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| Focus Area | Implementation Guide | Project Page | Scenarios Included | Future Enhancements | Imp Guide Status #Build #STU | Reference Imp Live | Number of Connectathons (Live/Virtual) | Detail Project Status | Sponsoring Workgroup | Project Number | PSS Link | Reference Implementation | Zulip Stream |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Quality & Risk | Data Exchange for Quality Measures includes Gaps in Care (GIC) | v1 Medication Reconciliation Post Discharge v2 Colorectal Cancer Screening and Venous Thromboembolism Prophylaxis Measures | STU4 Published ⬤ | DEQM -11 GIC-7 | ICF and MITRE leading Active WG Calls | Clinical Quality Information (CQI) Co-sponsor: Clinical Decision Support , Patient Care | 1429 1427 | GitHub Repository: | DEQM and GIC stream | ||||
| Coverage, Transparency & Burden Reduction | Burden Reduction: Coverage Requirements Discovery (CRD) | CRD Future Enhancements | STU2 Published! ⬤ | 17 | Active WG Calls for implementer support STU1 Published 12/22/2020 STU1.1 early May Ballot (Feb - March 2022). Reconciliation complete. STU2 Published 10/20/23 | FM | 1515 | PSS for Coverage Requirements Discovery | GitHub Repository: Endpoints for testing:
| CRD Zulip stream | |||
| Coverage, Transparency & Burden Reduction | Documentation Templates and Payer Rules | Burden Reduction: Documentation Templates and Payer Rules (DTR) | DTR Future Enhancements | STU2 Published! ⬤ | 16 | Active WG Calls for implementer support STU1.1 early May Ballot (Feb - March 2022). Reconciliation complete. STU2 Published 11/7/23 | Co-sponsor: Attachments, Patient Care | 1493 | PSS for Documentation Templates and Rules | GitHub Repository:
Endpoints for testing:
Note: "Cannot GET /smart/launch.html" actual means it is up. | DTR Zulip stream | ||
| Coverage, Transparency & Burden Reduction | Prior Authorization Support | Burden Reduction: Prior Authorization Support (PAS) | PAS Future Enhancements | STU2 Published! ⬤ | 16 | Active WG Calls for implementer support STU1.1 early May Ballot (Feb - March 2022). Reconciliation complete. STU2 Published 11/21/23 | Co-sponsor: Attachments | 1490 | PSS for Prior-Authorization Support | GitHub Repository: Endpoints for testing:
| PAS Zulip Stream | ||
| Foundational | Health Record Exchange Framework (HRex) | Health Record Exchange Framework (HRex) | HRex Future Enhancements | STU1 Published ⬤ | N/A | 4 | 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/A | HRex/CDex Zulip Stream | |
| Clinical Data Exchange | Clinical Data Exchange (CDex) | Clinical Data Exchange (CDex) | Provider to Provider Provider to Payer | STU2 Published ⬤ | 13 | Active WG Calls CDex v1.1.0 published in August 2022. STU2 published March 2023 | Co-sponsor: PIE/Attachments, Structured Documents | 1495 | PSS for eClinical Data Exchange (CDex) | Sandbox Applications: GitHub Repository: Endpoints for testing:
| CDex Zulip Stream | ||
| Clinical Data Exchange | Payer Data Exchange (PDex) | Payer Data Exchange (PDex) | Payer to Provider Payer to Member Payer to Payer | STU2 Publication - anticipated Nov 2023 ⬤ | 15 | Active WG Calls for implementer support and STU2 development STU1.2 early May Ballot (Feb - March 2022); reconciliation complete and expect to publish in Q4 2023. | Co-sponsor: Attachments | 1489 | PSS for Payer Data Exchange (PDex) | GitHub Repository:
| PDex Zulip Stream | ||
| Coverage, Transparency & Burden Reduction | Payer Data Exchange (PDex): Formulary | PDex-Formulary Future Enhancements | STU2 Published ⬤ | 14 | Active WG Calls STU2 Balloted Jan 2022 STU2 Published August 2022 | Co-sponsor: Attachments | 1489 | PSS for Payer Data Exchange (PDex) | GitHub Repository: Endpoints for testing:
| PDex Zulip Stream | |||
| Coverage, Transparency & Burden Reduction | Payer Data Exchange (PDex): Plan Network Directory | PDex Plan Net Future Enhancements | STU1.1 - Published ⬤ | 17 | STU Update (v1.1.0) Published April 2022 | Co-sponsor: Attachments | 1489 | PSS for Payer Data Exchange (PDex) | GitHub Repository: Endpoints for testing:
| PDex Zulip Stream | |||
| Foundational | Da Vinci Unsolicited Notifications | Notifications (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) | GitHub Repository: | Notification Zulip stream | ||
| Coverage, Transparency & Burden Reduction | Payer - Payer Coverage Decision Exchange | Payer Coverage Decision Exchange (PCDE) | STU1 -Published ⬤ | 6 | STU1 Published Published STU1 - Dec 2020 On Hold. | Co-sponsor: Attachments | 1515 | PSS for Payer Coverage Decision Exchange | GitHub Repository: | PCDE Zulip Stream | |||
| Foundational | Member Attribution (ATR) List (formerly Risk Based Contract Member Identification) | Member Attribution List (aka: Risk Based Contract Member Identification) | Member ATR Future Enhancements | Phase 2 Testing STU2 Publication - anticipated Dec 2023 ◕ | 14 | Active WG Calls for continuous build for STU2 Call to Action: Need Testers on STU2 balloted in January 2023. Ballot reconciliation complete and expect to publish in Q4 2023 | Co-sponsor: Attachments | 1517 | PSS for Risk Based Contract Member Identification (Updated) | GitHub Repository: | ATR Zulip Stream | ||
| Quality & Risk | Risk Adjustment | Risk Adjustment | Payer to provider STU2 Focus: Provider to Payer | STU2 Ballot Reconciliation ◕ | 8 | STU1 Published June 2022 Active WG Calls for STU2 (Provider to Payer) | Clinical Quality Information (CQI) | 1705 | Reference Implementation using cqf-ruler /HAPI
| RA Zulip Stream | |||
| Coverage, Transparency & Burden Reduction | Patient Cost Transparency | Patient Cost Transparency (PCT) | Provider to Payer (Good Faith Estimate) Payer to Member and Provider (AEOB) | STU1 Published ⬤ | 7 | Active WG Calls STU1 published March 2023 | Co-sponsor: Attachments | 1514 | PSS for Patient Cost Transparency | GitHub Repository: Endpoints for testing:
| PCT Zulip Stream | ||
| Quality & Risk | Value Based Performance Reporting | Value Based Performance Reporting (VBPR) | Payer/Provider Contracts | VBPR: Future Enhancements | STU1 Ballot Sept 2023 ◔ | 3 | Active WG Calls STU1 Ballot Sep 2023 | Clinical Quality Information (CQI) Payer/Provider Information Exchange( PIE) | 1781 | Touchstone: https://touchstone.aegis.net/touchstone VBPR Test Scripts: https://touchstone.aegis.net/touchstone/testdefinitions?selectedTestGrp=/FHIRSandbox/DaVinci/FHIR4-0-1-VBPR/VBPR-STU1&activeOnly=true&contentEntry=TEST_SCRIPTS
Endpoint for testing: https://cloud.alphora.com/sandbox/r4/vbpr/fhir | VBPR Zulip Stream |
GitHub - Use Case Reference Code
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