This page is part of the Da Vinci Payer Data Exchange (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions 
Implementation Guide HomePage
Description
This specification is currently undergoing ballot and connectathon testing. It is expected to evolve, possibly significantly, as part of that process. Feedback is welcome and may be submitted through the FHIR gForge tracker indicating US Da Vinci PDex as the specification. If balloting on this IG, please submit your comments via the tracker and just reference them in your ballot submission implementation guide.
Financial Management is the Sponsoring Work Group for this Implementation Guide.
The Payer Data Exchange (PDex) Implementation Guide (IG) is provided for Payers/Health Plans to enable them to create a Member’s Health History using clinical resources (based on US Core Profiles based on FHIR R4) which can be understood by providers and, if they choose to, committed to their Electronic Medical Records (EMR) System.
This IG uses the same Member Health History “payload” for member-authorized exchange of information with other Health Plans and with Third-Party Applications. It describes the interaction patters that, when followed, allow the various parties involved in managing healthcare and payer data to more easily integrate and exchange data securely and effectively.
This IG covers the exchange of:
- Claims-based information
- Clinical Information (such as Lab Results, Allergies and Conditions)
This IG covers the exchange of this information using US Core and Da Vinci Health Record Exchange (HRex) Profiles. This superset of clinical profiles forms the Health Plan Member’s Health History.
This IG covers the exchange of a Member’s Health History in the following scenarios:
- Provider requested Provider-Health Plan Exchange using CDS-Hooks and SMART-on-FHIR
- Member-authorized Health Plan to Health Plan exchange
- Member-authorized Health Plan to Third-Party Application exchange
The latter two scenarios are provided to meet the requirements identified in the CMS Interoperability Notice for Proposed Rule Making issued on February 11, 2019.
There are items in this guide that are subject to update. This includes:
- Value Sets
- Vocabularies (X12, NUBC etc.)
- Examples
The Vocabulary, Value Sets and codings used to express data in this IG are subject to review and will be reconciled with X12.
See the Table of Contents for more information.
Latest Changes
- (283) rebuild to test broken CI process
- (280) fix more links
- (275) fix links
- (274) Change Business Version to 0.1.0, Change navigation links
- (271) Change Business Version to 1.0.0
- (270) reformat section 2-1
- (269) Fix corrupted section 2-1
- (266) Add remaining previous/next links to narrative
- (255) Adding Previous / Next Page Links to narrative thru section 3
- (254) Add CDS Hooks Justification, revisions per review comments.
- (245) Add section 4-8 sub-content links
- (243) Add FM as sponsoring workgroup to description
Authors
| Name | |
|---|---|
| Mark Scrimshire (mark@ekivemark.com) | mark@ekivemark.com |
