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.
Primary author: John D'Amore, Co-Founder, Diameter Health; Co-authors: Brett Marquard, Principal, Wave One Associates and Wayne Kubick, CTO, HL7 International
While HL7 FHIR® (Fast Healthcare Interoperability Resources) is today’s hottest healthcare standard, clinical documents are already exchanged in the billions today. HL7 published the Consolidated Clinical Document Architecture (C-CDA) in 2011 to support care coordination and patient engagement. The ONC 2014 certification rule named C-CDA R1.1 and adoption exploded. The current version of C-CDA, R2.1, remains backwards compatible to that version today. While C-CDA is a flexible, robust standard to record patient care longitudinally or for an encounter, it is structurally complex. The C-CDA standard itself is over 1,000 pages long. Applying the standard to the latest US requirements for clinical data exchange, known as the US Core Data for Interoperability, also routinely requires information from the C-CDA Companion Guide.
HL7 publishes the C-CDA standard and its Companion Guide as PDF documents. That will remain the official version of the standard, but a small team from the CDA Management and Structured Documents Working Groups saw an opportunity to make the C-CDA content easier to use by developing a new web tool. Since the C-CDA has reusable parts, known as “templates,” it seemed logical to make each template searchable and distinct via unique web pages so the standard would be much easier to absorb.
The new HL7 C-CDA Online Search Tool is a searchable, web-based navigation resource for the Consolidated Clinical Document Architecture (C-CDA 2.1) and its Companion Guide. The solution includes over 240 unique web pages that make each template accessible on the web with linkage back to the original PDF content. This navigation is managed through a single searchable index page, like a smart table of contents.
Using the template webpages, health IT vendors can ensure that their C-CDAs are conformant and high-quality for document exchange. The search tool enables users to search the C-CDA by description, template object identifier (OID) or conformance number. Conformance number searches are particularly valuable for C-CDA implementers, since validators will return these numbers when there’s a violation or warning associated with C-CDA testing.
Join the Webinar Highlighting MCG Health’s Prior Authorization Journey and Da Vinci’s Two New Use Cases for 2021 on Wednesday, February 24 from 4:00 - 5:30 pm ET.
Healthcare organizations increasing their exposure to value-based care find many tasks complicating the transition, and reducing the burden of those changes is key to thriving under new reimbursement schemes.
New payment approaches incentivize both payers and providers to become more efficient, and that means reducing the number of manual interventions in exchanging data. In addition, value-based care is uncovering new reasons to make information more easily available, to bring new efficiencies to the system.
Examples of these capabilities will be featured in the HL7 Da Vinci Project’s Community Roundtable on February 24. The title for the event is "What it Takes: Learn about MCG Health’s Journey to Help Reduce Prior Auth Burdens and Discover New Da Vinci Use Cases."
The upcoming roundtable will offer an inside understanding of the 18-month effort at MCG Health to advance the use of the HL7 Fast Healthcare Interoperability Resource (FHIR®) standard in solutions that support burden reduction in facilitating the prior authorization process.
Monthly Event is Scheduled for 4:00 to 5:30 p.m. ET on Wednesday, January 27, 2021
In the first community roundtable of 2021, project managers of the HL7 Da Vinci Project will provide updates for how the project’s implementation guides can be used to solve interoperability challenges and meet federal rules.
The roundtable is intended to highlight how Da Vinci Project implementation guides can help organizations reduce burden, advance data exchange and enable better patient access to data.
Participants from the HL7 Da Vinci Project include Jocelyn Keegan, program manager; Viet Nguyen, MD, technical director; and Vanessa Candelora, project manager. The Da Vinci team will show the progress of Implementation Guides (IGs), which give guidance for using the HL7’s Fast Healthcare Interoperability Resources (FHIR®) coding. The team will also provide linkages to specific federal rules and policies, giving you the recipe to solve challenges in alignment with federal rules and leverage the power of standards to improve connectivity across all of your patient populations.
A Closer Look at the 26th Virtual HL7 FHIR Connectathon Held January 13-15, 2021
Despite adjusting almost everything in life to a pandemic-driven “new normal” these past ten months, most of us have discovered a few unexpected benefits from the upheaval. Such is the case for the HL7 FHIR Connectathons, which migrated from in-person to virtual beginning with the May 2020 Connectathon. The January Connectathon #26, occurring last week, carries the distinction of being the largest Connectathon yet – with over 800 participants!
The in-person, face-to-face Connectathons of the past provided a rare (and delightful) opportunity to join developers, implementers, clinicians and interested stakeholders in testing and development of FHIR standards. Moving to the virtual format, however, has allowed more people to participate without having to travel to the event.
What Happens at a FHIR Connectathon?
If you are still fuzzy on the detailed activities of Connectathons—and whether you should attend one, there are many avenues where you can learn more. FHIR Connectathons serve as events that are centered upon developing the FHIR specification; including resources, profiles, and implementation guides (IG). The first Connectathon occurred in September 2012 and readily set the stage for future Connectathons that typically occur in the days ahead of an HL7 Working Group Meeting, thereby encouraging members to participate in both.
Presentation at HL7 Da Vinci Project’s Community Roundtable Outlines Wide-Ranging Corporate Effort to Democratize and Liberate Data
For Humana, achieving interoperability is more than a nice-to-have way to exchange data every once in a while. It’s something that the company – and the entire healthcare industry – needs to operate efficiently and effectively for patients and clinicians.
It expects that the use of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard will be crucial for achieving widespread interoperability. Current information exchange approaches offer a patchwork solution that works in isolated instances. FHIR’s promise is that it can provide standardized solutions that every industry participant can use.
“Exchange works at small scale because (information) roadways are rebuilt every time a connection is made,” said Patrick Murta, Humana’s chief interoperability architect and solutions architecture fellow, speaking at the November Community Roundtable for the Da Vinci Project, an accelerator program of HL7 seeking to expand the use of FHIR to support information exchange needed for successful value-based care.
Projects required crucial coordination between three HL7 Da Vinci Project members – Cedars-Sinai, Anthem and CareEvolution
Two challenging problems in improving care coordination and quality are the focus of efforts between a prominent Los Angeles-area care delivery system, a large healthcare payer and a technology vendor.
The HL7 Fast Healthcare Interoperability Resource (FHIR®) is playing a role in aiding the effort, but those involved say the FHIR standard, while important, is only a part of the components of their successful project.
Cedars-Sinai, Anthem and CareEvolution detailed the lessons they have learned in the data exchange project during the HL7 Da Vinci Project’s Community Roundtable in October. While FHIR has played an important role in exchanging information, it is only one piece of the puzzle – all participants had several technical and planning tasks to accomplish to ensure the projects succeed and reduce users’ workloads.
Da Vinci’s use cases and implementation guides are “a great starting point, but they only define one stage in that pipeline,” said Brandon Raab, engineer lead for enterprise data and analytics solutions for Anthem. “The end-to-end actualization of the use case will likely involve the integration of upstream and downstream systems.” Achieving the desired results “was a substantially heavier lift than we anticipated.”
Cedars-Sinai, Anthem and CareEvolution – all members of the Da Vinci Project – began discussions about how they could work together to put FHIR into practical use, said Ray Duncan, MD, executive director for technology research and development in enterprise information services for Cedars-Sinai. The partners chose notifications and data exchange for quality measures (DEQM) use cases because those use cases were “pretty far along in the balloting process” and because the organizations “wanted to focus on use cases where we could try them without a lot of changes to clinician workflow.”
Joint Community Roundtable, Member Forum Event for the HL7 Da Vinci Project is November 18
Gaining traction for standardized approaches across a variety of healthcare organizations can be challenging but possible when common goals are identified, and everyone benefits from the collaborative effort.
That was the track taken by Humana, when the healthcare payer sought to win the support of healthcare provider organizations to adopt the HL7 Fast Healthcare Interoperability Resource (FHIR®) to achieve mutually beneficial goals as a result of easier information exchange.
The Da Vinci Project’s November Community Roundtable will look at Humana’s efforts to better integrate care for its members through the use of FHIR. The session is entitled, “Humana: Achieving Integrated Care Delivery Using FHIR: Why it’s a Big Deal.”
Recap of the September HL7 Da Vinci Project Community Roundtable
Exchanging information is much like a dancing competition – it takes partners who are willing to work hard to coordinate their actions.
Multicare Connected Care and Regence Blue Pilot Medication Reconciliation Project
That was a bedrock of the initiative that paired MultiCare Connected Care and Regence Blue Shield, now bearing results in enabling better medication reconciliation between the healthcare organizations.
The partners described their journey to implement a use case from the HL7 Da Vinci Project in September’s Community Roundtable, noting that they are achieving substantial results in improving data exchange efforts, reducing manual work for the two organizations and enabling them to redirect resources to other projects that benefit both patients and the organizations.
The effort has paid off – MultiCare has achieved dramatic improvements in its compliance with medication reconciliation requirements, while reducing the amount of manual intervention by both organizations, said Anna Taylor, director of operations for population health at MultiCare for its an accountable care organization.
Using standardized interoperability, in the form of a use case for coding from HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard, helps to reduce the burden “on us as providers and as an ACO,” Taylor said. “Success in value-based care models requires data and information from partnering entities; we’re able to use this data and information to make sure that those that are the most sick and need the most care navigation get what they need to stay healthy.”
Anthem, Cedars-Sinai, and CareEvolution to share on project to implement Data Exchange for Quality Measures and Event Notification on Wednesday, October 28
Like peeling back the layers of an onion, exchanging information to support value-based care involves complex data challenges for providers and payers alike.
That’s particularly true when it comes to navigating essential communications between providers and payers, using that dialogue to better coordinate care and achieve the best possible results for patients.
Two key areas that challenge everyone is ensuring that quality measures are met and that everyone in the chain is on the same page when it comes to events. Typically, these are hard for all parties in sharing relevant information.
HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard offers an approach that everyone can use to facilitate data exchanges. In an upcoming community roundtable scheduled for 4 to 5:30 p.m. ET on Wednesday, October 28, HL7 Da Vinci Project members Anthem, Cedars-Sinai and CareEvolution will discuss their efforts to put implementation guides for Data Exchange for Quality Measures and Event Notification in place.