Da Vinci Implementer Support

Welcome to the Da Vinci Implementer Support Page

Da Vinci use cases are interrelated, currently with five categories that have emerged: Quality Improvement, Coverage/Burden Reduction, Member Access, Process Improvement, and Clinical Data Exchange. Early use cases create building blocks and a framework upon which incremental improvements and additional content can be added over time.
Da Vinci adopts existing and emerging standards with broad support to create viable solutions, such as FHIR as the core, NCQA HEDIS, CDS Hooks, and SMART on FHIR (layering in OAuth security). Existing profiles are adopted where possible (e.g., Argonaut, US-Core, QI-Core)

What you need to know about FHIR

Fast Healthcare Interoperability Resources (FHIR) - standard for exchanging healthcare information electronically

Basic FHIR- utilizing one or more Resources to build use cases.

Base Resources can be used alone or as building blocks into profiles. See Resource Index and Resource guide.

FHIR defines simple framework for extending existing resources and describing their use with profiles. Implementation guides provide structure of how to use the profiles.

Key concepts with FHIR

New to FHIR- Check these educational resources

HL7 FHIR Certification
- HL7 FHIR Fundamentals Course
- Introduction to FHIR (part 1 and 2)
  - HL7 FHIR Path to certification bundle

Additional resources

US Core

HL7 FHIR

US Core Implementation Guide (FHIR R4)- defines minimum conformance requirements for accessing patient data.

Meet 2015 Edition certification criterion for Patient Selection 170.315(g)(7), and Application Access - Data Category Request 170.315(g)(8)
Follows USCDI v1- United States Core Data for Interoperability

General guidance page for mapping/profiles

Check out examples of US Core profile

For full list of available profiles, click here.

QI Core

HL7 FHIR

Quality Improvement Core (QI Core) Implementation Guide (FHIR R4)- defines set of profiles to allow interoperable, quality-focused applications.

Further extend use of US Core profiles to build standards on quality measure, includes guidance on use of vocabularies and value sets
Encourage consistent access and use of data for clinical quality applications
Standardize the exchange of quality-related information between data server and data consumers on calculation of quality measures and decision support.

Quality Data Model to QI Core draft mapping

Check out examples of QI Core Profiles

For full list of available profiles, click here

CDS Hooks

HL7 FHIR

CDS Hooks- HL7 published specification for clinical decision support

Evaluate remote clinical decision support by triggering it within the clinician workflow in near real-time
API supports return of information and suggestions and launch user-facing SMART app when additional interaction is required

Clinical Decision Support Services

Check out examples of CDS Hooks

SMART on FHIR

HL7 FHIR

SMART App launch framework - may connect from inside or outside the user interface to an EHR system

Intended to be used by app developers, may be stand alone or launch from EHR system
Use OAuth scopes to communicate access requirements

Check out examples of SMART on FHIR App

Bulk Data

HL7 FHIR

FHIR Bulk Data Access (Flat FHIR)- defines standardize approach for exporting bulk data.

Request bulk data export from server, receive status information and retrieve files

Bulk Data Touchstone TestScripts

What you need to know about an Implementation Guide

Overview of Implementation Guide

Implementation Guide (IG) - set of rules about how HL7 FHIR resources are used to solve a problem. Published as a single unit, provides coherent and concise application of profiles.

Contains two different types of resource references- Contents and examples

Contents- include Use Case, specification, profiles/extension, conformance
Examples of resources applicable to the IG (see Table of Contents)

Check out this presentation

Demystifying the Implementation Guide: Data Exchange for Quality Measures (DEQM) By Linda Michaelson

Maturity of Implementation Guide

HL7 Implementation Guide Process Flow

IGs mature through stages that lead to Normative standards- refer to FHIR Maturity Model

Each IG will list the maturity level on the title of the Implementation guide.

Check out Da Vinci current maturity on Use Cases

Da Vinci Project Update Sept

Implementer support

Visit each Da Vinci Use Cases for additional supplemental materials

Have a question? Join us for our reoccurring calls

What you need to know about Da Vinci Use Cases Status of Use Cases: Da Vinci Implementation Guide Dashboard
Focus Area	Objective	Relevant Use Case IG's	Aligns with US Core/USCDI Aligns with ONC/CMS Rule Example: CMS Interoperability and Patient Access final rule
Coverage/Burden Reduction Example: Prior Authorization for home oxygen therapy, hospital admission	To enable provider, at point of service, to request prior authorization (including all necessary approval requirements, documentation, and rules to support the request) and receive immediate authorization to reduce provider burden and support treatment planning	Coverage Requirements Discovery (CRD) Documentation Templates and Payer Rules (DTR) Burden Reduction: Prior Authorization Support (PAS)	US Core/USCDI
Quality Improvement Example: 30 Day medication reconciliation, colorectal cancer screening	To support value based data exchange by: Represent open and closed gaps in care Define how providers and payers can be informed of gaps and closings Define a close the loop framework between authorities and providers	Data Exchange for Quality Measures (DEQM) with Gaps in Care & Information	US Core/USCDI
Member Access (Patient have a right to access their medical information) Example diagram: Patient Access and Interoperability API CMS/ONC Ruling Support Refer to CMS Interoperability and Patient Access final rule	To enable sharing of clinical data generated by providers with payers or other providers	Clinical Data Exchange (CDex) Health Record Framework (HRex)	US Core/USCDI
	To enable sharing of clinical data generated by payers to be shared with other payers or providers	Payer Data Exchange (PDex) Health Record Framework (HRex)	US Core/USCDI Aligns with ONC or CMS rule
	To enable payers to share drug estimated cost and information (drug formulary) for patients/consumers To determine out of pocket cost under current health plan Compare multiple health plans medication cost	Payer Data Exchange (PDex)- Formulary Health Record Framework (HRex)	US Core/USCDI Aligns with ONC or CMS Rule
	To enable payers to share the provider directory for members to identify in-network providers and their information Example: network status, specialty, language, hours of operations and new patient acceptance	Payer Data Exchange (PDex)- Provider Directory (Plan Net) Health Record Framework (HRex)	US Core/USCDI Aligns with ONC or CMS rule
	To support the portability of coverage by exchanging information between payers to define decision making and supporting documentation with regard to treatment for chronic illnesses without the need to burden the provider and/or patient or risk a discontinuity of care.	Payer Coverage Decision Exchange (PCDE) Health Record Framework (HRex)	US Core/USCDI Aligns with ONC or CMS rule
Process Improvement	To enable payers and provider to exchange information that identifies members of a patient population associated with a particular risk based contract	Risk Based Contracts Member Attribution (ATR)	US Core/USCDI
	Standard methodology (format) for payers to communicate coding gaps to providers. Ability to communicate coding gaps for individual or group of patients.	Risk Adjustment
Clinical Data Exchange	To support the real-time exchange of alerts that impact patient care and value based or risk based services Example: Admit/Discharge/Transfers	Notifications	US Core/USCDI Aligns with ONC or CMS rule

Da Vinci Use Case Maturity

Developer ToolBox
Zulip	Zulip Chat platform allows you to ask questions and view comments from fellow developers to the FHIR community. Click here to get started. For a list of available zulip streams, click here	*Did you know-* *Each Use Case has additional links specific to their use case. This include Logica specific sandbox, GitHub and Touchstone test scripts.* *Visit the Da Vinci Use Case page.* *Additional questions or comments?* *Bring them to the Da Vinci Public calls.*
Logica Health Sandbox	Logica Health Sandbox offers the FHIR sandbox as a free environment to develop FHIR applications. Click here for more information New to Logica- check out this video .
GitHub	Detailed examples of our Reference Implementation are located in GitHub. Browse the repositories and examples here.
FHIR Servers	FHIR public servers are available as testing servers. Click here for a list of available public servers
Build and Validate with Touchstone	AEGIS Touchstone provides test driven development feedback as you build to Base FHIR and the Da Vinci IGs. Get Setup and Learn more here!

Analyst ToolBox
Da Vinci Use Cases	Visit each of the Da Vinci Use Cases for additional information and supplemental materials *Did you know- Each Use Case has supplemental materials and example diagrams.*
Public Conference Calls	Have a question or feedback? Join us on our reoccurring calls.
Educational Session	Join us at the Da Vinci Education & FHIR Implementation Event by HL7 - April 26 - 30 that include educational sessions geared toward Business Analysts April 26 - 30
FHIR Connectathons	Join HL7 Connectathons to engage in hands-on development and testing. Participate with members of the FHIR development communities. Click here for past Da Vinci related Connectathons.