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Missouri AAAs advance FHIR interoperability


The Missouri Association of Area Agencies on Aging (ma4) has leveraged Cumulus Fast Healthcare Interoperability Resources (FHIR)* capabilities to streamline data sharing within the Missouri Adult Protective Services Direct Services initiative. The project is a collaboration of Missouri’s Area Agencies on Aging (AAAs) and Missouri Adult Protective Services (APS) to deliver services and supports to clients of APS, with a goal of helping those clients remain in the least restrictive environment and improve their quality of life and health. The Cumulus hub connects 300+ Missouri Department of Health and Senior Services APS and AAA workers with closed loop referrals and collaboration.

“To be successful in a rapidly changing landscape, AAAs must be able to interoperate with healthcare partners and payers. That requires modern interoperability capabilities that align with FHIR standards. But it also means that our unique aging services data sets must be part of the equation. We’re thrilled Cumulus has embraced the vendor-agnostic draft ASDIS and eLTSS FHIR frameworks, and IDS is leveraging them for our APS Direct Services partnership with the Missouri Department of Health and Senior Services.”

–Lisa Knoll, Aging Ahead CEO and ma4 board member

Cumulus’ FHIR APIs and support for the SMART Backend Service authorization profile were leveraged by Innovative Data Systems (IDS) to pull incoming Cumulus referrals from APS investigators into AgingIS, the AAA case management system. For AAA workers this interoperability saves time, eliminates manual tasks, and improves outcomes.

“Standards-based interoperability underpins everything we build on the Cumulus platform. Alignment with HL7 FHIR, eLTSS, and ASDIS standards is a success multiplier for our customers, enabling them to extend their workflows beyond Cumulus. Our work on the Missouri APS Direct Services initiative in partnership with ma4, the Missouri Department of Health and Senior Services, and Innovative Data Systems has been incredibly valuable, and we’re excited to see our commitment to open interoperability take flight for the benefit of our mutual customers.”

–Jeremy Danyow, Cumulus CTO

The Missouri APS/AAA Direct Services project represents the first live implementation of the proposed FHIR-based Aging Services Data Set and Interoperability Standards (ASDIS) originally proposed by the Missouri Aging Services Data Collaborative, which was a final winner of the Administration for Community Living’s Social Care Referrals Challenge. The three-phase challenge was a competition to identify IT solutions to support health care systems and community-based organizations to facilitate social care referrals and information sharing between organizations, systems, and platforms.

“The IDS team is pleased to provide a streamlined experience for our AgingIS users through interoperability with Cumulus. Leveraging Cumulus APIs, AgingIS pulls data for referrals initiated by APS state investigators in Cumulus and presents it to AAA staff directly in AgingIS. This provides immediate advantages for the AAAs and by extension the clients they’re serving.”

–Tim Wright, Innovative Data Systems President

The Missouri Aging Services Data Collaborative, comprised of Cumulus, ma4, and the University of Missouri-St. Louis (UMSL) Community Innovation & Action Center, initiated the FHIR-based ASDIS. The proposed vendor-agnostic standards categorize and organize commonly used aging services data elements and can be used to exchange data between partners and payers, regardless of which data system or vendor they use.

"We know that having a common language is essential for care coordination and collaboration across service providers. ASDIS and interoperability between Cumulus and AgingIS are a phenomenal step forward for deeper alignment across our sector.”

–Paul Sorenson, lead organizer for the Missouri Aging Services Data Collaborative at the University of Missouri.

To further enhance aging services organizations’ capacity to interoperate with healthcare partners, Cumulus has since proceeded to align ASDIS with the draft electronic Long-Term Services and Supports (eLTSS) Implementation Guide (IG), based on FHIR R4 and US Core v3.1.1. The eLTSS IG was developed to support exchange of data generated during the planning and provision of long-term services and supports and is currently scoped to data commonly found on LTSS service plans. Interoperability with AgingIS for the Missouri APS/AAA Direct Services project aligns with the proposed eLTSS IG.

IDS has activated its interoperability with Cumulus for Aging Ahead and Senior Age. Interoperability for the remaining ma4 member AAAs will follow in early 2024.


FHIR® is the registered trademark of HL7 and is used with permission of HL7. Use of the FHIR trademark does not constitute endorsement of the contents of this repository by HL7.

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