The Standard

Community Roundtable Featuring Payer Data Exchange Implementation Guide on May 28 at 4 pm

If you're looking for a real-world take on how the healthcare industry is putting the HL7 Da Vinci Project’s Payer Data Exchange (PDex) Implementation Guide into action, you won’t want to miss this event! The 90-minute virtual community roundtable will feature how organizations are using FHIR-based APIs to improve transparency and value-based care.

How Organizations Are Using PDex in Production Today

After a brief update on the PDex Implementation Guide from Da Vinci’s technical director, attendees will hear about implementation considerations and first-hand implementer accounts from those actively applying PDex to solve real-world data exchange challenges:

• Blue Cross Blue Shield Association + InterSystems will discuss the immense potential of payer-to-payer APIs to increase patient transparency and improve value-based care in light of the high levels of churn of the impacted population, resulting in care gaps and a need to provide patients with longitudinal records of care. Presenters will highlight the relevant Implementation Guides and the workflow issues inherent in the process that are being worked on. 
  
  
• Availity, Healow Insights, and Humana will explore their experience with payer-to-payer data sharing using PDex—including workflow impacts, scaling considerations, and member-centered outcomes. Availity and Humana will share its observations and lessons learned along their payer-to-payer implementation journey through internal development, coordinating with their cohort of payers, and participating in Connectathons. Then Healow will highlight its experiences from two years in PDex production. 

Thanks to the dedicated efforts of Gravity Project’s community members, volunteers, and staff, we made significant progress in advancing standards for Social Determinants of Health (SDOH) in 2024 that will shape the future of health data sharing.

Key Achievements

Gravity focuses on developing consensus-based standards that enhance data interoperability for SDOH. Our terminology, technical, and implementation workstreams all made notable progress in 2024 that we can leverage this year.  We provided valuable resources and guidance to help implementers adopt Gravity terminology effectively.

One of our standout initiatives was a six-week discovery project in February 2024, where over 20 cross-sector stakeholders collaborated to explore social care payment and reporting standards. This effort not only resulted in a comprehensive report but also fostered a deeper understanding of the landscape surrounding social care.

Da Vinci’s Feb. 26 Community Roundtable and Feb. 27 Joint Education Session with FAST to provide implementation resources.

Two free online events coming up soon will provide practical insights on how to improve interoperability by leveraging Health Level Seven’s Fast Healthcare Interoperability Resources (FHIR®) standard for APIs.

A Community Roundtable, to be held at 4 p.m. ET on Feb. 26, will focus on “Da Vinci’s Trebuchet: Launching Your Interoperability Implementations.”

The HL7 Da Vinci Project is a private-sector initiative that’s leveraging FHIR to improve data sharing in value-based care (VBC) arrangements. The goal of Da Vinci’s Trebuchet effort is to accelerate FHIR adoption and scaling of FHIR APIs through pilot projects.

Attendees at this month’s Community Roundtable will receive information to equip them with the knowledge and resources needed to successfully launch an implementation journey.

Pilot leaders and a panel of payer and provider implementers will share their expertise. After a level-setting session that reviews the purpose and current state of Trebuchet pilots, presenters will describe what’s involved with piloting and how to determine your organization’s readiness.

Attendees will learn about key elements of finding or creating a pilot, including identifying other parties of the willing, the role of vendors in your pilot design, Qualified Health Information Network (QHIN) and Health Information Network (HIN) implications and how your current trading partners fit into your vision. The session will conclude with a panel of payers and providers who will share their piloting journey.

Register Today for the February Community Roundtable! 

To register and attend this free webinar, visit:
https://zoom.us/webinar/register/WN_T5IyY_NQQLybrIZdQ0zifw#/registration 

Second Event

The second event, to be held at 2 p.m. ET on Feb. 27, will be a joint session of FAST and Da Vinci focusing on alignment of Trebuchet and network exchange goals.

FAST stands for the FHIR at Scale Taskforce (FAST) Accelerator, which is working to identify ecosystem-wide barriers to deploying FHIR at scale, define solutions to address those barriers and develop infrastructural standards to support FHIR implementations. The desired outcome is a national API interoperability approach that enables consistent clinical data exchange using FHIR. 

The FAST Security Implementation Guide (IG) supports a multi-party trust framework within payer-payer and payer-provider networks. It supports implementing dynamic client registration in scalable exchange.

David Pyke, FAST technical director, will discuss the FAST IG with a focus on the implementer’s perspective, including:

• What to consider before and during implementation of the IG
• What is of primary importance as you begin and progress through implementation
• For payers, providers and vendors: What are the implications and experiences of the client, vendors and EHRs.

To attend, access the Zoom link on this page under the  Conference Call Schedule and Dial-ins section: https://confluence.hl7.org/display/DVP/Da+Vinci+Trebuchet+FHIR+Pilots   

Don’t miss these two opportunities to learn how to implement FHIR as a critical component of ramping up the exchange of clinical data to improve the quality of care.

Are you ready to go for 2025? 

Join the HL7 Da Vinci Project technical directors next week to learn the latest Da Vinci implementation guide developments. 

Ready to Go! 2025 HL7 Da Vinci Project Implementation Guide Progress, will be held online Jan. 22 at 4 p.m. ET.  As a participant, you will learn about Da Vinci’s use cases and the use case progress across the Da Vinci implementation guides. Da Vinci Project’s technical directors will provide an overview of all the use cases spanning clinical data exchange; coverage, transparency and burden reduction; quality and risk use cases; and foundational assets.  

Don’t miss this opportunity to hear an overview of each use case and learn about implementation guide functional enhancements and resources.  You will also learn the status and maturity of the guides to help inform your planning for your 2025 Fast Healthcare Interoperability Resources (FHIR®) implementation staffing and allocations. 

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.

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.

August 28 Webinar Features Recent Updates Direct from Federal Officials

Are you looking for guidance and insight as you plan for 2025? If so, plan to attend this month’s Health Level Seven (HL7^®) Da Vinci Project Community Roundtable, which features special guests from the Assistant Secretary for Technology Policy (ASTP) office, formerly known as the Office of the National Coordinator for Health Information Technology (ONC). ASTP presenters will highlight why the Trusted Exchange Framework and Common Agreement^TM (TEFCA^TM) is important and share recent updates to the program, including implementation, long term plans, education and outreach, and building trust.

In ASTP’s second segment, testing and adoption efforts will be discussed, covering TEFCA’s HL7 Fast Healthcare Interoperability Resources (FHIR^®) Roadmap, and ASTP’s new TEFCA Payer/Provider 10x10 Coalition. ASTP will provide an overview of the 10x10 and discuss why providers and payers should participate. They will also discuss resources available and the interplay of the 10x10 with Da Vinci.  

The session concludes with the Da Vinci PMO sharing themes and perspectives from its membership on the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule.

June 26discussion highlights efficiencies, burden reduction and features Blue Cross and Blue Shield Association, Providence and UC Davis Health  

This month’s roundtable focuses on the provider experience, as representatives from an academic health system and a seven-state comprehensive healthcare organization provide firsthand accounts regarding how clinicians and their teams are helping to lead the way with HL7 Da Vinci Project and HL7 Fast Healthcare Interoperability Resources (FHIR®) real-world production implementations of Da Vinci implementation guidesto enable interoperability and advance value-based care.  

Moderated by a representative of the Blue Cross and Blue Shield Association, the discussion unveils how payers’ and providers’ interactions evolve as they collaborate to tackle problems and address current pain points with the healthcare system. The panelists will share considerations, challenges and benefits of working together to establish infrastructure to streamline and automate prior authorization workflows, remove latency, and enable real-time data sharing, ultimately creating win-wins for patients, clinicians, administrators, payers and technologists. 

May 29 Sessionfeatures athenahealth, Availity and Humana and honors HL7 Da Vinci Project Community Champions from 4:00 - 5:30 pm ET

Join us this month to hear real-world HL7 FHIR and Da Vinci implementation stories that will provide you with inspiration and insight into how you can apply the learnings of athenahealth, Availity and Humana to your organization’s efforts to reduce friction, increase efficiency and meet the federal interoperability rules. 

After recognizing the 2023 HL7 Da Vinci Project Community Champions, representatives of Availity and Humana will provide a current snapshot of Da Vinci’s effort to create a nationwide interoperable approach among payers using the Payer Data Exchange (PDex) Implementation Guide, which enables payers to create a member’s health history using clinical resources which can be understood by providers and electronic medical records (EMR) systems. This discussion provides an opportunity to better understand dynamics you’ll encounter in achieving payer-to-payer exchange compliance such as consent and endpoint discovery.  Attendees will gain a foundational understanding of the new regulatory requirements, learn about technical and business challenges and benefits from real-world implementers and gain insight into how industry is working together. 

April 25 Session Focuses on the Observation Screening Response Profile

Join us on April 25, 2024, at 2:30 – 4 p.m. ET for the next Gravity Project Implementation Affinity Group meeting, which features more real-world implementations and a key to their success: the Observation Screening Response profile.

Bringing Observation Screening Response into Focus for Gravity Implementers

Building upon the implementation approach and presentation by New York State Qualified Entities in February, this month’s Gravity Implementation Affinity Group session focuses on more real-world implementations and a key to their success: the Observation Screening Response profile.

The benefits of using this profile include explicit categorization of question/answer pairs by social determinants of health (SDOH) domains, flagging of positive findings, and using a common language (Gravity standardized terminology) to share and communicate these findings.

This session will highlight Observation Screening Response, including guidance on using key elements (e.g., Observation.category and Observation.interpretation) and using Observation Screening Response to create Observation Groupings.