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Problems

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Introduction

The Argonaut Problems provides the API documentation for searching for and fetching a patient's problem list. It is based on the Data Access Framework (DAF) Condition (a.k.a Problem) Profile and draws requirements from Argonaut Sprint 5. The search criteria provided in the Quick Start are intended to support the 2015 Edition ONC Certification criterion Data Category Request 170.315(g)(8).

Minimum Requirements

6-9 test items e.g. A client has connected to a server and fetched patient demographics via GET /Patient/{id}-->

Clients

 GET/Condition?patient=[id]&category=problem.
  • A server has ensured that every API request includes a valid Authorization token, supplied via:Authorization: Bearer {server-specific-token-here}
  • A server has rejected any unauthorized requests by returning an HTTP 401 Unauthorized response code.

Mandatory Data Elements

The following data-elements are mandatory (i.e data MUST be present). The following data-elements in the Condition resource are mandatory (i.e data MUST be present). These are presented below in simple human-readable explanation and a more thorough formal summary of the requirements. Sample data is provided to demonstrate the requirements.

Each Condition must have:

  1. a patient
  2. a code that identifies the problem
  3. a status of the problem
  4. a verification status
  5. a category code = "problem"

Formal Summary of the Mandatory Requirements


  1. One category in Condition.category which must have:
    • a fixed Condition.category.coding.system=" http://hl7.org/fhir/argo-condition-category"
    • a fixed Condition.category.coding.code="problem"
      • for this IG we have defined these codes to satisfy the 2015 Edition Common Clinical Data Set API search criteria for Problems and Health Concerns
Code Code System Print Name Definition
concern http://hl7.org/fhir/argo-condition-category Health Concern Concerns from other stakeholders which are outside the provider’s problem list.
problem http://hl7.org/fhir/argo-condition-category Problem The patients problems as identified by the provider(s). Items on the provider’s problem list
  1. One Identification of the condition, problem or diagnosis in Condition.code.
  2. One patient reference in Condition.patient
  3. Conditionally One clinical status in Condition.clinicalStatus
    • Invariants
      • required if Condition.verificationStatus != ‘entered-in-error‘
      • not present if Condition.verificationStatus = ‘entered-in-error‘
    • Condition.clinicalStatus is bound to Condition Clinical Status Codes Value set (Code set)
  4. One code in Condition.verificationStatus

Additional elements from DAF Condition Profile may be present.

Condition Resource Example Problem Example Health Concern Example

Quick Start

Below is a quick overview of the required search and read operations.


GET /Condition?patient=[id]&category=problem

Support: Mandatory to support search by patient and category.

Implementation Notes: Search for all Problems for a patient. Fetches a bundle of all Condition resources for the specified patient with a category code of "problem"(how to search by reference) and (how to search by token).

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope

Example:

[GET https://fhir-open-api-dstu2.smarthealthit.org/Condition?patient=1032702&category=problem]

GET /Condition?patient=[id]&category=problem&clinicalstatus=active,relapse,remission

Support: Optional to support search by category and status.

Implementation Notes: Search for all active Problems for a patient. Fetches a bundle of all Condition resources for the specified patient with a category code of "problem" and all "active" statuses (active,relapse,remission). (how to search by reference) and (how to search by token). This will not return any "entered in error" resources because of the conditional presence of the clinicalStatus element.

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope

Example:

[GET https://fhir-open-api-dstu2.smarthealthit.org/Condition?patient=1032702&category=problem&clinicalstatus=active,relapse,remission]

Open Issues

Issues for this IG have been identified and tracked HERE

Resources

Formalized testing with test scripts and objective results reporting is available through the participation of AEGIS and MITRE (Crucible). The testscript provided can be used to test servers: [todo]

References



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