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Short Description

A Da Vinci combined Track that covers the Drug Formulary and Provider/Pharmacy Directory Guides that address the CMS Patient Access API requirements of the Interoperability rule, including the Formulary STU2 balloted version (adding bulk data) and Plan Net STU Update (1.1.0) of the implementation guides

Long Description

This Da Vinci track brings together the Drug Formulary and Plan-Net IGs that are cited by CMS to enable payers to comply with the Patient Access API rule. For payers this is an opportunity to test out their APIs with reference applications. For Consumer applications this is an opportunity to connect with payers and test your apps against the Drug Formulary and Plan-Net Patient Access APIs.


Implementation Guide

Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group  

This track is organized by the HL7 Da Vinci Accelerator Project. The IGs are managed through the Financial Management and Pharmacy Work Groups

Track Lead(s)

Corey Spears, and Sean Mahoney

Track Lead Email(s)

Related Tracks

2022-05 CARIN IG For Blue Button® Track

2022-05 Da Vinci Payer Data Exchange (PDex STU2 inc. Payer-to-Payer)

FHIR Version


Specification(s) this track uses

US Core STU3 3.1.1 

DaVinci Payer Data Exchange (PDex) US Drug Formulary STU 1.1

DaVinci Payer Data Exchange (PDex) US Drug Formulary STU 2.0 ballot + bulk data (

DaVinci PDEX Plan Net STU1 1.0 (

DaVinci PDEX Plan Net STU1 1.1.0 Update (

Artifacts of focus

Plannet (Practitioner, Organization, Location), Formulary (PayerInsurancePlan, Formulary, FormularyItem, FormularyDrug)

Expected participants

Payers, Technology Vendors and Consumer Application Developers




Zulip stream

Track Kickoff

April 22, 2022 0 2:00pm Eastern


Track Details

System roles:

Payer FHIR API with member Authentication via SMART-on-FHIR App Launch Framework

Payer Open API for Provider-Directory API

Consumer App that can request access for member-mediated exchange via SMART-on-FHIR App Launch Framework

All testers are recommended to preparer the Connectathon in advance. 

A Reference Server will be available, as will reference applications. 

Preparation of suitable coordinated test data across claims, clinical and reference resources is recommended.

Role 1 Name: Referential consistency


Consumer App to connect to Patient Access API and Provider-Directory API and be able to reference Practitioner information from claim into the provider-directory provided by the same payer.

Scenario Step 1 Name


  • Consumer App connects to Patient Access API and enables member authentication and access to secured Patient Access API data.
  • Consumer App is able to retrieve Provider Directory information for practitioner and organization resources identified in a claim or clinical record.

Precondition: Success Criteria: 

  • Success retrieval of claim or clinical record and detailed reference information for Practitioner/Organization.

Success Criteria:  

Bonus point:

If Payer API configuration can demonstrate successful integration between data sources served up by independent FHIR Servers. e.g. Medical data and PBM data on separate servers and business logic is in effect to connect data related to a single member across the servers. 


Touchstone scripts are available for each IG

Security and Privacy Considerations:

Patient Access API is protected by SMART-on-FHIR App Launch Framework (OpenID Connect/OAuth2.0 protocols).

Bulk Data Scenario


  • Consumer App connects to unauthenticated API and queries for bulk data.
  • Consumer App is able to retrieve a full Formulary through bulk data access.

Formulary IG Postman Collection (for testing with Postman):

Da Vinci Formulary STU2 RI.postman_collection.json

January 2021 Connectathon Kickoff

Formulary Slides Jan 2022

20220111 - Formulary IG Review.pdf

Plan-Net Slides Jan 2022

Plan-Net IG Intro 20220111.pdf


20220504 - HL7 Connectathon - Formulary-PlanNet Highlights.pdf

Formulary May 2022 Update

20220513 - Da Vinci Formulary Update - HL7 May 2022 WGM.pptx