Background and Current Status

The Centers for Medicare & Medicaid Services (CMS) has initiated the Post-Acute Fast Healthcare Interoperability Resources (FHIR) Orders project to support the CMS Promoting Interoperability initiatives. This project will define exchange methods, use of other interoperability standards, and specific uses of Health Level Seven (HL7) FHIR to effectively exchange orders for Durable Medical Equipment (DME), Home Health Agency services, associated supplies, medications, and supporting clinical information (to qualify the order or establish medical necessity) between the ordering provider and the intended rendering provider or supplier.

The Post-Acute FHIR Orders Workgroup supported the pilots for the post-acute orders workflow, which is based on the Post-Acute FHIR based Order Implementation Guide and DME Order SMART on FHIR application. This workgroup provided guidance and collaboration platform for pilot participants implementing this workflow. It was conducted from June 2019 till October 2020 allowing participants to discuss issues, lessons learned, latest developments in Healthcare IT policies that affect our interoperability world. Organizations from this workgroup participated in HL7 Connectathon in Sept 2019, May 2020, Sept 2020, and Jan 2021 to test the Implementation Guide workflow.

As of January 2021, the support for the Post-Acute FHIR pilots through the EMDI contract has ended; however if you would like to continue implementing this workflow and you can stay involved through HL7's Orders and Observation workgroup.

The latest version of the Post-Acute DME Order FHIR Implementation Guide is posted HERE.


Post-Acute FHIR based Order Workflow

This diagram describes workflow between EHR system and supplier Health IT to send a FHIR based DME order.


Figure 1: Post_Acute FHIR Workflow



Workgroup Participants
ProvidersHealthcare OrganizationPayer
Adapt HealthDME Hub (Apria)CMS
BinsonsAA HomecareUnited Healthcare
Contra Coast HealthRotech Healthcare
Colonial MedicalBrightree
ClaimsjudgeeClinicalWorks
DME WorksElectromed
HoveroundHCPlan
LincareResmed GoScripts
Rotech HealthcareThe Van Halem Group


Workgroup Action Items:

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Send workgroup participants information about the HL7 Connectathons.

 

 



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Workgroup Documents

Workgroup Tools

DocumentPurposeSubmission MethodDownload
EMDI Participation Request Sheet

The EMDI Participation Request Sheet allows various healthcare organizations the opportunity to participate in the Electronic Medical Documentation Interoperability (EMDI) Initiative. This is not a legally binding agreement and is to be used to outline the program guidelines and expectations for participation. All organizations participating in EMDI initiatives are expected to complete and submit this document to the EMDI team for review and approval.

Click Here
Pilot Update TemplateThe Pilot Update Template will be used to provide pilot updates to CMS and the EMDI Team. EMDI participants may submit the Pilot Update template to the EMDI team at any time for review.

Click Here
HL7 FHIR DME Implementation GuidePayers, 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.  This implementation guide will provide a standard for adoption by providers and suppliers for the exchange of DME orders using FHIR based standards.

Click Here
DME eRx Workgroup SurveyThe workgroup survey allows participating organizations the opportunity to submit workgroup feedback to CMS and the EMDI team. All workgroup surveys should be submitted to the EMDI team upon completion. All surveys submitted will be confidential and used to enhance the workgroup.

Click Here
EMDI Connectathon FAQsThe EMDI Connecathon FAQ provides guidance around HL7 Connectathon details for Sept 14-15, 2019 and registration information. 

Click Here
SMART on FHIR Epic Testing and ApprovalsThis document outlines the requirements for SMART on FHIR app for EPIC system, test case scenarios and approval timeframes. 

Click Here
Links to GitHub RepositoryThis document provides details on the links to GitHub repository and other code repositories to set up the environment for the SMART on FHIR prototype app. 

Click Here
This document provides details on the questions that were asked to our panelist during the workgroup call held on Aug 27th on how organizations can be FHIR enabled.

Click Here