Smile CDR v2024.08.PRE
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33.0.1Da Vinci Clinical Data Exchange (CDex)


This page describes Smile CDR's support of various features as defined in the Da Vinci Clinical Data Exchange (CDex) implementation guide.

The current published version of this implementation guide can be found at the following URL:

  • Submit Attachment

Smile CDR supports the $submit-attachment operation as defined in version 2.0.0 - STU2.0 US of the CDex implementation guide.


The $submit-attachment operation saves the attached documents and links them to the related Task's output without modifying any existing claim or checking the existence of a claim or patient. It is expected that Payer's application to process the information saved in the Task to associate submitted information to a claim or prior authorization. The operation supports both solicited and unsolicited attachments. That is, if a Task whose Identifier matches the TrackingId parameter exists in the system, then that Task is updated. If such a Task does not exist, then it is created by the submit-attachment operation. and Exceptions

  • Presently, for solicited attachments there are validations to ensure Task.for matches the MemberId from the request and Task.owner matches either the OrganizationId or ProviderId from the request. For these validations to succeed Task.for and Task.owner should contain Identifiers, if Task.for or Task.owner contain References instead of Identifiers then the validation fails. from the earlier implementation

With Smile CDR 2023.11.R01, significant changes were made to the submit-attachment implementation that was initially introduced in Smile CDR 2022.11.R01 and was based on the CDex implementation guide version 1.1.0. The main differences of the current implementation from the earlier implementation are as follows:

  • Earlier implementation was updating the related claim with a link to the submitted attachment. With the current implementation, the links to the saved attachments are added to the Task output. Existence of a claim matching the submit-attachment request is not validated and no changes made to any claim as part of the operation.
  • Unsolicited attachments are now supported.
  • TrackingId input parameter type was a string, but now is an Identifier.
  • At least one of the OrganizationId or ProviderId fields must now be present. Previously they were both required.
  • Final parameter is now supported. The Task status is updated to Completed when Final is true, or absent. If Final exists and false, the Task status remains in IN PROGRESS.
  • Validation is added to require ServiceDate when AttachTo value is claim.
  • Validation is removed that checked a Patient matching the MemberId parameter exists in the system.