CH EPR FHIR (R4)
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CH EPR FHIR (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 5.0.0-ballot-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-epr-fhir/ and changes regularly. See the Directory of published versions

Provide Document Bundle [ITI-65]

This section describes the additional requirements for the Swiss EPR of the Provide Document Bundle [ITI-65] transaction defined in the MHD Profile published in the IHE ITI Trial Implementation “Mobile Access to Health Documents”.

Scope

In the Swiss EPR the transaction is used by the MHD Document Source to store documents in the EPR.

Actor Roles

Actor: Document Source
Role: Sends documents and metadata to the Document Recipient.
Actor: Document Recipient
Role: Accepts the document and metadata sent from the Document Source.

Referenced Standards

  1. Mobile access to Health Documents (MHD), Rev. 4.2.2
  2. This MHD Profile is based on Release 4 of the HL7® FHIR® standard.

Messages

Interaction Diagram for [ITI-65]Document SourceDocument RecipientRequest to publish documentsDocuments published

Provide Document Bundle Request Message

The FHIR Bundle.meta.profile shall have the following value:

https://profiles.ihe.net/ITI/MHD/StructureDefinition/IHE.MHD.Comprehensive.ProvideBundle

The additional Swiss EPR metadata is defined with:

The request Bundle SHALL follow the CH MHD Provide Document Bundle Comprehensive Profile (example: Bundle: 2-7-BundleProvideDocument).

DeletionStatus

The optional metadata about the DeletionStatus of the document is represented in the DocumentReference using the extension with the URL http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-deletionstatus. The values are defined in the ValueSet DocumentEntry.Ext.EprDeletionStatus.

SubmissionSet.Author.AuthorRole

The SubmissionSet.Author element MAY be used to track the user who made the latest changes to the document metadata. If present, the value of the AuthorRole attribute SHALL be taken from the SubmissionSet.Author.AuthorRole value set with the OID 2.16.756.5.30.1.127.3.10.1.41. The required metadata about the AuthorRole of the Author is represented in the List for the SubmissionSet using the extension with the URL http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-author-authorrole. The values are defined in the ValueSet SubmissionSet.Author.AuthorRole.

DocumentEntry.originalProviderRole

An extra metadata attribute SHALL be used to distinguish document originally provided by patients or their representatives from documents originally provided by healthcare professionals, assistants, technical users or document administrators. The extra metadata attribute SHALL be set by the Document Source actor to the role value of the current user and SHALL NOT be updated by Update Initiator or Document Administrator actors. The required metadata about the originalProviderRole of the Author is represented in the DocumentReference using the extension with the URL http://fhir.ch/ig/ch-epr-fhir/StructureDefinition/ch-ext-author-authorrole. The values are defined in the ValueSet DocumentEntry.originalProviderRole.

Provide Document Bundle Response Message

The response Bundle SHALL follow the CH MHD Provide Document Bundle Comprehensive Response Profile (example: Bundle: 2-7-BundleProvideDocument-Response).

CapabilityStatement Resource

The CapabilityStatement resource for the Document Source is MHD Document Source.

The CapabilityStatement resource for the Document Recipient is MHD Document Recipient.

Security Consideration

The transaction SHALL be secured by Transport Layer Security (TLS) encryption and server authentication with server certificates.

The transaction SHALL use client authentication and authorization using extended authorization token as defined in the IUA profile. The extended authorization token SHALL be conveyed as defined in the Incorporate Access Token [ITI-72] transaction.

The Document Recipient actor SHALL be grouped with the Authorization Decision Consumer actor of the CH:ADR profile defined in Extension 2.1 to Annex 5 of the ordinances and perform an Authorization Decision Request [CH:ADR] for every Provide Document Bundle [ITI-65] request.

The actors SHALL support the traceparent header handling, as defined in Appendix: Trace Context.

Security Audit Considerations

Document Source Audit

The Document Source shall record an CH Audit Event for [ITI-65] Document Source (example).

Document Recipient Audit

The Document Recipient shall record an CH Audit Event for [ITI-65] Document Recipient (example).