Interoperability
This release of the Foundation for Healthcare provides key enhancements supporting the Healthcare data interoperability initiatives by CMS (The Centers for Medicare and Medicaid Services). This release focused on the mandate for CMS-funded health plans to enable patients’ real-time access to clinical data on request, supported by the HL7 FHIR standards. These enhancements facilitate the transmission and receipt of clinical data according to the DaVinci Payer Data Exchange (PDex) framework, supporting payer-to-payer and payer-to-3rd party interactions.
Pega Foundation for Healthcare
Release Notes
- New Clinical Service APIs. The foundation provides 4 new and 1 updated FHIR clinical service APIs – Condition, Observation, Allergy intolerance, Document reference (e.g., Care plan or Discharge summary PDFs) and Patient (updated API), created to specifically support the mandate for access to clinical data held by payers upon patient request. The new service APIs establish the Foundation as the endpoint URL, allowing the exchange of data using GET capability. For more information on the FHIR clinical service APIs please see the 8.7 FHIR API Technical Specification Document.
- Enabled multi-source data pages. Historically, PFHC’s out-of-the-box data pages have enabled the user to invoke a single internal source of data (Pega database). Consequently, to invoke an external source of data (e.g., a FHIR-enabled repository), the user was required to override the existing OOTB data pages or create new ones. In this release, Pega Foundation for Healthcare has enhanced its data pages to enable the user to conditionally invoke a source of data (FHIR repository v. Pega database) from a single data page, thus easily configuring various sources of data based on business needs. This enhanced configuration is available for data pages related to member, clinical and care information, including Member, Allergies, Conditions, Encounters, Medications, Observations, and Medical history. For more information on multi-sourced data pages, see the 8.7 Pega Foundation for Healthcare Implementation Guide.
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