- Understanding the need: A key challenge is understanding the needs of healthcare stakeholders to properly design architectures to address those needs. The healthcare industry is complex, with multiple flows, participants, and regulatory oversight at several levels of government. We will document our understanding of the need by document scenarios using standard Use Case techniques (textual and graphical). Scenarios to be reviewed by this working group include:
- Beneficiary: enrollment into the Medicare Program,
- Providers and other CMS Programs like Medicaid and Healthcare.gov: Check beneficiary Medicare Eligibility benefit and deductibles
- Medicare Program: Claims processing, Provider Enrollment to serve Medicare beneficiaries, Oversight audit and Compliance of claims submitted, payment of services rendered
- Program Integrity: Fraud, Waste, and Abuse;
- Innovation Program: Clinician Enrollment into new innovative payment models, Quality reporting from their healthcare setting
- Consumers Enrollment into Healthcare.gov
2.Establish architectural patterns: We will develop architectural patterns that address the needs defined by the use cases. These patterns will address the topology of the blockchain network, assurance of the information, and types or classes of smart contracts that enable the architecture to function.
3.Publicize results: We will publicize our results through publication of position papers, The communication artifacts the HWG can produce include:
- Monthly GBA blog posts: These are progress notes on the projects and activities of the HWG
- Quarterly Newsletter: A summary of the blog posts produced quarterly
- Research Papers: A 10-12 page document investigating an issue in depth.
- Research Presentation: Accompanies the research paper. Ideally presented at conferences or industry forums