Introduction

Purpose

The IG provides specific guidance showing patterns of exchange so that providers and payers can reliably exchange information for patient care (including coordination of care), risk adjustment, and quality reporting, and other uses that may be documented as part of this effort. Clinical data payloads include C-CDA, C-CDA on FHIR, compositions, bundles, specific resources, and bulk data exchange. This list is intended to be illustrative and not prescriptive.

Value Proposition

The goal of this implementer guidance is to rapidly improve available computer processing methods that can be used between payers, providers, and service supplier systems. The project will accelerate the shift toward value-based care and support value-based reimbursement models. More efficient and effective exchange of health record information will improve coordinated care and network performance, increase operational efficiencies, improve delivery of patient care and care outcomes, and reduce the burden of quality reporting.

We request clarification given DEQM has been brought underneath the HRex umbrella. Is it still appropriate to suggest that CDex can be used for quality reporting? My concern is that software developers will be confused as to which IG to implement, even though CMS' will point (presumably) to DEQM.

In the Joint Commission's experience, you need to provide one method by which a particular type of data is to be transmitted in order to ensure interoperability between sender and receiver. For example, CMS' HIQR and HOQR programs have two slightly different XML file formats for transmitting chart-based measure data. The Joint Commission aligned with both formats to reduce burden on healthcare organizations. Our issue is the amount of education and transmission support that we have had to provide software vendors uncertain which format to use.