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Chair:  Mark Scrimshire and Tony Benson

Scribe: Dana Marcelonis
 

Attendees

Present

Name

Affiliation

  •  
SureScripts
  •  
Regence
  •  
Optum
  •  
Michael BaillieUHC
  •  
Humana
  •  
BCBS AL
  •  
Rush
  •  
SureScripts
  •  
Rush
  •  
Cerner
  •  
Laura BurckhardtWPS Health Solutions
  •  
Lindee ChinEdifecs
  •  
Independence Blue Cross
  •  
Allscripts
  •  
Regence
  •  
Didi DavisSequioa
  •  
InterSystems
  •  
BCBS IL
  •  
Allscripts
  •  
Cambia Health
  •  
Enable Care
  •  
David DodgeCambia Health
  •  
Rachel E. Foerster
  •  
Howard FollisJuxly
  •  
Reliant Medical Group
  •  
Lantana Consulting
  •  
SureScripts
  •  

  •  
Independence Blue Cross
  •  
GunjitZeOmega
  •  
Kenneth Hall
  •  
NCQA
  •  
Optum
  •  
Jackie HardisonHumana
  •  
Cigna
  •  
HealthLX
  •  
ZeOmega
  •  
BCBSA
  •  
Point of Care Partners
  •  
Edifecs
  •  
Heather KennedyBCBST
  •  
Edifecs
  •  
Sathaya KrishnasamyAnthem
  •  
BCBS AL
  •  
Stephen LaneSutter Health
  •  
InterSystems
  •  
Anthem
  •  
Luis MaasEMR Direct
  •  
Erin MajderBCBS IL
  •  
Point of Care Partners
  •  
Cognosante
  •  
BCBS AL
  •  
Lloyd McKenzie
  •  
Optum
  •  
Humana
  •  
MaxMD
  •  
Stratametrics
  •  
Sean ParsonsBCBS OK
  •  
Scott Parsons
  •  
BCBS AL
  •  
Allscripts
  •  
HealthLx
  •  
Joe QuinnOptum
  •  
Optum
  •  
Regence
  •  
InterSystems
  •  
NewWave
  •  
NewWave
  •  
ZeOmega
  •  
Anne Marie SmithNCQA
  •  
InterSystems
  •  
UHC
  •  
Casenet
  •  
Cigna
  •  
HealthLX
  •  
Independence Blue Cross
  •  
Joel WalkerHealthLX
  •  
Holly WeeksRegence
  •  
BCBS AL
  •  
Darrell Woelk
  •  
Cambia
  •  
Brent Woodman
  •  
Anthem
  •  
Cambia
  •  
NewWave
  •  
Edifecs
  •  

  •  
Tracy M. Fitzgibbon
  •  
Jim Taylor
  •  
Barbara AntunaAim Specialty Health
  •  
Christy Dodson
  •  
Danny
  •  
Evan CurrieBCBSM
  •  
Grace StambaughAllscripts
  •  
Jeanie SmithBCBSFL
  •  
Jim St. Clair
  •  
John BialowiczBCBSM
  •  
Melanie Combs-DyerCMS
  •  
Mike HurleyBRYJ Healthcare
  •  

  •  
Tori WillowsWellcare
  •  

  •  
EDMI Team
  •  
Beth Sprars
  •  
Nandini GangulyEMDI - Scope Info Tech
  •  
EMDI Team
  •  
Moxe Health
  •  
Jim McKinleyMedicaid Alabama
  •  
Raj
  •  
Ray WilkersonScope Info Tech
  •  
BCBST
  •  
Chris VanWaters
  •  
Bart CarlsonAzuba
  •  
Deepthi ReddyMettle Solutions
  •  
Emma JonesAllscripts
  •  
Eric SullivanInovalon
  •  
David HillMitre
  •  
Pallavi TalekarScope Info Tech
  •  
Ralph Saint-PhardHealow
  •  
Scott SwihartSumma Health
  •  
India DuncanOptum
  •  
Jason CassidyMoxe Health
  •  
Praveer MathurWellcare
  •  
Megan Soccorso

Cigna

  •  
Prashanth GolcandaLumeris
  •  
Rajesh Godavarthi
  •  
Susan BellileAvaility
  •  
Susan LestinaAHA
  •  
Bob BowmanCAQH
  •  
Thomas KesslerCMS
  •  
Patrick Edwards
  •  
Briana BarnesScope Info Tech
  •  
Kishore MetlaMettle Solutions
  •  
John DonnellyInterpro
  •  
Lorraine DooCMS
  •  
Melanie JonesCMS
  •  
Rim Cothren
  •  
Yolanda VillanovaCMS
  •  
Kathleen Connor
  •  
Manoj KumarBCBSFL
  •  
Saul KravitzMitre
  •  
Srinivas Konchada
  •  
Sheryl TurneyAnthem
  •  
Helina Gebremariam
  •  
Mike NovalesBCBSIL
  •  
Ric LightHumana
  •  
Ann GallagherOptum

Chris KlesgesMitre

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Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



PDex Implementation Guide

PDex IG: http://build.fhir.org/ig/HL7/davinci-epdx

The spreadsheet linked below is for collection of comments for pre-release versions of the PDex IG prior to the official early ballot that is part of the September HL7 ballot cycle:

PDex_comment_tracker.xlsx please send completed spreadsheets to mark@ekivemark.com 

  • Planning to use FHIR v4
    • Presents challenge in that many EHRs are supporting Argonaut or STU3
    • CDS Hooks applicaiton will have to provide a link to a SMART on FHIR app that allows provider to select the data they want to commit to EHR
    • If EHR using is using earlier version, would take bundle of records (document bundle) returned by payer, PDF and document bundle would be committed as document references attached to patient record in EHR
    • If EHR on v4, could take details and write to EHR as resources when possible
  • Provenance
    • Want to give the provider information regarding who's providing data, what's the source, and how it came to the payer
    • Provenance resource in FHIR v4
    • Need to represent the source of the data when the payer sends it to the provider - how do we indicate where it came from?  How did payer receive it? (clinical vs. admin transaction)
    • Mark Scrimshire will ask Kathleen Connor to put on agenda for Security workgroup
    • CDS Hooks payload could be filtered (e.g., exclude my organization's data)
    • CDS Hooks spec - user ID represents the practitioner in the provider's system - not the ID that identifies the provider in the payer's system (which is typically TIN or NPI of rendering provider)
      • Practitioner ID used by payer - does it need to incorporated into EHR record?
      • Practitioner record should already have NPI
        • Same NPI could be affiliated with 2 different organizations
    • Organization and individual provider are needed
    • Reference Implementation - recipient of the request needs to use the User ID and Organization and Location identifiers
    • Security workgroup call on Monday to discuss Provenance
      • Logical model coming out to ensure alignment across HL7 implementations
      • Need for federated Provenance capabilities - domain agrees upon a type of Provenance profile
      • Could have a federated repository
    • Members can submit claims - could express that one Agent is the health plan, the second Agent is the member, third Agent is the provider


Connectathon Planning

HL7 FHIR Connectathon - May 4-5 - Montreal

Da Vinci Connectathon - May 29-30 - Jacksonville, FL

2019-05 Connectathon 21

PDex Reference Implementation



12:45 - 1pm

Connectathon 21 + Jacksonville PDex Track Preview

This section of the meeting will be recorded as a guide to what is happening at the upcoming Connectathons in Montreal (5/4/19-5/5/19) and Jacksonville (5/29/19-5/30/19)

  • Mark Scrimshireis track lead for both Connectathons
  • Da Vinci tracks will be located next to one another in one section of the room
  • Ensure you have working configurations prior to arriving at Connectathon
  • Scenario 1: Provider to payer exchange
    • Provider will make a request from EHR via CDS Hooks to a payer
    • Working on Reference Implementation to handle the hook as a request
    • Patient presents to a new primary care provider due to a geographic move - staying with the same payer
    • Health plan will return information via a card with a link to a SMART on FHIR app
    • Provider can select the elements they want to commit to their EHR (Argonaut implementation) - create a document reference, attach the document records to the patient record
  • Scenario 2: Patient-mediated payer to payer exchange
    • Patient has option to import data from their 'old' health plan
    • Click on link, taken to old health plan, authenticate themselves using their old health plan credentials, presented with an authorization and choice to share behavioral health information
    • Patient chooses allow/ authorization and an access/ refresh token is handed to new health plan
    • New health plan then uses that with application credentials to make call to old health plan to request FHIR resources that were leveraged in Scenario 1 (USCDI data set - encounter, diagnostic report, medications, procedures, etc.)
    • New health plan will pull that data into their patient records
  • Concern re: some payers needing signed patient consent - FHIR consent/ contract with Provenance - next iteration may want to consider this
  • PDex Reference Implementation includes more details regarding CDS Hooks
PDex Connectathon Track Info_Recording

Chat feedback/ comments

Serafina Versaggi (to Everyone): 12:12 PM: And I would also suggest that even for R4-R4 transmissions, a copy of the human readable version or whatever of the entire message/document sent as well, like older versions of FHIR

Serafina Versaggi (to Everyone): 12:19 PM: how is 'reconciliation' managed?  Is there some similiarity in terms of how data are incorporated into a patient's medical record (versus the payer's EHR )

ric Light (to Everyone): 12:25 PM: For a payer's claims - the payer tracks the "claiment" provider (most often a TIN) and rendering provider (most often a NPI)  .   Dont foget that payers also get claims from members directly. 

Serafina Versaggi (to Everyone): 12:26 PM: I would worry about transformations between claims and back to 'clinical' due to the levels of granularity if info

Laurie Burckhardt (to Everyone): 12:28 PM: Need to consider that paper claim data is converted to 837 in which "dummy" info could be added to make claim compliant through validation.  I would think tracking the source of who provided the info (Bob's point) and everyone is going to use the information differently

Serafina Versaggi (to Everyone): 12:30 PM: just like in the paper world it seems

Serafina Versaggi (to Everyone): 12:35 PM: And an individual is a Type I NPI, not type II - used for Orgs and groups

John Bialowicz (to Everyone): 12:57 PM: how does claim data fit into the data request?


ManagementNext agenda



 Adjournment
Adjourned at 1pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items

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