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Chair:  Robert DieterleViet NguyenAnupam Goel

Scribe: Phung Matthews
 

Attendees

Section


Column


Present

Name

Affiliation

  •   
Enablecare
  •   
Stratametrics
  •   
Point of Care Partners
  •   
BCBSAL
  •   

Emily Calvert

CMS
  •   

Erica Ross

CMS
  •   
Heather McComasAMA
  •   
Optum
  •   

Kelly Anderson

BCBSAL
  •   
InterSystems
  •   

Mark Mundt

InterSystems
  •   
Megan SoccorsoCigna
  •   

Mike Funk

Humana
  •   
Nancy SpectorAMA
  •   
Terrence CunninghamAMA
  •   
Tori WillowsWellcare
  •   
BCBSFL
  •   
Aim/ Anthem
  •   

Marci Maisano

Cigna
  •   
Edifecs
  •   
Edifecs
  •   
United Healthcare
  •   
Anthem
  •   
Christy Dodson
  •   
BCBSAL
  •   
Laura Hoffman
  •   
WPS Health Solutions
  •   
Optum
  •   
Edifecs
  •   
CMS
  •   

  •   
CAQH
  •   
Raj
  •   
Ray WilkersonScope Info Tech
  •   
BCBST
  •   
Taha AnjarwallaCAQH
  •   
Tom
  •   
Sonja Ziegler
  •   
Intersystems
  •   
Nandini GangulyEMDI/ Scope Info Tech
  •   
BCBSM
  •   
Kasi
  •   
EMDI Team
  •   
Anthem
  •   
Bart CarlsonAzuba
  •   
Cambia
  •   
Duane WalkerBCBSM
  •   
InterSystems
  •   
Tibco
  •   
Louis BedorCognosante
  •   
Anthem
  •   
CMS
  •   
CMS
  •   
IBC
  •   
Anthem
  •   
Rian
  •   
Palmetto gba
  •   
Sandeep
  •   
Sreekanth PuramMettle Solutions
  •   
Allscripts
  •   
James Gallagher Jr.Premera
  •   
Joseph Figueroa
  •   
Tony LittleOptum
  •   
Pallavi TalekarEMDI/ Scope Info Tech
  •   
Thomas KesslerCMS
  •   
Todd Omundson
  •   
ZeOmega
  •   
Emily TenEyckCAQH
  •   
Mark Taylor
  •   
Julia SkapikCognitive Medicine
  •   
Michael BrodyCME Online
  •   
Michelle ZuttermanHumana
  •   
Surescripts
  •   
Laurie DarstMayo
  •   
Marianna SinghCAQH
  •   
Labcorp
  •   

  •   
Mariana SinghCAQH
  •   
Madhuri
  •   

  •   
Bob THompson
  •   
Ben LangleyMITRE
  •   
Michelle PriestAllscripts
  •   
Michael Hurley
  •   
Cedars-Sinai
  •   
Roland Gamache
  •   
Dave HCRT INC
  •   
Barbara WoodPNC
  •   

  •   
Padma KondaveetiMettles
  •   
Unknown User (meryl_bloomrosen)Premier
  •   
Cambia
  •   
Judy Williamson
  •   
Matthew Maurer
  •   
Smitha HarishMettles
  •   
BC Idaho
  •   
Michael LunzerAltegra Health
  •   
Rush
  •   
Shilesh NairGdit
  •   
Steve Favilla
  •   
Optum
  •   
Texas Health
  •   
Keya ShahCasnet
  •   
Epic
  •   
Josh Lamb
  •   

  •   
Edifecs
  •   
Max MD
  •   
Allen SaundersChange Healthcare
  •   
Molly Malavey
  •   
Rich BlochLumedic
  •   

  •   
Thomas GrannanAzuba
  •   
Beth ConnorCMS
  •   
MA Health Data
  •   
Kellie Ruff
  •   

  •   

  •   
Mark Fleming
  •   
Kumar Elubandi



Column


Present

Name

Affiliation

  •   
Rachel GoldsteinCAQH
  •   
Ralph Saint-PhardHealow
  •   
Susan LestinaAHA
  •   
Briana BarnesScope Info Tech
  •   
Cerner
  •   
Cassandra Bell
  •   
Deepthi ReddyMettle Solutions
  •   
Cognosante
  •   
Humana
  •   
Prashanth Golconda
  •   
Rajesh GodavarthiMCG
  •   
Rim Cothren
  •   
Scott LawrenceCMS
  •   
Chris JonesHumana
  •   
Christina BorgLumeris
  •   
Julie MaasEMR Direct
  •   
Kathleen Connor
  •   
Matt ReidAMA
  •   
Mike BerkmanCoverMyMeds
  •   
Monse SerenilHumad
  •   
Rian RaineyCoverMyMeds
  •   
Sandra StuartKP
  •   
Sheryl TurneyAnthem
  •   
Wanda Govan-JenkinsHHS
  •   
Chris HutchinsonCoverMyMeds
  •   
Anna MeisheidCMS
  •   
Cyrus PeyrovianFastAuth
  •   
Janice BakosAetna
  •   
SureScripts
  •   
Gevity
  •   
Melanie JonesCMS
  •   
eClinicalWorks
  •   
Tammy SchreinerWPS Health Solutions
  •   
Amy PetersonHumana
  •   
Dave Trotter, MD
  •   
BCBSIL
  •   
Renee FullerIBX
  •   
Helina Gebremariam
  •   
Cambia
  •   
Intepro
  •   
Carradora
  •   

  •   

  •   
MaxMD
  •   
Cindy Monarch BCBSM
  •   
Dawn PerreaultBCBSM
  •   
Cognizant
  •   
Mitre
  •   

  •   
Missy BoserSurescripts
  •   
CAQH
  •   
Phranil MehtaeClinicalWorks
  •   
Dylan TuggleBCBST
  •   
JPSys
  •   
Mario JarrinChange Healthcare
  •   
Jim AdamsonArkansas Blue Cross
  •   
Brian PoteetBCBST
  •   
Tony LaurieNoridian
  •   
Optum
  •   
Bonnie SirottZeOmega
  •   
MCG
  •   
ESAC
  •   
Geeta KrishnanEdifecs
  •   
Katherine LuskChildrens
  •   
Michael NovalesBCBSIL
  •   
Tracey McCutcheonKPMG
  •   
Anupam ThakurBCBS FL
  •   
Cathy PlattnerKP
  •   
Srinivasarao EadaraesMD
  •   
Availity
  •   
ZeOmega
  •   
Dennis ZanettiNantHealth
  •   
Haris BegCambia
  •   
Kishore MetlaMettle Solutions
  •   
Sunitha Godavarthi
  •   

  •   
C-HIT
  •   
SriniesMD
  •   
Anthem
  •   
Kumar SourabhGRSI
  •   
Julia ChanCW Global Consult
  •   
Ric LightHumana
  •   
UHC
  •   
Anil VezendlaMCG
  •   
Ken LordBook Zurman
  •   

Scott Robertson


  •   
Christopher GraconIndependent Health
  •   
Gary GryanMitre
  •   
Mitre
  •   
Marty StaszakVoluware
  •   
Stephen ReckfordGRSI
  •   
Joe HamiltonUnity Point
  •   

  •   
Dave Foster
  •   
Betty SullivanAllscripts
  •   
Cigna
  •   
Juzer KhorakiwallaUHC
  •   
Unknown User (patricekuppe)Surescripts
  •   
Express-Scripts
  •   
Celine LefebvreAMA
  •   
Eshaa DhalleClinicalWorks
  •   

  •   
Aakash DeliwalaeClinicalWorks
  •   
Chris JohnsonBCBSAL
  •   
Megan RileyMITRE
  •   

  •   
Crystal HyattTransunion
  •   
Epic
  •   
AEGIS
  •   
BCBSM
  •   
Pawan RegmiRush
  •   
Rajesh GarlapatiRush
  •   
Rush
  •   
Scott HoltItiliti Health
  •   
Cigna
  •   
Cigna
  •   
UHC
  •   
Steve KirbyCoverMyMeds
  •   
Neena DakuaWPS Health
  •   
Evicore
  •   
Med Allies
  •   
Laurie Henson
  •   
Healow
  •   
Bapi Beshara
  •   
David Delano
  •   

  •   
Vishnu
  •  
Carmela A. Couderc
  •  
Daniel C
  •  
Swapnil
  •  
Phung Matthews




Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy

Image RemovedImage Added



Reminder: conference call structure & name changes
  1. Burden Reduction (CRD/DTR/PAS) Implementer Support Call - Wednesday, DTR time slot (11at ET)
  2. Burden Reduction (CRD/DTR/PAS) Supplemental Examples - Friday, PAS time slot (3pm ET)
  3. Burden Reduction (CRD/DTR/PAS) IG Updates/Future Requirements - call to be scheduled, Mondays at 1pm ET


HL7 Patient Access API Implementation Event

Registration: https://www.hl7.org/events/fhir/implementation/2020/

  • Virtual, August 17-19
  • 1st day - kick-off, education
  • 2nd day - education
  • 3rd day - implementation day


HL7 Sept Connectathon

2020-09 Connectathon 25



Supplemental Material
  • Available in GIT Hub as a public repository
    • Contains a mock EHR 
    • Example of a Stress ECG in form of a questionnaire 
      • first part of the questionnaire is prefilled, ie populated from FHIR resources related to observation, procedures, CQL and diagnosis
        • information is based on what is available from the EHR
      • second part of the questionnaire is not prefilled but must be filled out manually
      • once the questionnaire is filled out, it is written back as a related source
      • the questionnaire is currently built to be purely for human review and trying to keep it simple
      • potential request
        • If the answers on the questionnaire is true, could we have the ability to enter ICD-10 related codes, or have a drop-down menu with applicable ICD-10 codes.
  • Robert Dieterle will place the link for this GIT Hub example on the confluence page


Further Discussion
  • Dr. Miller mentions there is a strong interest in seeing if there is the ability to determine what requirements are needed by the Payer before starting an order request
    • For example- having the requirements (based by the Payer) present at the time of consideration of a selected procedure
  • Discussion on order select and order signed- could order select hook provide the information on requirements
    • Are there any Payer working on the order select side vs order signed?
    • Will this require a payer specific form/documentation before the order is formed?
    • Can there be an interaction during the ordering process to provide additional information and then allow the clinician to change the order?
      • There is a difference between a substitution (such as different medications within the same pharmacologic/therapeutic class) and a requirement (such as a prerequisite laboratory test) in an order


















Next agenda

Bring examples between Payer and EHR 

Further discussion on potentially updating the scope of DTR


 Adjournment

Adjourned at 4:03PM EST


Outline Reference

Supporting Document

Minute Approval


...