International Patient Access
1.0.0 - STU1
International Patient Access
1.0.0 - STU1
This page is part of the International Patient Access (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
| Official URL: http://hl7.org/fhir/uv/ipa/CapabilityStatement/ipa-server | Version: 1.0.0 | |||
| Active as of 2022-12-09 | Computable Name: InternationalPatientAccessAPI | |||
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License |
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This CapabilityStatement describes the basic rules for the International Patient Access server actor that is responsible for providing responses to queries submitted by International Patient Access requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by International Patient Access servers are defined in this CapabilityStatement.
Raw OpenAPI-Swagger Definition file | Download
json, SHOULD support xmlapplication/json-patch+jsonNote to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as "SHALL NOT". A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.
serverThe IPA Server SHALL:
Support the IPA Patient resource profile.
Support at least one additional resource profile from the list of IPA Profiles.
Implement the RESTful behavior according to the FHIR specification.
Return the following response classes:
(Status 400): invalid parameter
(Status 401/4xx): unauthorized request
(Status 403): insufficient scope
(Status 404): unknown resource
Support JSON source formats for all IPA interactions.
Declare a CapabilityStatement identifying the list of profiles, operations, and search parameters supported.
The IPA Server SHOULD:
- See the General Security Considerations section for requirements and recommendations.
- A server SHALL reject any unauthorized requests by returning an HTTP
401 Unauthorized,403 Forbidden, or404 Not Foundresponse code.
transaction interaction.batch interaction.search-system interaction.history-system interaction.The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include_revinclude| Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
|---|---|---|---|---|---|---|---|---|---|
| AllergyIntolerance | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-allergyintolerance | y | y | clinical-status, patient, patient+clinical-status | Provenance:target | ||||
| Condition | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-condition Additional supported profiles: http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-problem-list-item | y | y | category, clinical-status, verification-status, code, onset-date, patient, patient+clinical-status, patient+category, patient+category+clinical-status, patient+code, patient+onset-date | Provenance:target | ||||
| DocumentReference | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-documentreference | y | y | _id, category, contenttype, date, period, status, type, patient, patient+category, patient+category+date, patient+type, patient+contenttype, patient+status, patient+type+date, patient+type+period | Provenance:target | $docref | |||
| Immunization | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-immunization | y | y | date, status, patient, patient+date, patient+status | Provenance:target | ||||
| Medication | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medication | y | Provenance:target | ||||||
| MedicationRequest | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medicationrequest | y | y | category, code, authoredon, intent, status, patient, patient+intent, patient+intent+authoredon, patient+intent+status | MedicationRequest:medication | Provenance:target | |||
| MedicationStatement | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-medicationstatement | y | y | status, patient, patient+status | MedicationStatement:medication | Provenance:target | |||
| Observation | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-observation Additional supported profiles: http://hl7.org/fhir/StructureDefinition/vitalsigns | y | y | category, code, date, status, patient, patient+category, patient+code, patient+category+date, patient+category+status, patient+code+date | Provenance:target | ||||
| Patient | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-patient | y | y | _id, birthdate, family, gender, given, identifier, name, family+gender, birthdate+family, birthdate+name, gender+name | Provenance:target | ||||
| Practitioner | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitioner | y | Provenance:target | ||||||
| PractitionerRole | http://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-practitionerrole | y | PractitionerRole:endpoint, PractitionerRole:practitioner | Provenance:target |
resolvesread, search-type.| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | patient | reference | The client SHALL provide at least a id value and MAY provide both the Type and id values. The server SHALL support both. |
| MAY | clinical-status | token | active | inactive | resolved |
| Conformance | Parameters | Types |
|---|---|---|
| SHOULD | patient+clinical-status | reference+token |
resolveshttp://hl7.org/fhir/uv/ipa/StructureDefinition/ipa-problem-list-item
read, search-type.Client applications should be prepared to encounter codes they do not recognize and handle the records accordingly. Servers SHOULD populate Condition.code.coding.display and/or Condition.code.text so that clients can always at least display the condition even if they do not know the codes that are used. Clients should be careful making use of the
codesearch parameter given that the codes used vary so much.Safety Issues:
- Clients SHALL not treat all conditions as if they are part of the patient's current problem list
- Note that some Condition resources may not have these status codes - this is usually due to poor record keeping reflected in legacy data
- Servers SHOULD avoid leaving these status codes missing
- Clients SHALL pay attention to the
clinicalStatusandverificationStatusand display and process them correctly- Clients SHALL still work safely when the server does not support all the search parameters listed here.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | patient | reference | The client SHALL provide at least a id value and MAY provide both the Type and id values. The server SHALL support both. |
| MAY | category | token | The category of the condition |
| MAY | clinical-status | token | The clinical status of the condition |
| MAY | verification-status | token | The verification status of the condition |
| MAY | code | token | Code for the condition |
| MAY | onset-date | date | Date of onset for the condition |
| Conformance | Parameters | Types |
|---|---|---|
| SHOULD | patient+clinical-status | reference+token |
| SHOULD | patient+category | reference+token |
| SHOULD | patient+category+clinical-status | reference+token+token |
| SHOULD | patient+code | reference+token |
| SHOULD | patient+onset-date | reference+date |
resolvesread, search-type.| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | |
| SHALL | patient | reference | The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both. |
| MAY | category | token | Categorization of document |
| MAY | contenttype | token | Mime type of the content, may include charset |
| MAY | date | date | When this document reference was created |
| MAY | period | date | Time of service that is being documented |
| MAY | status | token | current | superseded | entered-in-error |
| MAY | type | token | Kind of document (LOINC if possible) |
| Conformance | Parameters | Types |
|---|---|---|
| SHALL | patient+category | reference+token |
| SHALL | patient+category+date | reference+token+date |
| SHALL | patient+type | reference+token |
| SHOULD | patient+contenttype | reference+token |
| SHOULD | patient+status | reference+token |
| SHOULD | patient+type+date | reference+token+date |
| SHOULD | patient+type+period | reference+token+date |
| Conformance | Operation | Documentation |
|---|---|---|
| SHALL | $docref | A server SHOULD be capable of responding to a $docref operation and capable of returning at least a reference to a CDA document, if available. MAY provide references to other 'on-demand' and 'stable' documents (or 'delayed/deferred assembly') that meet the query parameters as well. If a context date range is supplied the server ** SHOULD** provide references to any document that falls within the date range If no date range is supplied, then the server SHALL provide references to last or current encounter. SHOULD document what resources, if any, are returned as included resources
|
resolvesread, search-type.resolvesread.The MedicationStatement and MedicationRequest resources can represent a medication, using an external reference to a Medication resource. If an external Medication Resource is used in a MedicationStatement or a MedicationRequest, then the READ and SEARCH Criteria SHALL be supported.
resolvesread, search-type.Clients SHALL query for both MedicationStatement and MedicationRequest when fetching patient Medication information.
The MedicationRequest resources can represent a medication using either a code or refer to the Medication resource. When referencing Medication, the resource may be contained or an external resource. The server application MAY choose any one way or more than one method, but if an external reference to Medication is used, the server SHALL support the
_includeparameter for searching this element. The client application SHALL support all methods. For example, A server SHALL be capable of returning all medications for a patient using one of or both:
GET /MedicationStatement?patient=[id]
GET /MedicationStatement?patient=[id]&_include=MedicationStatement:medicationWhen representing a prescribed medication, servers SHOULD use codings at the level of a clinical drug rather than ingredient or dose form (e.g. "loratadine 10mg oral tablet", rather than a bare ingredient like "loratadine" or a dose form like "loratadine oral tablet").
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | patient | reference | The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both. |
| SHOULD | category | token | Returns prescriptions with different categories |
| SHOULD | code | token | Return prescriptions of this medication code |
| MAY | authoredon | date | Returns prescriptions written on this date |
| MAY | intent | token | Return prescriptions with this encounter identifier |
| MAY | status | token | Status of the prescription |
resolvesread, search-type.Clients SHALL query for both MedicationStatement and MedicationRequest when fetching patient Medication information.
The MedicationRequest resources can represent a medication using either a code or refer to the Medication resource. When referencing Medication, the resource may be contained or an external resource. The server application MAY choose any one way or more than one method, but if an external reference to Medication is used, the server SHALL support the
_includeparameter for searching this element. The client application SHALL support all methods.
resolvesread, search-type.| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| MAY | category | token | The classification of the type of observation |
| MAY | code | token | The code of the observation type |
| MAY | date | date | Obtained date/time. If the obtained element is a period, a date that falls in the period |
| MAY | status | token | The status of the observation |
| MAY | patient | reference | The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both. |
resolvesread, search-type.Servers SHALL support the capability for a client application to access the patient record using any of the following API calls:
GET [url]/Patient/[id]
GET [url]/Patient?_id=[id]
GET [url]/Patient?identifier=[identifier]Servers are not required to support any additional search parameters, and clients SHOULD not expect servers to do so.
Additional rules and guidance for supporting
Patient.link:
- The server:
- SHALL have no more than one Patient with a status of active = "true" from the server being queried
- MAY include inactive patients on the same server
- MAY include inactive or active patients from a different server
- When returning a search Bundle that contains more than one Patient record for the same patient, the Patient record(s) SHALL use the
Patient.linkattribute to cross-link the Patient resources.- The client:
- SHALL be able to follow the link(s) to the other Patient resource(s) and understand the direction of the link (in other words, which Patient is linked to which other Patient)
- SHALL understand the
Patient.link.typecode which defines the type of link between this Patient resource and another Patient resource- SHALL be aware of the linked Patient
activeflag and that inactive patients may have relevant information
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | |
| SHALL | identifier | token | The client SHALL provide both the system and code values. The server SHALL NOT support only code values. |
| SHOULD | birthdate | date | A client SHALL provide a value precise to the day. A server SHALL support a value a value precise to the day. |
| SHOULD | family | string | |
| SHOULD | gender | token | The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both. |
| SHOULD | given | string | |
| SHOULD | name | string |
resolvesread.resolvesread.
IG © 2022+ HL7 International - Patient Care Work Group. Package hl7.fhir.uv.ipa#1.0.0 based on FHIR 4.0.1. Generated 2023-03-26
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