Chair: Mark Scrimshire
Scribe: Vanessa Candelora
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This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed." |
Minutes Approved as Presented
Agenda Topics
Agenda Outline | Agenda Item | Meeting Minutes from Discussion | Decision Link(if not child) | ||||||||||||||||
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| Management | Review ANSI Anti-Trust Policy |
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| Implementer Resources | Moved to Supporting section below! | ||||||||||||||||||
| 2021 CMS HL7® FHIR® Connectathon Overview of Track |
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| New Da Vinci Use Case | Patient Cost Transparency Use Case- Kick off public call June 25th, 2021 Fridays at 11AM Eastern- here for call details, confluence page here Kick off call started this week. Use case will mainly covering the price transparency rules for hospital and CAA. Join on Fridays. Use case will impact all providers/payers. | ||||||||||||||||||
| Today | Implementer Questions | Use Case #1: Need to develop an Advanced Search feature that may require to perform search across profiles e.g. single search that involves search using parameters such as Provider’s Name, Specialty, Health Plan, Spoken Language, Zip code or City/State and Gender. Issue/Challenge: I this case I could not figure out a single profile that can be used to perform this search. Similarly, we cannot perform search in multiple steps (searching the search result) as this will be too complex plus will not work with pagination provided via FHIR server. Discussion-
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Updates from last week. Was presented to pharmacy group and received approval.
Insurance Plan profile in Plan Net has a list code, under Insurance Plan Type or Insurance Product Type which has an extension.
Solution- set it to DRUGPOL as fixed value and use their code set. NCQA is currently using this resource to identify pharmacy plans. For Plan Net- did we determine that pharmacy was more of a health plan as it is not separate from the medical plan Are implementers already using a list for pharmacy plans? GET [base]/List?_profile=http://hl7.org/fhir/us/davinci-drugformulary/StructureDefinition/usdfCoveragePlan&identifer=[planID] could we use this code system and set to DRUGPOL. http://terminology.hl7.org/ValueSet/v3-ActCoverageTypeCode
Question- is this relevant for the shopping experience. Is there a requirement to search the medication knowledge drug without a plan ID? No strong solution, defer to STU2 to further drill down | |||||||||||||||||||
Next Steps for support of CMS-9123 Burden Reduction (pended rule) and future version of PDex guides. | Context: the NPRM identifies a requirement for payers to share the active and in process authorizations with members, providers and other payers. We're looking to exchange claim response, figure out accumulators, and how to identify the clinical data specific to the authorization. Let's talk about the elements from PCDE that are relevant to help meet this need. Change to calls going forward - we will use the former PCDE 2pm ET call time to drive the work to support the next version (HL7's STU2) of PDex, Formulary and Plan Net. Will update to weekly as well. The PDex call at 12noon ET will remain as is for Implementer Support and updates to existing version. Update 6/25/21- Put a list of enhancement together to add between now and January 22 Ballot, include updates for formulary. Enhance shopping experience and make it searier for formulary to be implemented Enhance Plan Net to include phone number and possibly looking at bulk data Enhance of PDex to see if we can include PA information, have data available to member, to payer and to next payer when member moved. Will using the current PCDE public call to start working sessions on the building the enhancements. This call will be used to continue to build implementation IG and help answers questions on the STU1. Next steps- have this ready by December to enter January ballot. Intent is to ballot new section only. Tentative date of publication for STU2 if able, end of April 22. | ||||||||||||||||||
| Next Week | Implementer Support Review FAQ Proposed Responses Review Formulary Tickets | ||||||||||||||||||
| Adjournment | Adjourned at 12:56pm EST. | ||||||||||||||||||
Outline Reference | Supporting Document |
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| Minute Approval | |
| PDex Companion Guides | |
| CARIN CPCDS to US Core Mapping | Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0818 v2.xlsx DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx |
| PDex - US Core inter-relationship |
Source PowerPoint: PDEXandUSCoreRelationship.pptx |
| Da Vinci is seeking answers to open questions and clarifications needed on the implementation and operational needs of the upcoming CMS Patient Directed API Rules. | Find initial questions and corresponding answers shared from our colleagues at CMS here |
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| Other Links: | Source code is here: https://github.com/HL7/davinci-epdx
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Implementer Resources | Da Vinci Implementer Support Page Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more! Da Vinci PDex for Patient Access API Frequently Asked Questions (FAQs) CMS Final Rule Questions and Answers log ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory |
Action items
- David Hill-Look in the coverage resource and Medication Knowledge to designate where you would include a Formulary ID.
- David Hill Create ticket for updating the definition column on the 7.26.1
- David Hill- add the second ticket referenced to the FAQ 0017 question.
- Mark Scrimshire- Add FAQ for $everything and provenance guidance - 6/11 convo today.
Corey Spears create ticket from the variation in names and what the proper names for display are
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Corey Spears create ticket on expected returns with regards to allowance for both brand and non-brand search matches.
Attendees - 31
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