Achieve Efficient Payer-to-Provider Interoperability by Leveraging Da Vinci

Blog Posts - 04 June 2019


If you are not yet familiar with The DaVinci Project, now is the time to start thinking about it. Why? Because interoperability is a critical topic for healthcare. The ONC (Office of National Coordinator for Health IT) has set a goal to achieve nationwide interoperability by 2024. Interoperability can only be achieved when a consistent set of data standards are deployed across all health plans, providers and within the health IT ecosystem. Health plans of all sizes need to start thinking now about how to prepare for their path toward clinical interoperability.

What is The Da Vinci Project

The Da Vinci Project is a group of health plans, health care providers and health IT vendors who understand how critical it is to develop common data standards and ways of exchanging information in support of value-based care. More formally, it is a private sector initiative working to help payers and health care providers “positively impact clinical, quality, cost and care management outcomes1” by facilitating the adoption of HL7®, FHIR® data standards.

Da Vinci is a community of leaders who understand specific challenges of information exchange under value-based care and who are committed to working together to identify the incremental steps needed to begin to solve those challenges. When issues are identified, Da Vinci then brings them into a public forum to discuss how to build implementation guides to solve specific problems. By using a community approach to defining the business challenge, supplemented by paid resources with expertise in FHIR, Da Vinci is accelerating the speed at which a draft standard can make its way into the market. The purpose being to bring these emerging tools into the public domain so that any health plan, provider or health IT vendor can use them.

What is HL7®, FHIR®?

Fast Healthcare Interoperability Resources (FHIR®) is a set of standards for exchanging health information electronically between organizations. It is created by the Health Level Seven International (HL7®), a healthcare interoperability and standards authority. When consistently used, the standard joins disparate systems together, facilitates the exchange of health information and make systems interoperable. It is designed to be easy to implement and enables fast development of applications that require access to healthcare information.

Why is Da Vinci and HL7® FHIR® important?

Interoperability and adoption of industry wide standards impact everyone in the healthcare ecosystem. In less than two years, Da Vinci efforts will drive standards for the exchange of information critical to patient care2. CMS has encouraged all payers offering plans through the Federally-Facilitated Exchange (FFE) to align with the Da Vinci Project. By doing so, health plans can join CMS in “helping to build an ecosystem that will allow providers to connect their EHRs or integrated practice management systems and establish efficient work flows with up-to-date information.”3

How can DaVinci help?

Health plans at all locations and sizes will are evaluating how to best adopt data standards to improve clinical interoperability. Da Vinci helps by making implementation guides and sample code publicly available, without licensing or fees. You can find resources on The Da Vinci Project Confluence Page. FHIR enables smaller health plans and their partners to adopt standards, improve automation and stay competitive by tapping into these resources.

The Latest Focus Areas for Da Vinci

The Da Vinci Project focuses efforts on key payer-provider data exchange scenarios, called use cases. The list of use case focus areas is defined by those who participate in Da Vinci’s Operations Committee and is ever evolving as the group learns from their experiences and responds to shifting regulatory requirements and market dynamics. As of March 2019 Da Vinci has 17 use cases – and further updates are expected soon.

How can Veradigm™ help?

Veradigm™ is proud to be a founding partner of The Da Vinci Project, in association with Allscripts®, our parent company. Our teams are actively engaged in projects across DaVinci to understand the current challenges our health plan and provider partners face and ensure proposed work is relevant to their needs.

Veradigm is partnering with health plans to develop product solutions that address their individual use case priorities and facilitate payer-to-provider bi-directional information exchange. The goal is to integrate the solutions into the workflow of the electronic health record (EHR), decrease the need for manual interventions, improve communication and positively impact the quality of care. Our product development efforts align with our work on the Da Vinci Project, capitalize on the project’s use cases and adhere to the relevant draft HL7®, FHIR® Implementation Guides requirements.

Veradigm™ has active health plan partnerships to develop products supporting the 30-Day Medication-Reconciliation needs under the Data Exchange for Quality Measures use case and Medicare Annual Wellness Visit documentation falling under the Documentation Template & Coverage Rules use case. We are looking for new health plan partners to work with us to develop solutions to address the use cases most important to them.

Need clinical information exchange support before transitioning to FHIR®?

Veradigm can also assist health plans in meeting clinical data needs prior transitioning to FHIR®. Veradigm eChart Courier™ facilitates the sharing of clinical data and increases efficiency by automating the chart retrieval process. Once the provider opts-into the program, eChart Courier pulls data from the provider’s EHR cloud and delivers it to health plans in a secure, encrypted format to preserve HIPAA security. It was designed by Veradigm to replace manual in-office chart audits and is easy to use for both the health plan and the provider.

To get more information on how to partner with us on a solution for your health plan, contact us.


1 http://www.hl7.org/about/davinci/index.cfm?ref=common

2 Da Vinci Project Update, January 14, 2018

3 https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/LookupServiceInitiative.html

Additional Resources:
https://healthitanalytics.com/news/4-basics-to-know-about-the-role-of-fhir-in-interoperability

https://www.hl7.org/fhir/overview.html