|Project facilitator (1Mandatory)||Robert Dieterle, Viet Nguyen, David Degandi|
Other interested parties and their roles
Viet Nguyen, Lloyd McKenzie and Mike Flanigan (technical FHIR support)
Multi-disciplinary project team (recommended)
Lloyd McKenzie, Nagesh Beshyam, Brett Marquard
Domain expert rep
Lenel James, Robert Dieterle, David Degandi,
Business requirement analyst
Christol Green, Mary Kay McDaniel, Linda Michaelsen, Nick Radov, Amit Shah, Mary Lynn Bushman, Durwin Day, Anna Taylor, Heather Kennedy, Justin Thompson
Conformance facilitator (for IG projects)
Lloyd McKenzie, Nagesh Beshyam
Other facilitators (SOA, etc)
Implementers (2Mandatory for STU projects)
FHIR Project Note: The implementer requirement will be handled by the “balloting” project. Therefore work groups do not fill out the above section. However, feel free to list implementers specific to your work group’s resources if you know of any.
|1) Cambia Healthcare Solutions|
2) BCBS Michigan
3) United Healthcare
|4) BCBS Florida|
This PSS will enable Payers and Provider to exchange information that identifies members of a patient population associated with particular risk based contract. The solution needs to define a simple, reliable, exchange method for payers and providers to synchronize data from practice management and EHRs, and to enable providers and payer organization to validate enrollment in Value-Based Care (VBC) programs at the point of care and for population level program management. The information that will be exchanged should be sufficient to identify a specific existing patient for inclusion in a risk based contract or create such a patient in the PM/EHR if the patient does already exist and the PM/EHR has the capability.
Workflow will be defined to initiate the exchange process automatically (e.g. CDS Hooks) or via an explicitly triggered request.
In addition, guidance will be provided for the use of these member lists to establish the scope of exchanges of provider and payer information defined in other Da Vinci implementation guides using the FHIR Bulk Data standards.
This PSS builds on the HRex implementation guide for the automated exchange of information between a payer and provider using standard profiles and constraints on existing exchange methods.
This project will reference, where possible the "standards" defined by the Health Record exchange (HRex) Library/Framework Implementation Guide which in turn will utilize prior work from Argonaut, US Core and QI Core effort for FHIR DSTU2, STU3, and R4 where appropriate. The following diagram depicts the anticipated scope of the HRex Library/Framework IG.
The ultimate goal is to support the accurate and timely exchange of risk based contact member information between payers and providers to facilitate VBC programs. The secondary goal is to use these these member list to enable FHIR bulk data exchange using the standards defined by other Da Vinci implementation guides (e.g. PDex, CDex, DEQM)
The project team plans to work with existing FHIR artifacts where possible. If changes are necessary, the project team will work with the responsible Work Group to review and implement (via tracker items or new PSS) any necessary enhancements to base FHIR resources, extensions, and/or profiles.