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 4.0.1-ballot-2 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

Find Document References [ITI-67]

This section describes the additional requirements for the Swiss EPR of the Find Document References [ITI-67] transaction defined in the MHD Profile published in the IHE ITI Trial Implementation “Mobile Access to Health Documents”.

Scope

The Find Document References transaction is used to find DocumentReference Resources that satisfy a set of parameters. It is equivalent to the FindDocuments and FindDocumentsByReferenceId queries from the Registry Stored Query [ITI-18] transaction. The result of the query is a FHIR Bundle containing DocumentReference Resources that match the query parameters.

Actor Roles

Actor: Document Consumer
Role: Requests a list of DocumentReference Resources, matching the supplied set of criteria, from the Document Responder.
Actor: Document Responder
Role: Returns DocumentReference Resources that match the search criteria provided by the Document Consumer.

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-67]Document ConsumerDocument ResponderFind Document References RequestFind Document References Response

Find Document References Request Message

The Document Consumer SHALL include the search parameter patient.identifier with the oid of the EPR-SPID. The search parameters of type token SHALL contain both the system and the code.

Find Document Reference example request:

GET [base]/DocumentReference?patient.identifier=urn:oid:2.16.756.5.30.1.127.3.10.3|761337610411353650&status=current HTTP/1.1
Accept: application/fhir+json
traceparent: 00-0af7651916cd43dd8448eb211c80319c-b7ad6b7169203331-00

Expected Actions

The Document Responder SHALL process the query to discover the DocumentReference entries that match the search parameters given.

Document Responder SHALL support search page count requests from the Document Consumer of up to 100 resources.

Federated Cross Community Access Option

If the Document Responder supports the Federated Cross Community Access Option the Document Responder SHALL delegate the queries to the different connected communities and aggregate and sort the results including the results of his own community.

The Document Responder SHALL freeze the result set from the federated cross community queries and allow paged access by the Document Consumer. Subsequent query to an individual result by the Document Consumer SHALL return the current resource, not the frozen one.

%%{ init: { 'theme': 'neutral', 'themeVariables': { 'fontSize': '14px' } } }%% flowchart LR A[Document Consumer] -->|Query| B(Document Responder Option FXCA Grouped with Document Consumer) B --> C(Document Responder own community) B --> D(Document Responders federated communities)

Find Document References Response Message

The response Bundle SHALL follow the CH MHD Find Document References Comprehensive Response message Profile (example: MHD Find DocumentReferences).

Federated Cross Community Access Option

If a Document Responder does not respond, an OperationOutcome with a severity warning SHALL be added to the aggregated results indicating the community does not respond.

For matching DocumentReferences returned by the Document Responder, the Document Responder SHALL ensure by rewriting the id and attachment.url that follow-up reads, updates or document retrieval will be handled by same Document Responder actor. Any id, url rewrite SHALL be resolvable for at least an hour.

CapabilityStatement Resource

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

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

Security Consideration

The transaction SHALL be secured by Transport Layer Security (TLS) encryption and server authentication with server certificates. Transactions across communities SHALL use mTLS.

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.

All Document Responders except the one with the Federated Cross Community Access Option 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 Find Document References [ITI-67] response.

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

Security Audit Considerations

Document Consumer Audit

The Document Consumer shall record a CH Audit Event for [ITI-67] Document Consumer (example).

Document Responder Audit

The Document Responder shall record a CH Audit Event for [ITI-67] Document Responder (example).