Chair: Mark Scrimshire
Scribe: Vanessa Candelora
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."
Minutes Approved as Presented
Meeting Minutes from Discussion
|Decision Link(if not child)|
|Management||Review ANSI Anti-Trust Policy|
|HL7 May Connectathon - May 17 - 19|
Showed how to get from a patient through coverage all the way to formulary Drug - awesome!
Big thanks to Mark and Lloyd helping Stanley get a test patient on a test server!
Link to the Read Out Mark shared today: HL7 FHIR Connectathon 27 Report Out.docx.pdf
Moved to Supporting section below!
|Today||Implementer Support Questions (PDex, Formulary, Plan Net)|
Call to All Implementers: We learn as a community and iterate on the IGs through real world experience, so your contributions are welcome! Please come with your questions. Options:
1) Send them to us on Zulip:
2) Ask questions live on the call
3) Edit and add your question to this page (in this box under "Question")
BB: Can we add Formulary ID into any of the FHIR resources?
Looking at the group level, where can I get the Formulary ID to group by tiers and group formularies? From BPM, want to tell which formulary the medication is. They have the tier info for the medication, but how do they say "which formulary does it belong to" e.g. returning Tylenol.
Drug tier extension has a drug tier ID and Type.
Currently, we group things by coverageplan and coveragetier. can group a set of alternatives.
They are grouping the formulary - managed at a higher level than the coverage plan. The plan has a formulary. Inside the formulary, there are drugs.
The assumption is that for each formulary API there is one formulary.
DB: typically you'll have a great than 1 ratio with multiple cost structures, 2 formulary's and 20 coverage plan codes. They are just repeating. no method for showing they share a given formulary. you don't need the list in pdf anymore.
It's not built to show that two plans share a single formulary.
Recommendation to add a value into Medication Knowledge that says this drug comes from this formulary. The downstream use case is for providing alternatives.
-Need a value that is shared across multiple data classes.
there is no method to make a search based on this ID, so unless you shape the API query, the ID isn't serving a purpose other than back end - unless you are wanting to make different queries -
In the scenario where they are looking for Alternatives, don't need member. E.g. Zocore is being requested, has alternatives like drug a and drug b. The ID isn't used by the consumer nor is it available for search. why push it across the wire? Should this be a back end system data setup to allow for sharing the return. Then the entry array, if you query the coverageplan, you get back the list of all the drugs on the formulary and each of those drugs could have a list of alternatives.
Next Step: David Hill Look in the coverage resource and designate where you would include a Formulary ID. Coverage in member specific. Coverage Plan is not tied to a particular patient, it's a list of drugs covered by that plan.
Note these are difference:
BP: Request to also look at adding to Medication Knowledge in addition to Coverage Plan.
Question 2: DB - Codeable concept, take the display and concatenate the code value with a description (CARIN Blue Button EOB IG use the definition element instead of the :long....
Go to the Drug Tier Code system, binding
(Note: Definition column not populated is an error - create ticket)
Formulary Ticket updates
Reviewed last time, share update: FHIR-32178 - Add co-pay value for drugs not subject to deductible - Pharmacy Approved the approach per last week's discussion.
New from last week's discussion: FHIR-32718 - Getting issue details... STATUS
Lloyd added some more tickets (see dashboard recent additions in the top right:17 Remaining Issues for Review
Review FAQ Proposed Responses
Cancelled on 5/28/21 due to WGM. See you on 6/4
Adjourned at 12:55pm EST.
|PDex Companion Guides|
|CARIN CPCDS to US Core Mapping|
Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0818 v2.xlsx
DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx
|PDex - US Core |
Source PowerPoint: PDEXandUSCoreRelationship.pptx
|Da Vinci is seeking answers to open questions and clarifications needed on the implementation and operational needs of the upcoming CMS Patient Directed API Rules.|
Find initial questions and corresponding answers shared from our colleagues at CMS here
Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more!
ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory
Attendees - 31
Intepro Solutions Rakesh Mathew Daniel Lilavois Patricia R Harbin Shalabh Gautam Kamaraj Kaliaperumal, Carefirst Bhanu Vemuri Narasimha Murthy Accenture Google Cloud Healthcare Maggie Mellon Courtney Bland
Present Name Affiliation CMS BCBST Deepthi Reddy Mettle Solutions Allscripts Eric Sullivan Inovalon MITRE India Duncan Optum Availity Susan Lestina AHA Bob Bowman CAQH Thomas Kessler CMS Patrick Edwards Briana Barnes Scope Info Tech Kishore Metla Mettle Solutions John Donnelly Lorraine Doo CMS Melanie Jones CMS Rim Cothren Yolanda Villanova CMS Manoj Kumar BCBSFL MITRE Srinivas Konchada Centene Corporation Sheryl Turney Anthem Helina Gebremariam Mike Novales BCBSIL Ric Light Humana Ann Gallagher Optum Chris Klesges Mitre Adam Gronsky Health Fidelity CaseNet Anthem CMS eClinicalWorks Healow Interfaceware Mark Rucci Spectramedix Anthem Cindy Monarch BCBSM Michael Kim Jim Catan Accenture BCBSA Jia Chen Robert Dieterle Jeff Eastman Ernestine Cooper Jason Teeple CIGNA Lloyd McKenzie Mary Winter Rachel E. Foerster Tom Grannan Azuba Tony Benson BCBS AL Independence BC Henry Archibong Inovalon HL7 Consultant Abdul Sattar Anirudh Choudhary Todd Biske ESI Darrell Woelk Doug Stoss Rick Lisseveld Aegis LakshminarayananSaravanan Laurie Burckhardt WPS Health Plan Kevin Lynch Inovalon Joseph Minieri MITRE Durwin Day BCBS IL Pamela West Ravi Thakkar Aetna UO Aetna Swati Nanda Aetna CVS Health Cyrus Kevin MITRE Fred Harmon Ready Computing Blue Cross NC Michael Ryan NCQA HealthSparq CVS/Aetna Dorothy Lee NCQA Khoa Nguyen Suma Addagadde BCBSNC Caitlyn Campi FL Blue Diane Bengtson Sean Mahoney MITRE Balaji Richard Lisseveld Shanna Hartman CMS Kevin Day Edifecs Sai Bagewadi Cognizant Kechia Scott Kerri Wing Krithika Kumar Accenture Don Zacharia Evernorth Pamela Maklari Cognizant @David Bradsher BenMedica @DJ Gallagher @Follis @Nidhi @Emily Lozada
Patricia R Harbin
Google Cloud Healthcare
Chris Johnson Independent Health Scott M. Robertson David Clowers Anthony Omosule Accenture
Present Name Affiliation Nancy Spector AMA Bruce Wilkinson BenMedica Avality BCBSAL MCG ONC Surescripts NCPDP Anupam Thakur BCBSFL Jonathan Hutchins BCBST Anthem Sunitha Godavarthi Christopher Gracon Labcorp James Derrickson Intersystems Cognizant Neetha Joseph Cognizant Kaiser Permanente MITRE Rutika Express Scripts Brody Brodock Allscripts Michael Brody CME Online Theressa Baumann BCBS AL Mona Chandrapal eClinicalWorks Optum Aakash Deliwala eClinicalWorks Mayo Epic Shaheer Stanley Nachimson Anthony Smith UNC Health Howard Cohen Minaei Behnaz FDA BCBSA Shilesh Nair gdit NewWave MaxMD BC Idaho Edward Castagna Altarum Andrea Kent CoverMyMeds Carrie Denny Kim Pham Celine Lefebvre AMA Edifecs Josh Lamb UPMC Keya Shah Casenet Gevity MITRE Mrugen Mehta eClinicalWorks Revathi Jayakumuar Supriya Bapi Bhera Matt Dyer Vyne Sree Vijetha Vegi C-HIT BCBSA Rich Bloch Lumedic Cigna Paul Knapp Ron Urwongse CAQH Anand Raghavan HealthLX Ezequiel Morales Cigna Evernorth Frank McKinney Hanna ? Brett Rauschke Carolyn McKinney Clarissa Winchester BCBS AL JC HealthShare Exchange (HSX) River Wong Rob McClure MD Partners Ronald Wampler CVS Health Aetna Derrick Woolridge Beata Ferraiz Ed Donaldson Consultant with Humana Julie Burgoon Mark Neumuth Aetna Raj Sankuratri Aetna Dr. Cheryl D. Lohman Germantown, MD | Family Physician Barbara Valeno Eshaa Dhall eclinicalworks Angie Brandon Bryan Briegal ACP Beatrice Thompson CVS Health Hema Srinivasa Kristin Ashby Aetna Nag Sanivarapu Abhishek Pandey Shailesh Prabhu Travis Hendrix Dr. First Zakir Guler Jason VanderJagt edifecs Erika Wagner Shamil Nizamov Michael Robinson Christopher Marchand Chris Busch Nathaniel Hosenpud Christopher Roedocker SKYGEN Jeff Brown Evernorth Sid Nehal Amin Amit Cudykier C45214 Noah Lincoff Yukta Bellani Evernorth/Cigna Brian Schoonover Optum Tone Southerland OneRecord @Ram Optum
Scott M. Robertson