HL7 Calls on NCVHS to Designate FHIR as Clinical Attachments Data Standard

In a recent letter, Health Level Seven International (HL7) called on the National Committee on Vital and Health Statistics (NCVHS) to include FHIR as a data standard for electronic clinical attachments.

HL7 officials expressed concern that the proposed Attachments rule in the CMS Unified Agenda may not include HL7 FHIR and the Da Vinci Clinical Data Exchange Implementation Guide (CDex) as standards since NCVHS did not recommend a specific standard in their July 2022 letter to the HHS Secretary.

“If they are not included, the healthcare industry may miss a significant opportunity to build upon the FHIR foundations,” Charles Jaffe, MD, PhD, HL7 CEO, said in a public statement.

“This may have lasting impact on patients, providers, government and commercial entities and the broader healthcare community. We must continue to adopt HL7 FHIR to support HIPAA-mandated transactions,” Jaffe added.

In the letter, HL7 officials outlined recent advances related to the HL7 FHIR Implementation Guides (IGs) capable of supporting HIPAA-mandated prior authorization (PA) and clinical attachments workflows.

The prior authorization guides, collectively known as the Burden Reduction Implementation Guides, specify a FHIR-based approach that stakeholders can implement within the EHR. Experts say the IGs can help reduce the burden of identifying the need for PA, gathering the required data from the EHR, and submitting the PA to payers.

Further, HL7 plans to publish the Da Vinci Clinical Data Exchange Implementation Guide (CDex) in the First Quarter of 2023. The guide defines a FHIR-based approach to support electronic clinical attachments for solicited and unsolicited attachments.

Additionally, the guide defines ways to use FHIR for requests for additional information not identified and exchanged during the initial PA and quality measure exchange processes described by other Da Vinci FHIR implementation guides.

“The rapid advancements in FHIR adoption by providers, payers, and others establishes a foundation for future progress in interoperability based on the FHIR standard,” said Viet Nguyen, MD, HL7 chief standards implementation officer.

“HL7 will collaborate with stakeholders in the standards and interoperability community such as the Designated Standards Maintenance Organization (DSMO) members and WEDI, to develop and adopt standards that support foundational clinical and administrative processes,” Nguyen added.