Support a Transition of Care or Referral to Another Health Care Provider

NCPDP Comment

NCPDP recommends that ONC add the following:

Type- Implementation Specification

Standard Implementation/Specification- NCPDP SCRIPT Standard, Implementation Guide, Version 2022011

Standards Process Maturity – Final

Implementation Maturity- Pilot

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – No

Pharmacy HIT Collaborative (PHIT) comment

PHIT supports NCPDP’s recommendation of adding NCPDP SCRIPT Standard, Implementation Guide, Version 2022011 to the implementation specification.

NCPDP Comments

NCPDP supports ONC’s recommendations.

NCPDP Comment

1. Modify the following:

Type-Change to: Implementation Specification

Standard Implementation/Specification- HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Release 2.1

Standards Process Maturity –Final

Implementation Maturity- Production

2. Add the following:

Type- Implementation Specification

Standard Implementation/Specification- NCPDP SCRIPT Standard, Implementation Guide, Version 2020101

Standards Process Maturity – Final

Implementation Maturity- Production

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – No

Remove: NCPDP Specialized Standard. The Referral transactions have been moved to the NCPDP SCRIPT Standard, Implementation Guide, Version 2020101

NCPDP Comment

1. Add the following:

Type-Emerging Standard

Standard Implementation/Specification- HL7 Implementation Guide for C-CDA Release 2.1: Consolidated CDA for Clinical Notes and C-CDA on FHIR R4

Standards Process Maturity – Final

Implementation Maturity- Production

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – No

Available – Spring 2020

2. Emerging Standard New transactions proposed within NCPDP SCRIPT Standard:
   1. Patient Care Service Referral (ServiceReferral)
   2. Patient Care Service Documentation (ServiceDocumentation)
   3. Response to Request for Patient Care Service Referral (ResponseToReferralRequest)
   4. Request for Patient Care Service Referral (RequestForReferral)
   5. Response to Patient Care Service Referral (ServiceReferralResponse)
3. Request NCPDP PatientCareServiceReferral Transactions be added to the ONC 360 project

Specifications to manage x-organizational referrals and TOC

See attached file for comments related to referrals/transitions of care - received via email on 9/23. 

2019_ISA_Comments_Approval_Final Submitted_2.pdf

Pharmacy HIT Collaborative's Comments on ONC's Proposed 2018 ISA

The Pharmacy HIT Collaborative supports the use of HL7 Clinical Document Architecture (CDA), Release 2.0, Final Edition; the balloted drafts of: HL7 Consolidated CDA Release 1.1 (HL7 Implementation Guide for CDA Release 2: IHE Health Story Consolidation, DSTU Release 1.1, US Realm), HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Release 2.1, and  IHE Patient Care Coordination Technical Framework Supplement 360 Exchange Closed Loop Referral, Rev. 1.1, Trial Implementation; and NCPDP Specialized Standard.

​​​​​​​Does ONC anticipate 360x becoming federally required

HE Patient Care Coordination Technical Framework Supplement 360 Exchange Closed Loop Referral (360X) Rev. 1.1 – Trial Implementation

The Shall use XDM needs to be reduced to May. That will be consistent with MU2015 requirements to send/receive a single document and use of XDR. Sending a single document is patient based workflow facilitating patient matching and meeting the workflow requirements when sending direct, it lowers the bar for adoption.  

Does ONC anticipate use of 360x becoming federally required?

Consider CDA on FHIR and…

Consider CDA on FHIR and CCDA on FHIR.

NCPDP - Comment

In Emerging Implementation Specification add the following:

• NCPDP Specialized Standard supports request/referral for MTM Services may be initiated by the payer, treating or prescribing physician, pharmacist, a hospital or other facility, and/or the patient or caregiver.
• CCDA R2 is the basis for NCPDP recommendations for Pharmacy Transition of Care, Pharmacy/Pharmacist care notes, and HL7 CDA® R2 Implementation Guide: Medication Therapy Management (MTM) Templates, Release 1 - US also known as HL7 IG for CDAR2: Medication Therapy Management (MTM) Templates, R1", MTM CMR Take-away document; MTM CMS document, CDAR2, MTM
• Adoption Level should be a 1.