HL7 CMHAFF Standard Sources of Regulations, Policies, Rules, and References

Express Scripts Creates a Digital Health Formulary
Nathan E Botts
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Express Scripts Creates a Digital Health Formulary

Efforts to increase provider and patient safety

From the Express Scripts news release:

 

By adopting a digital health formulary, plan sponsors can confidently deploy a digital health product to their members knowing it has been through a uniform review process to ensure its safety, quality, usability and affordability. The digital health formulary also will:

  • Reduce the administrative burden for plan sponsors associated with contracting and managing digital health companies
  • Help improve affordability by leveraging Express Scripts’ size and scale in the purchasing of digital health products, and
  • Create a pathway to cover the increasing number of prescription-only digital therapeutics that are coming to market.

Initially, the digital health formulary will include solutions for diabetes, cardiovascular, behavioral health and pulmonary conditions, and will later expand to include tools for other chronic and complex conditions.

Clients still will have the ability to choose which digital solutions they provide or cover for their members; inclusion on the digital health formulary will not guarantee that a plan will cover a certain technology. 

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HL7 CMHAFF Glossary

Philosophically, the HL7 Mobile Health group favors using terms that are commonly accepted in the consumer mobile space, in preference to terms that are used only in the EHR space. Simply put, the target user for these devices are consumers, rather than clinicians. However, where terms are used differently in EHR vs consumer spaces, we take note of that, and acknowledge the various uses.

This does not purport to be an exhaustive set of mobile health definitions, but terms are included only to provide clarity within cMHAFF.

See British Standards Institution Publicly Available Specification (PAS) 277:2015 Health and wellness apps. Quality criteria across the life cycle. Code of practice (https://shop.bsigroup.com/forms/PASs/PAS-2772015/) which has a good set of Terms and Definitions (section 3).

Terms and Definitions

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