The Standard

The Da Vinci Project’s Year-End Meeting to Be Held December 8, 2021

The HL7 Da Vinci Project will hold a combined virtual Community Roundtable and Member Forum on December 8 titled "Are You  Ready for 2022? Hear Progress and Plans, Available Testing tools and Implementation Perspectives." During this meeting,  Da Vinci’s program management office will share insights on the year’s achievements, as well as the latest on strategic planning. They will top it off with a synopsis of Da Vinci’s priorities for 2022.

The agenda includes:

The Da Vinci Project’s October Community Roundtable, to be held Oct. 27 from 4:00 – 5:30 p.m. EDT, will feature Clinical Data Exchange (CDex)

This “Swiss army knife” of implementation guides (IGs) is responsible for identifying, documenting and constraining specific patterns of exchange so that providers and payers can reliably share patient information and coordinate care.

The scope of the CDex encompasses defining combinations of exchange methods with specific payloads, search criteria, conformance, provenance, and other relevant requirements, to support specific exchanges of clinical information between providers and and/or payers. CDex is also responsible for aiding in risk adjustment and quality reporting--and it helps payers to identify whether a requested service is necessary and appropriate.

The roundtable, titled, “Harnessing Clinical Data Exchange (CDex) to Improve Performance within Value-Based Care,” will give a current snapshot of the functionality, benefits and capabilities of CDex, helping providers to share the clinical data they have generated with payers and other industry partners.

At the roundtable, members of the Providence team will share their strategy for using CDex to support payer value-based care arrangements focusing on their initial target to achieve supplemental data exchange.

Presenters will include:

• Viet Nguyen, MD, Technical Director, HL7 Da Vinci Project, and Clinical Informaticist, Stratametrics, LLC
• Semira Singh, Product Manager, Population Health Informatics, Providence
• Michael Westover, Vice President, Population Health Informatics, Providence

Come to the roundtable and learn how HL7 is making progress on CDex, with its eye on what remains to be conquered to provide the fully maximized data exchange needed to support value-based care. The good news is, HL7® Fast Healthcare Interoperability Resource (FHIR®) is helping to drive interoperability forward, and Da Vinci is poised to accelerate that data exchange in such a way that it will greatly reduce the burden between providers and payers.

Da Vinci Project's Monthly Meeting to Describe Progress on Price Cost Transparency and Risk Adjustment Initiatives on Wednesday Event, 9/22 at 4:00 pm ET

Important updates on two implementation guide initiatives and a demo of how standards could support prior authorization burden reduction are on the agenda for the next Community Roundtable of the Da Vinci Project.

The roundtable will begin with an update from the project management office of the Da Vinci Project, which will feature updates on the status of the Price Cost Transparency and Risk Adjustment Implementation Guides (IGs). These efforts to use HL7® Fast Healthcare Interoperability Resource (FHIR®) are more complex than previous initiatives. Both efforts anticipate challenges that the industry will face to make healthcare costs more transparent and to accurately reflect patients’ comprehensive conditions and risks related to reimbursement for coverage.

After the update, the prior authorization demonstration will show how FHIR IGs can be used to reduce administrative challenge of anticipating prior authorization documentation requirements, a nagging concern within the industry.

Recent Initiatives of the ONC’s FHIR at Scale Taskforce (FAST) and Update on Payer-to-Payer Mandate are Key Topics for Wednesday Event, 8/25 at 4:00 pm ET

The success of the HL7® Fast Healthcare Interoperability Resource (FHIR®) standard is becoming increasingly evident.

Successful case studies are emerging. For example, a recently published HL7 case study documents how MultiCare Connected Care and Regence are recognizing significant cost savings by using a FHIR implementation guide standard to definitively ascertain that medication reconciliation has been completed. This case study can be found at https://www.hl7.org/participate/case-studies/index.cfm .

But these isolated successes beg the question – can FHIR be used more broadly, and implemented more widely across the country, handling a multiplicity of interactions across dozens of healthcare organizations simultaneously?

That is the task given to the ONC’s FHIR at Scale Taskforce (FAST), which is seeking to determine solutions and opportunities to influence emerging solutions.

Progress by the ONC FAST effort is of prime importance to the dissemination of FHIR solutions to solve information exchange challenges in healthcare. The panel’s progress over the past year will be one of the topics of the Da Vinci Project’s monthly Community Roundtable event, to be held from 4 to 5:30 p.m. ET on Wednesday, August 25.

HL7 Da Vinci Roundtable  on July 28 from 4:00 to 5:30 p.m. ET to Feature Payer-to-Payer Data Exchange

Join the Da Vinci Project next Wednesday at its July Community Roundtable titled "Payer-to-Payer Data Exchange: Rising to the Opportunities and the Challenges." The session will focus on the use of HL7's 's Fast Healthcare Interoperability Resources (FHIR®) for payer-to-payer data exchange, highlighting the Payer Data Exchange (PDex) use case.

Presenters for the session include:

• Michael Gould, business lead - interoperability at Blue Cross Blue Shield Association
• Patrick Murta, chief interoperability architect & solutions architecture fellow, Humana
• Heather Kennedy Tanner, director of enterprise architecture, BlueCross BlueShield of Tennessee

Da Vinci Roundtable  on June 23 from 4:00 to 5:30 p.m. ET to Look at the Potential for Getting More Value from the Use of Standards

Exchanging clinical data sets is getting more attention, particularly as healthcare organizations focus efforts on gaining efficiency and improving clinical care, while reducing clinician burden.

The ultimate challenge is freeing the data contained in these communications and making it computable and usable with minimal or no manual intervention. That looks ahead to the incorporation of fielded data, which will enable the use of agreed-upon approaches to make data usable.

Sharing the current state of the art for these advances through the use of Fast Healthcare Interoperability Resources (FHIR®) will be the focus of the June Community Roundtable of the Da Vinci Project, taking a deep dive into the Clinical Data Exchange (CDX) use case.

The session, with the title of “Demystifying Attachments to Enable Clinical Data Exchange,” will take place from 4 to 5:30 p.m. ET on June 23. The roundtable will focus specifically on the importance of implementing clinical data exchange capabilities, to anticipate emerging data exchange requirements and potential regulatory efforts.

Steven Lane, MD, MPH, clinical informatics director for privacy, information security and interoperability at Sutter Health, will share the clinician view regarding the challenges, opportunities and benefits of standardized data exchange.

In addition, Mary Lynn Bushman, agile product managers for National Government Services, will showcase their attachments implementation and production successes that it’s experienced with more than 1,500 provider organizations, improving multiple workflows and reducing burden. Da Vinci’s Technical Director Viet Nguyen, MD, will discuss emerging capabilities for provider-provider and provider-payer clinical data exchange.

Monthly Event is Scheduled for 4:00 to 5:30 p.m. ET on Wednesday, May 26, 2021

The Da Vinci Project is offering real-life examples of how healthcare organizations are using its Use Cases to make a difference in information exchange and interoperability. 

The community roundtable will feature a session entitled, “Reducing Burden: Da Vinci Quality Measures tied to CMS RFI and HIPAA Exception Request for Prior Authorization.” The Da Vinci PMO will provide an update including the latest federal proposed rule Request for Information related to digital quality measurement collection using HL7's  Fast Healthcare Interoperability Resources (FHIR®). Learn about Da Vinci’s DEQM and Gaps in Care Implementation Guides to assist you during your review and with crafting your RFI response. Da Vinci leadership will discuss current prior authorization burden and how the available implementation guides can streamline the processes. In addition, the PMO will discuss opportunities provided by the newly granted exception to the HIPAA requirement for Da Vinci payers and their trading partners when using the FHIR standard for prior authorization.

• Kirk Anderson, Da Vinci Project Steering Committee Member, Vice President & CTO, Cambia Health Solutions
• Robert Dieterle, Senior Advisor, Da Vinci PMO
• Jocelyn Keegan, Program Manager, Da Vinci PMO
• Linda Michaelsen, Director of Healthcare Interoperability Standards, Optum
• Steven Waldren, MD, Da Vinci Co-Chair, Clinical Advisory Committee, Vice President and CMIO, American Academy of Family Physicians

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.

Monthly Event is Scheduled for 4:00 to 5:30 p.m. ET on Wednesday, March 24, 2021

Advancing the use of HL7’s Fast Healthcare Interoperability Resources (FHIR®) takes both strong proponents advocating for the cause and pioneering organizations that lead the industry by putting concepts into practice.

Both aspects important to FHIR adoption will be on display at the March Community Roundtable of the Da Vinci Project, scheduled for Wednesday, March 24, from 4 to 5:30 p.m. ET. The roundtable has become a staple of the Da Vinci Project’s efforts to highlight successful deployments of its implementation guides, intended to help healthcare organizations manage value-based care initiatives.

MiHIN Shares Lessons Learned with Plan-Net

An example of a real-world implementation will be provided by the Michigan Health Information Network (MiHIN). A team from the organization will share lessons learned from its deployment of Plan-Net, the Payer Data Exchange (PDex)-Plan Network Directory Implementation Guide that focuses on Payer-Provider Directories. FHIR offers the potential to automate this typically manually intensive process for all parties, and MiHIN will describe its journey to putting the implementation guide into place to achieve this.

Project Achieves a Tipping Point as Adoption Begins in Earnest to Meet Upcoming and Proposed Federal Regulation and Solve Interoperability Challenges

The Da Vinci Project made significant progress in 2020 in advancing the maturity of implementation guides, and now looks to increasingly demonstrate the value of its implementation guides (IGs) across production implementations this year.

Members of the HL7 FHIR® Accelerator group helped push forward work on several implementation guides that were published in 2020, but further refinement lies ahead, said project managers who presented a progress report on the Da Vinci Project at its January Community Roundtable.

In addition to the update on progress with publishing new standards, the presentation offered members a tour of the Da Vinci Project’s enhanced Confluence website, as well as an invitation for more organizations to consider membership to help ensure implementation guides meet the needs of the entire healthcare community.

This year, there will be a growing need to use the HL7 Fast Healthcare Interoperability Resources (FHIR®) standard, as application programming interfaces (APIs) emerge to meet federal information exchange requirements and business needs of value-based care.