Da Vinci PDEX PlanNet Patient Access API ImplementationAThon

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Da. Vinci PDEX Plan-Net Patient Access API Implementation-A-Thon Track Orientation Saul A. Kravitz MITRE

Da. Vinci PDEX Plan-Net Patient Access API Implementation-A-Thon Track Orientation Saul A. Kravitz MITRE 1/2/2022 © 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 • What is a Plan-Net (Payer Provider Directory)? • Status of Plan-Net IG

Agenda • What is a Plan-Net (Payer Provider Directory)? • Status of Plan-Net IG • Goals for this Implementation-A-Thon • Tracking Issues • Resources • Reference Implementation Demonstration (maybe) © 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. 2

What is Plan-Net (aka Provider Directory) • Plan-Net (aka Payer Provider Directory) – Defines

What is Plan-Net (aka Provider Directory) • Plan-Net (aka Payer Provider Directory) – Defines a FHIR interface to a health insurer’s insurance plans, their associated networks, and the organizations (including pharmacies) and providers that participate in these networks. – Enables third parties to develop applications through which consumers and providers can query the participants in a payer’s network that may provide services that address their health care needs. • Plan-Net Content: – Services provided by Payer’s network – Provider (practitioner and organization) locations, contact info, accessibility, network participation – Endpoints for electronic exchange (FHIR server URLs, Direct addresses, portals) © 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. 3

How to Get Involved REGISTER: https: //www. hl 7. org/events/fhir/implementation/2020/#section-pricing AGENDA: https: //www. hl

How to Get Involved REGISTER: https: //www. hl 7. org/events/fhir/implementation/2020/#section-pricing AGENDA: https: //www. hl 7. org/events/fhir/implementation/2020/#section-agenda Plan-Net Track Information: https: //confluence. hl 7. org/pages/viewpage. action? page. Id=86978615 © 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

Agenda Highlights • • – Kickoff Aug 18, 12: 45 – 1: 30 pm

Agenda Highlights • • – Kickoff Aug 18, 12: 45 – 1: 30 pm ET – Da Vinci Plan-Net Saul Kravitz - MITRE Aug 19, 11: 00 - 11: 30 am ET • Aug 19, 11: 30 -3: 30 pm ET Parallel Tracks: – Da Vinci Provider Directory • Aug 19, 3: 30 – 4: 45 pm ET – Readout from all tracks © 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

Status of Plan-Net IG • STU 1 ballot Implementation Guide published 10/24/2019 – http:

Status of Plan-Net IG • STU 1 ballot Implementation Guide published 10/24/2019 – http: //hl 7. org/fhir/us/davinci-pdex-plan-net/2020 Feb/ • Ballot reconciliation nearing completion, current build of IG available – https: //build. fhir. org/ig/HL 7/davinci-pdex-plan-net/ • CMS has Referenced this IG on its webpage as an in IG supporting the CMS Interoperability Rule requirements – Search for “Provider Directory” © 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

Changes Since Last Connectathon • Capability Statement • Reduced set of search parameters –

Changes Since Last Connectathon • Capability Statement • Reduced set of search parameters – The number of search parameters has been reduced to ease deployment by payers. – Some functionality has been transferred from server to client (e. g. , near search) • Improved examples and explanatory text • Modest polishing of terminology bindings © 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

Tracking Issues • Reference Implementation Integration Issues • Zulip - https: //chat. fhir. org/#narrow/stream/207606

Tracking Issues • Reference Implementation Integration Issues • Zulip - https: //chat. fhir. org/#narrow/stream/207606 -Da. Vinci. 2 Fplan -net-connectathon • Implementation Guide Issues: • Jira - https: //jira. hl 7. org/projects/FHIR/issues © 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

Resources • Postman query collection: – https: //github. com/saulakravitz/plan-net-postman-collection • Reference Implementation Code and

Resources • Postman query collection: – https: //github. com/saulakravitz/plan-net-postman-collection • Reference Implementation Code and Docker Images – Server: https: //github. com/HL 7 -Da. Vinci/plan-net-ri – Generated Data Collection: https: //github. com/HL 7 -Da. Vinci/pdex-plan-net-sample-data – Client: https: //github. com/HL 7 -Da. Vinci/plan-net_client • Hosted Reference Implementation – Server: https: //davinci-plan-net-ri. logicahealth. org/fhir – Client: https: //davinci-plan-net-client. logicahealth. 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

Use Cases • Scenario : Find a Specialist That Accepts My Insurance – Action:

Use Cases • Scenario : Find a Specialist That Accepts My Insurance – Action: • Select a payer and a network • Select a specialty and a geography – Success Criteria: Display list of practitioners. • Scenario : Find a Pharmacist That Accepts My Insurance – Action: • Select a payer and a network • Select a name and/or geography – Success Criteria: Display list of Pharmacies © 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

Demonstration of Reference Implementation • Go to Client: – https: //davinci-plan-net-client. logicahealth. org •

Demonstration of Reference Implementation • Go to Client: – https: //davinci-plan-net-client. logicahealth. org • Connect to server: – https: //davinci-plan-net-ri. logicahealth. org/fhir © 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