Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1 United States of America flag

Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

Conforming to CDex Task Based Approach

Page standards status: Trial-use

Introduction

CDex Task-based transactions have many optional capabilities. Systems may choose some or all of these capabilities and implement any combination. Refer to the CDex CapabilityStatements resources for conformance expectations for the various actors and roles. In contrast to the expectations in the CDex CapabilityStatements, Systems should define what they support in their local capability statement in one or more of the following ways:

  1. (Preferred) Formally derived implementable profile from CDex Task Data Request Profile
  2. Document their systems' capabilities for requesting attachments in CapabilityStatement.rest.resource.documentation for the Task resource.
  3. (Preferred) Formal OperationDefinition derived from $submit-attachment
  4. Document their systems' capabilities for submitting attachments in CapabilityStatement.rest.documentation

Actors for CDex Task Data Request Profile

  • Data Source in the Role of Data Source Server
  • Data Consumer in the Role of Data Consumer Client

Task-based Interaction Functional Requirements

Capability Required Optional
Signatures ✔  
Polling ✔  
Subscriptions   ✔
Support of Provenance   ✔

Capabilities for Task-based Requests

Capability Must Support* Optional
Requesting Attachments Using Attachment Codes ✔  
Requesting Attachments Using FHIR RESTful Query Syntax ✔  
Requesting Attachments Using Free Text   ✔
Requesting Attachments Using Questionnaire   ✔
Support of Contained Task Outputs   ✔
Signatures ✔  
Representing The Purpose Of Use (POU) For The Requested Data   ✔
Support of Work Queues Tags   ✔
Support of Formal Authorizations ✔  

* See the next section

CDex Must Support Definition

The CDex Profile elements consist of Mandatory, Must Support, and Optional elements. Elements that are neither Mandatory or Must Support are Optional. Mandatory elements are elements with a minimum cardinality greater than 0. [Must Support] elements are marked with the mustSupport flag and SHALL be interpreted as follows:

Task Source
Data Source server where the Task is stored and updated, or Data Consumer client that POST the Task to Data Source server.
Task Consumer
Data Consumer client receiving a Task from the Data Source server due to a FHIR interaction.
  • If the minimum cardinality of an element is greater than 0, the element is required and the Task Source SHALL populating the data element with value unless:
    • The profile references a dataAbsentReason (DAR) extension, then the Task Source SHALL use that extension to communicate the reason for missing data.
  • If the minimum cardinality of an element is equal to 0, the Task Source SHALL be capable of populating the data element when sharing Task compliant with a CDex profile. Therefore, the system must demonstrate the population and sharing of the element. However, it is acceptable to omit the element if the system doesn't have values in a particular instance. A system that is incapable of ever sharing the the element would be non-conformant.
  • The Task Consumer SHALL be capable of processing Task instances containing the data elements without generating an error or causing the application to fail.

NOTE: mustSupport indicates what Da Vinci CDex conformant systems are expected to be able to handle. Systems are free to include additional data - and receivers SHOULD NOT reject instances that contain unexpected data elements if those elements are not [modifier elements]. However, the Task Source should be aware that they can't count on the Task Consumer storing, processing, or doing anything other than ignoring data that is not marked as mustSupport.

[Da Vinci Prior Authorization Support (PAS)]: [CDex Work Queue Value Set]: ValueSet-cdex-work-queue.html [What is Signed]: signatures.html#what-is-signed [Signatures for Task Based Requests]: task-based-approach.html#signatures [X12]: https://x12.org/ [X12 transactions]: https://x12.org/ [X12 Transaction Sets]: https://x12.org/products/transaction-sets [HEDIS]: https://en.wikipedia.org/wiki/Healthcare_Effectiveness_Data_and_Information_Set [Specification]: specification.html [$match]: http://hl7.org/fhir/R4/patient-operation-match.html [Coverage]: http://hl7.org/fhir/R4/coverage.html [FHIR RESTful Search syntax]: http://hl7.org/fhir/R4/search.html#Introduction [DocumentReference]: http://hl7.org/fhir/R4/documentreference.html [FHIR Signature]: http://hl7.org/fhir/R4/datatypes.html#signature [Bundle.signature]: http://hl7.org/fhir/R4/bundle-definitions.html#Bundle.signature [enveloped signature]: http://www.w3.org/TR/xmldsig-core/#def-SignatureEnveloped [(Verification Signature)]: http://hl7.org/fhir/R4/valueset-signature-type.html [FHIR Document]: http://hl7.org/fhir/R4/documents.html [RFC 7515]: https://tools.ietf.org/html/rfc7515 [JSON Signature rules]: http://hl7.org/fhir/R4/datatypes.html#JSON [RFC 7515: JSON Web Signature (JWS)]: https://tools.ietf.org/html/rfc7515 [Detached]: https://tools.ietf.org/html/rfc7515#appendix-F [Canonical JSON]: http://hl7.org/fhir/R4/json.html#canonical [JWS JSON Serialization]: https://datatracker.ietf.org/doc/html/rfc7515#section-3.2 [X.509 certificates]: https://www.itu.int/rec/T-REC-X.509 [RFC 7518]: https://tools.ietf.org/html/rfc7518 [RFC 7517]: https://tools.ietf.org/html/rfc7517 [RFC 8785]: https://datatracker.ietf.org/doc/rfc8785 [self-signed certificates]: https://en.wikipedia.org/wiki/Self-signed_certificate [Signed SearchSet Bundle Example]: signed-searchset-bundle-example.html [Signed Document Bundle Example]: signed-document-bundle-example.html [FHIR-36158]: https://jira.hl7.org/browse/FHIR-36158 [Solicited and Unsolicited Attachments]: solicited-unsolicited-attachments.html [Sending Attachments]: sending-attachments.html [Requesting Attachments Using Attachment Codes]: requesting-attachments-code.html [Requesting Attachments Using Questionnaires]: requesting-attachments-questionnaire.html [Using Questionnaire as Task Input]: task-based-approach.html#using-questionnaire-as-task-input [Using CDex Attachments with DaVinci PAS]: burden-reduction.html [CDex Task Attachment Request Profile]: StructureDefinition-cdex-task-attachment-request.html [LOINC attachment codes]: https://loinc.org/attachments/ [Parameters]: http://hl7.org/fhir/R4/parameters.html [CDex Patient Demographics Profile]: StructureDefinition-cdex-patient-demographics.html [CDex Claim Use Value Set]: ValueSet-cdex-claim-use.html [Prior-Auth AttachmentRequest Example]: Task-cdex-task-example20.html [Claim AttachmentRequest Example]: Task-cdex-task-example19.html [CDex Temporary Code System]: CodeSystem-cdex-temp.html [NHIN Purpose Of Use Code System]: http://hl7.org/fhir/R4/codesystem-nhin-purposeofuse.html [LOINC Document Ontology]: https://loinc.org/document-ontology/ [CDex Signature Bundle Profile]: StructureDefinition-cdex-signature-bundle.html [FHIR RESTful search]: http://hl7.org/fhir/R4/http.html#search [FHIR RESTful read]: http://hl7.org/fhir/R4/http.html#read [Change Log]: changes.html [CDex Parameters Example1]: Parameters-cdex-parameters-example1.html [CDex Parameters Example2]: Parameters-cdex-parameters-example2.html [CDex Parameters Example3]: Parameters-cdex-parameters-example3.html [CDex Parameters Example4]: Parameters-cdex-parameters-example4.html [validating profiles and resources]: http://hl7.org/fhir/R4/validation.html [ImplementationGuide]: http://hl7.org/fhir/R4/implementationguide.html [CDex ImplementationGuide Resource]: ImplementationGuide-hl7.fhir.us.davinci-cdex.html [Da Vinci DTR]: http://hl7.org/fhir/us/davinci-dtr/2.1.0-preview [Questionnaire]: http://hl7.org/fhir/R4/questionnaire.html [Smart Version 2.0.0 EHR launch flow]: https://hl7.org/fhir/smart-app-launch/app-launch.html#launch-app-ehr-launch [Using Da Vinci DTR to Complete the Questionnaire]: requesting-attachments-questionnaire.html#using-da-vinci-dtr-to-complete-the-questionnaire [Conforming to CDex Attachments]: attachments-conformance.html [Request for Additional Information]: /additionalinfo.html [SDC Questionnaire Response Profile]:http://hl7.org/fhir/uv/sdc/STU3StructureDefinition-sdc-questionnaireresponse.html [SDC Adaptive Questionnaire Response Profile]:http://hl7.org/fhir/uv/sdc/STU3StructureDefinition-sdc-questionnaireresponse-adapt.html [45 CFR 164.506 Treatment, Payment, and Health Care Operations (TPO)]: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.506 [must support]: http://hl7.org/fhir/us/davinci-hrex/STU1.1/conformance.html [DTR SMART App Launch]: requesting-attachments-questionnaire.html#dtr-smart-app-launch [Conforming to CDex Task Based Approach]: task-based-conformance.html [Signature Extension]: http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature [DTR Standard Questionnaire]: http://hl7.org/fhir/us/davinci-dtr/2.1.0-previewStructureDefinition-dtr-std-questionnaire.html [signatureRequired]: http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired [CDex Signature Profile]: StructureDefinition-cdex-signature.html [CDex SDC QuestionnaireResponse Profile]: StructureDefinition-cdex-sdc-questionnaireresponse.html [QuestionnaireResponse]: http://hl7.org/fhir/R4/questionnaireresponse.html [Topic-Based Subscriptions Framework]: http://hl7.org/fhir/2022Sep/subscriptions.html [C-CDA on FHIR Documents]: http://www.hl7.org/fhir/us/ccda/index.html [FHIR Conformance]: http://hl7.org/fhir/R4/conformance-rules.html#conflang [Must Support]: http://hl7.org/fhir/R4/profiling.html#mustsupport [modifier elements]: http://hl7.org/fhir/R4/conformance-rules.html#isModifier [CDex PractitionerRole Profile]: StructureDefinition-cdex-practitionerrole.html [CDex Task Update]: SubscriptionTopic-cdex-task-update.html [Subscription R5 Backport Implementation Guide]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1 [SubscriptionTopic]: https://hl7.org/fhir/R4B/subscriptiontopic.html [CapabilityStatement SubscriptionTopic Canonical]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-capabilitystatement-subscriptiontopic-canonical.html [Conformance in FHIR R4]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/conformance.html#conformance-in-fhir-r4 [R4/B Topic-Based Subscription Profile]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-backport-subscription.html [R4 Topic-Based Subscription Notification Bundle]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-backport-subscription-notification-r4.html [HRex Task Status ValueSet]: http://hl7.org/fhir/us/davinci-hrex/STU1.1/ValueSet-hrex-task-status.html [Task.businessStatus]: http://hl7.org/fhir/R4/task-definitions.html#Task.businessStatus [Benefits]: task-based-approach.html#benefits [Task Inputs and Outputs]: task-based-approach.html#task-inputs-and-outputs [Purpose of Use]: task-based-approach.html#purpose-of-use [Task Reason]: task-based-approach.html#task-reason [Discovery of Identifiers]: task-based-approach.html#discovery-of-identifiers [Task State Machine]: task-based-approach.html#task-state-machine [Approaches to Exchanging FHIR Data]: https://hl7.org/fhir/R5/exchanging.html [PAS Claim Response Bundle]: /StructureDefinition-profile-pas-response-bundle.html [PAS Task]: /StructureDefinition-profile-task.html [Patient Matching]: https://hl7.org/fhir/us/identity-matching/patient-matching.html [Guidance on Identity Assurance]: https://hl7.org/fhir/us/identity-matching/guidance-on-identity-assurance.html [Interoperable Digital Identity and Patient Matching]: https://hl7.org/fhir/us/identity-matching/index.html [CQL]: https://cql.hl7.org/ [Da Vinci Use Cases]: https://confluence.hl7.org/display/DVP/Da+Vinci+Use+Cases [FHIR R4 core]: http://hl7.org/fhir/R4/fhir-spec.zip [FHIR core downloads]: http://hl7.org/fhir/R4/downloads.html [validator]: https://fhir.github.io/latest-ig-validator/org.hl7.fhir.validator.jar [instructions on how to use it]: https://confluence.hl7.org/display/FHIR/Using+the+FHIR+Validator