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This page is a template for creating companion guide pages to support the PDex IG.
Name of GuideVersionStatusDate
PDex IG Companion Guide Template0.1DRAFT2019-06-26

Mapping from Sources:

Source InformationTargetMinimum FHIR FieldsLink
Hl7 V2ObservationLOINChttps://www.hl7.org/fhir/us/core/StructureDefinition-us-core-observation-lab.html
CCDAObservation

ClaimObservation


DiagnosticReport




Specimen

Why this companion guide

Add some context here.

Provide a guide for translating from different sources including providing a provenance resource to describe the actions taken to translate to the observation resource.

Most likely sources:

  • C-CDA 1.1, 2.1
  • HL7 V2 2.3, 2.5.1
  • X12 837


Three target audiences:

  • Provider
  • Member
  • Next Payer


We are working with US Core resources. Each profile has a minimum set of required fields. Beyond those fields additional data SHALL be provided if it is available. When dealing with different data sources there will likely be different levels of data granularity.

In the context of this guide this document provides a mapping of different data sources to the observation profile. The objective of this guide is to enable Payers to map their data from different sources consistently.

A provenance resource SHALL be constructed for each record to identify the originator of the data (the provider/organization etc.), the transmission format (C-CDA, ADT, 837 etc.) which indicates the type of translation performed.


Resource Spreadsheet

The attached Spreadsheet provides a mapping from Health Plan data sources to the FHIR US Core (R4) Profile:

Latest: Observation-FHIR_R4 v1.4.xlsx

Earlier versions

Observation-FHIR_R4 v1.3.xlsx

Examples


Provenance Resource 

https://www.hl7.org/fhir/provenance.html

Data received from:

  • Provider via HL7 V2
  • Provider via C-CDA
  • Provider via 837 Claim
  • Provider via "Paper Chart"
  • Provider Attestation (Pass through billing)
  • Payer Intermediate Translation
  • Provider by copy of formal lab report



Health Plan Data Exchange Overview

Document how the health plan will support the use case scenario outlined above....

Health Plan Data Sources

Identify the potential data sources the Health Plan would use to support the data exchange...


PDex FHIR Resources 

Identify the FHIR Resources from the PDex IG that are used to support the data exchange...


Value Sets and Terminologies

Identify the value sets, codings and terminologies that will support the data exchange

Data Crosswalks

Identify the source to target field mapping by FHIR Resource


Resource

FHIR FieldValue/Coding Set usedExample values Health Plan Source Data FieldIndustry Standard document/field source










Data Preparations

Identify the dependencies for creating FHIR resources.....

For example, Patient and Practitioner Resources need to be created before Encounter, Procedure etc. 


Author

Author/contact person with contact information for this page

Tony Benson , BCBS Alabama

Mark Scrimshire, NewWave, mark@ekivemark.com


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