Short Description

This track focuses on FHIR based RESTFUL exchange of orders from an EHR to a supplier or supplier HIT (or Hub) and the ability to update the order after order fulfillment.

Long Description

Ability to define a Post-Acute FHIR based Order (PAO) for DME and Home Health Services to facilitate order exchange between the ordering provider and the DME supplier or the Home Health Agency.

Agenda

To send a Task and optionally a Subscription Request. The receiver (supplier, service provider, HUB) is able to receive it, and GET the corresponding Order (ServiceRequest, DeviceRequest, MedicineRequest) and associated documentation. The receiver will update the TASK with current status. If a Subscription references the Task an alert will be sent to the ordering provider when the Task is updated. If there is no Subscription the Ordering provider system will periodically poll to determine if the Task is updated. We also want to test the ability to update and or cancel the order.

Connectathon Agenda

Thursday, 1/14/2021

  • 8:00 AM PT

o   Kickoff day 1 / Introductions (identify observers vs. active participants)

o   Discuss Implementation Guide with Bob Dieterle

  • 8:10 AM PT

o   Review Implementation Guide

  • 11:00 AM PT

o   Check-in #1

  • 1:00 PM PT

o   Check-in #2

  • 3:00 PM PT

o   Check-in #3

  • 5:00 PM PT

o   Check-in #4

Friday, 1/15/2021

  • 8:00 AM PT

o   Kickoff day 2

o   Discuss Implementation Guide with Bob Dieterle

  • 10:00 AM PT

o   Check-in #5

  • Noon PT

o   Check-in #6

  • 2:00 PM PT

o   Check-in #7

  • 2:30-2:45 PM PT

o   Report Out session

  • 4:00 PM PT

o   Connectathon ends

Type

Test an Implementation Guide (https://build.fhir.org/ig/HL7/dme-orders/index.html)

Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group  

Post-acute Order Workgroup (for Orders and Observations)

Proposed Track Lead

Track Lead: Zane Schott, zane.schott@hme360.com; Kenneth Hodel, kenneth.hodel@dmehub.com ;Nandini Ganguly, nganguly@scopeinfotechinc.com 

SME: Robert Dieterle, rdieterle@enablecare.us

Related Tracks

Provide links to other tracks that are likely to have overlap of use-cases and/or participants (used to help guide seating arrangements and possibly drive track consolidation)

FHIR Version

FHIR R4

Specification(s) this track uses

Implementation Guide: https://build.fhir.org/ig/HL7/dme-orders/index.html 

Artifacts of focus

Clinical input requested (if any)

Not Required

Patient input requested (if any)

Not Applicable

Expected participants

EHR vendors, DME suppliers or DME order management systems, home health agency technology suppliers. If interested please email at nganguly@scopeinfotechinc.com. 

Based on your confirmed participation, please fill out the table below.

Participant NameParticipant EmailOrganization Name

Participant Role

(Ordering/Rendering Provider/Intermediary)

Johnny (Chung Ko)chung.ko@rotech.comRotech HealthcareRendering Provider

Neil Howard (Primary)

Cooper Thompson


nhoward@epic.com

cooper@epic.com


EpicOrdering Provider

Matt Pestritto

Josh Lee

Jon Chan

matt@parachutehealth.com

josh.lee@parachutehealth.com

jon.chan@parachutehealth.com 

Parachute HealthRendering Provider/Intermediary
Ming Yumingyu@hchb.com HomeCare HomeBaseRendering Provider
Ken Hodel (Track Lead)

kenneth.hodel@dmehub.com

DMEhub

Ordering Provider/Intermediary

Zane Schott (Track Lead)zane.schott@hme360.com HME360Intermediary

Gary Bartlett

Harold Lownds

gbartlett@brightree.com

hlownds@brightree.com

BrightreeRendering Provider 
Billy Waldropbwaldrop@vorrohealth.comVorro HealthIntegration Provider/Intermediary
Eddy Hsuehsu@bonafide.comBonafide

Rendering Provider

Ravi Kafleravi_kafle@outlook.comGlobal HealthIntermediary


Zulip stream

Zulip chat: https://chat.fhir.org/#narrow/stream/236612-DME-Orders.20on.20FHIR

FINAL REPORT out link

FINAL REPORT Participation

Track Orientation Details

Track Orientation Session Recording

Track Details

System Roles

Role 1: Ordering System – creates and send FHIR based orders for DME and/or Home Health Services (should prepare in advance but may build at connectathon)

Role 2: Rendering System – receives and interprets the FHIR based orders for DME and/or Home Health Services and performs the requested actions (should prepare in advance but may build at connectathon)

Role 3: Intermediary System – receives order and routes it to the correct Rendering System(s) – may split/modify order and/or convert order and to other format based on capability of the Rendering System(s) (should prepare in advance but may build at connectathon)

Scenarios

Scenario 1 Step 1: Home Oxygen Order

Action: Ordering System creates a POA order and Task for Home Oxygen Therapy including PAO DeviceRequest as the basis for the order and POST the Task to the endpoint of the Rendering System or Intermediary System.

Precondition: None

Success Criteria:  Rendering System or Intermediary System receives a valid Task for Home Oxygen Therapy using the PAO Task profile

Bonus point: Ordering System updates status of Task locally based on HTTP return code (200x: received, 40x: failed)

Success Criteria:  Ordering System recognizes HTTP code and sets Task.status accordingly

Scenario 1 Step 2: Rendering System or Intermediary System retrieves Order and associated documentation

Action: GET the Device Request that is the .focus of the Task

Success Criteria: Demonstrate ability to retrieve (GET) the DeviceRequest that is the focus of the Task

Bonus point:  GET associated clinical documentation referenced by DeviceRequest.supportingInfo (Observation resource (O2 Saturation)

Success Criteria:  Demonstrates ability to get Observation

Scenario 1 Step 3: Ordering System subscribes to the Task

Action: Create a Subscription to the Task and POST it to the Rendering System or Intermediary System.

Success Criteria:  Receive a valid Subscription to the Task

Scenario 1 Step 4: Rendering System or Intermediary System  sends a notification to the Ordering System

Action: Rendering System or Intermediary System  updates the Task status and statusReason and sends a Subscription notification to the Ordering System indicating that the Task resource has been updated.

Success Criteria: Ordering Systems receiving a valid notification

Bonus point:  Ordering System GETs the Task pointed to by the notification.

Success Criteria:  Demonstrate retrieving the updated Task resource pointed to by the notification

Scenario 2 Step 1-4: Hospital Discharge Order for Home Health Physical Therapy

Same steps as for the Home Oxygen Order but focused on Home Health using the PAO ServiceRequest profile

Bonus Point: includes exchange of documentation supporting the order (suggestion to include specific resources that support the order for Physical Therapy (e.g. condition, observation, procedure, encounter)

Scenario 3 Step 1-4: Medication Order for Immunosuppressives

Same steps as for the Home Oxygen Order but focused on Immunosuppressives using the PAO MedicationRequest profile

Bonus Point: includes exchange of documentation supporting the order (suggestion to include specific resources that support the order for Immunosuppressives (e.g., .basedOn: condition)

TestScript(s)

Use basic Aegis test scripts for the R4 release: https://wildfhir4.aegis.net/fhir4-0-0-gui/index.jsf

Security and Privacy Considerations

Identify any expectations around security (e.g. will TLS, mutual-TLS, OAuth, etc. be required to participate)