Da Vinci Clinical Data Exchange (CDex)
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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 might 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 populate the data element with a 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.§ Although the system needs to demonstrate it is capable of populating and sharing of the element, 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 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, Task Sources cannot rely on Task Consumers to store, process, or do anything other than ignore data that is not marked as mustSupport.

The rules above are consistent with, and additional to, the general Da Vinci-wide Must Support expectations defined in HRex. For a detailed discussion of how to interpret Must Support for primitive, complex, and choice elements, references, and slices in this guide — see the US Core Must Support rules.  For content profiled in other guides, see the Must Support rules in those guides.

CDex Task Based Approach Requirements

This section lists all narrative conformance statements in the Task Based Approach section of this IG. The tables offer a concise summary for implementers to identify essential requirements and support evaluation and testing. The data is also available as CSV and Excel files, as well as in CDex Requirements Resources.

Data Consumer Requirements

Key Context Conformance Requirement
CONF-057 the task resource SHALL

For CDex Task-based transactions, the CDex Task Data Request Profile SHALL be used by the Data Consumer to solicit information from a system.
CONF-058 task reason SHALL

When known, Task.reasonCode or Task.reasonReference SHALL reference the object that directly leads to the task - a particular claim, for example.
CONF-082 StructureDefinition-cdex-task-data-request.html SHALL

The Task.reasonReference DocumentReference.author is a Must Support element with four target profile and three Coverage profiles….Clients SHALL support all four profiles.
CONF-087 task-based-conformance.html SHALL

Must Support elements are marked with the mustSupport flag and SHALL be interpreted [by the Task Source and Task Consumer] as follows in CONF-089, CONF-091, CONF-093, CONF-095, CONF-097.
CONF-089 task-based-conformance.html SHALL

[for Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required and the Task Source SHALL populatie the data element with a value unless {CONF-091].
CONF-091 task-based-conformance.html SHALL

[For Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required unless the profile references a dataAbsentReason (DAR) extension, then the Task Source SHALL use that extension to communicate the reason for missing data.
CONF-093 task-based-conformance.html SHALL

[For Must Support elements marked with the mustSupport flag and ] 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.
CONF-095 task-based-conformance.html SHALL

[ For Must Support elements are marked with the mustSupport flag , the] … Task Consumer SHALL be capable of processing Task instances containing the data elements without generating an error or causing the application to fail.
CONF-062 polling SHOULD

Data Consumers SHOULD … [poll for Task updates] in an automated/background manner after 1 minute to return automated responses and no more than every 5 minutes for the first 30 minutes and no more frequently than once every hour after that.
CONF-078 introduction SHOULD

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] (StructureDefinition-cdex-task-data-request.html)
  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
CONF-097 task-based-conformance.html SHOULD-NOT

[Data Consumers] …SHOULD NOT reject instances that contain unexpected data elements if those elements are not modifier elements.

Data Source Requirements

Key Context Conformance Requirement
CONF-059 task state machine SHALL

The Data Source SHALL support all the statuses in the HRex Task Status ValueSet.
CONF-064 subscription SHALL

Da Vinci CDex Data Sources who choose to support Subscription SHALL comply with the Subscription R5 Backport Implementation Guide and the Da Vinci Health Record Exchange (HRex) Subscription requirements for subscribing to Task updates.
CONF-065 hrex task subscription topic SHALL

Da Vinci CDex Data Sources who choose to support Subscription …SHALL support the HRex Task Subscription Topic….
CONF-067 discovery SHALL

Da Vinci CDex Data Sources who choose to support Subscription …SHALL support discovery of the CDex Task Update Subscription Topic canonical URL.
CONF-080 StructureDefinition-cdex-task-data-request.html SHALL

The Task.reasonReference DocumentReference.author is a Must Support element with four target profile and three Coverage profiles. Servers SHALL support at least one of them ….
CONF-081 StructureDefinition-cdex-task-data-request.html SHALL

The Task.reasonReference DocumentReference.author is a Must Support element with four target profile and three Coverage profiles … when supporting a Coverage profile, SHALL support the Coverage Profile based on the US Core version [they are supporting].
CONF-087 task-based-conformance.html SHALL

Must Support elements are marked with the mustSupport flag and SHALL be interpreted [by the Task Source and Task Consumer] as follows in CONF-089, CONF-091, CONF-093, CONF-095, CONF-097.
CONF-089 task-based-conformance.html SHALL

[for Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required and the Task Source SHALL populatie the data element with a value unless {CONF-091].
CONF-091 task-based-conformance.html SHALL

[For Must Support elements are marked with the mustSupport flag and ] the minimum cardinality of an element is greater than 0, the element is required unless the profile references a dataAbsentReason (DAR) extension, then the Task Source SHALL use that extension to communicate the reason for missing data.
CONF-093 task-based-conformance.html SHALL

[For Must Support elements marked with the mustSupport flag and ] 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.
CONF-095 task-based-conformance.html SHALL

[ For Must Support elements are marked with the mustSupport flag , the] … Task Consumer SHALL be capable of processing Task instances containing the data elements without generating an error or causing the application to fail.
CONF-068 discovery SHOULD

Da Vinci CDex Data Sources who choose to support Subscription … SHOULD support discovery using the CapabilityStatement SubscriptionTopic Canonical extension and
CONF-078 introduction SHOULD

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] (StructureDefinition-cdex-task-data-request.html)
  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
CONF-085 data source requirements SHOULD

if multiple documents need to be signed, systems SHOULD minimize the number of interactions required by the user
CONF-097 task-based-conformance.html SHOULD-NOT

[Data Consumers] …SHOULD NOT reject instances that contain unexpected data elements if those elements are not modifier elements.
CONF-060 task state machine MAY

The Data Source MAY support additional transitions [than shwn in the CDex State Diagram], including transitions from terminal states (e.g., back to "in-progress" from "failed" or "completed").
CONF-061 task state machine MAY

The Data Source MAY use Task.businessStatus to track intermediate business statuses for their specific implementation.
CONF-066 hrex task subscription topic MAY

Da Vinci CDex Data Sources who choose to support Subscription … MAY support other subscription topics [in addtion to the HRex Task Subscription Topic].
CONF-069 discovery MAY

Da Vinci CDex Data Sources who choose to support Subscription … MAY support discovery by some other method.