Blog

Attendance

Administrative topics

Reminders

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There is an archive of all messages sent to the mailing list, including the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH Referrals

We reviewed the upcoming tasks on SDOH-related standards. The 360X-SD specification needs to be prepared for publishing for trial implementation. Everyone is invited to give it a look-over at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf and propose any clarifications, fixing possible typos or any other improvement. At the next SDOH call on June 14 we will review any suggestions.

We continued the discussion of the current state of the SDOH Referral Status Query, which is being developed as a IHE FHIR IG. The development will result in two FHIR IGs

• The IHE International IG will only describe the required support for searching based on a Task resource, without profiling any resource profiling, or vocabulary binding. This will establish the transaction framework that national or regional implementations can reuse.
• The IHE US IG will reference the Gravity profiles and value sets, and use the transaction described in the International IG

The latest approved change proposals for the base 360X IHE profile are ready to be incorporated, and we discussed the process of publishing the 360X IHE profile as final text. We determined that it is worth the effort to initiate the uplift of the PCC technical framework to web publishing, and making 360X the fist web-published PCC profile on https://profiles.ihe.net. This process will happen over the summer.

Mark Mollenkopf (Feeding America) mentioned being at a Food as Medicine conference last week that was attended by folks from USDA, Veterans  Health Administration, and HHS. They presented as a panel and were actively seeking questions and ideas that could move SDOH work along. Mark offered on today’s call that if this team had questions and ideas in support of the 360X-SD work, he would help surface those in conversations and work that Feeding America is doing with HHS. Feeding America and HHS announced a public-private partnership in February 2024.
https://www.hhs.gov/about/news/2024/02/02/hhs-hosts-first-ever-food-medicine-summit-launches-three-public-private-partnerships.html

Garry Miller contributed to this thinking that funding and policy support would help overcome some of the implementation barriers. Key point of the early work will be to show providers that improvements via 360XSD can have a measurable impact for patients. If they can get behind it, because they see value, this can help accelerate the adoption/implementation of the new standards.

Matt Bishop commented that easing the process of SNAP/WIC applications with options for API submissions can show a measurable impact on getting help to patients/clients.

Attendance

Administrative topics

Announcement

The call on May 24 will be cancelled (week of HL7 WG meeting, and Friday before Memorial Day weekend).

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH Referrals

We continued the discussion of the current state of the SDOH Referral Status Query, which is being developed as a IHE FHIR IG. Looking at the the ServiceRequest and workflow-related Task resources in Gravity, we have to make sure that there are two points to cover:

• The IHE International profiles need to accommodate various non-US needs, therefore we can't reference Gravity resources directly due to the requirements on US Core and specific US-based value sets. The IHE spec will work with base-standard ServiceRequest and Task, and will have a US-specific part that will reference the Gravity resources and value sets
• We have to make sure that the Referral Recipient owns the workflow Task, so that the query can be based on it. Gravity explicitly allows for the Task to live on the recipient's FHIR server.

The work on getting the 360X-SD published for trial implementation will start after Memorial Day.

The latest approved change proposals for the base 360X IHE profile are ready to be incorporated, and the process of publishing the 360X IHE profile as final text will develop over the summer.

Attendance

Administrative topics

Announcement

The call on May 24 will be cancelled (week of HL7 WG meeting, and Friday before Memorial Day weekend).

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

IHE Committee meeting

At the face to face meeting this week the IHE PCC committee reviewed the 360X-HH profile (see below), the SDOH-RSQ profile, and the status of the 360X-SD public comment. The IHE ITI committee reviewed the ITI Scheduling FHIR profile.

SDOH Referral Status Query (SDOH-RSQ)

This FHIR-based profile is complementary to the the 360X-SD profile. The review of the current status pointed out that the Gravity Project resource profiles are tightly coupled with US-Core, and the IHE general purpose profile will need to be more generic. One option is to simply define the search parameters for the query, and have a US-specific section that references the Gravity Project resources.

360X-SD Public Comment

There are no current issues submitted, and with the impending end of the comment period, the work on publishing the profile for trial implementation will commence after Memorial Day.

Home Health referrals

The 360X-HH Profile was reviewed at the IHE meeting. The current suggestion is to have the capability for "Deferred referral" designated as a named option. This will allow implementations to be clear that they support this particular transaction. The initial information for some of the 360X-HH - specific transactions will be available for review at the next Home Health call on June 7.

Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH Referrals

We discussed the current state of the SDOH Referral Status Query, which is being developed as a IHE FHIR IG. The goal is to have volume 1 completed for the face to face meeting. That, and the comments for the 360X-SD IHE profile will be discussed at the next IHE face-to-face meeting. The tentative time slots for 360X topics are:

• 360X-HH (Home Health) 11 am - 1 pm Eastern time on Wednesday, May 8,
• 360X-SD (SDOH comment review + Referral Status Query) 10 am - 11 am  Eastern Time on Thursday, May 9.

The conference call information will be sent to the mailing list as soon as it becomes available.

Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

The comments will be discussed at the next IHE face-to-face meeting. The tentative time slots for 360X topics are:

• 360X-HH (Home Health) 11 am - 1 pm Eastern time on Wednesday, May 8,
• 360X-SD (SDOH comment review + Referral Status Query) 10 am - 11 am  Eastern Time on Thursday, May 9.

The conference call information will be available towards the end of next week.

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

Home Health referrals

We looked at volume 1 of the IHE specification, and discussed the requirements for the Responsible Clinician Determination transaction. The discussions will continue at the face-to-face meeting, and will be reviewed at the call in two weeks.

Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

The comments will be discussed at the next IHE face-to-face meeting. The tentative time slots for 360X topics are:

• 360X-HH (Home Health) 11 am - 1 pm Eastern time on Wednesday, May 8,
• 360X-SD (SDOH comment review + Referral Status Query) 10 am - 11 am  Eastern Time on Thursday, May 9.

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH referrals

The 360X-SD IHE specification has a "named option" for enabling updates of the status of an SDOH referral to make it to the Referral initiator. One of the mechanisms for the retrieving the status is a FHIR query. The implementation guide for the FHIR query is being developed at https://build.fhir.org/ig/IHE/PCC.SDOH.RSQ/ and it will be discussed at the next SDOH call.

Industry news

We got a brief update on TEFCA with a new update coming up, which will introduce FHIR access.

Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

Home Health referrals

Work continues on the IHE profile document for 360X-HH. The goal is to get it complete for the IHE face-to-face meeting in May, the specific 360X sessions will likely be May 8-10. The details for the meeting will become available at https://wiki.ihe.net/index.php/ITI,_PCC_%26_QRPH_Meetings#May_2024_Meeting.

Attendance

Administrative topics

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH referrals

We took a high-level look of the document as submitted to IHE to be published for public comment. The expected timeline is for public comment to start early next week, and to be done by the end of the next IHE face-to-face meeting (May 6-10). Due to availability, the discussions for 360X will be on May 8-10.

Everyone is encouraged to review the document and prepare their comments.

Attendance

Administrative topics

Mailing list is up and running. Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 

Home Health

Work is continuing on the Home Health specification. Next IHE meeting is during the week of May 6-10, the 360X activities will be most likely focused during May 8-10.

The timeline for the HH specification is to have it available for initial review before the next call on April 12, and the second round of review before the following call on April 26.

The links for review will be sent to mailing list in advance to the calls.

Attendance

Administrative topics

Mailing list is up and running. Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 

The meeting request for the HH calls will come out early next week.

SDOH

There was SDOH buzz at HIMSS, and even though there was no 360X-specific demo there were some discussions about it.

SDOH supplement is being prepared for public comment, which is expected to start early April. Responses to any comments can be done and approved at the next IHE face-to face meetings during the week of May 6-10, after which the supplement is expected published in time to be considered for the IHE connectathon 2025, and subsequently for the HIMSS Interop showcase in Las Vegas.

The candidate document for public comment will be sent to the mailing list for reference.

Next call will have the details on how to send public comment.

The recording from the HIMSS 2021 Interoperability Showcase is now available, and has been added to the 360X homepage.

Happy New Year!

We are continuing our work on the two main areas from last year: LTPAC transfer to ED, and Social Determinants of Health (SDoH) interactions with extra-clinical providers.

LTPAC transfers to ED:

• Review list of data items from Partners
• Next steps to be taken: start documentation in Confluence for

  • transition flows

  • data elements (see document)

  • any HL7 message contents

We reviewed the testing schedule for the week of 1/18

Discussion on plans for Connectathon, and HIMSS Interoperability Showcase.

For next week - look at the Gravity Project HL7 ballot: 

http://hl7.org/fhir/us/sdoh-clinicalcare/2021JAN/index.html

Timeline for 360XL - to be approved for publication at the IHE meeting next week.

Review of current document about Food Needs and SDOH in general  - several outstanding tasks remain for Vassil Peytchev  to follow up on.

Discussion on possible alternatives to current 360X conventions as the basis for SDOH interactions, or mixed model where 360X initiates, and other types of exchange continue as a result.

In a spooky Halloween fashion, this call was cancelled...

• Report out from discussion with ONC SDOH lead and Gravity project: overall well-received, groups to stay connected. Potential for HIMSS21 interoperability showcase alongside a FHIR-based Gravity/SDOH referral demonstration.
  • Use case / user story in development. Dan P/OHIP to distribute user story from their work for reference. Dr. Miller to share user story for input.
• Walkthrough of 360X SDOH Needs Referral Management document in development
  • Discussion on patient consent – largely handled by providers at time referral is made, but to non-clinical providers may be slight differences. OHIP getting legal opinion for sending of PHI from CE to non-CE w/ no BA. Some precedent for social services referrals. Dan P. to bring back legal opinion once they have it.
  • Discussion of statuses – potential need for “pending” status given potential lag
    • Should be addressed by vendor behavior (e.g., eCW referrals go into pending queue in system until next status is received)
    • Still a need for systems to configure or somehow flag if a referral has not been accepted to ensure patients do not fall through cracks.
  • C-CDA template for use: Unstructured Document template – no clinical info, just patient header/demographics. Could include unstructured attachment (e.g. benefits application pdf or image)
    • Could be heavy lift for vendors – conformance validation, etc. XDM metadata could allow PDF sent alongside C-CDA instead of within C-CDA. Unstructured C-CDA as optional.
    • Possibility for two options – one very light information, one with more information as needed for referral. Need to ensure not too onerous for vendor implementation
    • Alan to help make updates to C-CDA section of document based on discussion
  • Direct address provision for non-CEs may be a bit more complicated, but should be possible.
    • If non-provider, non-CE gets a direct address, there’s nothing in the directory to indicate someone is or is not a covered entity.
    • Dan P to look into how DT may be including/flagging non-clinical providers in directory.