Enhancing Healthcare Interoperability: Launching the DaVinci Prior Authorization Support (PAS) Test Kit

There has been significant progress in interoperability among providers for treatment purposes, and while there is still considerable work to do, we now need to broaden our scope to also focus on payer-provider interoperability. The Interoperability Rules finalized by our colleagues at CMS have laid down important cornerstones, and we at ONC are continuing to explore complementary infrastructure and policies to advance those efforts.

In our previous blog post, Unveiling Inferno Testing Support for Payer Data Exchange API Standards, we shared that voluntary tests for standards-based APIs focused on accessing payer drug formulary information, insurance plan network directory information, and consumer access to digital health information had been made available. Today we are thrilled to announce the release of our newest voluntary test kit: the DaVinci Prior Authorization Support (PAS) Test Kit. This test kit provides developers and other health IT implementers with a tool to test health IT systems support for prior authorization using the HL7® Fast Healthcare Interoperability Resources (FHIR®) standard.

Specifically, the DaVinci PAS Test Kit focuses on prior authorization support according to the PAS implementation guide version 2.0.1 and includes tests for clients (e.g., electronic health record systems) and servers (e.g., payer systems). Tests for these systems include verifying support for required FHIR® operations and profiles from the PAS implementation guide. The open source DaVinci PAS Test Kit is available for download on GitHub alongside other health IT test kits designed using the Inferno FHIR® testing framework. The DaVinci PAS Test Kit is also available online at Inferno.HealthIT.gov.

The goal of this initial release is to provide developers a starting point to test their FHIR® implementations of prior authorization workflows. This release of the DaVinci PAS Test Kit focuses on testing the FHIR® -specific components within the DaVinci PAS implementation guide.

The DaVinci PAS Test Kit marks a significant step forward in supporting the health IT community in efforts to advance interoperability across use cases. By providing health IT developers and implementation guide authors with the necessary tools to test their systems' prior authorization capabilities, we aim to enhance interoperability within the healthcare ecosystem.

During the HL7 FHIR May 2024 Connectathon, ONC plans to demonstrate the draft test kits for other DaVinci implementation guides, including Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Payer Data Exchange (PDex). Health IT developers, the standards community, and other interested parties are encouraged to utilize these test kits and provide feedback to further improve the implementation guides.

Consistent with requirements established by the 21st Century Cures Act and as required by the ONC Cures Act Final Rule, we are actively working through open-source tooling to ensure that certified API developers maintain a list of the FHIR® Endpoints exposed by their customers. The FHIR® Application Programming Interface (API) Monitoring System, otherwise known as Lantern, provides analytics about the availability and adoption of FHIR® Endpoints across healthcare organizations in the United States and supports industry with infrastructure and market information to promote interoperability, including whether such endpoints make available data necessary to support individuals' access to their information. We are continuing to explore and intend on releasing future enhancements to the Lantern that will focus on incorporating user feedback and monitoring publicly available FHIR® endpoints.

Stay tuned for future updates on our open-source tools such as and Lantern. Together, we can advance the development, testing, and implementation of FHIR® standard, ultimately improving health data interoperability on a nationwide scale.