Hospital Portal 1.0.0
As of July 1, 2021, two of the policies from the May 2020 Interoperability and Patient Access final rule are now in effect. On April 30, 2021, the requirements for hospitals with certain EHR capabilities to send admission, discharge and transfer notifications to other providers went into effect. On July 1, 2021, CMS began to enforce requirements for certain payers to support Patient Access and Provider Directory APIs. Additional information is available on the FAQ page and in the other information available below.
Hospital Portal 1.0.0
The DTR IG specifies how payer rules can be executed in a provider context to ensure that documentation requirements are met. In turn, provider burden will be reduced because of reduced manual data entry. The IG: HL7 FHIR Da Vinci - DTR IG: Version STU 1.0.0.
The PAS IG defines a way to directly submit prior authorization requests from EHR or practice management systems (PMS). Direct submission of prior authorization requests from an EHR or PMS can reduce costs for both providers and payers. It can also result in faster prior authorization decisions, which will lead to improved patient care experiences. The IG is: HL7 FHIR Da Vinci - PAS IG: Version STU 1.0.0.
The PCDE IG defines a mechanism for sharing information from one payer (the previous payer) to a 'new' payer when a patient has switched plans to help ensure continuity of care and reduce/eliminate the need for repeating lab or diagnostic tests, re-trying previous therapies, etc. The IG is: HL7 FHIR Da Vinci - PCDE IG Version STU 1.0.0.
Your organization must be a healthcare provider (such as a health system, hospital, clinic, physician practice, telehealth provider, medical laboratory, or pharmacy) in Canada, the United Kingdom, or the United States.
3. Log in to the PDS API portal, select Application from the navigation, and complete the PDS API Partner Application form. The information you enter will be displayed to EHR users as shown below. See here for the information to have available:
The AI Deployment and Evaluation (AIDE) Lab at the Institute for Better Health (IBH), Trillium Health Partners (THP) was involved in a Supercluster Canada-funded multi-centre study that collected a dataset containing key demographics and clinical parameters of hospitalized patients diagnosed with COVID-19. The dataset is comprised of de-identified health related data associated (demographics, clinical parameters such as vital signs and laboratory values, imaging findings and hospital outcomes) of a cohort of 509 patient visits admitted to THP via the Emergency Department between November 1, 2020, to March 15, 2021 meeting criteria for likely COVID-19. The dataset was sourced from three distinct systems (The THP Enterprise Data Warehouse, Electronic Health Records, the Picture Archiving and Communication System). This dataset was combined with data from 2 other Ontario sites and used to develop a machine learning model to predict outcomes of patients, specifically death and discharge.
The purpose of this project was two-fold. Firstly, it involved producing a large, feature rich dataset and making it available to the global community of innovators and researchers, with the goal of encouraging the creation of valuable insights to fight against COVID-19. The second purpose was centered on utilizing the carefully curated dataset to develop a machine-learning clinical prediction tool to aid in management of hospitalized COVID-19 patients.
Following completion of the validation stage, the authors verified an additional 5% of all data elements by comparing the values in the web portal with the values from the patient chart in the EHR to ensure no issues remained.
Medplum uses the SMART Application Launch Framework Implementation Guide ( -app-launch/1.0.0/) and provides an OAuth 2.0 compliant authorization server to enable patients and providers secure authentication access to their health data. As described by the specification itself, SMART on FHIR:
Through their selected application, patients will be prompted for their login and credentials which they established in their patient portal accounts. SMART-on-FHIR enables the user to authenticate themselves with Medplum authorization and choose the scope of their patient data which they intend to access and share withtheir application. This decision provides an access token to their application of choice, and applications which are compliant with SMART on FHIR can then use this access token to access their health data stored on Medplum. These applications will continue to have access to the patient data until the patient revokes their access permission.
Authorization documentation is located in the application owner portal. This information is shared after successful organization registration and approval. Please login and register your organization to view this information.
The Healthcare Service resource typically describes services offered by an organization/practitioner at a location. The resource may be used to encompass a variety of services covering the entire healthcare spectrum, including promotion, prevention, diagnostics, pharmacy, hospital and ambulatory care, home care, long-term care, and other health-related and community services.
The Healthcare Service resource typically describes services offered by a Pharmacy or Pharmacy Organization. The resource may be used to encompass a variety of services covering the entire healthcare spectrum, including promotion, prevention, diagnostics, pharmacy, hospital and ambulatory care, home care, long-term care, and other health-related and community services.
Authorization server launch URL documentation is located in the application owner portal. This information is shared after successful organization registration and approval. Please login and register your organization to view this information.
A member may revoke access to your application via their member portal. When you encounter an invalid token indicating a member has revoked access, you should make a reasonable attempt to handle that case making it easy for the member to understand what is happening with their data.
To test out your sandbox application with the UnitedHealthcare interoperability API, you will need to create a test member account via OneHealthcare ID when prompted to login as part of the authentication/authorization process. Note: You can use the same OneHealthcare ID that was registered to access the vendor portal and register applications.
With regard to laboratory markers of liver disease in CVID, especially elevations in alkaline phosphatase (ALP), bilirubin and transaminases have been described [18, 19]. Abdominal ultrasound and magnetic resonance imaging as well as transient elastography (FibroScan) can be used to assess structural changes in the liver as well as signs of portal hypertension [20,21,22]. There is, however, so far no standard in the field with regard to which parameters should be assessed in CVID patients to determine whether the patient suffers from portal hypertension. In this study, we therefore characterized patients with CVID who developed portal hypertension in a cohort of 479 CVID patients treated at the University Hospital of Freiburg, Germany, and longitudinally assessed conventional and novel laboratory, clinical, endoscopic, and ultrasound characteristics of these patients.
Patients with CVID were retrospectively identified from the hospital information system of the University Hospital of Freiburg according to documentation from the outpatient department of the Centre for Chronic Immunodeficiency. Laboratory data and clinical data as well as ultrasound and endoscopy data for these patients were exported and manually validated from the hospital information system. Clinically significant portal hypertension was defined as occurrence of esophageal varices and/or portal hypertensive gastropathy and/or ascites. Female patients with a single episode of ascites in the recto-uterine pouch due to gynecological reasons were not included in the patient group with portal hypertension. The date of onset of portal hypertension was identified according to the date of the first documentation of the aforementioned symptoms. If documentation from previous inpatient or outpatient stays in other hospitals was available, the date of onset was corrected to the first description of aforementioned signs. Patients that never showed esophageal varices, portal hypertensive gastropathy, or ascites were assigned to the control group.
In total, we identified 479 CVID patients of whom 27 showed clinical signs of portal hypertension (for details, see Table 1). Not all data were available for every patient; the number of available data points is indicated in the figures.
Where available, results of transient elastography (FibroScan) measurements were included in the study. This ultrasound-based technique using a hand-held ultrasound probe allows non-invasive measurement of liver stiffness. Interpretation of generated data depends on the underlying disease-pathology [23,24,25,26,27]; however, transient elastography has previously been demonstrated to be of diagnostic value for CVID patients, particularly in those at risk for portal hypertension [20, 28]. ROC analysis of the LSM was performed, and the optimal cutoff for determination of portal hypertension was calculated by the Youden Index.
In a retrospective analysis of patients treated at the Centre for Chronic Immunodeficiency of the University Hospital of Freiburg, we have identified 479 CVID patients of whom 27 (6%, 13 female and 14 male) showed clinical signs of portal hypertension (see Table 1). Ninety two percent (23 of 25 patients with available data for ascites) of the CVID patients with portal hypertension presented with ascites and 62% (16 of 26 patients with available data for esophageal varicosis) with esophageal varices during the disease course. Liver biopsy was performed in 21 patients, revealing nodular regenerative hyperplasia of the liver in 52% (11/21) and granulomatous liver disease in 14% (3/21) of patients with biopsy. Typical cirrhosis was histologically seen in only 2 patients. On average, signs of portal hypertension first occurred 11.8 years after first diagnosis of CVID and 19.1 years after first manifestation of CVID respectively (Fig. 1). Compared to other manifestations of CVID, signs of portal hypertension appeared markedly later (Fig. 2). 041b061a72