Introducing the First Cohort of the Bulk FHIR Quality Coalition
October 28, 2024 · Becky Kolinski
NCQA’s Bulk FHIR® Quality Coalition is evaluating FHIR data quality and identifying common gaps and challenges that might limit organizations from fully utilizing FHIR data for quality measurement. Participants will perform end-to-end testing of regulated FHIR data using the real-world use case of digital HEDIS® measurement.
The coalition will have multiple cohorts—each comprising a health care payer and a care delivery organization—working to create a FHIR data pipeline by sharing data directly or connecting through a health information exchange. Representatives from CMS and the ASTP (formerly ONC) are participating in the coalition as observers.
Meet the First Cohort
We are pleased to announce the inaugural cohort for the Bulk FHIR Quality Coalition.
Cambia Health Solutions (Health Plan)
Cambia Health Solutions is dedicated to making the health care experience simpler, better and more affordable for the more than 3.4 million people it serves through its six regional health plans. Cambia serves as a catalyst to transform health care, creating a person-focused and economically sustainable health care system.
Imagine trying to get a complete picture of someone’s health, but only having a few pieces of the puzzle. That’s the challenge Cambia faces. Despite applying many methods to collect health information, including chart chasing, working with clinics, labs and state HIEs, there are significant gaps in member clinical data. Inconsistent data formats and exchange methods lead to costly data wrangling of millions of rows of data each month. Cambia hopes Bulk FHIR APIs will streamline this process.
“Acquiring clinical data is time consuming and complex,” says Ravi Kondiparthi, Engineering Manager at Cambia Health Solutions. “By participating in the Bulk FHIR Coalition, we can leverage FHIR APIs to gather clinical data more efficiently and connect to a larger number of providers and vendors. Ultimately, we will have more data available for quality measurement and reporting.”
MultiCare Connected Care (Care Delivery System)
MultiCare Connected Care, a subsidiary of MultiCare Health System, boasts a comprehensive network that includes doctors, hospitals and clinics, and services such as imaging, labs and pharmacies. Its mission is to partner for healing and a healthy future. Data exchange with industry partners and patients is integral to delivering healthier futures to the communities it serves.
By leveraging advanced technology like open standard-based APIs, MultiCare delivers critical data to the point of care, influencing patient behavior and advancing health outcomes. Real-time data facilitates high-value care and enhances the quality and experience of care, while also driving operational efficiencies. Sharing data with payers has significantly improved performance metrics, closed care gaps and reduced chart chases, saving $50 per chart and enabling improved deployment of resources to their patients.
“Joining the Bulk FHIR Quality Coalition enables MultiCare to continue contributing to the advancement of open standard data exchange,” says Anna Taylor, Associate Vice President of Population Health & Value-Based Care at MultiCare Connected Care. “Adopting Da Vinci HL7’s implementation guide called Risk Based Membership (ATR) that utilizes open standard FHIR-based APIs has enabled MultiCare to enhance patient match rates from 75% to 95% when moving identities into our EHR, substantially reducing the administrative burden of reconciling records for our patients.”
eHealth Exchange (TEFCA QHIN)
eHealth Exchange is an independent, non-profit health information network that connects health care providers, regional and state HIEs, public health authorities, payers and federal agencies to exchange medical data and improve patient care and public health. eHealth Exchange is one of the first organizations to achieve QHIN™ (Qualified Health Information Network) designation under TEFCA™ (Trusted Exchange Framework and Common Agreement).
Processing more than 21 billion transactions annually, eHealth Exchange is transforming health data exchange across the country using FHIR and other standards. As health care organizations prepare to respond to federal regulations that mandate the use of FHIR for a larger number of use cases, such as CMS-0057, more testing is needed to ensure the accuracy and quality of FHIR data.
“Now is the time for health care organizations to move toward more standardized data exchange, including the use of FHIR APIs,” says Bill Howard, Board Chair of eHealth Exchange. “Pilot programs like the Bulk FHIR Quality Coalition remove barriers for organizations and accelerate FHIR adoption by demonstrating that it can be done successfully.”
Join the Bulk FHIR Quality Coalition
Organizations can join the Bulk FHIR Quality Coalition here. You can select a cohort partner—a payer or care delivery system you wish to partner with—or NCQA can match you with compatible organizations. When you sign up, NCQA will conduct a high-level readiness assessment of your progress in the digital transition, and will guide you through the requirements to participate in Bulk FHIR testing.
The first cohort should complete testing within 4–6 months. NCQA anticipates sharing the progress and results of the Bulk FHIR Quality Coalition to help health care organizations advance their digital quality strategy.
FHIR® is a registered trademark of Health Level Seven International and its use does not constitute endorsement by HL7.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
The Bulk FHIR Quality Coalition requires HIPAA data-sharing agreements between cohort participants before creating data pipelines. No PHI or PII data are shared outside the production environment.
