Fhir dme orders

Proposed IG Name

FHIR DME (Durable Medical Equipment) Orders

Owning work group name

Orders & Observations

Committee Approval Date:

Please enter the date that the committee approved this IGproposal

Contributing or Reviewing Work Groups

None

FHIR Development Project Insight ID

1496

Scope of coverage

This project will define exchange methods, use of other interoperability "standards" (e.g. CDS Hooks and SMART on FHIR) and specific use of FHIR resources to effectively exchange orders for DME and associated supplies and medications, supporting clinical information (to qualify the order or establish medical necessity), provenance of the order and supporting clinical information, between the ordering provider and the intended supplier. Support will be provided for the communication of substantiating review (e.g. prior authorization, appropriate use, medical review services) information (e.g. tracking and authorization numbers)

This project will utilize, where possible, existing profiles for each of the relevant FHIR releases (e.g. Argonaut for DSTU2, US Core for STU3, and US Core for R4). Creation of resources, extensions and profiles will be limited to situations here the current artifacts do not meet the requirements for DME ordering.

The project team plans to work with existing FHIR artifacts where possible. If changes are necessary, the project team will work with the responsible Work Group to review and implement (via tracker items or new PSS) any necessary enhancements to base FHIR resources, extensions, and/or profiles.

IG Purpose

Payers, Providers, Suppliers and Patients need the ability to order Durable Medical Equipment (DME) electronically to eliminate paper / FAX / verbal orders, ensure accurate ordering, minimize denials, reduce time required to supply patients with needed DME and related supplies. There is currently no well adopted standard for ordering DME equipment and supplies. An informal survey of the DME industry leaders conducted by a CMS contractor noted that over 90% of all orders are conducted by FAX or verbal exchanges and the fewer than 5% utilize any published standards (excluding NCPDP for items that can be ordered via the pharmacy networks). This implementation guide will provide a standard for adoption by providers and suppliers for the exchange of DME orders using FHIR based standards.

Content location

https://github.com/HL7/DMEOrders

Proposed IG realm and code

US/DMEOrders

Maintenance Plan

This IG will be maintained by CMS working with the sponsoring working group

Short Description

The purpose of this IG is to define the electronic exchange of Durable Medical Equipment (DME) orders, supporting documentation and provenance between the ordering provider and the supplier using multiple releases of the FHIR standard.

Long Description

The purpose of this IG is to define the electronic exchange of Durable Medical Equipment (DME) orders, supporting documentation and provenance between the ordering provider and the supplier using multiple releases of the FHIR standard. This project will define exchange methods, use of other interoperability standards and specific use of FHIR resources to effectively exchange orders for DME and associated supplies and medications, supporting clinical information, provenance of the order and supporting clinical information, between the ordering provider and the intended supplier.

Involved parties

Orders & Observations, CMS

Expected implementations

CMS DMEHub Rush Systems

Content sources

O&O FHIR Lab order profile

Example Scenarios

The ability to order Home Oxygen Therapy with all required elements to meet the CMS standard for ordering (see Home Oxygen therapy order template) and the documentation to meet the requirements for medical necessity and appropriateness along with the provenance to support both the order and the documentation requirements.

he ability to order CPAP (Continuous Positive Airway Pressure) device with all required elements to meet the CMS standard for ordering (see CPAP order template) and the documentation to meet the requirements for medical necessity and appropriateness along with the provenance to support both the order and the documentation requirements.

IG Relationships

CDeX

Timelines

Plan to have IG ready for review for ballot for comment for the May 2019 ballot cycle and full IG available for STU for the September 2019 ballot cycle

When IG Proposal Is Complete

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