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HCX Protocol
v0.6
v0.6
  • Context
  • Introduction to HCX
  • Open Specifications
    • Design Principles
    • Key Specifications
    • Governance
  • Technical Specifications
    • Open Protocol
      • Key Design Considerations
      • Registries
      • Health Claims Exchange (HCX) Protocol
      • Data Security and Privacy
        • Transport Security
        • Message Security and Integrity
        • API Security
        • Audit and Reporting
    • Appendix A - HCX Relay example
  • Domain Specifications
    • Domain Data Specifications
      • Domain Data Models
        • eObjects
        • Implementation Guide
      • Terminologies (Code sets or Metadata standards)
      • Domain Specific Languages (DSLs)
    • Healthcare Operations Policies
      • Access Control (Roles)
      • Guidelines for Participant Onboarding
      • Guidelines for Grievance Redressal
      • Guidelines for Event audits
      • Guidelines for Beneficiary Authentication by Providers/Payors
  • Future roadmap
  • How to submit responses?
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  • Specifications roadmap
  • HCX Development roadmap
  • Questions for Consultation
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Future roadmap

Next steps on specifications and open-source reference implementation

As indicated in Key User cases/Workflows, the current version of specifications mainly covers cashless insurance use cases. Also, the real test of specifications and approach defined so far would be in using them in live scenarios. With these two objectives in mind, below are two key dimensions of the proposed roadmap:

Specifications roadmap

Following key focus areas are proposed to be further worked upon while the first version of the open-source HCX tech platform is made available for implementation:

  1. Enhancements of the specifications for the reimbursement use case

  2. Further detailing of formulation approach and model policies for

    1. Participant onboarding/deboarding

    2. Grievance redressal

    3. Event audits

    4. Beneficiary authentication (by participants)

    5. Market rules around charges and fees

    6. Claims adjudication

  3. Guidelines for Technical Operations

  4. Domain Specific Languages:

    1. Policy Markup language - To assist auto-adjudication and eligibility checks through the machine-readable encoding of policies

    2. Bill Markup Language - To assist auto-adjudication through the machine-readable encoding of bills

    3. Explanation Markup Language (Low priority)

HCX Development roadmap

To enable the Learn-Do-Learn cycle of taking the HCX work forward, Swasth proposes to build the first version of Open Source reference implementation of the HCX software. Following timelines are proposed for this reference version:

  1. V1 of the open-source reference software - December 2021

  2. Availability of sandbox for pilot integrations - January 2022

  3. Production readiness/Go Live of HCX and integrations - March 2022

Questions for Consultation

Question 1

PreviousGuidelines for Beneficiary Authentication by Providers/PayorsNextHow to submit responses?

Last updated 3 years ago

The provides a list of areas that are being planned for further work. Please provide your priority order for these areas. Kindly feel free to add additional areas that you may want to include in the specification work.

Instructions to send responses to the consultation questions are available .

here
Roadmap on specifications