Chair: Mark Scrimshire
Scribe: Vanessa Candelora
This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."
Minutes Approved as Presented
Meeting Minutes from Discussion
|Decision Link(if not child)|
|Management||Review ANSI Anti-Trust Policy|
Call Structure & Name Changes
See Supporting section below!
Visit the Da Vinci HL7 Connectathon page for quick highlights on each tracks.
Connectathon Kick Off (add recording)
|PDex - Payer to payer consent and membermatch - Questions from Review?|
Review and Feedback from homework for all to review this http://build.fhir.org/ig/HL7/davinci-ehrx/consent-oauth.html and give us your thoughts on requiring this approach (for those that are using membermatch.)
Stage for people to review: https://build.fhir.org/ig/HL7/davinci-pdex-formulary/branches/stu-update-1.1/
Update on STU Update process - currently in review process, get comments in by 9/15 (next Wed)
|HRex impact to Coverage resource|
Raised by Lloyd - see tracker:
Re-validated that #1 - edge case with Medicaid and counties - but still wouldn't have multiple coverages. MK has seen it happen but is still comfortable tightening down to cardinality to 1..1 You could very easily split it.
Proceeding with tightening the cardinality to ..1. If needed, you can have two coverage resources with identical elements for edge case. No objections from group. 27ppl on call.
On #2-6 from the tracker - Long Discussion on Beneficiaries and what info is on the card. exploring value of a second patient resource.
Knowledge of new plan, basic info from old plan card, and demographics - That's what was planned for the exchange.
On PAS, Patient Subscriber and Patient Beneficiary - send both. Different problem.
This is trying to identify an individual based on the info on the Insurance Card.
Coverage resource has a subscriber and beneficiary elements and both are reference back to the patient resource. Coverage is the us core patient. the member match process, says you take the coverage, details from the card and trying to link it to a patient demographics record that is relevant to the card.
Trying to take the deterministic info from the card and allow the prior payer to use the demographics to align with their member/subscriber.
1) ID issued for each person
2) Subscriber number used for everyone on the plan.
Concern that the ID could be bogus - Mickey Mouse ID - it would need to be in the system.
Proposal that Patient.identifier would no longer be mandatory or must support (drop expectation to use USCORE). If that's the case, then you can't derive the patient resource from US Core. Then, we would need a PDex version which would be a slimmer version of USCore's Patient Resource that would be must support for:
(Same as above for minors)
Implementers of USCORE would work fine (nothing would break) but systems would not have to have an Identifier or other data elements not needed for this use case.
The profile requirements are met right now by putting anything in the Identifier so that is not useful. We want to tighten down the profile. We want to say, it's still optional to have the Identifier, but if you have it, you must support it.
Must have an ID string or a coverage.value.id string and one of those two things must be present.
y putting anything in the Identifier so that is not useful. We want to tighten down the profile. We want to say, it's still optional to have the Identifier, but if you have it, you must support it.
Multiple addresses needed? Kid vs. Mom vs. Dad Address.
Send everything you have?
|New Implementer Support / Questions|
Adjourned at 1:01pm EST.
|PDex Companion Guides|
|CARIN CPCDS to US Core Mapping|
Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0818 v2.xlsx
DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx
|PDex - US Core |
Source PowerPoint: PDEXandUSCoreRelationship.pptx
|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
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!
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:
- David Hill - Dave will get more clarity on https://chat.fhir.org/#narrow/stream/229922-Da.2BVinci.2BPDex.2BPlan-Net/topic/InsurancePlan.2Eplan.2Etype . May need some or all: clarifying language, A written example for Medicare, changes to IG.
- Mark Scrimshire - Mark and Bob work offline on the FAQ #14 to address Dan's concern .
- Sean Mahoney - Update the proposal for Plan Type additions/changes based on discussion on 8/20 for review next week.
- Lloyd Test McKenzie - Write up draft for HRex IG based on Feedback for ticket: FHIR-33263 to test at Connectathon next week.
Attendees - 27
Intepro Solutions Rakesh Mathew Daniel Lilavois Patricia R Harbin Shalabh Gautam Kamaraj Kaliaperumal, Carefirst Bhanu Vemuri Narasimha Murthy Accenture Maggie Mellon Courtney Bland
Present Name Affiliation MITRE HealthLX MITRE Evernorth Mettle Solutions Rachel E. Foerster BCBST Tom Grannan Azuba Vanessa Candelora POCP, Da Vinci PMO Deepthi Reddy Mettle Solutions Allscripts Eric Sullivan Inovalon India Duncan Optum Availity Susan Lestina AHA Bob Bowman CAQH Thomas Kessler CMS Patrick Edwards Briana Barnes Scope Info Tech Kishore Metla Mettle Solutions John Donnelly Lorraine Doo CMS Melanie Jones CMS Rim Cothren Yolanda Villanova CMS Manoj Kumar BCBSFL MITRE Srinivas Konchada Centene Corporation Sheryl Turney Anthem Helina Gebremariam Mike Novales BCBSIL Ric Light Humana Ann Gallagher Optum Chris Klesges Mitre Adam Gronsky Health Fidelity CaseNet Anthem CMS eClinicalWorks Healow Interfaceware Mark Rucci Spectramedix Anthem Cindy Monarch BCBSM Michael Kim Jim Catan Accenture BCBSA Jia Chen Jeff Eastman Ernestine Cooper Jason Teeple CIGNA Mary Winter Tony Benson BCBS AL Independence BC Henry Archibong Inovalon HL7 Consultant Abdul Sattar Anirudh Choudhary Todd Biske ESI Darrell Woelk Doug Stoss Rick Lisseveld Aegis LakshminarayananSaravanan Laurie Burckhardt WPS Health Plan Kevin Lynch Inovalon Joseph Minieri MITRE Durwin Day BCBS IL Pamela West Ravi Thakkar Aetna UO Aetna Swati Nanda Aetna CVS Health Cyrus Kevin Fred Harmon Ready Computing Blue Cross NC Michael Ryan NCQA HealthSparq CVS/Aetna Dorothy Lee NCQA Khoa Nguyen Suma Addagadde BCBSNC Caitlyn Campi FL Blue Diane Bengtson Sean Mahoney MITRE Balaji Richard Lisseveld Shanna Hartman CMS Kevin Day Edifecs Sai Bagewadi Cognizant Kechia Scott Kerri Wing Krithika Kumar Accenture Don Zacharia Pamela Maklari Cognizant @David Bradsher BenMedica @DJ Gallagher @Follis @Nidhi @Emily Lozada Bruce Schreiber Ed Hafner WEDI / Change Healthcare Alberto S. Llanes FEHRM Danny Iacovou Kimberly Bradbury Prime Kranthi Pathca Sreeram vedururi Joel Hansen Milinda Perera WSO2 Nirmal Fernando WSO2 Viroopi Ujjawal Bhatnagar Jim McHugh Kenny Wang Alan Viars
Patricia R Harbin
Chris Johnson Anthony Omosule Accenture Google Cloud Healthcare Independent Health; X12 Scott M. Robertson David Clowers Ramandeep Dhanoa "Raman"
Present Name Affiliation Nancy Spector AMA Bruce Wilkinson BenMedica Avality Daniel Venton Optum BCBSAL Rob McClure MD Partners Ronald Wampler CVS Health Aetna Bryan Briegal ACP @Callie Phillips MCG ONC Surescripts NCPDP Anupam Thakur BCBSFL Jonathan Hutchins BCBST Anthem Sunitha Godavarthi Christopher Gracon Labcorp James Derrickson Intersystems Deb Conklin Medical Mutual of Ohio Cognizant Neetha Joseph Cognizant Kaiser Permanente MITRE Rutika Express Scripts Brody Brodock Allscripts Michael Brody CME Online Theressa Baumann BCBS AL Mona Chandrapal eClinicalWorks Optum Aakash Deliwala eClinicalWorks Mayo Epic Shaheer Stanley Nachimson Anthony Smith UNC Health Howard Cohen Minaei Behnaz FDA BCBSA Shilesh Nair gdit NewWave MaxMD BC Idaho Edward Castagna Altarum Andrea Kent CoverMyMeds Carrie Denny Kim Pham Celine Lefebvre AMA Edifecs Josh Lamb UPMC Keya Shah Casenet Gevity MITRE Mrugen Mehta eClinicalWorks Revathi Jayakumuar Supriya Bapi Bhera Matt Dyer Vyne Sree Vijetha Vegi C-HIT BCBSA Rich Bloch Lumedic Cigna Paul Knapp Ron Urwongse CAQH Anand Raghavan Ezequiel Morales Cigna Evernorth Frank McKinney Hanna ? Brett Rauschke Carolyn McKinney Clarissa Winchester BCBS AL JC HealthShare Exchange (HSX) River Wong Derrick Woolridge Beata Ferraiz Ed Donaldson Consultant with Humana Julie Burgoon Mark Neumuth Aetna Raj Sankuratri Aetna Dr. Cheryl D. Lohman Germantown, MD | Family Physician Barbara Valeno Eshaa Dhall eclinicalworks Angie Brandon Beatrice Thompson CVS Health Hema Srinivasa Kristin Ashby Aetna Nag Sanivarapu Abhishek Pandey Shailesh Prabhu Travis Hendrix Dr. First Zakir Guler Jason VanderJagt edifecs Erika Wagner Shamil Nizamov Michael Robinson Christopher Marchand Chris Busch Nathaniel Hosenpud Christopher Roedocker SKYGEN Jeff Brown MITRE Sid Nehal Amin Amit Cudykier C45214 Noah Lincoff Yukta Bellani Evernorth/Cigna Brian Schoonover Optum Tone Southerland OneRecord @Ram Optum Kat Sobel NCQA Phung Matthews Benji Graham @Grace Stambaugh Donnielle Williams Rob Brull Eric Liu, PharmD, MBA Chris Geisler Abhinav Garg Cindy Harber CBC Gevity Eric Heflin Rennil Cruz Avinash Kanal
Google Cloud Healthcare
Independent Health; X12
Scott M. Robertson
Ramandeep Dhanoa "Raman"