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Version

2

Modifier

Dave Hamill

Modify Date

Oct 18, 2019 16:11

1a. Project Name

PACIO Project Functional Status

1b. Project ID

1571

1c. Is Your Project an Investigative Project (aka PSS-Lite)?

No

1d. Is your Project Artifact now proceeding to Normative directly or after being either Informative or STU?

No

2a. Primary/Sponsor WG

Payer/Provider Information Exchange

2b. Co-Sponsor WG

Conformance

2c. Co-Sponsor Level of Involvement

Request formal content review prior to ballotRequest periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2d. Project Facilitator

Dave Hill

2e. Other Interested Parties (and roles)

Patient Administration Work Group, PACIO Project

2f. Modeling Facilitator

Chris Pugliese

2h. Vocabulary Facilitator

Matt Elrod

2i. Domain Expert Representative

Matt Elrod

2j. Business Requirements Analyst

Raj Mahajan

2k. Conformance Facilitator

Chris Pugliese

2m. Implementers

MITRE, MatrixCare

3a. Project Scope

Poor quality discharge information is a major barrier to safe and effective transitions. With 45% of Medicare beneficiaries requiring post-acute care (PAC) services after hospitalization, the need for a seamless exchange of health information is great.

In 2014, the Social Security Act was amended to include the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which required the standardization and interoperability of patient assessment in specific categories for post-acute care (PAC) settings, including long-term care hospitals (LTCHs), home health agencies (HHAs), skilled nursing facilities (SNFs), and inpatient rehabilitation facilities (IRFs). It focuses on standardizing data elements in specified quality measure domains and patient assessment domains for cross setting comparison and clinical information exchange, respectively. The Act requires:

• Reporting of standardized patient assessment data through commonly used PAC assessment instruments for LTCHs, SNFs, HHAs, and IRFs
o Minimum Data Set (MDS)for SNFs
o Inpatient Rehabilitation Facility – Patient Assessment Information (IRF – PAI) for IRFs
o LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) for LTCHs
o Outcome and Assessment Information Set (OASIS) for HHAs
• Implementation of data elements specified in each assessment domain using standardized data elements to be nested within the assessment instruments currently required for submission by LTCH, IRF, SNF, and HHA providers
• Data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

Required assessment content includes standardized questions and response options (aka “data elements”) for assessing a patient’s functional status.

This project seeks to:
(1) determine the data model required to comprehensively exchange functional status information between health care settings,
(2) develop FHIR Implementation Guides, Profiles, and necessary Extensions to specify how to syntactically and semantically exchange that data between care settings, (3) develop client and server reference implementations to validate the Implementation Guide, Profiles, and Extensions work in a software system, (4) develop automated test suites to validate operation, and (5) build real world pilots that successfully demonstrate the new capabilities in production.

3b. Project Need

Interoperability challenges persist in post-acute care; providers are not receiving complete and accurate information in a timely manner, leading to patient harm, adverse outcomes, and additional expense. Failure to exchange accurate, timely data often leads to inefficient workflows, duplicative data entries, and increased risk of patient harm attributable to missing or inaccurate information. Health IT can significantly alleviate this administrative burden by exchanging post-acute care assessments and associated clinical information between care settings to ensure that the receiving care setting has all of the relevant information they need to best treat the incoming patient, improving patient outcomes, reducing provider burden, improving cost efficiencies, and improving workflows. Moreover, it would allow for advanced computability, standardization, usability, and real-time analytics for PAC facilities, enabling broader use by health IT developers, researchers, providers, and payers.

3c. Security Risk

Yes

3d. External Drivers

The IMPACT Act requires data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

3e. Objectives/Deliverables and Target Dates

Project Scope Statement Due: 2019 Oct 4
FHIR IG Proposals Due: 2020 Feb 16
Notice of Intent to Ballot: 2020 Mar 1
FHIR Ballot Core Substantive Freeze: 2020 Mar 13
Initial Content Deadline: 2020 Mar 15
Reconciliation Deadline and Ballot Preview Period: 2020 Mar 22
Final Content Deadline: 2020 April 5
Ballot Readiness Sign Off: 2020 Apr 10-11
Ballot Open for Voting: 2020 Apr 10 – 2020 May 11

3f. Common Names / Keywords / Aliases:

PAC Assessments 1) Resident Assessment Instrument (RAI) Minimum Data Set (MDS) used by Skilled Nursing Facilities (SNFs) 2) Inpatient Rehabilitation Facility – Patient Assessment Information (IRF-PAI) used by IRFs 3) LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) used by Long-Term Care Hospital (LTCHs) 4) Outcome and Assessment Information Set used by Home Health Agencies (HHAs)

3g. Lineage

N/A

3h. Project Dependencies

To be determined

3i. HL7-Managed Project Document Repository URL:

To be determined

3j. Backwards Compatibility

No

3l. Using Current V3 Data Types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

To be determined

3o. Earliest prior release and/or version to which the compatibility applies

N/A

4a. Products

FHIR Implementation Guide, FHIR Profiles, FHIR Resources, Guidance (e.g. Companion Guide, Cookbook, etc)

4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to?

FHIR version R4

4c. FHIR Profiles Version

FHIR version R4

5a. Project Intent

Create new standard

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

Center for Medicare and Medicaid Services (CMS), Office of the National Coordinator (ONC), Department of Veteran Affairs (VA)

6b. Content Already Developed

25%

6c. Content externally developed?

No

6e. Is this a hosted (externally funded) project?

Yes

6f. Stakeholders

Clinical and Public Health Laboratories, Quality Reporting Agencies, Regulatory Agency, Standards Development Organizations (SDOs)

6g. Vendors

Pharmaceutical, EHR, PHR, Health Care IT

6h. Providers

Emergency Services, Healthcare Institutions (hospitals, long term care, home care, mental health)

6i. Realm

U.S. Realm Specific

7a. Management Group(s) to Review PSS

FHIR

Version

1

Modifier

David Hill

Modify Date

Oct 05, 2019 10:36

1a. Project Name

PACIO Project Functional Status

1c. Is Your Project an Investigative Project (aka PSS-Lite)?

No

1d. Is your Project Artifact now proceeding to Normative directly or after being either Informative or STU?

No

2a. Primary/Sponsor WG

Payer/Provider Information Exchange

2b. Co-Sponsor WG

Conformance

2c. Co-Sponsor Level of Involvement

Request formal content review prior to ballotRequest periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2d. Project Facilitator

Dave Hill

2e. Other Interested Parties (and roles)

Patient Administration Work Group, PACIO Project

2f. Modeling Facilitator

Chris Pugliese

2h. Vocabulary Facilitator

Matt Elrod

2i. Domain Expert Representative

Matt Elrod

2j. Business Requirements Analyst

Raj Mahajan

2k. Conformance Facilitator

Chris Pugliese

2m. Implementers

MITRE, MatrixCare

3a. Project Scope

Poor quality discharge information is a major barrier to safe and effective transitions. With 45% of Medicare beneficiaries requiring post-acute care (PAC) services after hospitalization, the need for a seamless exchange of health information is great.

In 2014, the Social Security Act was amended to include the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which required the standardization and interoperability of patient assessment in specific categories for post-acute care (PAC) settings, including long-term care hospitals (LTCHs), home health agencies (HHAs), skilled nursing facilities (SNFs), and inpatient rehabilitation facilities (IRFs). It focuses on standardizing data elements in specified quality measure domains and patient assessment domains for cross setting comparison and clinical information exchange, respectively. The Act requires:

• Reporting of standardized patient assessment data through commonly used PAC assessment instruments for LTCHs, SNFs, HHAs, and IRFs
o Minimum Data Set (MDS)for SNFs
o Inpatient Rehabilitation Facility – Patient Assessment Information (IRF – PAI) for IRFs
o LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) for LTCHs
o Outcome and Assessment Information Set (OASIS) for HHAs
• Implementation of data elements specified in each assessment domain using standardized data elements to be nested within the assessment instruments currently required for submission by LTCH, IRF, SNF, and HHA providers
• Data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

Required assessment content includes standardized questions and response options (aka “data elements”) for assessing a patient’s functional status.

This project seeks to:
(1) determine the data model required to comprehensively exchange functional status information between health care settings,
(2) develop FHIR Implementation Guides, Profiles, and necessary Extensions to specify how to syntactically and semantically exchange that data between care settings, (3) develop client and server reference implementations to validate the Implementation Guide, Profiles, and Extensions work in a software system, (4) develop automated test suites to validate operation, and (5) build real world pilots that successfully demonstrate the new capabilities in production.

3b. Project Need

Interoperability challenges persist in post-acute care; providers are not receiving complete and accurate information in a timely manner, leading to patient harm, adverse outcomes, and additional expense. Failure to exchange accurate, timely data often leads to inefficient workflows, duplicative data entries, and increased risk of patient harm attributable to missing or inaccurate information. Health IT can significantly alleviate this administrative burden by exchanging post-acute care assessments and associated clinical information between care settings to ensure that the receiving care setting has all of the relevant information they need to best treat the incoming patient, improving patient outcomes, reducing provider burden, improving cost efficiencies, and improving workflows. Moreover, it would allow for advanced computability, standardization, usability, and real-time analytics for PAC facilities, enabling broader use by health IT developers, researchers, providers, and payers.

3c. Security Risk

Yes

3d. External Drivers

The IMPACT Act requires data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

3e. Objectives/Deliverables and Target Dates

Project Scope Statement Due: 2019 Oct 4
FHIR IG Proposals Due: 2020 Feb 16
Notice of Intent to Ballot: 2020 Mar 1
FHIR Ballot Core Substantive Freeze: 2020 Mar 13
Initial Content Deadline: 2020 Mar 15
Reconciliation Deadline and Ballot Preview Period: 2020 Mar 22
Final Content Deadline: 2020 April 5
Ballot Readiness Sign Off: 2020 Apr 10-11
Ballot Open for Voting: 2020 Apr 10 – 2020 May 11

3f. Common Names / Keywords / Aliases:

PAC Assessments 1) Resident Assessment Instrument (RAI) Minimum Data Set (MDS) used by Skilled Nursing Facilities (SNFs) 2) Inpatient Rehabilitation Facility – Patient Assessment Information (IRF-PAI) used by IRFs 3) LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) used by Long-Term Care Hospital (LTCHs) 4) Outcome and Assessment Information Set used by Home Health Agencies (HHAs)

3g. Lineage

N/A

3h. Project Dependencies

To be determined

3i. HL7-Managed Project Document Repository URL:

To be determined

3j. Backwards Compatibility

No

3l. Using Current V3 Data Types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

To be determined

3o. Earliest prior release and/or version to which the compatibility applies

N/A

4a. Products

FHIR Implementation Guide, FHIR Profiles, FHIR Resources, Guidance (e.g. Companion Guide, Cookbook, etc)

4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to?

FHIR version R4

4c. FHIR Profiles Version

FHIR version R4

5a. Project Intent

Create new standard

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

Center for Medicare and Medicaid Services (CMS), Office of the National Coordinator (ONC), Department of Veteran Affairs (VA)

6b. Content Already Developed

25%

6c. Content externally developed?

No

6e. Is this a hosted (externally funded) project?

Yes

6f. Stakeholders

Clinical and Public Health Laboratories, Quality Reporting Agencies, Regulatory Agency, Standards Development Organizations (SDOs)

6g. Vendors

Pharmaceutical, EHR, PHR, Health Care IT

6h. Providers

Emergency Services, Healthcare Institutions (hospitals, long term care, home care, mental health)

6i. Realm

U.S. Realm Specific

7a. Management Group(s) to Review PSS

FHIR


1a. Project Name

PACIO Project Functional Status

1b. Project ID

1571

1c. Is Your Project an Investigative Project (aka PSS-Lite)?

No

1d. Is your Project Artifact now proceeding to Normative directly or after being either Informative or STU?

No

2a. Primary/Sponsor WG

Patient Care

2b. Co-Sponsor WG

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request formal content review prior to ballotRequest periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2d. Project Facilitator

Dave Hill

2e. Other Interested Parties (and roles)

Patient Administration Work Group, PACIO Project

2f. Modeling Facilitator

Chris Pugliese

2h. Vocabulary Facilitator

Matt Elrod

2i. Domain Expert Representative

Matt Elrod

2j. Business Requirements Analyst

Raj Mahajan

2k. Conformance Facilitator

Chris Pugliese

2m. Implementers

MITRE, MatrixCare

3a. Project Scope

Poor quality discharge information is a major barrier to safe and effective transitions. With 45% of Medicare beneficiaries requiring post-acute care (PAC) services after hospitalization, the need for a seamless exchange of health information is great.

In 2014, the Social Security Act was amended to include the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, which required the standardization and interoperability of patient assessment in specific categories for post-acute care (PAC) settings, including long-term care hospitals (LTCHs), home health agencies (HHAs), skilled nursing facilities (SNFs), and inpatient rehabilitation facilities (IRFs). It focuses on standardizing data elements in specified quality measure domains and patient assessment domains for cross setting comparison and clinical information exchange, respectively. The Act requires:

• Reporting of standardized patient assessment data through commonly used PAC assessment instruments for LTCHs, SNFs, HHAs, and IRFs
o Minimum Data Set (MDS)for SNFs
o Inpatient Rehabilitation Facility – Patient Assessment Information (IRF – PAI) for IRFs
o LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) for LTCHs
o Outcome and Assessment Information Set (OASIS) for HHAs
• Implementation of data elements specified in each assessment domain using standardized data elements to be nested within the assessment instruments currently required for submission by LTCH, IRF, SNF, and HHA providers
• Data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

Required assessment content includes standardized questions and response options (aka “data elements”) for assessing a patient’s functional status.

This project seeks to:
(1) determine the data model required to comprehensively exchange functional status information between health care settings,
(2) develop FHIR Implementation Guides, Profiles, and necessary Extensions to specify how to syntactically and semantically exchange that data between care settings, (3) develop client and server reference implementations to validate the Implementation Guide, Profiles, and Extensions work in a software system, (4) develop automated test suites to validate operation, and (5) build real world pilots that successfully demonstrate the new capabilities in production.

3b. Project Need

Interoperability challenges persist in post-acute care; providers are not receiving complete and accurate information in a timely manner, leading to patient harm, adverse outcomes, and additional expense. Failure to exchange accurate, timely data often leads to inefficient workflows, duplicative data entries, and increased risk of patient harm attributable to missing or inaccurate information. Health IT can significantly alleviate this administrative burden by exchanging post-acute care assessments and associated clinical information between care settings to ensure that the receiving care setting has all of the relevant information they need to best treat the incoming patient, improving patient outcomes, reducing provider burden, improving cost efficiencies, and improving workflows. Moreover, it would allow for advanced computability, standardization, usability, and real-time analytics for PAC facilities, enabling broader use by health IT developers, researchers, providers, and payers.

3c. Security Risk

Yes

3d. External Drivers

The IMPACT Act requires data to be standardized and interoperable to allow exchange of data between PAC providers, among others, using common standards and definitions to provide access to longitudinal information and facilitate coordinated care.

3e. Objectives/Deliverables and Target Dates

Project Scope Statement Due: 2019 Oct 4
FHIR IG Proposals Due: 2020 Feb 16
Notice of Intent to Ballot: 2020 Mar 1
FHIR Ballot Core Substantive Freeze: 2020 Mar 13
Initial Content Deadline: 2020 Mar 15
Reconciliation Deadline and Ballot Preview Period: 2020 Mar 22
Final Content Deadline: 2020 April 5
Ballot Readiness Sign Off: 2020 Apr 10-11
Ballot Open for Voting: 2020 Apr 10 – 2020 May 11

3f. Common Names / Keywords / Aliases:

PAC Assessments 1) Resident Assessment Instrument (RAI) Minimum Data Set (MDS) used by Skilled Nursing Facilities (SNFs) 2) Inpatient Rehabilitation Facility – Patient Assessment Information (IRF-PAI) used by IRFs 3) LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) used by Long-Term Care Hospital (LTCHs) 4) Outcome and Assessment Information Set used by Home Health Agencies (HHAs)

3g. Lineage

N/A

3h. Project Dependencies

To be determined

3i. HL7-Managed Project Document Repository URL:

To be determined

3j. Backwards Compatibility

No

3l. Using Current V3 Data Types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

To be determined

3o. Earliest prior release and/or version to which the compatibility applies

N/A

4a. Products

FHIR Implementation Guide, FHIR Profiles, FHIR Resources, Guidance (e.g. Companion Guide, Cookbook, etc)

4b. For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to?

FHIR version R4

4c. FHIR Profiles Version

FHIR version R4

5a. Project Intent

Create new standard

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

Center for Medicare and Medicaid Services (CMS), Office of the National Coordinator (ONC), Department of Veteran Affairs (VA)

6b. Content Already Developed

25%

6c. Content externally developed?

No

6e. Is this a hosted (externally funded) project?

Yes

6f. Stakeholders

Clinical and Public Health Laboratories, Quality Reporting Agencies, Regulatory Agency, Standards Development Organizations (SDOs)

6g. Vendors

Pharmaceutical, EHR, PHR, Health Care IT

6h. Providers

Emergency Services, Healthcare Institutions (hospitals, long term care, home care, mental health)

6i. Realm

U.S. Realm Specific

7a. Management Group(s) to Review PSS

FHIR