About 50 organizations are now involved in the HL7 Da Vinci Project’s ongoing Trebuchet pilot program, working toward launching pilots to test using standard application program interfaces (APIs) and a central hub to streamline data exchange among providers and payers.
Pioneers of the effort named the coalition “Trebuchet” to illustrate how the success of a third-century military catapult could launch providers, payers, and a Qualified Heath information Network, or QHIN, into production of trusted and scalable exchange.
Participants will be using APIs that leverage HL7’s Fast Healthcare Interoperability Resources® (FHIR®) standard to exchange data via a QHIN, as called for in the Trusted Exchange Framework and Common Agreement, or TEFCA, to maintain trust.
Pilots now in the planning stage are focusing on leveraging the HL7 FHIR implementation guides (IGs) for Clinical Data Exchange (CDex); three burden reduction IGs: Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR) and Prior Authorization Support (PAS); and provider access.
Scott Rossignol, a consultant with eHealth Exchange, a QHIN participating in Trebuchet, points out: “We recently went live with data exchange between two organizations, MultiCare (provider) and Cambia (payer), using CDex and Bulk Data. This work is now progressing to a stable production feed.
Compliance
The Trebuchet initiative is helping organizations prepare for compliance with the
federal Interoperability and Prior Authorization Rule , which requires many payers to use FHIR APIs for prior authorization transactions and other patient data exchange.
The rule, which has a compliance date of January 2027, does not, however, require the use of a TEFCA-defined QHIN. Organizations can opt to use FHIR APIs for point-to-point data exchange instead.
“Organizations are familiarizing themselves with the Da Vinci IGs, preparing to exchange data to support compliance with prior authorization regulations, and will pilot exchanging this data with partners in test environments,” says Michele Galioto, project management support to the Trebuchet Project and senior consultant with Point-of-Care Partners. “This will inform their individual organizations of gaps and/or enhancements that may improve their approach to meeting requirements in an efficient, effective, compliant manner.”
Key Factors
Preparing for compliance raises technical, operational and legal considerations, Rossignol notes.
“Educating the right folks at an organization is critical to getting buy-in,” he stresses. “A lot of organizations are still trying to understand the value of joining a QHIN vs. the risks of a common agreement that the network requires.”
On the technical side, organizations are digging further into the requirements of different IGs, Rossignol says. “It’s great to see organizations choose different IGs to focus on and different approaches to using them, as this work is crucial in determining the real ‘winning’ approaches. By sharing our lessons learned via Trebuchet, we’re able to avoid mistakes and make things easier for new implementers.”
Sharing Insights
Pilot participants will share their insights during Trebuchet public meetings. They also will provide feedback to Da Vinci IG teams regarding the need for IG clarifications and enhancements, Galioto explains.
All organizations are welcome to join Trebuchet and participate in piloting. Organizations do not need to be Da Vinci members to participate. Meetings are held every other Thursday at 2 p.m. ET.
Trebuchet offers a non-competitive environment for testing APIs and learning from others who are moving toward regulatory compliance, Galioto says.
“Peer-to-peer learning supports broadening understanding and improving how we all do this work,” she notes. “Participation may support your own organizational preparedness for regulatory compliance and opportunities to leverage FHIR and Da Vinci IGs to support data exchange. Trebuchet supports the pilot, fail-fast approach to preparing in a supportive environment.”
For updates on the project, visit: https://confluence.hl7.org/display/DVP/Da+Vinci+Trebuchet+FHIR+Pilots
Here’s a link to another story about Trebuchet:
Trebuchet Pilot Program Demonstrating the Practical Use of HL7® FHIR® Transactions | HL7 News
