{
  "package-id" : "hl7.fhir.us.davinci-cdex",
  "title" : "Da Vinci Clinical Documentation Exchange",
  "canonical" : "http://hl7.org/fhir/us/davinci-cdex",
  "introduction" : "This IG provides detailed guidance that helps implementers use FHIR-based interactions to support specific clinical data exchanges between providers and payers (or other providers). This guide documents the Direct Query, Task-Based, and Attachments transaction approaches for requesting and sending information. Key scenarios this IG can support include:\n\n* Requesting and Sending attachments for claims and prior authorization\n* Requesting documentation to support payer operations such as claims audits\n* Gathering information for Quality programs and Risk Adjustment between payers and providers\n* Exchanging clinical data between referring providers\n\nIn the context of this guide, *clinical data* means any information a provider holds in a patient’s health record. The format of the data exchanged is not limited to FHIR resources but includes C-CDA documents, PDFs, text files, and other types of data. In addition to requesting FHIR resources, there can be requests for payloads of clinical care records such as CCD Documents, clinical data sets that may be represented in a FHIR Bundle (including C-CDA on FHIR Documents), or a FHIR QuestionnaireResponse.",
  "category" : "Financial",
  "list" : [
    {
      "version" : "current",
      "desc" : "Continuous Integration Build for Da Vinci CDex (latest in version control)",
      "path" : "http://build.fhir.org/ig/HL7/davinci-ecdx",
      "status" : "ci-build",
      "current" : true
    },
    {
      "version" : "2.1.0",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/STU2.1",
      "status" : "trial-use",
      "sequence" : "STU2",
      "fhirversion" : "4.0.1",
      "date" : "2025-02-11",
      "current" : true,
      "desc" : "This STU Update of The Da Vinci Clinical Data Exchange (CDex) Implementation Guide is the fourth published version of this guide. The sponsoring HL7 International Payer/Provider Information Exchange Work Group members agreed to and voted on the resolution of the community review comments and edits to this guide. For a detailed list of the changes for this version, see the Change Notes at http://hl7.org/fhir/us/davinci-cdex/STU2.1/changes.html.",
      "descmd" : "This STU Update of The Da Vinci Clinical Data Exchange (CDex) Implementation Guide is the fourth published version of this guide. The sponsoring [HL7 International Payer/Provider Information Exchange Work Group](http://www.hl7.org/Special/committees/claims) members agreed to and voted on the resolution of the community review comments and edits to this guide. For a detailed list of the changes for this version, see the [Change Notes](http://hl7.org/fhir/us/davinci-cdex/STU2.1/changes.html).",
      "changes" : "changes.html"
    },
    {
      "version" : "2.1.0-snapshot",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/STU2.1-snapshot",
      "status" : "preview",
      "sequence" : "STU2",
      "fhirversion" : "4.0.1",
      "date" : "2024-09-28",
      "desc" : "The changes in this STU update to Da Vinci CDEX include updates with US Core 6.1.0 compatible and change requests submitted by the Da Vinci and HL7 community. The HL7 International Payer/Provider Information Exchange (PIE) work group members have agreed to and voted on the resolution of the community comments. For a detailed list of the changes for this version, see the Change Notes: http://hl7.org/fhir/us/core/STU7/changes.html.",
      "descmd" : "The changes in this STU update to Da Vinci CDEX include updates to be [US Core 6.1.0](https://hl7.org/fhir/us/core/STU6.1/) compatible and change requests submitted by the Da Vinci and HL7 community. The HL7 International Payer/Provider Information Exchange (PIE) work group members have agreed to and voted on the resolution of the community comments. For a detailed list of the changes for this version, see the [Change Notes](http://hl7.org/fhir/us/core/STU7/changes.html).",
      "changes" : "changes.html"
    },
    {
      "version" : "2.0.0",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/STU2",
      "status" : "trial-use",
      "sequence" : "STU2",
      "fhirversion" : "4.0.1",
      "date" : "2023-03-22",
      "desc" : "This STU2 version of Da Vinci Clinical Data Exchange (CDex) Implementation Guide is the third published version of this guide and is the result of the 2022 Sept HL7 balloting process. The resulting resolution of the community comments and edits to the guide has been agreed to and voted on by the members of the sponsoring HL7 International Patient Care and Payer/Provider Information Exchange Work Groups.  Details of the changes in this version can be seen at http:/hl7.org/fhir/us/davinci-cdex/STU2/changes.html"
    },
    {
      "version" : "2.0.0-ballot",
      "desc" : "2022 September Ballot Version: This ballot is restricted to the Draft content in the STU 1.1.0 version of CDex. The draft content includes 1) requesting and sending attachments and 2) communicating the purpose of use in Task Based Queries. Details of the changes in this version can be seen at http://hl7.org/fhir/us/davinci-cdex/2022Sept/changes.html",
      "sequence" : "STU2",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/2022Sep",
      "status" : "ballot",
      "fhirversion" : "4.0.1",
      "date" : "2022-08-08"
    },
    {
      "version" : "1.1.0",
      "desc" : "This STU1.1.0 version of Da Vinci Clinical Data Exchange (CDex) Implementation Guide is the second published version of this guide and is the result of the 2022 May HL7 balloting process. The resulting resolution of the community comments and edits to the guide has been agreed to and voted on by the members of the sponsoring HL7 International Patient Care and Payer/Provider Information Exchange Work Groups.  Details of the changes in this version can be seen at http:/hl7.org/fhir/us/davinci-cdex/STU1.1.0/changes.html",
      "sequence" : "STU1.1",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/STU1.1",
      "status" : "trial-use",
      "fhirversion" : "4.0.1",
      "date" : "2022-08-08"
    },
    {
      "version" : "1.0.0",
      "descmd" : "This STU1 version of Da Vinci Clinical Data Exchange (CDex) Implementation Guide is the first published version of this guide and is the result of the June 2019 and January 2021 HL7 balloting process. The resulting resolution of the community comments and edits to the guide has been agreed to and voted on by the members of the sponsoring HL7 International Patient Care Work Group.\n\nJanuary 2021 Ballot comments and links to the updated content are below::\n\n**Status: Summary (Jira Issue) Link to Change**\n\n1. **Applied**: CDex documents require signature, but don't explain how used ([FHIR-26855](https://jira.hl7.org/browse/FHIR-26855)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1direct_query#signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approache#signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1attachments#signatures.html)\n1. **Applied**: Add reference to C-CDA on FHIR ([FHIR-28158](https://jira.hl7.org/browse/FHIR-28158)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Provide another example of a use case not covered by another Da Vinci IG ([FHIR-30146](https://jira.hl7.org/browse/FHIR-30146)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html##where-does-cdex-fit-in-the-da-vinci-project)\n1. **Applied**: Fix link and expectations to CapabilityStatements ([FHIR-30147](https://jira.hl7.org/browse/FHIR-30147)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1CapabilityStatement-data-source-server.html#resource-details)\n1. **Applied**: Failed task or task without result? ([FHIR-30148](https://jira.hl7.org/browse/FHIR-30148)) See Changes:\n   -  [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n   -  [Here](http://hl7.org/fhir/us/davinci-cdex/STU1CapabilityStatement-data-source-server.html#task)\n1. **Applied**: add item to list of benefits ([FHIR-30440](https://jira.hl7.org/browse/FHIR-30440)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Update section on What Payers Do with Clinical Information ([FHIR-30442](https://jira.hl7.org/browse/FHIR-30442)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1ackground.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Update text in sequence diagrams ([FHIR-30445](https://jira.hl7.org/browse/FHIR-30445)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#steps)\n1. **Applied**: Update Scenarios to include to support claim submission - Attachments. ([FHIR-30446](https://jira.hl7.org/browse/FHIR-30446)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#example-scenarios)\n1. **Applied**: Update definition of clinical data and added guidance on data provenance([FHIR-30489](https://jira.hl7.org/browse/FHIR-30489)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1direct-query.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html#provenance)\n1. **Applied**: Referennce clinical safety section in HREX ([FHIR-30490](https://jira.hl7.org/browse/FHIR-30490)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html#da-vinci-hrex-security-and-privacy-requirements)\n1. **Applied**: Delete use of word 'complete' ([FHIR-30494](https://jira.hl7.org/browse/FHIR-30494)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Explicitly reference the Da Vinci Guiding Principles in new Privacy and Security section. ([FHIR-30498](https://jira.hl7.org/browse/FHIR-30498)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html)\n1. **Applied**: Update Figure 1 ([FHIR-30500](https://jira.hl7.org/browse/FHIR-30500)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#where-does-cdex-fit-in-the-da-vinci-project)\n1. **Applied**: Typo. ([FHIR-30812](https://jira.hl7.org/browse/FHIR-30812)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Remove word complete. ([FHIR-30813](https://jira.hl7.org/browse/FHIR-30813)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#example-scenarios)\n1. **Applied**: Corrects and clarifies direct provider to provider scenario. ([FHIR-30814](https://jira.hl7.org/browse/FHIR-30814)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#example-scenarios)\n1. **Applied**: Updates to Provider to Provider use case([FHIR-30815](https://jira.hl7.org/browse/FHIR-30815)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#provider-to-provider-data-exchange)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1exchanging-clinical-data.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#provider-to-provider)\n1. **Applied**: Please clarify whether any human involvement is required, and an example, as well as define the term fulfillment as it relates to attestation. ([FHIR-30816](https://jira.hl7.org/browse/FHIR-30816)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1direct_query#signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approache#signatures.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1attachments#signatures.html)\n1. **Applied**: Rephrase. ([FHIR-30817](https://jira.hl7.org/browse/FHIR-30817)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1direct-query.html)\n1. **Applied**: Clarify how subscripition mitigates risks ([FHIR-30819](https://jira.hl7.org/browse/FHIR-30819)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Add section on termination of access to request([FHIR-30820](https://jira.hl7.org/browse/FHIR-30820)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification#how-long-is-the-data-available)\n1. **Applied**: Update how a client's set of requests is terminated([FHIR-30821](https://jira.hl7.org/browse/FHIR-30821)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification#fetching-the-data)\n1. **Applied**: Formalize the current scenarios ([FHIR-30826](https://jira.hl7.org/browse/FHIR-30826)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html)\n1. **Applied**: replace /Patient/$everything with /Group/$export in the bulk example ([FHIR-30827](https://jira.hl7.org/browse/FHIR-30827)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1exchanging-clinical-data.html)\n1. **Applied**: Remove empty pages ([FHIR-30828](https://jira.hl7.org/browse/FHIR-30828))\n1. **Applied**: Clarified formal authorization use case ([FHIR-30829](https://jira.hl7.org/browse/FHIR-30829)) See Changes:\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n   - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Data Consumer Server SHOULD support Claim. ([FHIR-30830](https://jira.hl7.org/browse/FHIR-30830)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1CapabilityStatement-data-source-server.html#claim)\n1. **Applied**: Modify CapabilityStatement Rest summary table ([FHIR-30831](https://jira.hl7.org/browse/FHIR-30831)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1CapabilityStatement-data-consumer-server.html#resource--details)\n1. **Applied**: Add hyperlinks. ([FHIR-30834](https://jira.hl7.org/browse/FHIR-30834)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specifications)\n1. **Applied**: Add benefit of transition towards direct queries to Task benefits. ([FHIR-30835](https://jira.hl7.org/browse/FHIR-30835)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification#task-based-approach)\n1. **Appied**: Update section on Authoization requirements ([FHIR-30836](https://jira.hl7.org/browse/FHIR-30836)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification#formal-authorization)\n1. **Applied**: Typo ([FHIR-30840](https://jira.hl7.org/browse/FHIR-30840)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Typo ([FHIR-30841](https://jira.hl7.org/browse/FHIR-30841)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Typo ([FHIR-30842](https://jira.hl7.org/browse/FHIR-30842)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Updated anticipated benefits of standard ([FHIR-30843](https://jira.hl7.org/browse/FHIR-30843)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#home)\n1. **Applied**: Typo ([FHIR-30844](https://jira.hl7.org/browse/FHIR-30844)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Correct Grammar ([FHIR-30845](https://jira.hl7.org/browse/FHIR-30845)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Correct Grammar ([FHIR-30846](https://jira.hl7.org/browse/FHIR-30846)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Remove unsubstantiated claims. ([FHIR-30847](https://jira.hl7.org/browse/FHIR-30847)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Remove HEDIS score claim. ([FHIR-30849](https://jira.hl7.org/browse/FHIR-30849)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#what-do-payers-do-with-clinical-information)\n1. **Applied**: Relocate paragraph. ([FHIR-30850](https://jira.hl7.org/browse/FHIR-30850)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#actors-and-roles)\n1. **Applied**: Remove paragraph and refer to HREX security page. ([FHIR-30851](https://jira.hl7.org/browse/FHIR-30851)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.md)\n1. **Applied**: Typo ([FHIR-30852](https://jira.hl7.org/browse/FHIR-30852)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#where-does-cdex-fit-in-the-da-vinci-project)\n1. **Applied**: Reword statement. ([FHIR-30853](https://jira.hl7.org/browse/FHIR-30853)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#where-does-cdex-fit-in-the-da-vinci-project)\n1. **Applied**: Typo ([FHIR-30854](https://jira.hl7.org/browse/FHIR-30854)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#example-scenarios)\n1. **Applied**: Typo ([FHIR-30855](https://jira.hl7.org/browse/FHIR-30855)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#example-scenarios)\n1. **Applied**: Typo ([FHIR-30856](https://jira.hl7.org/browse/FHIR-30856)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#steps)\n1. **Applied**: Typo ([FHIR-30857](https://jira.hl7.org/browse/FHIR-30857)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#steps)\n1. **Applied**: Updated STU-note on when authorization needed? ([FHIR-30863](https://jira.hl7.org/browse/FHIR-30863)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification#formal-authorization)\n1. **Applied**: Remove '?' or correct the section name if it is in question ([FHIR-30864](https://jira.hl7.org/browse/FHIR-30864)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Typo ([FHIR-30865](https://jira.hl7.org/browse/FHIR-30865)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Updated Purpose of Use section for Direct Query. ([FHIR-30867](https://jira.hl7.org/browse/FHIR-30867)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1direct-query.html)\n1. **Applied**: Updated Sensitivity and Confidentiality protection guidance. ([FHIR-30868](https://jira.hl7.org/browse/FHIR-30868)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html#sensitive-and-confidential-data)\n1. **Applied**: Updated Sensitivity and Confidentiality protection guidance. ([FHIR-30869](https://jira.hl7.org/browse/FHIR-30869)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html#sensitive-and-confidential-data)\n1. **Applied**: clarify when attribution is not present or non-repudiable ([FHIR-30870](https://jira.hl7.org/browse/FHIR-30870)) various changes\n1. **Applied**: Fix sequential numbering of figures  ([FHIR-30935](https://jira.hl7.org/browse/FHIR-30935)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1specification.html)\n1. **Applied**: correct last example bullet ([FHIR-31050](https://jira.hl7.org/browse/FHIR-31050)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1davinci-ecdx/background.html#example-scenarios)\n1. **Applied**: Remove reference to HREX CommunicationRequest plus Task transaction ([FHIR-31516](https://jira.hl7.org/browse/FHIR-31516)) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Clarify human involvement in Task transaction ([FHIR-31886](https://jira.hl7.org/browse/FHIR-31886) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Create privacy and security page ([FHIR-31885](https://jira.hl7.org/browse/FHIR-31885) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html)\n1. **Applied**: Clarify when HIEs are data sources ([FHIR-31884](https://jira.hl7.org/browse/FHIR-31884))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#actors-and-roles)\n1. **Applied**: Add supplemental security guidance on audit ([FHIR-31888](https://jira.hl7.org/browse/FHIR-31888))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html#general-considerations)\n1. **Applied**: Add supplemental security guidance on scopes([FHIR-31887](https://jira.hl7.org/browse/FHIR-31887))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1security.html#general-considerations)\n1. **Applied**: Clarify human involvement needed([FHIR-31886](https://jira.hl7.org/browse/FHIR-31886))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Provide guidance on finding organization and provider identifiers([FHIR-32841](https://jira.hl7.org/browse/FHIR-32841))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Update how to represent Purpose of Use and reason in Task Based Query ([FHIR-31996](https://jira.hl7.org/browse/FHIR-31996))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html)\n1. **Applied**: Clarify the relationship between this guide and others([FHIR-32116](https://jira.hl7.org/browse/FHIR-32116))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#where-does-cdex-fit-in-the-da-vinci-project)\n1. **Applied**: Added guidance on matching patients([FHIR-32840](https://jira.hl7.org/browse/FHIR-32840))[See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html#discovery-of-fhir-ids)\n1. **Applied**: Update to the USCDI link ([FHIR-33265](https://jira.hl7.org/browse/FHIR-33265)\n1. **Applied**: Add guidance how to provide some work queue tags([FHIR-31890](https://jira.hl7.org/browse/FHIR-31890) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1task-based-approach.html#work-queues)\n1. **Applied**: Add push mechanism to support Attachments for Claims and Prior Auth([FHIR-33129](https://jira.hl7.org/browse/FHIR-33129) See Changes:\n  - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1background.html#attachments-workflow)\n  - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1attachments.html)\n  - [Here](http://hl7.org/fhir/us/davinci-cdex/STU1OperationDefinition-submit-attachment.html)\n1. **Applied**: Add figure to clarify relationship between cdex and hrex([FHIR-34559](https://jira.hl7.org/browse/FHIR-34559) [See Change Here](http://hl7.org/fhir/us/davinci-cdex/STU1index.html#about-this-guide)",
      "sequence" : "STU1",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/STU1",
      "status" : "trial-use",
      "fhirversion" : "4.0.1",
      "date" : "2022-03-28"
    },
    {
      "version" : "0.2.0",
      "desc" : "Jan 2021 Ballot for Da Vinci CDex: Based on balloter feedback, this IG has been completely re-written. The refactoring has been sufficiently large that it is not practical/useful to enumerate a list of changes.",
      "sequence" : "STU1",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/2021Jan",
      "status" : "ballot",
      "fhirversion" : "4.0.1",
      "date" : "2020-12-16"
    },
    {
      "version" : "0.1.0",
      "desc" : "June 2019 Ballot for Da Vinci CDex",
      "date" : "2019-06-20",
      "sequence" : "STU 1",
      "path" : "http://hl7.org/fhir/us/davinci-cdex/2019Jun",
      "status" : "ballot",
      "fhirversion" : "4.0.0"
    }
  ]
}