Da Vinci PDex-plan-net FHIR IG Proposal

Da Vinci Payer Data exchange Plan Network (PDex-plan-net) Implementation Guide

Owning work group name

Financial Management

Committee Approval Date:

5/6/2019

Publishing Lead

Mark Scrimshire, mark@ekivemark.com

Contributing or Reviewing Work Groups

Attachments, Patient Administration

Scope of coverage

This guide will define the exchange methods and interoperability "standards" and specific use of FHIR resources to support Health Plan member-authorized exchange of healthcare directory and pharmacy directory information for members and third-party applications.May also support an unsecured exchange of directory information (depending on final detailed requirements)

Content location

https://github.com/HL7/davinci-pdex-plan-net

Proposed IG realm and code

US/Davinci-PDex-plan-net

Maintenance Plan

The Da Vinci project intends to provide ongoing support of this implementation guide.

Short Description

API-based data exchange to Third-Party Applications via Member-authorized sharing of Health Plan's Healthcare Service Network and Pharmacy Network.

Long Description

The PDex FHIR IG will support two scenarios:

1. Secure Member-authorized Exchange of information between Payers and Third-Party Applications using OAuth2.0 and FHIR APIs for information sharing via API of a Health Plan's Healthcare Network Directory. 2. Secure Member-authorized Exchange of information between Payers and Third-Party Applications using OAuth2.0 and FHIR APIs for information sharing via API of a Health Plan's Pharmacy Network Directory

May also support an unsecured exchange of directory information (depending on final detailed requirements)

Involved parties

This implementation guide has been developed by U.S. Payer organizations as part of the Da Vinci project.

Content sources

Requirements are drawn from payer and provider organizations as part of the Da Vinci initiative.

Example Scenarios

1. An Authenticated Member at a Health Plan will be able to use an OAuth2.0 authorization to permit a Third-Party Application to access the Health Plan's FHIR API to read the Plan's Healthcare Network Directory. 2. An Authenticated Member at a Health Plan will be able to use an OAuth2.0 authorization to permit a Third-Party Application to access the Health Plan's FHIR API to read the Plan's Pharmacy Network Directory.

IG Relationships

This guide will reference, where possible, the "standards" defined by the Da Vinci Health Record exchange (HRex) Framework Implementation Guide which in turn will utilize prior work from Argonaut, US Core, and QI Core efforts for FHIR DSTU2, STU3, and R4.

This Guide will also be referenced by the Da Vinci Payer Data Exchange (PDex) Implementation Guide and will in turn reference the Validated Healthcare Directory Implementation Guide.

Timelines

Submit for STU Ballot 2019 Sep Early Ballot

When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org