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Attention! Da Vinci will be revisiting the PCDE use case in 2023 and directing our resources to other use cases at this time. We appreciate all who contributed to PCDE thus far. If you have questions, are looking to implement, or need any support that you cannot find here, please reach out to us on this Zulip Channel, we will continue to monitor for questions.

Objective:

Support the portability of coverage by exchanging information between payers to define decision making and supporting documentation with regard to treatment for chronic illnesses without the need to burden the provider and/or patient or risk a discontinuity of care.


Workflow (click on the image to enlarge it)

Benefits

Supports continuity of treatment when patients enroll with a new payer by enabling a transfer of “current active treatments” between the prior payer and the new payer

Reduces the need for providers and/or patients to resubmit supporting documentation to the new payer in order to continue patient treatment

Reduces interruption in care plan and medication adherence

Reduces waste and rework by all parties

Sponsoring Workgroup: Financial Management 

Payer Coverage Decision Exchange Implementation Guide:

STU Ballot Reconciliation:

Reference Implementation:

Test Scripts: Touchstone_DaVinciPCDE_Scripts

Zulip Channel: https://chat.fhir.org/#narrow/stream/273550-DaVinci-PCDE

Conference Call Sign Up

HL7 Conference Call Center

Da Vinci Conference Call Sign Up Instructions


Conference Call Schedule & Dial-Ins

Not meeting at this time. 

Project Milestones

Milestone

September Ballot Deadlines (2019)

Publish IG STU1

December 2020
Ballot Project Milestone Goals coming soon.H2 2021

PCDE Team:

RoleName OrganizationEmail 
Project Co-LeadIBCNita.Thingalaya@ibx.com 
Implementation Guide LeadLloyd McKenzieGevitylloyd@lmckenzie.com
Implementation Guide Co-AuthorJean Duteau

jean@duteaudesign.com

Reference Implementation Co-Lead@Joe MinieriMITREjminieri@mitre.org 
Reference Implementation Co-LeadMITREmayT@mitre.org
Business Process SMERobert DieterleEnablecarerdieterle@enablecare.us
Program ManagerJocelyn KeeganPoint of Care Partnersjocelyn.keegan@pocp.com
Technical DirectorDr. Viet NguyenStratametrics vietnguyen@stratametrics.com 
Project ManagerCrystal KallemPoint of Care Partnerscrystal.kallem@pocp.com  

Historical Milestones Met:

Jan2019 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
STU1 Milestones
Continuous Improvement

Requirements

IG Development

Reference Implementation

STU Ballot (Sept2019)

Ballot Reconciliation

Connectathon

Connectathon

Connectathon

Connectathon

Tentative Target: STU Ballot Round 2