Da Vinci Connectathon, 2019


Lee Eubanks
Director of Product Management

Limited interoperability of clinical data continues to constrain the healthcare community from providing better care at lower cost.  As we often write about in this space,  technical and, particularly, semantic interoperability is challenged by over four million clinicians documenting care in over one hundred brands of certified electronic health records.

While the emergence of data standards (e.g. HL7, C-CDA) hasn’t solved interoperability challenges historically, the emergence of the FHIR (Fast Healthcare Interoperability Resources) standard prescribes modern web technologies like application programming interfaces to enable more direct querying and retrieval of specific data, as well as complete documents such as the CCD, for delivery into downstream workflows.  FHIR architecture has the potential to substantially increase clinical data flowing through the healthcare ecosystem by making it easier to physically exchange data.  However, it does not necessarily follow that the semantic interoperability of the data will improve because more data flows.  The conditions for clinical data disorder do not change.  So, inconsistent coding structures and information hidden in clinical notes will continue to inhibit interoperability with meaning.

Nevertheless Diameter Health was excited to participate in the first Da Vinci Connectathon in Jacksonville, Florida on May 29-30th.  Along with other vendors and health plans, the Diameter Health team worked on the Clinical Data Exchange (CDex) track, focused on provider to payer and provider to provider clinical information exchange.

The Da Vinci Project is a private sector initiative comprised of industry and health IT experts working together to accelerate the adoption of HL7® FHIR® as the standard to support and integrate value-based care (VBC) data exchange. Specific project goals include helping payers and providers positively impact clinical, quality, cost and care management outcomes.

The work during the Connectathon on the CDex track was a collaborative development effort between payers and vendors, which focused on support for the Document Reference and binary resources to enable payers to query patients, retrieve a list of document IDs, and exchange the clinical data XML as a binary payload.  This solicited communication protocol is integral to the value FHIR brings to the market, and Diameter Health is one of the initial vendors working on support for the normative R4 standard.

The Clinical Data Exchange (CDex) track is one of 14 high volume, high manual effort Use Cases identified by the Da Vinci project which would benefit from workflow automation.

In the CDex use case, Providers and Payers exchange information regarding prior and current healthcare services planned for, or received by, the patient/member to more effectively manage the patient’s care.

Whereas CDex typically focuses on EHR-Payer communication, Diameter Health’s extensive experience with Health Information Exchanges enables an even broader data set to be shared.  Through our work with HIEs and their participants’ disparate EHR systems, Diameter Health produces more complete patient data by supporting not only individual document retrieval but also by supporting patient summaries that have been normalized, deduplicated, and enriched.

For a recording of our summary report out to the Connectathon team on our use case and to see the patient summary referenced above, watch this video.

Effective collaboration between payers and vendors was exciting to experience, and the ability to code, test, and review with other vendors and payers in near real-time was a great way to move our own solutions forward as well as contribute to the larger value that FHIR can bring to the healthcare landscape.



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