Da Vinci HRex FHIR IG Proposal

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Owning work group name

Clinical Interoperability Council

Committee Approval Date:

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Contributing or Reviewing Work Groups

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FHIR Development Project Insight ID

1494

Scope of coverage

The Health Record exchange (HRex) Framework is part of the larger Da Vinci use case for Health Record exchange (HRex).

The project scope statement (PSS) can be found here:

https://confluence.hl7.org/display/CIC/PSS+for+Health+Record++Exchange+%28HRex%29+Framework

After careful evaluation, the HRex project was decomposed into four independent efforts (and tied to 4 separate PSSs). The exchange of Quality Measures was included in the existing work on the Data Exchange for Quality Measures (DEQM) that is sponsored by the CQI workgroup. The exchange of Payer Data (PDex) is sponsored by Financial Management. The exchange of provider originated data or Clinical Data exchange (CDex) is sponsored by Patient Care. The overall HRex Framework described in the PSS is planned to be sponsored by CIC as a US Realm specific framework that defines common elements and interactions necessary for the other implementation guides.

The following depicts the relationship of the multiple Da Vinci use cases developed during 2018 and planned for 2019. Many of these will use the HRex Framework as their basis for defining the use of specific FHIR artifacts.

https://confluence.hl7.org/download/attachments/40738385/image2019-1-29_5-44-7.png?version=1&modificationDate=1548762242388&api=v2

The scope of the HRex Framework project is to defined combinations of exchange methods (push, pull, subscribe, CDS Hooks, …), specific payloads (Documents, Bundles, and Individual Resources), search criteria, conformance, provenance, and other relevant requirements to support specific exchanges of clinical information between: 1) providers, 2) a provider and a payer, 3) a payer and providers, and/or a provider and any third party involved in value based care (e.g. a quality management organization). The goal is to identify, document and constrain very specific patterns of exchange so that providers and payers can reliably exchange information for patient care (including coordination of care), risk adjustment, quality reporting, identifying that requested services are necessary and appropriate (e.g. should be covered by the payer) and other uses that may be documented as part of this effort. The specific use case driven implementation guides will inherit the HRex Framework to avoid defining the same exchanges, profiles, constraints in multiple guides with slightly differed variations.

https://confluence.hl7.org/download/attachments/40738385/image2019-1-29_5-44-7.png?version=1&modificationDate=1548762242388&api=v2 https://confluence.hl7.org/download/attachments/40738385/image2019-1-29_5-43-27.png?version=1&modificationDate=1548762203104&api=v2

This project will reference, where possible, the prior work from Argonaut, US Core and QI Core effort for FHIR DSTU2, STU3, and R4. The following diagram depicts the anticipated scope of the eHRx Framework IG.

https://confluence.hl7.org/download/attachments/40738385/image2019-1-29_5-42-37.png?version=1&modificationDate=1548762152463&api=v2

IG Purpose

The ultimate goal is to provide a framework from which specific implementation guides can be developed with reduces effort and potential conflicting definitions to support the exchange of provider and payer data on specific patients/members or groups of patients/members to reduce provider and payer burden, and improve patient care using technology that supports FHIR DSTU2, STU3, and R4 releases of the FHIR standard.

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.

Content location

The GitHub repository is here:

https://github.com/HL7/davinci-ehrx

The IG is being edited using Trifolia on FHIR, and can be found here (after logging in and selecting the R4 HAPI server in settings):

https://trifolia-fhir.lantanagroup.com/implementation-guide/davinci-hrex

Maintenance Plan

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

When IG Proposal Is Complete

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