The Standard

Explore the Cross Accelerator Collaboration During the Discussion Aug. 23, 4 :00 – 5:30 p.m. ET

“Reducing Prior Authorization Burden and Improving Oncologic Care with HL7 FHIR,” August’s Community Roundtable, will highlight why and how Da Vinci is tackling prior authorization and hear how CodeX is leveraging the work of the Da Vinci Implementation Guides (IGs), which have been referenced in federal proposed interoperability rules, to tackle prior authorization challenges in oncology.  

 Join the session and discover the endeavors of the CodeX Prior Authorization in Oncology Use Case team to improve the care journey for cancer patients by expediting prior authorization via automation. 

The discussion will share real-world success stories from Da Vinci and how these efforts can serve as building blocks for CodeX solutions, as well as reveal how you can become involved and the benefits of participation in this work.

Presenters for this session include:

• Ellen Anderson, Enterprise Architect, Evernorth
• Kirk Anderson, Vice President and Chief Technology Officer, Chair, Da Vinci Steering Committee, Cambia Health Solutions
• Su Chen, MD, CodeX Program Manager, Clinical Science Principal, MITRE

Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners, serves as the session moderator.

Hear about the ONC’s USCDI+ Quality Initiative and learn the latest about the Quality Measures for Cancer Use Case on July 28

Latest advances in the use case and the success of Mayo Clinic’s adoption of minimal Common Oncology Data Elements (mCODE) to improve routine oncology clinical care focus of June Community of Practice

Prior authorization continues to be a pain point across the health care spectrum, and this month’s CodeX Community of Practice meeting will be highlighting prior authorization and how a standards-based approach is improving care at the Mayo Clinic.

According to a 2022 American Medical Association survey, 94% of physicians reported care delays associated with prior authorization, and 80% said these requirements can at least sometimes lead to patients abandoning treatment.

When treating cancer, the delays could be deadly.

Within CodeX, the Prior Authorization in Oncologyuse case focused on prostate cancer treatment is making strides in its iteratively phased proof-of-concept (POC). A goal of the use case is to automate prior authorization for cancer treatment so that 80% of approvals do not require manual inspection, expediting care for patients and reducing physician burden. CodeX participants are proving the utility of the Implementation Guides Coverage Requirements Discovery (CRD), Documents Template Requirements (DTR) and Prior Authorization Support (PAS) as developed by the HL7 Da Vinci Project Burden Reduction use case as well as in the Centers for Medicare and Medicaid Services December 2022 proposed rule Advancing Interoperability and Improving Prior Authorization Processes.

The Da Vinci Project’s June Community Roundtable to be held June 28 from 4:00 – 5:30 pm ET

Representatives from athenahealth and Optum discuss the HL7 Da Vinci Project’s newest use case during the June Community Roundtable, scheduled on Wednesday, June 28, from 4 – 5:30 p.m. ET.

In addition to learning the latest project updates, attendees will learn how the Da Vinci Risk Adjustment Implementation Guide (IG) supports exchange of risk adjustment gap reports at the point of care. Attendees will discover how standard protocols, which are payer agnostic, enable communication of chronic conditions and simplified workflows. Presenters will also illustrate how providers gain the ability to share real-time feedback and clinical evidence to address gaps. An overview of the IG and a question-and-answer period will conclude the webinar.

 Presenters for this session, “Risk Adjustment Reporting at the Point-of-Care​,” include:

• Josh Lamb, Integration Architect, Optum
• Linda Michaelsen, Director, Healthcare Interoperability Standards, Optum
• Nidhi Pengoria, Senior Product Manager, athenahealth

Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners, serves as the session moderator.

The Da Vinci Project’s April Community Roundtable to be held April 26 from 4:00 – 5:30 pm ET

Join us for our April Community Roundtable this Wednesday, April 26, from 4 – 5:30 pm, to hear the latest from the HL7 Da Vinci Project and recent industry activity as well as our featured implementation story from athenahealth, Availity and Humana.

Straight from the Spotlight Theater at HIMSS23, this national payer, EHR vendor and health information network will share lessons learned from their collaborative development of an end-to-end prior authorization process leveraging the Da Vinci Burden Reduction Implementation Guides.

Presenters for this session, “A Transformative Trifecta: An End-to-End Prior Authorization Journey,” include:

• Susan Bellile, Principal, Clinical Solutions, Availity
• Jocelyn Keegan, Program Manager, HL7 Da Vinci Project; Payer/Practice Lead, Point-of-Care Partners
• Amy Mattingly, Director, UM Interoperability Product Management, Humana
• Gillian McCabe, Director, Product Management, Authorization Management, athenahealth

The moderator for the Community Roundtable is Alix Goss, HL7 Da Vinci Project PMO, Vice President and Senior Consultant, Imprado.

The Da Vinci Project’s January Community Roundtable to be held January 25 from 4:00 – 5:30 p.m. ET

With the issuance of the new federal prior authorization and attachments rule proposals last month, the innovative interoperability work advanced by the HL7 Da Vinci Project is once again being recognized as a path forward for game-changing industry transformation that will reduce burden, increase automation and improve care.

The Intersection of Federal Regulation and The HL7 Da Vinci Project, January’s Community Roundtable, features an overview and frequently asked questions about the rules and their accompanying RFIs from CMS officials. Da Vinci leaders then will share an overview of the implementation guides that are suggested in the proposed rules and how they meet the rules’ objectives.

At the January 25 session, which is scheduled from 4:00 – 5:30 p.m. ET, attendees will learn how to access the resources, participate in community feedback and start getting involved.

The Da Vinci Project’s November Community Roundtable to be held November 30 from 4:00 – 5:30 p.m. ET

During November's Community Roundtable, HL7 Da Vinci Project leaders representing providers, payers and EHR vendors will offer an insightful program discussing real-world implementations of Da Vinci’s Implementation Guides.

“Significant Progress: HL7 Da Vinci Project Year-end Review and 2023 Plans,” begins with a review of this year’s program accomplishments and continues with a panel of industry and HL7 Da Vinci Project leaders sharing the impact of corresponding regulations and the proven guides that reduce burden and enable efficient value-based care workflows.

In particular, they will discuss the reality and progress of Da Vinci implementations in a world where HL7 FHIR APIs are becoming the de facto norm for data sharing for clinical data exchange and prior authorization. The session concludes with a preview of the project goals and activities planned for 2023.

The Da Vinci Project’s September Community Roundtable to be held September 28 from 4:00 – 5:30 p.m. ET

As fee for service shifts to value-based care, value-based contracts have emerged as a mechanism that providers and payers may use to better align their contracting structures with broader changes in the healthcare system.

"Dive Into Performance Reporting for Value-Based Contracts,” this month’s Da Vinci Community Roundtable presentation by representatives from Humana, Providence and the Da Vinci PMO, provides you with front-row access to HL7 Da Vinci Project’s newest use case that aims to develop an HL7 FHIR Implementation Guide to support value-based performance reporting for quality and risk contracts.

The HL7 Da Vinci Project’s August Community Roundtable to be held August 24  from 4:00 – 5:30 p.m. ET

Da Vinci’s Community Roundtable returns after a summer hiatus with a powerful program highlighting a real-world implementation of Da Vinci’s Prior Authorization Implementation Guides.

“Celebrating HL7 FHIR's Success: From Champions to Prior Authorization Implementers,” will begin with a program update and brief recognition of the 2021 HL7 Da Vinci Community Champions, showcasing individuals making significant contributions to advancing value-based care by leveraging HL7 Fast Healthcare Interoperability Resources (FHIR®) and making the outputs of Da Vinci real.

After the updates, representatives of the 646-bed health system UC Davis Health, the 25.4-million-member payer Centene, and technology solutions vendor InterSystems will discuss their Da Vinci prior authorization journey and the benefits achieved to date.

Presenters for next week’s session include:

• Howard Cohen, Director, Advanced Technology Team, Centene
• Michael B. Marchant, Director, Health Information Exchange, UC Davis Health
• Lynda Rowe, Senior Advisor, Value-based Markets, InterSystems
• Mahesh Siddanati, Vice President, Digital Solutions and Product (Regulatory and Quality), Centene

Attendees will hear first-hand accounts of the considerations, challenges and benefits of working together to establish infrastructure to streamline prior authorization workflows, remove latency and enable real-time data sharing.

The Da Vinci Project’s April Community Roundtable to be held April 27 from 4:00 – 5:30 p.m. ET

Why does interoperability require governance? Find out at this month’s April HL7 Da Vinci Community Roundtable.

This month’s session, Effective Interoperability Governance: The People, Processes and Data, features multiple vantage points to approaching interoperability governance and its complexities in our HL7 FHIR API landscape around people, processes and data.

Learn about the meaning of governance and the importance, challenges and lessons learned when applying these guardrails from four different perspectives: an Accountable Care Organization, an academic medical center, a payer and an IT vendor. Critical considerations around process controls, systems and frameworks will also be addressed.

Presenters include:

• Michael Gould, Business Lead – Interoperability, Blue Cross Blue Shield Association 
• Michael B. Marchant, Director, Health Information Exchange, UC Davis Health
• Charlotte Morris, Data Governance Program Director, MultiCare Connected Care
• Lukasz Nosol, Senior Director, Software Development - Enterprise Clinical Integration and Interoperability, Optum