Approved by TSC 2019 04
Updated with new name after May 2019 WGM
Mission and Charter AWG 2019 - Mission and Charter Updates
WORK GROUP NAME to replace Attachments WG:
Payer/Provider Information Exchange (PPIE pronounced "pie")
Mission
The mission of the WG is to convene and coordinate payers, health plans, consumers, providers, and other organizations (e.g. ACOs, HIEs) to improve the administrative (not direct patient care) exchange of information for:
- Identifying gaps in care and quality Levels,
- Performing Care Overview/Oversight,
- Informing care
- Population management/overview/oversight
This may result in developing artifacts including but not limited to Implementation Guides, Health Stories, and Use Cases to support:
- healthcare claims or encounters
- healthcare services review (e.g., prior authorizations/precertification’s, referrals)
- claim audits
- coverage requirements discovery
- value based care (e.g., analytics, care management, reporting, care gaps etc.)
Charter
Our Work Group supports HL7’s mission.
Work Products and Contributions to HL7 Processes
The Attachments implementation guides are based on CDA Release 2.0 Consolidated CDA Templates built upon HL7 version 3 messaging. These guides include Document types such as, but not limited to, Continuity of Care; History and Physical; Operative Report; Progress Notes; Diagnostic and Imaging Reports; Discharge Summary; Consultation Notes; Procedure Notes; Care Plan; Dental and Unstructured Documents.
The Attachments Work Group is active in contributing to the development of the FHIR standard and participates actively in HL7 joint work group efforts. Such as:
- Attachment Collaborative Project (ACP) Informational Guide
- Value Based Care Health Story
Formal Relationships with Other HL7 Groups
The PIE Work Group coordinates its work products with other work groups such as, but not limited to; Structured Documents, Financial Management, FHIR Management, US Realm and other HL7 Work Groups, along with HL7 Da Vinci Project, Payer User Group, Payer Summit, etc. as further defined in Project Scope Statements (PSS).
Formal Relationship with Groups Outside of HL7
The HL7 PIE Work Group collaborates with other organizations under the existing HL7 SOUs.
This may include the X12 Standards Development Committee, CAQH CORE Committee on Operating Rules, American Dental Association Standards Committee on Dental Informatics (ADA SCDI), National Council for Prescription Drug Programs (NCPDP), and other standards development organizations as guided by the Board of HL7. The work group also collaborates with Workgroup for Electronic Data Interchange (WEDI) and the Regenstrief Institute in conjunction with the LOINC® (Logical Observation Identifiers Names and Codes) Committee, National Committee on Vital Health Statistics (NCVHS), and Office of the National Coordinator (ONC) P2 FHIR Task Force.