The Attachment Work Group supports HL7’s mission to create and promote its standards. The Attachments Work Group standardizes supplemental information needed to support health care insurance. Our purpose is to encourage the use of HL7 for uniform implementation of this supplemental information.
Important efforts, as guided by the Board of HL7, are to: • Work jointly with X12N, the insurance subcommittee of ASC X12 and other industry stakeholders. • Work jointly with HL7 Structured Documents Work Group in the creation of Clinical Document Architecture (CDA) for attachments • Provide support in the development and maintenance of attachments • Bridge the gap between clinical and administrative data exchange
Work Products and Contributions to HL7 Processes History Since its inception in 1997, the work group has created and balloted implementation guide and attachment specifications built upon HL7 version 2.x messaging and upon the HL7 Clinical Document Architecture (CDA) standards. The initial attachment standard included an implementation guide and detailed specifications for six attachment types: Ambulance Service, Rehabilitation Services, Clinical Reports, Laboratory Results, Medication and Emergency Department. These were incorporated into a notice of proposed rulemaking (NPRM) under HIPAA in 2005 which was subsequently withdrawn in 2008. Other Non-HIPAA attachment offerings included but were not limited to, Patient Information Unspecified Content (PIUC), Children's Preventive Health Services, Periodontal, and Pre-Authorization/Referrals.
Current With passage of the American Recovery and Reinvestment Act (ARRA) of 2009 and Patient Protection and Affordable Care Act (PPACA) which required the Health and Human Services Secretary to establish a health claims transaction standard by January 1, 2014, the Attachment Work Group voted to align and harmonize the attachment standard based on the supposition that meaningful use and electronic medical health records may drive providers and payers to request increased access to codified clinical data. In 2011 the work group formally decided to move from the original six specifications and adopted the implementation guide for CDA Release 2.0 Consolidated CDA Templates built upon HL7 version 3 messaging. This guide provides nine attachment types: Continuity of Care, History and Physical, Operative Report, Progress Notes, Diagnostic and Imaging Reports, Discharge Summary, Consultation Notes, Procedure Notes and Unstructured Documents.
Formal Relationships With Other HL7 Groups
The Attachments Work Group coordinates its work products with the Structured Documents Work Group.
In addition, the HL7 version 3 Financial Claims and Reimbursement (FICR) Domain supports attachments globally for invoice, authorization, coverage extension, and pre-determination events. The Financial Management (FM) Work Group intends to directly reference claim attachments in FICR Release 2.
Formal Relationship With Groups Outside of HL7
The HL7 Attachments Work Group works jointly with the insurance subcommittee of Accredited Standards Committee X12 (ASC X12), American Dental Association Standards Committee on Dental Informatics (ADA SCDI), National Council for Prescription Drug Programs (NCPDP), International Association of Industrial Accident Boards and Commissions (IAIABC) and other standards development organizations as guided by the Board of HL7. The work group also collaborates with Workgroup for Electronic Data Interchange (WEDI) and the Regenstrief Institute in conjunction with the LOINC® (Logical Observation Identifiers Names and Codes) Committee. Possibly S&I Framework (ESMD)