10.2.1 Base Flow
The Base Flow presents the step by step process of the information exchange depicted in the activity
diagram (above). It indicates the actor who performs the action, the description of the event/action, and
the associated inputs (records/data required to undertake the action) and outputs (records/data
produced by actions taken).
Note - Current actions involving the Provider Directories are covered in UC 1 and 2. In the event access
to the Public Key is required to be independent of interactions as a result of harmonization of standards,
then the Provider Directories may be the location where the recipient of transaction retrieves the Public
Key.
Step
#
1A
Actor
Role
Event/Description
Inputs
Payer Entity
Requests Digital
Identity
Payer Entity request
Digital Identity from
Registration Authority
Payer Entity need
for Digital Identity
1B
Provider
Entity
Requests Digital
Identity
Provider Entity request
Digital Identity from
Registration Authority
Provider Entity need
for Digital Identity
2
Registration
Authority
Validates and
assist in
completion of
information
required to
obtain a
certificate
Registration Authority
approves( or rejects) the
request for Identity
Proofing and upon
approval sends
information to
Certificate Authority
Relevant
Payer/Provider
Entity identification
information
3A
Certificate
Authority
Creates, Issues
and manages
security
credentials and
revocation lists
Certificate Authority
generates the Digital
Certificate/Credentials
and informs the Payer
Entity of their availability
Registration
Authority’s approval
of identification
information
3B
Certificate
Authority
Creates, Issues
and manages
security
credentials and
revocation lists
Certificate Authority
generates the Digital
Certificate/Credentials
and informs the Provider
Entity of their availability
4A
Payer Entity
Receives Digital
Certificate /
Credentials
Payer Entity obtains and
incorporates Digital
Certificate/ Credentials
into their business
process
Response to
Provider Entity
request to receive
Digital
Certificate/Credenti
als
Digital Credentials /
Certificate made
available by
Certificate Authority
Outputs
Relevant Payer
Entity
identification
information
Relevant
Provider Entity
identification
information
Response to
Payer or
Provider Entity
request for a
Digital Identity
and request to
Certificate
Authority to
issue Digital
Certificate/
Credentials
Digital
Certificate/
Credentials
made available
by Certificate
Authority
Digital
Credentials /
Certificate made
available by
Certificate
Authority
END
Interoperability
or System Step
Interoperability
Interoperability
Interoperability
and System
Interoperability
and System
Interoperability
and System
System
Step
#
4B
Actor
Role
Event/Description
Inputs
Provider
Entity
Receives Digital
Certificate /
Credentials
Digital Credentials /
Certificate issued by
Certificate Authority
END
5
Provider
Entity
Send
Registration
request to
Payer Entity
Provider Entity obtains
and incorporates Digital
Certificate/ Credentials
into their business
process
Provider Entity sends
request to register with
esMD to Payer Entity
(PPA Use Case 1)
Provider
registration
information
Interoperability
6
Payer Entity
Approves or
Rejects
Provider Entity
Registration
Request
Provider
registration
transaction
7
Payer Entity
Send eMDR to
Provider Entity
Payer Entity processes
the request and sends a
response either
confirming or rejecting
registration request to
Provider Entity (PPA Use
Case 1)
Payer Entity sends
eMDR(s) to registered
Provider Entity (esMD
Use Case 2)
Provider
registration
transaction
(transaction
meaning
exchange of
structured
information
based on a
national
standard)
Response to
provider
registration
request
eMDR
transaction
Interoperability
8
Provider
Entity
Digitally attest
to document
submission
Digitally Signed
Medical
Documentation
bundle and
Signature
Artifact
Interoperability
and System
Provider Entity
assembles relevant
Medical Documentation,
applies a nonrepudiation digital
signature to each
document bundle and
sends to Payer Entity
Need for additional
Medical
Documentation and
information
required for eMDR
transaction
eMDR and Medical
Documentation
required
Outputs
Interoperability
or System Step
System
Interoperability
and System
Step
#
9
Actor
Role
Event/Description
Inputs
Outputs
Interoperability
or System Step
System
Payer Entity
Authenticate
Signature
Artifacts and
data integrity
Payer Entity receives
Medical Documentation
bundle and
authenticates Signature
Artifacts and validate
data integrity of
submission from the
Provider Entity
Digitally Signed
Medical
Documentation
Bundle and
Signature Artifact
Success or failure
of Signature
Artifact and Data
integrity
authentication
10
Payer Entity
Sends Medical
Documentation
receipt
acknowledgem
ent to Provider
Entity
Payer Entity sends an
acknowledgement of the
success or failure of the
authentication and
validation performed to
the Provider Entity
Success or failure of
Signature Artifact
and Data integrity
authentication
Acknowledgeme
nt of transaction
Interoperability
11
Provider
Entity
Receives
acknowledgem
ent
Provider Entity Receives
acknowledgement of
receipt of Medical
Documentation from
Payer Entity
Acknowledgement
of transaction
END
System