2022-11-02 CDex/HRex Meeting

Review ANSI Anti-Trust Policy

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Block Vote 1: We have prepared proposed dispositions for 31 trackers from the CDex September 2022 Ballot. This Block Vote will take place on the November 14th Patient Care 2nd Monday Co-Chair Call. Many of these comments have been discussed on Da Vinci CDex calls. If there are any items that you would like withdrawn from the block vote for further discussion, please contactEric Haasor respond on the Zulip stream.

Read the full announcement in Zulip: https://chat.fhir.org/#narrow/stream/180805-Da-Vinci-CDex/topic/CDEX.20Sept.20.202022.20Ballot/near/306794622 

• Eric reviewed the Connectathon track page with the group
• Seeking participants who are willing to test - if you are interested, reach out to Eric Haas 

Continue the discussion from 10/19:

• https://jira.hl7.org/browse/FHIR-38588 (Celine Lefebvre)

Key: Summary (Reporter) Resolution

-----deferred from last week ----

FHIR-38588 - Getting issue details... STATUS

• This ticket relates to the Background Section 
• Eric drafted a proposed resolution 
• Celine's point is if PA can be sent without human intervention, you would want data to show that EHR is the source. The proposed revision doesn't necessarily capture this point.
• As a business use case, we aren't making the rules - smaller providers may not have an EHR system; data could come out of a practice management system.
• Want to mitigate situation where provider would have to sign off on everything. 
• Not trying to provide guidance; just trying to provide background information.
• Bob questioned whether the paragraph adds any value. We aren't dealing with HIEs so why do we care? Recommends we remove it.
• Celine and Christol agreed to remove the paragraph.
• Amol asked if removal of the paragraph effects position on adding provenance? 
• Don't say that you have to use provenance. It can be requested. 
• No other questions or concerns raised. 
• Ticket marked ready for vote

FHIR-38325 - Getting issue details... STATUS

• This is a duplicate; has already been discussed.

FHIR-38585 - Getting issue details... STATUS

• The group reviewed proposed resolution 
• Celine noted that the concern is the work involved in building out the CRD and DTR and that people will just use CDex and never move to the others
• Don't want to open the door on using CDex as a CRD prefetch. Don't want to open the door to this. 
• In CDS Hooks, if you don't support pre-fetch, you just request the access token and read from the resources directly. 
• CRD services will not use CDex to get data. 
• We don't need pre-fetch to have CRD work just fine. 
• But you have to have an access token and not all can issue an access token. 
• Access token is required for CRD. 
• Better to frame the language in CDex to indicate that the process envisioned by CRD and DTR will not result in all needed information being available to the payer for PA evaluation and claims processing and in those circumstances, CDex provides a mechanism to make this happen.
• Bob suggested updating the examples for each bullet. He will draft some examples and bring back to the group for review. 

FHIR-38320 - Getting issue details... STATUS  

• Isaac also has a ticket which gets at Andrea's concern in this case (https://jira.hl7.org/browse/FHIR-38188)
• Would like the IG to clarify when needed
• What authority does CDex have to establish rules for when payers want signatures? 
• CDex doesn't have authority, but feel should include a policy statement on intended use
• Could include a statement like, "the inclusion of signature capability in this IG should not be interpreted as advocating for their use, but rather support of a technical mechanism for allowing them when business requirements mandate their use."
• Peter offered some language in the chat
• Updated the disposition in Isaac's ticket
• Andrea's ticket will be marked duplicate of this one. 
• Eric will confirm that Isaac is ok with this revised disposition.

JIRA Dashboard shows all Feedback received and results of the September Ballot: https://jira.hl7.org/secure/Dashboard.jspa?selectPageId=11801