Patient

• Overview
• Terminology Bindings
• Extensions
• Search
  • Authorization Types
  • Parameters
  • Headers
  • Example
  • Errors
• Retrieve by ID
  • Authorization Types
  • Headers
  • Example
  • Linking Duplicate Patient Records Example
  • Errors

Overview

The Patient resource provides general demographic information about a person receiving health care services from a specific organization. Common demographic fields include patient ID, patient name, gender, date of birth, address, phone, and primary language. Additional concepts returned as extensions and not part of the base resource include race, ethnicity, and birth sex. Soarian Clinicals^® is a patient-centric application, so many of its other resources include the patient ID in their queries. A person receiving care from multiple organizations may have data available in multiple patient resources in multiple Fast Healthcare Interoperability Resources^® (FHIR)^® servers.

Soarian Clinicals^® supports a read-only Application Programming Interface (API). This API accepts GET and POST based search and and GET based read interactions. The response represents the most current information about the patient that is charted in Soarian Clinicals^® at the time of the query.

The search results include the following fields if they are valued:

• Patient id
• Patient Identifier, only MR, PI and SB values are supported
• Active
• Patient name
• Telecom Information, may include phone and email
• Gender (administrative)
• Extensions including birth sex, ethnicity and race
• Date of Birth
• Address
• Communication (preferred language)

Terminology Bindings

Patient.identifier.type

Description A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Details: Identifier Type Codes System: https://hl7.org/fhir/v2/0203/index.html

Patient.communication.language

Description The language that can be used to communicate with the patient about their health. Details: Tags for the Identification of Languages System: urn:ietf:bcp:47

Extensions

• US Core Race
• US Core Ethnicity
• US Core Birth Sex

Search

Search for Patients that meet specified query parameters:

GET /Patient?:parameters

Implementation Notes

• A 422 (unprocessable entity) HTTP response status code and OperationOutcome are returned when >499 patients qualify for the search criteria. FHIR^® applications may prompt the user for more specific search criteria to avoid this possibility.

Authorization Types

Parameters

Name	Required?	Type	Description
_id	This or any other required search parameter	token	The logical resource ID associated with the resource.
identifier	This or any other search parameter, or _id	token	A patient identifier. Only MR, PI, or SB identifiers are supported and therefore searched. Example: urn:oid:1.1.1.1.1.1|1022228
name	This or any other search parameter, or _id	string	The start of either the family or the given name of the patient. Previous name values are not searchable. Example: Doe
family	This or any other search parameter, or _id	string	The start of the patient’s family name. Previous name values are not searchable. Example: Doe
given	This or any other search parameter, or _id	string	The start of the patient’s given name. Previous name values are not searchable. Example: Jane
birthdate	This or any other search parameter, or _id	date	The patient’s date of birth. Example: 1990-01-01
gender	No	token	The patient’s gender. Example: male
_revinclude	No	_revinclude	A request to include any Provenance resource in the bundle that refers to a Patient resource in the search results. Only supported with Provenance.

Notes:

• For the Patient user
  • A search without any parameter is supported that returns all the Patient resources that the user can access. This is applicable only for authorization_type = patient.
  • All other search parameters are supported as either the _id, or a combination of identifier , birthdate, name, family, or given parameters must be provided, while still returning only the Patient resources that the user can access.
• For the Provider user, either the _id, or a combination of identifier , birthdate, name, family, or given parameters must be provided.
• The gender parameter may only be provided if at least one of the identifier , birthdate, name, family, or given parameters is provided.
• The identifier parameter supports the :of-type modifier and has the format system|code|value, where the system and code refer to an Identifier.type.coding.system and .code, and match if any of the type codes match. All three parts of the format must be present.
• The name, family, and given parameters search for current and previous names.
• The name, family, and given parameters allow search for normalized values as well when these may contain accented characters. For example, Schlüter will match Schlüter and Schlueter, but not Schluter
• The identifier, name, family, given, and gender parameters may be provided exactly once and may have only a single value.
• The birthdate parameter
  • May be provided once using the eq prefix
  • May be provided up to twice to imply a date range using one of the following prefixes: ge, le, gt, or lt
  • Must not be provided with a time component
• The _revinclude parameter may be provided once with the value Provenance:target. Example: _revinclude=Provenance:target
• When _revinclude is provided in a request, the OAuth2 token must include the patient/Provenance.read system/Provenance.read or user/Provenance.read scope as applicable.

Headers

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

Example

Request

GET https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient?_id=A879904FD2FE4B2D90C89FDA84E1285F

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "2fa0b1dc-ecab-4744-bb53-d4a21f3e7b73",
  "type": "searchset",
  "timestamp": "2021-02-15T15:09:40-05:00",
  "entry": [
    {
      "fullUrl": "https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient/A879904FD2FE4B2D90C89FDA84E1285F",
      "resource": {
        "resourceType": "Patient",
        "id": "A879904FD2FE4B2D90C89FDA84E1285F",
        "meta": {
          "lastUpdated": "2021-01-21T15:08:01-05:00"
        },
        "gender": "female",
        "birthDate": "2010-03-11",
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "EN"
                }
              ],
              "text": "English"
            }
          }
        ],
        "active": true,
        "name": [
          {
            "use": "usual",
            "text": "Mcgovern,Astrid Santiago",
            "family": "Mcgovern",
            "given": [
              "Astrid",
              "Santiago"
            ],
            "suffix": [
              "Mrs."
            ]
          }
        ],
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "SB",
                  "display": "Social Beneficiary Identifier"
                }
              ],
              "text": "SSN"
            },
            "system": "http://hl7.org/fhir/sid/us-ssn",
            "value": "598-00-4749"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "MR",
                  "display": "Medical record number"
                }
              ],
              "text": "MR"
            },
            "system": "urn:oid:2.1.5.234.99.1.3.7.1",
            "value": "INF103"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "PI",
                  "display": "Patient internal identifier"
                }
              ],
              "text": "MPI"
            },
            "system": "urn:oid:2.1.5.234.99.1.3.7.2",
            "value": "INF1003"
          }
        ],
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode": "F"
          },
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2106-3",
                  "display": "White"
                }
              },
              {
                "url": "text",
                "valueString": "White"
              }
            ]
          },
          {
            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
            "extension": [
              {
                "url": "ombCategory",
                "valueCoding": {
                  "system": "urn:oid:2.16.840.1.113883.6.238",
                  "code": "2135-2",
                  "display": "Hispanic or Latino"
                }
              },
              {
                "url": "text",
                "valueString": "Hispanic or Latino"
              }
            ]
          }
        ],
        "address": [
          {
            "use": "home",
            "text": "PO Box 549,Des Moines ,IA,50301-0549",
            "line": [
              "PO Box 549"
            ],
            "city": "Des Moines ",
            "state": "IA",
            "postalCode": "50301-0549",
            "period": {
              "start": "2020-04-15T00:00:00-04:00"
            }
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "(818)999-555-4444",
            "use": "home",
            "period": {
              "start": "2020-04-15T00:00:00-04:00"
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><b>Patient</b><br /><b>Status</b>:Active;<b>Name</b>:Mcgovern,Astrid Santiago;<b>DOB</b>:2010-03-11;<b>Administrative Gender</b>:female;</div>"
        }
      }
    }
  ],
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient?_id=A879904FD2FE4B2D90C89FDA84E1285F"
    }
  ]
}

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.
• In addition, a 422 Unprocessable Entity HTTP response status code and OperationOutcome is returned when >499 patients qualify for the search criteria.

Retrieve by ID

Return an individual Patient resource by the resource ID:

GET /Patient/:id

Authorization Types

Headers

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

Example

Request

GET https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient/A879904FD2FE4B2D90C89FDA84E1285F

Response

Status: 200 OK

{
  "resourceType": "Patient",
  "id": "A879904FD2FE4B2D90C89FDA84E1285F",
  "meta": {
    "lastUpdated": "2021-01-21T15:08:01-05:00"
  },
  "gender": "female",
  "birthDate": "2010-03-11",
  "communication": [
    {
      "language": {
        "coding": [
          {
            "system": "urn:ietf:bcp:47",
            "code": "EN"
          }
        ],
        "text": "English"
      }
    }
  ],
  "active": true,
  "name": [
    {
      "use": "usual",
      "text": "Mcgovern,Astrid Santiago",
      "family": "Mcgovern",
      "given": [
        "Astrid",
        "Santiago"
      ],
      "suffix": [
        "Mrs."
      ]
    }
  ],
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "SB",
            "display": "Social Beneficiary Identifier"
          }
        ],
        "text": "SSN"
      },
      "system": "http://hl7.org/fhir/sid/us-ssn",
      "value": "598-00-4749"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MR",
            "display": "Medical record number"
          }
        ],
        "text": "MR"
      },
      "system": "urn:oid:2.1.5.234.99.1.3.7.1",
      "value": "INF103"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "PI",
            "display": "Patient internal identifier"
          }
        ],
        "text": "MPI"
      },
      "system": "urn:oid:2.1.5.234.99.1.3.7.2",
      "value": "INF1003"
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
      "valueCode": "F"
    },
    {
      "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
      "extension": [
        {
          "url": "ombCategory",
          "valueCoding": {
            "system": "urn:oid:2.16.840.1.113883.6.238",
            "code": "2106-3",
            "display": "White"
          }
        },
        {
          "url": "text",
          "valueString": "White"
        }
      ]
    },
    {
      "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
      "extension": [
        {
          "url": "ombCategory",
          "valueCoding": {
            "system": "urn:oid:2.16.840.1.113883.6.238",
            "code": "2135-2",
            "display": "Hispanic or Latino"
          }
        },
        {
          "url": "text",
          "valueString": "Hispanic or Latino"
        }
      ]
    }
  ],
  "address": [
    {
      "use": "home",
      "text": "PO Box 549,Des Moines ,IA,50301-0549",
      "line": [
        "PO Box 549"
      ],
      "city": "Des Moines ",
      "state": "IA",
      "postalCode": "50301-0549",
      "period": {
        "start": "2020-04-15T00:00:00-04:00"
      }
    }
  ],
  "telecom": [
    {
      "system": "phone",
      "value": "(818)999-555-4444",
      "use": "home",
      "period": {
        "start": "2020-04-15T00:00:00-04:00"
      }
    }
  ],
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><b>Patient</b><br /><b>Status</b>:Active;<b>Name</b>:Mcgovern,Astrid Santiago;<b>DOB</b>:2010-03-11;<b>Administrative Gender</b>:female;</div>"
  }
}

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.

Linking Duplicate Patient Records Example

The link element is used to assert that patient resources refer to the same patient. This element is used to support the scenario where a duplicate record is retired; this process is known as a patient merge in Soarian Clincials^®. When the requested patient record has been merged into another record, an inactive Patient entry is returned that has a link to the current Patient entry. Entries for merged, or source, patients are only returned when retrieving the entries directly by ID. Entries for the target patient are returned with all qualifying searches.

The ability to perform patient merge operations is not available through the Cerner Ignite APIs for Soarian Clinicals^® platform.

Request

GET https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient?_id=0A1119CA2414486AAD618F5A2D25556B

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "33db58d6-4a16-4987-8976-40793f9077af",
  "type": "searchset",
  "timestamp": "2021-02-15T16:40:28-05:00",
  "entry": [
    {
      "fullUrl": "https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient/0A1119CA2414486AAD618F5A2D25556B",
      "resource": {
        "resourceType": "Patient",
        "id": "0A1119CA2414486AAD618F5A2D25556B",
        "active": false,
        "gender": "unknown",
        "name": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
                "valueCode": "unknown"
              }
            ]
          }
        ],
        "link": [
          {
            "other": {
              "reference": "Patient/3280623E3DD547CFA210B9E645748EEA"
            },
            "type": "replaced-by"
          }
        ],
        "identifier": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
                "valueCode": "unknown"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><b>Patient</b><br /><b>Status</b>:Inactive;</div>"
        }
      }
    }
  ],
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-myrecord-sc.cerner.com/r4/2f8f5ec1-b7b8-4be5-ae27-e308284dd9c1/Patient?_id=0A1119CA2414486AAD618F5A2D25556B&_format=json"
    }
  ]
}

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.