DaVinci PDEX Plan Net
1.0.0 - 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 1.0.0). 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: 2020-11-19
  • 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.
  6. Support the searchParameters on each profile individually and in combination. 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, identifier, _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]
SHALLidentifier token GET [base]/InsurancePlan?identifier=[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]