The Standard

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.

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.

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.

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.

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.

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.

The Da Vinci Project’s April Community Roundtable to be held April 27 from 4:00 – 5:30 p.m. ET

Why does interoperability require governance? Find out at this month’s April HL7 Da Vinci Community Roundtable.

This month’s session, Effective Interoperability Governance: The People, Processes and Data, features multiple vantage points to approaching interoperability governance and its complexities in our HL7 FHIR API landscape around people, processes and data.

Learn about the meaning of governance and the importance, challenges and lessons learned when applying these guardrails from four different perspectives: an Accountable Care Organization, an academic medical center, a payer and an IT vendor. Critical considerations around process controls, systems and frameworks will also be addressed.

Presenters include:

• Michael Gould, Business Lead – Interoperability, Blue Cross Blue Shield Association 
• Michael B. Marchant, Director, Health Information Exchange, UC Davis Health
• Charlotte Morris, Data Governance Program Director, MultiCare Connected Care
• Lukasz Nosol, Senior Director, Software Development - Enterprise Clinical Integration and Interoperability, Optum

The healthcare industry is in a state of rapid innovation. From aggregated health data apps to telemedicine and digital front doors, the pandemic has propelled consumer demand for innovative and enhanced healthcare solutions. Additionally, The Centers for Medicare and Medicaid (CMS) and The Office of the National Coordinator for Health Information Technology (ONC) mandates on interoperability and HL7 Fast Healthcare Interoperability Resources (FHIR®) have accelerated this innovation by helping bring multiple healthcare stakeholders together to provide better access to quality health data across the board.

Within this context, digital healthcare interoperability has now become a digital supply chain challenge as healthcare providers must retrieve data or information from systems of record, such as electronic health record (EHR) systems, into destination systems and consumers across multiple organizational boundaries while ensuring security and data privacy.

The pandemic taught us that innovation is key in healthcare - organizations with unique digital experiences thrived while those that struggled to adapt suffered. Consumer expectations have also soared in recent years as patients and members expect a frictionless digital experience from their healthcare organizations and access to their data across the healthcare ecosystem. Interoperability - the ability to share the right data across stakeholders, is a key, if not the most important, building block of this movement.

From digital check-ins to connected devices and telehealth programs, patients expect the benefits of a more digitized healthcare experience.

 At the same time, they’re also demanding a more personalized approach from healthcare providers. This duality - the need to provide a more convenient experience with one that’s more tailored to the patient - is fueling a wave of technology modernization efforts and the replacement of monolithic legacy IT systems.

 With limited re-use outside of the context they were built for and a reliance on nightly batch processing, legacy IT systems fail to deliver the services healthcare IT teams need or provide the experiences patients demand. Modernization should come with a move to microservices that can be used by multiple applications, agile teams that embrace domain driven design principles, and event busses like Kafka to deliver real-time data and functionality to users.

While this transformation is occurring, there’s an 800 lb. gorilla not being widely addressed:  Analytics.

 What the healthcare industry doesn’t want to talk about is how costly analytics has become; the people, the software, the infrastructure, and particularly how difficult it is to move data in and out of data lakes and warehouses. It's hindering the industry’s ability to deliver insights to patients and providers in a timely and efficient manner.

And yet, so many organizations are modernizing their analytics data warehouses and data lakes with an approach that simply updates the underlying technology. It’s a lift-and-shift effort of tremendous scale and cost, but one that is not addressing the underlying issues preventing the speedy delivery of meaningful insights.