HL7 Implementation Guide for CDA® R2: Plan-to-Plan Personal Health Record (PHR) Data Transfer, Release 1

DESCRIPTION

This document describes constraints on the Health Level Seven International (HL7®) Clinical Document Architecture (CDA®) Release 2 - Continuity of Care Documents (CCD) specification to support personal health record data exchange between personal health records managed by insurance plans. These exchanged documents will be known as “Plan to Plan Personal Health Record” documents, shortened here to “P2PPHR”.

The exchange of a P2PPHR could be initiated by a single member of an insurance plan or via a batch of records if an insurance plan sponsor (i.e employer) chose to change plans.

ALTERNATIVE NAMES

HL7 Implementation Guide for CDA® R2: Plan-to-Plan Personal Health Record (PHR) Data Transfer, Release 1 may also go by the following names or acronyms:

TARGETS

• PHR Software developers and consultants
• Payer stakeholder community in the U.S.
• PHR Trading partners such as insurers and health plans, government programs, and third-party administrators

BENEFITS

• Provide for PHR data portability between Health Plans
• Definition of additional extensions or constraints to CCD and CDA for PHRs

IMPLEMENTATIONS/CASE STUDIES

• Several major labs in the US are beginning the implementation process at this time.

DEVELOPMENT BACKGROUND

This implementation guide (IG) was produced and developed through the efforts of a joint project initiated by America's Health Insurance Plans and the Blue Cross Blue Shield Association. Accredited Standards Committee X12, through its Healthcare Insurance Patient Information Workgroup, is also a participant in the joint project. Overall, the approach taken here is consistent with balloted implementation guides (IGs) for CDA with this exception: the base specification here is not CDA; instead, the base specification is the HL7 Implementation Guide: CDA Release 2 – Continuity of Care Document (CCD), 2007. Furthermore, for the convenience of the implementer, this IG illustrates in XML examples of how to use CCD for plan to plan PHR transfer even where no additional constraints have been imposed on CCD.

This IG provides a portion of the guidance for the exchange of personal health records (PHRs) between health insurance plans. Such exchanges could be initiated by an individual member or by a health insurance sponsor. Exchanges may be for a single member's PHR data or for one or more members of a group. Information regarding one approach to PHR data transfers is contained in Accredited Standards Committee X12's Type 3 Technical Report (TR3) ASC X12N/005050X274 with which this document is intended to be used. Also key to performing PHR data transfers among trading partners adopting this approach are the operating rules provided by America's Health Insurance Plans and the Blue Cross Blue Shield Association (AHIP/BCBSA).

RELATED DOCUMENTS

HL7 Implementation Guide for CDA® R2: Plan-to-Plan Personal Health Record (PHR) Data Transfer, Release 1

(Download) (1.24 MB)

ADDITIONAL DETAILS

For specifications and information about this projects and more, visit the
HL7 Wiki page for this project at:

http://wiki.hl7.org/index.php?title=Plan-to-Plan_Personal_Health_Record

TOPIC

• Patient Referral

BALLOT TYPE

• Informative

STATUS DATE

2011-04-18

RESPONSIBLE WORK GROUP

FAMILY

• CDA

CURRENT STATE

• Stable

REALM

• US Realm