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Spring 2021 CTO Tooling Update

[fa icon="calendar'] May 12, 2021 11:07:30 AM / by Wayne Kubick posted in FHIR, CDA, HL7, health IT, C-CDA, news, tooling, JIRA, Confluence, publishing, UTG, FHIR registry

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Déjà Vu All Over Again

My last tooling update was titled Focus on Finishing. Thus, in homage to the inimitable Yogi Berra, it would be hypocrisy to change focus now. Focus on Finishing is still the principal theme for the year, building on essentialism, my other guiding light, as expressed in the axiom “Do less, better.”

Toward that end, we continue to move ahead with our transition to our core collaboration tool stack and processes based on workflow-driven online forms. As of this writing, we’re completing final improvements to make the online PSS available to all later this spring. We’ll be working to finish automating most other key form-driven processes after that.

In addition, we hope to finish our transition to a new JIRA-based balloting system, which is also being piloted as of this writing. This, together with the recent transition from GForge Tracker and the STU Feedback web page to JIRA, puts all of our specification feedback in one repository moving forward.

While finishing our transition for balloting is critically important, we also have to update and replace some peripheral systems supporting the balloting process for members, as well as our core business systems for managing membership, events and operations. While we don’t expect to complete this transition to a new Association Management System before the end of 2021, we’ll be focused on finishing this as rapidly as possible since it’s an essential foundation to further systems improvements for the HL7 organization.

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HL7 International Appoints Three New Members to the Board of Directors

[fa icon="calendar'] Mar 17, 2021 5:27:27 PM / by HL7 posted in HL7, HL7 community, health IT, HL7 members

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Health Level Seven® (HL7®) International recently announced the appointment of three new members to the HL7 board of directors to serve a two-year term: Lori Evans Bernstein, MPH, co-founder and president, HealthReveal; Karen DeSalvo, M.D., MPH, chief health officer, Google Health; and Carolyn Petersen, MS, MBI, FAMIA, senior editor, Mayo Clinic.

“These leaders represent a broad spectrum of global stakeholders who are committed to advancing health through information technology. We are delighted to welcome them to the HL7 board of directors,” said Charles Jaffe, M.D., Ph.D., CEO of HL7. “Their strategic expertise and diverse experience will contribute greatly to HL7’s goal of improving the quality of care and reducing costs by overcoming the barriers to interoperability.”

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C-CDA Implementation-A-Thon to Expand Outreach to Engage New Communities

[fa icon="calendar'] Mar 1, 2021 3:53:46 PM / by Lisa R. Nelson, MS, MBA posted in CDA, HL7, HL7 community, health IT, C-CDA

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The CDA Management Group (CMG) aims to use the next C-CDA Implementation-A-Thon (IAT) to expand outreach to engage new communities and increase the impact of this content improvement effort.  “We learned so much last year about how to maximize the value of implementer-led implementation-a-thons,” said CMG Co-Chair Lisa Nelson. “The new approach was a step in the right direction. It helped implementers drive the conversation and focus the community on making changes that would yield valuable improvements,” she explained.  

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CMS New Rules to Address Prior Authorization for Patient and Provider Interests

[fa icon="calendar'] Feb 8, 2021 12:23:17 PM / by Shobhit Saran posted in FHIR, interoperability, health IT, Payers, CMS, Da Vinci, prior authorization, ONC, payer data exchange, Patient Access API

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The Centers for Medicare & Medicaid Services (CMS) released the much-awaited Interoperability & Patient Access Rule in March 2020. The objective is to reinforce this rule by further improving health information exchange and obtaining member health records at a single location to reduce burden on payers, providers and members.

The enforcement date for this rule is January 1, 2023, and will be applicable to Medicaid programs, the Children’s Health Insurance Programs (CHIP) and Qualified Health Plan (QHP) issuers on the individual market Federally Facilitated Exchanges (FFEs). However, it will not be applicable to Medicare Advantage (MA) plans.

The CMS proposed rule will include policies to enhance the current Application Programming Interfaces (APIs) from its interoperability rule such as patient access API and payer to payer API. There are a few new APIs and requirements proposed to improve the overall prior authorization process.

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HL7 FHIR Accelerator for Translational and Clinical Research; Vulcan Launches

[fa icon="calendar'] Jan 7, 2021 9:35:50 AM / by Amy Cramer, MMCi, RN, CPHQ posted in FHIR, interoperability, health IT, clinical research, FHIR Accelerator, Vulcan

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Clinical care data is a foundation for research. It is used to understand patient populations and as the core for clinical data capture. The introduction of HL7 Fast Healthcare Interoperability Resources (FHIR®) and its adoption rate creates a new opportunity to exchange data for clinical and translational research. Building off the work already accomplished to create interoperability standards for the exchange of healthcare data bridges clinical research into the greater healthcare ecosystem.

HL7 FHIR® accelerators have been a successful catalyst for standards development and adoption. Following the path of other accelerators, the research community collaborated to create Vulcan. In August 2020, Vulcan was launched by convening the following member organizations: TransCelerate Biopharma, Duke University, Johns Hopkins, Oregon Health and Sciences University, UT Health San Antonio, Society for Clinical Data Management, U.S. National Library of Medicine, National Center for Advancing Translational Sciences (NCATS), Danish Medicines Agency and U.S. Food and Drug Administration. Membership is rapidly growing with new organizations being onboarded each month.

Vulcan Use Cases

After consultation with the Steering and Operations Committee of Vulcan, project teams have been formed to move forward three use cases. These were selected from a larger effort to collect as many as eighteen uses cases which were prioritized based on impact and the ability to deliver to the community. The initial selected use cases include:

  • Real world data (including secondary use of electronic health record data)
  • Phenopackets
  • Schedule of activities
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The Gravity Project Completes Food Insecurity and Housing Data Identification

[fa icon="calendar'] Dec 17, 2020 1:08:31 PM / by HL7 posted in FHIR, interoperability, health IT, implementation guide, COVID-19, Gravity, Social Determinants of Health, SDOH

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Social Determinants of Health Data Matter for National COVID-19 Response Efforts

The Gravity Project is pleased to announce the publication of its consensus recommendations for food insecurity, housing instability and homelessness data elements. The Gravity Project is a national cross sector grassroots informed collective charged with building consensus data elements and data standards for the capture, exchange, and use of social determinants of health (SDOH) information. The Gravity food insecurity and housing data elements are the result of a year of development with input from its over 1,000 participants with intentional representation from key stakeholders such as patients, providers, community based organizations, payors, technology vendors, and federal and academic food insecurity and housing subject matter experts.

Social determinants of health—the circumstances in which we are born, grow, live, work and ageare estimated to account for 80-90% of health. There is growing interest from the healthcare sector to integrate social risk evaluation and intervention to advance the triple aim: improved health outcomes and quality of care while containing costs. In 2018, Gravity founders University of California San Francisco (UCSF) Social Interventions Research and Evaluation Network (SIREN) conducted an assessment of existing SDOH data and found much work was needed to advance the documentation and use of this data. Enter, the Gravity Project. The Office of the National Coordinator for Health Information Technology (ONC), a Gravity Project sponsor, noted the growing recognition across healthcare that by capturing and accessing SDOH data during the course of care, providers can more easily address non-clinical factors, such as food, housing and transportation insecurities, which can have a profound impact on a person’s overall health.

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Winter 2020 CTO Tooling Update

[fa icon="calendar'] Dec 11, 2020 12:11:46 PM / by Wayne Kubick posted in FHIR, HL7, health IT, C-CDA, news, tooling, JIRA, Confluence, publishing, UTG, FHIR registry

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Doing Less, but Better

Imagine you’re struggling in a long race – maybe an ultra-marathon over a winding, hilly course. You’ve been running for many hours, and you’re tired, sore and hungry. You’re running up a hill, hoping the end will soon be in sight. But when you get to the top, you only see a turn, not a finish. And after that turn – oh, no! – another hill. We’ve had that feeling during the long pandemic, and, for some of us, we’ve had that feeling even longer with respect to tooling at HL7. We’ve covered a lot of ground, and climbed a lot of hills, and we can feel the end should be in sight very soon. But we’re still running.

Fortunately, we have a team of supporters handing out Gatorade, clapping and cheering us on, and we’ve got our fellow runners pulling us along. And so it is with the HL7 community. We ask a lot of you to help us move forward, with support and understanding; sometimes contributing your valuable time to help us with development or testing, or to struggle patiently with change and the unexpected discoveries of new technology rollouts. While we don’t see that finish line yet, we see plenty of blue skies and greener fields beyond. We won’t always make it on the podium, and sometimes we stumble along the way. But the important thing is to keep moving forward and getting better.

The View from Above

We may not always seem to be progressing very fast, but we’ve really come a long way in the last few years thanks to the important contributions of many of you as well as the ongoing generous support of the US Office of the National Coordinator for Health IT (ONC), which has funded many of our retooling efforts. To list a few prominent examples:

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CMS Interoperability Rule and Impact of COVID-19

[fa icon="calendar'] Sep 8, 2020 1:16:05 PM / by Shobhit Saran posted in FHIR, interoperability, health IT, Payers, CMS, Da Vinci, ONC, CARIN Alliance, payer data exchange, USCDI

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The Centers for Medicare & Medicaid Services (CMS) released the much-awaited Interoperability & Patient Access Rule in early March this year. This rule establishes policies that aim to break down barriers in the health system across the US for better patient engagement. Government bodies are taking significant efforts for governments-sponsored health plans to adopt interoperability to make healthcare system efficient. Multiple initiatives by the Department of Health and Human Services (HHS) and its CMS and Office of the National Coordinator for Health Information Technology (ONC) aim to improve care-coordination and member experience. CMS had proposed the Interoperability & Patient Access Rule to support regulations of the MyHealthEData initiative, with implementation timelines to drive programs such as BlueButton, BlueButton 2.0 and Data at the Point of Care.

In the times of pandemic, healthcare organizations have realized the importance of having access to data for better care coordination and efficient care delivery. With seamless data access, organizations can:

  • Share health data of beneficiaries with different care teams
  • Identify high-risk population and implement preventive actions to control risk
  • Leverage tele-health with access to patient historical health data
  • Take timely decisions on emergency treatments based on patient medication history
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Summer 2020 CTO Tooling Update

[fa icon="calendar'] Sep 3, 2020 3:09:20 PM / by Wayne Kubick posted in FHIR, HL7, health IT, C-CDA, news, tooling, JIRA, Confluence, publishing, UTG, essentialism, FHIR registry

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Doing Less, but Better

For many of us, this desperate pandemic year has led to plenty of introspection.  This has also been true for the HL7 Board, which has been contemplating the future of the HL7 organization after emerging from the current crisis. Among a set of core principles adopted by the Board are agility and focus. To be agile, we need to simplify and refine the organization and core processes as well as provide support with continued improvements to our tooling. This also requires getting our global community to better understand and use the processes more consistently and effectively, so we can better focus on our core work of developing and implementing interoperability standards.  This a perfect segue back toward my long-held core belief in essentialism.

Back to Basics

I first espoused the concept of essentialism to an enthusiastic Board and Technical Steering Committee back in 2016. While we’ve only made small incremental progress in the four years since, it has been guiding our process improvement and tooling initiatives. Essentialism was a driving force behind our adoption of Confluence and JIRA as well as efforts to simplify our product portfolio. Of course, we operate in a complex field, and there were many confounding forces acting at the same time. The HL7 community is more adept at introducing new processes, tools and content than at retiring or eliminating the old stuff. Thus, our commitment to essentialism faded over time, tempered by inertia and continuing demands, not the least of which has been the black swan events of 2020.

Perhaps it’s time to once again review the key elements of essentialism and discuss how it fits with our ongoing tooling strategy and plans.

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Integrated Approach for Radiology and Clinical Information to Support Clinical Decision Making

[fa icon="calendar'] Aug 28, 2020 10:17:32 AM / by Shujah Dasgupta posted in FHIR, interoperability, health IT, CMS, ONC, radiology, USCDI

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Limitations in existing healthcare interoperability present a significant barrier to next-gen computing solutions such as Machine Learning (ML) and Artificial Intelligence (AI). New workflow standards aimed at addressing the integration of AI/ML actors to clinicians in delivering better patient care.

One of the main limitations of standards is streamlining access to data from electronic medical record (EMR) applications. There is a growing need for a holistic view of patient data, and the inclusion of the allied healthcare services such as radiology will play a crucial role in building a 360° patient view. This will help healthcare professionals take accurate and informed decision on patient care, and bridge the gap between fragmented and siloed information that is currently limiting hospitals and healthcare systems from gaining insights to drive better health outcomes.

To seek better exchange of health data among providers and patients, the Health and Human Services (HHS) published final rules that put patients first and bring one step closer to achieving Interoperability. The ONC’s (Office of the National Coordinator for Health Information Technology) rule aims to standardize API via HL7 Fast Healthcare Interoperability Resources (FHIR®) R4, a latest version of the FHIR standard, and making its use mandatory under this rule.

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