CarePlan

Overview

For the CarePlan resource query, the API returns the most current charted data applicable to encounter(s) contained by the explicit or implicit date(s) in the query for content configured by the Soarian Clinicals client as relevant to this resource. The ONC (Office of the National Coordinator) CCDS (common clinical data set) definition includes types of data relevant to this resource: Concerns, Goals, Assessments and Plans. Note that concerns may or may not be classified as problems or diagnoses and concerns and goals may be patient and/or caregiver expressed. While conceptually health concerns, goals, planned activities and assessments are four different data sets, in clinical practice they maybe documented as a consolidated thought and an individual query of just one of the data types may result in clinical inaccuracy. Additionally, clients may configure variable amounts of charting. For example, the same clinical scenario might be documented in practice as:

or as

or as

Soarian Clinicals has a robust capability for clients to configure their clinical charting content, format, and structure as appropriate to their practice; therefore, the API response will depend on that configuration. While the resource structure supports specific relationships between data types, that structure cannot be enforced without restricting client practice or risking inaccurate or incomplete information. Therefore to preserve completeness and accuracy per clinically charted content, clients configure the data relevant to this resource and the API will return charted content, not marked as erroneous, for the elements the client has configured. To preserve accuracy and completeness, conceptual data types of Concerns, Goals, Assessments and Plans will all be returned together as a CarePlan response. Data is returned in reverse chronological order by most current charted date for qualifying encounters in the sequence defined in configuration.

Note that this information is documented during and in context of an encounter, may not be actively managed, and may not be consolidated across encounters as a “patient-level” plan. Therefore, this data should be interpreted as a snapshot in time of a point in time. For example, if a patient has an encounter related to injury due to a car accident, there will be a snapshot of this information in context of those injuries. If there is a subsequent encounter related to an illness, there may be a snapshot of this data set related to that illness. If a patient queries for the care plan resource a week after the last encounter, the response will be the latest instance of the last set of this data documented; i.e., the most recent charted version of the illness related data. If the query includes a date range inclusive of both encounters, the response will include the most recent charted version of both the injury and illness data sets. Both data sets will be the most recent data documented for the encounter, not of a specific dated instance, and, since in practice, they may not be actively managed, they may not reflect the current state of goals, concerns and plans; they may represent the initially documented state. For context, the narrative response will provide a charted date to represent to what date context this information is relevant.

Custom Extensions

The bundle extension can be returned, see possible codes in the errors section below.

GET /CarePlan?:parameters

Implementation Notes

Parameters

Name Required? Type Description
patientId Y reference The patient identifier provided in a pre-requisite authorization step.
date N date as adjusted per implementation notes Null or specific date or a date range.

Notes:

Headers

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

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/CarePlan?patientId=D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "cba85764-7528-410d-bf8a-809277dbf649",
  "meta": {
    "lastUpdated": "2017-03-10T14:22:59.287-05:00"
  },
  "extension": [
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi029"
          },
          {
            "url": "Message",
            "valueString": "Information provided is from 2017-02-09 through 2017-03-10 inclusive."
          }
        ]
      }
    },
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi026"
          },
          {
            "url": "Message",
            "valueString": "The information provided is the latest configured data available at the time of charting and may not be reflective of the current clinical state of the care plan. It is the responsibility of the patient or patient representative to confirm care plan status with appropriate care providers."
          }
        ]
      }
    }
  ],
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "base-url/123abc/CarePlan?patientId=D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27&_format=json"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.Assessments.95442.70425'><li>MU3 Assessment123 : <HTML><HEAD><style type='text/css'>BODY,TD,TH,BUTTON,INPUT,SELECT,TEXTAREA{FONT-SIZE: 10pt; FONT-FAMILY: Arial,Helvetica; COLOR: black;} P,DIV,UL,OL,BLOCKQUOTE{MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px;} BODY{MARGIN: 5px;} </style></HEAD><BODY> <p style='MARGIN-BOTTOM: 0px; margin-top: 0px' align='left'> </p><font style='FONT-SIZE: 11pt'> <p style='MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px'>i. The patient was found to have Anemia and Dr Seven and his staff diagnosed the condition and treated Ms Rebecca for Anemia during the 2 day stay at Community Health Hospitals. Ms Rebecca recovered from Anemia during the stay and is being discharged in a stable condition. If there is fever greater than 101.5 F or onset of chest pain/breathlessness the patient is advised to contact emergency. </p></font></BODY></HTML></li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.Assessments.95442.70425"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    },
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.CLX-Goals.95442.70431.value.0'><li>Goal : Decrease Sodium Intake</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.CLX-Goals.95442.70431.value.0"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    },
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.CLX-Goals.95442.70431.value.1'><li>Goal : Maintain Active Lifestyle as Tolerated</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.CLX-Goals.95442.70431.value.1"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    },
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.CLX-Health_Concerns.95442.70432.value.0'><li>Health Concern : Depression</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.CLX-Health_Concerns.95442.70432.value.0"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    },
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.CLX-Health_Concerns.95442.70432.value.1'><li>Health Concern : Diet</li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.CLX-Health_Concerns.95442.70432.value.1"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    },
    {
      "resource": {
        "resourceType": "CarePlan",
        "text": {
          "status": "additional",
          "div": "<ul ccdRefId='Zcombined_NRS03.CLX-Treatment_Plan.95442.70426'><li>Treatment Plan : <HTML><HEAD><style type='text/css'>BODY,TD,TH,BUTTON,INPUT,SELECT,TEXTAREA{FONT-SIZE: 10pt; FONT-FAMILY: Arial,Helvetica; COLOR: black;} P,DIV,UL,OL,BLOCKQUOTE{MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px;} BODY{MARGIN: 5px;} </style></HEAD><BODY> <p style='MARGIN-BOTTOM: 0px; margin-top: 0px' align='left'> </p><font style='FONT-SIZE: 11pt'> <p style='MARGIN-BOTTOM: 0px; MARGIN-TOP: 0px'>i. Schedule an appointment with Dr Seven after 1 week for Follow up with Outpatient facility for Immunosuppressive therapy. </p></font></BODY></HTML></li></ul>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "Zcombined_NRS03.CLX-Treatment_Plan.95442.70426"
          }
        ],
        "subject": {
          "reference": "Patient/D4292B7B-AEDF-4CEF-B783-BD3AA1B0DD27"
        },
        "status": "active"
      }
    }
  ]
}

Errors and Informational messages

The common errors and informational messages can be returned.

These additional informational messages may be returned within the bundle extension:

Code Message
papi027 No relevant clinical data exists.
papi026 The information provided is the latest configured data available at the time of charting and may not be reflective of the current clinical state of the care plan. It is the responsibility of the patient or patient representative to confirm care plan status with appropriate care providers.