Page tree
Skip to end of metadata
Go to start of metadata




1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

No

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

No

1e. Today's Date

1f. Name of standard being reaffirmed

1g. Project Artifact Information

1h. ISO/IEC Standard to Adopt

1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption?

1j. Unit of Measure

2a. Primary/Sponsor WG

Patient Empowerment

2b. Co-Sponsor WG

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2b. Co-Sponsor WG 3

Orders & Observations

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2l. Other Facilitators

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

PACP: Title: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan Document, Release 1 - US Realm STU R2
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=434

Advance Directives:
Title: HL7 CDA® R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 – US Realm
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=473

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

This FHIR implementation guide will use the US Core profiles. If this FHIR implementation guide is unable to use a US Core profile we will request approval from US Realm SC, and provide the US Realm approved rationale for deviation in the implementation guide where applicable.

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3k. Additional Backwards Compatibility Information (if applicable)

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

4c. FHIR Profiles Version

4d. Please define your New Product Definition

4d. Please define your New Product Family

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. White Paper Type

5a. Is the project adopting/endorsing an externally developed IG?

No

5a. Externally developed IG is to be (select one)

5a. Specify external organization

5a. Revising Current Standard Info

5b. Project Ballot Type

STU to Normative

5c. Additional Ballot Info

5d. Joint Copyright

No

5e. I understand I must submit a Joint Copyright Letter of Agreement to the TSC in order for the PSS to receive TSC approval.

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

6d. List Developers of Externally Developed Content

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

Yes

6f. Stakeholders

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

6h. Providers

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

6h. Other Providers

6i. Realm

U.S. Realm Specific

7d. US Realm Approval Date

7a. Management Group(s) to Review PSS

FHIR

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

7c. Co-Sponsor 4 Approval Date

7c. Co-Sponsor 5 Approval Date

7c. Co-Sponsor 6 Approval Date

7c. Co-Sponsor 7 Approval Date

7c. Co-Sponsor 8 Approval Date

7c. Co-Sponsor 9 Approval Date

7c. Co-Sponsor 10 Approval Date

7e. CDA MG Approval Date

7f. FMG Approval Date

7g. V2 MG Approval Date

7h. Architecture Review Board Approval Date

7i. Steering Division Approval Date

7j. TSC Approval Date



 Show Changes

Version

21

Modifier

Maria D. Moen

Modify Date

Oct 28, 2020 16:40

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

PACP: Title: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan Document, Release 1 - US Realm STU R2
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=434

Advance Directives:
Title: HL7 CDA® R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 – US Realm
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=473

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

This FHIR implementation guide will use the US Core profiles. If this FHIR implementation guide is unable to use a US Core profile we will request approval from US Realm SC, and provide the US Realm approved rationale for deviation in the implementation guide where applicable.

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

20

Modifier

Maria D. Moen

Modify Date

Oct 28, 2020 16:38

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

19

Modifier

Maria D. Moen

Modify Date

Oct 28, 2020 16:38

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

18

Modifier

Maria D. Moen

Modify Date

Oct 28, 2020 16:37

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

17

Modifier

Dave Hamill

Modify Date

Oct 16, 2020 18:14

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

1b. Project ID

1652

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

16

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 19:10

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

7c. Co-Sponsor Approval Date

Oct 06, 2020

7c. Co-Sponsor 2 Approval Date

Oct 07, 2020

7c. Co-Sponsor 3 Approval Date

Oct 08, 2020

Version

15

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 19:09

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Update Periods

Monthly

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 2 Update Periods

At the Care Plan WGMs and upon request

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Periodically and at design review

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities when a patient cannot communicate for themselves.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

Version

14

Modifier

David Hill

Modify Date

Oct 08, 2020 18:18

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

Community Based Care and Privacy

2b. Co-Sponsor WG 2

Patient Care

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

Version

13

Modifier

David Hill

Modify Date

Oct 08, 2020 18:16

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation IG(s) for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7b. Sponsoring WG Approval Date

Oct 01, 2020

Version

12

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 18:15

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

Community Based Care and Privacy

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2b. Co-Sponsor WG 2

Patient Care

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor Level of Involvement

Request periodic project updates; specify period in text box below (e.g. 'Monthly', 'At WGMs', etc.)

2c. Co-Sponsor 3 Update Periods

Monthly, at WGMs

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

11

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 17:59

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance directive information through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

10

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 17:37

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The FHIR IG will cover the use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-generated advance care plans through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

9

Modifier

Maria D. Moen

Modify Date

Oct 08, 2020 17:35

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: living will, durable medical power of attorney, personal health goals at end of life, care experience preferences, patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The information exchange mechanisms will make use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-centered advance care plans through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

8

Modifier

Maria D. Moen

Modify Date

Oct 05, 2020 20:16

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community, Orders & Observations WG

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: personal advance care plan (living will, durable medical power of attorney, personal health goals at end of life, care experience preferences), patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The information exchange mechanisms will make use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-centered advance care plans through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

7

Modifier

Maria D. Moen

Modify Date

Oct 05, 2020 19:50

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of advance directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent advance directive content such as: personal advance care plan (living will, durable medical power of attorney, personal health goals at end of life, care experience preferences), patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The information exchange mechanisms will make use of RESTful API interactions for query, retrieve and verification of advance directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1: Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-centered advance care plans through a patient-directed process need a way for individuals to communicate information about their advance medical care goals, preferences, and priorities.

Individuals need a way to generate and update information related to their advance directives so that their current wishes can inform provider-generated care plans.

Interoperable exchange of the advance directive information supports more effective sharing of advance directive information across transitions in care and enables practitioners to create person-centered care plans that align with a patient’s values, goals of care, treatment preferences, and quality of life priorities.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer safely interact freely with. Never before has the availability of verifiable digital advance directive information been so essential to delivering care. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

6

Modifier

Maria D. Moen

Modify Date

Oct 02, 2020 21:02

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2h. Vocabulary Facilitator

Rachel Richesson

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of Advance Directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent Advance Directive content such as: personal advance care plan (living will, durable medical power of attorney, personal health goals at end of life, care experience preferences), patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The information exchange mechanisms will make use of RESTful API interactions for query, retrieve and verification of Advance Directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-centered advance care plans through a patient-directed process need a way for individuals to communicate information about their care goals, preferences, and priorities.

Individuals need a way to generate information related to their treatment goals, preferences and priorities so that their wishes can inform provider-generated care plans.

Enabling interoperable exchange of the advance directive information allows a person's care plan to center on the individual's goals, preferences and priorities while supporting transitions in care.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer interact freely with, making the action of advance care planning more important now than ever. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

5

Modifier

Maria D. Moen

Modify Date

Oct 01, 2020 16:12

1a. Project Name

PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2i. Domain Expert Representative

Maria D. Moen

2j. Business Requirements Analyst

Scott Brown

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

This project will create FHIR implementation guidance for Advance Directives Interoperability (ADI).

It is a complex area that involves many stakeholders. The Post-Acute Care Interoperability (PACIO) Community has a strong interest in the topic of Advance Directives and will support the community engagement and technical FHIR IG development needed for Advance Directives Interoperability. PACIO is supported by MITRE, CMS, ONC and many other stakeholders (both clinical and technical).

FHIR profiles will be developed for several existing FHIR resources to represent Advance Directive content such as: personal advance care plan (living will, durable medical power of attorney, personal health goals at end of life, care experience preferences), patient instructions (obligation, prohibitions, and consent), and portable medical orders for life sustaining treatments.

The information exchange mechanisms will make use of RESTful API interactions for query, retrieve and verification of Advance Directive information between systems.

The guidance will be consistent with FHIR US Core IG and will build upon existing standards such as: HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan (PACP) Document, Release 1 - US Realm STU Release 2 August 2020 and HL7 CDA® R2 Implementation Guide: C-CDA R2.1; Advance Directives Templates, Release 1 - US Realm

Attachments

3b. Project Need

Systems used to create and update patient-centered advance care plans through a patient-directed process need a way for individuals to communicate information about their care goals, preferences, and priorities.

Individuals need a way to generate information related to their treatment goals, preferences and priorities so that their wishes can inform provider-generated care plans.

Enabling interoperable exchange of the advance directive information allows a person's care plan to center on the individual's goals, preferences and priorities while supporting transitions in care.

3c. Security Risk

No

3d. External Drivers

The aging population receiving healthcare in skilled nursing facilities and assisted living communities have been under forced isolation to reduce the risk of contracting COVID-19. During COVID as well, those requiring medical care have found themselves during a transition in care without anyone to accompany them to influence medical care or be at their side. The impact is a sense of disempowerment, isolation, and a disconnection with the world they can no longer interact freely with, making the action of advance care planning more important now than ever. The role of technology and expanded adoption by the aging population, providers, and care teams has brought to the forefront the expectation of seamless accessibility of advance directive information. An additional factor is an increased understanding that a person’s goals, preferences, and priorities for care are a critical element in a person-centered healthcare system.

3e. Objectives/Deliverables and Target Dates

FHIR IG Proposal – November 2020
Connectathon 1 – January 2021
Connectathon 2 – March 2021
Ballot an STU 1 IG – May 2021
Connectathon 3- June 2021
Connectathon 4 – September 2021
Publish FHIR IG STU1 V1.0.0 – September 2021

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACIO page (TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

N/A

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

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

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients, Providers

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

4

Modifier

Maria D. Moen

Modify Date

Sep 30, 2020 15:00

1a. Project Name

(IN PROCESS) PACIO: Advance Directives Interoperability (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2i. Domain Expert Representative

Maria D. Moen

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

TBD: FHIR IG, May 2021 Ballot, STU 1, FHIR Resources included, Use Cases

3b. Project Need

TBD:

3c. Security Risk

No

3d. External Drivers

TBD

3e. Objectives/Deliverables and Target Dates

FHIR IG, Ballot May 2021, Two Connectathon Testing Experiences (1/30/2021 and 3/30/2021), Publish FHIR IG STU1 V1.0.0 (9/30/2021), STU Ballot, Iterative Updates heading towards Normative

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACP (URL TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

TBD

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

TBD

6b. Content Already Developed

25%

6c. Content externally developed?

No

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

Yes

6f. Stakeholders

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

3

Modifier

Maria D. Moen

Modify Date

Sep 29, 2020 16:47

1a. Project Name

(IN PROCESS) PACIO: Interoperability of Advance Directives (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2i. Domain Expert Representative

Maria D. Moen

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

TBD: FHIR IG, May 2021 Ballot, STU 1, FHIR Resources included, Use Cases

3b. Project Need

TBD:

3c. Security Risk

No

3d. External Drivers

TBD

3e. Objectives/Deliverables and Target Dates

FHIR IG, Ballot May 2021, Two Connectathon Testing Experiences (1/30/2021 and 3/30/2021), Publish FHIR IG STU1 V1.0.0 (9/30/2021), STU Ballot, Iterative Updates heading towards Normative

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACP (URL TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

TBD

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

TBD

6b. Content Already Developed

25%

6c. Content externally developed?

No

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

Yes

6f. Stakeholders

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

2

Modifier

Maria D. Moen

Modify Date

Sep 28, 2020 22:34

1a. Project Name

PACIO: Interoperability of Advance Directives (in FHIR)

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

2d. Project Facilitator

Maria D. Moen

2e. Other Interested Parties (and roles)

Post-Acute Care Interoperability (PACIO) Community

2f. Modeling Facilitator

David Hill

2g. Publishing Facilitator

David Hill

2i. Domain Expert Representative

Maria D. Moen

2k. Conformance Facilitator

David Hill

2m. Implementers

ADVault, Inc.
MaxMD
Patient Centric Solutions, Inc.

3a. Project Scope

TBD: FHIR IG, May 2021 Ballot, STU 1, FHIR Resources included, Use Cases

3b. Project Need

TBD:

3c. Security Risk

No

3d. External Drivers

TBD

3e. Objectives/Deliverables and Target Dates

FHIR IG, Ballot May 2021, Two Connectathon Testing Experiences (1/30/2021 and 3/30/2021), Publish FHIR IG STU1 V1.0.0 (9/30/2021), STU Ballot, Iterative Updates heading towards Normative

3f. Common Names / Keywords / Aliases:

advance directives, personal advance care plan, patient preferences/consent, portable medical order (POLST, MOLST, etc.)

3g. Lineage

Profiles in this FHIR IG will be consistent with USCore Profiles

3h. Project Dependencies

PACIO Community schedules and participation

3i. HL7-Managed Project Document Repository URL:

PACP (URL TBD)

3j. Backwards Compatibility

N/A

3l. Using Current V3 Data Types?

No

3l. Reason for not using current V3 data types?

N/A

3m. External Vocabularies

Yes

3n. List of Vocabularies

SNOMED-CT, LOINC

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

TBD

4a. Products

FHIR Implementation Guide

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

FHIR R4

5a. Project Intent

Implementation Guide (IG) will be created/modified

5a. Is the project adopting/endorsing an externally developed IG?

No

5b. Project Ballot Type

STU to Normative

5d. Joint Copyright

No

6a. External Project Collaboration

TBD

6b. Content Already Developed

25%

6c. Content externally developed?

No

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

Yes

6f. Stakeholders

Quality Reporting Agencies, Standards Development Organizations (SDOs), Payors, Other

6f. Other Stakeholders

Patients

6g. Vendors

EHR, PHR, Health Care IT, Clinical Decision Support Systems, Other

6g. Other Vendors

Advance Directive Registries, HIEs, ACOs

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

Sep 23, 2020 13:55

1a. Project Name

PACIO Project: Advance Directives

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

2d. Project Facilitator

David Hill

3j. Backwards Compatibility

No