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Focus AreaImplementation GuideProject PageScenarios Included

Imp Guide Status

#Build

#STU1

#Link to JIRA

Reference Imp Live

Number of Connectathons (Live/Virtual)

HIMSSDetail Project Status



Sponsoring Workgroup

Project Number

PSS LinkReference Implementation
Quality 

Data Exchange for Quality Measures

Data Exchange for Quality Measures (DEQM)

v1 Medication Reconciliation Post Discharge

v2 Colorectal Cancer Screening and Venous Thromboembolism Prophylaxis Measures

STU2 - Ballot for FHIR R4

◕  


insert link to JIRA

  •  
7
  • HIMSS19
  • HIMSS20

Active WG Calls 

Balloted for STU2 in May 2019 

Published August 2020

In planning to add additional patterns (see Gaps in Care)

Clinical Quality Information (CQI)


Co-sponsor: Clinical Decision Support , Patient Care 

1429

MRP-Reference-App

MRP-Payer-App

MRP-Sample-Patients

MRP-Operation-Submit-Example

COL-CollectData-App

COL-Submit-App

Burden Reduction

Coverage Requirements Discovery

Coverage Requirements Discovery (CRD)

STU2 - Reconcile

◕  

  •  
8
  • HIMSS19
  • HIMSS20

Active WG Calls

Balloted for STU2 in May 2019 

Ballot reconciliation in WG

Target Publication Q4 2020

Financial Management1515PSS for Coverage Requirements Discovery

CRD

crd-request-generator

Burden ReductionDocumentation Templates and Payer Rules   Documentation Templates and Payer Rules (DTR)

STU1- Reconcile


  •  
7
  • HIMSS19
  • HIMSS20

Active WG Calls

Balloted for STU1 in Sept 2019 

Target Publication Q4 2020

Clinical Decision Support

Co- sponsor: Attachments, Patient Care

1493PSS for Documentation Templates and Rules

DTR GitHub Repository

CDS Library (contains rules)

Member AccessHealth Record Exchange Framework (HRex)Health Record Exchange Framework (HRex)

STU1 -Reconcile

N/A1NM

Active WG Calls (combined with CDex)

Balloted for STU1 in early Sept 2020

Ballot reconciliation in WG

Clinical Interoperability Council (CIC)

Co-sponsor: Patient Care, Attachments, Financial Management

1494PSS for eHealth Record Exchange (eHRx) FrameworkN/A
Member AccessClinical Data Exchange (CDex)Clinical Data Exchange (CDex)

Provider to Provider

Provider to Payer

STU1 -Reconcile

  •  
6
  • HIMSS20

Active WG Calls

Balloted for STU1 in early Sept 2019 

Re-ballot due to updated content Q1 2021

Patient Care

Co-sponsor: Attachments, Structured Documents

1495PSS for eClinical Data Exchange (eCDx)

CDex Communication Response App

CDex Communication Request App

Member AccessPayer Data Exchange (PDex)Payer Data Exchange (PDex)

Payer to Provider

Payer to Member

Payer to Payer

STU1 -Reconcile

  •  
6
  • HIMSS19
  • HIMSS20

Active WG Calls

Balloted for STU1 in early Sept 2019 

Target Publication Q4 2020

Financial Management

Co-sponsor: Attachments

1489PSS for Payer Data Exchange (PDex)

PDex GitHub Repository


Member AccessPayer Data Exchange (PDex): FormularyPayer Data Exchange (PDex)

STU1 (Published 1/21/2020)

  •  
5
  • HIMSS20

Active WG Calls

Balloted for STU1 in early Sept 2019 

STU1 Published 1/21/2020

Financial Management

Co-sponsor: Attachments

1489PSS for Payer Data Exchange (PDex)

drug-formulary-ri

pdex-formulary-client

Member AccessPayer Data Exchange (PDex): Plan Network DirectoryPayer Data Exchange (PDex)

STU1 - Reconcile

  •  
5
  • HIMSS19
  • HIMSS20

Active WG Calls (combined with PDex)

Balloted for STU1 10/29/2019

Target Publication Q4 2020

Financial Management

Co-sponsor: Attachments

1489PSS for Payer Data Exchange (PDex)

plan-net-ri

plan-net_client

Burden ReductionPrior Authorization SupportPrior Authorization Support (PAS)

STU1 -Reconcile

  •  
5
  • HIMSS20

Actve WG Calls

Balloted for STU1 in Sept 2019 

Target Publication Q4 2020

Financial Management

Co-sponsor: Attachments

1490PSS for Prior-Authorization Support

prior-auth

prior-auth-client

Clinical Data ExchangeAlerts: Notification (ADT), Transitions in Care, ER admit/dischargeNotifications (formerly known as Alerts)

Admit

Discharge

STU1 - 

  •  
5
  • HIMSS20

Active WG Calls

Balloted for STU1 in Jan 2020 

STU1 Publication complete as of October 15, 2020

Infrastructure And Messaging Work Group

Co-sponsor: 

Financial Management

1516PSS for Notifications (formerly known as Alerts)

Alerts Sender

Alerts Receiver

Member AccessPayer - Payer Coverage Decision ExchangePayer Coverage Decision Exchange (PCDE)

STU1 -Reconcile

  •  
5
  • HIMSS20

Active WG Calls

Balloted for STU1 in Sept 2019 

Target Publication Q4 2020

Financial Management

Co-sponsor: Attachments

1515PSS for Payer Coverage Decision Exchange

pcde-ri

QualityGaps in Care & Information

STU1- Reconcile


1
  • HIMSS20

Active WG Calls

Balloted for STU1 in Sept 2020

Ballot reconciliation in WG

Clinical Quality Information (CQI)1427HL7 Project Scope Statement Gaps In Care.docx
Process ImpRisk Based Contract Member IdentificationRisk Based Contract Member Identification

STU1 -Reconcile

  •  
2
  • HIMSS20

Active WG Calls

Balloted for STU1 in February 2020 

Target Publication Q4 2020


Financial Management

Co-sponsor: Attachments

1517PSS for Risk Based Contract Member Identification (Updated)Da Vinci ATR
Clinical Data ExchangePerforming Laboratory Reporting

Planning


NoneOrders & Observations (O&O)


Process ImpChronic Illness Documentation for Risk Adjustment

Planning


Early Discovery

Financial Management

Co-sponsor: 

Attachments, Patient Care

1513PSS for Chronic Illness Documentation for Risk Adjustment
Member AccessPatient Cost Transparency

Planning


Early Discovery

Financial Management

Co-sponsor: Attachments

1514PSS for Patient Cost Transparancy
Clinical Data ExchangeHealth Record Exchange: Patient Data Exchange

Planning


None

Patient Care

Co-sponsor: 

Attachments, Orders and Observations

1518PSS for Patient Data Exchange for Value-Based Care

GitHub - Use Case Reference Code


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