This page will be used by the use case teams and Da Vinci PMO to draft and collaborate on 2022 goals. We want to capture plans and high level activities at the use case level to help teams stay aligned throughout the goal period.
High Level Overview
This will be used to communicate with Da Vinci Committees for planning, budgeting, and high level alignment. Please highlight in red any changes made to this table so we can update the source of truth.
| Project Area | Project | Key Activity | 2022 Activity & Version | Proposed 2023 Activity & Version (To be reviewed) |
| IG Build and Maturity | ||||
| Cross Use Case & Project Coordination | Maintain | Continue Transition to < Resources and Routinize | ||
| Burden Reduction (CRD, DTR, PAS) | Ballot | STU2 and HIPAA Exception | Publish STU1.1 | |
| Health Record Exchange | Publish & Maintain | Publish STU1 | Ballot STU2 | |
| Clinical Data Exchange | Publish & Maintain | Publish STU1, Ballot New Content, Test and Feedback | Ballot & Publish | |
| Payer Data Exchange | Ballot & Maintain | STU2 and Evaluate Transition PDex: STU2 Ballot PDex Formulary: Publish STU2 PDex Directory (Aka Plan Net): Publish STU1.1 | Evaluate Transition PDex: Publish STU2 | |
| Quality & Gaps | Transition | Monitor Transition to Public | See ICF Hadassah Gholian - please get an update on plans so we can report out) | |
| Attribution | Ballot | Publish and Evaluate Transition | STU2 Ballot and Publish | |
| Risk Adjustment | Ballot & Publish | Publish STU1; Test and Feedback; Develop STU 2 | Ballot - I thought they were Balloting STU2 in Sept 2022? | |
| Notifications | Maintain | Feedback, Revaluate in H2. | Ballot and Publish STU2 | |
| Patient Cost Transparency | Ballot & Publish | Publish, Test and Feedback | Ballot and Publish STU2 | |
| Payer Coverage Decision Exchange | Hold | Hold, Revaluate in H2. | Hold. | |
| VBC Performance Reports | Discovery | Requirements and Build | Ballot and Publish STU1 |
Individual Use Case Goals -
The table below will be used to ensure the use case leads are aligned on the high level goals for the year and to stay aligned with the scope of work. Should we need to pivot to different work, a discussion to assess timeline and budget implications is needed before starting work.
Activities for Reference:
- IG Build and Maturity- *Public, member, small group calls, IG and RI updates, edits, maintenance, manage jira backlogs, HL7 process management
- Community Support - Community Roundtable, events not supported by add'l SOW, external requests for use case specific updates e.g. WEDI, AHIP
Implementer Support - Assumes 4 Connectathons, implementer questions, Monitoring Zulip and HL7 workgroup monitoring.
- Communication Support - (minimal from leads) Biweekly communication updates, collateral for external audience, scheduling, support for member presentations, coordination with/for other Accelerator -
- Additional Da Vinci Member and Demo/Education Events would be under Separate SOW or addendum, as needed.
| Use Cases | Abbreviation | 2022 Goals and Activities (Please review and update) | 2022 Build Focus Area Goals (Please review and update, link to relevant documents or pages, or JIRA tickets) | Same/Bigger/Smaller (from previous year) | Gaps/Difference/Missing Roles (call out any needs) |
|---|---|---|---|---|---|
| Coverage Requirements Discovery | CRD | IG Maintenance, Community Support (like 2021) + STU2 Ballot, Publish, and Ballot Rec. Plan for a tech correction and/or STU update. Work to get better Connectathon participation and testing via Touchstone. This way know who is conformant with the IG. | Increased EHR testing, support for both payer-stored and EHR-stored context Did pass on initial voting – 62/35 needed 59 to pass Top negative votes: Evernorth 9, Epic 13 107 Jira Tickets to reconcile Top reporters: Celine Lefebvre 38, Andrea Preisler 13 Major effort is ballot reconciliation | Bigger (ballot, rec & publish in one year, expect more community engagement, testing requirements) | New Member Leads engaged! |
| Documentation Templates & Rules | DTR | IG Maintenance, Community Support (like 2021) + STU2 Ballot, Publish, and Ballot Rec. Plan for a tech correction and/or STU update. Work to get better Connectathon participation and testing via Touchstone. This way know who is conformant with the IG. | Increased EHR testing, support for both payer-stored and EHR-stored context Did pass on initial voting – 58/30 needed 53 to pass Top negative votes: Evernorth 9, Kaiser 12, Epic 13 146 Jira Tickets to reconcile Top reporters: Lloyd 93, Celine Lefebvre 21 Major effort is ballot reconciliation | Bigger (ballot, rec & publish in one year, expect more community engagement, testing requirements) | New Member Leads engaged! |
| Prior Auth Support | PAS | IG Maintenance, Community Support (like 2021) + STU2 Ballot, Publish, and Ballot Rec. Plan for a tech correction and/or STU update. Work to get better Connectathon participation and testing via Touchstone. This way know who is conformant with the IG. | Did not pass on initial voting – 35/54 need 54 to pass Top negative votes: Evernorth 9, Kaiser 12, Epic 13 86 Jira Tickets to reconcile Top Reporters: Celine Lefebvre 29, Andrea Barbieri 11, and Chris Cioffi 10 Major effort is ballot reconciliation | Smaller. Mapping work was biggest effort and is now done. Changes are small | New Member Leads engaged! |
| Data Exchange for Quality Measures with Gaps in Care | DEQM/GIC | The ongoing maintenance and new development of the DEQM IG has been transitioned to the CQI community beginning from December 2021, with MITRE and ICF playing the lead role. Attend the DEQM/GIC calls and continue to support and monitor the DEQM and GIC activities. Publish an Errata update to align with USCore 3.1.1, QI-Core Errata 4.1.1, and the QM IG STU3. (QI-Core Errata 4.1.1 and QM IG STU3 are in the process of being published, likely beginning of April) Tentatively planned to ballot in September 2022 | Smaller | ||
| Health Record Exchange Framework | HREX | IG Maintenance, Community Support (as applicable) Recommend planning for STU update/Tech. correction(s). Are we going back to ballot this week? Are we going back to ballot for all content that's marked as 'draft' (added post ballot) such as the security stuff? Bob recommends we do plan for this - Need Testing first. Need to update cross-references to include all artifacts across all officially published Da Vinci IGs (which is now most of them). May also migrate more shared content into this IG as additional sharing is identified. | Support Testing for Payer to Payer Data exchange process for authentication, authorization, trust, membermatch, | Same | |
| Clinical Data Exchange | CDEX | IG Maintenance, Community Support Plan for a tech correction and/or STU update. Recommend planning for Testing support for unsolicited push of clinical data; STU update/Tech. correction(s); Support for potential Attachments Rule? | Support Testing for unsolicited push of clinical data testing and support and signature support across all transaction types. | More - If Attachment Rule drops? | 1. Missing RI Developers, support for dev/testing. 2. Missing Formal Member Leadership (call participation ebbs and flows) Need EHRs and steady Providers. |
| Payer Data Exchange | PDEX | Continue Support Payer to Payer, Bulk; Support 9123 (Prior Auth inclusion). Jan Ballot Rec., Publish STU2; may want to plan for possible STU update/tech correction Addition of Payer to Provider Bulk Exchange | See PDex Supporting Materials#PDexV2 for the 2021 Da Vinci PDex IG STU2 Versions document Did not pass on initial voting – 42/39 need 49 to pass Top negative votes: Evernorth 8, VA 11, Epic 13 43 Jira Tickets to reconcile Top reporters: Celine Lefebvre 5, Chris Shawn 8 Major effort is ballot reconciliation | Bigger. | Additional Formal Member Leadership would be valuable, but many active participants engaged. |
| Payer Data Exchange Formulary | Formulary | Ballot rec and publish STU2. implementer support, plan for a tech correction or stu update. Update/Split PSS to explicitly include non-patient specific data (Formulary definition only). Add bulk data for formulary definition (Non-member specific) | Increased testing of member authenticated access. Testing of bulk data access. | n/a - MITRE | Additional Formal Member Leadership would be valuable |
| Payer Data Exchange Directory | PlanNet | STU Update (no need for Ballot). Implementer support, plan for a tech correction or stu update? | n/a - MITRE | Additional Formal Member Leadership would be valuable | |
| Payer Coverage Decision Exchange | PCDE | H1 - Maintenance Mode. H2 - Re-evaluate. | Smaller. | ||
| Member Attribution | Member ID | Ballot STU 2 in H1, Ballot Reconciliation, Connectathon Tracks, continue building RI, STU2 publication | same (I think same for phase 2 work and HL7 process work) | Looking for more provider implementers, but team is great! | |
| Alerts/Notifications | Notifications | Q1 - Maintenance Mode. Target ballot in Jan2023 being considered. | same | ||
| Patient Cost Transparency | PCT | Ballot and Ballot Rec - Expected to be large. Publish STU1. Work to get better Connectathon participation and testing via Touchstone. This way know who is conformant with the IG. | Phase 2 list grows weekly- See #9 on Patient Cost Transparency FAQs - would support other parts of NSA, TiC Rule (Shopping, Provider to Provider, complex scenarios, non-happy path GFE and AEOB; | Bigger | |
| Risk Adjustment | RA | Ballot STU 1 in January, ballot reconciliation, and publish STU1. Continue building RI, test scripts, and test in Connectathons. Work on the 2nd phase. Plan to ballot STU2 in the Jan 2023 ballot cycle. | Bigger | Need more implementers. | |
| Performing Lab Reporting | PLR | ||||
| Patient Data Exchange | |||||
| Care Coordination | |||||
| Provider Roster | |||||
| VBC Cost Reports | |||||
| Cross-use-case | Set quality, layout and other requirements across IGs, enhance tooling to enforce quality rules. Improve rigor of test cases for IGs and consider publishing as part of IGs | ?? |
Framework Notes for Planning and Estimating:
- Da Vinci Balloting Timeline Decision Making Rubric:
- Policy – Is there a policy driver and if so, what facts do we know about timeline and content need.
- Maturity - Has there been feedback from a large implementation community or likely much more to come?
- Testing - Has the new content been well-tested at many Connectathons or need more testing time?
- With FHIR R5 ballot in summer, we likely won’t have any need to update our IGs until R5 is published which is likely 2023+.
- USCore, QICore, CCDA will likely update first as well and then we’d update Da Vinci IGs. USCore updates every year – Jan Ballot cycle, publish by June; QICore – Publishing process now, then Ballot again in May22.
- Also want to monitor SVAP and the process there to see what version of FHIR is named. (SVAP is FHIR R4 right now)
- Only planning for Da Vinci use cases around R5 for 2022 is to share anything we want added to R5 prior to their ballot in May.
- PMO recommendation to re-evaluate the budget after the Ballot comments come back – after February (ish) and May (ish) to align on work for the Ballot Reconciliation based on commenting volume (and any Regulatory activity)
- Potential/Expected Regulatory activity in 2022 and IG impacts:
- Attachments Rule - CDex
- NSA Rule (after 1/1/2022) - PCT
- Interoperability and Prior Auth (Feb 2022)- CRD, DTR, PAS, PDex, Formulary, PlanNet
- Quality Rules - DEQM/GIC
- Potential/Expected Regulatory activity in 2022 and IG impacts:
- Bob and Viet aligned:
- H1 – Good understanding of the work needed.
- H2 – CMS activities may change so will also need to factor this into the plan.
- Review your JIRA Dashboards for any open tickets. Each IG has a dashboard linked from here: JIRA
- Tips for Budgeting:
- Start with what you know has to be done.
- Then, estimate the unknown work: Assume 150 Ballot Comments per IG; 3 tiers broken out evenly:
- 1) Tech Correction (simple, easy)
- 2) Some conversation
- 3) Much conversation, testing and Connectathon.
Actions:
1) Use Case Leads - Review and Update the 2022 Goals above on this page by Monday, 12/6
2) Once there is agreement here, we may share the goals on the membership dashboard for further transparency.