Chair: Mark Scrimshire

Scribe: Crystal Kallem 


 Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Management

Review ANSI Anti-Trust Policy


Announcements

Single meeting on Fridays from 1:00-2:00 PM ET

Zoom Meeting https://hl7-org.zoom.us/j/92482555863?pwd=TWQzVENNeStqeEpVTHdicGM2cGdMQT09 

Next PlanNet Discussion:

  • Friday, June 9th at 1:30 PM ET (during this meeting)
  • Friday, July 14th at 1:30 PM ET (during this meeting)



Planning Da Vinci IG Implementation Testing?

Learn More here: Open Testing Tools - Build and Validate with Touchstone

The Touchstone Support team and Da Vinci Test Script authors are available to answer questions and provide support with testing Da Vinci Test Scripts in Touchstone.  Please don't hesitate to reach out to Touchstone_Support@AEGIS.net.



Upcoming CMS HL7 FHIR Connectathon (Virtual Testing Event)

Join developers, programmers, technology experts, analysts, and CMS colleagues to learn about and test emerging Fast Healthcare Interoperability Resources (FHIR) Application Programming Interfaces (APIs) and supporting FHIR Implementation Guides (IGs) at the 2023 CMS and HL7 FHIR Connectathon.

Kick-off for PDex Track is proposed to take place on June 16th from 1pm - 1:30pm ET during our weekly call.



Save the Date: HL7 Meetings, Phoenix, AZ

  • HL7 FHIR Connectathon, Sept 9-10, 2023
  • HL7 Working Group Meeting, Sept 11-15, 2023

Register before Friday, August 18th to take advantage of the early bird rate.


CMS Connectathon Planning


We have sent out some emails to those who have registered. Registrants have opportunity to select all tracks of interest but it's unclear if folks are coming to test or observe. If you receive an email from us, please respond with your plans, especially if you plan to test. Preparation is key to a successful testing event. 

PDex IG Tickets

Latest CI Build - 2023-06-09: https://build.fhir.org/ig/HL7/davinci-epdx/PayerToPayerExchange.html

New Section to Payer-To-Payer Page: https://build.fhir.org/ig/HL7/davinci-epdx/PayerToPayerExchange.html#trust-framework

mTLS examples currently removed. Build is clean. Next step is to add back in updated mTLS examples.

Unresolved:

T Key Summary Assignee Reporter P Status Resolution Created Updated Due
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Latest Change History: http://build.fhir.org/ig/HL7/davinci-epdx/ChangeHistory.html


  • Trying to get the PDex IG ready for publication. Mark posted an update to the CI Build this morning. 
  • Corey also added a ticket requesting narrative stating that the PA profile also applies to the payer to payer use case.
  • To get the IG to a point where it's clean of errors, had to remove the mTLS examples. Mark will begin to add them back in to see if he can resolve the errors that were occurring. 
  • Mark also needs to suppress the warnings; don't just suppress them, make sure you can back up why they are suppressed and not addressed. 
  • Two steps toward publication - will have to take the changes to FM for review and then submit for publication
Plan Net Discussion Topics

Healthcare Services and Plan Net Value Sets

  • The Human and Social Services WG has sponsored a Human Services Directory IG; took approach to derive from PlanNet IG. In doing so, selected three profiles from PlanNet IG (e.g., healthcare service, organization). Extensible bindings associated with these value sets. Prior to ballot, lots of discussion about the value sets - they were based on human and social service taxonomies. In Dec, the publisher did not catch the fact that they could add an override extensible bindings. Went into ballot with example bindings in the ballot. The healthcare service profile was derived from PlanNet and should have gotten an error. Received a ticket to include PlanNet in our bindings since derived from the guide. Objections from implementing the PlanNet bindings. Trying to identify options to reconcile the ballot. The concept of introducing an abstract profile for healthcare service to PlanNet, could help maintain alignment with PlanNet IG. Purpose is to integrate social services referrals into the the healthcare payer environment. Thought that the alignment would provide a base of implementers already. Goal was to ask this group for feedback. This would enable the group to move forward, complete ballot reconciliation.
  • Rick expressed some concerns. We currently have no defined plan to update  the PlanNet IG. If choosing completely different terminology, then your compatible with PlanNet is abstract; not compatible with implementable instances.
  • Bob asked if HL7 has agreement/written understanding with 211LA. At time of SDOH IG, they did not and had to take it out. Unless there is an agreement with terminology owner, you can't include in the IG anyway.
  • Brian noted that the issue isn't merely to extend PlanNet vocabularies with 211LA. Even within 211, the use of terminologies is not consistent. They extend with local codes. It's not even the defacto standard. How do we get a Human Services Directory IG written that is flexible to allow implementations of a standards based directory while allowing the approach to curation of vocabularies.
  • You can't reference any taxonomy that isn't HL7 or with orgs that HL7 doesn't have an agreement with.
  • But existing PlanNet types and categories could be given a binding of example which would then open
  • You can't publish with a binding of example. Yes you can. Serafina has received approval from FMG. Da Vinci has this requirement.
  • Through reconciliation there will be at least one human services taxonomy. There have been ongoing discussions between Dan V. and 211. It's still an ongoing conversation. FMG and 211 approved reference to a set of codes in the guide (value set rules text). Understand that before we can publish, have to have an SOU.
  • Could leave category alone and put all codes into a slice on type. That would be compatible with PlanNet.
  • There is a ticket asking that restriction on category be changed to a slice which would allow other categories on other bindings. Bob noted this was done at the request of payers who created PlanNet. Rick said it can be done with a slice to mandate that you must select one of those and then not prohibit. Bob noted it's not about what can be done technically, it's about what the stakeholders wanted.
  • If going to do in addition, would need to change cardinality. Would need to change to a slice, not cardinality. If we make it into a slice and say that that slice is cardinality 1:1, you could have other categories with other value sets and still be legit.
  • You can have a 1..1 slice. This is on category, with a codable concept. That would allow other categories that don't conform to that slice.
  • That's not the point, PlanNet is 1..1. It wasn't a good thing for PlanNet to have done; it's not helpful. If you have a single category, as long as what you are saying is the same thing, you can express with single category with multiple codings from different coding systems. If you want to say different things, it's not the same.
  • There is an "Other" category - but we have another ticket requesting that other be removed. Or leave it in and make it required.
  • Serafina noted that when researching approaches, as long as PDex had changes in the build, we may be able to derive based on CI Build.
  • It is possible to derive from a frozen snapshot, you cannot derive from CI Build itself. Risks - if there is a change made to Da Vinci spec for snapshot, it may get reversed.
  • Re: extensible value set, human services folks would still have to map to this value set. The problem is, they have to map to their value set and there are thousands.
  • We have other in the value set, why don't you include as part of category, another slide of type. Slice type and let them use other as category.
  • The social services directory is not the payer directory.

The group agreed to continue PlanNet discussion next week during the second half of the call to address issue tickets.


Not discussed

Plan Net IG Tickets (1:30 pm ET)

T Key Summary Assignee Reporter P Status Resolution Created Updated Due
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Not discussed

Implementer Support

Implementation Questions


  • Any timeline on real registry, real CA, real bundles? These are the implementation details needed to move this into the real world. 
  • Is there going to be a trust community, who will run it, how will it work? 
  • Where we will put it, who it will go to, etc.
  • As far as Trust Framework, don't have answers on where things stand with TEFCA. Bob will think about this further and try to bring back to the group next week. 
  • Trying to get Medicaid formulary data loaded earlier in the month. CMS requires that it's loaded within 24 hours of an update. Problem with RxNorm file which is released on first Monday of month; if holiday, it's on Tuesday. Which means there is no way to load it in 24 hour timeline that CMS requires. This is a question we need to submit to CMS. 
Chat

12:02:56 From  Crystal Kallem (POCP / Da Vinci PMO)  to  Everyone:
    Today's Agenda: https://confluence.hl7.org/pages/viewpage.action?pageId=171447871
12:03:15 From  Greg Bloom  to  Everyone:
    Hi everybody. New here. I’m Greg Bloom of the Open Referral Initiative, I have been advising on the HSD IG
12:03:36 From  Crystal Kallem (POCP / Da Vinci PMO)  to  Everyone:
    Thanks for joining, Greg!
12:04:39 From  Crystal Kallem (POCP / Da Vinci PMO)  to  Everyone:
    Please take a moment to update your Zoom profile with your full name and organization. You can do this by selecting the three dots to the right of your name.
12:08:17 From  Amrit  to  Everyone:
    Hi All.  New to supporting PDEX at work, joined to learn! and stay on top of it.
12:08:19 From  Demri Toop Henderson, EMI Advisors  to  Everyone:
    Hi everyone, Demri Toop Henderson with EMI Advisors. We have been working closely with Serafina and the FEI team on the HSD IG
12:08:21 From  Brian Handspicker - Open City Labs  to  Everyone:
    Brian D. Handspicker, CTO, Open City Labs - considering participating in the Connectathon
12:08:37 From  Amrit  to  Everyone:
    From Optum Technology.  Minnesota.
12:08:50 From  Serafina Versaggi FEI/BookZurman  to  Everyone:
    The HSS WG has requested a new profile for Planned IG; the invitation was forwarded by cochairs of the HSS WG to other members as well
12:09:05 From  Serafina Versaggi FEI/BookZurman  to  Everyone:
    Plannet :-)
12:09:27 From  Michelle Zancan-HL7 HSS WG - Zane Networks, LLC  to  Everyone:
    Michelle Zancan, RN, BSN - Work with the HSS WG and was invited to this meeting by Serafina
12:09:29 From  Serafina Versaggi FEI/BookZurman  to  Everyone:
    30 minutes into the hours
12:10:43 From  Gordon Campbell - FEI Systems  to  Everyone:
    Will be back at 1:30
12:11:40 From  Brian Handspicker (Open City Labs)  to  Everyone:
    BTW, as context, Michelle Zancan, Courtney Baldridge, and I are also co-chairs of HSSWG here in support of the proposal to add an HSD Profile to Plannet.
12:13:56 From  courtney Baldridge  to  Everyone:
    Courtney Baldridge, USAging, HSSWG co-chair and here to support the proposal to add an HSD Profile to Plannet as Brian noted above.
12:14:35 From  Mark Neumuth - Aetna  to  Everyone:
    I have a question regarding NIH timing of the RxNorm file and the challenge of loading our Medicaid Formulary data within the timeframe CMS requires.
12:15:37 From  Mark S(Onyx/Da Vinci PDex)  to  Everyone:
    http://build.fhir.org/ig/HL7/davinci-epdx/
12:40:28 From  Greg Bloom  to  Everyone:
    The articulated use cases for the HSD IG could potentially involve actual implementation with a Plan-Net directory, but also might involve various other implementations that do not. If implementers are required to use the PDEX categories, the only ones who can be expected implement this will be those who want to use the PDEX categories/types. (I’m not aware of any such use cases, fwiw.)
12:41:03 From  Greg Bloom  to  Everyone:
    In the long run, we do care about semantic interoperability and want to promote alignment among these vocabularies. That work is being done elsewhere, and we’re not prepared to force through a simplistic requirement here.
12:49:32 From  Greg Bloom  to  Everyone:
    Glad we got some jokes
12:50:57 From  Brian Handspicker (Open City Labs)  to  Everyone:
    Making the category vocabulary "required" would eliminate the potential for addition of socialcare services to a Plannet directory.
12:53:15 From  Brian Handspicker (Open City Labs)  to  Everyone:
    And therefore we could not base HSD on Plannet as inherited from. We could still mirror Plannet/copy it with our own changes/bindings.  But that wouldn't be in the long-term interests of interoperability between now independent healthcare service directories and socialcare service directories. That would be a major issue for payers that are trying to look up Home and Community Based Services that are socialcare oriented rather than healthcare oriented.
12:59:42 From  Brian Handspicker (Open City Labs)  to  Everyone:
    For example aligning HSD categories with SDOHCC IG service request categories https://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/StructureDefinition-SDOHCC-ServiceRequest.html
13:01:20 From  Michelle Zancan-HL7 HSS WG - Zane Networks, LLC  to  Everyone:
    tHANK YOU

 Adjournment

Adjourned at 2:01 PM ET

Outline Reference

Supporting Document

PDex Companion Guides

PDex IG Companion Guide List

PDex IG Companion Guide - Laboratory Reporting Resources

Da Vinci is seeking answers to open questions and clarifications needed on the implementation and operational needs of the upcoming CMS Patient Directed API Rules.

Find initial questions and corresponding answers shared from our colleagues at CMS here

Links to Published IGs

Other Links:

Source code is here: https://github.com/HL7/davinci-epdx

Payer-Payer Trust outline: Payer-Payer Trust V3.docx

Implementer Resources

Da Vinci Implementer Support Page 

Implementers can take advantage of tools: See the Reference links on the Payer Data Exchange (PDex) page to access links for Reference Implementations, sandboxes, test scripts, and more!

Da Vinci PDex for Patient Access API Frequently Asked Questions (FAQs)

CMS Final Rule Questions and Answers log

ONC FAST National Healthcare Directory (including end points) solution page that includes links to everything (solution doc, Connectathon, HL7 workgroup, etc.): https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/National+Healthcare+Directory

For questions, reach out to us on Zulip:

Formulary STU 1.1.0 Overview

Formulary - Searching by DrugName.docx

Recording of Formulary Tickets for STU 1.1.0 Overview

PDex Future Enhancements

PDex Future Enhancements

Action items

  •  

Attendees =

PresentNameAffiliation
PresentNameAffiliation
PresentNameAffiliation
  •  
ONC
  •  
Jacki HemenwayUPMC
  •  

  •  
Cambia Health
  •  
Jamie Smith

IQVIA


  •  
Naveenkumar Mani Anthem
  •  
Andrea Preisler AHA
  •  
James DerricksonIntersystems
  •  
Nehal AminCVS Health
  •  
Anthony Omosule

  •  
Janice HsiehAetna
  •  
UnitedHealthcare
  •  
Edifecs
  •  
Jarrett Cox

  •  
Nitin SahasrabudheCVS/Aetna
  •  
Ancel Salunga





  •  
MaryKay McDanielMarkam
  •  
Balaji NarayananOnyx
  •  
Jaspreet Kaur

  •  
Parth GabhawalaAetna/CVS Health
  •  
Barbara Doyle

  •  
Jamie ParkerAEGIS
  •  
Peter Gunter VA
  •  
Evernorth
  •  
Lantana, FM Co-Chair
  •  
Prabal Basu 
  •  
EnableCare
  •  
AEGIS
  •  
Rachel E. FoersterRFA Ltd
  •  
Brandon Raab 

  •  
Jim Iverson

  •  
Raj SankuratriAetna
  •  
Brian HandspickerOpen City Labs




  •  
Ravi ThakkarAetna
  •  
Brandon StewartLantana
  •  
Joanna ChanLantana
  •  
Richard AmbercrombiePalmetto GBA
  •  


  •  
Joe Joseph Quinn SmileCDR
  •  
Rick Geimer Lantana
  •  
Bruce WilkinsonBenmedica
  •  
Joel HansenCVS/Aetna
  •  
AEGIS
  •  
Bryan Briegel IBM Watson Health




  •  
CVS/Aetna
  •  
Caleb SuggsUPMC
  •  
Kanchan Kavimandan

  •  
Rosaline Shaw Elevance Health
  •  
Carie Hammond Aegis
  •  
Evernorth
  •  
Leavitt Partners/ CARIN Alliance
  •  
Smile CDR
  •  
Karen Landin

  •  
AEGIS
  •  
HealthLX
  •  
Kassie MintesnotLantana
  •  
Aetna/CVS
  •  
BCBSAL
  •  
Kate Dech 

  •  
Kaiser Permanente
  •  

Elevance


  •  
Kelli FordahlEvernorth
  •  

  •  


  •  
BCBS SC
  •  
Serafina Versaggi FEI/BookZurman




  •  
Kyle Brew 

  •  
Shamil Nizamov SmileCDR
  •  
Clarissa WinchesterBCBSAL
  •  
LakshmiAetna
  •  
CMS
  •  
Lantana
  •  
Linda

  •  
Elevance Health
  •  
Court Collins

  •  
Dogwood
  •  
Shital Patil
  •  
Courtney BlandCVS/Aetna
  •  

Malcolm McRoberts



  •  
Sonja Ziegler Optum
  •  
Crystal Kallem POCP, Da Vinci PMO
  •  

Manish Agarwal



  •  
Spencer Utley Epic




  •  
Margaret CouttsEvernorth
  •  
Stanley Nachimson Nachimson Advisors
  •  
Damian SmithEvernorth
  •  
 Aetna
  •  
IBM




  •  
Leavitt Partners/ CARIN Alliance
  •  
Sean Muir
  •  
Dan Cinnamon 

  •  
Onyx
  •  
Susan CromwellIBM




  •  
Matthew MosierOnyx
  •  
BCBST
  •  
Aetna/CVS Health
  •  
Michael J. Cox Onyx
  •  
Tanner FuchsCAHQ CORE
  •  
United
  •  
Peraton
  •  
Evernorth
  •  
SmileCDR
  •  
ZeOmega
  •  
Traci O'Brien
  •  
Divya Pahilwani

  •  
MicheleCareEvolution
  •  

Tulsi

Aetna
  •  
Donna Haid

  •  
Michelle BarryAvaility
  •  
Vency MenezesCNSI
  •  
Demri Toop HendersonEMI Advisors
  •  
Michelle Benz

  •  
VijayCVS Health
  •  

Doug Williams



  •  
Mike Evans

  •  
AEGIS
  •  

Gordon Campbell

FEI Systems
  •  
Lantana
  •  
Yukta BellaniEvernorth/Cigna
  •  
Evernorth/Cigna
  •  
@Muhammad Muddassar Ali

  •  
UdyAetna/CVS
  •  
Farheen Khalil

  •  
Gregg BloomOpen Referral Initiative
  •  
Richard RogersAvaility
  •  
Gregg JohnsonBCBS SC
  •  
AmritOptum Technology
  •  
Ami PatelACL
  •  


  •  
Michelle ZancanZane Networks, LLC 
  •  
Chirag BhattFEI Systems