The Standard

One of the most efficient ways to exchange data among providers and payers for prior authorization and other purposes is by taking advantage of standard application program interfaces (APIs) and a central hub to avoid manual processes and support of point-to-point interfaces.

The HL7^® Da Vinci Project’s new Trebuchet pilot program, launched earlier this year, is enabling additional pioneers to test that approach.

Trebuchet was created when Da Vinci members Regence, MultiCare Connected Care, and Blue Cross Blue Shield Arkansas sought ways to pilot Da Vinci use cases on the emerging TEFCA framework. They contacted multiple Qualified Health Information Networks™, or QHINs™, to gauge their interest in joining the pilot. eHealth Exchange joined the effort to perform the QHIN functions and provided valuable project management support.

The team named the coalition “Trebuchet” to illustrate how the success of a third-century military catapult could inspire providers, payers, and a QHIN to accelerate trusted and scalable exchange. 

As efforts advanced and participants increased, Trebuchet asked Da Vinci to take over project management. Now a priority project adopted by Da Vinci, Trebuchet is proving how eHealth Exchange’s nationwide trust model and “Networked FHIR” architecture rapidly deploy Smart-on-FHIR Prior Authorization and Clinical Data Exchange (CDex) at scale

Looking for an update on the HL7 Da Vinci Project’s accomplishments this year and the outlook for 2025? Then don’t miss a special year-end online session at 4 p.m. ET on December 11.

This meeting, which combines Da Vinci’s Member Forum and Operating Committee meetings and the December Community Roundtable, will review this year’s programmatic accomplishments and set the stage for 2025.

A Da Vinci leadership panel will discuss 2024 highlights, sharing progress across policy, use cases and implementer support. The panel will address the successful Fast Healthcare Interoperability Resources (FHIR®)) implementation outcomes listed in the HIPAA exception report as well as key partnerships and their interoperability journeys. (For more on the HIPAA exception report, see: Report on HIPAA Exception Project Describes Benefits of Using FHIR APIs).

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

In its SDOH Playbook, “US Playbook to Address the Social Determinants of Health,” the White House explained that supporting flexible funding to address social needs, such as those offered through health-related social needs (HRSN) reimbursement programs, improves health outcomes: “Increasing funding flexibility and offering technical assistance that empowers organizations to utilize funding from a variety of sources will better equip them to address unmet social needs.”

The success of these reimbursement programs requires the existence of exchange and data standards that serve the interests of all stakeholders. Payers and community-based organization (CBOs) currently experience complexities and pain points that have presented challenges and made it difficult to meet the HRSN reimbursement programs’ full potential exist as these benefits roll out today.

As momentum has grown among states and payers for the reallocation of healthcare funds to address HRSNs, Gravity Project decided to undertake a discovery effort to understand and define the existing landscape for CBO reimbursement and identify the components of the CBO reimbursement process and where national standards play a role. 

"Unite Us is proud to work with the Gravity Project. Together, we are making it easier for community-based organizations to participate in Medicaid reimbursement programs, expanding the availability of these benefits to more individuals seeking care,” Emily Anders, director of payments strategy for Unite Us, said.

A report from the HL7 Da Vinci Project describes how two pioneering organizations demonstrated the real-world practicality and value of applying standard application program interfaces (APIs) to streamline the prior authorization process.

Regence, a payer based in the Pacific Northwest, and MultiCare Health System, a provider based in Washington state, spent about a year testing and fine-tuning processes that leverage HL7’s Fast Healthcare Interoperability Resources (FHIR^®) standard for APIs.

In addition, dozens of other organizations have tested FHIR APIs at more than 15 Connectathon testing events.

"Our response to interoperability isn’t just about managing data—it’s about building the future of healthcare through open standards." - Dan Vreeman, DPT, Chief Standards Development Officer, HL7 International

Last week at Civitas 2024 in Detroit, HL7 International/s Chief Standards Development Officer,Dan Vreeman, DPT, led an insightful panel session on how HL7® Fast Healthcare Interoperability Resources (FHIR®) is revolutionizing interoperability. As data sharing becomes increasingly critical, HL7 is at the forefront, driving collaboration with over 45 organizations and developing 35-45 new FHIR implementation guides annually! Dan was joined by leaders from the Da Vinci Project, FAST, Gravity Project, and Helios, to discuss their HL7 FHIR Accelerator projects, including objectives and progress made to date in advancing open data standards development and interoperability.

An Overview, Demo and Benefits of Da Vinci-related Test Kits on Wednesday, October 23

Are you implementing Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) APIs and looking for testing resources? Find out about the Inferno Health API Testing Framework at this month’s October HL7 Da Vinci Project Community Roundtable.

This month’s session, Exploring Inferno: An Overview, Demo and Benefits of Da Vinci-related Test Kits, is scheduled for Wednesday, Oct. 23, from 4 – 5:30 PM EDT and features presenters from the Assistant Secretary for Technology Policy (ASTP) / Office of the National Coordinator for Health Information Technology (ONC) and MITRE. Presenters will introduce the Inferno Framework and voluntary test kits, which may be used as testing tools to further advance implementation guide development and testing of industry implementations.

The FHIR at Scale Taskforce (FAST) community has been at the forefront of shaping the future of healthcare interoperability. By working closely with the FHIR community and other FHIR Accelerators, FAST is building the framework for a robust FHIR infrastructure that supports the scalability of FHIR solutions across the healthcare ecosystem. Today, we are excited to announce an important leadership transition as we continue this vital work.

A New Opportunity for Dana Marcelonis

Dana Marcelonis, who has been a cornerstone of FAST as our Program Manager, will be transitioning to a new role at Point-of-Care Partners, where she will provide program support for the Coalition for Health AI (CHAI) project. Dana’s expertise, dedication, and leadership have been instrumental in guiding FAST’s efforts, and her impact on our work cannot be overstated. While Dana managed both roles admirably, the increasing demands of these projects have made it necessary to have a dedicated resource for each. Dana will continue to support Janice and the team through November to ensure a smooth transition.

August 28 Webinar Features Recent Updates Direct from Federal Officials

Are you looking for guidance and insight as you plan for 2025? If so, plan to attend this month’s Health Level Seven (HL7^®) Da Vinci Project Community Roundtable, which features special guests from the Assistant Secretary for Technology Policy (ASTP) office, formerly known as the Office of the National Coordinator for Health Information Technology (ONC). ASTP presenters will highlight why the Trusted Exchange Framework and Common Agreement^TM (TEFCA^TM) is important and share recent updates to the program, including implementation, long term plans, education and outreach, and building trust.

In ASTP’s second segment, testing and adoption efforts will be discussed, covering TEFCA’s HL7 Fast Healthcare Interoperability Resources (FHIR^®) Roadmap, and ASTP’s new TEFCA Payer/Provider 10x10 Coalition. ASTP will provide an overview of the 10x10 and discuss why providers and payers should participate. They will also discuss resources available and the interplay of the 10x10 with Da Vinci.  

The session concludes with the Da Vinci PMO sharing themes and perspectives from its membership on the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule.

The Vulcan FHIR® Accelerator, in coordination with the US Assistant Secretary for Technology Policy/ Office of the National Coordinator (ASTP/ONC) and the Food and Drug Administration (FDA), invites you to an informational webinar for the Vulcan Interoperability Bridge (VIB) event.

The VIB event aims to accelerate the adoption of healthcare data standards for research – underscoring the value of using HL7 Fast Healthcare Interoperability Resources (FHIR®) to solve existing challenges and explore novel opportunities in research data interoperability.

The August 21 webinar is designed to share information on how we will convene clinical research sponsors, including pharmaceutical companies and academic medical centers, EHR providers, clinical research sites, and technology solutions providers to work together to demonstrate how clinical care and research interoperability is achievable utilizing existing HL7 FHIR® standards and implementation guides.

If you can’t think of a reason to pay attention to FAST's work, we have a couple for you! Recent requirements related to TEFCA (Trusted Exchange Framework and Common Agreement) and the latest HTI-2 proposed rule have named the FAST Security Implementation Guide (IG). This recognition underscores the importance and foundational nature of FAST's contributions to healthcare interoperability. 

On July 1st, the Recognized Coordinating Entity (RCE) released the Facilitated FHIR Implementation Standard Operating Procedure (SOP), outlining the requirements for using FHIR within the TEFCA framework. Notably, these requirements include adopting the FAST HL7 UDAP Security for Scalable Registration, Authentication, and Authorization FHIR Implementation Guide (SSRAA) by January 1, 2026. This timeline allows organizations to implement FAST Security while still using SMART or other security options in the interim. 

Specifically, the SOP states: 

Prior to January 1, 2026: 

• All FHIR Adopters MAY follow the requirements of HL7 SSRAA FHIR IG 1.0.0 STU 1 US Section 3 Registration. 

• Manual registration requests for client_id MUST be resolved within 5 business days where sufficient information has been provided. Information requirements MUST NOT exceed those in Section 3 of HL7 SSRAA FHIR IG and this SOP. 

• All FHIR adopters MUST use one of the following: 
  • HL7 SSRAA FHIR IG 1.0.0 – STU 1 US Sections 4 and 5; 
  • SMART Release 1.0.0; or 
  • Another authentication and authorization framework that adheres to the QTF requirements is based on out-of-band agreements between exchange partners.