DocumentReference

Overview

The DocumentReference resource is used to reference a clinical document for a patient within the health system. This resource supports reading Continuity of Care Documents (CCD), returning a list of clinical documents, and a reference to retrieve a document as a PDF. When retrieving document links and metadata, this resource will refer to the Binary resource for downloading the complete document.

Additionally, this resource supports writing and updating documents. For fields supported on write or update operations, see the Create and Update sections of this page.

The following HL7® FHIR® US Core Implementation Guide STU 4.0.0 Profiles are supported by this resource:

The following fields are returned if valued for clinical documents:

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Terminology Bindings

DocumentReference.status
  • Description
    • The status of the document reference.
  • Details: DocumentReference status
    System: http://hl7.org/fhir/document-reference-status

DocumentReference.docStatus
  • Description
    • Status of the underlying document.
  • Details: DocumentReference docStatus
    System: http://hl7.org/fhir/r4/codesystem-composition-status.html

DocumentReference.type
DocumentReference.category

Search for DocumentReferences that meet supplied query parameters:

GET /DocumentReference?:parameters

Authorization Types

Parameters

Name Required? Type Description
_id Conditionally token The logical resource id associated with the resource. This parameter is required if the patient parameter is not used. Example: 12345
patient Conditionally reference The specific patient to return Document(s) for. This parameter is required if the _id parameter is not used. Example: 12345
encounter No reference The Encounter(s) in which the document was created. Example: 12345
type No token The type of document. May be a list separated by commas. Example: http://loinc.org|11488-4
_count No number The maximum number of results to return. Defaults to 10 and maximum 100 documents can be returned.
category No token The categorization of document. Example: http://loinc.org|11488-4
_revinclude No token Provenance resource entries to be returned as part of the bundle. Example: _revinclude=Provenance:target
date No date When this document reference was created. Example: date=ge2020-01-01T08:00:00.000Z&date=le2020-01-31T17:00:00.000Z
period No date Time of service that is being documented. Example: period=ge2017-01-01&period=lt2017-01-05
_lastUpdated No date Date range in which the document was last updated. Either 1 or 2 date/times can be given. Example: _lastUpdated=gt2014-09-24 or _lastUpdated=lt2015-09-24T12:00:00.000Z

Implementation Notes

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "271fc608-6a12-48f3-a9f8-2d1bfe395328",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381924",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381924",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: Model, User 154 Cerner</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "author": [
          {
            "reference": "Practitioner/11638428",
            "display": "Model, User 154 Cerner"
          }
        ],
        "authenticator": {
          "reference": "Practitioner/11638428",
          "display": "Model, User 154 Cerner"
        },
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381926",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381926",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381926-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381926",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    },
    {
      "resourceType": "DocumentReference",
      "id": "201318478",
      "meta": {
        "versionId": "1",
        "lastUpdated": "2022-12-08T08: 26: 36.000Z"
      },
      "text": {
        "status": "generated",
        "div": "<div xmlns='http: //www.w3.org/1999/xhtml'><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Admission Note Physician</p><p><b>Service Start Date</b>: Dec  7, 2022  6:51 A.M. UTC</p><p><b>Service End Date</b>: Dec  7, 2022  6:51 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: SYSTEM, SYSTEM Cerner</p></div>"
      },
      "identifier": [
        {
          "system": "https: //fhir.cerner.com/ceuuid",
          "value": "CE87caf4b7-9397-4667-9897-702218017c9e-201318478-2022120808263700"
        }
      ],
      "status": "current",
      "docStatus": "final",
      "type": {
        "coding": [
          {
            "system": "https: //fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
            "code": "2820507",
            "display": "Admission Note Physician",
            "userSelected": true
          },
          {
            "system": "http: //loinc.org",
            "code": "83805-2",
            "display": "Physician Admission evaluation note",
            "userSelected": false
          }
        ],
        "text": "Admission Note Physician"
      },
      "category": [
        {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "LP29684-5",
              "display": "Radiology",
              "userSelected": false
            }
          ],
          "text": "Radiology"
        },
        {
          "coding": [
            {
              "system": "http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category",
              "code": "clinical-note",
              "display": "Clinical Note",
              "userSelected": false
            }
          ],
          "text": "Clinical Note"
        }
      ],
      "subject": {
        "reference": "Patient/12769853",
        "display": "GETEST, PatientOneHundredSixtySix"
      },
      "date": "2022-12-08T08: 26: 36Z",
      "author": [
        {
          "reference": "Practitioner/1",
          "display": "SYSTEM, SYSTEM Cerner"
        }
      ],
      "authenticator": {
        "reference": "Practitioner/1",
        "display": "SYSTEM, SYSTEM Cerner"
      },
      "content": [
        {
          "attachment": {
            "contentType": "application/xhtml+xml",
            "url": "https: //fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/R-201318478",
            "creation": "2022-12-07T06: 51: 22.000Z"
          },
          "format": {
            "system": "http: //ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
            "code": "urn:ihe:iti:xds: 2017:mimeTypeSufficient",
            "display": "mimeType Sufficient"
          }
        },
        {
          "attachment": {
            "contentType": "application/xml",
            "url": "https: //fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XML-201318478",
            "creation": "2022-12-07T06: 51: 22.000Z"
          },
          "format": {
            "system": "http: //ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
            "code": "urn:ihe:iti:xds: 2017:mimeTypeSufficient",
            "display": "mimeType Sufficient"
          }
        }
      ],
      "context": {
        "period": {
          "start": "2022-12-07T06: 51: 22Z",
          "end": "2022-12-07T06: 51: 22Z"
        },
        "related": [
          {
            "reference": "DiagnosticReport/201318478"
          }
        ]
      }
    }
  ]
}

Example with Nil Status Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "271fc608-6a12-48f3-a9f8-2d1bfe395328",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381924",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381924",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: Model, User 154 Cerner</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "author": [
          {
            "reference": "Practitioner/11638428",
            "display": "Model, User 154 Cerner"
          }
        ],
        "authenticator": {
          "reference": "Practitioner/11638428",
          "display": "Model, User 154 Cerner"
        },
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381926",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381926",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381926-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381926",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    },
    {
      "fullUrl": "urn:uuid:98ae7843-46b7-4792-8613-a0b9cf196b27",
      "resource": {
        "resourceType": "OperationOutcome",
        "issue": [
          {
            "severity": "warning",
            "code": "suppressed",
            "diagnostics": "Other search results were found but could not be compliantly expressed and hence have been suppressed"
          }
        ]
      },
      "search": {
        "mode": "outcome"
      }
    }
  ]
}

Example with RevInclude

Authorization Types

Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?_id=198449751&_revinclude=Provenance:target

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "e6af8dd8-78e2-4e9e-b04c-760b76128426",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?_id=198449751&_revinclude=Provenance%3Atarget"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198449751",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198449751",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-15T07:45:48.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: SMART, WILMA</p><p><b>Document Type</b>: Height Weight Allergy Rule - Text</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: Clinical Note</p><p><b>Service Start Date</b>: Jul 15, 2022  1:15 P.M. UTC</p><p><b>Service End Date</b>: Jul 15, 2022  1:15 P.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: Allen, Jodi</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198449751-2022071507454800"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "20732501",
              "display": "Height Weight Allergy Rule - Text",
              "userSelected": true
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Height Weight Allergy Rule - Text"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12724065",
          "display": "SMART, WILMA"
        },
        "date": "2022-07-15T07:45:48Z",
        "author": [
          {
            "reference": "Practitioner/12743472",
            "display": "Allen, Jodi"
          }
        ],
        "authenticator": {
          "reference": "Practitioner/12743472",
          "display": "Allen, Jodi"
        },
        "content": [
          {
            "attachment": {
              "contentType": "text/plain",
              "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/R-198449751",
              "title": "Clinical Note",
              "creation": "2022-07-15T13:15:46.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97953483"
            }
          ],
          "period": {
            "start": "2022-07-15T13:15:46.000Z",
            "end": "2022-07-15T13:15:46.000Z"
          }
        }
      },
      "search": {
        "mode": "match"
      }
    },
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Provenance/INT.doc-198449751",
      "resource": {
        "resourceType": "Provenance",
        "id": "INT.doc-198449751",
        "meta": {
          "versionId": "198449751",
          "lastUpdated": "2022-07-15T07:45:48Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Provenance</b></p><p><b>Target</b>:</p><ul><li>DocumentReference/198449751</li></ul><p><b>Recorded</b>: Jul 15, 2022  7:45 A.M. UTC</p><p><b>Agents</b>:</p><dl><dt>Allen, Jodi</dt><dd><b>Agent Type</b>: Author</dd><dd><b>Agent Role</b>: Source</dd><dt>Model Cancer Center</dt><dd><b>Agent Type</b>: Author</dd><dd><b>Agent Role</b>: Source</dd></dl></div>"
        },
        "target": [
          {
            "reference": "DocumentReference/198449751"
          }
        ],
        "recorded": "2022-07-15T07:45:48Z",
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                  "code": "author"
                }
              ],
              "text": "Author"
            },
            "role": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
                    "code": "SOURCE"
                  }
                ],
                "text": "Source"
              }
            ],
            "who": {
              "reference": "Practitioner/12743472",
              "display": "Allen, Jodi"
            }
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                  "code": "author"
                }
              ],
              "text": "Author"
            },
            "role": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
                    "code": "SOURCE"
                  }
                ],
                "text": "Source"
              }
            ],
            "who": {
              "reference": "Organization/1024451",
              "display": "Model Cancer Center"
            }
          }
        ]
      },
      "search": {
        "mode": "include"
      }
    }
  ]
}

Example: search by encounter filters patients level documents

Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853&encounter=97966172

Response

Status: 200 OK
{
  "resourceType": "DocumentReference",
  "id": "198381924",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2022-07-07T09:43:56.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: M., User 154 Cerner</p></div>"
  },
  "identifier": [
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
    }
  ],
  "status": "current",
  "docStatus": "final",
  "type": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2574499721",
        "display": "Waveform Strip"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code": "UNK",
        "display": "unknown"
      }
    ],
    "text": "Waveform Strip"
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
          "code": "unknown",
          "display": "Unknown"
        }
      ],
      "text": "Unknown"
    }
  ],
  "subject": {
    "reference": "Patient/12769853",
    "display": "GETEST, PatientOneHundredSixtySix"
  },
  "date": "2022-07-07T09:43:56Z",
  "author": [
    {
      "reference": "Practitioner/11638428",
      "display": "M., User 154 Cerner"
    }
  ],
  "authenticator": {
    "reference": "Practitioner/11638428",
    "display": "M., User 154 Cerner"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "url": "https://fhir-ehr.devcerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
        "title": "test1",
        "creation": "2022-07-07T09:43:56.000Z"
      },
      "format": {
        "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
        "code": "unknown",
        "display": "Unknown"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/97966172"
      }
    ],
    "period": {
      "start": "2022-07-07T09:43:56.000Z",
      "end": "2022-07-07T09:43:56.000Z"
    }
  }
}

Patient Authorization Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "74e2c51e-96af-4f95-abd1-bbbe566e386b",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference?patient=12769853"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381924",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381924",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: M., User 154 Cerner</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip"
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "author": [
          {
            "reference": "Practitioner/11638428",
            "display": "M., User 154 Cerner"
          }
        ],
        "authenticator": {
          "reference": "Practitioner/11638428",
          "display": "M., User 154 Cerner"
        },
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    },
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381926",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "198381926",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2022-07-07T09:43:56.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p></div>"
        },
        "identifier": [
          {
            "system": "https://fhir.cerner.com/ceuuid",
            "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381926-2022070709435600"
          }
        ],
        "status": "current",
        "docStatus": "final",
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2574499721",
              "display": "Waveform Strip"
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code": "UNK",
              "display": "unknown"
            }
          ],
          "text": "Waveform Strip"
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                "code": "unknown",
                "display": "Unknown"
              }
            ],
            "text": "Unknown"
          }
        ],
        "subject": {
          "reference": "Patient/12769853",
          "display": "GETEST, PatientOneHundredSixtySix"
        },
        "date": "2022-07-07T09:43:56Z",
        "content": [
          {
            "attachment": {
              "contentType": "application/pdf",
              "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381926",
              "title": "test1",
              "creation": "2022-07-07T09:43:56.000Z"
            },
            "format": {
              "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
              "code": "unknown",
              "display": "Unknown"
            }
          }
        ],
        "context": {
          "encounter": [
            {
              "reference": "Encounter/97966172"
            }
          ],
          "period": {
            "start": "2022-07-07T09:43:56.000Z",
            "end": "2022-07-07T09:43:56.000Z"
          }
        }
      }
    }
  ]
}

Retrieve by id

List an individual DocumentReference by its id:

GET /DocumentReference/:id

Authorization Types

Implementation Notes

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381924

Response

Status: 200 OK
{
  "resourceType": "DocumentReference",
  "id": "198381924",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2022-07-07T09:43:56.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: Model, User 154 Cerner</p></div>"
  },
  "identifier": [
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
    }
  ],
  "status": "current",
  "docStatus": "final",
  "type": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2574499721",
        "display": "Waveform Strip",
        "userSelected": true
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code": "UNK",
        "display": "unknown"
      }
    ],
    "text": "Waveform Strip"
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
          "code": "unknown",
          "display": "Unknown"
        }
      ],
      "text": "Unknown"
    }
  ],
  "subject": {
    "reference": "Patient/12769853",
    "display": "GETEST, PatientOneHundredSixtySix"
  },
  "date": "2022-07-07T09:43:56Z",
  "author": [
    {
      "reference": "Practitioner/11638428",
      "display": "Model, User 154 Cerner"
    }
  ],
  "authenticator": {
    "reference": "Practitioner/11638428",
    "display": "Model, User 154 Cerner"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
        "title": "test1",
        "creation": "2022-07-07T09:43:56.000Z"
      },
      "format": {
        "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
        "code": "unknown",
        "display": "Unknown"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/97966172"
      }
    ],
    "period": {
      "start": "2022-07-07T09:43:56.000Z",
      "end": "2022-07-07T09:43:56.000Z"
    }
  }
}

Example with Nil Status Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/206098371

Response

Status: 200 OK
{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "not-found",
      "details": {
        "text": "Resource not found"
      }
    }
  ]
}

Patient Authorization Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/198381924

Response

Status: 200 OK
{
  "resourceType": "DocumentReference",
  "id": "198381924",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2022-07-07T09:43:56.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Document Reference</b></p><p><b>Patient Name</b>: GETEST, PatientOneHundredSixtySix</p><p><b>Document Type</b>: Waveform Strip</p><p><b>Document Category</b>: Unknown</p><p><b>Document Title</b>: test1</p><p><b>Service Start Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Service End Date</b>: Jul  7, 2022  9:43 A.M. UTC</p><p><b>Document Status</b>: Final</p><p><b>Verifying Provider</b>: M., User 154 Cerner</p></div>"
  },
  "identifier": [
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CE87caf4b7-9397-4667-9897-702218017c9e-198381924-2022070709435600"
    }
  ],
  "status": "current",
  "docStatus": "final",
  "type": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2574499721",
        "display": "Waveform Strip"
      },
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code": "UNK",
        "display": "unknown"
      }
    ],
    "text": "Waveform Strip"
  },
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
          "code": "unknown",
          "display": "Unknown"
        }
      ],
      "text": "Unknown"
    }
  ],
  "subject": {
    "reference": "Patient/12769853",
    "display": "GETEST, PatientOneHundredSixtySix"
  },
  "date": "2022-07-07T09:43:56Z",
  "author": [
    {
      "reference": "Practitioner/11638428",
      "display": "M., User 154 Cerner"
    }
  ],
  "authenticator": {
    "reference": "Practitioner/11638428",
    "display": "M., User 154 Cerner"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/XR-198381924",
        "title": "test1",
        "creation": "2022-07-07T09:43:56.000Z"
      },
      "format": {
        "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
        "code": "unknown",
        "display": "Unknown"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/97966172"
      }
    ],
    "period": {
      "start": "2022-07-07T09:43:56.000Z",
      "end": "2022-07-07T09:43:56.000Z"
    }
  }
}

Create

Create a new document reference:

POST /DocumentReference

Implementation Notes

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json

Body Fields

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • {
        "resourceType": "DocumentReference"
      }
      
  • Notes
    • resourceType must be DocumentReference.
status Yes code
  • Description
    • The status of this document reference.
  • Example
    • {
        "status": "current"
      }
      
  • Notes
    • Only current is supported.
docStatus Yes code
  • Description
    • The status of the underlying document.
  • Example
    • {
        "docStatus": "final"
      }
      
  • Notes
    • Only final is supported for provider access. final and amended are supported for system access.
type Yes CodeableConcept
  • Description
    • Specifies the particular kind of document referenced.
  • Example
    • {
        "type": {
          "coding": [
            {
              'system': 'https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72',
              'code': '2820507',
              'display': 'Admission Note Physician',
              'userSelected': true
            }
          ],
          'text': 'Admission Note Physician'
        }
      }
      
  • Notes
    • The type must include a LOINC or a proprietary coding but not both together. Multiple LOINC codings or a single proprietary coding can be provided.

      When providing proprietary code system, it should be of format 'https://fhir.cerner.com/<your EHR source id>/codeSet/<code set>' (where code set is Millennium codeset 72). Example: 'https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72'.

subject Yes Reference
  • Description
    • Who the document is about.
  • Example
    • {
        "subject": {
          "reference": "Patient/12457977"
        }
      }
      
  • Notes
    • Only patient references are supported.
author Yes Reference
  • Description
    • Identifies who is responsible for adding the information to the document.
  • Example
    • {
        "author": [
          {
            "reference": "Practitioner/3332064"
          }
        ]
      }
      
  • Notes
    • Must contain only Practitioner references with valid millennium ids. Optional for system access. For provider access, only a single author can be provided, and it must be the authorized provider.
authenticator No Reference
  • Description
    • Which person authenticates that this document is valid.
  • Example
    • {
        "authenticator": {
          "reference": "Practitioner/3332064"
        }
      }
      
  • Notes
    • If set, must be a Practitioner reference with valid millennium id. Only supported with system access. Cannot be populated for provider access.
content Yes BackboneElement
  • Description
    • The document and format referenced.
  • Example
    • {
         "content": [
           {
             "attachment": {
               "contentType": "text/xml;charset=utf-8",
               "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
               "title": "Height Weight Allergy Rule",
               "creation": "2020-07-29T21:02:04.000Z"
             }
           }
         ]
      }
      
  • Notes
    • Must contain only one entry
content.attachment Yes Attachment
  • Description
    • The document or URL of the document along with critical metadata to prove content has integrity.
  • Example
    • {
        "attachment": {
               "contentType": "application/xml;charset=utf-8",
               "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
               "title": "Height Weight Allergy Rule",
               "creation": "2020-07-29T21:02:04.000Z"
             }
      }
      
  • Notes
    • Data and content type must be provided.
content.attachment.contentType Yes Code
  • Description
    • Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes MIME type parameters such as charset where appropriate.
  • Example
    • {
        "contentType": "application/xml;charset=utf-8"
      }
      
  • Notes
    • Must be provided. Content Type must include a supported MIME type and character set. The supported values are `application/pdf`, `text/plain;charset=utf-8`, `text/richtext;charset=utf-8`, `text/rtf;charset=utf-8`, `text/html;charset=utf-8`, `application/xml;charset=utf-8`, and `application/xhtml+xml;charset=utf-8`
content.attachment.data Yes base64Binary
  • Description
    • The actual data of the attachment - a sequence of bytes, base64 encoded.
  • Example
    • {
        "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4="
      }
      
  • Notes
content.attachment.title No Attachment
  • Description
    • A label or set of text to display in place of the data.
  • Example
    • {
        "title": "Height Weight Allergy Rule",
      }
      
content.attachment.creation No dateTime
  • Description
    • The date that the attachment was first created.
  • Example
    • {
        "creation": "2020-07-29T21:02:04.000Z"
      }
      
  • Notes
    • A time component must be provided with the date.
context Yes BackboneElement
  • Description
    • The clinical context in which the document was prepared.
  • Example
    • {
        "encounter": [
           {
             "reference": "Encounter/97987761"
           }
         ],
        "period": {
           "start": "2020-01-01T00:00:00.000Z",
           "end": "2020-01-01T01:00:00.000Z"
        }
      }
      
context.encounter No Reference
  • Description
    • Describes the clinical encounter that the document content is associated with.
  • Example
    • {
        "encounter": [
          {
            "reference": "Encounter/97987761"
          }
        ]
      }
      
  • Notes
    • Only a single encounter reference is supported.
context.period Yes Period
  • Description
    • The time period over which the service that is described by the document was provided.
  • Example
    • {
        "period": {
          "start": "2020-01-01T00:00:00.000Z",
          "end": "2020-01-01T01:00:00.000Z"
        }
      }
      
  • Notes
    • The period.end field is required; the period.start field is optional. All dates require a time component.

Example

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference

Body

{
  "resourceType": "DocumentReference",
  "status": "current",
  "docStatus": "final",
  "type": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2820507",
        "display": "Admission Note Physician",
        "userSelected": true
      }
    ],
    "text": "Admission Note Physician"
  },
  "subject": {
    "reference": "Patient/12457977"
  },
  "author": [
    {
      "reference": "Practitioner/3332064"
    }
  ],
  "authenticator": {
    "reference": "Practitioner/3332064"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/xml;charset=utf-8",
        "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
        "title": "Height Weight Allergy Rule",
        "creation": "2020-07-29T21:02:04.000Z"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/97987761"
      }
    ],
    "period": {
      "start": "2020-01-01T00:00:00.000Z",
      "end": "2020-01-01T01:00:00.000Z"
    }
  }
}

Response

Status: 201 Created
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Fri, 04 Nov 2022 10:15:11 GMT
Etag: W/"1"
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/201051629
Vary: Origin
opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
X-Request-Id: 11111111-1111-1111-1111-111111111111

Update

Update an existing document reference:

PUT /DocumentReference/:id

Authorization Types

Implementation Notes

Headers

Authorization: <OAuth2 Bearer Token>
Accept: application/json+fhir
Content-Type: application/fhir+json
If-Match: W/"<Current version of the DocumentReference resource>"

Body fields

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • {
        "resourceType": "DocumentReference"
      }
      
  • Notes
    • resourceType must be DocumentReference.
status Yes code
  • Description
    • The status of this document reference.
  • Example
    • {
        "status": "entered-in-error"
      }
      
  • Notes
    • Both current and entered-in-error are supported. If either status or docStatus are updated to "entered-in-error", the document will be treated as a document that was entered in error, regardless of the values of the other fields.
docStatus Yes code
  • Description
    • The status of the underlying document.
  • Example
    • {
        "docStatus": "amended"
      }
      
  • Notes
    • Allowed values for docStatus are: final, amended, and entered-in-error. If either status or docStatus are updated to "entered-in-error", the document will be treated as a document that was entered in error, regardless of the values of the other fields.
type ‘Yes’ CodeableConcept
  • Description
    • Specifies the particular kind of document referenced.
  • Example
    • {
        "type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
              "code": "2820507",
              "display": "Admission Note-Physician",
              "userSelected": true
            }
          ]
        }
      }
      
  • Notes
    • The type must include a LOINC or a proprietary coding but not both together. Multiple LOINC codings or a single proprietary coding can be provided.

      When providing proprietary code system, it should be of format 'https://fhir.cerner.com/<your EHR source id>/codeSet/<code set>' (where code set is Millennium code set 72). Example: 'https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72'.

subject Yes Reference
  • Description
    • Who the document is about.
  • Example
    • {
        "subject": {
          "reference": "Patient/12457977"
        }
      }
      
  • Notes
    • The patient has to match the original document.
author Yes Reference
  • Description
    • Identifies who is responsible for adding the information to the document.
  • Example
    • {
        "author": [
          {
            "reference": "Practitioner/3332064"
          }
        ]
      }
      
  • Notes
    • Must contain only Practitioner references with valid millennium ids. Optional for system access. For provider access, only a single author can be provided, and it must be the authorized provider.
authenticator No Reference
  • Description
    • Which person authenticates that this document is valid.
  • Example
    • {
        "authenticator": {
          "reference": "Practitioner/3332064"
        }
      }
      
  • Notes
    • If set, must be a Practitioner reference with valid millennium id. Only supported with system access. Cannot be populated for provider access.
content Yes BackboneElement
  • Description
    • The document and format referenced.
  • Example
    • {
         "content": [
           {
             "attachment": {
               "contentType": "application/xml;charset=utf-8",
               "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
               "title": "Height Weight Allergy Rule",
               "creation": "2020-07-29T21:02:04.000Z"
             }
           }
         ]
      }
      
  • Notes
    • Must contain only one entry
content.attachment Yes Attachment
  • Description
    • The document or URL of the document along with critical metadata to prove content has integrity.
  • Example
    • {
        "attachment": {
               "contentType": "application/xml;charset=utf-8",
               "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
               "title": "Height Weight Allergy Rule",
               "creation": "2020-07-29T21:02:04.000Z"
             }
      }
      
  • Notes
    • Data and content type must be provided.
content.attachment.contentType Yes Code
  • Description
    • Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes MIME type parameters such as charset where appropriate.
  • Example
    • {
        "contentType": "application/xml;charset=utf-8"
      }
      
  • Notes
    • Must be provided. Content Type must include a supported MIME type and character set. The supported values are `application/pdf`, `text/rtf;charset=utf-8`, `text/html;charset=utf-8`, `application/xml;charset=utf-8`, and `application/xhtml+xml;charset=utf-8`
content.attachment.data Yes base64Binary
  • Description
    • The actual data of the attachment - a sequence of bytes, base64 encoded.
  • Example
    • {
        "data": "PGh0bWw+Cjx0aXRsZT4gVGVzdCBEb2N1bWVudCA8L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4="
      }
      
  • Notes
content.attachment.title No Attachment
  • Description
    • A label or set of text to display in place of the data.
  • Example
    • {
        "title": "Height Weight Allergy Rule"
      }
      
content.attachment.creation No dateTime
  • Description
    • The date that the attachment was first created.
  • Example
    • {
        "creation": "2020-07-29T21:02:04.000Z"
      }
      
  • Notes
    • A time component must be provided with the date. The new date must not be earlier than the previous content.attachment.creation date.
context Yes BackboneElement
  • Description
    • The clinical context in which the document was prepared.
  • Example
    • {
        "encounter": [
           {
             "reference": "Encounter/97987761"
           }
         ],
        "period": {
          "start": "2020-01-01T00:00:00.000Z",
          "end": "2020-01-01T01:00:00.000Z"
        }
      }
      
context.encounter No Reference
  • Description
    • Describes the clinical encounter that the document content is associated with.
  • Example
    • {
        "encounter": [
          {
            "reference": "Encounter/97987761"
          }
        ]
      }
      
  • Notes
    • The encounter has to match the original document encounter.
context.period Yes Period
  • Description
    • The time period over which the service that is described by the document was provided.
  • Example
    • {
        "period": {
          "start": "2020-01-01T00:00:00.000Z",
          "end": "2020-01-01T01:00:00.000Z"
        }
      }
      
  • Notes
    • The period.end field is required; the period.start field is optional. All dates require a time component.

Example

Request

PUT https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/16885181

Body

{
  "resourceType": "DocumentReference",
  "id": "201051629",
  "status": "entered-in-error",
  "docStatus": "amended",
  "type": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/72",
        "code": "2820507",
        "display": "Admission Note-Physician",
        "userSelected": true
      }
    ]
  },
  "subject": {
    "reference": "Patient/12457977"
  },
  "author": [
    {
      "reference": "Practitioner/3332064"
    }
  ],
  "authenticator": {
    "reference": "Practitioner/3332064"
  },
  "identifier": [
    {
      "system": "https://fhir.cerner.com/ceuuid",
      "value": "CE87caf4b7-9397-4667-9897-702218017c9e-201051629-2022110410151000"
    }
  ],
  "content": [
    {
      "attachment": {
        "contentType": "application/xml;charset=utf-8",
        "data": "PGh08L3RpdGxlPgoKRG9jdW1lbnQgY29udGVudCEKCjwvaHRtbD4=",
        "title": "Height Weight Allergy Rule",
        "creation": "2020-07-29T21:02:04.000Z"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/97987761"
      }
    ],
    "period": {
      "start": "2020-01-01T00:00:00.000Z",
      "end": "2020-01-01T01:00:00.000Z"
    }
  }
}

Response

Status: 200 OK
Cache-Control: no-cache
Content-Length: 0
Content-Type: application/json+fhir
Date: Fri, 04 Nov 2022 11:54:04 GMT
Etag: W/"2"
Last-Modified: Fri, 04 Nov 2022 11:54:04 GMT
Vary: Origin
opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
X-Request-Id: 11111111-1111-1111-1111-111111111111

The ETag response header indicates the current If-Match version to use on subsequent update.

Operation: $docref

US Core operation for querying DocumentReferences for the supplied parameters:

GET /DocumentReference/$docref?:parameters

Terminology Bindings

DocumentReference.type
  • Description
    • Precise type of clinical document.
  • Details: LOINC
    System: http://loinc.org

    • Supported Values
      • 34133-9 - Summary of episode note
DocumentReference.content.format

Authorization Types

Parameters

Name Required? Type Description
patient Yes reference The specific patient to return DocumentReferences for. Example: 12345
type No token The document reference type, can be a list of comma separated values. Example: http://loinc.org\|34133-9
start No number The start of the date range from which document reference records should be included. Example: 2014-09-24T12:00:00.000Z
end No number The end of the date range till which document reference records should be included. Example: 2016-09-24T12:00:00.000Z

Implementation Notes

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/$docref?patient=13160351&type=http%3A%2F%2Floinc.org%7C34133-9

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "2cb9157f-0f05-4fe4-af14-95d5808a4070",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/$docref?patient=13160351"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/b79484c9-1170-44cd-9910-f9013ff2ea1f",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "b79484c9-1170-44cd-9910-f9013ff2ea1f",
        "status": "current",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "34133-9",
              "display": "Summary of episode note"
            }
          ],
          "text": "Summary of episode note"
        },
        "subject": {
          "reference": "Patient/13160351"
        },
        "date": "2020-12-14T08:20:26Z",
        "content": [
          {
            "attachment": {
              "contentType": "application/xml",
              "url": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/$autogen-ccd-if?patient=13160351"
            },
            "format": {
              "system": "urn:oid:1.3.6.1.4.1.19376.1.2.3",
              "code": "urn:hl7-org:sdwg:ccda-structuredBody:2.1",
              "display": "For documents following C-CDA constraints using a structured body."
            }
          }
        ]
      }
    }
  ]
}

Patient Authorization Request

GET https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/$docref?patient=13160351&type=http%3A%2F%2Floinc.org%7C34133-9

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "2cb9157f-0f05-4fe4-af14-95d5808a4070",
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/$docref?patient=13160351"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/DocumentReference/b79484c9-1170-44cd-9910-f9013ff2ea1f",
      "resource": {
        "resourceType": "DocumentReference",
        "id": "b79484c9-1170-44cd-9910-f9013ff2ea1f",
        "status": "current",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "34133-9",
              "display": "Summary of episode note"
            }
          ],
          "text": "Summary of episode note"
        },
        "subject": {
          "reference": "Patient/13160351"
        },
        "date": "2020-12-14T08:20:26Z",
        "content": [
          {
            "attachment": {
              "contentType": "application/xml",
              "url": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/Binary/$autogen-ccd-if?patient=13160351"
            },
            "format": {
              "system": "urn:oid:1.3.6.1.4.1.19376.1.2.3",
              "code": "urn:hl7-org:sdwg:ccda-structuredBody:2.1",
              "display": "For documents following C-CDA constraints using a structured body."
            }
          }
        ]
      }
    }
  ]
}