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|
Professional Associations, such as HL7, which bring together competing entities are subject to strict
Call Structure & Name Changes
|Call for Da Vinci Member leads for PDex Use Cases|
See Supporting section below!
|Today||Da Vinci Testing Event October 26-27, 2021 Read out - See recordings here: 2021-10 Da Vinci Testing Event|
|PDex Next Steps|
|Formulary and Plan Net Learnings Summary|
Formulary - MITRE and Onyx tested the new work. Edifecs came and tested as well.
Discussion about the lack of client (vs. server) testing that we have seen on this IGs and the cause of that.
One payer spoke up ans said that Care Evolution and few others have already connected to their Patient Access APIs. It may be more of a business resource focus and decision to come test vs. implementing. You could go to the CMS.gov site and see the certified apps. Optum is working on their app to connect as well.
Call to Community: If you are a payer and see apps connecting to your APIs, you are likely getting feedback. If any of that feedback is valuable to this community and to the improvement of the IGs, please send it to us via Zulip chat (broader) and/or JIRA ticket (if pertaining to a specific part of the IG).
Mark N. will send some feedback, including a question on Versioning. Thank you!
|Open Questions||Team is focused on Phase 2 items (join us as 2pm ET). We will open this call for Implementer Support questions, so please come with questions this week|
Provenance two parts:
1) Source - how you as a payer received the data, it's how you received it (claim, CDA, transaction, etc. )
2) Transmitter record - "As a payer, I am sending this to you" I am the transmitter of this data to send it to someone else.
If you have "assembled it from" you are no longer the author. If you have a lab that ran a test - the lab is the author. Unless you collect it directly through the care management process, it would be rare for the payer to be the author. Ex. Payer Nurse that recorded goals for the care management, then they would be the author. If the data is coming in from a claim, then it's still sourced from the provider or source of the claim - Payer is not the author.
Discussion about when a patient is looking to get their data.
1) When you enroll as a new payer, during the enrollment process you would request the data.
2) Consent as a member to control the data.
The question from EQ is about the personal rep scenario and request my mom's data to consent to exchange from old payer to new payer. I'd do it through the new payer. "The member or authorized representative" - the process for being the authorized representative comes to play here. That relationship would need to be established and includes many scenarios. Parent of minor, grown adult for parent. etc.
Next Step: ask CMS - If person is an authorized rep with the new payer, is that sufficient to request information form the old payer on your behalf or do you also need to be an authorized rep on the old payer?
Whether the auth. rep. should be appointed on the previous payer side
Discussion about if its a HIPAA tx. or not. They are sharing more than minimum necessary data. We are doing it as a HIPAA Tx. Min. necessary only applies without the member consent.
Because it's part of a regulation, it falls under operations likely.
Including Provenance in the EOB for the Prior Auth. information - for discussion at 2pm call.
Question on Provenance for EOBs
Adjourned at 12:45pm ish. ET.
|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:
|Formulary STU 1.1.0 Overview|
|Recording of PDex Provenance Discussion 10/1/2021||Recording of PDex Provenance Discussion 10/1/2021|
|Recording of PDex calls on 10/29||Discussion on Provenance Source and Transmitter - Payer Authoring; Authorized Rep rather than Patient request process for consent, and more.|
- Mark Scrimshire reach out to Corey: Is there something unique in Dental and Vision that would have an impact on USCDI? Does the way CARIN is representing CPCDS warrant any changes needed in PDex?
- Mark Scrimshire - Longer term Action Item from call on 10/15 to provide FAQ guidance on the de-duplication or linking options for payer to payer provenance record sharing. see recording from 10/15 notes.
- Robert Dieterle - Draft and submit questions to CMS about the Authorized representative for consent on Payer-to-Payer data exchange.
- Mark Neumuth to share feedback from their learnings as thir party apps start connecting to their API.
Ramandeep Dhanoa "Raman" Tom
Present Name Affiliation Present Name Affiliation Onyx Yukta Bellani Evernorth/Cigna Gevity MITRE Alex Kontur HealthLX MITRE Bryan Briegel IBM Watson Health Chris Johnson Evernorth Chetana Suresh IBC Stanley Nachimson Jim Denyer IBC Dave Shekar Mettle Solutions Ezequiel Morales Evernorth/Cigna Rachel E. Foerster Todd Grinaway CBC Versaggi Consultant James Derrickson BCBST Jason Brito Tom Grannan Azuba Jason Teeple Vanessa Candelora POCP, Da Vinci PMO Kat Cobel NCQA Joel Hansen Mark Neumuth Aetna United Michael Ryan NCQA @joe quinn SmileCDR Rich Tallon Jamie Stamps Ronald Wampler CVS Aetna Health Sarah scott Craig Knier Change Healthcare Jeff Brown MITRE, FM Co-Chair @Dustin R Nides Anil N @anthony Omosule Bob Bowman Brett Atwood Dale Brown Grace Stambaugh Optum Michelle Barry Availity
Ramandeep Dhanoa "Raman"