Medical Policy Digitization and Medical Review with FHIR and CQL. Sponsored by Smile Digital Health

Digitizing medical policies into computable content requires clinical expertise, structured knowledge authoring, and a technology pipeline designed to support digitization at scale.

In this technical session, experts from Smile Digital Health will share how FHIR and Clinical Quality Language (CQL), combined with Smile's knowledge authoring expertise and tooling, support the transformation of narrative medical policies into standardized, computable logic.

The session will explore how this approach supports an “encode once, reuse everywhere” model, enabling medical policy to be applied across prior authorization, care management, digital quality reporting, and value-based care. Attendees will gain insight into the expertise, processes, and technology required to make medical policies consistent, reusable, and actionable across healthcare workflows.

SPEAKERS:

Rob Reynolds, VP and Chief Engineer, Clinical Intelligence, Smile Digital Health
Rob is VP of Clinical Intelligence at Smile Digital Health. A serial entrepreneur (4 start-ups) with 20+ years in software, he leads HL7's Da Vinci Risk Adjustment Use Case and contributes to several other HL7 FHIR standards related to the Clinical Reasoning Module.

Dr. Purvi Mehta, Director, Clinical Enablement, Smile Digital Health
Purvi Mehta, DHSc, MD, MBI, is a physician and healthcare interoperability leader at Smile Digital Health, specializing in clinical informatics, HL7 standards, and payer-provider data exchange to advance standards-based interoperability.