CMS Patient Access API Payer Data Exchange Da

CMS Patient Access API Payer Data Exchange Da Vinci Formulary PDex Plan-Net CARIN Blue Button Mark Scrimshire | Dave Hill | Saul Kravitz | Amol Vyas 12/13/2021 © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office.

Agenda - Why Connectathons? Why This Track? Track Organization/Timeline Logistics Communication Tools Connecting With Test Partners Questions JANUARY 13 -15, 2021 Disclaimer 2

Why Connectathons? • Join the community of FHIR users • Develop and test systems and use of the standard • Increase the visibility of resources, profiles and implementation guides. • In-Depth discussion of a use case • Demonstrate what’s possible • Refine the FHIR Specification • Testing as part of a connectathon is a pre-requisite for resources and implementation guides progressing up the FHIR Maturity Model. Disclaimer 3

Why the Da Vinci CMS Patient Access API Track • CMS Interoperability and Patient Access Rule – Deadline: 1/1/2021 >> Enforcement: 7/1/2021 • Test the IGs in parallel – – US Core + Payer Data Exchange + Plan-Net + Formulary Integrated data Reference Implementations (Client and Server) OAuth 2. 0 / SMART-on-FHIR App Launch Framework • Find Test Partners © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 4

Get Prepared – Start by Registering NOW! • http: //www. hl 7. org/events/fhir/connectathon/2021/01/ – Early-bird rate expires on 12/30/2020 – Whova Instructions are provided once registered • Main Connectathon Page: https: //confluence. hl 7. org/display/FHIR/2021 -01+Connectathon+26 • Check out the Individual Track Pages: • 2021 -01 Da Vinci Payer Data Exchange (PDex) – https: //confluence. hl 7. org/pages/viewpage. action? page. Id=97463736 • 2021 -01 Da Vinci - PDex Drug Formulary – https: //confluence. hl 7. org/display/FHIR/2021 -01+Da+Vinci++PDex+Drug+Formulary • 2021 -01 Da Vinci - PDex Plan-Net (Provider Directory) – https: //confluence. hl 7. org/pages/viewpage. action? page. Id=97464494 • 2021 -01 CARIN Consumer Directed Payer Data Exchange (CARIN IG For Blue Button®) – https: //confluence. hl 7. org/pages/viewpage. action? page. Id=97464608 © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 5

MEET YOUR TRACK LEADS © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 6

Track Leads – Mark Scrimshire @ekivemarks Mark. Scrimshire@onyxhealth. io Co-Chair Da Vinci Payer Data Exchange Workgroup Chief Interoperability Officer, Onyx Technology, LLC Previously CMS Blue Button Innovator: Architected and built the Blue Button 2. 0 API for Medicare. © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 7

Track Leads – Dave Hill Project Manager, Tech Lead, MITRE Add Profile Picture Author – Da Vinci Drug Formulary DWHill@mitre. org © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 8

Track Leads – Saul Kravitz Principal Engineer, MITRE Add Profile Picture Author – Da Vinci Plan-Net IG saul@mitre. org © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 9

Track Leads – Amol Vyas @mister_pdx amol. vyas@cambiahealth. com Add Profile Picture Technical Lead, CARIN Health Plan Workgroup Chief Architect (Interoperability), Cambia Health Solutions © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 10

TRACK OVERVIEW AND TIMELINE © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 11

Test the APIs • Q&A Sessions • Discuss Use Case Scenarios • Review Reference Implementations • Test Cross-IG Scenarios © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 12

Cross IG Use Case Scenarios Elaborate on Provider and Organization Data 1 a) Claim to Provider Directory 1 b) Encounter to Provider Directory 2 a) Pharmacy Claim to Formulary 2 b) Medication. Dispense to Formulary © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 13

Road to the Connectathon Pre-Events Tues, 12/15/20, 4: 00 P Connectathon Prep Information Session Fri, 12/18/20 & 1/8/20 12 P PDex Work Group Meeting Tues, 1/12/21, 4: 00 P Whova for Connectathon Participants Kick-Off Events Connectathon Weds, 1/13/21, 4: 00 P Connectathon 26 Kick Off Thurs, 1/14/21, 9: 00 A – 7: 00 p Connectathon Weds, 1/13/21, 5: 00 P Intro to FHIR Fri, 1/15/21, 9: 00 A – 4: 00 p Connectathon Weds, 1/13/21, 5: 00 P Track Kick-Off Fri, 1/15/21, 4: 00 P – 4: 30 p Wrap-up / Report Out © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. Fri, 1/15/21, 4: 30 P – 5: 30 p Virtual Happy Hour (BYOB) 14

Patient Access API Track Special Sessions Thursday Friday 09: 00 10: 00 11: 00 12: 00 01: 00 TBD – Avoiding Conflicting Sessions 02: 00 03: 00 04: 00 Wrap-up 05: 00 © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 15

COMMUNICATION TOOLS © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 16

Get connected - Zulip • PDex: – https: //chat. fhir. org/#narrow/stream/235286 -Da-Vinci. 20 PDex • Formulary: – https: //chat. fhir. org/#narrow/stream/197730 -Da-Vinci. 20 PDex. 20 Drug. 20 Formulary • Plan-Net: – https: //chat. fhir. org/#narrow/stream/207606 -Da-Vinci. 2 Fplan-net-connectathon © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 17

PREPARING FOR THE EVENT © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 18

Preparation Makes All the Difference • Familiarize yourself with base technologies - Re. ST-based APIs and conventions – e. g. GET vs. POST vs. PUT, HTTP headers - Inspect and understand the HTTP protocol with tooling – i. e. Postman, Browser debugger, Server-side debugger • Is your software configured? • Bringing a Server? Is it accessible from the Internet? © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 19

Testing and Test Partners • Aegis Test Scripts • • Pdex. Parent: Touchstone_Da. Vinci_PDex_Scripts Formulary: Touchstone_Da. Vinci_PDex. Formulary_Scripts Plan-Net: Touchstone_Da. Vinci_PDex_Plan. Net_Scripts CARIN-For-BB: Touchstone_CARIN_Blue. Button_Scripts • Register in the Con Man App: http: //conman. clinfhir. com/connectathon. html? event=con 25 • This will get updated for the upcoming event. © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 20

QUESTIONS © 2019 Health Level Seven ® International. Licensed under Creative Commons Attribution 4. 0 International HL 7, Health Level Seven, FHIR and the FHIR flame logo are registered trademarks of Health Level Seven International. Reg. U. S. TM Office. 21