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(Breast Radiology FHIR IG Proposal)
 
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Payer Coverage Decision Exchange
+
=Breast Radiology Profiles=
  
==Owning work group name==
+
==Owning Workgroup==
 
+
HL7 Clinical Interoperability Council (CIC)
Financial Management
 
  
 
==Committee Approval Date:==
 
==Committee Approval Date:==
<i>Please enter the date that the committee approved this IGproposal</i>
+
May 2019
  
 
==Publishing Lead==
 
==Publishing Lead==
Paul Knapp
+
Richard Esmond (richard.esmond@gmail.com)
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
Attachments
+
  HL7 Clinical Information Modeling Initiative (CIMI)
 +
  HL7 Imaging Integration / DICOM
  
 
==FHIR Development Project Insight ID==
 
==FHIR Development Project Insight ID==
1515
+
1363
  
 
==Scope of coverage==
 
==Scope of coverage==
This IG will provide a FHIR standard for exchanging, at member request,  current 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 another.  This 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.
+
The breast radiology implementation guide intends to formalize the radiology-specific data-elements sufficient to support breast cancer diagnosis, treatment and research, focusing on the key data necessary to facilitate clinical decision-making for medical and surgical oncologists, pathologists and the referring physician community of general practices Obstetrics and gynecology (OB/GYN) clinicians who order the vast majority of screening mammography procedures.
 +
 
 +
The implementation guide is expected to incrementally cover a wide variety breast radiology use cases, while supporting secondary data use in for clinical research, cancer registry reporting.</span>
  
 
==Content location==
 
==Content location==
https://github.com/HL7/davinci-pcovex
+
<i><span>https://github.com/HL7/fhir-breast-radiology-ig</span></i>
  
 
==Proposed IG realm and code==
 
==Proposed IG realm and code==
US
+
us/breast-radiology
  
 
==Maintenance Plan==
 
==Maintenance Plan==
Da Vinci project intends to provide ongoing support of this implementation guide.
+
The CIC WG is aware and willing to maintain the content in the future. Among participants, at least MITRE, MRS and PenRad are committed to the maintenance of the content.
 +
 
 +
This IG comprises FHIR Profiles for breast radiology core data elements long established to be critical for breast cancer diagnosis and staging within the scope of radiology.
 +
 
 +
In the first 'For Comment' cycle the terminology bindings are preliminary, and in some cases, defined in terms of local codes only.
 +
 
 +
Our team is collaborating with the VA SOLOR groups, RSNA RadLex and Regenstrief (LOINC) to organize and fund the required unique concept authoring efforts that will be necessary to sufficiently define the data-elements and value-sets represented in the 'For Comment' and 'Informative' breast-radiology draft ballot cycles.
  
 
==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.
+
Breast Radiology CIMI Logical Models and FHIR Profiles.
  
 
==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
+
The first iteration of the CIMI logical models and FHIR Profiles for breast radiology reporting will be focused on the core modeling structures, patterns and informational relationships between these architectural elements. Our group has works extensively with the HL7 Orders and Observations workgroup to investigate the numerous 'cross cutting' concerns that confront many similar projects.
1) The exchange will use OAuth2.0 and FHIR APIs for information sharing
+
 
2) Information to exchange will include the "careplan" for any current conditions/treatments
+
This IG defines FHIR profiles for data elements that are either directly or indirectly used in the reporting of breast radiology.
3) Relevant conditions
 
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.
+
The breast-radiology IG is being authored through a formal collaboration under the HL7-CIC workgroup with a wide range of organizations and individual contributors that informally refer the themselves as the 'Cancer Interoperability' Group, which includes representatives from the FDA, NIH, CCO, SBI, HSPC, CiiC, ACS, various health IT vendors and interested solution vendors.
 +
 
 +
The American College of Radiology (ACR) has will established and long standing guidelines that have been in common and broad use for almost two decades. The Radiological Society of North America (RSNA) and the Society of Breast Imaging (SBI) which the breast focused arm of the ACR are all represented on the subject matter expert team that is reviewing all content and will be used as the definitive source of truth for all our near-term deliverables.
  
 
==Expected implementations==
 
==Expected implementations==
Da Vinci payer members in response to the details in the CMS final rule
+
  MITRE's Standard Health Record Collaborative
 +
  PenRad, Inc.
 +
  Mammography Reporting System, inc (MRS).
 +
 
 +
  PenRad and MRS represent well over fifty percent of the almost forty million screening mammography studies performed each year. PenRad and MRS are also committed to participating in FHIR Connectathons to proof the draft profiles.
  
 
==Content sources==
 
==Content sources==
Requirements are drawn from payer organizations as part of the Da Vinci initiative.
+
  American College of Radiology Breast Reporting Guidelines
 +
  College of American Pathology (CAP) Breast Reporting SDC Forms
 +
  Society of Breast Imaging Reporting Guidelines
 +
  In addition to sources specifically providing clinical content related to cancer and breast cancer, from a modeling perspective, CIMI models were also used as a source.</span>
  
 
==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.
+
  Capture and delivery of breast radiology reports to EHR systems
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.
+
  Reporting to cancer registries
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.
+
  Reporting for clinical trials
  
 
==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.
+
The breast-radiology project is intended to target compliance with US Core v4.
  
 
==Timelines==
 
==Timelines==
Submit for STU Ballot for 2019 Sep Ballot cycle
+
  For Comment September 2019 Ballot
 +
  Informative Jan 2020 Ballot
 +
  STU May 2020 Ballot
  
==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==
 
==FMG Notes==

Latest revision as of 16:50, 8 August 2019

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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


Breast Radiology Profiles

Owning Workgroup

HL7 Clinical Interoperability Council (CIC)

Committee Approval Date:

May 2019

Publishing Lead

Richard Esmond (richard.esmond@gmail.com)

Contributing or Reviewing Work Groups

  HL7 Clinical Information Modeling Initiative (CIMI)
  HL7 Imaging Integration / DICOM

FHIR Development Project Insight ID

1363

Scope of coverage

The breast radiology implementation guide intends to formalize the radiology-specific data-elements sufficient to support breast cancer diagnosis, treatment and research, focusing on the key data necessary to facilitate clinical decision-making for medical and surgical oncologists, pathologists and the referring physician community of general practices Obstetrics and gynecology (OB/GYN) clinicians who order the vast majority of screening mammography procedures.

The implementation guide is expected to incrementally cover a wide variety breast radiology use cases, while supporting secondary data use in for clinical research, cancer registry reporting.

Content location

https://github.com/HL7/fhir-breast-radiology-ig

Proposed IG realm and code

us/breast-radiology

Maintenance Plan

The CIC WG is aware and willing to maintain the content in the future. Among participants, at least MITRE, MRS and PenRad are committed to the maintenance of the content.

This IG comprises FHIR Profiles for breast radiology core data elements long established to be critical for breast cancer diagnosis and staging within the scope of radiology.

In the first 'For Comment' cycle the terminology bindings are preliminary, and in some cases, defined in terms of local codes only.

Our team is collaborating with the VA SOLOR groups, RSNA RadLex and Regenstrief (LOINC) to organize and fund the required unique concept authoring efforts that will be necessary to sufficiently define the data-elements and value-sets represented in the 'For Comment' and 'Informative' breast-radiology draft ballot cycles.

Short Description

Breast Radiology CIMI Logical Models and FHIR Profiles.

Long Description

The first iteration of the CIMI logical models and FHIR Profiles for breast radiology reporting will be focused on the core modeling structures, patterns and informational relationships between these architectural elements. Our group has works extensively with the HL7 Orders and Observations workgroup to investigate the numerous 'cross cutting' concerns that confront many similar projects.

This IG defines FHIR profiles for data elements that are either directly or indirectly used in the reporting of breast radiology.

Involved parties

The breast-radiology IG is being authored through a formal collaboration under the HL7-CIC workgroup with a wide range of organizations and individual contributors that informally refer the themselves as the 'Cancer Interoperability' Group, which includes representatives from the FDA, NIH, CCO, SBI, HSPC, CiiC, ACS, various health IT vendors and interested solution vendors.

The American College of Radiology (ACR) has will established and long standing guidelines that have been in common and broad use for almost two decades. The Radiological Society of North America (RSNA) and the Society of Breast Imaging (SBI) which the breast focused arm of the ACR are all represented on the subject matter expert team that is reviewing all content and will be used as the definitive source of truth for all our near-term deliverables.

Expected implementations

  MITRE's Standard Health Record Collaborative
  PenRad, Inc. 
  Mammography Reporting System, inc (MRS). 
  PenRad and MRS represent well over fifty percent of the almost forty million screening mammography studies performed each year. PenRad and MRS are also committed to participating in FHIR Connectathons to proof the draft profiles.

Content sources

  American College of Radiology Breast Reporting Guidelines 
  College of American Pathology (CAP) Breast Reporting SDC Forms
  Society of Breast Imaging Reporting Guidelines
  In addition to sources specifically providing clinical content related to cancer and breast cancer, from a modeling perspective, CIMI models were also used as a source.

Example Scenarios

  Capture and delivery of breast radiology reports to EHR systems
  Reporting to cancer registries
  Reporting for clinical trials

IG Relationships

The breast-radiology project is intended to target compliance with US Core v4.

Timelines

  For Comment September 2019 Ballot
  Informative Jan 2020 Ballot
  STU May 2020 Ballot


FMG Notes