DaVinci PDEX Plan Net
0.1.5 - STU1

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.1.5). This version is based on the current content of https://github.com/HL7/davinci-pdex-plan-net/ and changes regularly. See the Directory of published versions

CapabilityStatement: Plan-Net CapabilityStatement

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Plan-Net CapabilityStatement

  • Implementation Guide Version: 1.0.0
  • FHIR Version: 4.0.1
  • Supported formats: xml, json
  • Published: 2020-10-23
  • Published by: HL7 Financial Management Working Group (FM WG)

This Section describes the expected capabilities of the Plan-Net Server actor which is responsible for providing responses to the queries submitted by the Plan-Net Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Plan-Net Servers are defined. Systems implementing this capability statement should meet the CMS FInal Rule requirement for provider directory access. Plan-Net Clients can use the required capabilities to access necessary data based on their local use cases and other contextual requirements.

FHIR RESTful Capabilities

The Plan-Net Server SHALL:

  1. Support all profiles defined in this Implementation Guide..
  2. Implement the RESTful behavior according to the FHIR specification.
  3. Return the following response classes:
    • (Status 400): invalid parameter
    • (Status 401/4xx): unauthorized request
    • (Status 403): insufficient scope
    • (Status 404): unknown resource
    • (Status 410): deleted resource.
  4. Support json source formats for all Plan-Net interactions.
  5. Identify the Plan-Net profiles supported as part of the FHIR meta.profile attribute for each instance. 1.Support forward and reverse chaining on all search parameters that specify the 'chain' property

The Plan-Net Server SHOULD:

  1. Support xml source formats for all Plan-Net interactions.

Security:

  1. See the General Security Considerations section for requirements and recommendations.
  2. A server SHALL reject any unauthorized requests by returning an HTTP 401 unauthorized response code.

RESTful Capabilities by Resource/Profile:

Summary of Search Criteria

Resource TypeSupported ProfilesSupported SearchesSupported _includesSupported _revincludesSupported Operations
EndpointPlan-Net Endpoint organization, _id, _lastUpdated Endpoint:organization
HealthcareServicePlan-Net HealthcareService location, coverage-area, organization, endpoint, name, service-category, service-type, specialty, _id, _lastUpdated HealthcareService:location, HealthcareService:coverage-area, HealthcareService:organization, HealthcareService:endpoint PractitionerRole:service, OrganizationAffiliation:service
InsurancePlanPlan-Net InsurancePlan administered-by, owned-by, coverage-area, name, plan-type, _id, _lastUpdated, type InsurancePlan:administered-by, InsurancePlan:owned-by, InsurancePlan:coverage-area
LocationPlan-Net Location partof, organization, endpoint, address-city, address-state, address-postalcode, address, type, _id, _lastUpdated Location:endpoint, Location:organization, Location:partof HealthcareService:location, InsurancePlan:coverage-area, OrganizationAffiliation:location, PractitionerRole:location
OrganizationPlan-Net Network, Plan-Net Organization partof, endpoint, address, name, _id, _lastUpdated, type, coverage-area Organization:partof, Organization:endpoint, Organization:coverage-area Endpoint:organization, HealthcareService:organization, InsurancePlan:administered-by, InsurancePlan:owned-by, OrganizationAffiliation:primary-organization, PractitionerRole:organization, PractitionerRole:network, OrganizationAffiliation:participating-organization
OrganizationAffiliationPlan-Net OrganizationAffiliation primary-organization, participating-organization, location, service, network, endpoint, role, specialty, _id, _lastUpdated OrganizationAffiliation:primary-organization, OrganizationAffiliation:participating-organization, OrganizationAffiliation:location, OrganizationAffiliation:service, OrganizationAffiliation:endpoint, OrganizationAffiliation:network
PractitionerPlan-Net Practitioner name, _id, _lastUpdated, family, given PractitionerRole:practitioner
PractitionerRolePlan-Net PractitionerRole practitioner, organization, location, service, network, endpoint, role, specialty, _id, _lastUpdated PractitionerRole:practitioner, PractitionerRole:organization, PractitionerRole:location, PractitionerRole:service, PractitionerRole:network, PractitionerRole:endpoint

Endpoint

Conformance Expectation: SHALL

Supported Profiles: Plan-Net Endpoint

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Endpoint resource using:
    GET [base]/Endpoint/[id]

  • A Server SHOULD be capable of returning a Endpoint resource using:
    GET [base]/Endpoint/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    Endpoint:organization - GET [base]/Endpoint?[parameter=value]&_include=Endpoint:organization

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLorganization reference GET [base]/Endpoint?organization=[organization]
SHALL_id token GET [base]/Endpoint?_id=[id]
SHALL_lastUpdated date GET [base]/Endpoint?_lastUpdated=[_lastUpdated]

HealthcareService

Conformance Expectation: SHALL

Supported Profiles: Plan-Net HealthcareService

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a HealthcareService resource using:
    GET [base]/HealthcareService/[id]

  • A Server SHOULD be capable of returning a HealthcareService resource using:
    GET [base]/HealthcareService/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    HealthcareService:location - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:location
    HealthcareService:coverage-area - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:coverage-area
    HealthcareService:organization - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:organization
    HealthcareService:endpoint - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:endpoint

  • A Server SHALL be capable of supporting the following _revincludes:
    PractitionerRole:service - GET [base]/HealthcareService?[parameter=value]&_revinclude=PractitionerRole:service
    OrganizationAffiliation:service - GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLlocation reference GET [base]/HealthcareService?location=[location]
SHALLcoverage-area reference GET [base]/HealthcareService?coverage-area=[coverage-area]
SHALLorganization reference GET [base]/HealthcareService?organization=[organization]
SHALLendpoint reference GET [base]/HealthcareService?endpoint=[endpoint]
SHALLname string GET [base]/HealthcareService?name=[name]
SHALLservice-category token GET [base]/HealthcareService?service-category=[system]|[code]
SHALLservice-type token GET [base]/HealthcareService?service-type=[system]|[code]
SHALLspecialty token GET [base]/HealthcareService?specialty=[system]|[code]
SHALL_id token GET [base]/HealthcareService?_id=[id]
SHALL_lastUpdated date GET [base]/HealthcareService?_lastUpdated=[_lastUpdated]

InsurancePlan

Conformance Expectation: SHALL

Supported Profiles: Plan-Net InsurancePlan

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a InsurancePlan resource using:
    GET [base]/InsurancePlan/[id]

  • A Server SHOULD be capable of returning a InsurancePlan resource using:
    GET [base]/InsurancePlan/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    InsurancePlan:administered-by - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:administered-by
    InsurancePlan:owned-by - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:owned-by
    InsurancePlan:coverage-area - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLadministered-by reference GET [base]/InsurancePlan?administered-by=[administered-by]
SHALLowned-by reference GET [base]/InsurancePlan?owned-by=[owned-by]
SHALLcoverage-area reference GET [base]/InsurancePlan?coverage-area=[coverage-area]
SHALLname string GET [base]/InsurancePlan?name=[name]
SHALLplan-type token GET [base]/InsurancePlan?plan-type=[system]|[code]
SHALL_id token GET [base]/InsurancePlan?_id=[id]
SHALL_lastUpdated date GET [base]/InsurancePlan?_lastUpdated=[_lastUpdated]
SHALLtype token GET [base]/InsurancePlan?type=[system]|[code]

Location

Conformance Expectation: SHALL

Supported Profiles: Plan-Net Location

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Location resource using:
    GET [base]/Location/[id]

  • A Server SHOULD be capable of returning a Location resource using:
    GET [base]/Location/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    Location:endpoint - GET [base]/Location?[parameter=value]&_include=Location:endpoint
    Location:organization - GET [base]/Location?[parameter=value]&_include=Location:organization
    Location:partof - GET [base]/Location?[parameter=value]&_include=Location:partof

  • A Server SHALL be capable of supporting the following _revincludes:
    HealthcareService:location - GET [base]/Location?[parameter=value]&_revinclude=HealthcareService:location
    InsurancePlan:coverage-area - GET [base]/Location?[parameter=value]&_revinclude=InsurancePlan:coverage-area
    OrganizationAffiliation:location - GET [base]/Location?[parameter=value]&_revinclude=OrganizationAffiliation:location
    PractitionerRole:location - GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLpartof reference GET [base]/Location?partof=[partof]
SHALLorganization reference GET [base]/Location?organization=[organization]
SHALLendpoint reference GET [base]/Location?endpoint=[endpoint]
SHALLaddress-city string GET [base]/Location?address-city=[address-city]
SHALLaddress-state string GET [base]/Location?address-state=[address-state]
SHALLaddress-postalcode string GET [base]/Location?address-postalcode=[address-postalcode]
SHALLaddress string GET [base]/Location?address=[address]
SHALLtype token GET [base]/Location?type=[system]|[code]
SHALL_id token GET [base]/Location?_id=[id]
SHALL_lastUpdated date GET [base]/Location?_lastUpdated=[_lastUpdated]

Organization

Conformance Expectation: SHALL

Supported Profiles: Plan-Net Network, Plan-Net Organization

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Organization resource using:
    GET [base]/Organization/[id]

  • A Server SHOULD be capable of returning a Organization resource using:
    GET [base]/Organization/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    Organization:partof - GET [base]/Organization?[parameter=value]&_include=Organization:partof
    Organization:endpoint - GET [base]/Organization?[parameter=value]&_include=Organization:endpoint
    Organization:coverage-area - GET [base]/Organization?[parameter=value]&_include=Organization:coverage-area

  • A Server SHALL be capable of supporting the following _revincludes:
    Endpoint:organization - GET [base]/Organization?[parameter=value]&_revinclude=Endpoint:organization
    HealthcareService:organization - GET [base]/Organization?[parameter=value]&_revinclude=HealthcareService:organization
    InsurancePlan:administered-by - GET [base]/Organization?[parameter=value]&_revinclude=InsurancePlan:administered-by
    InsurancePlan:owned-by - GET [base]/Organization?[parameter=value]&_revinclude=InsurancePlan:owned-by
    OrganizationAffiliation:primary-organization - GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:primary-organization
    PractitionerRole:organization - GET [base]/Organization?[parameter=value]&_revinclude=PractitionerRole:organization
    PractitionerRole:network - GET [base]/Organization?[parameter=value]&_revinclude=PractitionerRole:network
    OrganizationAffiliation:participating-organization - GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:participating-organization

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLpartof reference GET [base]/Organization?partof=[partof]
SHALLendpoint reference GET [base]/Organization?endpoint=[endpoint]
SHALLaddress string GET [base]/Organization?address=[address]
SHALLname string GET [base]/Organization?name=[name]
SHALL_id token GET [base]/Organization?_id=[id]
SHALL_lastUpdated date GET [base]/Organization?_lastUpdated=[_lastUpdated]
SHALLtype token GET [base]/Organization?type=[system]|[code]
SHALLcoverage-area reference GET [base]/Organization?coverage-area=[coverage-area]

OrganizationAffiliation

Conformance Expectation: SHALL

Supported Profiles: Plan-Net OrganizationAffiliation

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a OrganizationAffiliation resource using:
    GET [base]/OrganizationAffiliation/[id]

  • A Server SHOULD be capable of returning a OrganizationAffiliation resource using:
    GET [base]/OrganizationAffiliation/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    OrganizationAffiliation:primary-organization - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:primary-organization
    OrganizationAffiliation:participating-organization - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:participating-organization
    OrganizationAffiliation:location - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:location
    OrganizationAffiliation:service - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:service
    OrganizationAffiliation:endpoint - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:endpoint
    OrganizationAffiliation:network - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:network

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLprimary-organization reference GET [base]/OrganizationAffiliation?primary-organization=[primary-organization]
SHALLparticipating-organization reference GET [base]/OrganizationAffiliation?participating-organization=[participating-organization]
SHALLlocation reference GET [base]/OrganizationAffiliation?location=[location]
SHALLservice reference GET [base]/OrganizationAffiliation?service=[service]
SHALLnetwork reference GET [base]/OrganizationAffiliation?network=[network]
SHALLendpoint reference GET [base]/OrganizationAffiliation?endpoint=[endpoint]
SHALLrole token GET [base]/OrganizationAffiliation?role=[system]|[code]
SHALLspecialty token GET [base]/OrganizationAffiliation?specialty=[system]|[code]
SHALL_id token GET [base]/OrganizationAffiliation?_id=[id]
SHALL_lastUpdated date GET [base]/OrganizationAffiliation?_lastUpdated=[_lastUpdated]

Practitioner

Conformance Expectation: SHALL

Supported Profiles: Plan-Net Practitioner

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Practitioner resource using:
    GET [base]/Practitioner/[id]

  • A Server SHOULD be capable of returning a Practitioner resource using:
    GET [base]/Practitioner/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _revincludes:
    PractitionerRole:practitioner - GET [base]/Practitioner?[parameter=value]&_revinclude=PractitionerRole:practitioner

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLname string GET [base]/Practitioner?name=[name]
SHALL_id token GET [base]/Practitioner?_id=[id]
SHALL_lastUpdated date GET [base]/Practitioner?_lastUpdated=[_lastUpdated]
SHALLfamily string GET [base]/Practitioner?family=[family]
SHALLgiven string GET [base]/Practitioner?given=[given]

PractitionerRole

Conformance Expectation: SHALL

Supported Profiles: Plan-Net PractitionerRole

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a PractitionerRole resource using:
    GET [base]/PractitionerRole/[id]

  • A Server SHOULD be capable of returning a PractitionerRole resource using:
    GET [base]/PractitionerRole/[id]/_history/vid

  • A Server SHALL be capable of supporting the following _includes:
    PractitionerRole:practitioner - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:practitioner
    PractitionerRole:organization - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:organization
    PractitionerRole:location - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:location
    PractitionerRole:service - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:service
    PractitionerRole:network - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:network
    PractitionerRole:endpoint - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:endpoint

Search Parameter Summary:

ConformanceParameterTypeExample
SHALLpractitioner reference GET [base]/PractitionerRole?practitioner=[practitioner]
SHALLorganization reference GET [base]/PractitionerRole?organization=[organization]
SHALLlocation reference GET [base]/PractitionerRole?location=[location]
SHALLservice reference GET [base]/PractitionerRole?service=[service]
SHALLnetwork reference GET [base]/PractitionerRole?network=[network]
SHALLendpoint reference GET [base]/PractitionerRole?endpoint=[endpoint]
SHALLrole token GET [base]/PractitionerRole?role=[system]|[code]
SHALLspecialty token GET [base]/PractitionerRole?specialty=[system]|[code]
SHALL_id token GET [base]/PractitionerRole?_id=[id]
SHALL_lastUpdated date GET [base]/PractitionerRole?_lastUpdated=[_lastUpdated]