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Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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

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

Meeting Minute Approval

2023-01-09 National Directory Meeting

2023-01-12 National Directory Meeting

Both dates approved by unanimous consent

Project Links

Project Page: National Healthcare Directory

Project Scope Statement: National Healthcare Directory PSS

Implementation Guides:

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

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

Predecessor work that this effort builds upon:



Milestones

Sept 2022 Ballot Cycle Milestones

Milestone
Ballot VotingComplete
Ballot ReconciliationIn Progress


Tentative: May 2023 Ballot Cycle Milestones

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





Announcements





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

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

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

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


Agenda








Track report out from Connectathon (Ming)

Questions, discussions re: meeting

Connectathon:

  • 2 breakout sessions - testing with RI, can perform search and validate and debug. Had 2 issues with search parameters - defined incorrect in IG. Successfully able to have endpoints loaded for payer to payer exchange, export, validation based on profiles in IG 
  • Exchange must update parameter questions
  • Several meetings re: endpoint security & exchanges; received input, will have ongoing conversations

WGM -

  • Discussed payload type and mimetype & resolution passed to combine as 1, will go to base in R5
  • Conversations with Human services re: merging directories
  • Aegis had  meeting re: versions, how the IG will be able to test for conformance, must-support discussions, consent restrictions, resource permissions in addition to consent (see the need, concern around patient-centric issues, introduced new resource for R5 or R6 to address registry information need for patients)


LN looking for roadmap 12-24 months out to when we plan to ballot guide, changes expected, etc. Plan to ballot in May 2023. RD: No additional ballots planned, just planning feedback from implementations. 

LN: Is internal update process or attestation of updated information as part of scope for IG. RD: Process by which information gets updated is operational for Directory.  Process stage is likely missing from picture below. 


LN: Scenario Step 3 Query Bulk Data endpoint from Connectathon - RD: tools that can go into query, was used back in September connectathon. 

TZ: Since this is now a consolidated project, should we review scope? Might need concise, clearer scope description. RD: scope is updated. Details behind the scope likely needs more clarity. 



Ballot reconciliation

FHIR-38606 - Move base profiles to separate IG

  • From before we consolidated IGs.
  • RD: will retract the vote. Proposed disposition - not persuasive. Noting we agreed to combine 3 IGs into 1.
  • Description: Defined the base resources in a well defined section of the guide.
  • Grouping: ready for vote


FHIR-38546 PractitionerRole.code versus PractitionerRole.specialty

  • Came from pdex - we did the same thing as pdex because US Core 3.1.1 treated it in a way we couldn't use
    • US Core defined valuesets - limited differently
    • We are not pulling from US Core - therefore have the liberty of changing; ticket is pointing out specific values they want to see in the valuesets
    • MB: tasked with creating a ticket noting that the valuesets do not support social services
    • Plan Net represents payers - described use case and require valuesets 
    • Ours needed to be extensible
  • Proposed disposition - persuasive with modification
  • Change impact: compatible, substantive
  • Description: value sets were inherited from Plan Net. The ND has a need to expand the scope of both .code and .specialty value sets beyond that defined in either US core or Plan Net. We will change the binding of both value sets to extensible and expand the value sets based on feedback during the next ballot cycle. 
  • Grouping: Ready for vote
  • LN: Good work for National Direct group - could build out the extensible valueset; need to open for other use cases
    • MB: agrees; LN and MB will work on this
  • Timeline - submit ballot comment against the guide re: need for expansion 
  • TZ: once we put as extensible and give to implementers, is there accountability re: their ability to add new code values, will there be review to look for overlap? semantic interoperability will be assured?  RD: if there is a value that already describes semantically what you're trying to achieve, you have to use it. Reviewed by THO. 


FHIR-38522 3855 Duplication of Code System across IGs. Same code systems exits in multiple IGs by the same author

  • Resolution: Persuasive with modification
  • Description: we are combining the 3 IGs into 1 and the base profile definitions will indicate the value sets and code system for each of the required/must support elements. Additionally, profiles in the new IG will all be based on the base profiles and therefore avoid the problem with multiple IG and independent references to value sets in each
  • Change impact - not substantive
  • Grouping: ready for vote


FHIR-38362 - Introduction language should be tailored for this IG

  • Resolution: persuasive with modification
  • Description: since we are combining the 3 IGs into 1 the descriptions (including technical descriptions) will be updated to accurately reflect the overall approach to the ND and each section (e.g., attestation, verification) will add additional description information as well as specific use cases and examples. 
  • Change category: clarification
  • Change impact: non-substantive
  • Grouping: ready for vote


FHIR-38361

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


FHIR-38359

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

ManagementNext Agenda

Future meetings:

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

 Adjournment
Adjourned at at 1:05 PM ET

Supporting Documents

Outline Reference

Supporting Document

Presentation


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