHIR, HL7, health IT, C-CDA, news, tooling, JIRA, Confluence, publishing, UTG, essentialism, FHIR registry

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Doing Less, but Better

For many of us, this desperate pandemic year has led to plenty of introspection.  This has also been true for the HL7 Board, which has been contemplating the future of the HL7 organization after emerging from the current crisis. Among a set of core principles adopted by the Board are agility and focus. To be agile, we need to simplify and refine the organization and core processes as well as provide support with continued improvements to our tooling. This also requires getting our global community to better understand and use the processes more consistently and effectively, so we can better focus on our core work of developing and implementing interoperability standards.  This a perfect segue back toward my long-held core belief in essentialism.

Back to Basics

I first espoused the concept of essentialism to an enthusiastic Board and Technical Steering Committee back in 2016. While we’ve only made small incremental progress in the four years since, it has been guiding our process improvement and tooling initiatives. Essentialism was a driving force behind our adoption of Confluence and JIRA as well as efforts to simplify our product portfolio. Of course, we operate in a complex field, and there were many confounding forces acting at the same time. The HL7 community is more adept at introducing new processes, tools and content than at retiring or eliminating the old stuff. Thus, our commitment to essentialism faded over time, tempered by inertia and continuing demands, not the least of which has been the black swan events of 2020.

Perhaps it’s time to once again review the key elements of essentialism and discuss how it fits with our ongoing tooling strategy and plans.

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Integrated Approach for Radiology and Clinical Information to Support Clinical Decision Making

[fa icon="calendar'] Aug 28, 2020 10:17:32 AM / by Shujah Dasgupta posted in FHIR, interoperability, health IT, CMS, ONC, radiology, USCDI

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Limitations in existing healthcare interoperability present a significant barrier to next-gen computing solutions such as Machine Learning (ML) and Artificial Intelligence (AI). New workflow standards aimed at addressing the integration of AI/ML actors to clinicians in delivering better patient care.

One of the main limitations of standards is streamlining access to data from electronic medical record (EMR) applications. There is a growing need for a holistic view of patient data, and the inclusion of the allied healthcare services such as radiology will play a crucial role in building a 360° patient view. This will help healthcare professionals take accurate and informed decision on patient care, and bridge the gap between fragmented and siloed information that is currently limiting hospitals and healthcare systems from gaining insights to drive better health outcomes.

To seek better exchange of health data among providers and patients, the Health and Human Services (HHS) published final rules that put patients first and bring one step closer to achieving Interoperability. The ONC’s (Office of the National Coordinator for Health Information Technology) rule aims to standardize API via HL7 Fast Healthcare Interoperability Resources (FHIR®) R4, a latest version of the FHIR standard, and making its use mandatory under this rule.

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HL7 Da Vinci Project Use Cases Aim to Reduce Documentation Burden in VBC

[fa icon="calendar'] Jul 16, 2020 4:09:54 PM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, SMART on FHIR, health IT, implementation, Da Vinci, value based care, implementation guide, prior authorization, coverage requirements discovery, documentation templates and payer rules

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Report from Virtual FHIR DevDays 2020 on HL7 Da Vinci Project Use Cases

Developers are fine-tuning ways to use the HL7 Fast Healthcare Interoperability Resource (FHIR) standard to reduce communication challenges and decision impediments between providers and payers.

Working on use cases involving coverage and burden reduction, the HL7 Da Vinci Project is refining early versions of standards and developing implementation guides for value based care (VBC). Speaking to more than 150 attendees during the virtual HL7 FHIR DevDays event, Dr. Viet Nguyen, Da Vinci Project Technical Director, noted that the coverage and burden reduction use cases are intended to address workflows around provider-payer interactions. FHIR implementation guides are then created based on a set of use cases. 

Coverage Requirements Discovery

One use case, Coverage Requirements Discovery, gives providers real-time access to payer approval requirements, documentation and rules at point of service to reduce provider burden and support treatment planning. In its essence, this would answer a provider’s question about whether a procedure or treatment needs a prior authorization from a payer. The aim is to use CDS Hooks to supply an answer to a clinician posing the request within his or her workflow. Work is continuing on developing an implementation guide for this use case.

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HL7 FHIR Dev Days Highlights How FHIR Can Support Patient Empowerment Efforts

[fa icon="calendar'] Jul 9, 2020 2:01:02 PM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, health IT, Patient Experience, patient empowerment

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Report from Virtual FHIR DevDays 2020 on the Patient Innovator Track

Initiatives seeking to expand the use of HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard were highlighted at the recent HL7 FHIR Dev Days 2020 virtual event.

The Patient Innovator track included four presentations highlighting its recent move to encourage the use of technology to support patient involvement in care. HL7’s Patient Empowerment Work Group has a mission of promoting and amplifying the viewpoint of patients and caregivers in HL7’s standards work. Its initial priorities include enabling patients to correct errors in records, contribute their data to records, plan care, and efficiently gather and store patient consents.

The four presentations were judged by a panel of HL7 experts for their use or projected vision for the use of FHIR to solve problems in patient empowerment in healthcare. In addition, attendees at the virtual Dev Days event could vote to award one of the participants a People’s Choice award.

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HL7 FHIR Helps Bridge the Gap Between Cleveland Clinic and Payer in Collaboration

[fa icon="calendar'] Jul 7, 2020 5:27:01 PM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, health IT, Payers, scheduling

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Report from Virtual FHIR DevDays 2020

The Cleveland Clinic and Oscar Health announced a partnership in mid-2017 that was going to require a level of provider-payer integration that the organization hadn’t attempted before.

More challenging still was the fact that the timeline was short – some of the capabilities that would enable improved patient interactions had to be in place by January 2018. The use of the HL7 Fast Healthcare Interoperability Resources (FHIR®) standard addressed many of the technical challenges in hitting those deadlines.

Integration between the entities still was difficult to achieve, noted Matthew Coolidge, who was then the IT product director at the Cleveland Clinic and is now CEO of Orbital Health. When he was in his Cleveland Clinic role, he was the organization’s subject matter expert on FHIR. Coolidge shared lessons learned in the initiative in a keynote presentation at the recent HL7 FHIR DevDays virtual meeting.

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HL7 FHIR for HIEs: State Health Information Network for New York

[fa icon="calendar'] Jul 2, 2020 2:26:54 PM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, health IT, implementation guide, COVID-19, public health

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Report from Virtual FHIR DevDays 2020

A New York State initiative is aiming to change its approach for exchanging patients’ health information among the state’s health information exchanges, using HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard as the conduit.

In addition, the new approach being implemented for the State Health Information Network for New York (SHIN-NY) has taken less time to develop and is expected to enable the exchange of more granular patient data than is possible with the current approach.

Speaking at the HL7 FHIR DevDays virtual meeting on June 15, Luke Doles, senior director of services management for the New York eHealth Collaborative (NYeC), said further implementation of the FHIR-based framework has been delayed because of the urgency to shift resources to support the state’s COVID-19 response. However, the initiative has thus far proven that the concept can be expanded to provide more information across SHIN-NY.

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APIs Could Help in Pandemics, but More Capability is Needed

[fa icon="calendar'] Jul 1, 2020 11:39:29 AM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, health IT, implementation guide, COVID-19, public health

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Report from Virtual FHIR DevDays 2020

Work on incorporating application programming interfaces using HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard can help healthcare organizations better manage the COVID-19 crisis, but much more could be done.

A virtual panel at HL7’s FHIR DevDays indicated that API usage can help with the sharing of data, but more widespread use of this supportive programming could provide more benefits.

“If you look inside the typical hospital, there are more than 20 different clinical systems being used, but only one is the electronic health record getting the API love,” said Keith Boone, enterprise architect for Audacious Inquiry. “COVID data is showing up in bed management systems, command and control systems, ICU central monitoring and more.” Those systems are five years behind EHRs in enabling data exchange.

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SANER Project Using HL7 FHIR to Enable Easier Reporting for Public Health

[fa icon="calendar'] Jun 25, 2020 1:28:48 PM / by Fred Bazzoli posted in FHIR, HL7 community, interoperability, health IT, implementation guide, COVID-19, SANER Project

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Report from Virtual FHIR DevDays 2020

A new initiative is making rapid progress in developing a way to improve how providers report COVID 19 data to public health agencies.

Started in late March, the Situational Awareness for Novel Epidemic Response (SANER) Project has made “huge progress in a short period of time,” said Keith Boone, enterprise architect for Audacious Inquiry, a consulting firm that helped to start the initiative.

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A Special Message from the HL7 CEO and Board Chair

[fa icon="calendar'] Jun 10, 2020 10:30:25 AM / by Health Level Seven posted in HL7, HL7 community, interoperability, health IT

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HL7's Commitment to Diversity, Equity and Inclusion

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