Implementation Guide
25.0.0 - R4 APIs

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Da Vinci

Da Vinci

Da Vinci is an industry sponsored project which is contributing to the development of HL7 standards. It brings together the U.S. payer, providers, and technology suppliers (including EHR vendors) to help payers and providers to positively impact clinical, quality, cost, and care management outcomes using FHIR-related technologies. The project organizes meetings (face-to-face and conference calls) as well as connectathons to find ways to leverage FHIR technologies to support and integrate value-based care (VBC) data exchange across communities. Da Vinci identifies value-based care use cases of interest to its members and the community as a whole.

Main Goals of the Da Vinci Project

The Da Vinci project focuses on improving payer–provider interoperability to support:

  1. Value-based care
  2. Real-time data exchange
  3. Reduced administrative burden
  4. Automated prior authorization
  5. Improved clinical decision support

Key Da Vinci Use Cases

Prior Authorization Support (PAS)

Da Vinci PAS Implementation Guide

Purpose:

  • Automates prior authorization requests and responses using FHIR.

Typical workflow:

  • Provider sends PAS Claim (prior auth request)
  • Payer reviews
  • Payer sends PAS ClaimResponse
  • Additional documents sent via DocumentReference

Resources commonly used: