Vital Records FHIR Messaging (VRFM) IG
2.0.0-Preview3 - ci-build
Vital Records FHIR Messaging (VRFM) IG
2.0.0-Preview3 - ci-build
Vital Records FHIR Messaging (VRFM) IG, published by CDC NCHS. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nightingaleproject/vital_records_fhir_messaging_ig/ and changes regularly. See the Directory of published versions
The FHIR messaging infrastructure provides reliable message delivery between jurisdictions and NCHS. This section provides pseudo code that describes the behavior of jurisdiction and NVSS FHIR messaging endpoints, and discusses implementation considerations and approaches that may be useful to developers or purchasers of this infrastructure.
The following entities are referred to throughout this section:
[VRDR document] a VRDR Death Record document[message] a FHIR message, one of the types described earlier in this document[pending queue] a software service used to track messages that have been sent to NCHS but not responded to[message log] a software service used to track received messages and eliminate duplicates[response] a [message] received from NVSS[acknowledgment] an acknowledgment messageIn some places components of the above entities are referenced. E.g. [message.header.id] refers to the id component of the header component of [message].
The following describes the processing performed when a jurisdiction death registration system submits a death report to the FHIR messaging infrastructure.
Create [message] for [VRDR document]
Add [message] to [pending queue]
Send [message] to NVSS
Note that the [pending queue] should be implemented to be durable in the case of a system failure. Use of a database system would be one suitable approach.
When a jurisdiction receives a [response] from NVSS it is processed as described in the following subsections. Note that the type of the [response] message can be determined by examining the value of the response.header.eventUri property.
The [message log] facilitates handling of duplicate messages that may result from retransmissions that may occur when an acknowledgement message is lost.
Extract [acknowledgment.header.response.identifier] as [id]
Remove [message] where [message.header.id] equals [id] from [pending queue]
Log successful [message] delivery to [message log]
If [message log] does not contain [response.header.id]
Extract [response.header.response.identifier] as [id]
Remove [message] where [message.header.id] equals [id] from [pending queue]
Log failed [message] delivery to [message log]
Add [response.header.id] to [message log]
Create [acknowedgement] for [response]
Send [acknowledgment] to NVSS
If [message log] does not contain [response.header.id]
Extract [response.result] as [coding]
If extraction fails
Create [extraction error] for [response]
Add [extraction error] to [pending queue]
Send [extraction error] to source of [response]
Else
Extract [response.timestamp] as [timestamp]
Deliver [coding], [timestamp] to local death registration system
Add [response.header.id] to [message log]
Create [acknowledgement] for [response]
Send [acknowledgement] to NVSS
The pending queue contains messages that are not yet known to have been successfully sent to NVSS, these messages should be periodically resent until acknowledged or an extraction error is received.
Periodically
For each [message] in [pending queue]
If [message.timeout] > current time
Resend [message] to NVSS
Update [message.timeout]
It is recommended that message timeouts follow an "exponential backoff" approach where the time between retries is increased for each retry of a given message. This approach prevents retries from overloading the receiver in the case of transient outages.
Implementing the FHIR messaging infrastructure at a jurisdiction requires the following components:
[message log] component. This is used to record:
a. Received messages (for duplication elimination and audit purposes)
b. Successfully delivered messages (for audit purposes)
c. Unsuccessfully delivered messages (for audit purposes)[pending queue] componentItems 1, 2, 3 above are within the scope of the vrdr-dotnet open source project, an implementation of the FHIR messaging infrastructure at a jurisdiction could leverage this project to accelerate development.
Items 5 and 6 both require persistent storage and a transactional, durable implementation such as a database management system. This will ensure that the message processing algorithms implemented as part of item 4 are able to function in parallel and that the system will recover without undue message retransmissions should a system failure occur.
The following pseudo code outlines the processing steps taken by NVSS on receipt of a VRDR Death Report Submission message
Extract [death_record] from [message]
If extraction fails
Create [extraction error] for [message]
Add [extraction error] to [pending queue]
Send [extraction error] to source of [message]
Else
Create [acknowledgment] for [message]
Send [acknowledgment] to source of [message]
If [message log] does not include [message.header.id]
Add [message] to [message log]
Submit [death_record] for coding
The following pseudo code outlines the processing steps taken by NVSS on receipt of a VRDR Death Report Update message
Extract [death_record] from [message]
If extraction fails
Create [extraction error] for [message]
Add [extraction error] to [pending queue]
Send [extraction error] to source of [message]
Else
Create [acknowledgment] for [message]
Send [acknowledgment] to source of [message]
If [message log] includes [message.header.id]
Ignore duplicate
Else if [message log] does not include [death_record.cert_id, death_record.state_id]
Log receipt of update with no preceding submission
Add [message] to [message log]
Submit [death_record] for coding
Else if [message log].latest_timestamp for [death_record.cert_id, death_record.state_id] > [message.timestamp]
Log receipt of update older than previously received update or submission
Else
Add [message] to [message log]
Submit [death_record] for coding
The following describes the processing performed when NVSS submits a coding response or update to the FHIR messaging infrastructure.
Create [message] for [Coding]
Add [message] to [pending queue]
Send [message] to jurisdiction
Note that the [pending queue] should be implemented to be durable in the case of a system failure. Use of a database system would be one suitable approach.
The following describes the processing performed when NVSS receives an acknowledgement to a Coding Response or Coding Update message.
Extract [acknowledgment.header.response.identifier] as [id]
Remove [message] where [message.header.id] equals [id] from [pending queue]
Log successful [message] delivery to [message log]
The pending queue contains messages that are not yet known to have been successfully sent to jurisdictions, these messages should be periodically resent until acknowledged
Periodically
For each [message] in [pending queue]
If [message.timeout] > current time
Resend [message] to jurisdiction
Update [message.timeout]
It is recommended that message timeouts follow an "exponential backoff" approach where the time between retries is increased for each retry of a given message. This approach prevents retries from overloading the receiver in the case of transient outages.