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Focus AreaImplementation GuideProject PageScenarios IncludedFuture Enhancements

Imp Guide Status

#Build

#STU

Reference Imp Live

Number of Connectathons (Live/Virtual)

Detail Project Status



Sponsoring Workgroup

Project Number

PSS LinkReference ImplementationZulip Stream
Quality & Risk

Data Exchange for Quality Measures includes Gaps in Care (GIC)

Data Exchange for Quality Measures (DEQM)

Gaps in Care

v1 Medication Reconciliation Post Discharge

v2 Colorectal Cancer Screening and Venous Thromboembolism Prophylaxis Measures


STU4 Ballot Jan 2023

◔ 

  •  

DEQM -11

GIC-7

ICF and MITRE leading Active WG Calls 


Clinical Quality Information (CQI)


Co-sponsor: Clinical Decision Support , Patient Care 

1429

1427

MRP-Reference-App

MRP-Payer-App

MRP-Sample-Patients

MRP-Operation-Submit-Example

COL-CollectData-App

COL-Submit-App

DEQM and GIC stream
Coverage, Transparency & Burden Reduction

Coverage Requirements Discovery

Burden Reduction: Coverage Requirements Discovery (CRD)

STU1.1 Ballot Reconciliation

  

  •  
15

Active WG Calls for implementer support 

STU 1 Published 12/22/2020

STU1.1 early May Ballot (Feb - March 2022) Reconciliation nearing completion. Expect to publish in Q2 2023.

Financial Management1515

PSS for Coverage Requirements Discovery


CRD

crd-request-generator

Endpoint: https://crd.davinci.hl7.org 

CRD Zulip stream
Coverage, Transparency & Burden ReductionDocumentation Templates and Payer Rules   Burden Reduction: Documentation Templates and Payer Rules (DTR)

STU1.1 Ballot Reconciliation


  •  
14

Active WG Calls for implementer support 

STU1.1 early May Ballot (Feb - March 2022) Reconciliation nearing completion. Expect to publish in Q2 2023.

Clinical Decision Support

Co-sponsor: Attachments, Patient Care

1493

PSS for Documentation Templates and Rules


DTR GitHub Repository

CDS Library (contains Questionnaires/CQL)

Endpoint: https://dtr.davinci.hl7.org 

Note: "Cannot GET /smart/launch.html" actual means it is up.

DTR Zulip stream
Coverage, Transparency & Burden ReductionPrior Authorization SupportBurden Reduction: Prior Authorization Support (PAS)

STU1.2 Ballot Reconciliation

  •  
14

Active WG Calls for implementer support 

STU1.1 early May Ballot (Feb - March 2022) Reconciliation complete. Expect to publish in Q2 2023.

Financial Management

Co-sponsor: Attachments

1490

PSS for Prior-Authorization Support


prior-auth

prior-auth-client

Endpoint: https://prior-auth.davinci.hl7.org

PAS Zulip Stream
FoundationalHealth Record Exchange Framework (HRex)Health Record Exchange Framework (HRex)

STU1 Published

N/A4

Active WG Calls (combined with CDex)

STU1 published in March 2022

Clinical Interoperability Council (CIC)

Co-sponsor: Patient Care, Attachments, Financial Management

1494

PSS for eHealth Record Exchange (eHRx) Framework


N/AHRex/CDex Zulip Stream
Clinical Data ExchangeClinical Data Exchange (CDex)Clinical Data Exchange (CDex)

Provider to Provider

Provider to Payer


STU2 Published

  •  
11

Active WG Calls

CDex v1.1.0 published in August 2022. 

STU2 published March 2023

Patient Care

Co-sponsor: PIE/Attachments, Structured Documents

1495

PSS for eClinical Data Exchange (CDex)


Sandbox Applications:

GitHub Repository:

Open Endpoints:

CDex Zulip Stream
Clinical Data ExchangePayer Data Exchange (PDex)Payer Data Exchange (PDex)

Payer to Provider

Payer to Member

Payer to Payer

PDex Future Enhancements

STU2 Ballot Reconciliation

  •  
15

Active WG Calls for implementer support and STU2 development

STU1.2 early May Ballot (Feb - March 2022); reconciliation nearly complete and expect to publish in Q2 2023.

Financial Management

Co-sponsor: Attachments

1489

PSS for Payer Data Exchange (PDex)


PDex GitHub Repository


PDex Zulip Stream
Coverage, Transparency & Burden ReductionPayer Data Exchange (PDex): Formulary

PDex Formulary



STU2 Published

  •  
14

Active WG Calls 

STU2 Balloted Jan 2022 

STU2 Published August 2022

Financial Management

Co-sponsor: Attachments

1489

PSS for Payer Data Exchange (PDex)


drug-formulary-ri

pdex-formulary-client

PDex Zulip Stream
Coverage, Transparency & Burden ReductionPayer Data Exchange (PDex): Plan Network Directory

PDex Directory/Plan Net



STU1.1 - Published

  •  
11

STU Update (v1.1.0) Published April 2022

Financial Management

Co-sponsor: Attachments

1489

PSS for Payer Data Exchange (PDex)


plan-net-ri

plan-net_client

PDex Zulip Stream
FoundationalDa Vinci Unsolicited NotificationsNotifications (formerly known as Alerts)

Admit

Discharge


STU1 - Published

  •  
7

Active WG Calls for implementer support monthly

STU1 published October 2020

Infrastructure And Messaging Work Group

Co-sponsor: 

Financial Management

1516

PSS for Notifications (formerly known as Alerts)


Alerts Sender

Alerts Receiver

Notification Zulip stream
Coverage, Transparency & Burden ReductionPayer - Payer Coverage Decision ExchangePayer Coverage Decision Exchange (PCDE)

STU1 -Published

  •  
6

STU1 Published  

Published STU1 - Dec 2020

On Hold. 

Financial Management

Co-sponsor: Attachments

1515

PSS for Payer Coverage Decision Exchange


pcde-ri

PCDE Zulip Stream
FoundationalMember Attribution (ATR) List (formerly Risk Based Contract Member Identification)Member Attribution List (aka: Risk Based Contract Member Identification)

Phase 2 Testing

STU2 Ballot Reconciliation

  •  
12

Active WG Calls for continuous build for STU2

Call to Action: Need Testers on STU2 balloted in January 2023. Ballot reconciliation to begin soon.


Financial Management

Co-sponsor: Attachments

1517

PSS for Risk Based Contract Member Identification (Updated)


Da Vinci ATRATR Zulip Stream
Quality & RiskRisk Adjustment Risk Adjustment

Payer to provider

STU2 Focus: Provider to Payer


STU2 Ballot May 2023

  •  
6

STU1 Publication process started May 2022

Active WG Calls for STU2 (Provider to Payer)

Clinical Quality Information (CQI)


1705

PSS for Risk Adjustment


Reference Implementation using cqf-ruler /HAPI

RA Zulip Stream
Coverage, Transparency & Burden Reduction Patient Cost TransparencyPatient Cost Transparency (PCT)

Provider to Payer (Good Faith Estimate)

Payer to Member and Provider (AEOB)


STU1 Published

  •  
5

Active WG Calls

STU1 published March 2023

Financial Management

Co-sponsor: Attachments

1514

PSS for Patient Cost Transparency


https://github.com/HL7-DaVinci/test-pct-payer

Endpoints for testing: 

PCT Zulip Stream
Quality & RiskValue Based Performance ReportingValue Based Performance Reporting (VBPR)Payer/Provider Contracts

STU1 Development


0

Active WG Calls

STU1 Projected Ballot Sep 2023

Clinical Quality Information (CQI)

Co-Sponsor:

Payer/Provider Information Exchange( PIE)

1781



GitHub - Use Case Reference Code


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Example Statuses: 

L

IIII--------------

IIIIIIIII---------

IIIIIIIIIIIIII----

IIIIIIIIIIIIIIIIIIIIIII





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