Alerts (Da Vinci project; PSS in Confluence)

Description

Currently, ADT exchange approaches typically use HL7 V2 ADT messages. This a legacy EDI-style technology that uses HL7 specific protocols over ports hat are not typically exposed to the internet. While HL7 V2 works will within the confines of a hospital system's intranet, it is not particularly well suited to cross-enterprise data exchange.

FHIR resources can be used to transport patient information relevant to a specific event (e.g. admission, discharge, change in treatment, new diagnosis) to another provider or the health plan to communicate the details of where care was delivered and help to ensure timely follow-up as needed. Health care stakeholders are increasingly responsible for knowing what chare their patients have received and what care they need, regardless of where the patient sought care. This information can be used to build an encounter record in the receiving system with appropriate provenance and make it available to CDS and other local services. Since this is a 'push' transactions, additional work is needed to determine the best exchange methods (Push, Subscribe, Operations, etc), authentication, patient matching, and endpoint determination.

This PSS builds on existing or in process implementation guides for the automation of coverage discovery (Coverage Requirements Discovery - CRD), access to provider information (Clinical Data Exchange - CDex) and the Health Record Library/Framework (HRex).

Workflow will be defined to establish consistently adoptable and reproducible methods to exchange the alerts.

This project will reference, where possible the 'standards' defined by the Health Record exchange (HRex) Library/Framework Implementation Guide which in turn will utilize prior work from Argonaut, US Core and QI Core effort for FHIR DSTU2, STU3, and R4 where appropriate.

The ultimate goal is to support the real-time exchange of alerts that impact patient care and value based or risk based services.

The project team plans to work with existing FHIR artifacts where possible. If changes are necessary, the project team will work with the responsible Work Group to review and implement (via tracker items or new PSS) any necessary enhancements to base FHIR resources, extensions, and/or profiles.

Misc Notes
2025 March: TSC approved STU Extension Request for Da Vinci Notifications for 2 years 2025 January: TSC approved Unballoted STU Update Publication Request for Da Vinci Unsolicited Notifications 1.1.0 2022 Sept: TSC approved STU Extension Request for HL7 FHIR Implementation Guide: Unsolicited Notifications (Alerts), Release 1 for 2 years 2020 Sept: TSC approved STU Publication Request for Da Vinci Unsolicited Notifications 1.0.0 - STU1 2019 October: Bob Dieterle: Per FMG, sponsorship should be CDS, not InM. External Vocabularies: HCPCS, SNOMED, CPT, ICD, RxNorm, LOINC For FHIR IGs and FHIR Profiles, what product version(s) will the profiles apply to? R4, STU3, DSTU2 Other Stakeholders and Providers: Federal Healthcare Agencies (e.g. CMS), Providers (e.g. Physicians)