Da Vinci Payer Data exchange Implementation Guide Release 0.1.0

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5 Provider-controlled Information Requests and Filtering

Question_For_Comment (Q_F_05):
How could Health Plan initiated data exchange be handled?

The Payer Data exchange Implementation Guide defines methods for Providers to request information from Health Plans.

This IG does not cover the Payer-initiated transfer of unsolicited information to a provider. All Provider-oriented exchanges will be initiated as part of a Provider workflow, such as when a new patient presents for an appointment, using CDS-Hooks or triggered via a manual interaction with a SMART-on-FHIR app that generates the necessary CDS-Hook.

All search parameters and subsequent filtering of returned information SHALL be controlled by the Provider making the information request. The Payer does not filter information that has been requested by the provider.

Health Plans should only restrict provider access to a member’s data where that access is required in accordance with State or FEderal regulations.

Health Plan to Health Plan or Third-Party Application exchange is controlled by the Member using an OAuth2.0 Authorization.