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Da Vinci Profiles OverviewXES Module for FHIR is distributed with a set of preconfigured XEServer profiles (XESModuleForFHIR\assets\ProfileImages). The profiles illustrate data exchange scenarios where the provider may use HL7/CCD clinical data, but the patient's payer stores the clinical data on a FHIR server in the form of FHIR resources. XES Module for FHIR allows interaction between the provider (practitioner) and the payer, even though they use different formats. The Da Vinci profiles illustrate four typical use cases that in combination form the following flow:
 Step 1. Schedule an appointment
The scenario Da Vinci 1 Scheduling Generic Profile has the following workflow: A patient schedules an appointment with a Provider by using the Member’s Portal of the Payer. The patient gets a list of available practitioners, selects a practitioner, and then requests the practitioner's time slots. The route returns a list of available slots from the Payer's FHIR server. The patient selects a suitable time slot and submits a request to schedule an appointment with the Provider. Step 2. Fetching Patient information from the Payer
The scenario Da Vinci 2 Payer Provider Ex Generic Profile has the following workflow: When the patient visits the Provider, the Provider requests the Payer for all the information on the patient. At this step, the parties exchange data in the form of CDS hooks. The Payer receives a CDS hook, processes the hook, and uploads all the patient data onto the FHIR server of the Provider. The Provider receives patient data in the form of CDS cards in a human-readable form. Step 3. Discover Coverage Requirement
The scenario Da Vinci 3-4 Coverage Requirement Discovery and Medication Reconciliation Profile has the following workflow: Prior to prescribing a treatment, the Provider makes a request to the Payer for information on the co-payment and other requirements for the patient, if any. Here the Provider and the Payer exchange the data using CDS hooks and the Provider receives CDS cards along with information about the co-payment and other requirements. Step 4. Reconcile Medication
The scenario Da Vinci 3-4 Coverage Requirement Discovery and Medication Reconciliation Profile has the following workflow: After the treatment, the provider (PCP) schedules a visit with the patient to comply with HEDIS measures by analyzing the prescribed medications and the medications the patient has actually consumed during the treatment period. The Provider requests the Payer for the FHIR resources that are currently supported on the payer's FHIR server, and then, submits a Medication Reconciliation report to the Payer's FHIR server. |
