The Founda Health Platform supports exchanging clinical documents as described in the IHE (Integrating the Healthcare Enterprise) Mobile Access to Health Documents (MHD) Profile.
The MHD Profile defines one pair of actors and a transaction to submit or push new “document entries” from the mobile device to a receiving system. Another set of actors and transactions is used to query a list of “document entries” having specific metadata, and to retrieve a document. To support this profile we have integrated the following 4 ITI-transactions inside our platform:
ITI-65: Provide Document Bundle (Upload a document)
ITI-66: Find Document List (Find submission sets/folders of document (sets))
The Founda Health Platform supports MHD to MHD and MHD to XDS/XCA transactions. MHD to MHD transactions will query for data in backbones that use the FHIR specification, while MHD to XDS/XCA queries the data stored in Cross-Enterprise Document Sharing (XDS) or Cross Community Access (XCA) backends.
Upload documents (ITI-65)
Uploading documents on the Founda Health Platform is based on the Provide Document Bundle [ITI-65] transaction, which allows healthcare applications to send documents to a (target) Provider Organization.
Request
Send a POST request to endpoint https://api.eu.founda.com/1/health/organizations/{organizationId}/fhir/4/. All document types are supported by creating a resource and including the base64 encoded data in the data field. The whole payload should be a FHIR4 Bundle resource with type transaction.
An example submissionset Bundle payload with minimal metadata:
The payload is a FHIR4 Bundle resource of type transaction-response.
Payload
Each entry of the response Bundle contains an OperationOutcome resource indicating the result of processing each Bundle entry provided with the request.
Bundle.entry.response.status will be 201 to indicate the Resource has been created.
Status code: 200
Find submissionsets or folders (ITI-66)
This endpoint is used to locate and return metadata for previously stored document submission sets or folders. The endpoint is located on our FHIR4 List endpoint. The Founda platform supports this part of the functionality as pointed out in ITI-66 transaction.
Request
Send a GET request to endpoint https://api.eu.founda.com/1/health/organizations/{organizationId}/fhir/4/List.
The following query parameters are supported:
Property
Type
Required
Format
Allowed values
patient
string
x [1]
patient.identifier
string
x[1]
token
code
string
x
token
submissionset, folder
status
string
x
token
current, superseded
date
string
date
designationType
string
token
identifier
string
token
source.given
string
source.family
string
sourceId
string
token
[1] Either patient or patient.identifier should be provided.
Response
If the request is processed successfully, whether or not any FHIR List Resources are found, the HTTP status code shall be 200. The response message is a FHIR Bundle Resource with type searchset, containing zero or more List Resources.
Status code: 200
Payload: FHIR Bundle
An example response:
JSON
|
{"link":[{"relation":"self","url":"https://api.eu.founda.com/1/health/organizations/org-x/fhir/4/List?patient=466050&status=current"}],"entry":[{"resource":{"subject":{"reference":"Patient/466050"},"encounter":{"reference":"Encounter/466101"},"meta":{"tag":[{"code":"HTEST","display":"test health data","system":"http://terminology.hl7.org/CodeSystem/v3-ActReason"}],"source":"#E9pZKf4ownVxJ3BA","versionId":"1"},"identifier":[{"system":"urn:uuid:a9fcea7c-fcdf-4d17-a5e0-f26dda030b59","value":"23974652"}],"entry":[{"flag":{"text":"Deleted due to error"},"deleted":true},{"flag":{"text":"Added"}}],"resourceType":"List","status":"current","mode":"changes","id":"466102"},"search":{"mode":"match"},"fullUrl":"https://api.founda.com/1/health/organizations/<Healthcare_Organisation>/fhir/4/List/466102"}],"type":"searchset","total":1,"resourceType":"Bundle"}
Status code: 404
An example response:
JSON
|
{"resourceType":"OperationOutcome","issue":[{"severity":"error","code":"not-found","diagnostics":"Resource could not be found"}]}
Finding document metadata (ITI-67)
As stated in ITI transaction 67, this operation will get all metadata related to zero or more documents. The response contains a Bundle of FHIR4 DocumentReferences. A FHIR4 DocumentReference resource is used to index a document, clinical note, and other binary objects to make them available to a healthcare system.
Request
Send a GET request to endpoint https://api.eu.founda.com/1/health/organizations/{organizationId}/fhir/4/DocumentReference.
The following query parameters are supported:
Property
Type
Required
Format
Allowed values
Note
patient
string
x [1]
patient.identifier
string
x [1]
token
status
string
x
token
current, superseded
author.given
string
author.family
string
category
string
token
creation
string
dateTime
Specifies a search against the creation time of the attachment
event
string
token
facility
string
token
format
string
token
identifier
string
token
period
string
date
security-label
string
token
setting
string
token
type
string
token
[1] Either patient or patient.identifier should be provided.
Response
If the request is processed successfully the HTTP status code shall be 200. The response message is a FHIR4 Bundle Resource with type searchset, containing zero or more DocumentReference Resources.
The location to the downloadable content can be found in DocumentReference.content.attachment.url. This url is encrypted and only works for a certain Provider Organization.
Status code: 200
An example response:
JSON
|
{"link":[{"relation":"self","url":"https://api.eu.founda.com/1/health/organizations/org-x/fhir/4/DocumentReference"}],"entry":[{"resource":{"masterIdentifier":{"system":"urn:ietf:rfc:3986","value":"urn:oid:1.3.6.1.4.1.21367.2005.3.7"},"type":{"coding":[{"code":"34108-1","display":"Outpatient Note","system":"http://loinc.org"}]},"subject":{"reference":"Patient/285871"},"authenticator":{"reference":"Organization/285780"},"custodian":{"reference":"Organization/285780"},"context":{},"meta":{"tag":[{"code":"HTEST","display":"test health data","system":"http://terminology.hl7.org/CodeSystem/v3-ActReason"}],"source":"#B7fc7bpVGs69hlfC","versionId":"1"},"identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"}],"category":[{"coding":[{"code":"History and Physical","display":"History and Physical","system":"http://ihe.net/xds/connectathon/classCodes"}]}],"author":[{"reference":"Practitioner/285892"},{"reference":"#a2"}],"securityLabel":[{"coding":[{"code":"V","display":"very restricted","system":"http://terminology.hl7.org/CodeSystem/v3-Confidentiality"}]}],"content":[{"attachment":{"contentType":"application/hl7-v3+xml","hash":"2jmj7l5rSw0yVb/vlWAYkK/YBwk=","language":"en-US","size":3654,"title":"Physical","url":"https://api.test.founda.com/1/health/organizations/<Healthcare_Organisation>/mhd/documents/mjxJoWA87f0mJl%2B1ztHqa2z%2BC2eiN4i5ADBjM7csSvY%3D%2Cy01PyeBz0sArK%2BIj0%2F9Uhg%3D%3D%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"},"format":{"code":"urn:ihe:pcc:handp:2008","display":"History and Physical Specification","system":"urn:oid:1.3.6.1.4.1.19376.1.2.3"}}],"resourceType":"DocumentReference","status":"current","docStatus":"preliminary","date":"2005-12-24T09:43:41+11:00","description":"Physical","id":"285919"},"search":{"mode":"match"},"fullUrl":"https://api.eu.founda.com/1/health/organizations/org-x/fhir/4/DocumentReference/285919"}],"type":"searchset","total":1,"resourceType":"Bundle"}
Download document (ITI-68)
In order to download from a Document trough the Founda Health Platform, a URL is needed from ‘Retrieve document metadata’ transaction. This endpoint will stream the document to the Application.
Request
Send a GET request to endpoint https://api.eu.founda.com/1/health/organizations/{organizationId}/mhd/documents/{encrypted_metadata}. The encrypted_metadata part of the url is generated by Founda and contains metadata for downloading the document.
