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The eClinical Data exchange is part of the larger Da Vinci use case for eHealth Record exchange (eHRx).

After careful evaluation, the eHRx project was decomposed into four independent efforts (and tied to 4 separate PSSs). The exchange of Quality Measures (eQDx) was included in the existing work on the Data Exchange for Quality Measures (DEQM) that is sponsored by the CQI workgroup. The exchange of Payer Data (ePDx) is sponsored by Financial Management. The overall eHRx Framework is planned to be sponsored by FHIR Infrastructure and we are looking to a combination of Structured Documents, Patient Care and Attachments to sponsor the work on e Clinical Data exchange (eCDx).

The scope of the eCDx project is to defined combinations of exchange methods (push, pull, subscribe, CDS Hooks, …), specific payloads (Documents, Bundles, and Individual Resources), search criteria, conformance, provenance, and other relevant requirements to support specific exchanges of clinical information between provider and other providers and/or payers. The goal is to identify, document and constrain very specific patterns of exchange so that providers and payers can reliably exchange information for patient care (including coordination of care), risk adjustment, quality reporting, identifying that requested services are necessary and appropriate (e.g. should be covered by the payer) and other uses that may be documented as part of this effort. Clinical data payloads will include C-CDA, C-CDA on FHIR, compositions, bundles, specific resources, and bulk data exchange. This list is intended to be illustrative and not prescriptive. The project will address patient consent where appropriate. 

This project will reference, where possible the "standards" defined by the electronic Health Record exchange (eHRx) Framework Implementation Guide which in turn will utilize prior work from Argonaut, US Core and QI Core effort for FHIR DSTU2, STU3, and R4. The following diagram depicts the anticipated scope of the eHRx Framework IG.

The ultimate goal is to support the exchange of provider data on specific patients/members for better patient care with other providers and payers using technology that support FHIR DSTU2, STU3, and R4 releases of the FHIR standard.