davinci_pdex_test_kit 0.11.0 → 0.12.0

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Files changed (65) hide show
  1. checksums.yaml +4 -4
  2. data/config/presets/pdex_payer_server_fhir_foundry_ri_preset.json +2 -2
  3. data/config/presets/pdex_payer_server_inferno_ri_preset.json +2 -2
  4. data/lib/davinci_pdex_test_kit/pdex_payer_client/client_member_match_tests/client_member_match_validation_test.rb +7 -5
  5. data/lib/davinci_pdex_test_kit/pdex_payer_client/client_workflow_interaction_test.rb +8 -7
  6. data/lib/davinci_pdex_test_kit/pdex_payer_client_suite.rb +8 -10
  7. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_must_support_test.rb +50 -0
  8. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_patient_search_test.rb +68 -0
  9. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_patient_type_search_test.rb +54 -0
  10. data/lib/davinci_pdex_test_kit/pdex_payer_server/{explanation_of_benefit/explanation_of_benefit_provenance_revinclude_search_test.rb → device/device_provenance_revinclude_search_test.rb} +7 -7
  11. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_read_test.rb +26 -0
  12. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_reference_resolution_test.rb +42 -0
  13. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/device_validation_test.rb +39 -0
  14. data/lib/davinci_pdex_test_kit/pdex_payer_server/device/metadata.yml +154 -0
  15. data/lib/davinci_pdex_test_kit/pdex_payer_server/device_group.rb +88 -0
  16. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_id_search_test.rb +7 -24
  17. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_identifier_search_test.rb +10 -24
  18. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_must_support_test.rb +37 -5
  19. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_lastupdated_search_test.rb +48 -0
  20. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_search_test.rb +62 -0
  21. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_service_date_search_test.rb +7 -23
  22. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_type_search_test.rb +6 -23
  23. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_reference_resolution_test.rb +7 -4
  24. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_validation_test.rb +9 -10
  25. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/metadata.yml +276 -264
  26. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit_group.rb +62 -64
  27. data/lib/davinci_pdex_test_kit/pdex_payer_server/export_patient_group.rb +8 -9
  28. data/lib/davinci_pdex_test_kit/pdex_payer_server/export_validation_group.rb +1 -2
  29. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_must_support_test.rb +42 -0
  30. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_search_test.rb +64 -0
  31. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_status_search_test.rb +54 -0
  32. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_patient_status_type_search_test.rb +55 -0
  33. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_provenance_revinclude_search_test.rb +54 -0
  34. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_read_test.rb +26 -0
  35. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_reference_resolution_test.rb +42 -0
  36. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/medication_dispense_validation_test.rb +39 -0
  37. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense/metadata.yml +206 -0
  38. data/lib/davinci_pdex_test_kit/pdex_payer_server/medication_dispense_group.rb +69 -0
  39. data/lib/davinci_pdex_test_kit/pdex_payer_server/multiple_member_matches_group.rb +36 -36
  40. data/lib/davinci_pdex_test_kit/pdex_payer_server/no_member_matches_group.rb +30 -30
  41. data/lib/davinci_pdex_test_kit/pdex_payer_server/patient_operation_in_capability_statement_validation.rb +15 -13
  42. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/metadata.yml +173 -0
  43. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_must_support_test.rb +51 -0
  44. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_read_test.rb +26 -0
  45. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_reference_resolution_test.rb +46 -0
  46. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance/provenance_validation_test.rb +39 -0
  47. data/lib/davinci_pdex_test_kit/pdex_payer_server/provenance_group.rb +59 -0
  48. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_clinical_data_group.rb +22 -11
  49. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_everything_group.rb +19 -6
  50. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_export_group.rb +22 -16
  51. data/lib/davinci_pdex_test_kit/pdex_payer_server/workflow_member_match_group.rb +44 -25
  52. data/lib/davinci_pdex_test_kit/pdex_payer_server_suite.rb +123 -110
  53. data/lib/davinci_pdex_test_kit/pdex_provider_client_suite.rb +8 -8
  54. data/lib/davinci_pdex_test_kit/requirements/davinci-pdex-test-kit_out_of_scope_requirements.csv +1 -0
  55. data/lib/davinci_pdex_test_kit/requirements/davinci-pdex-test-kit_requirements.csv +64 -0
  56. data/lib/davinci_pdex_test_kit/requirements/generated/davinci-pdex-test-kit_requirements_coverage.csv +64 -0
  57. data/lib/davinci_pdex_test_kit/version.rb +2 -2
  58. data/lib/davinci_pdex_test_kit.rb +1 -0
  59. data/lib/inferno_requirements_tools/ext/inferno_core/runnable.rb +22 -0
  60. data/lib/inferno_requirements_tools/rake/rakefile_template +19 -0
  61. data/lib/inferno_requirements_tools/tasks/requirements_coverage.rb +284 -0
  62. data/lib/requirements_config.yaml +17 -0
  63. metadata +56 -11
  64. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_last_updated_search_test.rb +0 -64
  65. data/lib/davinci_pdex_test_kit/pdex_payer_server/explanation_of_benefit/explanation_of_benefit_patient_use_search_test.rb +0 -69
data/lib/davinci_pdex_test_kit/pdex_payer_server_suite.rb CHANGED
@@ -9,96 +9,89 @@ require_relative 'pdex_payer_server/no_member_matches_group'
9
9
  require_relative 'pdex_payer_server/multiple_member_matches_group'
10
10
 
11
11
  require_relative 'pdex_payer_server/explanation_of_benefit_group'
12
+ require_relative 'pdex_payer_server/device_group'
13
+ require_relative 'pdex_payer_server/medication_dispense_group'
14
+ require_relative 'pdex_payer_server/provenance_group'
12
15
 
13
16
  module DaVinciPDexTestKit
14
- class PDexPayerServerSuite < Inferno::TestSuite
15
- id :pdex_payer_server
16
- title 'Da Vinci PDex Payer Server Test Suite'
17
- description File.read(File.join(__dir__, 'docs', 'payer_server_suite_description_v200.md'))
18
-
19
- links [
20
- {
21
- label: 'Report Issue',
22
- url: 'https://github.com/inferno-framework/davinci-pdex-test-kit/issues'
23
- },
24
- {
25
- label: 'Open Source',
26
- url: 'https://github.com/inferno-framework/davinci-pdex-test-kit'
27
- },
28
- {
29
- label: 'Download',
30
- url: 'https://github.com/inferno-framework/davinci-pdex-test-kit/releases'
31
- },
32
- {
33
- label: 'Implementation Guide',
34
- url: 'https://hl7.org/fhir/us/davinci-pdex/STU2/'
35
- }
36
- ]
37
-
38
- input :url,
39
- title: 'FHIR Server Base Url'
40
-
41
- input :credentials,
42
- title: 'OAuth Credentials',
43
- type: :oauth_credentials,
44
- optional: true
45
-
46
- fhir_client do
47
- url :url
48
- oauth_credentials :credentials
49
- end
50
-
51
- VALIDATION_MESSAGE_FILTERS = [
52
- /Observation\.effective\.ofType\(Period\): .*vs-1:/, # Invalid invariant in FHIR v4.0.1
53
- /\A\S+: \S+: URL value '.*' does not resolve/
54
- ].freeze
55
-
56
- VERSION_SPECIFIC_MESSAGE_FILTERS = [].freeze
57
-
58
- # Hl7 Validator Wrapper:
59
- fhir_resource_validator do
60
- igs 'hl7.fhir.us.davinci-pdex#2.0.0'
61
- # hrex 1.0.0 and other dependencies will auto-load
62
-
63
- # Copy messages limit from Bulk Data Export tests
64
- message_filters = VALIDATION_MESSAGE_FILTERS + VERSION_SPECIFIC_MESSAGE_FILTERS
65
-
66
- $num_messages = 0
67
- $capped_message = false
68
- $num_errors = 0
69
- $capped_errors = false
70
-
71
- exclude_message do |message|
72
- matches_filter = message_filters.any? { |filter| filter.match? message.message }
73
-
74
- unless matches_filter
75
- if message.type != 'error'
76
- $num_messages += 1
77
- else
78
- $num_errors += 1
79
- end
17
+ class PDexPayerServerSuite < Inferno::TestSuite
18
+ id :pdex_payer_server
19
+ title 'Da Vinci PDex Payer Server Test Suite'
20
+ description File.read(File.join(__dir__, 'docs', 'payer_server_suite_description_v200.md'))
21
+
22
+ links [
23
+ {
24
+ label: 'Report Issue',
25
+ url: 'https://github.com/inferno-framework/davinci-pdex-test-kit/issues'
26
+ },
27
+ {
28
+ label: 'Open Source',
29
+ url: 'https://github.com/inferno-framework/davinci-pdex-test-kit'
30
+ },
31
+ {
32
+ label: 'Download',
33
+ url: 'https://github.com/inferno-framework/davinci-pdex-test-kit/releases'
34
+ },
35
+ {
36
+ label: 'Implementation Guide',
37
+ url: 'https://hl7.org/fhir/us/davinci-pdex/STU2/'
38
+ }
39
+ ]
40
+
41
+ input :url,
42
+ title: 'FHIR Server Base Url'
43
+
44
+ VALIDATION_MESSAGE_FILTERS = [
45
+ /Observation\.effective\.ofType\(Period\): .*vs-1:/, # Invalid invariant in FHIR v4.0.1
46
+ /\A\S+: \S+: URL value '.*' does not resolve/
47
+ ].freeze
48
+
49
+ VERSION_SPECIFIC_MESSAGE_FILTERS = [].freeze
50
+
51
+ # Hl7 Validator Wrapper:
52
+ fhir_resource_validator do
53
+ igs 'hl7.fhir.us.davinci-pdex#2.0.0'
54
+ # hrex 1.0.0 and other dependencies will auto-load
55
+
56
+ # Copy messages limit from Bulk Data Export tests
57
+ message_filters = VALIDATION_MESSAGE_FILTERS + VERSION_SPECIFIC_MESSAGE_FILTERS
58
+
59
+ $num_messages = 0
60
+ $capped_message = false
61
+ $num_errors = 0
62
+ $capped_errors = false
63
+
64
+ exclude_message do |message|
65
+ matches_filter = message_filters.any? { |filter| filter.match? message.message }
66
+
67
+ unless matches_filter
68
+ if message.type == 'error'
69
+ $num_errors += 1
70
+ else
71
+ $num_messages += 1
80
72
  end
81
-
82
- matches_filter ||
83
- (message.type != 'error' && $num_messages > 50 && !message.message.include?('Inferno is only showing the first')) ||
84
- (message.type == 'error' && $num_errors > 20 && !message.message.include?('Inferno is only showing the first'))
85
73
  end
86
74
 
87
- perform_additional_validation do
88
- if $num_messages > 50 && !$capped_message
89
- $capped_message = true
90
- { type: 'info', message: 'Inferno is only showing the first 50 validation info and warning messages.' }
91
- elsif $num_errors > 20 && !$capped_errors
92
- $capped_errors = true
93
- { type: 'error', message: 'Inferno is only showing the first 20 validation error messages.' }
94
- end
75
+ matches_filter ||
76
+ (message.type != 'error' && $num_messages > 50 && !message.message.include?('Inferno is only showing the first')) ||
77
+ (message.type == 'error' && $num_errors > 20 && !message.message.include?('Inferno is only showing the first'))
78
+ end
79
+
80
+ perform_additional_validation do
81
+ if $num_messages > 50 && !$capped_message
82
+ $capped_message = true
83
+ { type: 'info', message: 'Inferno is only showing the first 50 validation info and warning messages.' }
84
+ elsif $num_errors > 20 && !$capped_errors
85
+ $capped_errors = true
86
+ { type: 'error', message: 'Inferno is only showing the first 20 validation error messages.' }
95
87
  end
96
88
  end
89
+ end
97
90
 
98
- group do
99
- title 'Payer to Payer Workflow'
100
- id :payer_to_payer_workflow
101
- description %(
91
+ group do
92
+ title 'Payer to Payer Workflow'
93
+ id :payer_to_payer_workflow
94
+ description %(
102
95
  # Background
103
96
 
104
97
  This Payer to Payer Workflow test sequence is designed to simulate a realistic use case for
@@ -125,22 +118,34 @@ module DaVinciPDexTestKit
125
118
  See the corresponding test group's description for the testing methodology of each part.
126
119
  )
127
120
 
128
- group from: :pdex_workflow_member_match
129
- group from: :pdex_workflow_clinical_data
130
- group from: :pdex_workflow_everything
131
- group from: :pdex_workflow_export
121
+ group from: :pdex_workflow_member_match
122
+ group from: :pdex_workflow_clinical_data
123
+ group from: :pdex_workflow_everything
124
+ group from: :pdex_workflow_export
125
+ end
126
+
127
+ group do
128
+ title 'API Capability and Must Support Coverage'
129
+ id :api_and_ms_coverage
130
+
131
+ verifies_requirements 'hl7.fhir.us.davinci-pdex_2.0.0@9', 'hl7.fhir.us.davinci-pdex_2.0.0@14'
132
+
133
+ input :smart_auth_info,
134
+ title: 'OAuth Credentials',
135
+ type: :auth_info,
136
+ optional: true
137
+
138
+ fhir_client do
139
+ url :url
140
+ auth_info :smart_auth_info
132
141
  end
133
142
 
134
143
  group do
135
- title 'API Capability and Must Support Coverage'
136
- id :api_and_ms_coverage
137
-
138
- group do
139
- title '$member-match failure cases'
140
- id :member_match_failure_cases
141
- description %{
144
+ title '$member-match failure cases'
145
+ id :member_match_failure_cases
146
+ description %{
142
147
  # Background
143
-
148
+
144
149
  This test sequence is for the negative results specification in
145
150
  [member matching logic](http://hl7.org/fhir/us/davinci-hrex/STU1/OperationDefinition-member-match.html#member-matching-logic)
146
151
  from HRex 1.0.0 Implementation Guide, and is required by the PDex 2.0.0 Implementation Guide.
@@ -155,25 +160,33 @@ module DaVinciPDexTestKit
155
160
  + POST request to server and validiate HTTP 422 response status
156
161
  }
157
162
 
158
- input_order :url, :credentials, :no_member_match_request, :multiple_member_match_request
159
-
160
- group from: :pdex_no_member_matches
161
- group from: :pdex_multiple_member_matches
162
- end
163
+ input_order :url, :smart_auth_info, :no_member_match_request, :multiple_member_match_request
163
164
 
164
- group do
165
- title 'PDEX Search and Read API (US Core plus additional PDex resource types)'
166
- id :pdex_fhir_api_coverage
167
-
168
- group from: :pdex_eob
165
+ group from: :pdex_no_member_matches
166
+ group from: :pdex_multiple_member_matches
167
+ end
169
168
 
170
- # Import all US Core v3.1.1 groups without the Suite
171
- USCoreTestKit::USCoreV311::USCoreTestSuite.groups[1].groups.each do |group|
172
- # This prevents a second OAuth credentials box from appearing in UI
173
- group(from: group.ancestors[1].id, id: group.ancestors[1].id.delete_prefix('us_core_v311_'))
174
- end
169
+ group do
170
+ title 'PDEX Search and Read API (US Core plus additional PDex resource types)'
171
+ id :pdex_fhir_api_coverage
172
+
173
+ verifies_requirements 'hl7.fhir.us.davinci-pdex_2.0.0@3', 'hl7.fhir.us.davinci-pdex_2.0.0@7',
174
+ 'hl7.fhir.us.davinci-pdex_2.0.0@16', 'hl7.fhir.us.davinci-pdex_2.0.0@43',
175
+ 'hl7.fhir.us.davinci-pdex_2.0.0@48', 'hl7.fhir.us.davinci-pdex_2.0.0@49',
176
+ 'hl7.fhir.us.davinci-pdex_2.0.0@50', 'hl7.fhir.us.davinci-pdex_2.0.0@51',
177
+ 'hl7.fhir.us.davinci-pdex_2.0.0@52'
178
+
179
+ group from: :pdex_eob
180
+ group from: :pdex_device
181
+ group from: :pdex_medication_dispense
182
+ group from: :pdex_provenance
183
+
184
+ # Import all US Core v3.1.1 groups without the Suite
185
+ USCoreTestKit::USCoreV311::USCoreTestSuite.groups[1].groups.each do |group|
186
+ # This prevents a second OAuth credentials box from appearing in UI
187
+ group(from: group.ancestors[1].id, id: group.ancestors[1].id.delete_prefix('us_core_v311_'))
175
188
  end
176
189
  end
177
-
178
190
  end
191
+ end
179
192
  end
data/lib/davinci_pdex_test_kit/pdex_provider_client_suite.rb CHANGED
@@ -8,7 +8,7 @@ module DaVinciPDexTestKit
8
8
  This suite validates that a provider system can act as a client
9
9
  retrieving patient data from a payer system using
10
10
  the APIs described in the PDex implementation
11
- guide. Inferno will act as a payer server that the
11
+ guide. Inferno will act as a payer server that the
12
12
  system under test will connect to and retrieve data from.
13
13
  )
14
14
 
@@ -30,22 +30,22 @@ module DaVinciPDexTestKit
30
30
  url: 'https://hl7.org/fhir/us/davinci-pdex/STU2/'
31
31
  }
32
32
  ]
33
-
33
+
34
34
  # These inputs will be available to all tests in this suite
35
35
  input :url,
36
36
  title: 'FHIR Server Base Url'
37
-
38
- input :credentials,
37
+
38
+ input :smart_auth_info,
39
39
  title: 'OAuth Credentials',
40
- type: :oauth_credentials,
40
+ type: :auth_info,
41
41
  optional: true
42
-
42
+
43
43
  # All FHIR requests in this suite will use this FHIR client
44
44
  fhir_client do
45
45
  url :url
46
- oauth_credentials :credentials
46
+ auth_info :smart_auth_info
47
47
  end
48
-
48
+
49
49
  # Hl7 Validator Wrapper:
50
50
  fhir_resource_validator do
51
51
  igs 'hl7.fhir.us.davinci-pdex#2.0.0'
data/lib/davinci_pdex_test_kit/requirements/davinci-pdex-test-kit_requirements.csv ADDED
@@ -0,0 +1,64 @@
1
+ Req Set,ID,URL,Requirement,Conformance,Actor,Sub-Requirement(s),Conditionality
2
+ hl7.fhir.us.davinci-pdex_2.0.0,1,https://hl7.org/fhir/us/davinci-pdex/STU2/#intellectual-property,Implementers ... of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation.,SHALL,Server,,false
3
+ hl7.fhir.us.davinci-pdex_2.0.0,2,https://hl7.org/fhir/us/davinci-pdex/STU2/#intellectual-property,Terminology licenses SHALL be obtained from the Third-Party IP owner for each code system and/or other specified artifact used.,SHALL,Server,,false
4
+ hl7.fhir.us.davinci-pdex_2.0.0,3,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [US Core and referenced by PDex], the meaning of Must Support [for Servers] is established in [the US Core IG].",SHALL,Server,"hl7.fhir.us.core_3.1.1@75,77,78,80",false
5
+ hl7.fhir.us.davinci-pdex_2.0.0,4,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [US Core and referenced by PDex], the meaning of Must Support [for Clients] is established in [the US Core IG].",SHALL,Client,"hl7.fhir.us.core_3.1.1@76,79",false
6
+ hl7.fhir.us.davinci-pdex_2.0.0,5,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [DaVinci HRex and referenced by PDex], the meaning of Must Support [for Servers] is established in [the HRex IG].",SHALL,Server,"hl7.fhir.us.davinci-hrex_1.0.0@21,22,24,25,27",false
7
+ hl7.fhir.us.davinci-pdex_2.0.0,6,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [DaVinci HRex and referenced by PDex], the meaning of Must Support [for Clients] is established in [the HRex IG].",SHALL,Client,"hl7.fhir.us.davinci-hrex_1.0.0@23,26,28",false
8
+ hl7.fhir.us.davinci-pdex_2.0.0,7,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"[For profiles defined in the PDex IG, Servers SHALL follow] Must Support requirements … [from] the US Core Implementation Guide.",SHALL,Server,"hl7.fhir.us.core_3.1.1@75,77,78,80",false
9
+ hl7.fhir.us.davinci-pdex_2.0.0,8,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"[For profiles defined in the PDex IG, Clients SHALL follow] Must Support requirements … [from] the US Core Implementation Guide.",SHALL,Client,"hl7.fhir.us.core_3.1.1@76,79",false
10
+ hl7.fhir.us.davinci-pdex_2.0.0,9,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#overview,All data exchanged by Health Plans using the interactions covered in this IG SHALL be transformed to FHIR R4 resources.,SHALL,Server,,false
11
+ hl7.fhir.us.davinci-pdex_2.0.0,10,"https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#oauth20-or-smart-on-fhir-member-authorized-exchange,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.html,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api",The member SHALL authenticate using [and the server SHALL accept only] credentials that have been issued by or are recognized and accepted by the Health Plan. These are typically the member’s customer portal credentials for accessing the health plan.,SHALL,Client,,false
12
+ hl7.fhir.us.davinci-pdex_2.0.0,11,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#patient-everything-exchange-via-alternate-secure-transport,The use of the Bulk FHIR specification for transmission of member data SHALL honor jurisdictional and personal privacy restrictions that are relevant to a member’s health record.,SHALL,Server,,false
13
+ hl7.fhir.us.davinci-pdex_2.0.0,12,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#provenance,Health Plans SHALL incorporate provenance records that they receive as part of any exchange of FHIR data.,SHALL,Server,,false
14
+ hl7.fhir.us.davinci-pdex_2.0.0,13,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#provenance,"Health Plans SHALL provide Provenance records [for each non-Provenance instance] that, at a minimum, indicate that they are playing the role of Transmitter of the data in any PDex information exchange.",SHALL,Server,,false
15
+ hl7.fhir.us.davinci-pdex_2.0.0,14,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#implementation-hierarchy-and-priorities,"[F]or profiles and APIs identified in this IG, the FHIR R4 version SHALL be used.",SHALL,Server,,false
16
+ hl7.fhir.us.davinci-pdex_2.0.0,15,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#pdex-data-payloads,All resources available via a FHIR API endpoint SHALL be declared in a FHIR CapabilityStatement.,SHALL,Server,,false
17
+ hl7.fhir.us.davinci-pdex_2.0.0,16,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#pdex-data-payloads,The Read and Search Operations SHALL be supported for the FHIR Profiles [that are part of the member health history].,SHALL,Server,,false
18
+ hl7.fhir.us.davinci-pdex_2.0.0,17,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#capabilitystatement,The Read ... Operation... SHALL be supported for … Resource Type … Coverage [using the [HRex Coverage](https://hl7.org/fhir/us/davinci-hrex/STU1/StructureDefinition-hrex-coverage.html) profile].,SHALL,Server,,false
19
+ hl7.fhir.us.davinci-pdex_2.0.0,18,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#capabilitystatement,The ... Search Operation... SHALL be supported for … Resource Type … Coverage [using the [HRex Coverage](https://hl7.org/fhir/us/davinci-hrex/STU1/StructureDefinition-hrex-coverage.html) profile].,SHALL,Server,,false
20
+ hl7.fhir.us.davinci-pdex_2.0.0,19,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#data-payloads,All resources and operations available via a FHIR API endpoint SHALL be declared in a FHIR CapabilityStatement.,SHALL,Server,,false
21
+ hl7.fhir.us.davinci-pdex_2.0.0,20,"https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#oauth20-or-smart-on-fhir-member-authorized-exchange,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.html,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api","[When a payer allows their member to authorize information sharing, a]fter authenticating to the (source) Health Plan’s authorization server, the Member SHALL be presented with an Authorization screen that enables them to approve the sharing of information with their intended application, service or (target) Health Plan.",SHALL,Server,,false
22
+ hl7.fhir.us.davinci-pdex_2.0.0,21,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,"For this authorization [of data sharing by a member] to occur the Application, service or (target) Health Plan will require OAuth 2.0 client application credentials, which ... the (source) Health Plan [SHALL issue during client] register[ation]",SHALL,Server,,false
23
+ hl7.fhir.us.davinci-pdex_2.0.0,22,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","The Authorization process [of data sharing by a member], in accordance with applicable privacy policy, SHALL provide a mechanism to support current regulations allowing members the right to decide what information is permitted to be exchanged.",SHALL,Server,,false
24
+ hl7.fhir.us.davinci-pdex_2.0.0,23,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","After successfully authorizing [data sharing with] an application [on behalf of the Member,] an Access Token ... SHALL be returned to the requesting application.",SHALL,Server,,false
25
+ hl7.fhir.us.davinci-pdex_2.0.0,24,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","After successfully authorizing [data sharing with] an application [on behalf of the Member,] an … Optional Refresh Token ... [MAY] be returned to the requesting application.",MAY,Server,,false
26
+ hl7.fhir.us.davinci-pdex_2.0.0,25,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,The scopes of the access token [returned by the server for data sharing on behalf of a member] SHALL be restricted to the authorizing Member’s information and the scopes approved.,SHALL,Server,,false
27
+ hl7.fhir.us.davinci-pdex_2.0.0,26,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,Any subsequent Access Token [returned by the server for data sharing on behalf of the member] issued based on the Refresh Token SHALL be restricted (at least) to the same restrictions.,SHALL,Server,,false
28
+ hl7.fhir.us.davinci-pdex_2.0.0,27,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm",The requesting application [authorized to access member information] SHALL use the access token to access the Health Plan’s secure FHIR API to download the information that the Application is allowed to access.,SHALL,Client,,false
29
+ hl7.fhir.us.davinci-pdex_2.0.0,28,https://hl7.org/fhir/us/davinci-pdex/STU2/handlingdataprovenance.html#handling-data-provenance,Health Plans SHALL accept and retain Provenance records received with data based on Member-authorized Payer-to-Payer exchange.,SHALL,Client,,false
30
+ hl7.fhir.us.davinci-pdex_2.0.0,29,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,Each [data] retrieval ... SHALL be preceded by the use of the ... [HRex [$member-match](https://hl7.org/fhir/us/davinci-hrex/STU1/OperationDefinition-member-match.html)] interaction to match a member and provide consent.,SHALL,Client,"hl7.fhir.us.davinci-hrex_1.0.0@34,37,38,40,46,47",false
31
+ hl7.fhir.us.davinci-pdex_2.0.0,30,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,Health Plans SHALL support the $member-match operation.,SHALL,Server,"hl7.fhir.us.davinci-hrex_1.0.0@35,36,39,41-45,48",false
32
+ hl7.fhir.us.davinci-pdex_2.0.0,31,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,"[Before allowing a $member-match operation, Servers SHALL e]stablish a secure connection [with the client payer] via mTLS.",SHALL,Server,,false
33
+ hl7.fhir.us.davinci-pdex_2.0.0,32,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,[Servers SHALL allow clients to u]se mTLS secure connection to perform OAuth2.0 Dynamic Client Registration to acquire OAuth2.0 client credentials,SHALL,Server,,false
34
+ hl7.fhir.us.davinci-pdex_2.0.0,33,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,[Servers SHALL allow clients to u]se Client Credentials to acquire OAuth2.0 token to perform $member-match operation,SHALL,Server,,false
35
+ hl7.fhir.us.davinci-pdex_2.0.0,34,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,"If a Patient ID is returned from $member-match, [Servers SHALL allow clients to make] a request for an OAuth2.0 Access Token that is scoped to the identified shared member",SHALL,Server,,false
36
+ hl7.fhir.us.davinci-pdex_2.0.0,35,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,In the case where a [member] match is confirmed the receiving payer will: … [r]eturn a Unique Patient Identifier (Patient FHIR ID) in the $member-match Operation Response.,SHALL,Server,,true
37
+ hl7.fhir.us.davinci-pdex_2.0.0,36,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,When no [member] match is found ... a 422 Unprocessable entity status code will be returned [by the receiving payer].,SHALL,Server,,true
38
+ hl7.fhir.us.davinci-pdex_2.0.0,37,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"When … multiple matches are found, a 422 Unprocessable entity status code will be returned [by the receiving payer].",SHALL,Server,,true
39
+ hl7.fhir.us.davinci-pdex_2.0.0,38,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"If the receiving payer matches to a unique member but is unable to comply with the consent request, a Patient ID SHALL NOT be returned in the $member-match response",SHALL NOT,Server,,true
40
+ hl7.fhir.us.davinci-pdex_2.0.0,39,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"If the receiving payer matches to a unique member but is unable to comply with the consent request [e.g., because they do not support the requested data segmentation policy], … a 422 status code SHALL be returned with an Operation Outcome that indicates that the consent request could not be complied with.",SHALL,Server,,true
41
+ hl7.fhir.us.davinci-pdex_2.0.0,40,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#evaluation-of-consent,"[Servers SHALL consider consent requirements to be met only if]
42
+ - Member Identity is matched
43
+ - Consent Policy (Everything or only Non-Sensitive data) matches the data release segmentation capabilities of the receiving payer
44
+ - Date period for consent is valid
45
+ - Payer requesting retrieval of data is matched.",SHALL,Server,,false
46
+ hl7.fhir.us.davinci-pdex_2.0.0,41,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#data-retrieval-methods,"Once Health Plans have completed the Member Access stage of the Exchange the requesting Health Plan SHALL utilize the access token returned from the Member Access step to request/retrieve data using one of the following three methods:
47
+ - Query all clinical resource individually
48
+ - $patient-everything operation
49
+ - Bulk FHIR Asynchronous protocols.",SHALL,Client,,false
50
+ hl7.fhir.us.davinci-pdex_2.0.0,42,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#data-retrieval-methods,"Each of the above methods[, query all clinical resource individually, $everything, and $export,] SHALL support the retrieval of the profiles and resources [in the scope of the member health history, defined in the Server CapabilityStatement]",SHALL,Server,,false
51
+ hl7.fhir.us.davinci-pdex_2.0.0,43,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#query-all-clinical-resources-individually,Health Plans SHALL support search of a member’s clinical data.,SHALL,Server,,false
52
+ hl7.fhir.us.davinci-pdex_2.0.0,44,,[Servers SHALL support] the _revInclude and _include parameters to ... retrieve the associated Provenance and supporting records.,SHALL,Server,,false
53
+ hl7.fhir.us.davinci-pdex_2.0.0,45,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#constraining-data-based-upon-permissions-of-the-requestor,The FHIR Server SHALL constrain the data returned from the server to a requester based upon the access permissions of the requester.,SHALL,Server,,false
54
+ hl7.fhir.us.davinci-pdex_2.0.0,46,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#everything-operation,Health Plans SHOULD support the use of the $everything operation… defined in the FHIR R4 specification here: https://www.hl7.org/fhir/operation-patient-everything.html,SHOULD,Server,fhir_4.0.1,false
55
+ hl7.fhir.us.davinci-pdex_2.0.0,47,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#bulk-fhir-asynchronous-protocols,"Payer-to-Payer Data Exchange SHOULD support the use of Bulk FHIR methods, as defined in the HL7 FHIR [Bulk Data Access Implementation Guide](https://hl7.org/fhir/uv/bulkdata/authorization/).",SHOULD,Server,hl7.fhir.uv.bulkdata_2.0.0,false
56
+ hl7.fhir.us.davinci-pdex_2.0.0,48,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#data-mapping,Health Plans SHALL map claims and clinical information for a member to US Core v3.1.1 FHIR Resources based on R4.,SHALL,Server,hl7.fhir.us.core_3.1.1,false
57
+ hl7.fhir.us.davinci-pdex_2.0.0,49,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#data-mapping,"Where a US Core FHIR R4 Resource is not defined Health Plans SHALL map claims and clinical information to FHIR Profiles defined in this IG, or the Da Vinci HRex IG.",SHALL,Server,hl7.fhir.us.davinci-hrex_1.0.0,true
58
+ hl7.fhir.us.davinci-pdex_2.0.0,50,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"If a field is marked as required (cardinality n.., where n>0) the Health Plan SHALL populate the field.",SHALL,Server,,true
59
+ hl7.fhir.us.davinci-pdex_2.0.0,51,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"For a field specified as MUST SUPPORT and the cardinality is 0.., the Health Plan SHALL be capable of populating the field and do so if the relevant data exists.",SHALL,Server,,true
60
+ hl7.fhir.us.davinci-pdex_2.0.0,52,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"For a field specified as MUST SUPPORT and the cardinality is 0.., the Health Plan SHALL … [populate] the field ... if the relevant data exists.",SHALL,Server,,true
61
+ hl7.fhir.us.davinci-pdex_2.0.0,53,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"If a field is marked as MUST SUPPORT the receiver must be able to consume it without generating an error, unless the field is a sub-element of another field where that parent field does NOT have a minimum cardinality of 1 [or a Must Support Flag]. For example, if the parent field has a cardinality of “0..1” or “0..*” the sub-element field does not need to be populated.",SHALL,Client,,true
62
+ hl7.fhir.us.davinci-pdex_2.0.0,54,https://hl7.org/fhir/us/davinci-pdex/STU2/usecasescenarios.html#versioning-of-fhir-data,"If a payer chooses to support FHIR resource data versioning of related resource references, the referring resource **SHALL** use the vread format of reference: `[type]/[id]/_history/[vid]`",SHALL,Server,,true
63
+ hl7.fhir.us.davinci-pdex_2.0.0,55,https://hl7.org/fhir/us/davinci-pdex/STU2/usecasescenarios.html#versioning-of-fhir-data,Supporting versioning of FHIR data implies supporting the [vread](https://www.hl7.org/fhir/http.html#vread) and [history](https://www.hl7.org/fhir/http.html#history) interactions in the FHIR specification.,SHALL,Server,,true
64
+ hl7.fhir.us.davinci-pdex_2.0.0,56,https://hl7.org/fhir/us/davinci-pdex/STU2/StructureDefinition-pdex-priorauthorization.html,"Payers SHALL make available pending and active prior authorization decisions and related clinical documentation and forms for items and services, not including prescription drugs, including the date the prior authorization was approved, the date the authorization ends, as well as the units and services approved and those used to date, no later than one (1) business day after a provider initiates a prior authorization for the beneficiary or there is a change of status for the prior authorization.",SHALL,Server,,false
data/lib/davinci_pdex_test_kit/requirements/generated/davinci-pdex-test-kit_requirements_coverage.csv ADDED
@@ -0,0 +1,64 @@
1
+ Req Set,ID,URL,Requirement,Conformance,Actor,Sub-Requirement(s),Conditionality,Da Vinci PDex Payer Server Test Suite Short ID(s),Da Vinci PDex Payer Server Test Suite Full ID(s),Da Vinci PDex Payer Client Test Suite Short ID(s),Da Vinci PDex Payer Client Test Suite Full ID(s)
2
+ hl7.fhir.us.davinci-pdex_2.0.0,1,https://hl7.org/fhir/us/davinci-pdex/STU2/#intellectual-property,Implementers ... of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation.,SHALL,Server,,false,,,NA,NA
3
+ hl7.fhir.us.davinci-pdex_2.0.0,2,https://hl7.org/fhir/us/davinci-pdex/STU2/#intellectual-property,Terminology licenses SHALL be obtained from the Third-Party IP owner for each code system and/or other specified artifact used.,SHALL,Server,,false,,,NA,NA
4
+ hl7.fhir.us.davinci-pdex_2.0.0,3,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [US Core and referenced by PDex], the meaning of Must Support [for Servers] is established in [the US Core IG].",SHALL,Server,"hl7.fhir.us.core_3.1.1@75,77,78,80",false,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
5
+ hl7.fhir.us.davinci-pdex_2.0.0,4,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [US Core and referenced by PDex], the meaning of Must Support [for Clients] is established in [the US Core IG].",SHALL,Client,"hl7.fhir.us.core_3.1.1@76,79",false,NA,NA,,
6
+ hl7.fhir.us.davinci-pdex_2.0.0,5,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [DaVinci HRex and referenced by PDex], the meaning of Must Support [for Servers] is established in [the HRex IG].",SHALL,Server,"hl7.fhir.us.davinci-hrex_1.0.0@21,22,24,25,27",false,,,NA,NA
7
+ hl7.fhir.us.davinci-pdex_2.0.0,6,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"For profiles defined in [DaVinci HRex and referenced by PDex], the meaning of Must Support [for Clients] is established in [the HRex IG].",SHALL,Client,"hl7.fhir.us.davinci-hrex_1.0.0@23,26,28",false,NA,NA,,
8
+ hl7.fhir.us.davinci-pdex_2.0.0,7,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"[For profiles defined in the PDex IG, Servers SHALL follow] Must Support requirements … [from] the US Core Implementation Guide.",SHALL,Server,"hl7.fhir.us.core_3.1.1@75,77,78,80",false,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
9
+ hl7.fhir.us.davinci-pdex_2.0.0,8,https://hl7.org/fhir/us/davinci-pdex/STU2/index.html#must-support,"[For profiles defined in the PDex IG, Clients SHALL follow] Must Support requirements … [from] the US Core Implementation Guide.",SHALL,Client,"hl7.fhir.us.core_3.1.1@76,79",false,NA,NA,,
10
+ hl7.fhir.us.davinci-pdex_2.0.0,9,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#overview,All data exchanged by Health Plans using the interactions covered in this IG SHALL be transformed to FHIR R4 resources.,SHALL,Server,,false,,,NA,NA
11
+ hl7.fhir.us.davinci-pdex_2.0.0,10,"https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#oauth20-or-smart-on-fhir-member-authorized-exchange,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.html,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api",The member SHALL authenticate using [and the server SHALL accept only] credentials that have been issued by or are recognized and accepted by the Health Plan. These are typically the member’s customer portal credentials for accessing the health plan.,SHALL,Client,,false,NA,NA,,
12
+ hl7.fhir.us.davinci-pdex_2.0.0,11,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#patient-everything-exchange-via-alternate-secure-transport,The use of the Bulk FHIR specification for transmission of member data SHALL honor jurisdictional and personal privacy restrictions that are relevant to a member’s health record.,SHALL,Server,,false,,,NA,NA
13
+ hl7.fhir.us.davinci-pdex_2.0.0,12,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#provenance,Health Plans SHALL incorporate provenance records that they receive as part of any exchange of FHIR data.,SHALL,Server,,false,,,NA,NA
14
+ hl7.fhir.us.davinci-pdex_2.0.0,13,https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#provenance,"Health Plans SHALL provide Provenance records [for each non-Provenance instance] that, at a minimum, indicate that they are playing the role of Transmitter of the data in any PDex information exchange.",SHALL,Server,,false,,,NA,NA
15
+ hl7.fhir.us.davinci-pdex_2.0.0,14,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#implementation-hierarchy-and-priorities,"[F]or profiles and APIs identified in this IG, the FHIR R4 version SHALL be used.",SHALL,Server,,false,,,NA,NA
16
+ hl7.fhir.us.davinci-pdex_2.0.0,15,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#pdex-data-payloads,All resources available via a FHIR API endpoint SHALL be declared in a FHIR CapabilityStatement.,SHALL,Server,,false,,,NA,NA
17
+ hl7.fhir.us.davinci-pdex_2.0.0,16,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#pdex-data-payloads,The Read and Search Operations SHALL be supported for the FHIR Profiles [that are part of the member health history].,SHALL,Server,,false,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
18
+ hl7.fhir.us.davinci-pdex_2.0.0,17,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#capabilitystatement,The Read ... Operation... SHALL be supported for … Resource Type … Coverage [using the [HRex Coverage](https://hl7.org/fhir/us/davinci-hrex/STU1/StructureDefinition-hrex-coverage.html) profile].,SHALL,Server,,false,,,NA,NA
19
+ hl7.fhir.us.davinci-pdex_2.0.0,18,https://hl7.org/fhir/us/davinci-pdex/STU2/introduction.html#capabilitystatement,The ... Search Operation... SHALL be supported for … Resource Type … Coverage [using the [HRex Coverage](https://hl7.org/fhir/us/davinci-hrex/STU1/StructureDefinition-hrex-coverage.html) profile].,SHALL,Server,,false,,,NA,NA
20
+ hl7.fhir.us.davinci-pdex_2.0.0,19,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#data-payloads,All resources and operations available via a FHIR API endpoint SHALL be declared in a FHIR CapabilityStatement.,SHALL,Server,,false,,,NA,NA
21
+ hl7.fhir.us.davinci-pdex_2.0.0,20,"https://hl7.org/fhir/us/davinci-pdex/STU2/overview.html#oauth20-or-smart-on-fhir-member-authorized-exchange,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.html,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api","[When a payer allows their member to authorize information sharing, a]fter authenticating to the (source) Health Plan’s authorization server, the Member SHALL be presented with an Authorization screen that enables them to approve the sharing of information with their intended application, service or (target) Health Plan.",SHALL,Server,,false,,,NA,NA
22
+ hl7.fhir.us.davinci-pdex_2.0.0,21,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,"For this authorization [of data sharing by a member] to occur the Application, service or (target) Health Plan will require OAuth 2.0 client application credentials, which ... the (source) Health Plan [SHALL issue during client] register[ation]",SHALL,Server,,false,,,NA,NA
23
+ hl7.fhir.us.davinci-pdex_2.0.0,22,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","The Authorization process [of data sharing by a member], in accordance with applicable privacy policy, SHALL provide a mechanism to support current regulations allowing members the right to decide what information is permitted to be exchanged.",SHALL,Server,,false,,,NA,NA
24
+ hl7.fhir.us.davinci-pdex_2.0.0,23,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","After successfully authorizing [data sharing with] an application [on behalf of the Member,] an Access Token ... SHALL be returned to the requesting application.",SHALL,Server,,false,,,NA,NA
25
+ hl7.fhir.us.davinci-pdex_2.0.0,24,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm","After successfully authorizing [data sharing with] an application [on behalf of the Member,] an … Optional Refresh Token ... [MAY] be returned to the requesting application.",MAY,Server,,false,,,NA,NA
26
+ hl7.fhir.us.davinci-pdex_2.0.0,25,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,The scopes of the access token [returned by the server for data sharing on behalf of a member] SHALL be restricted to the authorizing Member’s information and the scopes approved.,SHALL,Server,,false,,,NA,NA
27
+ hl7.fhir.us.davinci-pdex_2.0.0,26,https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,Any subsequent Access Token [returned by the server for data sharing on behalf of the member] issued based on the Refresh Token SHALL be restricted (at least) to the same restrictions.,SHALL,Server,,false,,,NA,NA
28
+ hl7.fhir.us.davinci-pdex_2.0.0,27,"https://hl7.org/fhir/us/davinci-pdex/STU2/pdeximplementationactorsinteractionsdatapayloadsandmethods.html#oauth20-and-fhir-api,https://hl7.org/fhir/us/davinci-pdex/STU2/member-authorizedoauth2exchange.htm",The requesting application [authorized to access member information] SHALL use the access token to access the Health Plan’s secure FHIR API to download the information that the Application is allowed to access.,SHALL,Client,,false,NA,NA,1.1.01,pdex_payer_client-payer_to_payer_workflow-client_workflow_interaction-pdex_client_workflow_interaction
29
+ hl7.fhir.us.davinci-pdex_2.0.0,28,https://hl7.org/fhir/us/davinci-pdex/STU2/handlingdataprovenance.html#handling-data-provenance,Health Plans SHALL accept and retain Provenance records received with data based on Member-authorized Payer-to-Payer exchange.,SHALL,Client,,false,NA,NA,,
30
+ hl7.fhir.us.davinci-pdex_2.0.0,29,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,Each [data] retrieval ... SHALL be preceded by the use of the ... [HRex [$member-match](https://hl7.org/fhir/us/davinci-hrex/STU1/OperationDefinition-member-match.html)] interaction to match a member and provide consent.,SHALL,Client,"hl7.fhir.us.davinci-hrex_1.0.0@34,37,38,40,46,47",false,NA,NA,1.2.01,pdex_payer_client-payer_to_payer_workflow-member_match_validation-pdex_initial_member_match_validation
31
+ hl7.fhir.us.davinci-pdex_2.0.0,30,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,Health Plans SHALL support the $member-match operation.,SHALL,Server,"hl7.fhir.us.davinci-hrex_1.0.0@35,36,39,41-45,48",false,"1.1.01, 1.3.01","pdex_payer_server-payer_to_payer_workflow-pdex_workflow_member_match-pdex_member_match_operation_in_cap_stmt, pdex_payer_server-payer_to_payer_workflow-pdex_workflow_everything-pdex_patient_operation_in_cap_stmt_validation",NA,NA
32
+ hl7.fhir.us.davinci-pdex_2.0.0,31,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,"[Before allowing a $member-match operation, Servers SHALL e]stablish a secure connection [with the client payer] via mTLS.",SHALL,Server,,false,,,NA,NA
33
+ hl7.fhir.us.davinci-pdex_2.0.0,32,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,[Servers SHALL allow clients to u]se mTLS secure connection to perform OAuth2.0 Dynamic Client Registration to acquire OAuth2.0 client credentials,SHALL,Server,,false,,,NA,NA
34
+ hl7.fhir.us.davinci-pdex_2.0.0,33,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,[Servers SHALL allow clients to u]se Client Credentials to acquire OAuth2.0 token to perform $member-match operation,SHALL,Server,,false,,,NA,NA
35
+ hl7.fhir.us.davinci-pdex_2.0.0,34,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#member-match-with-consent,"If a Patient ID is returned from $member-match, [Servers SHALL allow clients to make] a request for an OAuth2.0 Access Token that is scoped to the identified shared member",SHALL,Server,,false,,,NA,NA
36
+ hl7.fhir.us.davinci-pdex_2.0.0,35,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,In the case where a [member] match is confirmed the receiving payer will: … [r]eturn a Unique Patient Identifier (Patient FHIR ID) in the $member-match Operation Response.,SHALL,Server,,true,1.1.08,pdex_payer_server-payer_to_payer_workflow-pdex_workflow_member_match-pdex_member_match_identifier_to_id,NA,NA
37
+ hl7.fhir.us.davinci-pdex_2.0.0,36,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,When no [member] match is found ... a 422 Unprocessable entity status code will be returned [by the receiving payer].,SHALL,Server,,true,2.1.1.05,pdex_payer_server-api_and_ms_coverage-member_match_failure_cases-pdex_no_member_matches-pdex_member_match_has_no_matches,NA,NA
38
+ hl7.fhir.us.davinci-pdex_2.0.0,37,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"When … multiple matches are found, a 422 Unprocessable entity status code will be returned [by the receiving payer].",SHALL,Server,,true,2.1.2.05,pdex_payer_server-api_and_ms_coverage-member_match_failure_cases-pdex_multiple_member_matches-pdex_member_match_has_multiple_matches,NA,NA
39
+ hl7.fhir.us.davinci-pdex_2.0.0,38,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"If the receiving payer matches to a unique member but is unable to comply with the consent request, a Patient ID SHALL NOT be returned in the $member-match response",SHALL NOT,Server,,true,,,NA,NA
40
+ hl7.fhir.us.davinci-pdex_2.0.0,39,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#the-member-match-operation,"If the receiving payer matches to a unique member but is unable to comply with the consent request [e.g., because they do not support the requested data segmentation policy], … a 422 status code SHALL be returned with an Operation Outcome that indicates that the consent request could not be complied with.",SHALL,Server,,true,,,NA,NA
41
+ hl7.fhir.us.davinci-pdex_2.0.0,40,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#evaluation-of-consent,"[Servers SHALL consider consent requirements to be met only if]
42
+ - Member Identity is matched
43
+ - Consent Policy (Everything or only Non-Sensitive data) matches the data release segmentation capabilities of the receiving payer
44
+ - Date period for consent is valid
45
+ - Payer requesting retrieval of data is matched.",SHALL,Server,,false,,,NA,NA
46
+ hl7.fhir.us.davinci-pdex_2.0.0,41,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#data-retrieval-methods,"Once Health Plans have completed the Member Access stage of the Exchange the requesting Health Plan SHALL utilize the access token returned from the Member Access step to request/retrieve data using one of the following three methods:
47
+ - Query all clinical resource individually
48
+ - $patient-everything operation
49
+ - Bulk FHIR Asynchronous protocols.",SHALL,Client,,false,NA,NA,1.1.01,pdex_payer_client-payer_to_payer_workflow-client_workflow_interaction-pdex_client_workflow_interaction
50
+ hl7.fhir.us.davinci-pdex_2.0.0,42,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#data-retrieval-methods,"Each of the above methods[, query all clinical resource individually, $everything, and $export,] SHALL support the retrieval of the profiles and resources [in the scope of the member health history, defined in the Server CapabilityStatement]",SHALL,Server,,false,"1.2, 1.3, 1.4.1","pdex_payer_server-payer_to_payer_workflow-pdex_workflow_clinical_data, pdex_payer_server-payer_to_payer_workflow-pdex_workflow_everything, pdex_payer_server-payer_to_payer_workflow-pdex_workflow_export-pdex_patient_export",NA,NA
51
+ hl7.fhir.us.davinci-pdex_2.0.0,43,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#query-all-clinical-resources-individually,Health Plans SHALL support search of a member’s clinical data.,SHALL,Server,,false,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
52
+ hl7.fhir.us.davinci-pdex_2.0.0,44,,[Servers SHALL support] the _revInclude and _include parameters to ... retrieve the associated Provenance and supporting records.,SHALL,Server,,false,2.2.1.08,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage-pdex_eob-pdex_eob_provenance_revinclude_search,NA,NA
53
+ hl7.fhir.us.davinci-pdex_2.0.0,45,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#constraining-data-based-upon-permissions-of-the-requestor,The FHIR Server SHALL constrain the data returned from the server to a requester based upon the access permissions of the requester.,SHALL,Server,,false,,,NA,NA
54
+ hl7.fhir.us.davinci-pdex_2.0.0,46,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#everything-operation,Health Plans SHOULD support the use of the $everything operation… defined in the FHIR R4 specification here: https://www.hl7.org/fhir/operation-patient-everything.html,SHOULD,Server,fhir_4.0.1,false,1.3.02,pdex_payer_server-payer_to_payer_workflow-pdex_workflow_everything-Test02,NA,NA
55
+ hl7.fhir.us.davinci-pdex_2.0.0,47,https://hl7.org/fhir/us/davinci-pdex/STU2/payertopayerexchange.html#bulk-fhir-asynchronous-protocols,"Payer-to-Payer Data Exchange SHOULD support the use of Bulk FHIR methods, as defined in the HL7 FHIR [Bulk Data Access Implementation Guide](https://hl7.org/fhir/uv/bulkdata/authorization/).",SHOULD,Server,hl7.fhir.uv.bulkdata_2.0.0,false,1.4.1.01,pdex_payer_server-payer_to_payer_workflow-pdex_workflow_export-pdex_patient_export-pdex_patient_export_in_cap_stmt,NA,NA
56
+ hl7.fhir.us.davinci-pdex_2.0.0,48,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#data-mapping,Health Plans SHALL map claims and clinical information for a member to US Core v3.1.1 FHIR Resources based on R4.,SHALL,Server,hl7.fhir.us.core_3.1.1,false,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
57
+ hl7.fhir.us.davinci-pdex_2.0.0,49,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#data-mapping,"Where a US Core FHIR R4 Resource is not defined Health Plans SHALL map claims and clinical information to FHIR Profiles defined in this IG, or the Da Vinci HRex IG.",SHALL,Server,hl7.fhir.us.davinci-hrex_1.0.0,true,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
58
+ hl7.fhir.us.davinci-pdex_2.0.0,50,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"If a field is marked as required (cardinality n.., where n>0) the Health Plan SHALL populate the field.",SHALL,Server,,true,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
59
+ hl7.fhir.us.davinci-pdex_2.0.0,51,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"For a field specified as MUST SUPPORT and the cardinality is 0.., the Health Plan SHALL be capable of populating the field and do so if the relevant data exists.",SHALL,Server,,true,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
60
+ hl7.fhir.us.davinci-pdex_2.0.0,52,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"For a field specified as MUST SUPPORT and the cardinality is 0.., the Health Plan SHALL … [populate] the field ... if the relevant data exists.",SHALL,Server,,true,2.2,pdex_payer_server-api_and_ms_coverage-pdex_fhir_api_coverage,NA,NA
61
+ hl7.fhir.us.davinci-pdex_2.0.0,53,https://hl7.org/fhir/us/davinci-pdex/STU2/datamapping.html#providing-data-in-sub-element-fields,"If a field is marked as MUST SUPPORT the receiver must be able to consume it without generating an error, unless the field is a sub-element of another field where that parent field does NOT have a minimum cardinality of 1 [or a Must Support Flag]. For example, if the parent field has a cardinality of “0..1” or “0..*” the sub-element field does not need to be populated.",SHALL,Client,,true,NA,NA,,
62
+ hl7.fhir.us.davinci-pdex_2.0.0,54,https://hl7.org/fhir/us/davinci-pdex/STU2/usecasescenarios.html#versioning-of-fhir-data,"If a payer chooses to support FHIR resource data versioning of related resource references, the referring resource **SHALL** use the vread format of reference: `[type]/[id]/_history/[vid]`",SHALL,Server,,true,,,NA,NA
63
+ hl7.fhir.us.davinci-pdex_2.0.0,55,https://hl7.org/fhir/us/davinci-pdex/STU2/usecasescenarios.html#versioning-of-fhir-data,Supporting versioning of FHIR data implies supporting the [vread](https://www.hl7.org/fhir/http.html#vread) and [history](https://www.hl7.org/fhir/http.html#history) interactions in the FHIR specification.,SHALL,Server,,true,,,NA,NA
64
+ hl7.fhir.us.davinci-pdex_2.0.0,56,https://hl7.org/fhir/us/davinci-pdex/STU2/StructureDefinition-pdex-priorauthorization.html,"Payers SHALL make available pending and active prior authorization decisions and related clinical documentation and forms for items and services, not including prescription drugs, including the date the prior authorization was approved, the date the authorization ends, as well as the units and services approved and those used to date, no later than one (1) business day after a provider initiates a prior authorization for the beneficiary or there is a change of status for the prior authorization.",SHALL,Server,,false,,,NA,NA
data/lib/davinci_pdex_test_kit/version.rb CHANGED
@@ -1,4 +1,4 @@
1
1
  module DaVinciPDexTestKit
2
- VERSION = '0.11.0'.freeze
3
- LAST_UPDATED = '2025-02-25'.freeze
2
+ VERSION = '0.12.0'.freeze
3
+ LAST_UPDATED = '2025-04-03'.freeze
4
4
  end
data/lib/davinci_pdex_test_kit.rb CHANGED
@@ -1,3 +1,4 @@
1
+ require_relative 'inferno_requirements_tools/ext/inferno_core/runnable'
1
2
  require_relative 'davinci_pdex_test_kit/metadata'
2
3
  require_relative 'davinci_pdex_test_kit/pdex_payer_server_suite'
3
4
  require_relative 'davinci_pdex_test_kit/pdex_payer_client_suite'
data/lib/inferno_requirements_tools/ext/inferno_core/runnable.rb ADDED
@@ -0,0 +1,22 @@
1
+ module Inferno
2
+ module DSL
3
+ # This module contains the DSL for defining child entities in the test
4
+ # definition framework.
5
+ module Runnable
6
+ # Set/Get the IDs of requirements verifed by this runnable
7
+ # Set with [] to clear the list
8
+ #
9
+ # @param requirements [Array<String>]
10
+ # @return [Array<String>] the requirement IDs
11
+ def verifies_requirements(*requirement_ids)
12
+ if requirement_ids.empty?
13
+ @requirement_ids || []
14
+ elsif requirement_ids == [[]]
15
+ @requirement_ids = []
16
+ else
17
+ @requirement_ids = requirement_ids
18
+ end
19
+ end
20
+ end
21
+ end
22
+ end
data/lib/inferno_requirements_tools/rake/rakefile_template ADDED
@@ -0,0 +1,19 @@
1
+ namespace :requirements do
2
+ desc 'Generate requirements coverage CSV'
3
+ task :generate_coverage do
4
+ require 'inferno'
5
+ Inferno::Application.start(:suites)
6
+
7
+ require_relative 'lib/inferno_requirements_tools/tasks/requirements_coverage'
8
+ InfernoRequirementsTools::Tasks::RequirementsCoverage.new.run
9
+ end
10
+
11
+ desc 'Check if requirements coverage CSV is up-to-date'
12
+ task :check_coverage do
13
+ require 'inferno'
14
+ Inferno::Application.start(:suites)
15
+
16
+ require_relative 'lib/inferno_requirements_tools/tasks/requirements_coverage'
17
+ InfernoRequirementsTools::Tasks::RequirementsCoverage.new.run_check
18
+ end
19
+ end