FINAL AGENDA
NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS
Subcommittee on Standards
Hearing on Electronic Attachments Standards and Operating
Rules
Hubert H. Humphrey Building
200 Independence Ave, SW, Room 705A
Washington, DC 20201
Wednesday, February 27, 2013
Transcript
Wednesday, February 27
|
| 9:05 - 9:15am |
Call to order, Welcome,
Introductions |
Dr. Walter Suarez and Mr.
Ob Soonthornsima, Co-Chairs
|
| 9:15- 11:15am |
Panel 1 - Attachments
Standards and Operating Rules
- Current State of Attachment Standards
- HL7 Standard
- Attachment Coding
- X12 Standard
- Pharmacy
- Current State of Attachment Operating Rules
- Medicare - esMDInitiative
- Questions from Subcommittee
|
Jim McKinley & John Quinn, HL7
Dan Vreeman, Regenstrief Institute
Margaret Weiker, X12
Lynn Gilbertson, NCPDP
Gwen Lohse, CORE
Melanie Combs, CMS
Bob Dieterle, Signature Consulting
Kari Gaare, OESS |
| 12:00 - 12:15pm |
BREAK |
|
| 12:15 - 12:25pm |
Big Picture Perspective of
Technology
|
Doug Fridsma, ONC
|
| 12:25 - 2:10pm |
Panel 2 - Industry
Perspectives
- Plan Perspective
- Provider Perspective
- Multi-stakeholder Perspective
- Questions from Subcommittee
|
Gail Kocher, BCBSA
George Arges, AHA
Mari Savickis, MGMA/AMA
Durwin Day, WEDI
Lindy Benton and Don Gerdts, Healthcare Information
Sevices |
| 2:10 pm |
Adjournment |
|
| 2:10 - 3:00pm |
LUNCH BREAK |
|
Afternoon Session of
the NCVHS Standards Subcommittee
|
| 3:00 - 3:05pm |
Welcome and Introductions
|
|
| 3:05 - 3:45pm |
Subcommittee
Discussion
- Debriefing from Hearing
- Identification of Observations and Areas of Recommendations
|
|
| 3:45 - 4:00pm |
BREAK |
|
| 4:00 - 4:45pm |
Subcommittee
Discussion
- Continue debriefing from Hearing
- Subcommittee Plans for March - June 2013
|
|
| 4:45 - 5:00pm |
Public Input |
|
| 5:00 pm |
Adjournment |
|
Hearing Background
PURPOSE:
Under ACA provision, HHS must adopt standards and operating rules for
electronic attachments by January 2014, with a compliance date of January
2016. The goals of this hearing are to:
- Explore the entire spectrum of the need to exchange clinical, medical
and/or additional administrative data between providers and payers to support
administrative processes, including claim, eligibility, prior authorization,
etc. (currently referred to as "attachments")
- Discuss the policy, business, and technical approaches to
"attachments" and their various elements, including
solicited/unsolicited, structured/unstructured, human readable/computer
processable, etc., with special emphasis on claim "attachments"
- Discuss the status of development of "attachments" standards and
operating rules, and the degree to which they are ready for adoption and use
- Review and discuss current work associated with "attachments"
being done by the industry (including esMD)
- Identify the implementation issues and milestones needed for a successful
implementation of attachments within the timeframe defined in law
- Review and discuss industry perspectives on the adoption and implementation
of "attachment" standards and operating rules
QUESTIONS TO TESTIFIERS:
Testifiers are asked to address the following questions and topics,as
appropriate,in their prepared remarks. In other words, every speaker
need notaddress every item – just those that are relevant to
his or her topic.Testifiers are encouraged to submit written
comments addressing any of the questions from the list below that they did not
cover during their remarks.
- Attachment Standards and Operating Rules
- Are there multiple definitions of attachments under discussion, and what is
the recommended definition of "attachments" to be adopted under
regulations?
- What are the priority business (health related) areas for which
"attachments’ are necessary? How is this expected to change in the
next five or 10 years?
- What are the recommended approaches to the submission of
‘attachments’?
- What is the status of development of ‘attachment’ standards?
- Are there other standards for clinical information exchange rather than or
in addition to HL7 C-CDA that should be considered?
- What metadata or pieces of information would be necessary to include in the
envelope that is not available today in the HL7 C-CDA?
- With respect to the ‘envelope’ of the message, should more than
one enveloping standard be permitted to wrap the standard clinical information?
What are examples of these standards that build on existing or future
infrastructures?
- With respect to transport, how would you envision the
routing/transport(sending or receiving) of clinical/medical information
occurring? How does it relate to HealtheWay and/or ONC Direct and/or ONC
Connect?
- Should we consider optional or situational enveloping (and/or transport)
standards?
- What is the set of attachment standards being recommended for adoption?
- Are there any known limitations or gaps in the recommended standards? How
will they be addressed?
- Are there any Operating Rules to be recommended for adoption at this time?
Which would they be? Are the ‘infrastructure’ related
operating rules in place applicable to attachments? What are the plans
for developing further ‘attachment’ operating rules?What
processes/steps have been taken to identify/develop such operating rules? What
might be some of the lessons learned thus far from the development of previous
operating rules that may be applicable to the development of attachments
operating rules?
- Are the recommended standards (and operating rules, if any) applicable only
to claim attachments, or will they be applicable also to other types of
attachments?
- What are some of the most important business and technical issues
surrounding attachments for providers, health plans, and vendors, and how would
you recommend addressing them?
- What is the current state of industry with respect to the exchange of
standard clinical information to support administrative or financial
transactions?
- What problems or repercussions occur because of the current state? How
would these be addressed if this process was standardized?
- For this transaction, can we predict the technological state of the
industry so that we adopt standard(s) that provide consistency, yet are
flexible enough to take advantage of emerging systems and technologies?
- With regard to claims attachment or attachments in general, what is the
role of operating rules in relation to the transactions; i.e. what problems
could they solve? What problems do they create? How can the process
of development be improved?
- Overall, what would you say are the most significant benefits we should
expect to see (i.e., efficiency, quality, safety, economic, other) that we can
rely upon to monitor progress and measure success? Where do you think
would benefit realization be most challenging?
- What are your current costs (estimate) associated with the exchange of
clinical information to support financial and administrative transactions?
- If clinical information in support of administrative transactions was
exchanged electronically, what are the estimated costs and savings? In what
areas, would you realize these costs and savings?
- How would use of existing infrastructure or infrastructure that will be in
place by 2016 impact costs and savings? Providers, health plans and
vendors are asked to speak about this from their individual perspectives.
- With respect to operating rules, what areas related to attachment
transactions do you see are most important to address through the creation of
operating rules?
- Are the current standards (and operating rules) you have heard about
applicable only to claim attachments, or will they be applicable also to other
types of attachments?
- What are some of the most important business and technical issues
surrounding attachments for providers, health plans, and vendors, and how would
you recommend addressing them?
Should you require reasonable accommodation, please
contact the CDC Office of Equal Employment Opportunity on (301) 458-4EEO (4336)
as soon as possible.
Times, topics, and speakers are subject to change. For final
agenda, please call 301-458-4200 at NCHS or visit the NCVHS Home Page at
http://www.ncvhs.hhs.gov
April 2, 2013