Provider Directory API - Implementation Template (Da Vinci PDEX Plan Net)
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
Implementation templates included
See the RAML asset for the API specification.
| Resource | Definition |
|---|---|
| Location | A Location is the physical place where healthcare services are provided, practitioners are employed, organizations are based, etc. |
| PractitionerRole | PractitionerRole 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. |
| Practitioner | Practitioner is a person who is directly or indirectly involved in the provisioning of healthcare. |
| Organization | An 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. |
| OrganizationAffiliation | Refers to a healthcare provider insurance network. It is an aggregation of organizations and individuals that deliver a set of services. |
| HealthcareService | The HealthCareService resource typically describes services offered by an organization/practitioner at a location. |
| InsurancePlan | An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. |