×

To enhance security, Multi-Factor Authentication (MFA) is mandatory for all HL7 users. More information

 
Return to Search

Documentation Templates and Rules (Da Vinci pjt; PSS in Confluence)

Return to Search

Basics

Documentation Templates and Rules (Da Vinci pjt; PSS in Confluence)

1493
Ballot - STU to Normative


FHIR Implementation Guide; FHIR Profile

Implementation Guide

Details

See PSS in Confluence for a full description:

https://confluence.hl7.org/display/DVP/PSS+for+Documentation+Templates+and+Rules?preview=/39160919/40730674/image2019-1-9_11-10-18.png

The scope on Confluence describes details of the scope...the summary below isn't very descriptive

- Providers need to easily incorporate payer requirements into their clinical workflow

- Use a FHIR based standard for representing payer 'rules' to communicate, in real time, payer medical necessity and best clinical practice requirements that may affect the ability to have certain services or devices covered by the responsible payer

- Template rules

- Provider/Payer Initiated Actions

- Documentation templates provide for

Create framework for template/rules that address


Providers need to have access to executable payer requirements to ensure that documentation supports the medical necessity and appropriateness of a covered service, gather information for authorizations, perfect orders and referrals for patient treatment. The need is for standard representation of payer requirements that can be executed by payer CDS or by rules that can be executed in the context of a SMART of FHIR application. The solution must support the ability to evaluate the current patient information, request missing information, suggest addition evaluations that need to be performed/documented, and incorporate the answers in the clinical record.



Ballot for Comment - Target: 2019 May Ballot Submit for STU 1 Ballot - Target: 2019 Sep Ballot Complete STU 1 Reconciliation - Target: 2020 Jan WGM Request STU 1 Publication - Target: 2020 Jan WGM STU Period - Target: 2020 Jan Submit for STU 2 Ballot(First Ballot Cycle) - Target: 2020 Sep Ballot Complete STU 2 Reconciliation - Target: 2021 Jan WGM Request STU 2 Publication - Target: 2021 Jan WGM STU Period - Target: 2021 Jan -2022 Jan Submit for Normative Ballot - Target: 2021 May Ballot Complete Normative Reconciliation - Target: 2021 Sep WGM Submit Publication Request - Target: 2021 Oct Project End Date (all objectives have been met) - Target: 2021 Dec


HTTP: //confluence.hl7.org/pages/viewpage.action?pageId=39158184

How much content for this project is already developed? 10% Was the content externally developed ? : Y Da Vinci Is this a hosted (externally funded) project? (not asking for amount just if funded) X Yes

Coverage Requirements Discovery

Clinical and Public Health Laboratories, Immunization Registries, Quality Reporting Agencies, Regulatory Agency, Payors, Other (specify in Misc. Notes below),Clinical and Public Health Laboratories; Emergency Services; Local and State Departments of Health; Medical Imaging Service; Healthcare Institutions (hospitals, long term care, home care, mental health),Pharmaceutical; EHR, PHR; Equipment; Health Care IT; Clinical Decision Support Systems; Lab; Other (specify in Misc. Notes below)

1. CMS


Documentation Templates and Rules, DTR, Payer Rules, Da Vinci



N/A

No

2026 March: TSC approved an STU Publication Request for HL7 FHIR® Implementation Guide: Documentation Templates and Rules (DTR), Edition 2.2 - US Realm 2024 December: TSC approved Unballoted STU Update Publication Request for HL7 FHIR Implementation Guide: Da Vinci - Documentation Templates and Rules Edition 2.0, US Realm 2023 October: TSC approved STU Publication Request for Da Vinci Documentation Templates and Rules Implementation Guide Release 1.1 - US Realm STU for 2 years 2022 August: TSC approved STU Extension Request for HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 1- US Realm for one year 2021 December: TSC approved an out of cycle ballot request for HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 2- US Realm. 2020 Dec: TSC Approved STU Publication Request for HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 1 - US Realm for 24 months For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to? DSTU2, STU3, R4 Other Stakeholders and Vendors: Federal Healthcare Agencies (e.g. CMS), Providers (e.g. Physicians)
Organization & Realm

Realm Specific - Enter "U.S." or name of HL7 Affiliate below

U.S.
People

Robert Dieterle, Kevin Larsen



Clinical Decision Support Work Group

Patient Care Work Group; Payer/Provider Info Exchange Work Group

Status & Dates

Active

STU - Reconcile

01/28/2019

01/01/2028

2028 Jan WGM/Ballot

01/01/2028

2028 Jan WGM/Ballot

2025 Sept Ballot Cycle Info: STU Ballot Results: Met basic vote requirements. 31 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Edition 3 - US Realm 2024 Sept Ballot Cycle Info: STU Ballot Results: Postponed Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 2- US Realm 2022 Jan Ballot Cycle Info: STU Ballot Results: Postponed Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 1- US Realm 2022 May Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 30 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 2- US Realm 2019 Sept Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 32 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 1- US Realm 2019 May Ballot Cycle Info: COMMENT ONLY Ballot results: Did not meet basic vote requirements. 18 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Documentation Templates and Payer Rules (DTR), Release 1- US Realm
Approvals

06/07/2019


Received


All Received




System Info



View Ballot Items (with NIBs)



04/03/2026

Anne Wizauer
Return to Search