The Standard

January Roundtable also features Providence’s Clinical Data Exchange Implementation Journey

Are you interested in hearing federal officials provide an overview of the CMS Interoperability and Prior Authorization Final Rule (CMS-0057)?

If so, register now for next week’s HL7 Da Vinci Project Community Roundtable, “CMS Interoperability Final Rule Overview and a Clinical Data Exchange Success Story: How Standardization Improves Value Based Care Performance,” scheduled for Jan. 24 from 4 – 5:30 p.m. ET.

The HL7 Da Vinci Project is thrilled to have CMS join next Wednesday’s Community Roundtable to offer highlights of the final rule in addition to the scheduled program showcasing Providence’s Da Vinci Clinical Data Exchange (CDex) Implementation Guide implementation journey.

Providence became the first major health system to implement CDex standards, and their journey included piloting with Premera Blue Cross and the vetting and approval by internal quality teams and external Healthcare Effectiveness Data and Information Set (HEDIS) auditors. The session concludes with a discussion of benefits experienced using CDex, including improved decision making, reduced burden, improved patient outcomes and enhanced quality of care to patients.

The Da Vinci Project is a private-sector initiative that accelerates the adoption of HL7 FHIR as the standard to support and integrate value-based care (VBC) data exchange across communities. The goal of the project is to help payers and providers positively impact clinical, quality, cost and care management outcomes, enabling providers to see the right data at the right time for patient-centered care.

The presenters will include:

• Lorraine Doo, Senior Policy Advisory,Centers for Medicare & Medicaid Service
• Alex Mugge, Deputy Chief Health Informatics Officer, Centers for Medicare & Medicaid Service
• Semira Singh, Director, Population Health Informatics, Providence  
• Michael Westover, Vice President, Population Health, Providence 

The session will be  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."

Register Now for January Virtual FHIR Connectathon and Gain Perspective from a New Participant: the Value-Based Performance Reporting Use Case Co-Lead

Those interested in gaining a better understanding of how the HL7 Fast Healthcare Interoperability Resource (FHIR®) standard works – and helping to develop specification refinements – should consider attending the upcoming connectathon, which will be held online January 16-18, 2024.

“Connectathons can be an effective way for organizations to initiate or advance their FHIR capabilities,’ Viet Nguyen, MD, HL7 Da Vinci Project Technical Director and HL7 Chief Implementation Officer, says.

Nguyen notes that the numerous tracks within the connectathon event allows organizations to pick and choose which tracks they want to emphasize based on their regulatory or strategic needs.

First-time HL7 FHIR Connectathon participant Teresa Younkin, HL7 Value-Based Performance Reporting (VBPR) Project Co-Lead and Senior Consultant at Point-of-Care Partners, attended the September 2023 event. She says, “The value of the connectathons is to actually get to see the systems work and move from the theoretical to the concrete.”

According to Younkin, connectathons are an opportunity to bridge the gap between the technical and the business. It goes beyond just exchanging bits and bytes; instead, you can see in real time how the data could be ingested and utilized in an organization. Many reference implementations have simple interfaces to make computer code human readable. Having the ability to physically see how this data exchange impacts workflows opens cross functional dialogs, addressing communication gaps that traditionally exist between technical teams and business teams.

Discussion offers insights on real-world implementations of Da Vinci’s Implementation Guides

Join us on Wednesday, December 6, from 4 – 5:30 p.m. EST for the December Community Roundtable presentation titled, “A Year of Active Implementation: HL7 Da Vinci Project Year-end Review and 2024 Plans.”

At this combined Member Forum, Operating Committee and Community Roundtable, Da Vinci Project leaders will share the latest on use case progress and implementations, regulatory response and alignment, and how HL7 FHIR brings value to implementers and the marketplace. The session will conclude with considerations and opportunities for 2024.

Presenters will be:

• Hans Buitendijk, HL7 Da Vinci Project Steering Committee Vice Chair, and Director, Interoperability Strategy, Oracle Health
• Crystal Kallem, Project Manager, HL7 Da Vinci Project, and Senior Consultant, Point-of-Care Partners
• Jocelyn Keegan, Program Manager, HL7 Da Vinci Project, and Payer/Practice Lead, Point-of-Care Partners

The moderator will be Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners.

October Community Roundtable to be held October 25 from 4:00 – 5:30 p.m. ET

Are you interested in learning the latest on the following:

•  Clinical data exchange; coverage, transparency and burden
• Quality and risk use cases
• The HL7 Da Vinci Project’s Implementation Guide foundational assets?

If so, register now for the next Da Vinci Community Roundtable, to be held Oct. 25 from 4:00 – 5:30 p.m. ET. The session will offer timely updates on changes made in 2023 to the Da Vinci Implementation Guides and offer an outlook for next year.

“The Power of Collaboration: 2023 HL7 Da Vinci Project Implementation Guide Progress,” will feature presenters discussing Implementation Guide functional enhancements as well as the current status and maturity of the guides to help inform your planning for next year’s HL7 Fast Healthcare Interoperability Resources (HL7® FHIR®) implementation staffing and allocations. Attendees will also learn where they can provide needed input and participation in the use cases.

The Da Vinci Project is a private-sector initiative that accelerates the adoption of HL7 FHIR as the standard to support and integrate value-based care (VBC) data exchange across communities. The goal of the project is to help payers and providers positively impact clinical, quality, cost and care management outcomes, enabling providers to see the right data at the right time for patient-centered care.

The presenters will include:

• Michael Gould, Associate Vice President, Interoperability Strategy, ZeOmega and HL7 Da Vinci Project Architectural Group Co-Lead
• Crystal Kallem, Project Manager, HL7 Da Vinci Project, and Senior Consultant, Point-of-Care-Partners
• Mark Scrimshire, PDex Project Lead & Implementation Guide Lead, HL7 Da Vinci Project, and Chief Interoperability Officer, Onyx Health
• Teresa Younkin, Value Based Performance Reporting Co-Lead, HL7 Da Vinci Project PMO and Senior Consultant, Point-of-Care Partners

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

Multistakeholder Discussion Features Panelists from Centers for Medicare & Medicaid Services, Epic, Florida Blue and Providence

Is your organization planning to use FHIR APIs to support data exchange for patient cost transparency (PCT)?

Join us on Wednesday, Sept. 27, from 4:00 – 5:30 p.m. for the September Community Roundtable presentation titled, “No Surprises Now: How the HL7 Da Vinci Project Accelerates Patient Cost Transparency.” Featuring a provider, payer, vendor and regulator, the multistakeholder discussion begins with an initial level setting session outlining the regulatory landscape, including the No Surprises Act, regulations and resources.

Next is a review of the HL7 Da Vinci Project’s PCT use case, which aims to develop a standard data exchange in support of patient cost transparency for devices, services and collection of services using FHIR APIs for exchange of data. The session will close with insights on the benefits of testing and implementation of PCT from the following presenters:

• Vanessa Candelora, HL7 Da Vinci Project Patient Cost Transparency Co-Lead and Senior Consultant, Point-of-Care-Partners
• Tina Mintyala, Program Manager, Revenue Cycle, Providence
• Alice O’Carroll, HL7 Da Vinci Project Patient Cost Transparency Co-Lead and Interoperability Product Manager, Florida Blue
• Carmen Smiley, Health Insurance Specialist, Division of Consumer Protection Policy, Consumer Support Group, Center for Consumer Information and Insurance Oversight, Centers for Medicare & Medicaid Services
• Zackery Welch, Executive Director, Pre-Services: Providence Health and Services
• Jacob Woodford, HL7 Da Vinci Project Patient Cost Transparency Co-Lead and Technical Services, Epic

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

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.

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.

May Community Roundtable Will Feature Case Study on How Standardized Information Sharing Between Providers, Payers Improves Patient Care

In this month’s Community Roundtable, the HL7 Da Vinci Project will offer timely insights on achieving bidirectional clinical data exchange between payers and providers using Da Vinci’s PDex (Patient Data Exchange) and CDex (Clinical Data Exchange) implementation guides.

The virtual roundtable, titled “Improving Patient Outcomes Using FHIR: How providers are exchanging clinical data with payers to deliver better quality of care,” will be held 4-5:30 p.m. EDT on Wednesday, May 24.

This free online event will feature an implementation story from Florida Blue, healow Insights and Humana that describes how standardized information sharing improves patient care. The session will include a demonstration of clinical data exchange capabilities, such as point of care alerts and up-to-date patient histories, underscoring the value of using HL7 FHIR® (Fast Healthcare Interoperability Resources) standards to optimize electronic medical record integration to assist in achieving value-based care outcomes.

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.