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August 2, 2022

Da Vinci Standards, Decoded: 3 Eye-Opening Ways Every Provider, Payer & HIT Vendor Will Reap Rewards

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

Let’s talk about Da Vinci. Not the artist, although he is a source of inspiration for everything from best-selling books to robotic surgical systems. (Not to mention, the namesake of a Teenage Mutant Turtle.) 

No, we’re talking about the Da Vinci Project, a private-sector collaborative working to define common interoperability standards for healthcare. An HL7 blog notes, “Under the leadership of over 45 prominent industry providers, payers and vendors, the growing Da Vinci community is standardizing the building blocks necessary to support organizations like yours to make the shift to value-based care (VBC) a reality.”  

What do HL7® FHIR® APIs have to do with Da Vinci Standards?

Before diving into what the Da Vinci Standards entail, it’s important to understand some acronyms tied to healthcare interoperability. 

  • HL7:  A not-for-profit, international organization, Health Level Seven International focuses on developing a framework and standards for data integration and sharing of health information. 
  • FHIR:  Fast Healthcare Interoperability Resources is a data protocol to enable interoperability—even for complex healthcare data. HL7 explains that “The philosophy behind FHIR is to build a base set of resources that, either by themselves or when combined, satisfy the majority of common use cases.”
  • API: Application Programming Interfaces are the pipelines for data, allowing users to connect to different systems or applications to talk to each other and exchange information. 

HL7 FHIR APIs are integral to achieving the Da Vinci Standards, which address a variety of use cases in four distinct areas: 

  • Clinical Data Exchange
  • Quality & Risk
  • Coverage, Transparency & Burden Reduction
  • Foundational Assets

Development of the Da Vinci Standards aligns with both current and anticipated regulations. Now, on to some clear advantages the Da Vinci Standards can deliver as adoption grows. 

Advantage 1: Enables consistent, secure data exchange

The Da Vinci Project has made accelerating the adoption of FHIR a key component of its mission. That’s because FHIR suits a variety of applications, from electronic health records to mobile apps. It creates a shared standard for health data, whether the use case covers financial transactions, clinical care, or public health research. Why? Because a standardized format allows healthcare information to be understood by any system, regardless of the information source. 

This type of interoperability is certainly within reach; other industries already make significant use of it. Micky Tripathi, the national coordinator for health IT at the Department of Health and Human Services, likens it to ordering from Amazon. “If you’re logged in and you click on something,” Tripathi notes, “what you’ll see is a URL that says ‘https’ and then this huge string of nonsense. That’s a query-retrieve system that’s generated in your browser and sent to Amazon, and then Amazon immediately returns the results securely.” 

Equally important, you can access this system from a wide range of devices and web browsers. Right now, healthcare lacks such flexibility. Getting different systems to share information presents an ongoing challenge. 

With FHIR APIs, however, patient-generated health data can be easily integrated with clinical data in EHRs. Data from smart watches, glucose meters, or other personal health and fitness devices could complement medical records, giving healthcare providers a more well-rounded view of patients. 

Likewise, provider/payer data exchange is easier, which will make a dent in some of the administrative burdens in healthcare. (More on that later.) Data exchange uniformity also levels the playing field for app development, which should spur innovation for health information technologies.

Advantage 2: Creates a single source of truth

The problem with exchanging information on paper is that the back-and-forth means there can be multiple versions in play at any given time. FHIR standardizes resources, be it one piece of information or a collection of information. Multiple applications can access a particular resource and get the same version of the data, every time. This benefits providers and patients alike. 

Consider the status quo. A patient may see several different providers, not all of them using the same EHR. Because of a lack of interoperability, the completeness of patient records vary.  If a patient has moved around multiple providers over the years or has experienced a health event when on vacation, details from those encounters might not be visible to the patient’s preferred providers. The result? Knowledge gaps that keep you from delivering optimal care. 

With a single source of truth, the data delivers better insights. And it’s not limited to individual patients. Having uniform data that is always current and accessible will prove extremely useful for medical research, population health analytics and more. 

Advantage 3: Reduces coverage discovery and prior authorization burdens

The lack of interoperability and over-reliance on paper makes prior authorization especially time-consuming. Instead of the ability to directly interact with payers for coverage determination and prior authorization requirements, for instance, providers typically rely on institutional knowledge (a problem in itself when key staff members leave) or time-consuming research and phone calls. 

Smaller healthcare providers find the burden especially high, according to a study published in the July 2022 issue of the Journal of the American Medical Informatics Association. While 51% of large practices (50+ physicians) can integrate data from queries in their EHRs, only 17% of solo practitioners can do likewise. Either way, that leaves a substantial number of providers unable to unlock the benefits of real-time data exchange of critical patient and payer information. 

With a FHIR-based API and the use cases being tested by the Da Vinci Project, providers can integrate prior authorization within the workflow. It’s not as far off as you might think. Myndshft uses HL7 FHIR APIs to enable a fully-automated, end-to-end, prior authorization workflow, from benefits verification to prior authorization determination, pre-submission validation, and submission. Add in clinical decision support and customizable auto-adjudication on the payer side, and you’ve got the type of interoperability and burden reduction that the Da Vinci Project encourages.

Leonardo Da Vinci once said, “Simplicity is the ultimate sophistication.” (Honestly, he probably said it more than once because it’s catchy.) In the case healthcare interoperability, the Da Vinci Project shows that a consistent framework, resources, and data exchange tools remove complexity from the processes and paperwork that keep providers from focusing on what matters most—patients.

Arrange a demo to see how Myndshft works.