The Standard

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. 

February Roundtable also features Payer Data Exchange and Burden Reduction Overviews

This week’s HL7 Da Vinci Project Community Roundtable, “HL7 Da Vinci Implementation Guides Solve Your Real-World Business Problems: Postable Remittance, Payer Data Exchange and Burden Reduction Overviews,” is scheduled for Feruary 28 from 4 – 5:30 p.m. ET. 

Da Vinci leaders will introduce the newest use case focusing on postable remittance advice and will share an overview of the Implementation Guides that are suggested in the proposed rules and how they meet the rules’ objectives.

With the issuance of the new federal interoperability rules, 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. You will learn how to access the resources, participate in community feedback and start getting involved.

The presenters will include:

• Robert Dieterle, HL7 Da Vinci Project Sr. Advisor and Burden Reduction Lead
• Naomi Miao, Business Operations Manager, athenahealth
• Mark Scrimshire, PDex Project Lead & Implementation Guide Lead, HL7 Da Vinci Project, and Chief Interoperability Officer, Onyx Health

The session is moderated by Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners.

2023 Accomplishments Position Industry for Year Ahead

Substantial progress has been made this year on HL7 Da Vinci Project Implementation Guides (IGs), which describe how to use HL7’s Fast Healthcare Interoperability Resources (HL7 FHIR®) standard for exchanging data to support value-based healthcare and implementations of the guides.

Sizing Up Accomplishments

At the December Da Vinci Community Roundtable, Hans Buitendijk, Da Vinci Project Steering Committee Vice Chair, reviewed progress this year and offered an outlook for 2024.

“We have a number of organizations across the spectrum that have adopted one or more of our [FHIR implementation] capabilities. … That's fantastic in the short number of years that this initiative started to look at what is necessary to make it happen,” Buitendijk said.

“We currently have about eight publishing updates that have been accomplished and quite a few ballot processes that are in flight and being planned for, and there is a good amount of commitment to making this happen. So, we really need to be proud of what we have achieved to date, and particularly in the last year.”

In the year ahead, alignment with emerging regulations, including the final CMS Interoperability Rule, will be a top priority, he pointed out.

Interoperability efforts must go beyond a general set of data to ensure adequate support for public health, research, quality measures and more, he added. “We are all going to impact the ability and the opportunity to share more data over time,” he said.

The key to advancing interoperability by leveraging FHIR, he stressed, is to involve many different parties and develop “the same language where we have a minimum set of capabilities that everybody can support, and leaving room … to grow, to explore, to define new things.”

He also pointed out: “We must continuously raise the bar for what we can exchange and determine what is relevant across many different stakeholders that we should all do in the same way … because the data that we have covered so far is still only a part of the variety of data exchanges that are relevant and can benefit from improvements."

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.

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.

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.