The Standard

From digital check-ins to connected devices and telehealth programs, patients expect the benefits of a more digitized healthcare experience.

 At the same time, they’re also demanding a more personalized approach from healthcare providers. This duality - the need to provide a more convenient experience with one that’s more tailored to the patient - is fueling a wave of technology modernization efforts and the replacement of monolithic legacy IT systems.

 With limited re-use outside of the context they were built for and a reliance on nightly batch processing, legacy IT systems fail to deliver the services healthcare IT teams need or provide the experiences patients demand. Modernization should come with a move to microservices that can be used by multiple applications, agile teams that embrace domain driven design principles, and event busses like Kafka to deliver real-time data and functionality to users.

While this transformation is occurring, there’s an 800 lb. gorilla not being widely addressed:  Analytics.

 What the healthcare industry doesn’t want to talk about is how costly analytics has become; the people, the software, the infrastructure, and particularly how difficult it is to move data in and out of data lakes and warehouses. It's hindering the industry’s ability to deliver insights to patients and providers in a timely and efficient manner.

And yet, so many organizations are modernizing their analytics data warehouses and data lakes with an approach that simply updates the underlying technology. It’s a lift-and-shift effort of tremendous scale and cost, but one that is not addressing the underlying issues preventing the speedy delivery of meaningful insights.

The Da Vinci Project’s October Community Roundtable, to be held Oct. 27 from 4:00 – 5:30 p.m. EDT, will feature Clinical Data Exchange (CDex)

This “Swiss army knife” of implementation guides (IGs) is responsible for identifying, documenting and constraining specific patterns of exchange so that providers and payers can reliably share patient information and coordinate care.

The scope of the CDex encompasses defining combinations of exchange methods with specific payloads, search criteria, conformance, provenance, and other relevant requirements, to support specific exchanges of clinical information between providers and and/or payers. CDex is also responsible for aiding in risk adjustment and quality reporting--and it helps payers to identify whether a requested service is necessary and appropriate.

The roundtable, titled, “Harnessing Clinical Data Exchange (CDex) to Improve Performance within Value-Based Care,” will give a current snapshot of the functionality, benefits and capabilities of CDex, helping providers to share the clinical data they have generated with payers and other industry partners.

At the roundtable, members of the Providence team will share their strategy for using CDex to support payer value-based care arrangements focusing on their initial target to achieve supplemental data exchange.

Presenters will include:

• Viet Nguyen, MD, Technical Director, HL7 Da Vinci Project, and Clinical Informaticist, Stratametrics, LLC
• Semira Singh, Product Manager, Population Health Informatics, Providence
• Michael Westover, Vice President, Population Health Informatics, Providence

Come to the roundtable and learn how HL7 is making progress on CDex, with its eye on what remains to be conquered to provide the fully maximized data exchange needed to support value-based care. The good news is, HL7® Fast Healthcare Interoperability Resource (FHIR®) is helping to drive interoperability forward, and Da Vinci is poised to accelerate that data exchange in such a way that it will greatly reduce the burden between providers and payers.

Weclome to CodeX's New Patient Voices Series!

CodeX recently talked with cancer patients, survivors, and advocates to hear their stories and learn more about their perspective through the cancer care coordination process. CodeX (Common Oncology Data  Elements eXtensions) is a HL7 FHIR Accelerator, launched at the end of 2019, that is building a community to enable interoperable cancer data modeling and applications that lead to step-change improvements in cancer patient care and research.  

Bias in Healthcare is Deadly

“It’s almost like negligent homicide. Because of the bias that’s there—whether it’s explicit or implicit—is resulting in these people—patients of color—not receiving the full scope of care that they should be.” Jamil Rivers is a person with breast cancer and the Founder of The Chrysalis Initiative.

The Chrysalis Initiative is a patient advocacy organization looking to disrupt harmful disparities in accessibility, quality and outcome of cancer care. Looking at the source of disparities is the first step to rectifying them, and The Chrysalis Initiative provides equity assessments that evaluate all types of healthcare services that offer cancer care. The assessments evaluate whether the experiences of patients of color differ from White patients. When Jamil first started the equity assessments, she expected around 50% of patients of color to experience racism and bias. However, Jamil quickly discovered that this number was much higher. “90% of our preliminary data indicated that they [patients of color] were receiving substandard care and experiencing racism and bias in their care.” According to Jamil, many medical providers and researchers are cognizant of racism and bias affecting patients, but few understand the true pervasiveness of explicit and implicit racism in patient care. Even biases that at first glance seem trivial can be deadly because each action based upon bias deteriorates the quality of care a patient receives.

Weclome to CodeX's New Patient Voices Series!

CodeX recently talked with cancer patients, survivors, and advocates to hear their stories and learn more about their perspective through the cancer care coordination process. CodeX (Common Oncology Data  Elements eXtensions) is a HL7 FHIR Accelerator, launched at the end of 2019, that is building a community to enable interoperable cancer data modeling and applications that lead to step-change improvements in cancer patient care and research.  

Creating Patient-Centered Care

“We see patient-centered care as the patient is in the center, fully alert, fully informed, and fully able to contribute to the information as well as what [treatment] they want to happen in their lives.” Debi Willis is a kidney cancer survivor and the CEO and Founder of PatientLink and MyLinks. The phrase “patient-centered care” is frequently mentioned, but what do these words really mean? According to Debi, patient-centered care is sometimes mistakenly interpreted as having multiple medical professionals focusing on a single patient where the patient has little understanding nor input in decisions that are made. Instead, “patient-centered care” should involve the patient in all decision making and ensure that the patient understands all decisions that are made throughout the care process.

In the early 90s, Debi worked at the Federal Reserve Bank of Kansas City as a software engineer. She noticed that the financial sector was highly automated, but the healthcare industry was almost completely reliant on manual entry of data. Medical providers who switched to using EHR (Electronic Health Record) systems found them tedious and difficult to use. To explore the new field, Debi switched from the banking technology industry to medical technology and created software that would allow patients to easily send their information into their physician’s medical record as structured data. This allowed the physician to focus on their patient instead of typing into the EHR. Although it wasn’t in her initial plans, the demand for her technology from medical providers led her to launch PatientLink.

Da Vinci Project's Monthly Meeting to Describe Progress on Price Cost Transparency and Risk Adjustment Initiatives on Wednesday Event, 9/22 at 4:00 pm ET

Important updates on two implementation guide initiatives and a demo of how standards could support prior authorization burden reduction are on the agenda for the next Community Roundtable of the Da Vinci Project.

The roundtable will begin with an update from the project management office of the Da Vinci Project, which will feature updates on the status of the Price Cost Transparency and Risk Adjustment Implementation Guides (IGs). These efforts to use HL7® Fast Healthcare Interoperability Resource (FHIR®) are more complex than previous initiatives. Both efforts anticipate challenges that the industry will face to make healthcare costs more transparent and to accurately reflect patients’ comprehensive conditions and risks related to reimbursement for coverage.

After the update, the prior authorization demonstration will show how FHIR IGs can be used to reduce administrative challenge of anticipating prior authorization documentation requirements, a nagging concern within the industry.

Sessions at HIMSS21 Offer Glimpses into Progress, Potential New Uses for the Standard

After a hiatus of nearly 18 months, a slimmed-down, COVID-sensitive HIMSS 2021 Conference still managed to provide extensive insights into several major trends within the healthcare IT industry.

Along the dual tracks of federal regulations forbidding information blocking and the need for improved data exchange to facilitate, there were many discussions about the capabilities of HL7® Fast Healthcare Interoperability Resources (FHIR®) to support the industry.

The HL7 FHIR community had opportunities at the conference’s Interoperability Showcase to update the industry on dramatic progress by its accelerator groups to advance the use of FHIR in areas where data exchange is essential.

In July 2021, the Centers for Medicare & Medicaid Services (CMS) hosted its second HL7® FHIR® Connectathon, welcoming over 800 participants from Federal agencies, payer organizations, and the health IT industry to a three-day event with more than 70 presentations focusing on education, implementation guide testing, and community-building around Fast Healthcare Interoperability Resources (FHIR)-based application programming interfaces (APIs).

Recent Initiatives of the ONC’s FHIR at Scale Taskforce (FAST) and Update on Payer-to-Payer Mandate are Key Topics for Wednesday Event, 8/25 at 4:00 pm ET

The success of the HL7® Fast Healthcare Interoperability Resource (FHIR®) standard is becoming increasingly evident.

Successful case studies are emerging. For example, a recently published HL7 case study documents how MultiCare Connected Care and Regence are recognizing significant cost savings by using a FHIR implementation guide standard to definitively ascertain that medication reconciliation has been completed. This case study can be found at https://www.hl7.org/participate/case-studies/index.cfm .

But these isolated successes beg the question – can FHIR be used more broadly, and implemented more widely across the country, handling a multiplicity of interactions across dozens of healthcare organizations simultaneously?

That is the task given to the ONC’s FHIR at Scale Taskforce (FAST), which is seeking to determine solutions and opportunities to influence emerging solutions.

Progress by the ONC FAST effort is of prime importance to the dissemination of FHIR solutions to solve information exchange challenges in healthcare. The panel’s progress over the past year will be one of the topics of the Da Vinci Project’s monthly Community Roundtable event, to be held from 4 to 5:30 p.m. ET on Wednesday, August 25.

HL7 Da Vinci Roundtable  on July 28 from 4:00 to 5:30 p.m. ET to Feature Payer-to-Payer Data Exchange

Join the Da Vinci Project next Wednesday at its July Community Roundtable titled "Payer-to-Payer Data Exchange: Rising to the Opportunities and the Challenges." The session will focus on the use of HL7's 's Fast Healthcare Interoperability Resources (FHIR®) for payer-to-payer data exchange, highlighting the Payer Data Exchange (PDex) use case.

Presenters for the session include:

• Michael Gould, business lead - interoperability at Blue Cross Blue Shield Association
• Patrick Murta, chief interoperability architect & solutions architecture fellow, Humana
• Heather Kennedy Tanner, director of enterprise architecture, BlueCross BlueShield of Tennessee

Da Vinci Roundtable  on June 23 from 4:00 to 5:30 p.m. ET to Look at the Potential for Getting More Value from the Use of Standards

Exchanging clinical data sets is getting more attention, particularly as healthcare organizations focus efforts on gaining efficiency and improving clinical care, while reducing clinician burden.

The ultimate challenge is freeing the data contained in these communications and making it computable and usable with minimal or no manual intervention. That looks ahead to the incorporation of fielded data, which will enable the use of agreed-upon approaches to make data usable.

Sharing the current state of the art for these advances through the use of Fast Healthcare Interoperability Resources (FHIR®) will be the focus of the June Community Roundtable of the Da Vinci Project, taking a deep dive into the Clinical Data Exchange (CDX) use case.

The session, with the title of “Demystifying Attachments to Enable Clinical Data Exchange,” will take place from 4 to 5:30 p.m. ET on June 23. The roundtable will focus specifically on the importance of implementing clinical data exchange capabilities, to anticipate emerging data exchange requirements and potential regulatory efforts.

Steven Lane, MD, MPH, clinical informatics director for privacy, information security and interoperability at Sutter Health, will share the clinician view regarding the challenges, opportunities and benefits of standardized data exchange.

In addition, Mary Lynn Bushman, agile product managers for National Government Services, will showcase their attachments implementation and production successes that it’s experienced with more than 1,500 provider organizations, improving multiple workflows and reducing burden. Da Vinci’s Technical Director Viet Nguyen, MD, will discuss emerging capabilities for provider-provider and provider-payer clinical data exchange.