The Standard

As the Trusted Exchange Framework and Common Agreement (TEFCA) moves ahead for FHIR usage within the framework, the use of the HL7 FAST UDAP Security for Scalable Registration, Authentication and Authorization FHIR IG (FAST Security) is becoming more important to the security framework for FHIR within the US and in other countries. As part of our mission, the FHIR At Scale Taskforce (FAST) wants to help people get ready for the TEFCA January 1, 2026, deadline to have Fast Security implemented for FHIR Exchange over TEFCA.

To help implementers, CISOs, and anyone interested in FHIR on TEFCA out, FAST is holding a 1-day event to introduce the Security IG and how TEFCA will use it and information about general TEFCA security, Security IG testing, and other aspects. This event is FREE on January 13, 2025, right before the FHIR Connectathon. If you’re interested in FHIR on TEFCA or want to know the latest in FHIR OAuth security, you can sign up at: https://info.hl7.org/fast-security

One of the most efficient ways to exchange data among providers and payers for prior authorization and other purposes is by taking advantage of standard application program interfaces (APIs) and a central hub to avoid manual processes and support of point-to-point interfaces.

The HL7^® Da Vinci Project’s new Trebuchet pilot program, launched earlier this year, is enabling additional pioneers to test that approach.

Trebuchet was created when Da Vinci members Regence, MultiCare Connected Care, and Blue Cross Blue Shield Arkansas sought ways to pilot Da Vinci use cases on the emerging TEFCA framework. They contacted multiple Qualified Health Information Networks™, or QHINs™, to gauge their interest in joining the pilot. eHealth Exchange joined the effort to perform the QHIN functions and provided valuable project management support.

The team named the coalition “Trebuchet” to illustrate how the success of a third-century military catapult could inspire providers, payers, and a QHIN to accelerate trusted and scalable exchange. 

As efforts advanced and participants increased, Trebuchet asked Da Vinci to take over project management. Now a priority project adopted by Da Vinci, Trebuchet is proving how eHealth Exchange’s nationwide trust model and “Networked FHIR” architecture rapidly deploy Smart-on-FHIR Prior Authorization and Clinical Data Exchange (CDex) at scale

Looking for an update on the HL7 Da Vinci Project’s accomplishments this year and the outlook for 2025? Then don’t miss a special year-end online session at 4 p.m. ET on December 11.

This meeting, which combines Da Vinci’s Member Forum and Operating Committee meetings and the December Community Roundtable, will review this year’s programmatic accomplishments and set the stage for 2025.

A Da Vinci leadership panel will discuss 2024 highlights, sharing progress across policy, use cases and implementer support. The panel will address the successful Fast Healthcare Interoperability Resources (FHIR®)) implementation outcomes listed in the HIPAA exception report as well as key partnerships and their interoperability journeys. (For more on the HIPAA exception report, see: Report on HIPAA Exception Project Describes Benefits of Using FHIR APIs).

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

The latest FAST Focus webinar provided a comprehensive update on the progress and scope of the FAST Consent project, an initiative pivotal to streamlining data exchange in health IT. This quarterly series aims to engage the community, share updates, and encourage participation in ongoing FASTprojects. Below, we delve into the key takeaways from the session, with a spotlight on the objectives and contributions  

The FAST Consent Project: An Overview 

Consent management in healthcare is a complex issue that requires innovative solutions to manage and transmit consent records at scale. The FAST Consent project emerged in response to these challenges, focusing on how to make consent management effective across a diverse and multi-faceted ecosystem. Project leads—including Durwin Day, Mohammad Jafari, Kevin Day, Maidul Islam, Sam Schifman, and Jean Duteau—are spearheading efforts to define scalable consent handling strategies that align with both technical and legal requirements. 

In its SDOH Playbook, “US Playbook to Address the Social Determinants of Health,” the White House explained that supporting flexible funding to address social needs, such as those offered through health-related social needs (HRSN) reimbursement programs, improves health outcomes: “Increasing funding flexibility and offering technical assistance that empowers organizations to utilize funding from a variety of sources will better equip them to address unmet social needs.”

The success of these reimbursement programs requires the existence of exchange and data standards that serve the interests of all stakeholders. Payers and community-based organization (CBOs) currently experience complexities and pain points that have presented challenges and made it difficult to meet the HRSN reimbursement programs’ full potential exist as these benefits roll out today.

As momentum has grown among states and payers for the reallocation of healthcare funds to address HRSNs, Gravity Project decided to undertake a discovery effort to understand and define the existing landscape for CBO reimbursement and identify the components of the CBO reimbursement process and where national standards play a role. 

"Unite Us is proud to work with the Gravity Project. Together, we are making it easier for community-based organizations to participate in Medicaid reimbursement programs, expanding the availability of these benefits to more individuals seeking care,” Emily Anders, director of payments strategy for Unite Us, said.

A report from the HL7 Da Vinci Project describes how two pioneering organizations demonstrated the real-world practicality and value of applying standard application program interfaces (APIs) to streamline the prior authorization process.

Regence, a payer based in the Pacific Northwest, and MultiCare Health System, a provider based in Washington state, spent about a year testing and fine-tuning processes that leverage HL7’s Fast Healthcare Interoperability Resources (FHIR^®) standard for APIs.

In addition, dozens of other organizations have tested FHIR APIs at more than 15 Connectathon testing events.

As healthcare's digital transformation accelerates and data fluidity improves, the need to ensure patients maintain control over their health data becomes more urgent. While better interoperability brings many benefits, it also raises significant challenges around consent. The key question is: how do we efficiently manage patient consent to ensure privacy preferences are respected at scale, across multiple organizations and systems? 

The FHIR at Scale Taskforce (FAST), is focused on identifying scalability gaps, defining solutions to address current barriers, and identifying needed infrastructure for scalable HL7 Fast Healthcare Interoperability Resources (FHIR®) solutions so taking on consent as a use case was a natural evolution. 

The upcoming FAST Focus Webinar on November 7, 2024, will delve into this critical topic, offering stakeholders valuable insights into the FAST Consent team's efforts to develop a standardized framework for consent management. The webinar will provide an update on their progress, highlighting the collaborative work that has shaped the project’s evolution, as well as specific use cases that are central to its scope. 

"Our response to interoperability isn’t just about managing data—it’s about building the future of healthcare through open standards." - Dan Vreeman, DPT, Chief Standards Development Officer, HL7 International

Last week at Civitas 2024 in Detroit, HL7 International/s Chief Standards Development Officer,Dan Vreeman, DPT, led an insightful panel session on how HL7® Fast Healthcare Interoperability Resources (FHIR®) is revolutionizing interoperability. As data sharing becomes increasingly critical, HL7 is at the forefront, driving collaboration with over 45 organizations and developing 35-45 new FHIR implementation guides annually! Dan was joined by leaders from the Da Vinci Project, FAST, Gravity Project, and Helios, to discuss their HL7 FHIR Accelerator projects, including objectives and progress made to date in advancing open data standards development and interoperability.

An Overview, Demo and Benefits of Da Vinci-related Test Kits on Wednesday, October 23

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

This month’s session, Exploring Inferno: An Overview, Demo and Benefits of Da Vinci-related Test Kits, is scheduled for Wednesday, Oct. 23, from 4 – 5:30 PM EDT and features presenters from the Assistant Secretary for Technology Policy (ASTP) / Office of the National Coordinator for Health Information Technology (ONC) and MITRE. Presenters will introduce the Inferno Framework and voluntary test kits, which may be used as testing tools to further advance implementation guide development and testing of industry implementations.

Health Level Seven International (HL7^®), the global authority on interoperability of health information technology with members in 55 countries, announced election results for its board of directors, international council and technical steering committee during its annual business meeting at the 38th Annual Plenary and Working Group Meeting in Atlanta.

Chair-Elect

The membership selected Carol Macumber, executive vice president of Clinical Architecture, as chair-elect in 2025 and board chair for 2026-2027.

HL7 Board Member Elections

The following members were elected to the HL7 board of directors for the 2025-2026 term:

• Secretary — Yan Heras, Ph.D., principal, Optimum eHealth LLC
• Director — Gora Datta, FHL7, chairman and chief executive officer, CAL2CAL Corporation
• Director — Ken Rubin, FHL7, senior advisor, standards and interoperability, CIDMO, U.S. Department of Veterans Affairs
• Affiliate Director — Ron Parker, FHL7, chair, HL7 Canada; principal, Parker Digital Health Consulting Inc
• Affiliate Director — Line Saele​, chair, HL7 Norway; enterprise architect, Norwegian Institute of Public Health