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The goal of this use case is to reduce provider burden and simplify process by establishing electronic versions of administrative and clinical requirements that can become part of the providers workflow.  An exemplar for this use case is to follow the approach taken to incorporate formulary requirements interactively into the medication selection process. Proposal includes the ability to inject payer coverage criteria into provider workflows akin to clinical decision support (CDS Hooks), to expose rules prospectively while providers are making care decisions.

Sponsoring Workgroup: Clinical Decision Support

Documentation Templates and Rules Implementation Guide:

Project Milestones




Profile and Operation DevelopmentMarch 2019

Test Case Development

ConnectathonMay 2019
Ballot for CommentMay 2019
Reference ImplementationMay 2019
STU BallotSeptember 2019

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May Ballot Milestones


May Ballot Deadlines (2019)

PSS Sponsor Approval

January 27, 2019

Notice of Intent to Ballot

February 17, 2019

Initial IG Content

March 3, 2019

Final IG Content

March 24, 2019

Ballot Voting Starts

March 29, 2019

Ballot Voting Ends

April 29, 2019

Ballot Reconciliation Starts

May 5, 2019

Ballot Reconciliation CompleteJuly 21, 2019

September Ballot Milestones (STU)


September Ballot Deadlines (2019)

Project Scope Statement (PSS)April 7, 2019
Notice of Intent to Ballot (NIB)June 30, 2019
Ballot signup startsJuly 8, 2019
Initial contentJuly 14, 2019
Ballot QA period startsJuly 21, 2019
Final contentAugust 4, 2019
Ballot voting startsAugust 9, 2019
Ballot voting endsSeptember 9, 2019


RoleName OrganizationEmail 
Project LeadRobert (Bob) Dieterle Enable
Clinical Process SME Dr. Viet NguyenStratametrics 
Development Lead 

Larry Decelles
Program ManagerJocelyn KeeganPoint of Care
Project ManagerDana MarcelonisPoint of Care Partners

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  1. Location of Draft IG for Documentation Templates and Payer Rules -