The Standard

Join the Webinar Highlighting MCG Health’s Prior Authorization Journey and Da Vinci’s Two New Use Cases for 2021 on Wednesday, February 24 from 4:00 - 5:30 pm ET.

Healthcare organizations increasing their exposure to value-based care find many tasks complicating the transition, and reducing the burden of those changes is key to thriving under new reimbursement schemes.

New payment approaches incentivize both payers and providers to become more efficient, and that means reducing the number of manual interventions in exchanging data. In addition, value-based care is uncovering new reasons to make information more easily available, to bring new efficiencies to the system.

Examples of these capabilities will be featured in the HL7 Da Vinci Project’s Community Roundtable on February 24. The title for the event is "What it Takes: Learn about MCG Health’s Journey to Help Reduce Prior Auth Burdens and Discover New Da Vinci Use Cases."

The upcoming roundtable will offer an inside understanding of the 18-month effort at MCG Health to advance the use of the HL7 Fast Healthcare Interoperability Resource (FHIR®) standard in solutions that support burden reduction in facilitating the prior authorization process.

Monthly Event is Scheduled for 4:00 to 5:30 p.m. ET on Wednesday, January 27, 2021

In the first community roundtable of 2021, project managers of the HL7 Da Vinci Project will provide updates for how the project’s implementation guides can be used to solve interoperability challenges and meet federal rules.

The roundtable is intended to highlight how Da Vinci Project implementation guides can help organizations reduce burden, advance data exchange and enable better patient access to data.

Participants from the HL7 Da Vinci Project include Jocelyn Keegan, program manager; Viet Nguyen, MD, technical director; and Vanessa Candelora, project manager. The Da Vinci team will show the progress of Implementation Guides (IGs), which give guidance for using the HL7’s Fast Healthcare Interoperability Resources (FHIR®) coding. The team will also provide linkages to specific federal rules and policies, giving you the recipe to solve challenges in alignment with federal rules and leverage the power of standards to improve connectivity across all of your patient populations.

Presentation at HL7 Da Vinci Project’s Community Roundtable Outlines Wide-Ranging Corporate Effort to Democratize and Liberate Data

For Humana, achieving interoperability is more than a nice-to-have way to exchange data every once in a while. It’s something that the company – and the entire healthcare industry – needs to operate efficiently and effectively for patients and clinicians.

It expects that the use of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard will be crucial for achieving widespread interoperability. Current information exchange approaches offer a patchwork solution that works in isolated instances. FHIR’s promise is that it can provide standardized solutions that every industry participant can use.

“Exchange works at small scale because (information) roadways are rebuilt every time a connection is made,” said Patrick Murta, Humana’s chief interoperability architect and solutions architecture fellow, speaking at the November Community Roundtable for the Da Vinci Project, an accelerator program of HL7 seeking to expand the use of FHIR to support information exchange needed for successful value-based care.

Projects required crucial coordination between three HL7 Da Vinci Project members – Cedars-Sinai, Anthem and CareEvolution

Two challenging problems in improving care coordination and quality are the focus of efforts between a prominent Los Angeles-area care delivery system, a large healthcare payer and a technology vendor.

The HL7 Fast Healthcare Interoperability Resource (FHIR®) is playing a role in aiding the effort, but those involved say the FHIR standard, while important, is only a part of the components of their successful project.

Cedars-Sinai, Anthem and CareEvolution detailed the lessons they have learned in the data exchange project during the HL7 Da Vinci Project’s Community Roundtable in October. While FHIR has played an important role in exchanging information, it is only one piece of the puzzle – all participants had several technical and planning tasks to accomplish to ensure the projects succeed and reduce users’ workloads.

Da Vinci’s use cases and implementation guides are “a great starting point, but they only define one stage in that pipeline,” said Brandon Raab, engineer lead for enterprise data and analytics solutions for Anthem. “The end-to-end actualization of the use case will likely involve the integration of upstream and downstream systems.” Achieving the desired results “was a substantially heavier lift than we anticipated.”

Cedars-Sinai, Anthem and CareEvolution – all members of the Da Vinci Project – began discussions about how they could work together to put FHIR into practical use, said Ray Duncan, MD, executive director for technology research and development in enterprise information services for Cedars-Sinai. The partners chose notifications and data exchange for quality measures (DEQM) use cases because those use cases were “pretty far along in the balloting process” and because the organizations “wanted to focus on use cases where we could try them without a lot of changes to clinician workflow.”

Joint Community Roundtable, Member Forum Event for the HL7 Da Vinci Project is November 18

Gaining traction for standardized approaches across a variety of healthcare organizations can be challenging but possible when common goals are identified, and everyone benefits from the collaborative effort.

That was the track taken by Humana, when the healthcare payer sought to win the support of healthcare provider organizations to adopt the HL7 Fast Healthcare Interoperability Resource (FHIR®) to achieve mutually beneficial goals as a result of easier information exchange.

The Da Vinci Project’s November Community Roundtable will look at Humana’s efforts to better integrate care for its members through the use of FHIR. The session is entitled, “Humana: Achieving Integrated Care Delivery Using FHIR: Why it’s a Big Deal.”

Recap of the September HL7 Da Vinci Project Community Roundtable 

Exchanging information is much like a dancing competition – it takes partners who are willing to work hard to coordinate their actions.

Multicare Connected Care and Regence Blue Pilot Medication Reconciliation Project

That was a bedrock of the initiative that paired MultiCare Connected Care and Regence Blue Shield, now bearing results in enabling better medication reconciliation between the healthcare organizations.

The partners described their journey to implement a use case from the HL7 Da Vinci Project in September’s Community Roundtable, noting that they are achieving substantial results in improving data exchange efforts, reducing manual work for the two organizations and enabling them to redirect resources to other projects that benefit both patients and the organizations.

The effort has paid off – MultiCare has achieved dramatic improvements in its compliance with medication reconciliation requirements, while reducing the amount of manual intervention by both organizations, said Anna Taylor, director of operations for population health at MultiCare for its an accountable care organization.

Using standardized interoperability, in the form of a use case for coding from HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard, helps to reduce the burden “on us as providers and as an ACO,” Taylor said. “Success in value-based care models requires data and information from partnering entities; we’re able to use this data and information to make sure that those that are the most sick and need the most care navigation get what they need to stay healthy.”

Anthem, Cedars-Sinai, and CareEvolution to share on project to implement Data Exchange for Quality Measures and Event Notification on Wednesday, October 28

Like peeling back the layers of an onion, exchanging information to support value-based care involves complex data challenges for providers and payers alike.

That’s particularly true when it comes to navigating essential communications between providers and payers, using that dialogue to better coordinate care and achieve the best possible results for patients.

Two key areas that challenge everyone is ensuring that quality measures are met and that everyone in the chain is on the same page when it comes to events. Typically, these are hard for all parties in sharing relevant information.

HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard offers an approach that everyone can use to facilitate data exchanges. In an upcoming community roundtable scheduled for 4 to 5:30 p.m. ET on Wednesday, October 28, HL7 Da Vinci Project members Anthem, Cedars-Sinai and CareEvolution will discuss their efforts to put implementation guides for Data Exchange for Quality Measures and Event Notification in place.

Time is ticking away on healthcare organizations, who face fast approaching federal deadlines to improve the sharing of information to give patients access to their payer data. Additionally, the tools to reduce clinician burden and improve clinical data exchange between payers and providers are rapidly maturing.

The good news is that HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard is the tool that organizations can use to meet new requirements for data sharing. Use cases and accompanying implementation guides from the HL7 Da Vinci Project offer specific, standardized ways for organizations to use plug-and-play technologies with multiple other organizations.

But for many organizations, now the works begins in earnest. Implementing Da Vinci use cases will require input from IT departments and testing with a variety of partners. Fortunately, an upcoming Da Vinci Project event aims to equip participants with the necessary knowledge to get off the ground successfully.

HL7 is offering a Da Vinci-focused Education and FHIR Implementation Event on October 27 to 29, open to both members and non-members. The event goals are to educate the health IT community about HL7 FHIR and FHIR implementation guides develop by the Da Vinci Project and the CARIN Alliance.

Recap of the August Da Vinci Project Community Roundtable on DRLS and FAST

As the HL7 Da Vinci Project continues to make rapid progress in developing use cases to enable the exchange of healthcare information, work has been underway to test and widely deploy these cases among industry players.

Efforts led by federal agencies have been in motion to use solutions based on HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard at scale, as well as to incorporate FHIR use cases in a federal initiative that developed and tested a prototype to demonstrate the capability to streamline clinical workflow access to coverage requirements.

Presenters at a Da Vinci Project community roundtable on August 26 said the initiatives are important in bringing the benefits of automated information exchange throughout the healthcare industry, while taking steps to reduce the burden on providers.

The FAST Initiative
In one initiative, the Office of the National Coordinator for Health Information Technology (ONC) is convening a FHIR at Scale Taskforce (FAST) that brings together a representative group of motivated healthcare industry stakeholders. FAST aims to take use cases that are being demonstrated in initial efforts between partners in the industry and ensure that they can operate more broadly.

“In building solutions for FHIR for interoperability, we realize that individual solutions are being developed to work between one endpoint and another,” said Stephen Konya, senior advisor to ONC and the Department of Health and Human Services. “When we start to roll these out at scale – when there’s a large number of payers sharing a large amount of data with a large number of providers – the game changes.”

Providence St. Joseph, Cambia and MultiCare to Present on Collaborative Effort to Implement Use Case from the HL7 Da Vinci Project on Wednesday, September 23

Clinicians see the need for better access to healthcare information as clearly as others serving in the industry. Because of that, it should be no surprise that clinicians and their teams are playing key roles in the HL7 Da Vinci Project implementations.

Clinicians are not insulated from the changes being wrought by value-based care, so they see the need for adaptations to the digital health ecosystem. That is one force driving change at Providence St. Joseph, which is working with Cambia Health Solutions and MultiCare Connected Care to facilitate information exchange.

These organizations are collaborating on an initiative that is helping lead the way with Da Vinci Project production implementations to enable interoperability and advance value-based care. They will share their insights and experiences next week during the Da Vinci Project’s monthly Community Roundtable from 4:00 – 5:30 pm ET on Wednesday, September 23. The roundtable is entitled “Provider Leadership and Partnerships: The Key to Interoperability and Scalability of Value-Based Care.”