The Answer to Life the Universe and Everything

The answer to life the universe and everything is no longer 42, it is now 119.  At least that was the concensus of the HITSP Provider Perspective TC and the Care Management and Health Records TC as we reviewed what needed to be done to update HITSP Interoperability Specification 09 Consults and Transfers of Care for the next round of work.

Looking at the requirements for this specification, I've identified the cases where Capability 119 applies.

Capability	IER	Description
119	1	Provide authorization and consent
119	11	Identify provider based on patient preference
119	13	Send/receive notification of document availability
	14	Send/Receive health plan eligibility
	15	Send/Receive health plan authorization
119	16	Send/Receive clinical summary
119	17	Send/Receive transfer of care data
119	22	Send/Receive additional patient information
119	25	Send/Receive decision support data
119	28	Download historical health data
119	37	Update medication information
	43	Send/Receive accept patient
119	45	Send/Receive consult results report
	57	Identify provider based on health plan
119	60	Send/Receive discharge summary
119	62	Send/Receive encounter or full episode of care record
119	63	Request additional patient data
119	64	Send/Receive consult request/data

As you can see from the table above, capability 119 is quite a useful tool (in this case, it's not a hammer, but a leatherman).

The Care Management and Health Records committee recently updated this Capabilty in response to the Clinical Notes Extension delivered to HITSP by ONC.

I won't go into all the gory details, but in short, what Capability 119 requires is the exchange of clinical documents conforming the HL7 CDA Specification, using sections and entries conforming to the HITSP C83 CDA Modules specification (which relies heavily on C32 and the HL7 Continutity of Care Document).  ThC83 specification will be updated in the next public comment cycle following the one that is about to start.

We leave it up to the Interoperability specifications to further constrain the capability to a specific type of clinical document if need be (e.g., to allow the Consumer Empowerment IS to specify the use of the HITSP C32 Summary Documents using CCD).

I have to say that this capability stuff, as difficult as it wasis to put together, is certainly making my life easier.

     Keith

P.S.  Thanks to the Bean for keeping me sane as we worked all this out in committee.