Da Vinci PDex FHIR IG Proposal
Da Vinci Payer Data exchange (PDex) Implementation Guide
- 1 Owning work group name
- 2 Committee Approval Date:
- 3 Contributing or Reviewing Work Groups
- 4 FHIR Development Project Insight ID
- 5 Scope of coverage
- 6 IG Purpose
- 7 Content location
- 8 Proposed IG realm and code
- 9 Maintenance Plan
- 10 Short Description
- 11 Long Description
- 12 Involved parties
- 13 Expected implementations
- 14 Content sources
- 15 Example Scenarios
- 16 IG Relationships
- 17 Timelines
- 18 When IG Proposal Is Complete
- 19 FMG Notes
Owning work group name
Committee Approval Date:
Contributing or Reviewing Work Groups
FHIR Development Project Insight ID
Scope of coverage
This project will define exchange methods (push, pull, triggers, subscription), use of other interoperability "standards" (e.g. CDS Hooks and SMART on FHIR) and specific use of FHIR resources to effectively exchange payer information regarding the current or previous care, including the provenance of the data, of one or more specific patients/members with a provider responsible for evaluating/specifying/ordering/delivering care for the patient. The project will also define the exchange methods and interoperability "standards" and specific use of FHIR resources to support Health Plan member-authorized Health Plan to Health Plan exchange of member health history and API access for healthcare directory, pharmacy directory and drug formulary information for members and third-party applications authorized by the member.
Providers need access to payer information regarding current and prior healthcare services received by the patient/member to more effectively manage the patients care. Currently, no FHIR implementation guide exists to standardize the method of exchange (push, pull, triggers, subscription, etc.) or the formal representation (e.g. Bundles, Profiles and Vocabulary) for specific elements of payer information of interest to providers. This implementation guide will provide a standard for adoption by both payers and providers for the exchange of payer information.
Proposed IG realm and code
The Da Vinci project intends to provide ongoing support of this implementation guide
Payer data exchange with providers to support care coordination.
Initial use cases are focused on a patient seeing a provider (e.g. PCP) for the first time (relevant payer history) , a repeat visit for the same patient with the same provider (what happened since the last visit that occurred outside of my institution / HIE / ...), and a visit of a patient with specialist (+care team information) . Each of these use cases focuses on a subset of the total payer record for the patient that may be appropriate for the specific setting. Specific guidance will be given for query capability and subsequent filtering of results prior to incorporation of the information into the provider' patient record. The project is focused on identifying patterns of exchange (interaction and content) that are appropriate for establishing implementation guidance to ensure standardization in the request and response across providers and payers.
This implementation guide has been developed by U.S. EHR and Payer organizations as part of the Da Vinci project.
Requirements are drawn from payer and provider organizations as part of the Da Vinci initiative.
This project will reference, where possible the "standards" defined by the Health Record exchange (HRex) Framework Implementation Guide which in turn will utilize prior work from Argonaut, US Core and QI Core effort for FHIR DSTU2, STU3, and R4.
Ballot for Comment (First Ballot Cycle)
2019 May Ballot
Submit for STU Ballot (Second Ballot Cycle)
2019 Sep Ballot
When IG Proposal Is Complete
When you have completed your proposal, please send an email to FMGcontact@HL7.org