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Objective:

Support the portability of coverage by exchanging information between payers to define decision making and supporting documentation with regard to treatment for chronic illnesses without the need to burden the provider and/or patient or risk a discontinuity of care.


Workflow (click on the image to enlarge it)

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Benefits

Supports continuity of treatment when patients enroll with a new payer by enabling a transfer of “current active treatments” between the prior payer and the new payer

Reduces the need for providers and/or patients to resubmit supporting documentation to the new payer in order to continue patient treatment

Reduces interruption in care plan and medication adherence

Reduces waste and rework by all parties


January 2020

STU1 Ballot Reconciliation:

  • JIRA Dashboard Link coming soon

Reference Implementation:

Test Scripts: Touchstone_DaVinciPCDE_Scripts

Zulip Channel: https://chat.fhir.org/#narrow/stream/179207-connectathon-mgmt/topic/PCDE.20Track


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Sponsoring Workgroup: FM 

Payer Coverage Decision Exchange Implementation Guide:

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Project Milestones

Milestone

Timeframe

Requirements

May - July 2019
FHIR Gap AnalysisMay - June 2019
Profile and Operation DevelopmentJune - July 2019

Test Case Development

Aug - Sept 2019
HL7 FHIR ConnectathonSept 2019
Reference ImplementationJuly - August 2019
STU BallotSeptember 2019
CMS Connectathon



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Conference Call Sign Up

HL7 Conference Call Center

Da Vinci Conference Call Sign Up Instructions


Conference Call Schedule & Dial-Ins

Fridays at 2pm Eastern

Please join my meeting from your computer, tablet or smartphone.

https://global.gotomeeting.com/join/871056477

You can also dial in using your phone.

United States: +1 (571) 317-3112

Access Code: 871-056-477


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September Ballot Project Milestones

Milestone

September Ballot Deadlines (2019)

Notice of Intent to Ballot

June 30, 2019
Ballot Signup StartsJuly 8, 2019

Initial IG Content

July 14, 2019
Ballot QA PeriodJuly 21, 2019

Final IG Content

August 4, 2019

Ballot Voting Starts

August 9, 2019

Ballot Voting Ends

September 9, 2019

Ballot Reconciliation Starts

September 2019

Publish IG STU1

Oct/Nov 2020
Ballot Project Milestone Goals coming soon.H2 2021




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PCDE Team:

RoleName OrganizationEmail 
Project Co-LeadIBCNita.Thingalaya@ibx.com 
Implementation Guide LeadLloyd McKenzieGevity
Implementation Guide Co-AuthorJean Duteau

jean@duteaudesign.com

Reference Implementation Co-Lead@Joe MinieriMITREjminieri@mitre.org 
Reference Implementation Co-LeadMITREmayT@mitre.org
Business Process SMERobert DieterleEnablecarerdieterle@enablecare.us
Program ManagerJocelyn KeeganPoint of Care Partnersjocelyn.keegan@pocp.com
Technical DirectorDr. Viet NguyenStratametrics vietnguyen@stratametrics.com 
Project ManagerDana MarcelonisVanessa CandeloraPoint of Care Partnersdanavanessa.marcelonis@pocp.comcandelora@pocp.com 




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Historical Milestones Met:

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HistoricalMilestones
HistoricalMilestones

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