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Difference between revisions of "Template:FHIR IG Proposal"

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Payer Coverage Decision Exchange
+
=PutProposedIGNameHere=
 +
<noinclude><small><i>
 +
<span style="color:#0000FF">IG names should meet the following characteristics:</span>
 +
* <span style="color:#0000FF">Title Case</span>
 +
* <span style="color:#0000FF">U.S. English</span>
 +
* <span style="color:#0000FF">Domain-friendly</span>
 +
* <span style="color:#0000FF">Short</span>
 +
* <span style="color:#0000FF">Clear</span>
 +
* <span style="color:#0000FF">Unique</span>
 +
* <span style="color:#0000FF">Avoid non-universal abbreviations (e.g. URL would be ok)</span>
 +
* <span style="color:#0000FF">Be consistent with other similar IGs</span>
 +
</i></small><br/></noinclude>
 +
<!-- Resource names should meet the following characteristics:
 +
* Title Case
 +
* U.S. English
 +
* Domain-friendly
 +
* Short
 +
* Clear
 +
* Unique
 +
* Avoid non-universal abbreviations (e.g. URL would be ok)
 +
* Be consistent with other similar IGs
 +
-->
  
 
==Owning work group name==
 
==Owning work group name==
 
+
<noinclude><small><span style="color:#0000FF"><i>
Financial Management
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The name of the work group that is proposed to have responsibility for developing and maintaining the IG.
 +
</i></span></small><br/></noinclude>
 +
<!-- The name of the committee that is proposed to have responsibility for developing and maintaining the IG. -->
 +
[[YourWorkGroupName]]
  
 
==Committee Approval Date:==
 
==Committee Approval Date:==
Line 48: Line 72:
  
 
==Publishing Lead==
 
==Publishing Lead==
Paul Knapp
+
<noinclude><small><span style="color:#0000FF"><i>Name and email of the primary contact for the FMG with respect to publishing for this IG?</i></span></small</br/></noinclude>
 +
<!--Name and email of the primary contact for the FMG with respect to publishing for this IG?-->
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
Attachments
+
<noinclude><small><span style="color:#0000FF"><i>
 +
Additional work groups that may have an interest in contributing to, or reviewing the content of the IG (optional)
 +
</i></span></small><br/></noinclude>
 +
<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the IG (optional) -->
 +
* Work Group Name
 +
* or link
 +
* or "None"
  
 
==FHIR Development Project Insight ID==
 
==FHIR Development Project Insight ID==
1515
+
<noinclude><small><span style="color:#0000FF"><i>
 +
Please specify the id of your work group’s PSS for doing FHIR work that covers the development and maintenance of this IG.  (If submitted but not yet approved, just write “pending”.)  The link to the PSS template can be found [[http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc|here]]
 +
</i></span></small><br/></noinclude>
 +
<!-- Please specify the id of your work group’s PSS for doing FHIR work that covers the development and maintenance of this IG.  (If submitted but not yet approved, just write “pending”.) The link to the PSS template can be found here: http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc -->
  
 
==Scope of coverage==
 
==Scope of coverage==
This IG will provide a FHIR standard for exchanging, at member requestcurrent treatments/support, conditions, guidelines (commercial), and supporting documentation for a payer member with a new payer when the member moves from one covered payer to anotherThis is to support the "treatment portability" described in the CMS Interoperability NPRM from March 3, 2019. The plan is to use the CarePlan resource as the basis for associating the information with regard to current therapy.
+
<noinclude><small><i>
 +
<span style="color:#0000FF">Define the full scope of coverage for the IG.  <b>(NOT the project - Do NOT copy from the PSS)</b>  The scope must be clearly delineated such that it does not overlap with any other existing or expected HL7 Int'l-maintained IG.  The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%".  Essentially, set the boundaries that would determine whether new content brought to HL7 should fall within the scope of your IG or somewhere else. This should be 1 paragraph max.</span>
 +
 
 +
<span style="color:#0000FF">Scope should consider numerous aspects of breadth of scope, including:</span>
 +
* <span style="color:#0000FF">Subject: Human vs. non-human vs. non-patient (e.g. lab bench medicine)</span>
 +
* <span style="color:#0000FF">Disciplines: Environmental Health, Palliative, Respiratory, Psychology, Maternity, Clinical Research</span>
 +
* <span style="color:#0000FF">Delivery environment (Community, Geriatric, Home care, Emergency, Inpatient, Intensive, Neonatal, Pediatric, Primary)</span>
 +
* <span style="color:#0000FF">Locale: Country, region</span>
 +
 
 +
</i></small><br/></noinclude>
 +
<!-- Define the full scope of coverage for the IG**(NOT the project - Do NOT copy from the PSS)**  The scope must be clearly delineated such that it does not overlap with any other existing or expected HL7 Int'l-maintained IG. The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%".  Essentially, set the boundaries that would determine whether new content brought to HL7 should fall within the scope of your IG or somewhere else.  This should be 1 paragraph max.
 +
 
 +
Scope should consider numerous aspects of breadth of scope, including:
 +
* Subject: Human vs. non-human vs. non-patient (e.g. lab bench medicine)
 +
* Disciplines: Environmental Health, Palliative, Respiratory, Psychology, Maternity, Clinical Research
 +
* Delivery environment (Community, Geriatric, Home care, Emergency, Inpatient, Intensive, Neonatal, Pediatric, Primary)
 +
* Locale: Country, region
 +
-->
  
 
==Content location==
 
==Content location==
https://github.com/HL7/davinci-pcovex
+
<noinclude><small><i>
 +
<span style="color:#0000FF">What is the path within the HL7 github repository (i.e. https://github.com/HL7/xxx) or what is the Simplifier project name?</span>
 +
</i></small><br/></noinclude>
 +
<!-- What is the path within the HL7 github repository (i.e. https://github.com/HL7/xxx) or what is the Simplifier project name? -->
 +
 
  
 
==Proposed IG realm and code==
 
==Proposed IG realm and code==
US
+
<noinclude><small><i>
 +
<span style="color:#0000FF">What is the realm code (2-character country code or 'uv') and IG code to use for the path when the IG is published under http://hl7.org/fhir?  E.g. us/ccda</span>
 +
</i></small><br/></noinclude>
 +
<!-- What is the realm code (2-character country code or 'uv') and IG code to use for the path when the IG is published under http://hl7.org/fhir?  E.g. us/ccda -->
  
 
==Maintenance Plan==
 
==Maintenance Plan==
Da Vinci project intends to provide ongoing support of this implementation guide.
+
<noinclude><small><i>
 +
<span style="color:#0000FF">What commitment does the WG have to maintaining this IG as the FHIR core specification continues to evolve - particularly if the initial project sponsors are no longer providing resources.  I.e. Who will be maintaining this IG content 5 years after it's published?</span>
 +
</i></small><br/></noinclude>
 +
<!-- What commitment does the WG have to maintaining this IG as the FHIR core specification continues to evolve - particularly if the initial project sponsors are no longer providing resources.  I.e. Who will be maintaining this IG content 5 years after it's published? -->
  
 
==Short Description==
 
==Short Description==
Payer coverage decision exchange will promote continuity of treatment when a member moves from one covered payer to another without increasing provider burden or cost to the member. Member-authorized sharing of treatment, conditions, authorizations, relevant guidelines and supporting documentation.
+
<noinclude><small><i>
 +
<span style="color:#0000FF">1-2 sentences describing the purpose/scope of the IG for inclusion in the registry- this is the sentence that will be used here: http://www.fhir.org/guides/registry.  This must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS.</span>
 +
</i></small><br/></noinclude>
 +
<!-- 1-2 sentences describing the purpose/scope of the IG for inclusion in the registry- this is the sentence that will be used here: http://www.fhir.org/guides/registry.  This must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS. -->
 +
 
  
 
==Long Description==
 
==Long Description==
The Payer Coverage Decision (PCD) Exchange FHIR IG will support the secure Member-authorized exchange of information between a current and prior payer regarding ongoing problems/treatments
+
<noinclude><small><i>
1) The exchange will use OAuth2.0 and FHIR APIs for information sharing
+
<span style="color:#0000FF">1(-2) paragraphs describing the purpose/scope of the IG in more detail for inclusion in the version history - this is content that will be used in your IG's equivalent of this: http://www.hl7.org/fhir/us/core/history.cfml.  Again, this must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS.</span>
2) Information to exchange will include the "careplan" for any current conditions/treatments
+
</i></small><br/></noinclude>
3) Relevant conditions
+
<!-- 1-2 paragraphs describing the purpose/scope of the IG in more detail for inclusion in the version history - this is content that will be used in your IG's equivalent of this: http://www.hl7.org/fhir/us/core/history.cfml.  Again, this must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS. -->
4) Relevant guidelines (reference to commercially available guidelines)
+
 
5) Any relevant prior-authorizations, with any remaining scope/duration (e.g. number of authorized session left)
 
6) relevant past or current medical history used to support coverage of the current treatment
 
7) other information as appropriate
 
  
 
==Involved parties==
 
==Involved parties==
This implementation guide has been developed by U.S. Payer organizations as part of the Da Vinci project.
+
<noinclude><small><i>
 +
<span style="color:#0000FF">1 paragraph describing who is sponsoring or involved in creating the IG <b>for inclusion in the version history</b>.  Don't copy from the PSS - think about the specific language you want to appear in the registry.</span>
 +
</i></small><br/></noinclude>
 +
<!-- 1 paragraph describing who is sponsoring or involved in creating the IG **for inclusion in the version history**. Don't copy from the PSS - think about the specific language you want to appear in the registry. -->
 +
 
  
 
==Expected implementations==
 
==Expected implementations==
Da Vinci payer members in response to the details in the CMS final rule
+
<noinclude><small><span style="color:#0000FF"><i>
 +
Provide named implementations if possible - ideally provide multiple independent implementations
 +
</i></span></small><br/></noinclude>
 +
<!--Provide named implementations if possible - ideally provide multiple independent implementations. -->
  
 
==Content sources==
 
==Content sources==
Requirements are drawn from payer organizations as part of the Da Vinci initiative.
+
<noinclude><small><span style="color:#0000FF"><i>
 +
<span style="color:#0000FF">List all of the specifications (beyond those in the [[FHIR_Design_Requirements_Sources|standard]] list of source specifications) that you’re planning to consult</span>
 +
 
 +
<span style="color:#0000FF">Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider?</span>
 +
</i></span></small><br/></noinclude>
 +
<!-- List all of the specifications (beyond those in the "standard" (FHIR_Design_Requirements_Sources) list of source specifications) that you’re planning to consult
 +
 
 +
Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
  
 
==Example Scenarios==
 
==Example Scenarios==
1. General: An Authenticated Member at their old Health Plan will be able to use an OAuth2.0 authorization to permit their New Health Plan to access the old Health Plan's FHIR API to access the member's payer coverage decisions using a superset of profiles defined in this guide, US Core and Da Vinci Health Record Exchange (HRex) Profiles.
+
<noinclude><small><span style="color:#0000FF"><i>
2. Specific: A member that is currently receiving home oxygen therapy will be able to exchange supporting documentation form the prior payer to the new payer to avoid, where possible, discontinuation of the current treatment, payment out of pocket, and/or need for a provider to submit documentation that is currently available to the previous plan.
+
<span style="color:#0000FF">Provide a listing of the types of scenarios to be represented in the examples produced for this IG. They should demonstrate the full scope of the IG and allow exercising of the IG's capabilities (all profiles, different types of applications, etc.)</span>
2. Specific: A member that is currently receiving step therapy for diabetes will be able to exchange supporting decisions, prior treatment, guidelines and documentation form the prior payer to the new payer to avoid, where possible, a need to restart treatment that has deemed ineffective and/or need for a provider to submit documentation that is currently available to the previous plan.
+
</i></span></small><br/></noinclude>
 +
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this IG. They should demonstrate the full scope of the IG and allow exercising of the IG's capabilities (all profiles, different types of applications, etc.) -->
  
 
==IG Relationships==
 
==IG Relationships==
This project will reference, where possible the "standards" defined by the Health Record exchange (HRex) Framework Implementation Guide which in turn will utilize prior work from US Core and R4. In addition, this guide will refer to the Payer Data Exchange (PDex) Implementation Guide since it uses the same member directed exchange methods and clinical content standards for the Payer to Payer exchange described in PDex.
+
<noinclude><small><i>
 +
<span style="color:#0000FF">Are there any IGs this resource depends on or that depend on this IG?</span>
 +
</i></small><br/></noinclude>
 +
<!-- Are there any IGs this resource depends on or that depend on this IG? -->
  
 
==Timelines==
 
==Timelines==
Submit for STU Ballot for 2019 Sep Ballot cycle
+
<noinclude><small><span style="color:#0000FF"><i>
 +
Indicate the target date for having the IGcomplete from a committee perspective and ready for vetting and voting
 +
</i></span></small><br/></noinclude>
 +
<!-- Indicate the target date for having the IGcomplete from a committee perspective and ready for vetting and voting -->
  
 
==When IG Proposal Is Complete==
 
==When IG Proposal Is Complete==

Revision as of 18:20, 2 July 2019

To use this Template:

  1. Search (or Go to) for a page with name like xxxxx_FHIR_IG_Proposal
  2. Click on the RED link to the (previously) undefined page in order to edit it.
  3. Type {{subst::Template:FHIR IG Proposal}} as the only content for the new page.
  4. Preview (if desired) to verify the reference was typed correctly
  5. "Save" the page.
    At this point, the contents of this template (with the following exceptions) will replace the substitution link. The exceptions are:
    • These instructions will not appear.
    • The small blue-font annotations about each entry will be replaced with an <!-- XML Comment --> saying the same thing. These comments are visible while editing, but they do not appear when the Wiki page is previewed or saved.
  6. Re-edit the page to include the appropriate content in each of the sections
  7. Save again

IMPORTANT: DO NOT COPY & PASTE FROM YOUR PSS: The purpose of the elements in the IG Proposal is different. The IG Proposal should not talk about the "project" at all.

The displayed contents below this line is the outline for a resource proposal


For additional guidance on considerations for IG creation, refer to FHIR IG Considerations


PutProposedIGNameHere

IG names should meet the following characteristics:

  • Title Case
  • U.S. English
  • Domain-friendly
  • Short
  • Clear
  • Unique
  • Avoid non-universal abbreviations (e.g. URL would be ok)
  • Be consistent with other similar IGs


Owning work group name

The name of the work group that is proposed to have responsibility for developing and maintaining the IG.
YourWorkGroupName

Committee Approval Date:

Please enter the date that the committee approved this IGproposal

Publishing Lead

Name and email of the primary contact for the FMG with respect to publishing for this IG?</small

Contributing or Reviewing Work Groups

Additional work groups that may have an interest in contributing to, or reviewing the content of the IG (optional)

  • Work Group Name
  • or link
  • or "None"

FHIR Development Project Insight ID

Please specify the id of your work group’s PSS for doing FHIR work that covers the development and maintenance of this IG. (If submitted but not yet approved, just write “pending”.) The link to the PSS template can be found [[1]]

Scope of coverage

Define the full scope of coverage for the IG. (NOT the project - Do NOT copy from the PSS) The scope must be clearly delineated such that it does not overlap with any other existing or expected HL7 Int'l-maintained IG. The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%". Essentially, set the boundaries that would determine whether new content brought to HL7 should fall within the scope of your IG or somewhere else. This should be 1 paragraph max.

Scope should consider numerous aspects of breadth of scope, including:

  • Subject: Human vs. non-human vs. non-patient (e.g. lab bench medicine)
  • Disciplines: Environmental Health, Palliative, Respiratory, Psychology, Maternity, Clinical Research
  • Delivery environment (Community, Geriatric, Home care, Emergency, Inpatient, Intensive, Neonatal, Pediatric, Primary)
  • Locale: Country, region


Content location

What is the path within the HL7 github repository (i.e. https://github.com/HL7/xxx) or what is the Simplifier project name?


Proposed IG realm and code

What is the realm code (2-character country code or 'uv') and IG code to use for the path when the IG is published under http://hl7.org/fhir? E.g. us/ccda

Maintenance Plan

What commitment does the WG have to maintaining this IG as the FHIR core specification continues to evolve - particularly if the initial project sponsors are no longer providing resources. I.e. Who will be maintaining this IG content 5 years after it's published?

Short Description

1-2 sentences describing the purpose/scope of the IG for inclusion in the registry- this is the sentence that will be used here: http://www.fhir.org/guides/registry. This must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS.


Long Description

1(-2) paragraphs describing the purpose/scope of the IG in more detail for inclusion in the version history - this is content that will be used in your IG's equivalent of this: http://www.hl7.org/fhir/us/core/history.cfml. Again, this must describe the IG from the perspective of an implementer scanning a registry, it should not talk about the project and should NOT be copied from the PSS.


Involved parties

1 paragraph describing who is sponsoring or involved in creating the IG for inclusion in the version history. Don't copy from the PSS - think about the specific language you want to appear in the registry.


Expected implementations

Provide named implementations if possible - ideally provide multiple independent implementations

Content sources

List all of the specifications (beyond those in the standard list of source specifications) that you’re planning to consult

Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider?

Example Scenarios

Provide a listing of the types of scenarios to be represented in the examples produced for this IG. They should demonstrate the full scope of the IG and allow exercising of the IG's capabilities (all profiles, different types of applications, etc.)

IG Relationships

Are there any IGs this resource depends on or that depend on this IG?

Timelines

Indicate the target date for having the IGcomplete from a committee perspective and ready for vetting and voting

When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org

FMG Notes