Provider Directory API (Da Vinci PDEX Plan Net)

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Use case

Provider directories play a critical role in enabling identification of individual providers and provider organizations, as well as characteristics about them. Provider directories support a variety of use cases, including:

  • Patient/Payer focused
    • Find provider accessibility information (specialty, office hours, languages spoken, taking patients) - enables individuals and consumers to find contact and other accessibility information for individual healthcare providers and/or healthcare organizations
    • Relationship between provider and insurance plan (insurance accepted) or plan and provider (network) - enables individual healthcare providers, organizations, and payers to discover the relationships between providers, organizations, and payers, as well as additional details about the relationships and entities involved
  • Basic Information Exchange
    • Enable electronic exchange (e.g. discovery of electronic endpoints such as IHE/EHR endpoints, FHIR server URLs, Direct addresses) - enables the electronic exchange of health information by supporting the ability to discover electronic service information including electronic endpoints or electronic addresses
    • Find an individual and/or organization (even if no electronic endpoint is available) - enables users to find contact and other identifying information about healthcare organizations and individual healthcare providers

API-led architecture

API Led diagram for Provider Directory API

Implementation templates included

ResourceDefinition
LocationA Location is the physical place where healthcare services are provided, practitioners are employed, organizations are based, etc.
PractitionerRolePractitionerRole describes the role a practitioner plays at an organization, including the services they provide, the location(s) where they work, and their availability, electronic endpoints, and other relevant information.
PractitionerPractitioner is a person who is directly or indirectly involved in the provisioning of healthcare.
OrganizationAn organization is a formal or informal grouping of people or organizations with a common purpose, such as a company, institution, corporation, community group, or healthcare practice.
It also refers to a healthcare provider insurance network. It is an aggregation of organizations and individuals that deliver a set of services.
OrganizationAffiliationRefers to a healthcare provider insurance network. It is an aggregation of organizations and individuals that deliver a set of services.
HealthcareServiceThe HealthCareService resource typically describes services offered by an organization/practitioner at a location
InsurancePlanAn InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type

Reviews

TypeREST API
OrganizationMuleSoft
Published by
MuleSoft Solutions
Published onOct 12, 2023
Asset overview

Asset versions for 1.0.x

Asset versions
VersionActions
1.0.4
1.0.2
1.0.0