Da Vinci Payer Data Exchange
2.1.0-ballot - STU2 Ballot United States of America flag

This page is part of the Da Vinci Payer Data Exchange (v2.1.0-ballot: STU2.1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PDex Member Match Group

Official URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-member-match-group Version: 2.1.0-ballot
Standards status: Trial-use Computable Name: PDexMemberMatchGroup

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

A Group List created by the Payer to enable Bulk Payer-to-Payer API access by Other Payers to retrieve member information. Based on the Group resource. An Extension is added to capture the submitted parameters for the access request.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Group

NameFlagsCard.TypeDescription & Constraintsdoco
.. Group 0..* Group Group of multiple entities
... code S 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... characteristic
.... code S 1..1 CodeableConcept Kind of characteristic
..... coding 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... code 0..1 code Symbol in syntax defined by the system
Required Pattern: match
.... Slices for value[x] 1..1 CodeableConcept, boolean, Quantity, Range, Reference() Value held by characteristic
Slice: Unordered, Open by type:$this
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member
.... entity
..... Slices for extension Content/Rules for all slices
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Group C 0..* Group Group of multiple entities
grp-1: Can only have members if group is "actual"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type Σ 1..1 code person | animal | practitioner | device | medication | substance
Binding: GroupType (required): Types of resources that are part of group.

... code SΣ 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... characteristic 0..* BackboneElement Include / Exclude group members by Trait
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 1..1 CodeableConcept Kind of characteristic
Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

..... coding Σ 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: match
.... Slices for value[x] 1..1 Value held by characteristic
Slice: Unordered, Open by type:$this
Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference(Any)
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member C 0..* BackboneElement Who or what is in group
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entity 1..1 Reference(Patient | Practitioner | PractitionerRole | Device | Medication | Substance | Group) Reference to the group member
..... Slices for extension Content/Rules for all slices
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Group.typerequiredGroupType
http://hl7.org/fhir/ValueSet/group-type|4.0.1
from the FHIR Standard
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.codeexample
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.value[x]example
NameFlagsCard.TypeDescription & Constraintsdoco
.. Group C 0..* Group Group of multiple entities
grp-1: Can only have members if group is "actual"
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique id
... active Σ 0..1 boolean Whether this group's record is in active use
... type Σ 1..1 code person | animal | practitioner | device | medication | substance
Binding: GroupType (required): Types of resources that are part of group.

... actual ΣC 1..1 boolean Descriptive or actual
... code SΣ 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... name Σ 0..1 string Label for Group
... quantity Σ 0..1 unsignedInt Number of members
... managingEntity Σ 0..1 Reference(Organization | RelatedPerson | Practitioner | PractitionerRole) Entity that is the custodian of the Group's definition
... characteristic 0..* BackboneElement Include / Exclude group members by Trait
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 1..1 CodeableConcept Kind of characteristic
Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: match
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... Slices for value[x] 1..1 Value held by characteristic
Slice: Unordered, Open by type:$this
Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference(Any)
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member C 0..* BackboneElement Who or what is in group
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entity 1..1 Reference(Patient | Practitioner | PractitionerRole | Device | Medication | Substance | Group) Reference to the group member
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... display Σ 0..1 string Text alternative for the resource
.... period 0..1 Period Period member belonged to the group
.... inactive 0..1 boolean If member is no longer in group

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Group.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Group.typerequiredGroupType
http://hl7.org/fhir/ValueSet/group-type|4.0.1
from the FHIR Standard
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.codeexample
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.value[x]example
Group.member.entity.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard

This structure is derived from Group

Summary

Mandatory: 1 element
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Group.characteristic.value[x]

Differential View

This structure is derived from Group

NameFlagsCard.TypeDescription & Constraintsdoco
.. Group 0..* Group Group of multiple entities
... code S 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... characteristic
.... code S 1..1 CodeableConcept Kind of characteristic
..... coding 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... code 0..1 code Symbol in syntax defined by the system
Required Pattern: match
.... Slices for value[x] 1..1 CodeableConcept, boolean, Quantity, Range, Reference() Value held by characteristic
Slice: Unordered, Open by type:$this
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member
.... entity
..... Slices for extension Content/Rules for all slices
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Group C 0..* Group Group of multiple entities
grp-1: Can only have members if group is "actual"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type Σ 1..1 code person | animal | practitioner | device | medication | substance
Binding: GroupType (required): Types of resources that are part of group.

... code SΣ 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... characteristic 0..* BackboneElement Include / Exclude group members by Trait
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 1..1 CodeableConcept Kind of characteristic
Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

..... coding Σ 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: match
.... Slices for value[x] 1..1 Value held by characteristic
Slice: Unordered, Open by type:$this
Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference(Any)
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member C 0..* BackboneElement Who or what is in group
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entity 1..1 Reference(Patient | Practitioner | PractitionerRole | Device | Medication | Substance | Group) Reference to the group member
..... Slices for extension Content/Rules for all slices
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Group.typerequiredGroupType
http://hl7.org/fhir/ValueSet/group-type|4.0.1
from the FHIR Standard
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.codeexample
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.value[x]example

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Group C 0..* Group Group of multiple entities
grp-1: Can only have members if group is "actual"
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique id
... active Σ 0..1 boolean Whether this group's record is in active use
... type Σ 1..1 code person | animal | practitioner | device | medication | substance
Binding: GroupType (required): Types of resources that are part of group.

... actual ΣC 1..1 boolean Descriptive or actual
... code SΣ 1..1 CodeableConcept Kind of Group members
Binding: PDex Multi-Member Match Result Value Set (required)
... name Σ 0..1 string Label for Group
... quantity Σ 0..1 unsignedInt Number of members
... managingEntity Σ 0..1 Reference(Organization | RelatedPerson | Practitioner | PractitionerRole) Entity that is the custodian of the Group's definition
... characteristic 0..* BackboneElement Include / Exclude group members by Trait
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 1..1 CodeableConcept Kind of characteristic
Binding Description (No ValueSet): (example): List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
Binding: PDex Multi-Member Match Result Value Set (required)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Required Pattern: match
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... Slices for value[x] 1..1 Value held by characteristic
Slice: Unordered, Open by type:$this
Binding Description (No ValueSet): (example): Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

..... valueCodeableConcept CodeableConcept
..... valueBoolean boolean
..... valueQuantity Quantity
..... valueRange Range
..... valueReference Reference(Any)
..... value[x]:valueReference S 0..1 Reference() Value held by characteristic
.... exclude 1..1 boolean Group includes or excludes
Required Pattern: false
.... period S 0..1 Period Period over which characteristic is tested
... member C 0..* BackboneElement Who or what is in group
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entity 1..1 Reference(Patient | Practitioner | PractitionerRole | Device | Medication | Substance | Group) Reference to the group member
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... matchedMember S 0..1 Reference(Patient) Member-Match Input Patient Parameter
URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... display Σ 0..1 string Text alternative for the resource
.... period 0..1 Period Period member belonged to the group
.... inactive 0..1 boolean If member is no longer in group

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Group.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Group.typerequiredGroupType
http://hl7.org/fhir/ValueSet/group-type|4.0.1
from the FHIR Standard
Group.coderequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.codeexample
Group.characteristic.code.codingrequiredPDexMultiMemberMatchResultVS
http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS
from this IG
Group.characteristic.value[x]example
Group.member.entity.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard

This structure is derived from Group

Summary

Mandatory: 1 element
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Group.characteristic.value[x]

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Mandatory Search Parameters

  1. SHALL support searching for code for a Group. Group_Code Search Parameter

    GET [base]/Group?code={code}

    Example:

    GET [base]/Group?code="match"

    NOTE:

    Server should limit responses to records that requesting user or service (i.e. Payer in case of Member-Match) is permitted to access. For example, Matched Group lists for a Payer.

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