da vinci progress update progress update

DA VINCI PROGRESS UPDATENovember 2018

WHAT IS THE DA VINCI PROJECT AND WHAT ARE ITS GOALS?Some are familiar with the Da Vinci project and some have

only heard about it recently since formally announced in Sep-

tember 2018. To level set on the key details:

• Private sector initiative of industry leaders and health IT

technical experts

• Participants work together to accelerate the adoption of

HL7® FHIR® as the standard to support and integrate val-

ue-based care (VBC) data exchange

• Reduce provider burden and payer complexity from ad

hoc design and implementation of data exchange with an

industry-wide common design with modern technology

The goal of the Da Vinci Project is to help payers and pro-

viders positively impact clinical, quality, cost and care man-

agement outcomes.

The payers, health systems, and other industry participants

that are actively involved in the Da Vinci Project identify and

prioritize use cases that involve managing and sharing clini-

cal and administrative data between industry partners.

Since Da Vinci is an HL7 International supported initiative,

new and revised requirements can become open industry

standards.

HOW TO GET INVOLVEDDa Vinci members are looking for provider and payer orga-

nizations that want to test and implement the artifacts for our

use cases. Please contact the program team (davincipmo

@pocp.com) if you are interested.

To be a more informed participant, see HL7.org/davinci or

subscribe to the public Da Vinci listserv at http://www.hl7.

org/about/davinci/index.cfm?ref=common.

The Da Vinci Steering Committee represents all the ma-

jor stakeholder groups, including commercial payers, pro-

viders, HIT vendors, CMS, and HL7. It approves Da Vinci

Project use cases, contracts and monitors their progress. In

September 2018 we welcomed two new members to com-

plete our project leadership; Dr. Lane and Mike Funk.

Elections for 2019 Steering Committee members will com-

mence in February 2019.

• Sagran Moodley,

Chair (UnitedHealthcare)

• Hans Buitendijk,

Vice-Chair (Cerner)

• Peter DeVault (Epic)

• Shafiq Rab, MD

(Rush Medical Center)

• Kirk Anderson

(Cambia Health)

• Steven Lane, MD

(Sutter Health)

• Mike Funk (Humana)

• Melanie Combs-Dyer (CMS)

• W. Edward Hammond, PhD

(HL7)

Use Case ScenarioStage

StatusDesign Build Publish Implement Committed Adopters

Coverage Requirements Discovery STU1 Done STU1 Done Q4 ’18 Q418 CMS Draft Standard

Data Exchange Quality

Measures

30 Day Med Rec STU1 Done STU1 Done Q4 ’18 Planning Planning Draft Standard

Add’l Measures In Process Q119 Q2 ‘19 Planning PlanningApproved

Q3218

Document Templates & Rules (DTR) In Processs In Process Q2 ‘19 Q219 CMS Approved Q218

eHealth Clinical Data Exchange

(eHRx)

Provider Data In Process Q119 Q2 ’19 Planning PlanningApproved

Q3218Payer Data In Process Q119 Q2 ’19 Planning Planning

USE CASE REVIEW/UPDATE

Authorization Support Encounter NotificationsGaps in Care ExchangeRisk Based

Contract Attribution

2019 Prework

Execution of original plan Expanded scope due to additional funding and successful execution

PROGRESS UPDATENovember 2019

The Da Vinci Project was founded in 2018 by a group of industry

leaders focused on payers/provider collaboration needed to

identify and enable information exchange to positively impact

clinical, quality, cost and care management outcomes. Our

members and stakeholders work together to accelerate 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. VBC

programs enable providers to see the right data at the right time

for specific patient coverage, benefits and care coordination.

2Da Vinci Progress Update November 2018

DA VINCI AS AN INDUSTRY DRIVEN INITIATIVE

ARCHITECTURE UPDATE

Adopt StandardsAdoption of existing and emerging standards with broad sup-

port to create viable solution for Da Vinci goals, particularly:

• FHIR as the core

• NCQA HEDIS

• CDS Hooks

• SMART on FHIR—layering in OAuth security

Leverage the work of others:

• Support existing FHIR versions

• Adopt existing profiles where possible e.g., Argonaut,

US-Core, QI-Core

Build Using the Best Tools• Aegis Touchstone for test environment

• HSPC Sandbox environment to create and support refer-

ence implementations

• Lantana Trifolia to create implementation guides

Design Frameworks• Data Exchange for Quality Measures framework.

• Coverage Requirements Discovery

• Documentation Templates and Rules

Create Reproducible ProcessesCollaborative use case discovery and development fo-

cused on payer/provider workflows and information re-

quirements yielding:

• Quality, balloted implementation guides

• Reference implementations to support sandbox testing

• Test scripts and process

• Deliver balloted standards ready for testing and adoption

Build Using the Best PeopleContinue to use FHIR experts to design and build the stan-

dard implementation guide templates and processes.

Create as Sustainable Presence and Model

1. Create symbiotic relationship with ONC and their

P2 FHIR Task Force

2. Established partnerships with NCQA and HIMSS

3. Press release and communication framework to keep

industry informed

4. Emerging presence across industry events to

demonstrate Da Vinci outputs

5. Produce artifacts that are open source and generally

available to public

In Less Than Two Years, Da Vinci Efforts Will Drive Standards for the Exchange of Information Critical to Patient Care

Prior Auth and DocumentationRequirements Payer Clinical Data

Gaps in CareAttribution (Patient Panel)

Medical Records for Value-Based Care

Quality Measure ReportingEncounter Notifications

Payers Providers

The project:

• Focuses on use cases linked to high volume, manual activities that would benefit from automation

• Unlocks data using consistent APIs to empower organizations to achieve transformation to improve outcomes and value

• Identifies how and where in workflows critical data for VBC is exposed and captured across partners: care teams, vendors and payers

• Positions organizations for success by defining FHIR implementation guides to power and fulfill VBC contract data requirements

• Minimizes the development and deployment of unique solutions between trading partners (e.g. a payer and provider)

2019 IMPLEMENTATION GUIDE SCHEDULE

Health Record Exchange

Framework / Library

Documentation Templates and

Coverage Rules

Gaps in Care & Information

Coverage Requirements

Discovery

Performing Laboratory Reporting

Data Exchange for Quality Measures

Prior-Authorization Support

Risk Based Contract Member

Identification

Alerts/Notifications:Transitions in Care, ER admit/discharge

Patient Cost Transparency

Chronic Illness Documentation for

Risk Adjustment

Payer Data Exchange

Use Case Status

Health Record Exchange: Patient

Data Exchange

Payer Coverage Decision Exchange

Clinical Data Exchange

Payer Data Exchange:

Provider Network

Payer Data Exchange: Formulary

Project Process

Define requirements: Clinical Business Technical Testing

Create Implementation Guide (IG) Create and test Reference Implementation (RI)

(prove the IG works) Pilot the solution Deploy the Solution

In Ballot Reconciliation

Early February or February 2020 Ballot

In Build

In Discovery

WHAT IS THE DA VINCI PROJECT AND WHAT ARE ITS GOALS?

Project Process1. Define requirements:

• Clinical• Business• Technical • Testing

2. Create Implementation Guide (IG)3. Create and test Reference Implementation (RI)

(prove the IG works)4. Pilot the solution5. Deploy the solution

Visit confluence.HL7.org/display/DVP to stay up-to-date on the use case statuses.

GET INVOLVED!Da Vinci members are looking for provider and payer organizations that want to test and implement the artifacts for our use cases. Please contact the program team ([email protected]) if you are interested. Visit HL7.me/davinci to learn more.

Attend the December Da Vinci Connectathon in Philadelphia! Visit HL7.org/events/da-vinci/2019/12/ to register.




ARCHITECTURE UPDATE




• NCQA HEDIS

• CDS Hooks





US-Core, QI-Core



















P2 FHIR Task Force



industry informed




available to public






Payers Providers

KEY PROJECT MILESTONES

2019 AccomplishmentsImplementation Guide (IG) Build Out Process• Progressed 13 use cases through HL7 ballot process • Held two Da Vinci Connectathons and Working Session

Meetings and three HL7 Connectathons

Progressed Da Vinci Awareness in Industry• In February at HIMSS19 demonstrated initial three

Da Vinci implementation guides ɣ 14 members and partners ɣ 23 Presentations to over 500 attendees

• PMO and members brought Da Vinci updates to over 50 different associations, conference and meetings

• Delivered relevant updates and held open meetings at HL7 work group meetings

• Da Vinci use cases called out by name in February CMS NPRM

• Held three HL7 sponsored webinars

Members & Public• Established and held open community calls for

members to share learning and best practices

Ensure Industry Input into Progress• Established Clinical Advisory Council• Created deployment category of membership• Grew membership from 28 to 42 members• Eight of new members are provider organizations

ɣ AMA Medical Group ɣ Cedars-Sinai ɣ Children’s Health ɣ MultiCare Connected Care ɣ Oregon Health & Science University (OHSU) ɣ Providence St. Joseph Health ɣ Texas Health Resources ɣ Weill Cornell Medicine

• All active use cases calls are public for anyone in industry to attend

In 2020, We Plan To:• Continue to publish/progress implementation guides

ɣ Two draft standard for trial use – STU 2 ɣ 11 draft standard for trial use – STU 1

• Da Vinci booth presence at HIMSS20 with over a dozen members and partners

• Target relevant industry events for presentations• Initiate 2-3 new use cases• Share initial outputs from Clinical Advisory Council • Provide members with the right tooling for

implementation• Track and support initial pilots and early adopters of

Da Vinci IGs• Hold and support three or more connectathon events,

stand alone and with HL7 • Grow deployment members and tools

Implementation GuideIG

StatusRI

LiveNumber of

Connectathons

Quality Improvement

Data Exchange for Quality Measures 3 5

Gaps in Care & Information 1

Burden Reduction

Coverage Requirements Discovery 3 5

Documentation Templates and Payer Rules 2 4

Prior Authorization Support 2 2

Member Access

Health Record Exchange Framework (HRex) 2 * *Clinical Data Exchange (CDex) 2 3

Payer Data Exchange (PDex) 2 3

Payer Data Exchange (PDex): Formulary 2 2

Payer Data Exchange (PDex): Plan Network Directory 1 2

Payer - Payer Coverage Decision Exchange 2 2

Patient Cost Transparency 0 Clinical Data Exchange

Alerts: Notification (ADT), Transitions in Care, ER admit/discharge

1 2

Health Record Exchange: Patient Data Exchange 0

Health Record Exchange: Patient Data Exchange 0

Performing Laboratory Reporting 0

Process Improvement

Risk Based Contract Member Identification 1

Chronic Illness Documentation for Risk Adjustment 0

IG PROGRESS TRACKER

KEY0 Planning

1 Build

2 STU1 Ballot Reconciliation > Publish

3 STU2 Ballot Reconciliation > Publish

* Not Meaningful / Foundational IG




ARCHITECTURE UPDATE




• NCQA HEDIS

• CDS Hooks





US-Core, QI-Core



















P2 FHIR Task Force



industry informed




available to public






Payers Providers

MEMBERS

For current membership, visit HL7.org/about/davinci/members.cfm

Indicates a founding member of the Da Vinci Project.

Premier Members

Sponsors

Sponsored Members

Members

Deployment Partner

Associate Members

Contributors Partners

da vinci progress update progress update

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