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  1. FHIR Specification Feedback
  2. FHIR-45970

Deprecate single member match in favour of bulk member match

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • US Da Vinci PDex (FHIR)
    • current
    • Financial Mgmt
    • Payer-to-Payer Exchange (single member)
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      The Payer-to-Payer single member match defined in STU2.0 is being implemented by Payers in California to meet a 1/1/2025 deadline for compliance based on California Regulations. As such it is not appropriate to withdraw the single member match operation.

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      The Payer-to-Payer single member match defined in STU2.0 is being implemented by Payers in California to meet a 1/1/2025 deadline for compliance based on California Regulations. As such it is not appropriate to withdraw the single member match operation.

      During the May 2024 Connectathon issues with the single member match workflow were discussed (see below). These issues are already mitigated by the bulk member match workflow. Therefore the single member member match should be deprecated in favour of the the bulk workflow. Essentially, a single member match could be replaced by issuing a bulk member request with only a single member.

      1. In the bulk member match workflow the Consent check is done during execution time of the export operation. In comparison the Consent check for the single member match is supposed to be during the authorization process (when getting the access token). There are more implementation challenges associated with the workflow of checking the Consent in the authorization server than there are checking it in the resource server. It is unlikely that standard authorization servers on the market are easily capable of implementing these requirements.
      2. There is no standardized way of requesting a system-level access token scoped down to a single patient. Limiting the access to the group of all matched Patient records can be more easily handled by the currently exiting (SMART) mechanisms.
      3. Having bulk export, $everything and querying individual resources results in too much variability. Using bulk export is a well-known and tested process. PDex should limit the options here. 

            Unassigned Unassigned
            alexanderzautke Alexander Zautke
            Alexander Zautke
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