Page tree
Skip to end of metadata
Go to start of metadata

Chair:  Larry Decelles

Scribe: Dana Marcelonis


Attendees

Present

Name

Affiliation

  •  
Mitre
  •  
George BierOptum
  •  
BCBS AL
  •  
Rush
  •  
Matthew ByrneOptum
  •  
Rush
  •  
Cerner
  •  
Anthem
  •  
Allscripts
  •  
InterSystems
  •  
Allscripts
  •  
Mitre
  •  
Cambia Health
  •  
Cerner
  •  
Enable Care
  •  
Optum
  •  
Aegis
  •  
BCBS FL
  •  
InterSystems
  •  
Anthem
  •  
Mitre
  •  
Allscripts
  •  
Optum
  •  
Jackie HardisonHumana
  •  
Cigna
  •  
Claudia HartmanHighmark Health
  •  
Mark HinghamAnthem
  •  
Optum
  •  
Sheljina Ibrahim KuttyAnthem
  •  
Allscripts
  •  
Point of Care Partners
  •  
Edifecs
  •  
Mitre
  •  
InterSystems
  •  
Anthem
  •  
Tso LukeOptum
  •  
Point of Care Partners
  •  
Optum
  •  
Cognosante
  •  
Optum
  •  
Humana
  •  
Stratametrics
  •  
Casenet
  •  
Allscripts
  •  
Optum
  •  
Optum
  •  
InterSystems
  •  
C SimeoneOptum
  •  
Jeanie SmithBCBS FL
  •  
InterSystems
  •  
Veradigm
  •  
CMS
  •  
Casenet
  •  
Independence Blue Cross
  •  
Anthem
  •  
CentriHealth
  •  
CaseNet
  •  
India DuncanOptum
  •  
Jason Cassidy
  •  
Optum
  •  
Gevity
  •  
Tracy McCutcheonKPMG
  •  
Rashmi MenonKMHP
  •  
Mario JarrinChange healthcare
  •  

  •  
AMA
  •  
Ann GallagherOptum
  •  
Megan Smith-HallingsheadRegence
  •  
Regence
  •  
Anthony SmithUNC Health
  •  
Optum
  •  

  •  

  •  
Jennifer Joe
  •  
Texas Health
  •  

  •  
Cigna
  •  
Labcorp
  •  
Cigna
  •  
Matt Dyer-Vyne
  •  

  •  
Barbara Kramer-ZarinsMITRE
  •  
Centene
  •  
Barbara WoodPNC
  •  
Greta HoneycuttCoverMyMeds
  •  
BCBSA
  •  

  •  
MITRE
  •  
Keya ShahCasenet
PresentNameAffiliation
  •  
Peter MuirESAC
  •  

  •  
Ryanne LaurenceOHSU
  •  

  •  
Mitre
  •  
CMS
  •  
Aim Specialty Health
  •  
Christy DodsonMCG
  •  
Tibco
  •  

  •  
Rajesh Godavarthi
  •  
Santosh
  •  
Tom Hartman
  •  
Tori WillowsWellcare
  •  
Alise WidmerLumeris
  •  
Bart CarlsonAzuba
  •  
David BruinsmaColonial Med
  •  
Deepthi ReddyMettle Solutions
  •  
Danny BrennanMA Health Data
  •  
Patrick Edwards
  •  

  •  
Cambia Health
  •  
CMS
  •  
Pallavi TalekarScope Info Tech
  •  
Rajesh GarlapatiRush
  •  
Susan BellileAvaility
  •  
BCBST
  •  
Ralph Saint-Phard
  •  
Kristi CushmanOHSU
  •  
Briana BarnesScope Info Tech
  •  
Didi DavisSequoia Project
  •  
Sreekanth PuramMettle Solutions
  •  
Duane WalkerBCBSM
  •  
EMDI Team
  •  
David HillMitre
  •  
BCBS AL
  •  
Nandini GangulyEMDI
  •  

  •  
Rajesh GodavarthiMCG Health
  •  
Rim Cothren
  •  
Donna CampbellBCBSIL
  •  
Joanna GaskillLumeris
  •  
Edifecs
  •  
Michael CabralCMS
  •  
Sudhir NairAnthem
  •  
Saul KaravitzMitre
  •  
Dawn PerreaultBCBSM
  •  
Brent WoodmanBCBSM
  •  
Yolanda VillanovaCMS
  •  
Deryl Lam
  •  
Edifecs
  •  
Karen TottCMS
  •  
Mitre
  •  
Dacarba
  •  
Carradora
  •  
Rachel Goldstein
  •  
Ric LightHumana
  •  
eClinicalWorks
  •  
Healow
  •  
Wanda Govan-JenkinsHHS
  •  
Cindy MonarchBCBSM
  •  
Edward Yurcisin
  •  
Veradigm
  •  
Hibah QudsiMitre
  •  
Nancy SpectorAMA
  •  
Patrick Leblanc
  •  
Anupam ThakurBCBSFL
  •  
MCG
  •  
Chris KlesgesMitre
  •  
IBC
  •  
Gregory MagazuCaseNet
  •  
Isaac VetterEpic
  •  
Kat RuizUNC Health
  •  
Laura Bright
  •  
Humana
  •  
Roland Gamache
  •  
Katherine LuskChildrens
  •  
Anthem
  •  

  •  
Chris JohnsonBCBS AL
  •  
Jim AdamsonArkansas Blue Cross
  •  
Carry Denny
  •  
Infor
  •  

  •  
Anna MeisheidCMS
  •  
Celine LefebvreAMA
  •  
Eshaa DhalleClinicalWorks
  •  
BCBSM
  •  
Express Scripts
  •  
Sandhya
  •  
Christopher GraconIndependent Health
  •  
Candice TitusCrisp Health
  •  
Mariana SinghCAQH
  •  
BC Idaho
  •  
Shilesh NairGdit
  •  

  •  

  •  

  •  
UHC
  •  
Tammy BanksProvidence St. Joseph


Create Decision from template

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



Links

DTR IG: http://hl7.org/fhir/us/davinci-dtr/2019May/

Reference Implementation: https://github.com/HL7-DaVinci/dtr 



Connectathon

Philadelphia Connectathon Hosted by Independence Blue Cross - December 11-12, 2019

CMS HL7 Connectathon - January 2020 - January 7-8, 2020



Proposal to standardize the way payers ask for information via DTR
  • Standardize the way we ask for information
    • We have provided examples of how to use CQL to structure the query and provide some guidelines/constraints and questionnaire for basis for determining that we have the information that we need (the ability to pre-populate questionnaire and have a way to ask practitioner for missing information)
    • We haven't looked at how do we wind up with a consistent way of asking for information (across all payers)?
    • Take the categories of information available via FHIR API (USCDI, US Core Profiles on top of R4 - 17 different resources)
    • Number of other resources not part of US Core, for example Service Request - there are 10 of those
    • Develop a standard CQL template and define things that can be variables (e.g., condition, diagnosis)
    • Create a template for each of these 27 different resources, test them out at Connectathons, develop a questionnaire section that would go with it (to ask for missing data or present the data for display that was collected)
    • CQL templates and questionnaire sections could be incorporated into the DTR guide in the future
    • Pure questions/attestations - specify a standard set of questionnaire language that would account for the various types of questions to be asked (i.e., standard template for yes/no questions vs. multiple choices for selection via dropdown box)
    • Standard set of queries - e.g., if query for condition, shall use this... if query for practitioner, shall use this
  • Have not received negative feedback to date on the above proposal, but looking for feedback (pros/cons) today from participants
    • Reed D. Gelzer 
      • Feedback that application should capture and manage failures; follow up assignment is to come up with a scenario and use case
        • Above proposal applies to the 'happy path', not the failure scenarios
      • Working on skin wound assessment/prior auth project with Anthem that would capture this scenario - IG going to ballot in January and have test scenarios for May Connectathon that will substantially advance this discussion of how to detect/manage/message when there is a discrepancy between a specification and a given data object in a production environment
  • Plan to discuss further during Connectathon, bring additional information back to this group for review on January 15th 
  • Once ballot reconciliation is complete, we'll continue these weekly calls to work on these 'building blocks' to standardize the way payers ask for information


Ballot Comment Review

FHIR-25222

FHIR-25221

FHIR-24832

FHIR-24740

  • Thomson Kuhn said that he would withdraw this comment, but he'll need to go into JIRA to withdraw
  • Why is this comment being withdrawn?
    • Commenter had assumed that payer would be able to start a DTR session any time the payer chooses - that's not the way this is specified - the workflow is only started by request of the provider

FHIR-24730

FHIR-24725

FHIR-24715

FHIR-24714

  • The above will be put in a block vote for CDS workgroup - no remaining comments to review
  • Next call will focus on creating standard templates

ManagementNext Agenda
  • Calls cancelled Dec 25th, Jan 1st, and Jan 8th due to holidays and CMS Connectathon

 Adjournment
Adjourned at 12pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items

  •