The Standard

In May 2024, the FAST Focus webinar, "Secure Health Data Exchange," brought together experts from across the healthcare industry to delve into the intricacies of the HL7 Unified Data Access Profiles (UDAP) Security for Scalable Registration, Authentication, and Authorization Implementation Guide, commonly referred to as the FAST Security IG. This session featured insights on key components and practical implementations of the FAST Security IG. 

Introduction to the FAST Security IG 

The session began with an explanation of the role of FAST in addressing healthcare interoperability challenges. The FAST Security IG aims to create a scalable, secure framework for health data exchange across national networks like TEFCA, Carequality, and CommonWell. 

 

The Journey to Trustworthy Information Exchange 

A historical perspective on the FAST Security IG highlighted its roots back to 2017. The goal was to leverage existing standards like public key infrastructure (PKI), OpenID Connect, and OAuth 2.0 to ensure a scalable, secure data exchange solution. The FAST Security IG integrates these standards into a cohesive framework, emphasizing the importance of trust in health data transactions. 

 

Key Components of the FAST Security IG 

The core elements of the FAST Security IG include: 

• JWT-Based Authentication and Authorization: Utilizing JSON Web Tokens for secure assertions of claims from trusted third parties.
• Dynamic Client Registration: Automating client registration using digital certificates to eliminate the need for shared secrets.
• Tiered OAuth: Facilitating patient-facing workflows by directing patients to trusted identity providers for authentication.

This approach ensures that both clients and servers can be securely identified and authenticated, streamlining the registration process, and enhancing trust across the network. 

 

Real-World Implementations and Insights 

The panel discussion featured firsthand experiences from implementers of the FAST Security IG. The discussion emphasized the collaborative effort in refining the FAST Security IG and the importance of ongoing participation in workgroups to further enhance the specification. 

Open-source solutions to facilitate implementation were highlighted, including a .NET reference implementation and a diagnostic tool called UDAP Ed. These resources help developers visualize and test their implementations, accelerating the adoption of the FAST Security IG. 

The importance of identity assurance was underscored, advocating for a centralized, trusted entity to manage high-security registrations. The FAST Security IG's reliance on well-established standards makes it a robust and scalable solution for the healthcare industry. 

Industry invited to join and participate in the HL7 Da Vinci Project’s newest use case conference calls

Retrieving a duplicate of remittance advice that was previously issued by a payer is a headache-inducing manual process that can involve the use of web portals, phone calls, faxes and emails.

But implementing an HL7 Fast Healthcare Interoperability Resources (FHIR®) Application Programming Interface (API) could change all that.

The HL7 Da Vinci Project has launched a Postable Remittance Advice Use Case with the goal of publishing an implementation guide (IG) for such an API next year. The API will support the request for a duplicate copy of previously issued remittance advice – paper or electronic – in real time to allow efficient, timely and accurate posting of payments.

Remittance advice is a document that healthcare providers receive from insurance companies after submitting a claim. It provides information on the payment status of the claim, including the amount paid, the patient's responsibility and the reason for any denials or adjustments. The purpose of the remittance advice is to inform the healthcare provider of the remittance details and to allow them to reconcile their accounts and ensure that the payment is accurate.

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. 

March 2024 marked a pivotal moment for the healthcare IT sector, with the FHIR at Scale Taskforce (FAST) community survey revealing critical insights into the adoption, challenges, and perspectives surrounding various FAST implementation guides (IGs). This survey, engaging various stakeholders from providers to technology vendors, sheds light on the collective journey towards seamless healthcare interoperability. Let's dive into the nuanced feedback and the path it carves for the future of healthcare IT. 

 

Survey Results Overview 

 

FAST Security IG Adoption and the Quest for Clarity   

The uptake of the HL7 FAST UDAP Security for Scalable Registration, Authentication, and Authorization Implementation Guide (FAST Security IG) is on the rise, driven by an evident market need.  A notable proportion of respondents are keen to implement the HL7 FAST Security IG, likely due to its inclusion in the TEFCA FHIR Roadmap. There were some concerns expressed about market readiness. However, respondents expressed a need for clearer guidance beyond the existing FAST Security IG, suggesting the development of a companion document to aid in implementation strategies would be helpful. 

 

FAST Identity IG: Overcoming Adoption Barriers   

While there seems to be adoption readiness for the Interoperable Digital Identity and Patient Matching IG, the survey highlights perceived barriers to adoption. These barriers were related to industry issues such as cross-jurisdiction consent and broader market acceptance and adoption by other industry initiatives rather than any issues with the IG itself. 

The HL7 FHIR at Scale Taskforce (FAST) UDAP Security for Scalable Registration, Authentication and Authorization Implementation Guide (FAST Security IG) was designed to streamline and secure data exchange across different healthcare stakeholders. This blog post seeks to dispel common misconceptions about the complexity of implementing the FAST Security IG. 

April 24 Session Focuses on Importance of Testing and Connectathons for Implementation Success

In this timely overview, which allows you to prepare to participate in upcoming May, July and September Connectathons, the HL7 Da Vinci Projectwill highlight a key component of implementation: testing.

Experts and hands-on participants will outline why testing is important, the terms used in testing and how testing events, such as Connectathons, are organized and critical to implementation success. Who should be involved, the value of testing partnerships, what activities are planned, and how you can participate will also be discussed. The session concludes with an invaluable primer on testing tools and resources available for your use.

“Jumpstart Your HL7 FHIR Implementation: Testing and Connectathons Demystified,” is slated for April 24, 4 - 5:30 p.m. ET and features the following presenters:

• Jeff Brown, Healthcare Standards Advisor, Lantana Consulting Group
• Mike Gould, Associate Vice President, Interoperability Strategy, ZeOmega
• Kyle Johnsen, Software Developer, Epic

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

Register Now for March 27 Session

Fresh from the HIMSS24 stage, the presenters at the March HL7 Da Vinci Project Community Roundtable will explore existing pain points of scaling HL7 FHIR between payers and providers, the advantages of leveraging FHIR exchange networks, and the challenges that come with it to ensure security and privacy of health data.

“Interoperable FHIR: Networked FHIR Exchanges Learnings and Industry Reflections,” this month’s program, is slated for March 27, 4 - 5:30 p.m. ET.

Panelists will focus on specific use cases and stakeholders to compare different approaches.

In addition to the presentation, Da Vinci program leadership will present updates and reflections from recent months, including top themes from ViVE and HIMSS events.

Panelist include:

• Jim Adamson, Business Transformation Manager, Arkansas Blue Cross and Blue Shield
• Dave DeGandi, Interoperability Strategist, Cambia Health Solutions
• Bill Howard, Board Chair, eHealth Exchange
• Jocelyn Keegan, Program Manager, HL7 Da Vinci Project, and Payer/Practice Lead, Point-of-Care Partners
• Karuna Relwani, Business Lead Interoperability, Blue Cross Blue Shield

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

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.

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.