Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## US Core DocumentReference

Page standards status: Informative

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The Health Plan SHALL use the US Core 3.1.1 DocumentReference or US Core 6.1.0 DocumentReference resource to exchange:

- Unstructured data
- Imaging data
- C-CDA documents

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core DocumentReference resource are:

R4 Element | Name | Cardinality | Type
--- | --- | --- | ---
DocumentReference.identifier | identifier | 0..* | Identifier
DocumentReference.status | status | 1..1 | code
DocumentReference.type | type | 1..1 | CodeableConcept
DocumentReference.category | category | 1..* | CodeableConcept
DocumentReference.subject | subject | 1..1 | Reference(US Core Patient Profile)
DocumentReference.date | date | 0..1 | instant
DocumentReference.author | author | 0..* | Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)
DocumentReference.custodian | custodian | 0..1 | Reference(US Core Organization Profile)
DocumentReference.content | content | 1..* | BackboneElement
DocumentReference.content.attachment | attachment | 1..1 | Attachment
DocumentReference.content.attachment.contentType | contentType | 1..1 | code
DocumentReference.content.attachment.data | data | 0..1 | base64Binary
DocumentReference.content.attachment.url | url | 0..1 | url
DocumentReference.content.format | format | 0..1 | Coding
DocumentReference.context | context | 0..1 | BackboneElement
DocumentReference.context.encounter | encounter | 0..1 | Reference(US Core Encounter Profile)
DocumentReference.context.period | period | 0..1 | Period

Table Definition

#### Example DocumentReference resource

An example mapping of a DocumentReference for an episode of care is shown below:

###

###

    {
      "resourceType" : "DocumentReference",
      "id" : "episode-summary",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated Narrative with Detailsid: episode-summarymeta: identifier: urn:oid:2.16.840.1.113883.19.5.99999.1status: currenttype: CCD Document <span style=\"background: LightGoldenRodYellow\">(Details : {LOINC code '34133-9' = 'Summary of episode note', given as 'Summary of episode note'})</span>category: Clinical Note <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category code 'clinical-note' = 'Clinical Note', given as 'Clinical Note'})</span>subject: <a href=\"Patient-example.html\">Amy Shaw. Generated Summary: id: example; Medical Record Number = 1032702 (USUAL); active; Amy V. Shaw ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: Feb 20, 2007</a>date: Mar 9, 2016, 3:29:46 PMauthor: <a href=\"Practitioner-practitioner-1.html\">Ronald Bone, MD. Generated Summary: id: practitioner-1; 9941339108, 25456; Ronald Bone </a>description: Pulmonology clinic acute visitContents<table class=\"grid\">-AttachmentFormat*Documents following C-CDA constraints using a structured body (Details: urn:oid:1.3.6.1.4.1.19376.1.2.3 code urn:hl7-org:sdwg:ccda-structuredBody:2.1 = 'urn:hl7-org:sdwg:ccda-structuredBody:2.1', stated as 'Documents following C-CDA constraints using a structured body')</table>Contexts<table class=\"grid\">-Period*Dec 22, 2004, 9:00:00 PM --> Dec 22, 2004, 9:01:00 PM</table></div>"
      },
      "identifier" : [
        {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:oid:2.16.840.1.113883.19.5.99999.1"
        }
      ],
      "status" : "current",
      "type" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "34133-9",
            "display" : "Summary of episode note"
          }
        ],
        "text" : "CCD Document"
      },
      "category" : [
        {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
              "code" : "clinical-note",
              "display" : "Clinical Note"
            }
          ],
          "text" : "Clinical Note"
        }
      ],
      "subject" : {
        "reference" : "Patient/example",
        "display" : "Amy Shaw"
      },
      "date" : "2016-03-09T15:29:46Z",
      "author" : [
        {
          "reference" : "Practitioner/practitioner-1",
          "display" : "Ronald Bone, MD"
        }
      ],
      "description" : "Pulmonology clinic acute visit",
      "content" : [
        {
          "attachment" : {
            "contentType" : "text/plain",
            "url" : "/Binary/1-note",
            "title" : "Uri where the data can be found: [base]/Binary/1-note"
          },
          "format" : {
            "system" : "urn:oid:1.3.6.1.4.1.19376.1.2.3",
            "code" : "urn:hl7-org:sdwg:ccda-structuredBody:2.1",
            "display" : "Documents following C-CDA constraints using a structured body"
          }
        }
      ],
      "context" : {
        "period" : {
          "start" : "2004-12-23T08:00:00+11:00",
          "end" : "2004-12-23T08:01:00+11:00"
        }
      }
    }

The following example of a DocumentReference and associated PDex Provenance resource demonstrates how an unstructured document, such as a Portable Document Format (PDF) document could be attached or embedded as base64 encoded content in a DocumentReference. The associated PDex Provenance resource identifies the source document as a PDF file.

#### Example: Unstructured Document with Provenance

- The example US Core DocumentReference is here: DocumentReference-123456.html
- The associated PDex Provenance resource is here: Provenance-1000006.html

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