FHIR for HEDIS & Stars: Unanswered Questions

  • June 12, 2020
  • 11:00 AM – 12:00 PM ET
  • online

Quality management initiatives, especially HEDIS, are a strategic focus for health insurance providers, and efficiency of clinical data collection is now a key differentiator for improving performance scores. FHIR, the new standard for health care data exchange, can help simplify the data collection process. For this reason, both CMS & NCQA are encouraging FHIR adoption across the industry. FHIR has the potential to become the standard for payers to collect & share HEDIS and quality related data across multiple use cases, and also optimize costs of data collection when compared to traditional approaches (HL7/CCDAs, Charts). However, there is a gap in market awareness around specific use cases where FHIR can be used to streamline quality initiatives.

The webinar will lay out the importance of FHIR standard, the key regulatory changes being brought by NCQA and explain how health insurance providers can take advantage of the new standard for their quality initiatives. This webinar will also clarify the end to end HEDIS data exchange lifecycle and highlight specific use cases to leverage FHIR-based APIs.

Attendees will learn:

  • Key regulatory changes proposed by CMS & NCQA relating to the HL7 FHIR standard along with the proposed timelines
  • Benefits derived by adopting FHIR as the universal standard and capabilities provided to ease supplemental data collection needs as compared to the current process
  • New functionalities / avenues presented by the unique real-time, on demand, bidirectional nature of FHIR standards
  • Potential advantages of using FHIR to share gaps / compliance information with stakeholders – physicians, providers, and NCQA


Jeffrey Springer
SVP Performance Management

Jeffrey Springer has 20+ years of healthcare industry experience having worked with leading healthcare technology vendors. He is credited with finding the first payer-provider contract management company in the US. He is currently with CitiusTech, driving the product management, business analyst and product strategy for all products and solutions. Prior to CitiusTech, Jeff led the product management and strategy for analytics at Siemens and care management and analytics at MEDecision. He also ran a business unit at McKesson to develop new products working with payers & providers. Jeff holds a Mechanical Engineering Degree and an MBA from University of Pennsylvania, Wharton School, where he graduated as a Palmer Scholar.

Swanand Prabhutendolkar
SVP Data Management

Swanand leads the CitiusTech Healthcare Interoperability / BI-DW / Big Data practices. With more than 18 years of experience in information technology Swanand has worked across regulatory reporting requirements such as MU, and healthcare standards and frameworks including HL7.  Swanand has also served as the Senior Architect for the development of CitiusTech’s BI-Clinical product. Prior to CitiusTech, Swanand was with Epic Systems where he worked on development of EpicCare product. He holds a Master’s degree in Information Technology from IIT Mumbai.