Short Description

Payer Data Exchange with Members, Other Payers and Providers & end-to-end testing of the DaVinci Payer Data Exchange (PDex) US Drug Formulary | STU2 Ballot (with Bulk Data)  (Combined track)

Long Description

PDex Defines workflows for Payer to Member Clinical Exchange, Payer-to-Payer exchange and Payer-to-Provider Exchange. This track will look at the next development beyond the STU2 version which will incorporate workflows for Payer-to-Provider bulk data exchange.


Test proposed enhancements to PDex to accommodate Payer-to-Provider bulk data exchange

Track Lead(s)

Mark Scrimshire

Track Lead Email(s)


Specification Information

2022-05 Da Vinci Payer Data Exchange (PDex STU2 inc. Payer-to-Payer) https://confluence.hl7.org/pages/viewpage.action?pageId=90357728

Call for participants

Payers and Providers

Zulip stream

PDex: https://chat.fhir.org/#narrow/stream/235286-Da-Vinci.20PDex

Track Implementers Connection Call

Weekly Friday meetings leading up to the Connectathon starting June 17, 2022 2:00 - 3:00pm Eastern

Meeting Minutes: 2022-06-17 Payer Data Exchange - CMS Connectathon Orientation Call - Da Vinci - Confluence

Meeting Recording: https://hl7-org.zoom.us/rec/share/FmOwMTLtpfP3OHOwT6LkKa913bcwa-zuApZ9T0fzZ1FZVVnUMKvEXeWXylcVrWSA.2VUhuu4g_f9m58bJ

Join Zoom Meeting: https://hl7-org.zoom.us/j/92482555863?pwd=TWQzVENNeStqeEpVTHdicGM2cGdMQT09

Meeting ID: 924 8255 5863

Passcode: 818984

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Meeting ID: 924 8255 5863

Implementer Call Presentation:

Overview Session: 2022-07-20 1:00pm ET

PDex / Formulary Track Highlights:

Testing Scenario:

System roles:

Server: Payer API 

Client: Provider EMR

Connectivity will need to be confirmed prior to the connectathon between Payer APIs and Provider EMR systems.

Role 1 Name: Provider requests clinical data for Patient List


Provider compiles list of existing patients and requests updates from Payer for clinical data.

Payer evaluates list to determine attribution status

Payer compiles latest update of clinical data since last provider request (given by provider in _since parameter of transaction)

Provider uses bulk asynchronous protocol to watch for completion of bundle and subsequently downloads data.

Provider compiles list of new patients and requests all clinical data from payer.

Payer validates that members on the list supplied are attributed to the provider.

Provider uses bulk asynchronous protocol to watch for completion of bundle and subsequently downloads data.

Scenario Step 1: Determine attribution of patients to provider


  • Provider supplies list of payer members.
  • Payer confirms list
  • Provider supplies list of members in each submission for a data request.
  • Payer validates attribution of members and if confirmed supplies data via bulk protocols

Precondition: Success Criteria: 

  • Provider is able to supply list of attributed members and receive data for those members.

Success Criteria:  

Bonus point:



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