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Are You Preparing for the Proposed Prior Authorization and Attachments Rules?

[fa icon="calendar'] Feb 16, 2023 5:11:35 PM / by Diana Manos posted in FHIR, health IT policy, interoperability, CMS, Da Vinci, prior authorization, FHIR Accelerator, attachments

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Learn about the rules, how innovators are reaping the benefits of HL7 FHIR APIs and the value of automation at this month’s  Da Vinci Project Community Roundtable

In this month’s Community Roundtable, the HL7 Da Vinci Project is exploring healthcare interoperability with a full line-up of speakers. The virtual roundtable, titled, “Advancing Interoperability via FHIR APIs: An Industry Discussion on Progress, Proposed Rules and the Value of Automation,will be held Wednesday, Feb. 22, from 4:00 - 5:30 PM EST.

The session will break down the latest federal proposed rules impacting interoperability, the Prior Authorization and Attachments Rules, published last December. Continuing where the January Roundtable left off, Da Vinci guest speakers will address the complex rules and explain their significance in moving forward with FHIR APIs to seamlessly exchange information between payers and providers. CMS is awaiting March comments on the rule, and this roundtable will be a good prep for those who are preparing to comment on this landmark regulation impacting interoperability and seeking to invest in FHIR.

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CMS Officials and Da Vinci Leaders Present a Community Roundtable on the Proposed Federal Rules and How Da Vinci Implementation Guides Meet Them

[fa icon="calendar'] Jan 20, 2023 1:45:01 PM / by Leslie Amorós posted in FHIR, health IT policy, interoperability, CMS, Da Vinci, prior authorization, FHIR Accelerator, attachments

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The Da Vinci Project’s January Community Roundtable to be held January 25 from 4:00 – 5:30 p.m. ET

With the issuance of the new federal prior authorization and attachments rule proposals last month, 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.

The Intersection of Federal Regulation and The HL7 Da Vinci Project, January’s Community Roundtable, features an overview and frequently asked questions about the rules and their accompanying RFIs from CMS officials. Da Vinci leaders then will share an overview of the implementation guides that are suggested in the proposed rules and how they meet the rules’ objectives.

At the January 25 session, which is scheduled from 4:00 – 5:30 p.m. ET, attendees will learn how to access the resources, participate in community feedback and start getting involved.

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HL7 Gravity Project: An Ongoing Evolution

[fa icon="calendar'] Nov 28, 2022 5:08:40 PM / by Gravity Project PMO posted in FHIR, interoperability, health IT, implementation guide, Gravity, Social Determinants of Health, SDOH

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Highlighted here is a preview of what’s on the horizon as the Gravity Project matures and
recent examples of Gravity standards integration.

The Gravity Project®, an HL7® FHIR Accelerator, is evolving the way it advances social care data integration as a strategy to promote health equity while maintaining continuity with the mission and consensus-based processes that are core to the project. The project is a national public-private collaborative developing, testing, and implementing consensus-based social determinants of health (SDOH) data standards for use across the health, social services, public health, and research sectors. The Gravity community embodies a truly inclusive representation of over 2,500 stakeholder members of its public work groups and governance committees across the healthcare, health IT, community-based, federal and state agency, payer, academic, and patient/ consumer advocacy sectors.

In 2021, HL7 was awarded a cooperative agreement with the Office of the National Coordinator for Health Information Technology (ONC) to prioritize and expedite the development of standards specific to five gap areas including SDOH. Under this collaborative agreement, the Gravity Pilots Affinity Group was launched in September 2022 as a peer-to-peer learning forum for real-world testing of Gravity terminology and technical standards. Pilot sites are invited to demonstrate the use of social care coded terminologies (e.g., LOINC®, SNOMED-CT®, ICD-10®) and/or the HL7 SDOH Clinical Care FHIR Implementation Guide (SDOH CC IG), share implementation lessons learned with other pilot participants, seek/find partnerships for testing, and gain real-world experience.

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November Community Roundtable Highlights Da Vinci Implementation Progress and 2023 Plans

[fa icon="calendar'] Nov 21, 2022 4:57:19 PM / by Leslie Amorós posted in FHIR, interoperability, Da Vinci, value based care, FHIR Accelerator

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The Da Vinci Project’s November Community Roundtable to be held November 30 from 4:00 – 5:30 p.m. ET

During November's Community Roundtable, HL7 Da Vinci Project leaders representing providers, payers and EHR vendors will offer an insightful program discussing real-world implementations of Da Vinci’s Implementation Guides.

Significant Progress: HL7 Da Vinci Project Year-end Review and 2023 Plans,” begins with a review of this year’s program accomplishments and continues with a panel of industry and HL7 Da Vinci Project leaders sharing the impact of corresponding regulations and the proven guides that reduce burden and enable efficient value-based care workflows.

In particular, they will discuss the reality and progress of Da Vinci implementations in a world where HL7 FHIR APIs are becoming the de facto norm for data sharing for clinical data exchange and prior authorization. The session concludes with a preview of the project goals and activities planned for 2023.

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Next Community Roundtable to Feature Updates on HL7 Da Vinci Implementation Guides

[fa icon="calendar'] Oct 19, 2022 3:57:24 PM / by Howard Anderson posted in FHIR, interoperability, Da Vinci, value based care, FHIR Accelerator

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The Da Vinci Project’s September Community Roundtable to be held October 26 from 4:00 – 5:30 p.m. ET

The next Da Vinci Community Roundtable, to be held Oct. 26, will offer timely updates on changes recently made in the Da Vinci Implementation Guides and offer an outlook for next year.

 

The event, “Current State: HL7 Da Vinci Implementation Guide Progress in 2022,” will be held online from 4 p.m. to 5:30 p.m. ET.

 

The Da Vinci Project is a private-sector initiative that accelerates the adoption of HL7 Fast Healthcare Interoperability Resources (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.

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Sync for Social Needs

[fa icon="calendar'] Sep 28, 2022 11:06:00 AM / by Charles Jaffe, MD, PhD posted in FHIR, health IT policy, interoperability, CMS, ONC

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Background

The Biden-Harris Administration will host the White House Conference on Hunger, Nutrition, and Health on September 28, 2022. In addition to announcing a national strategy to address the intersections between food, hunger, nutrition and health, the Administration has issued a call for stakeholder commitments along five pillars, including the “integration of nutrition and health.”

We seek to better integrate nutrition information within a patient’s electronic health record (EHR) by accelerating a standards-based approach to implementing universal social needs screening. With the final CMS IPPS rule requiring hospitals to report on  social determinants of health (SDOH) screening quality measures in 2024, along with similar requirements of MA SNPs and ACO REACH model participants in 2023, we believe a multi-stakeholder effort, which should also include Medicaid agencies and managed care plans, to advance an HL7 Fast Health Interoperability Resources (“FHIR”)-based approach to meet these “functional” requirements will significantly enhance the ability of providers to meet these CMS requirements.

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Dive Into Performance Reporting for Value-Based Contracts at Da Vinci’s September Community Roundtable

[fa icon="calendar'] Sep 19, 2022 2:15:00 PM / by Leslie Amorós posted in FHIR, interoperability, Da Vinci, value based care, FHIR Accelerator

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The Da Vinci Project’s September Community Roundtable to be held September 28 from 4:00 – 5:30 p.m. ET

As fee for service shifts to value-based care, value-based contracts have emerged as a mechanism that providers and payers may use to better align their contracting structures with broader changes in the healthcare system.

"Dive Into Performance Reporting for Value-Based Contracts,” this month’s Da Vinci Community Roundtable presentation by representatives from Humana, Providence and the Da Vinci PMO, provides you with front-row access to HL7 Da Vinci Project’s newest use case that aims to develop an HL7 FHIR Implementation Guide to support value-based performance reporting for quality and risk contracts.

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HL7's FHIR Accelerator CodeX Launces Pilot to Simplify Prior Authorization in Oncology

[fa icon="calendar'] Sep 6, 2022 12:45:39 PM / by CodeX FHIR Accelerator posted in FHIR, HL7, health IT, prior authorization, FHIR Accelerator, FHIR Community, CodeX, oncology

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CodeX-logo-simple (003)                           Evernorth

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HL7® Da Vinci Project Names Eight Health IT Professionals ‘2021 Community Champions’

[fa icon="calendar'] Aug 18, 2022 9:03:00 AM / by HL7 posted in FHIR, HL7, health IT, Da Vinci, FHIR Accelerator, Da Vinci Champions

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The HL7 Da Vinci Project recently named eight healthcare technology experts as its 2021 Da Vinci Community Champions. The individuals recognized for this prestigious honor represent the diverse membership of the HL7® Da Vinci Project, a collaborative multi-stakeholder effort including health plans, hospital systems, accountable care organizations (ACOs) and technology vendors. The awards were announced on July 20, 2022, at the monthly HL7 Da Vinci Project member meeting. This is the second year in which the HL7® Da Vinci Project has recognized innovative leaders in health IT who are helping to guide the evolution of the HL7 Fast Healthcare Interoperability Resources (FHIR®) standard.

As a designated HL7 FHIR accelerator program, the Da Vinci Project is a private sector consortium dedicated to improving the healthcare delivery system by accelerating interoperability standards to support value-based care, reduce administrative burden, automate workflow and improve provider teams’ ability to impact health outcomes.

Last year, the Da Vinci Project leadership created the Community Champions Program to recognize and celebrate the talented problem solvers advancing interoperability within the industry. The Community Champion Program puts a spotlight on individuals who display the unique traits of “industry above self, a passion for making the healthcare system work better, supporting others, and promoting change.”

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Learn How UC Davis Health, Centene and InterSystems Use HL7 Da Vinci Implementation Guides to Tackle Prior Authorization at the HL7 Da Vinci Community Roundtable

[fa icon="calendar'] Aug 16, 2022 10:20:39 AM / by Leslie Amorós posted in FHIR, interoperability, Da Vinci, prior authorization, FHIR Accelerator

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The HL7 Da Vinci Project’s August Community Roundtable to be held August 24  from 4:00 – 5:30 p.m. ET

Da Vinci’s Community Roundtable returns after a summer hiatus with a powerful program highlighting a real-world implementation of Da Vinci’s Prior Authorization Implementation Guides.

“Celebrating HL7 FHIR's Success: From Champions to Prior Authorization Implementers,” will begin with a program update and brief recognition of the 2021 HL7 Da Vinci Community Champions, showcasing individuals making significant contributions to advancing value-based care by leveraging HL7 Fast Healthcare Interoperability Resources (FHIR®) and making the outputs of Da Vinci real.

After the updates, representatives of the 646-bed health system UC Davis Health, the 25.4-million-member payer Centene, and technology solutions vendor InterSystems will discuss their Da Vinci prior authorization journey and the benefits achieved to date.

Presenters for next week’s session include:

  • Howard Cohen, Director, Advanced Technology Team, Centene
  • Michael B. Marchant, Director, Health Information Exchange, UC Davis Health
  • Lynda Rowe, Senior Advisor, Value-based Markets, InterSystems
  • Mahesh Siddanati, Vice President, Digital Solutions and Product (Regulatory and Quality), Centene

Attendees will hear first-hand accounts of the considerations, challenges and benefits of working together to establish infrastructure to streamline prior authorization workflows, remove latency and enable real-time data sharing.

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