View source for Da Vinci CDex FHIR IG Proposal


<div class="messagebox cleanup metadata">
<div style="float: left;">[[Image:OpenHotTopic.GIF|35px| ]]</div>
<div style="background:#F0F0F0">
This page documents a [[:category:Pending FHIR IG Proposal|Pending]] [[:category:FHIR IG Proposal|FHIR IG Proposal]]
</div>
</div>
[[Category:FHIR IG Proposal]]
[[Category:Pending FHIR IG Proposal]]


<!-- For additional guidance on considerations for resource creation, refer to [[FHIR IG Considerations]] -->


=PutProposedIGNameHere=

<!-- 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
 -->
Da Vinci Clinical Data Exchange

==Owning work group name (Sponsor)==

Patient Care Work Group

==Committee Approval Date:==
<i>Please enter the date that the committee approved this IGproposal</i>

==Contributing or Reviewing Work Groups==

<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the IG (optional) -->
Structured Documents

==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 here: http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc -->

==Scope of coverage==

<!-- Define the full scope of coverage for the IG.  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%"

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
 -->

This Implementation Guide (IG) will define how to utilize exchange methods (push, pull, triggers, subscription) and other interoperability "standards" (e.g. CDS Hooks and SMART on FHIR) to effectively exchange clinical information captured by care providers in electronic health record (EHR) systems with payers responsible for the health plan used by a specific patient or a set of patients or with other providers where a patient has been referred for additional services. The IG defines specific use of FHIR resources to represent the information being exchanged, including the provenance of the data.
==IG Purpose==

<!-- Why is this IG necessary? -->
To transform and accelerate the shift in care delivery models toward a focus on health outcomes and value, provider and payer systems need standard ways to bi-directionally share electronic clinical, payer, and quality measure information. 

The goal of this project is to rapidly improve available computer processing methods that can be used between payers, providers, and service supplier systems. The project will accelerate the shift toward value-based care and support value-based reimbursement models. More efficient and effective exchange of health record information will improve coordinated care and network performance, increase operational efficiencies, improve delivery of patient care and care outcomes, and reduce the burden of quality reporting.
==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? -->
https://github.com/HL7/davinci-ecdx

==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 -->
US/Davinci-CDex

==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 -->

The Da Vinci project intends to provide ongoing support of this implementation guide.

==Short Description==

<!-- 1-2 sentences describing the purpose/scope of the IG for inclusion in the registry -->

Provider data exchange with Payers and other Providers to improve care coordination, support risk adjustment, ease quality management, facilitate claims auditing and confirm medical necessity, improve member experience, and support orders and referrals.

==Long Description==

<!-- 1 paragraph describing the purpose/scope of the IG in more detail for inclusion in the version history -->

This IG provides detailed guidance that helps implementers use FHIR-based interactions and resources relevant to scenarios associated with Provider exchange of clinical information with Payers and other Providers. The IG covers six specific use cases that demonstrate how to exchange clinical data generated by Providers with Payers and other Providers to improve care coordination, support risk adjustment, ease quality management, facilitate claims auditing and confirm medical necessity, improve member experience, and support orders and referrals. It supplies guidance on how to reuse existing profiles fit for this type of exchange and provides additional profiles and guidance, where needed, to specifically address the requirements not covered by existing Implementation Guides and profiles.

For these six use cases, the IG describes how to exchange required data as individual FHIR resources, data extracted together as a meaningful collection of information, or data shared in the form of a clinical document such as an encounter summary or patient summary. An encounter summary document includes a predefined collection of data that tells the story of an encounter where services were provided to a patient. A patient summary document includes a predefined collection of data that provides and overview of the provision of care services provided to a patient over a range of time. The IG clarifies exchange requirements for metadata that establishes the context (provenance) for documents, collections of resources, and individual informational resources as well.

==Involved parties==

<!-- 1 paragraph describing who is sponsoring or involved in creating the IG for inclusion in the version history -->
This implementation guide has been developed by U.S. EHR and Payer organizations as part of the Da Vinci project.

==Expected implementations==

<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. -->

==Content sources==

<!-- 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? -->

Source Specifications that will be used in this IG include:  Argonaut, US Core, C-CDA on FHIR

The subject matter experts engaged in the Da Vinci Project have sufficient expertise to make use of these source specifications.

==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.) -->

#Create a complete clinical record to improve care coordination and provide optimum medical care (e.g. reduce redundant care, in order to shift to more proactive/timely care, make better informed, more accurate medical treatment recommendations).
#Create complete, accurate risk profiles for members for value-based care contracts and population health adjustments.
#Augment claims data to satisfy quality reporting requirements and improve quality care scores, and to reduce preventable medical errors.
#Provide documentation to support prior authorization, claims processing, audit submitted claims, to confirm medical necessity and appropriateness.
#Improve member experience by improve processes between the payer and provider so member has fewer issues-less waiting, better planning/cost information and to allow the payer to have a more informed conversation with the member.
#Support provider to provider orders and referrals.

==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 [mailto:FMGcontact@HL7.org FMGcontact@HL7.org]'''

==FMG Notes==