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Chair:  Robert Dieterle

Scribe: Michele Galioto 


NOTE: This attendance applies if you are present at the related meeting/call, regardless if you have signed a different attendance for your WG. 

Attendees 

Present

Name

Affiliation

xEnablecare

POCP

Alex KonturONC

Chetan JainOptum

Bruce SchreiberMedAllies

Cooper ThompsonEpic

Greg Meyer

Cerner

StephanieCigna/Evernorth

Jeff BrownMITRE

Liz SheffieldCigna/Evernorth

Cigna/Evernorth

Sonja ZieglerOptum

Senthil

Optum

Brianna MathiowetzMITRE
xMaxMD

Matt Carroll

Alex MuggeCMS
xOpen City Labs

Stephen Konya ONC

Project Unify

Ron Urwongse 

CAQH



Jaffer Traish

Kevin Van Aucker

Dan ChaputIndependent

MITRE

Seth Blumenthal AMA

Jamie SmithIQVIA

Abigail Watson MITRE

Booz Allen

Douglas DeShazo Seneca Global



Onyx

Serafina Versaggi 
xAEGIS

Lenel James BCBSA

MITRE

Rachel E. Foerster Rachel Foerster & Associates

Alberto S. Llanes FEHRM

ONC

Jim HaleyArkansas Blue Cross

Nancy Lush Patient Centric Solutions

Anthem

Justin EdelmanCAQH

Sorin DavisCAQH

HCSC



Smile Digital Health

Lauree Tu  

Erin Clements 

Mark WholeyPatient Centric Solutions

Mel Combs-Dyer Mettle Solutions

UC Davis Health

Liz Turi ONC

Shaumik AshrafMITRE
xElevance Health
xLantana

Lantana

Momeena Ali
xCVS Health/ Aetna
x

Joseph Shook 

Surescripts

Dave Vaillancourt

Mahesh Patil


xRick Lisseveld AEGIS

Rosaline Shaw

Flexion

Elevance Health

Independent Health
xPOCP

Thomas Zhou AH

Steve AtwoodAthena
xJames Derrickson

Jackie HemenwayUPMC

Daniel LilavoisAetna/CVS Health

Crystal KallemPOCP / FAST PMO
xJames Derrickson

Joe KellySureScripts
xGregg Johnson
xRosaline Shaw
xRita Torkzadeh Aegis.net


Minutes Approved as Presented 

x

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementHL7 Antitrust StatementProfessional Associations, such as HL7, which bring together competing entities are subject to strict scrutiny under applicable antitrust laws. HL7 recognizes that the antitrust laws were enacted to promote fairness in competition and, as such, supports laws against monopoly and restraints of trade and their enforcement. Each individual participating in HL7 meetings and conferences, regardless of venue, is responsible for knowing the contents of and adhering to the HL7 Antitrust Policy as stated in §05.01 of the Governance and Operations Manual (GOM).

HL7 Code of Conducthttps://www.hl7.org/legal/code-of-conduct.cfm

Meeting Minute Approval

2023-01-23 National Directory Meeting

Approved by unanimous consent

Project Links

Project Page: National Healthcare Directory

Project Scope Statement: National Healthcare Directory PSS

Implementation Guides:

Connectathon: 2023- 01 FAST National Directory of Healthcare & Da Vinci Plan Net

Zulip Channel: https://chat.fhir.org/#narrow/stream/283066-united-states.2Fnational.20directory

Predecessor work that this effort builds upon:



Milestones

Sept 2022 Ballot Cycle Milestones

Milestone
Ballot VotingComplete
Ballot ReconciliationIn Progress

Tentative: May 2023 Ballot Cycle Milestones

Milestone
Notice of Intent to Ballot (NIB)February 19, 2023
Sept 2022 Ballot Reconciliation CompleteMarch 13, 2023




Announcements





CMS Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule (CMS-0057-P)

This proposed regulation cover areas like Patient Access API, Payer to Payer Exchange, Handling Prior Authorization, etc.

Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard Proposed Rule (CMS-0053-P)

This is the long awaited attachments rule from the Division of National Standards. It contains follow on requirements in the Accountable Care Act that mandated that CMS establish a standard for exchange of attachments compatible with HIPAA transactions. 


Agenda




Ballot reconciliation

FHIR-3873 The technical guidance page includes sections that don't appear to pertain to this IG

  • Relates to FHIR-38362
  • Resolution: persuasive with modification
  • Change category: Clarification
  • Change impact: non-substantive
  • Grouping: ready for vote


FHIR-38619 Expand on the terminology section

  • Going to have to write up something much broader. 
  • Resolution: persuasive
  • Description: update the combined IG with a more robust treatment of terminology and value sets
  • Change category: clarification
  • Change impact: non-substantive
  • Grouping: ready for vote


FHIR-38611 Expand description of subscription exchange method

  • Going to have do this
  • Resolution: Persuasive
  • Description: Will expand the description of subscription to include workflow diagrams, handling of deactivated records,  methods of alerting, and methods of exchange of data in the combined IG
  • Change category: clarification
  • Change impact: compatible, substantive
  • Grouping: ready for vote


FHIR-38610 Correct numbering and changing titles

  • Resolution: persuasive with modification
  • Description: Will ensure that the combined IG has clear section titles and numbering
  • Change category: Correction
  • Change impact: Non-substantive
  • Grouping: ready for vote


FHIR-38608 Add system flow diagrams to exchange methods

  • Resolution: persuasive 
  • Description: Will add flow diagram(s) to section on methods of exchange
  • Change category: Clarification
  • Change impact: Non-substantive
  • Grouping: ready for vote


FHIR-38620 Correct endpoint capability statement reference

  • Resolution: Persuasive 
  • Description: Will correct the profile and link to the endpoint profile(s) in the combined IG
  • Change category: Correction
  • Change impact: Non-substantive
  • Grouping: ready for vote


FHIR-38074 Allow direct reference form insurance plan to organization - "network" concept does not exist for all payers

  • Suggest we provide guidance on this one vs. create new construct; trying to connect one to many whereas we connect many to one; it's untenable and we are taking one of his suggestions
  • Resolution: Persuasive with modification
  • Description: The current network structure will work for the situation you described by creating a single network that is pointed to by the insuranceplan.network reference and using the ability of practitionerRole and OrganziationAffiliation to indicate participation in the network. We will provide guidance in the combined IG to describe this solution for the situation you have noted. 
  • Change category: Clarification
  • Change impact: Non-substantive
  • Grouping: ready for vote


Endpoint question

LN: Why do we need multiple endpoints is a question raised by others

  • RD: Extension - NDH endpoint non FHIR payload Type
    • wanted to connect payloadtype and mimetype together, couldn't do it in the existing base resource
    • nonFHIR payloadtype allows us to tie these together
    • LN: Direct addresses - what will we populate in payloadtype and mimetype? Won't populate anything, mimetype isn't required, payloadtype not applicable for everybody; fixed value

payloadtype and mimetype will be in a backbone element in R5,  0-* (JL submitted the ticket, FHIR-40247 - Getting issue details... STATUS ). JL: R5 would turn the payloadtype and mimetype in a way to allow more specificity. 

JL: FHIR-39617 - Getting issue details... STATUS - informational guidance welcome. Related to grouping but wanted to give general guidance in base spec. 






ManagementNext Agenda

Ballot reconciliation, addressing Alex Kontur's tickets during either 1/30 or 2/2 meeting. 

Future meetings:

  • Request to revisit discussion, resolution re: endpoint use case topic from a week or so ago - better suited to be called purpose, and needed a separate data element that would reflect the workflow
  • Review HSDS revisions to align with our work
  • Reference Implementation link

 Adjournment
Adjourned at 

Supporting Documents

Outline Reference

Supporting Document

Presentation



Tasks