Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Claims Management News

Da Vinci Project Connects Payers, Providers, FHIR for Value-Based Care

The Da Vinci Project is convening payers and providers to explore the role of FHIR in data exchange to support value-based care.

Da Vinci Project payers and providers evaluate FHIR's use in value-based care scenarios.

Source: Thinkstock

By Thomas Beaton

- Payer and provider members of the Da Vinci Project are undertaking a series of pilot projects exploring how to best leverage FHIR for data exchange to enhance value-based care.

“Da Vinci is a collective initiative of concerned, diverse market leaders that include payers, providers, HL7 and EHR vendors that understand how critical it is to put forward and employ standards that promote data exchange in real time,” explained Dr. Shafiq Rab, CIO at Rush System for Health and Rush University Medical Center.

“These efforts will enable data to be available at the right time to the right person every time securely.”

The Da Vinci Project includes payer organizations such as Anthem BlueCross and BlueShield, the BlueCross BlueShield Association, BlueCross of Idaho, Humana, and UnitedHealthcare.

Members of the collaborative effort are planning to leverage FHIR standards to improve management of medication reconciliation and foster more coordinated care.  

FHIR, an internet-based data standard that has become a staple of the health IT world, helps organizations update medication records for care teams by unlocking silos of information about inpatient discharges, discharge medication lists, and related information about a patient’s medication use.

The Da Vinci Project is also looking into new ways to share information about a health plan’s benefit package with providers.

In the test case, providers will use FHIR to access information about a health plan’s prior authorization requirements, documentation requirements, and other coverage details. Payers will be able to respond easily to provider inquiries and update providers about health plan protocols.

The Da Vinci Project also plans to test additional FHIR use cases at the end of 2018, including EHR interoperability functions and the exchange of performance metrics, such as HEDIS scores and Star Ratings.

A second use case will also measure FHIR’s ability to support the collection of real-time patient information and help alert providers about immediate patient needs.

Participants expect that these capabilities will improve communication between payers and providers while making it easier to participate in value-based care arrangements.

“Value-based care promotes better patient results at lower costs, and it relies on timely data sharing between doctors and health plans,” said Sagran Moodley. UnitedHealthcare senior vice president of Clinical Data Services and Technology.

“The associated data-sharing capabilities support physicians in a number of ways, including enabling them to see patients' benefits in real time, improving medical record exchange and reporting, informing clinical decisions at the point of care, and helping them reduce administrative burden.”

The Da Vinci Project builds off the ongoing successes of the Argonaut Project, which accomplishes similar goals on the clinical side of the healthcare industry.  Adding payer participation to the mix is a key development that is likely to cement FHIR’s place as the data exchange standard of choice.

“We are thrilled with the initial participation and interest in the work of the Da Vinci Project. The support demonstrates the shared understanding from industry stakeholders that health plans and care providers need to have in common and well-defined ways to exchange critical data in order for the focus on value and outcomes to succeed,” said Jocelyn Keegan, payer practice lead at Point-of-Care Partners.

“We believe the flexibility and specificity of HL7 FHIR and its underlying resources will enable our partners to define targeted use cases to power standard-based approaches to share the minimal data required by these new contracts and partnerships.”

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