The Standard

Last month’s virtual CMS HL7 FHIR Connectathon provided participants with policy updates, demonstrations and ample testing opportunities. With the focus on testing, participants shared API to test against and validate progress of the implementation guides as well as provide feedback. 

Resources, a recap of the session’s highlights and registration information for the September Connectathon is included below.

July CMS Connectathon Resources

• CMS 2022 - 07 FHIR Connectathon 3
• Planning Demos Schedule- CMS HL7 Virtual Connectathon - July 2022 
• Recordings are available in Whova for registrants for 90 days and  in Confluence as publicly available content

Day 1 – General Session

Day One featured CMS and industry experts’ policy updates with emphasis on future interoperability strategies. Themes focused on CMS, ONC, and other federal departments working together with Interoperability and Patient Access as starting points. Prior Auth, Healthcare on FHIR panel, No Surprises Act, Health Equity, TEFCA and FHIR were discussed.

The session tracks were devoted to implementers testing with Fast Healthcare Interoperability Resources (FHIR) servers and Implementation Guides (IGs) with application developers who are working to support better patient access, health equity and data access for the healthcare industry.

Day 2 – AM Da Vinci Track Highlights

Burden Reduction

• The track topped out at 99 participants (which was the max)!
• Google, MCG, Hook, Palmetto Health, Info, Redox and MITRE were involved.
• Participants conducted an end-to-end demonstration of CRD, DTR SMART on FHIR app, and PAS with Prior Authorization scenarios; conducted a deeper dive into the CDS Service and SMART on FHIR app (CRD + DTR) with CQL, and demonstrated PAS for Prior Authorization, with a focus on testing the mapping of FHIR to X12 to FHIR. 

CDex

• Approximately 35 participants attended.
• During the CDex track, stakeholders successfully demonstrated the CDex $submit-attachments operation to send attachments for claim or prior authorization.
• HealthLX demonstrated the CDex reference implementation.
• Aegis provided an overview and demonstration of the CDex test scripts.
• Edifecs used their server to demonstrate both the $submit-attachments and task-based query transactions.

National Directory and Plan Net

• Approximately 30 participants joined this track.
• Patient Centric, Mettle Solutions, Onyx Health, Open City Labs, and MITRE were involved.
• The track tested National Directory and PDex Plan Net Solutions. They verified that the implementation guides support the requirements in the CMS rules for Interoperability and Patient Access as well as Reducing Provider and Patient Burden.

Risk Adjustment

• Approximately 20 participants attended.
• Alphora demonstrated the Risk Adjustment Reference Implementation (for STU1) using Touchstone test scripts to test the input and output parameters that generate risk adjustment coding gap reports.
• United HealthCare also demonstrated their implementation of the Risk Adjustment Reference Implementation and shared experiences. 
• Lastly, Alphora and Novillus presented a proof of concept, using Hierarchical Condition Category (HCC) 189 as an example, to demonstrate specifying an HCC as a measure using Clinical Quality Language (CQL) and running $risk-adjustment operation on FHIR clinical data to automatically code and validate HCC 189 and generate a risk adjustment coding gap report.

Day 2 – PM Da Vinci Track Highlights

Patient Cost Transparency

• Approximately 40 participants attended.
• Edifecs demonstrated submission of a good faith estimate (gfe-sumbit) and return of the advanced explanation of benefits (AEOB) with a FL Blue back end.

PDex/Formulary

• Approximately 30 participants joined the track.
• 1up Health and Info connected to Onyx for Payer-to-Payer Exchange.
• MITRE connected with Onyx STU1 and STU2 Formulary APIs and demonstrated authenticated member access and searching for meds under the member’s plan.
• Citius Tech demonstrated member authentication and query of the STU1 endpoints using the required search parameters.

Member Attribution

• Approximately 10 participants attended.
• Drajer, LLC demonstrated the Member Attribution reference implementation.
• MultiCare Connected Care provided real-world Member Attribution implementation feedback which has resulted in a significant decrease in burden associated with patient matching error rates.
• Alphora demonstrated Member Attribution combined with the GapsInCare reference implementation to close care gaps.

Day 3 – Closing Comments

• Reminder that the HL7 FHIR Connectathon will be held in September.
• CMS was grateful to everyone who participated and thanked track leads who led the efforts.
• CMS plans to host this event annually.
• For those who attended, provide your feedback. 

Plan to join us for the next FHIR Connectathon, live and in person in Baltimore, MD, September 17 – 18, 2022. Learn more, prepare for the event and register here. Take advantage of the early bird discount by registering before August 26.

Contact davincipmo@pocp.com if you need feedback or guidance on where testers are needed.