2019-10-15 Meeting notes

FHIR Pilot Tiger Team

10/15/19

Attendees:

• Ashley Stedding – CMS, Provider Compliance Group, Management Analyst
  • Role: can assist with organization for different use cases and reaching out to folks to get them involved
• Yauheni Solad – Medical Director, Digital Health, Yale Health System; director of special projects; FHIR team lead
  • Role: can help coordinate pilot with provider sites
• Patrick Murta – Humana; co-lead architecture from FAST perspective
  • Role: can help to ensure the use cases are articulated well, and partner with exchange, testing, and scale tiger teams.
• Danielle Friend – Developer FHIR team at Epic; FHIR client for use cases, Davinci, Argonaut, generic HL7
  • Role: can bring in stakeholders through their customers
• Erik Eaker – Humana; Interoperability strategy and provider data exchange
  • Role: can orchestrate the pilot team work

• What kinds of participants are missing from our team?
  • Erik to reach out to Drew and Hans (Cerner), Allscrips (?), eCW (?) 
• Could use additional physicians/provider partners and let’s get the EMR vendors to support identifying provider partners.
• We should reach out to the additional EMR vendors to determine if they will continue to participate:

• Documents reviewed accessible through Confluent login - Diana Ciricean can provide if you don’t have access.
• Sources of use cases:
  • DaVinci consortium documents functional use cases – cost transparency, exchanges from payors to providers – taking their functionality and running it through FHIR processes to understand core capabilities to deliver them at scale
  • Existing workflow – e.g., prior authorization, coverage requirements, documentation requirements
  • Known barriers – e.g., static endpoints, dynamic endpoint resolution (hundred to a million end points (scale).
• To derive core capabilities, ran use case functionality through filter and applied FAST use case template
• Use cases are designed to document core capabilities – 4 defined at top of use case inventory
• An analogy: We’re building vehicles (from motorcycle to a van) carrying data to get from point a to point b. A FAST use case describes the highway infrastructure to allow those cars to get from point a to point b (bridges, stop lights, exits, emergency lanes).
• Endpoint use case: Epic needs to understand how to identify the endpoint when sending the data; ability to discover dynamically and in trusted way and with the most recent end point at scale. Expertise for endpoint discovery lives on the tiger teams – that’s where the solution frameworks come in.
• Shared care planning use case: don’t define the care plan, but define the features that make a care plan successful.
• Once a core capability has been proved for one or a few use cases, it can be checked off. We are not expected to test multiple variations/scenarios.
• We may outsource the pilot execution; TBD. The executive steering committee will recommend how the pilot team should act. There is an opportunity possibly to joint pilot with Da Vinci or other groups; we could test FAST at same time as Da Vinci use cases – with one overarching pilot construct.