On this page:
   59.5    Security & Privacy Framework
  • Explanation
  • 59.0 Overview
  • 59.1 Actors, Roles & Data Scope
  • 59.2 Solution Modules & Standards
  • 59.3 Matching Logic
  • 59.4 Data Exchange Patterns
  • 59.5 Security & Privacy Framework
  • 59.6 Glossary of Terms
    • Table of Contents

    Glossary of Terms

    59.6.1Glossary of Terms

     

    59.6.1.1Exchange Actors

    TermDefinition
    Requesting PayerThe payer organization receiving data in an exchange transaction. Also known as: Target, Client, or "New" Payer
    Responding PayerThe payer organization sharing data in an exchange transaction. Also known as: Source, Server, or "Old" Payer

    59.6.1.2Operations

    TermDefinition
    $sdh.s2s.invoke-exportOperation for orchestrating a data request with another payer (single-member exchange only)
    $member-matchSingle-member matching operation that identifies a patient record in the Responding Payer system
    $bulk-member-matchMulti-member matching operation for batch processing
    $exportAsynchronous bulk data export operation
    $everythingSynchronous operation returning all resources in a Patient compartment
    $davinci-data-exportAsynchronous operation for exporting data for multiple members in a Group

    59.6.1.3Key Concepts

    TermDefinition
    EID Auto-ExpandConfiguration that enables Smile CDR to search for all Patient compartments containing the enterprise identifier for a requested Patient and share all compartments in the response
    Enterprise Member IDA patient business identifier used to link pre-existing and imported patient records across Patient compartments
    Patient CompartmentThe set of FHIR resources associated with a specific Patient resource
    Pull-Based ExchangeExchange model where the Requesting Payer initiates all data transfers
    Single-Member ExchangeData exchange for one member at a time
    Multi-Member ExchangeGroup-based data exchange for multiple members simultaneously

    59.6.1.4Data Types

    TermDefinition
    Pre-existing DataPatient records already present in the CDR before a Payer-to-Payer import
    Imported DataPatient records received from other payers through Payer-to-Payer exchange
    NDJSONNewline Delimited JSON, the format used for bulk data export

    59.6.1.5Regulatory and Standards

    TermDefinition
    CMS-0057-FCMS Interoperability and Prior Authorization Final Rule requiring payer-to-payer data exchange
    PDexDa Vinci Payer Data Exchange Implementation Guide
    HRexDa Vinci Health Record Exchange Implementation Guide
    CARIN IG for Blue ButtonConsumer Directed Payer Data Exchange Implementation Guide

    59.6.1.6Modules and Components

    TermDefinition
    System-to-System Data Exchange ModuleSmile CDR module supporting P2P exchange operations
    Consent ServiceSmile CDR service that evaluates consent policies and filters or redacts resources based on defined rules
    SMART Outbound Security ModuleSmile CDR module handling token management for authentication
       59.5    Security & Privacy Framework
  • Explanation
  • 59.0 Overview
  • 59.1 Actors, Roles & Data Scope
  • 59.2 Solution Modules & Standards
  • 59.3 Matching Logic
  • 59.4 Data Exchange Patterns
  • 59.5 Security & Privacy Framework
  • 59.6 Glossary of Terms