Driving Interoperability Forward: How the HL7 Da Vinci Project Is Advancing Standards, Pilots, and Policy in 2026
The HL7 Da Vinci Project continues to advance standards-based interoperability across the healthcare ecosystem. The collaborative work continues to advance 2026 program priorities, including the maturation of key use cases, expansion of pilots, and responding to important federal policy developments shaping the path forward.
2026 Program Priorities
Da Vinci’s 2026 priorities reinforce the project’s core mission: to develop, pilot, and support adoption of HL7® Fast Healthcare Interoperability Resources (FHIR®) Implementation Guides (IGs) that meaningfully improve payer–provider data exchange and support value-based care across communities.
A central focus remains strengthening implementer support, particularly for IGs referenced directly or indirectly in federal regulation, through clearer guidance, shared implementation learnings, and improved feedback mechanisms during development cycles.
Da Vinci continues to coordinate closely with federal agencies and industry partners, including CMS, ONC, and a broad ecosystem of provider, payer, and standards organizations. These collaborations help ensure alignment between evolving policy direction and real‑world implementation capabilities, while elevating awareness of FHIR adoption progress and measurable success.
Use Case and Implementation Guide Progress
Several Da Vinci use cases have reached significant milestones. Implementation guides central to burden reduction and interoperability—Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), Prior Authorization Support (PAS), and Health Record Exchange (HRex)—have been published and are actively supporting payer–provider workflows across the industry.
Other use cases continue to evolve. Payer Data Exchange (PDex) is planning a potential STU update related to Provider Access in 2026, while the Risk Adjustment use case is preparing an STU update that includes new operations, simplified MeasureReports, and clearer data submission guidance. Da Vinci’s working group structure enables continuous stakeholder participation, ensuring updates are grounded in implementation experience.
Pilots in Action: Da Vinci Trebuchet and Patient Cost Transparency
Piloting remains central to Da Vinci’s approach, providing a structured pathway for validating standards in production‑like environments and accelerating adoption.
Patient Cost Transparency (PCT) pilots have entered their second year, with payers and provider systems now having tested the full end‑to‑end workflow for Good Faith Estimates and Advanced Explanation of Benefits (AEOBs). Recent testing expanded beyond polling-based techniques to leverage FHIR subscriptions, enabling more timely access to AEOB information for patients and providers. Notably, pilots now support collaboration across multiple providers on a single estimate, helping patients better understand expected out‑of‑pocket costs for complex services such as knee surgery.
Da Vinci Trebuchet continues to expand, reflecting growing interest in scalable interoperability models. A new Trebuchet Payer‑to‑Payer (P2P) Work Group is actively advancing payer‑to‑payer exchange by testing direct and networked connectivity approaches. The group is also developing practical guidance related to endpoint discovery, data governance, and member consent—foundational elements for broader exchange.
In addition, the Trebuchet Clearinghouse‑to‑Clearinghouse Prior Authorization Pilot, sponsored by the Cooperative Exchange in collaboration with the HL7 Da Vinci Project, is focused on reducing administrative burden by extending prior authorization standards to clearinghouse‑to‑clearinghouse workflows. Together, these efforts demonstrate how Da Vinci pilots support real‑world implementation and inform future standards development.
To learn more about current pilots and participating organizations, visit the Da Vinci Trebuchet FHIR Pilots page and PCT Pilots page. Organizations interested in participating in pilots are encouraged to contact davincipmo@pocp.com.
Federal Policy Spotlight: CMS 2026 Interoperability Proposed Rule
CMS and ONC has released the 2026 Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS‑0062‑P), representing the latest step in a multi‑year effort to advance nationwide interoperability and streamline prior authorization processes.
This proposal builds on earlier CMS interoperability rules by reinforcing and expanding requirements for APIs such as Patient Access, Provider Access, Payer‑to‑Payer, Provider Directory, and Prior Authorization. Collectively, these policies continue to signal a strong federal commitment to FHIR‑based data exchange as foundational infrastructure for healthcare operations. The new proposed rule relies heavily on the work of the HL7 Da Vinci Project community and could bring significant changes for industry, including adding Da Vinci implementation guides to HIPAA requirements.
The proposed rule has meaningful implications for Da Vinci use cases and implementation guides, particularly those supporting prior authorization, payer‑to‑payer exchange, and transparency workflows. Da Vinci has undertaken a consensus process with its members to respond to the proposal, identifying areas of significant impact, and supporting stakeholders as they evaluate operational, technical, and policy considerations.
Implementer Resources and Community Engagement
Da Vinci continues to expand implementer resources, including its Implementer Support page, recorded video presentations, and detailed pilot documentation. These tools are designed to support organizations across the implementation lifecycle—from early exploration through scaled adoption.
Community engagement remains central to Da Vinci’s success, and participation from payers, providers, vendors, and policy stakeholders continues to shape standards that are both implementable and impactful.To learn more about the HL7 Da Vinci Project and to sign up for the listserv, please visit: hl7.me/davincinews
