2021-03-12 PDex Meeting

Da Vinci April Education Session

Da Vinci Education & FHIR Implementation Event by HL7 - April 26 - 30

Register Here

Corey A Spears

Sean Mahoney

Any questions?  

For Formulary, when can we some of the newer searches and behavior for the patient queries. 

• We will discuss more today and it's also being discussed on the Pharmacy WG calls on Mondays. 
• For Pharmacy Directory (or Formulary), we are working in a PBM perspective, sending some references url that we have and are sharing with clients (Payers) they have to resolve that or can they send that directly to the third party that is calling? Pagination - they are doing it.  They are putting their URL and the page number.  Do we give that the the third party mobile app (not authenticated with the PBM)  - How do they resolve the url?
  • Does the client have to resolve or how do we streamline, when doing the pagination?
• This is the B to B to C (e.g., PBM to Payer to Consumer) - How do you keep the URL hidden?  there is some work on the payer side to re-write the URL and cache it so if the request comes back in, they can match it. The payer has opted not to take all the formulary data to load into the payers own FHIR server..
• So basically doing a proxy service, so the payer needs to manage the urls and not expose out the PBM end points since the third party app will fail since the security isn't there.  
  • Continuation urls
  • Other urls inside the resources, possible in narratives, if there is some there.  
• PBM guidance: This is part of the education process when talking with Payers (may want to just load the data and to a bulk extract. 
• So, with Payer hat on: how can the FHIR community help to translate and hide the urls? how would we resolve the issue?
  • May have FHIR server
  • May have FHIR interface on existing backend
• May expose URLs based on inbound request - Covert payer specific url to generic PBM url - - Not expecting the third party app to come to the PBM end point.  You will do the mapping and translate the pbm url to the payer url. The pbm takes on making the response look like it came from the payer for the third party app.  

PDex IG Links and Updates

PDex Supplemental Guides

PDex IG Companion Guide - Laboratory Reporting Resources

FAQ Review Cont. and Implementer Support

How to ensure Plan IDs are unique if not HIOS-based?

Consent Discussion Cont. (if updates from Architecture Group)

Latest draft CARIN CPCDS Mapping document: CARIN Mapping to FHIR interim 2020 0513.xlsx

DRAFT - PDEX US Core Mapping from CPCDS source: ResourceMappingUSCoreCPCDS-2020-05-29-v26.xlsx

Find initial questions and corresponding answers shared from our colleagues at CMS here

• Links to Published IGs

• PDex STU 1.0.0
• Plan Net STU 1.0.0
• Formulary - STU 1.0.1