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TRANSCRIPT
8/26/2019
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Da Vinci – NPAGEmerging Technologies / Initiatives
Gulf Shores, AL
August 26, 2019
ANSI Antitrust Policy
• ANSI neither develops standards nor conducts certification programs but instead accredits standards developers and certification bodies under programs requiring adherence to principles of openness, voluntariness, due process and non-discrimination. ANSI, therefore, brings significant, procompetitive benefits to the standards and conformity assessment community.
• ANSI nevertheless recognizes that it must not be a vehicle for individuals or organizations to reach unlawful agreements regarding prices, terms of sale, customers, or markets or engage in other aspects of anti-competitive behavior. ANSI’s policy, therefore, is to take all appropriate measures to comply with U.S. antitrust laws and foreign competition laws and ANSI expects the same from its members and volunteers when acting on behalf of ANSI.
• Approved by the ANSI Board of Directors May 22, 2014
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Terminology
HL7 FHIR© – Fast Healthcare Interoperability Resources -- (based on internet technologies;
XML, JSON, and RESTful exchanges -- current release is R4)
FHIR Resource – definition of a related set of clinical data elements (e.g. Observation)
CDS Hooks – Clinical Decision Support Hooks (triggers exchange base on clinical workflow events)
SMART – framework developed by MIT and Harvard for adding provider functionality to EHRs
USCDI – ONC’s US Core Data for Interoperability – Meaningful Use required elements
US Core Profiles – Constraints on a version of FHIR to represent the USCDI data set
CQL – Clinical Quality Language (SQL like language for clinical applications)
HL7 Da Vinci Project: An Overview
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To ensure the success of the industry’s shift to Value Based Care, Da Vinci established a rapid multi-stakeholderprocess to identify, exercise and implement initial use cases between payers and provider organizations.
The objective is to minimize the development and deployment of unique solutions with focus on reference architectures that will promote industry wide standards and adoption.
Payer Members:Anthem, BCBSA, BCBSAL, BCBSM, BCBST, BC Idaho, Cambia Health, Cigna, CMS, GuideWell, HCSC, Humana, Independence, United Healthcare
Vendor Members:Allscripts, Athenahealth/Virence(aka GE Centricity), Casenet, Cerner, Cognosante, eCW, Edifecs, Epic, HealthLX, InterSystems, Juxly, Optum, Surescripts, ZeOmega
Project Process Define requirements (clinical,
business, technical and testing Create Implementation Guide (IG) Create and test Reference
Implementation (RI) (prove the IG works)
Pilot the solution Deploy the Solution
Provider Members:Dallas Children's Health, MultiCare, OHSU, Providence St. Joseph Health, Rush University Medical Center, Sutter Health, Texas Health Resources, Weil Cornel Medicine
Partners:HIMSS, NCQA
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Sample Project Timeline
Assemble Team
FHIR Gap Analysis
Build Initial RI
Specify profiles, …
RI Tech Approach
Requirements
IG Development
RI Development Test RI Update Final RI
Project start
Represents 4 weeks2 - 4 sprints
Build Data Set
Week 0 2 4 6 8 10 12 14 16
Build Test Set
Work with appropriate HL7 workgroup for IG sponsorship and input
IG Framework Create Draft IG Revise and Finalize IG
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Documentation Templates and Rules
Documentation Templates and Rules
Gaps in Care & Information
Gaps in Care & Information
Coverage Requirements
Discovery
Coverage Requirements
Discovery
Performing Laboratory Reporting
Performing Laboratory Reporting
Data Exchange for Quality Measures
Data Exchange for Quality Measures
Prior-Authorization Support
Prior-Authorization Support
Risk Based Contract Member IdentificationRisk Based Contract
Member Identification
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Alerts / NotificationsAlerts / Notifications
Patient Cost TransparencyPatient Cost
Transparency
Chronic Illness Documentation for
Risk Adjustment
Chronic Illness Documentation for
Risk Adjustment
Payer Data ExchangePayer Data Exchange
Use Case Focus Areas
Patient Data ExchangePatient Data Exchange
Payer Coverage Decision Exchange
Payer Coverage Decision Exchange
Clinical Data Exchange
Clinical Data Exchange
Payer Data Exchange: Directory
Payer Data Exchange: Directory
Payer Data Exchange: Formulary
Payer Data Exchange: Formulary
Qu
ality Imp
rovem
ent
Clin
ical Data E
xchan
ge
Co
verage / B
urd
en R
edu
ction
Process Improvement
Payer Data ExchangePayer Data Exchange
Mem
ber A
ccess
Clinical Data Exchange
Clinical Data Exchange
May ballot STU and for comment
In early September ballot (July) as STU
September ballot as STU
Currently targeted for potential early or regular January 2020 ballot
Use cases in discovery (some may be balloted in January 2020)
Use Case Status
Documentation Templates and Rules
Documentation Templates and Rules
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January ConnectathonHL7
Connectathon
Da VinciConnectathon &Working Session
MAY BALLOT (Mar 29 – Apr 29)
STU Data Exchange for Quality Measures (DEQM)
STU Coverage Requirements Discovery (CRD)
Comment Documentation Templates & Rules (DTR)
HL7 Connectathon
Ballots and Connectathons
EARLY SEPTEMBER BALLOT (June 21 – July 21)
STU Health Record Exchange (HRex)
STU Payer Data Exchange (PDex)
STU PDex Formulary
STU Clinical Data Exchange (CDex)
20202019
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MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR
JANUARY BALLOT (Dec 27 – Jan 26)
STU Gaps in Care
STU STU Patient Cost Transparency
STU RBC Member ID and Bulk Data
SEPTEMBER BALLOT (Aug 9 - Sept 9)
STU Documentation Templates and Rules (DTR)
STU Payer Coverage Decision Exchange
STU Prior Authorization Support (Prior Auth) HL7 Connectathon
Potential early January ballot (Oct 15 – Nov 15)
STU PDex Payer Directory
STU Alerts / Notifications
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Information Exchanges Supported by Da Vinci IGs
Patient
Provider
Member directed
[3] USCDI[6] Continuity of Treatment
[2] Aggregated Quality Measure Reporting
[2] Gaps in Care[7] Coverage Requirements[8] Documentation Rules[11] Payer Data
[10] Provider Data[12] Alerts/Notifications
[1] Quality Data[10] Provider Data
[9] Prior-Authorization[12] Alerts/Notifications
Quality Measures and Gaps[1] Data Exchange for Quality Measures[2] Gaps in Care and Information
Member Directed Exchange (CMS NPRM)[3] Payer Data Exchange [4] Payer Data Exchange: Directory[5] Payer Data Exchange: Formulary[6] Payer Coverage Decisions (Treatment)
Coverage/Documentation Requirements[7] Coverage Requirements Discovery[8] Documentation Templates and Rule[9] Prior-Authorization Support
Patient Data Exchange[10] Clinical Data Exchange (Provider Data)[11] Payer Data Exchange (Payer Data)[12] Alerts/Notification
Patient Cost Transparency (in discovery)
[3] USCDI [4] Directory[5] Formulary
Provider
PayerPayer
[3] USCDI [4] Directory[5] Formulary
ConsumerApplication
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Coordination with CARIN Alliance
DATA SUB TYPE RESOURCE / PROFILE BUILD IG MEMBER PROVIDER PAYER
Financial EOB CARIN BB 2.0 CARIN
Clinical USCDI / US Core / Da Vinci Da Vinci PDex DV for CARIN Da Vinci Da Vinci
Clinical Data All USCDI / US Core / Da Vinci Da Vinci PDex DV for CARIN Da Vinci Da Vinci
Payer Decisions Treatment USCDI / US Core / Da Vinci Da Vinci PCD Da Vinci
Alerts/Notification Admit/Discharge USCDI / US Core / Da Vinci Da Vinci Alerts Da Vinci
RTBC SCRIPT FHIR R4? CARIN NCPDP RTBC CARIN NCPDP CARIN NCPDP
Medications USCDI / US Core Da Vinci PDex DV for CARIN Da Vinci Da Vinci
Formulary Da Vinci (new Profile) Da Vinci PDex Formulary DV for CARIN Da Vinci Da Vinci
Directory Data Payer & Pharma Network
USCDI / US Core / Da Vinci Da VinciPdex Provider
NetworkDV for CARIN Da Vinci
DV for CARIN CARIN may choose to add additional guidance
Claims Data
Pharma Data
PAYER TO:WORK BREAKDOWN TO SUPPORT CMS NPRM
Activities by the Numbers
Stats
Total practice runs 3
Total public runs 23
Filming runs 1
Total variations 14
Total roles 96
Total role system issues
7
Role availability 92.7%
Each step represents a provider – payer exchange using FHIR IG10
UNLOCKING PAYER INFORMATION TO IMPROVE CAREHIMSS19 Demonstration
CLINICAL SUMMARY
Da Vinci is demonstrating the ability to exchange information between payers and providers using HL7® FHIR® and CDS Hooks® as part of the Interoperability Showcase.
The vignette describes a clinical encounter for 78-year-old Asian women named Dara that starts with her primary care physician, proceeds to a cardiologist who admits Dara to the hospital for an angiogram and observation where it is determined that her chronic obstructive pulmonary disease has progressed to the point that she needs supplemental oxygen.
As Dara returns to her primary care physician, her previous medications are reconciled with those prescribed at discharge, the PCP reports the medication reconciliation, in support of a quality measure the Medicare Advantage program is following for its members.
Activities by the Numbers
Stats
AEGIS Touchstone available
100%
Total MCs 6
Total EHRs 2
Total Payer/Partner 4
Total Payer only 5
Total Sponsors 16
Number of visitors (approx.) 500
Percent that left during vignette
< 10 %
Patient Patient Patient Patient Patient1
2
3
4
PCP
Schedule Appt with
Payer
Admitted for Angioplasty
Discharged with O2
Therapy
PCPCardiologist Hospital
PayerMed Rec
PayerPayerPatient Data
The visual describes the interactions demonstrated at HIMSS Interoperability Showcase, direction of each exchange, the FHIR standards
used, the setting where the interaction is occurring and the participants.
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CMS NPRM Member Access
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CMS NPRM for Payer Data Exchange – to Member
1) Must implement and maintain an open API that permits third-party applications to retrieve, with the approval and at the direction of an individual MA enrollee, data specified below through the use of common technologies and without special effort from the enrollee.
a) Accessible content – all plansi) Standardized data concerning adjudicated claims, including claims …
ii) Standardized encounter data, …iii) Provider directory data on the MA organization’s network of contracted providers, including
names, addresses, phone numbers, and specialties, … andiv) Clinical data, including laboratory results, if the MA organization manages any such data …
b) Accessible content – for plans that offer an MA-PD plansi) Standardized data concerning adjudicated claims for covered Part D drugs …
ii) Pharmacy directory data …, andiii) Formulary data that includes covered Part D drugs, and any tiered formulary structure or
utilization management procedure which pertains to those drugs.
Notes: a) applies to other plans covered by the CMS NPRM – see specific language for eachb) applies in part to some other covered plans – see specific language for each
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CMS NPRM for Payer Data Exchange – to Payer
2) Coordination among payers.
a) MA organizations must maintain a process for the electronic exchange of, at a minimum, the data classes and elements included in the regulations regarding the content standard adopted at 45 CFR 170.213 (USCDI). Such information received by an MA organization must be incorporated into the MA organization’s records about the enrollee. At the request of an enrollee, the MA organization must:
i) Receive such data from any other health care plan that has provided coverage to the enrollee within the preceding 5 years;
ii) At any time an enrollee is currently enrolled in the MA plan and up to 5 years after disenrollment, send such data to any other health care plan that currently covers the enrollee;
Notes: a) applies to other plans covered by the CMS NPRM – see specific language for each
Documentation Templates and Rules
Documentation Templates and Rules
Gaps in Care & Information
Gaps in Care & Information
Coverage Requirements
Discovery
Coverage Requirements
Discovery
Performing Laboratory Reporting
Performing Laboratory Reporting
Data Exchange for Quality Measures
Data Exchange for Quality Measures
Prior-Authorization Support
Prior-Authorization Support
Risk Based Contract Member Identification
(Bulk Data)
Risk Based Contract Member Identification
(Bulk Data)
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Alerts / NotificationsAlerts / Notifications
Patient Cost TransparencyPatient Cost
Transparency
Chronic Illness Documentation for
Risk Adjustment
Chronic Illness Documentation for
Risk Adjustment
Payer Data Exchange
Use Case Focus Areas
Patient Data ExchangePatient Data Exchange
Payer Coverage Decision Exchange
Payer Coverage Decision Exchange
Clinical Data Exchange
Clinical Data Exchange
Payer Data Exchange: Directory
Payer Data Exchange: Formulary
Qu
ality Imp
rovem
ent
Clin
ical Data E
xchan
ge
Co
verage
/ Prio
r Au
tho
rization
Process Improvement
Payer Data ExchangePayer Data Exchange
Mem
ber A
ccess
Clinical Data Exchange
Clinical Data Exchange
May ballot STU and for comment
In early September Ballot (July) all STU
September ballot as STU
Currently targeted for early or regular January 2020 ballot
Use cases in discovery (some may be balloted in January 2020)
Use Case Status
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CMS NPRM Information Exchanges
Supported by Da Vinci IGs
Patient
Provider
Member authorization
[3] USCDI[6] Continuity of Treatment
[2] Aggregated Quality Measure Reporting
[2] Gaps in Care[7] Coverage Requirements[8] Documentation Rules[11] Payer Data
[10] Provider Data[12] Alerts/Notifications
[1] Quality Data[10] Provider Data
[9] Prior-Authorization[12] Alerts/Notifications
Quality Measures and Gaps[1] Data Exchange for Quality Measures[2] Gaps in Care and Information
Member Directed Exchange (CMS NPRM)[3] Payer Data Exchange [4] Payer Data Exchange: Directory[5] Payer Data Exchange: Formulary[6] Payer Coverage Decisions (Treatment)
Coverage/Documentation Requirements[7] Coverage Requirements Discovery[8] Documentation Templates and Rule[9] Prior-Authorization Support
Patient Data Exchange[10] Clinical Data Exchange (Provider Data)[11] Payer Data Exchange (Payer Data)[12] Alerts/Notification
Patient Cost Transparency (in discovery)
[3] USCDI [4] Directory[5] Formulary
Provider
PayerPayer
[3] USCDI [4] Directory[5] Formulary
ConsumerApplication
Health Record Exchange
Payer Data Exchange (PDex)
Provider to Payer Exchange (CDex)
PAYERPROVIDER16
Health Record Exchange Framework
Interactions & Profiles
Provider can receive relevant Payer Sourced Data about a patient
Provider can share relevant Provider Sourced Data to Payer and/or other Providers
Payer Data Exchange (PDex): Directory
Payer tData Exchange (PDex): Formulary
PATIENT/ MEMBER
Provider can access Plan Network Directory information
Provider can access Plan Formulary information
Patient can access Plan Network Directory information
Patient can access Plan Formulary information
Provider can receive their Payer Sourced Data
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MEMBER DIRECTEDAPPLICATION
Member Direction
USCDI* -- Da Vinci PDex
Blue Button 2.0 -- CARIN
Directory: Da Vinci Payer Network
Formulary: Da Vinci Formulary
*Supports bulk data exchange for USCDI
1
1
22
PAYER 1
3
3
44
PAYER 2
1
2
3
4
CMS NPRM Member Access for Covered Payers
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USCDI – US Core Profiles on FHIR R4
Examples of Payer Data Sources
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Continuity of CarePayer – Payer Exchange
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Member Direction
USCDI* -- Da Vinci PDex
Continuity: Da Vinci PCD
*Supports bulk data exchange for USCDI
2
PAYER 1
5
5PAYER 2
2
CMS NPRM Requirement for Covered Payers
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Goal: To address the portability of care/treatment as a member moves from one covered plan to another
Regulatory: CMS NPRM for member directed payer to payer exchange of USCDI data
Immediate Requirement: Support for information regarding ongoing treatmenta) Relevant diagnosesb) Current treatments (including start date, end date (if any), …)c) Guidelines for prior-authorization (e.g. specific Milliman guideline)d) Current prior-authorizations (service, duration, remaining)e) Clinical information that went into the decision for treatment coverage
Payer Coverage Decision Exchange
CMS NPRM Care Team Alerts
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CMS NPRM Information Exchanges
Supported by Da Vinci IGs
Patient
Provider
Member authorization
[3] USCDI[6] Continuity of Treatment
[2] Aggregated Quality Measure Reporting
[2] Gaps in Care[7] Coverage Requirements[8] Documentation Rules[11] Payer Data
[10] Provider Data[12] Alerts/Notifications
[1] Quality Data[10] Provider Data
[9] Prior-Authorization[12] Alerts/Notifications
Quality Measures and Gaps[1] Data Exchange for Quality Measures[2] Gaps in Care and Information
Member Directed Exchange (CMS NPRM)[3] Payer Data Exchange [4] Payer Data Exchange: Directory[5] Payer Data Exchange: Formulary[6] Payer Coverage Decisions (Treatment)
Coverage/Documentation Requirements[7] Coverage Requirements Discovery[8] Documentation Templates and Rule[9] Prior-Authorization Support
Patient Data Exchange[10] Clinical Data Exchange (Provider Data)[11] Payer Data Exchange (Payer Data)[12] Alerts/Notification
Patient Cost Transparency (in discovery)
[3] USCDI [4] Directory[5] Formulary
Provider
PayerPayer
[3] USCDI [4] Directory[5] Formulary
ConsumerApplication
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Alerts/Notification
Site of where notifiable event
occurred
Primary Care
Specialty Care
Inpatient Services
Payer
HIE / HIN
Potential Interactions:1) Subscribe to event directly (no intermediary)2) Subscribe to event via intermediary3) Push to “registered” member (perhaps via payer care team information)4) Push to intermediary
Any care team member can be connected directly or via an intermediary (e.g. HIE)
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Prior Authorization Support
Current Prior-Authorization Environment
Payers
Providers
Telephone
Portals
Electronic Transactions
PA Request
Medical Records
Currently providers and payer exchange prior authorization requests and supporting medical recordsusing a number of methods: telephone, fax, portals, and electronic transactions
Fax
r5r6
Slide 26
r5 same physiican, add [email protected], 8/17/2018
r6 add bunch of payers on right sycn graphic for physiican with mel's favorite [email protected], 8/17/2018
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Current HIPAA / Anticipated Attachment Approach
Must be ASC X12N 278 (PA request) / 275 (attachment with CDA)
May be any method (including ASC X12N)
BA
Any Method
ASC X12N 278/275
Any Method1a
2
1bASC X12N 278/275 Any Method
Virtual (within same CH)
Per the reqs (i.e. §162.923 Requirements for covered entities), if the Clearinghouse services both payer and provider, they must act as two virtual clearinghouses and must provide the transaction as a HIPAA compliant standard transaction internally – not currently enforced by CMS
Payer 1
Payer 2
Any Method
ASC X12N 278/275
Any Method1a
2
1bASC X12N 278/275
Any Method
Virtual (within same CH)
Payer 1
Payer 2
FHIR FHIR
FHIR
Future FHIR Enabled SolutionMust be ASC X12N 278 (PA request) / 275 (attachment with CDA)
May be any method (including ASC X12N)
HL7 FHIR
FHIR FHIR
ASC X12N 278/275
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Documentation Templates and Rules
Documentation Templates and Rules
Gaps in Care & Information
Gaps in Care & Information
Coverage Requirements
Discovery
Coverage Requirements
Discovery
Performing Laboratory Reporting
Performing Laboratory Reporting
Data Exchange for Quality Measures
Data Exchange for Quality Measures
Prior-Authorization Support
Prior-Authorization Support
Risk Based Contract Member IdentificationRisk Based Contract
Member Identification
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Alerts / NotificationsAlerts / Notifications
Patient Cost TransparencyPatient Cost
Transparency
Chronic Illness Documentation for
Risk Adjustment
Chronic Illness Documentation for
Risk Adjustment
Payer Data ExchangePayer Data Exchange
Use Case Focus Areas
Patient Data ExchangePatient Data Exchange
Payer Coverage Decision Exchange
Payer Coverage Decision Exchange
Clinical Data Exchange
Clinical Data Exchange
Payer Data Exchange: Directory
Payer Data Exchange: Directory
Payer Data Exchange: Formulary
Payer Data Exchange: Formulary
Qu
ality Imp
rovem
ent
Clin
ical Data E
xchan
ge
Co
verage
/ Bu
rden
Red
uctio
n
Process Improvement
Payer Data ExchangePayer Data Exchange
Mem
ber A
ccess
Clinical Data Exchange
Clinical Data Exchange
May ballot STU and for comment
In early September ballot (July) as STU
September ballot as STU
Currently targeted for early or regular January 2020 ballot
Use cases in discovery (some may be balloted in January 2020)
Use Case Status
Documentation Templates and Rules
Documentation Templates and Rules
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Prior Authorization Workflow (X12 processing at Health Plan)
Integrating FHIR and X12
1) Create FHIR bundle with required X12 information and supporting clinical documentation
2) Convert FHIR bundle to X12 278, X12 275 and X12 278 I
3) Process by payers as X12 278 with unsolicited attachments
4) Convert X12 278 tresponse o FHIR bundle
5) Present results to provider
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Disclaimer 31
FHIR Prior Authorization Endpoint Interactions
FHIR PA endpoint requirements
1) Receive and process PA bundle
• Respond in <15 seconds
2) Receive and process Subscription request for “PENDED” PA
• Reply on change in PA status
3) Receive and reply to PA status query
4) Receive and process cancel
5) Receive and process update
6) Support Status, Cancel, Update from both ordering and performing provider
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FHIR Prior Authorization Components
Coverage Requirements1) Initiates process
using CDS hooks2) As if PA is required
Templates and Rules1) If PA is required start
SMART app and retrieve Payer Rules and Template
2) Prepopulate 3) Solicit missing info
PA Support1) Package clinical data
and request/response2) Manage exchanges
with payer
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Summary
• Using new technologies (FHIR , CDS Hooks, SMART on FHIR, CQL) it is possible to integrate previously time intensive tasks into the clinical workflow to achieve significant efficiencies
• We can substantially reduce provider burden by1. Acquiring critical patient information while the patient is available2. Obtain prior-authorizations in real-time for certain common services3. Minimize rework by “getting it right the first time”
• One critical impact of improving the prior-authorization workflow is the improvement on patient care and experience.
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Bulk Data Access
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Pipelines can support many scenarios
Encryption Transformation EHR
EHRRESTful
Exchange Pop Health
Large volume of data for one patient:
RESTfulExchange
Population based Data
Bulk Data API
Bulk Data APIEHR
Bulk Data API
Encryption Transformation
Bulk Data API
Design Goals
● Focus on enabling automated communication between backend services and EHRs/clinical systems● Use mature, stable technologies wherever possible● Small API surface area
○ Limit number of query parameters○ Limit number of serialization formats
● Reuse as much of existing FHIR semantics as possible○ Data models○ API format and data types○ Implementation guide structure
● Use existing standards based authentication and authorization○ Base on widely used OAuth (SMART) standard
● Structure for efficiently generating and loading large datasets○ Asynchronous operation○ One data type per file○ Streaming data
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File RequestKickoff Request
Content Location
GET Content Location
File Generation Status (e.g. 20% complete)
GET Content Location
File Links
GET File (eg. 0001.Observation.ndjson)
FHIR Resources File
Bulk Data Client
(destination)
Bulk Data Server
(source)
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Blue Button 2.0 API
BB 2.0 FHIR Server
1
ACOApplication
Claims
CMS Blue Button 2.0
OAuthToken
Adjudicated Claims
Integrated Data
Repository
StoreSubmitted
Claims
Weekly Load
ACO Attribution
List
Chronic Condition
Data Warehouse
Blue Button 2.0
Data Repository
Data At Point of Care
Application
BeneficiaryApplication
DPC Roster
ACO processing
Bulk Data Access
DPCprocessing
Authentication Process
Authentication Process
Bulk Data Access
BB 2.0 1) Based on FHIR STU 3.02) Custom Extensions3) Resources
• Patient• Coverage• EOB (8)
Integrated Data
Repository
ACO Attribution
List
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Documentation Templates and Rules
Documentation Templates and Rules
Gaps in Care & Information
Coverage Requirements
Discovery
Coverage Requirements
Discovery
Performing Laboratory Reporting
Data Exchange for Quality Measures
Prior-Authorization Support
Prior-Authorization Support
Risk Based Contract Member Identification
(Bulk Data)
39
Alerts / NotificationsAlerts / Notifications
Patient Cost TransparencyPatient Cost
Transparency
Chronic Illness Documentation for
Risk Adjustment
Payer Data Exchange
Use Case Focus Areas
Patient Data ExchangePatient Data Exchange
Payer Coverage Decision Exchange
Clinical Data Exchange
Payer Data Exchange: Directory
Payer Data Exchange: Formulary
Payer Data Exchange: Formulary
Qu
ality Imp
rovem
ent
Clin
ical Data E
xchan
ge
Co
verage / P
rior A
uth
orizatio
n
Process Improvement
Payer Data Exchange
Mem
ber A
ccess
Clinical Data Exchange
May ballot STU and for comment
In early September Ballot (July) all STU
September ballot as STU
Currently targeted for early or regular January 2020 ballot
Use cases in discovery (some may be balloted in January 2020)
Use Case Status
Da Vinci Founder and PMO Member:
Bob Dieterle, EnableCare LLC
Da Vinci Program Manager:
Jocelyn Keegan, Point of Care Partners
Da Vinci Technical Director:
Dr. Viet Nguyen, Stratametrics LLC