The Standard

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.

Those of us who have been in healthcare a long time know that prior authorization can been a challenge for both payers, providers, and patients. One might think it’s time to remove prior authorization altogether, but until we have consistent clinical practice across the entire US healthcare system, it’s very hard to justify.

The current processes create a huge burden for providers and payers, and cause delays – sometimes critical – in patient care.

Why is prior authorization such a thorny problem[i]?

• Prior authorization issues contribute to 92% of care delays
• Nearly all of provider care delays are associated with inefficiencies and administrative issues with current prior authorization
• Providers take 6 hours on average to complete these requests, which is the equivalent of two business days. Thirty-four percent of providers have staff dedicated exclusively to completing prior authorizations.
• The prior authorization process costs $23 to $31 billion per year in the US, according to a 2009 study published in Health Affairs.
• The health plan cost per manual prior authorization is $3.68, compared to $0.04 per electronic prior authorization, according to a 2017 Chilmark Research report.

Whether Attendees are Novices or Experts on Implementation Guides, Education Will Increase Knowledge and Build Community

Communicating the value of HL7’s Fast Healthcare Interoperability Resource (FHIR®) in healthcare isn’t always easy. Do you tell the story in purely technical terms? Describe the problems it’s intended to solve? Or offer examples of where it’s providing benefits?

The upcoming Da Vinci Education & HL7 FHIR Implementation Event addresses all of those questions for a variety of audiences.

The presenters at the virtual event, scheduled for the week of April 26 to 30, will explain the sense of urgency that underscores the need to accelerate adoption of FHIR-based use cases. They will also provide real-world context to show that these use cases are not just a theoretical construct, but are providing immediate benefits to those organizations that are using it to power the shift to value-based care.

The adoption of FHIR is picking up speed because of this growing recognition of its benefits in reducing clinician burden, improving the exchange of quality measure data and enabling real-time access to data by patients, providers and payers. The adoption of FHIR-based use cases also provides a way for organizations to meet federal rules governing interoperability and patient access to their medical information.