Chair: Mark Scrimshire

ScribeVanessa Candelora

 

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Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



Call Structure & Name Changes



Implementer Resources

See Supporting section below!



Da Vinci Testing Event October 26-27, 2021

Click here for details. Registration coming soon!


Testing: Formulary - new structure and testing plan and relationship to go and create the 


Today




Formulary STU Update Progress update

See Recording of Formulary Tickets for STU 1.1.0 Overview

Stage for people to review:  https://build.fhir.org/ig/HL7/davinci-pdex-formulary/branches/stu-update-1.1/ 

  1. Formulary – STU Update 9/23 - Approved for publication request by Pharmacy WG! 
  2. 10/1 - 
  3. Target for Publication completion is Oct.


PDex 

Recording of PDex Provenance Discussion 10/1/2021

https://miro.com/app/board/o9J_lxZlj_w=/

Provenance - 

Example for testing: Payer receives data from another source, created an encounter resource with a provenance resource with the encounter to record the receipt of the record. 

A year later, the patient going to a third payer and wants records pulled over.  Walked through how this would work.  

 Make sure the transparency of where the data came, e.g., from the lab from the previous payer is key for pointing the patient to the right place and from a liability perspective, particularly if the data is incorrect and needs updating. 

  • how does the data flow when the original data owner needs to correct it?
  • Step 1: figure out where it came from, then figure out how to fix it and propagate. 

Meets a requirement by Payers to make it clear that they do not create clinical data but have it and can source it appropriately. 

Next Step to add an example for when the data is received from one payer with provenance and shared with another payer. Also update the description in the provenance in the profile.   Want this done for the STU Update, will work on it next week. 



PlanNet/Directory




New Implementer Support / Questions




Further Discussion on Testing event focus. 

Formulary - testing the whole IG with relationship changes, but also specific testing needs: 

  • Testing QuantityLimitDetail extension
  • More robust (real world scenario) search testing

Plan Net:

  • Testing more than the previous "snapshot" of active providers, need to test the status and active dates for providers getting added and ended (contract periods.) to support enrollment period changes and the CAA requirement for notification of changes within 48hours. 

PDex: 

  • Mapping for Dental and Vision
  • The EOB format for Prior Authorization status and information in PDex. 


Summarize the system version of the $export command across all three IGs. Leaves the Authentication and AUth out, just to show how you could Download.  (e.g. PDex is at the patient level. 




Chat: 









Next Week

Next Step to add an example for when the data is received from one payer with provenance and shared with another payer. Also update the description in the provenance in the profile.   Want this done for the STU Update, will work on it next week. 


 Adjournment

Adjourned at 12:45ish pm EST.






Outline Reference

Supporting Document

Minute Approval
PDex Companion Guides

PDex IG Companion Guide List

PDex IG Companion Guide - Laboratory Reporting Resources

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
inter-relationship

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

  • Links to Published IGs
Other Links:

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

Recording of PDex Provenance Discussion 10/1/2021Recording of PDex Provenance Discussion 10/1/2021

Action items

  •  Mark Scrimshire - Next Step to add an example for when the data is received from one payer with provenance and shared with another payer. Also update the description in the provenance in the profile.   Want this done for the STU Update, will work on it next week. 
  • Mark Scrimshire , David Hill , Corey Spears  - Summarize the system version of the $export command across all three IGs. Leaves the Authentication and AUth out, just to show how you could Download.  (e.g. PDex is at the patient level. 

Attendees - 

PresentNameAffiliation
PresentNameAffiliation
  •  
Onyx
  •  
Yukta BellaniEvernorth/Cigna
  •  


  •  
Gevity
  •  
MITRE
  •  
Alex Kontur 
  •  
HealthLX
  •  

  •  
MITRE
  •  
Bryan Briegel 
  •  


  •  
Chris Johnson 
  •  


  •  

  •  
Evernorth
  •  
Daniel Venton 
  •  


  •  
Dave Shekar 
  •  
Mettle Solutions
  •  
Ezequiel Morales Evernorth/Cigna
  •  
Rachel E. Foerster

  •  
Todd GrinawayCBC
  •  


  •  
James Derrickson
  •  
BCBST
  •  
Jason Brito
  •  
Tom GrannanAzuba
  •  
Jason Teeple 
  •  
Vanessa CandeloraPOCP, Da Vinci PMO
  •  
Kat CobelNCQA
  •  
Joel Hansen



  •  
 Mark Neumuth 
  •  
Optum
  •  
Michael RyanNCQA
  •  
@joe quinn

  •  
Rich Tallon
  •  
Jamie Stamps

  •  
 Ronald Wampler CVS Aetna Health