Physical Activity Implementation Guide
1.0.0 - STU Release 1 United States of America flag

This page is part of the U.S. Physical Activity IG (v1.0.0: STU 1.0) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

ExampleScenario: Scenario 3 - Patient Seeks Referral for Exercise Program

Official URL: http://hl7.org/fhir/us/physical-activity/ExampleScenario/Scen3ProviderToYMCAReferral Version: 1.0.0
Standards status: Informative Computable Name: PatientSeeksReferralforExerciseProgram

This scenario provides an example of the types of data exchanges that are described in the Patient Seeks Referral for Exercise Program scenario from the Scenarios page.

The scenario shows the flows of information between the different systems and the various FHIR calls involved, as well as what the data might have looked like in each of the exchanges. There are detailed tables below that provide details on each of the steps in the exchange as well as the types of data being shared. From the instances table, it's possible to navigate to sample XML and JSON instances.

Actors

NameTypeDescription
Main Street ClinicSystem

Dr. Blackrock's EHR - creates referral at patient's request

Cincinnati Central YMCASystem

Fitness service provider who offers exercise program

Diagram

PatientSeeksReferralforExerciseProgramMain Street ClinicMain Street ClinicCincinnati Central YMCACincinnati Central YMCASubscription EstablishmentdetailsCreate EHR-monitoring Subscription(payload)A minute after creation of ServiceRequestdetailsCreate Task on YMCA(payload)YMCA retrieves referral(payload)response(payload)EHR gets referral acceptance(payload)EHR retrieves in-progress Task(payload)response(payload)About 4 Months LaterdetailsEHR gets referral acceptance(payload)EHR retrieves completed Task(payload)response(payload)

Processes

Process: Subscription Establishment

Pre-conditions:

Main Street Clinic and Cinicinnati Central YMCA have established legal and technical arrangements for interoperability

Post-conditions:

Subscription is successfully created allowing Main Street Clinic to monitor YMCA-assigned Tasks

StepNameDescriptionInitatorReceiverRequestResponse
1Create EHR-monitoring Subscription - create

YMCA posts Subscription to EHR to monitor Tasks. Request: POST https://mainClinic.example.org/fhir/Subscription Response: 201 Created

Cincinnati Central YMCAMain Street ClinicSubscription from EHR
Process: A minute after creation of ServiceRequest

Pre-conditions:

EHR has created a ServiceRequest for Mr. Shevchenko

Post-conditions:

YMCA has retrieved the ServiceRequest and the Patient, and updated the Task to 'in-progress'

StepNameDescriptionInitatorReceiverRequestResponse
2Create Task on YMCA - create

New Task is created directly on YMCA's server. Request: POST https://YMCA.example.org/fhir/Task Response: 201 Created

Main Street ClinicCincinnati Central YMCAInitial YMCA Task
3YMCA retrieves referral - search-type

YMCA retrieves the ServiceRequest and Patient referenced by the Task.

Cincinnati Central YMCAMain Street ClinicQuery for Referral & Patient for YMCA TaskServiceRequest search response for YMCA
4EHR gets referral acceptance - create

A subscription notification to the EHR is triggered when YMCA changes the prescription status to 'in-progress'. Request: POST https://mainClinic.example.org/mySubscriptions Response: 200 Ok

Cincinnati Central YMCAMain Street ClinicSubscription Notification that Task has updated
5EHR retrieves in-progress Task - search-type

EHR retrieves the Task referenced by the subscription notification

Main Street ClinicCincinnati Central YMCAQuery for EHR-issued task based on notificationAccepted Task search response for EHR
Process: About 4 Months Later

Pre-conditions:

YMCA is actively working on the Task

Post-conditions:

YMCA has completed the referral and Dr. Blackrock is aware of the results

StepNameDescriptionInitatorReceiverRequestResponse
6EHR gets referral acceptance - create

A subscription notification to the EHR is triggered when the YMCA changes the Task status to 'completed'. Request: POST https://mainClinic.example.org/mySubscriptions Response: 200 Ok

Cincinnati Central YMCAMain Street ClinicSubscription Notification that Task has completed
7EHR retrieves completed Task - search-type

EHR retrieves the Task referenced by the subscription notification

Main Street ClinicCincinnati Central YMCAQuery for EHR-issued task based on notificationCompleted Task search response for EHR

Instances

NameTypeContentDescription
Query for Referral & Patient for YMCA TaskBinary

Search to retrieve ServiceRequest and Patient for specified Task: GET https://mainClinic.example.org/fhir/ServiceRequest?_id=Scen3ServiceRequest&_include=ServiceRequest:patient

Query for EHR-issued task based on notificationBinary

Search to retrieve Task: GET https://YMCA.example.org/fhir/Task?_id=Scen3TaskYMCA

Subscription from EHRSubscriptionhere

Establishes the subscription for the EHR to monitor tasks it's created

Task seeking FitLife to fulfill referralTask

A Task seeking fulfillment by the YMCA of the referral for an exercise program

  • Initial YMCA Task
here

A Task seeking fulfillment by the YMCA of the referral for an exercise program

  • Updated YMCA Task
here

A Task seeking fulfillment by the YMCA of the referral for an exercise program

  • Completed YMCA Task
here

A Task seeking fulfillment by the YMCA of the referral for an exercise program

ServiceRequest search response for YMCABundlehere

Search-set Bundle returning ServiceRequest and Patient for the Task posted to the YMCA

Subscription Notification that Task has updatedBundlehere

Pointer to the Task that has been updated

Subscription Notification that Task has completedBundlehere

Pointer to the Task that has been updated

Accepted Task search response for EHRBundlehere

Search-set Bundle returning 'accepted' Task with id based on subscription notification

Contains: Updated YMCA Task
Completed Task search response for EHRBundlehere

Search-set Bundle returning 'completed' Task with id based on subscription notification

Contains: Completed YMCA Task