FM January 2016 WGM Minutes

Return to FM WGM Agenda and Minutes page

FM 2016 WGM Meeting Attendees

FM Attendance Jan 2016 Orlando WGM Spreadsheet

Monday Q1

Agenda was revised and switched with Q2 because Mary Kay was only available for the first quarter to discuss UB issues. The discussion will continue on Thursday Q1.

Monday Q2

Housekeeping conducted.

Mission and Charter Review/Revision

The FM Mission Statement 5/2014was reviewed and slightly revised with addition of relationship with Structured Document WG for CDA templates related to financial information and for clinical information required to process certain financial transactions. Kathleen moved, David seconded. Revisions aproved 8-0-0.

Financial Management Mission and Charter January 2016

FM Jan 2016 WG SWOT Review

WG reviewed and updated the FM May 2014 SWOT

Add strength – creation and maintenance of FHIR. Kathleen moved; David seconded. Motion passed 8-0-0. Add threat of lack of interest in US to move from X12 – although there’s potential interest in real time claims/authorization and Direct Data Entry. Added competition with US financial standards such as NCPDP and X12 in US. Kathleen moved; David seconded. Motion passed 8-0-0. FHIR has increased vendor interest so there is lessened weakness of reduced participation. Saudi Arabia is all FHIR for all financial transactions. France, which has 1900 standards issued by French government, may be moving toward more FHIR implementations. Note that vendors are not allowed to view PHI – a provider is required to redact all PHI before allowing a payer or other service vendor to view. Payment is not based on specific patient information. Kathleen to check with Melva Peters on v.3 FM adoption in Canada.

Financial Management Work Group SWOT Analysis Updated January 2013Jan 2014 May 6 WGM Orlando, FL

Strengths • Candor and Humor • Domain expertise • Knowledge pool • Willingness to respond to list serve questions • Diversity of background • Ongoing interest in the established standards • Experience in creation and maintenance of v2 and, v3, and FHIR Weaknesses The following weaknesses have lessened due to increased interest in FM FHIR work • Reduced number of people participating • Limited implementation interest in existing v2/v3 standards outside of Prince Edwards Island and one clearinghouse – Emergis in Canada • Lack of implementer feedback on v3 content • Lack of maps needed for US profiles on FM FHIR Opportunities • Create FHIR-based resources and methodology to ease implementation • Wait for interest in v3 implementation • Increased adoption of FM FHIR – e.g., Saudi Arabia. Possibly France, which has government developed and mandated 1900 financial transaction standards. Threats • Lack of interest in implementing FM v3 content by v2 implementations • Lack of interest in implementing FM v3 content where there are existing standards • Very limited implementer interest in advancing v3 financial management artifacts • Competition with X12 and NCPDP in the US due to HIPAA transaction and code set regulations

Financial Management SWOT January 2016

Financial Management WG Charter Review

(Reviewed in May, 2014 WGM. Revised at January 2016 WGM) Revision limited to Raheem’s suggestion that we add Structured Documents WG as one of the WGs with which FM will coordinate due to the Payer section template, which is used in several CDA profiles, including the C-CDA, and the use of C-CDA for Claims Attachments. KC moved, David seconded. Motion approved 8-0-0. KC changed all statements in the future tense to the present tense per discussion at cochair dinner as a recommended practice, and added more of the recommended language related to SAIF.

Updated FM Charter

The Financial Management Work Group (FM) produces normative standards for financial event messages. FM works closely with appropriate Work Groups to coordinate and consolidate references to financial instruments in all HL7 artifacts. FM monitors complementary financial and administrative information interchange standards other than HL7, and fosters interoperability across financial domains by contributing to the harmonization of message content and vocabularies where possible. FM also collaborates with Patient Administration (PA) for cross-domain initiatives. Formal Relationships with Other HL7 Work Groups • Patient Administration (collaborative) • Attachments • Medication • Orders/Observations Structured Documents for CDA templates related to financial information and for clinical information required to process certain financial transactions.

Date of Previous Revision:2014-05-22 Updated 2016-01-11 The Work Group will develop specifications using the principles and language of the Services Aware Interoperability Framework (SAIF) Canonical Definition (CD) and the restrictions and specializations of the HL7 SAIF Implementation Guide to ensure traceability from Conceptual to Logical to Implementable specifications as appropriate to the projects to which the SAIF has bearing.

FM Jan 2016 WG Health Review

FM January 2016 WG Health Report January WG Health Reports Reviewed WG Health- no obvious shortfalls except that FHIR and V2 work may not be considered as balloting. Kathleen checked with Anne Wizauer, TSC Project Manager, what the deficit kept FM from receiving a gold star. She said that FM failed to vote in the TSC election. FHIR and v2 ballots were counted.

Housekeeping Action Items

FM Decision Making Practices 5/2014 and 3-year plan need to be reviewed during interim.

FM Wednesday Q1–Q4

FM WG conducted detailed review of all FM FHIR Resources and outstanding CPs. ==FM Thursday Q1 Ad Hoc with Claims Attachment and Continuation of the UB Issues

FM Joint with PA

See PA Thursday Q2 Joint Minutes