NCPDP is working with HL7 to define FHIR exchanges to help get specialty medications to the patient quicker--by providing pharmacies the information they need to dispense the drug, address insurance needs, and coordinate with the patient and other parties.
For Oncology, Rheumatoid Arthritis, Infusion drugs, etc., the current process for exchanging data, including prescription data regarding specialty medications is complex and manual, taking days to weeks to begin a patient on therapy.
There is no industry standard for exchanging clinical data when necessary for dispensing specialty medications by pharmacies as well as facilitating enrollment of patient in programs offered by third parties such as Hub vendors or Pharmaceutical Manufacturers. NCPDP started a task group several years ago focused on the exchange of data needed to help shorten the time to therapy for a patient who has been prescribed a specialty medication and over the past two years have been focused on identifying demographic, clinical and financial information that needs to be exchanged in order to get the patient the therapy they need.
This information is outside of the current e-Prescription that is sent to the pharmacy today. After an extensive analysis of the types of additional information that is required along with the prescription it was determined that developing an implementation guide using HL7 FHIR would be the best approach to support the exchange of this information.
We are in the process of creating a co-branded FHIR implementation Guide (Co-branded between HL7 and NCPDP) focused on the exchange of data (Demographic, prescription, clinical and financial) for dispensing specialty medications by pharmacies as well as facilitating enrollment of patients in programs offered by third parties such as but not limited to Hub vendors and Pharmaceutical manufacturers.
The implementation guide was approved by the NCPDP Work Group on 11/6/2020.
14 JAN 2021
8-8:30 Track Kickoff
8:30-9:30 Implementation Guide Overview
9:30-10 Using the mock application
10:30-3 General working session and discussion
15 JAN 2021
7:30-4 General working session and discussion continued
12:15 Track Highlight
4 Wrap up session
Test an Implementation Guide
Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group
Proposed Track Lead
Specification(s) this track uses
Artifacts of focus
Messaging and RESTful exchange model overview
Workflow to obtain information requiring human interaction (Task-to-SMART App launch)
All profiles and examples
Clinical input requested (if any)
Patient input requested (if any)
EHRs, pharmacy organizations, pharmacy technology vendors, hubs, manufacturers, intermediaries
Track Orientation Date
Friday December 18th - 10am central
Track Orientation Details
Supported business functions
The implementation guide supports these business functions:
1. Searching for patient data in the EHR
1. The Requesting System searches for needed patient clinical and coverage information using RESTful searches or the Specialty Rx Query message.
2. The Data Source System responds to the RESTful searches (or responds to a Specialty Rx Query messagy by collecting the requested information and returning a Specialty Rx Query Response).
2. Obtaining information that requires human intervention
The guide defines a Task-to-SMART app launch workflow enabling an EHR to trigger the launch of a SMART application in response to an external party's request (via a Task resource). In the context of specialty prescription fulfillment, this flow enables a pharmacy to ask the prescriber / clinic for additional information not available by searching the patient's chart–in a way that's integrated into the clinic user's work queue.
In short, the requester posts a Task to the prescriber's EHR, which places the request in the appropriate user's work queue, and subsequently launches the specified SMART app when the work item is initiated by an EHR user.
Requesting system. The requesting system is used by a stakeholder that requires information to perform an activity related to a specialty medication prescription.
The real-world actors below may initiate a specialty Rx data request:
The pharmacy typically will:
Specialty Hub staff or other third parties (examples include but are not limited to intermediary, hub, manufacturer)
These other parties typically will:
Data Source System.This system is used by the prescriber of the specialty medication or associated staff.
The real-world actors below may participate in a specialty Rx data request:
The prescriber typically will:
The prescriber agent can provide responses to requests on behalf of the provider
The EHR system will:
Data Exchange Roles (to be tested during the Connectathon)
Connectathon scenario 1: Request / Response with RESTful Data Source
Summary: An EHR responds to RESTful search requests made by a pharmacy or intermediary (roles that can be played by the sandbox system during the Connectathon)
Action: The EHR responds to the set of required searches defined in the Specialty Rx Implementation guide (http://build.fhir.org/ig/HL7/fhir-specialty-rx/searches.html)
Connectathon scenario 2: Request / Response using FHIR Messaging
Summary: A pharmacy or other Requesting System requests a set of information related to a specialty medication prescription it's received. (See Message Structures and Message Submission in the IG for messaging details.)
Action: The Requesting system creates a Specialty Rx Query Request message bundle and submits it to the Data Source System endpoint using the $process-message operation. (The sandbox system can play the role of either sender or receiver during the Connectathon)
The request bundle contains the following resources:
The Data Source System executes the searches specified in the request and initiates a Specialty Rx Query Response to the Requesting System.
Connectathon scenario 3: Obtain Additional Information Using a SMART App
Summary: An EHR user provides information using a SMART application, which is launched in response to a Task submitted by a requesting pharmacy.
Action: The pharmacy system POSTs a Task containing SMART app and context information to an EHR. The EHR places a task item in an appropriate user's work queue, and the EHR user launches the SMART app and responds to the pharmacy's questions. This process flow and details of Task population are described in the Specialty Rx Implementation guide at http://build.fhir.org/ig/HL7/fhir-specialty-rx/branches/master/human-interaction.html. An example task is at http://build.fhir.org/ig/HL7/fhir-specialty-rx/branches/master/Task-specialty-rx-task-smart-launch-1.html
Connectathon Sandbox System
There will be a test sandbox running during the Connectathon that can interact with participants as…
REST Requester and Data Source
EHR hosting a SMART application
SMART App that can be Launched from an EHR – prompted by Specialty Rx Task
To use the sandbox as a mock message-based requester...
To use the sandbox as a mock EHR...
To use the sandbox to simulate the Task-to-SMART App workflow...
To use the sandbox as a messaging-to-REST intermediary...
To use the sandbox's SMART application in a Task-to-SMART app launch process...
Security and Privacy Considerations
The mock EHRs provided by the test harness require that the patient's first and last name match exactly
Family name: Doe
Test data load scripts (transactions)