CH UMZH Connect IG (R4), published by UMZH. This guide is not an authorized publication; it is the continuous build for version 1.0.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/umzhconnect/umzhconnect-ig/ and changes regularly. See the Directory of published versions

Core Concepts

Core concepts

The UMZH-connect project aims to improve digital connectivity for referrals and external orders (e.g. lab orders) between healthcare providers in the Zurich area, particularly the university hospitals. The system is designed to be extensible — both in terms of use cases and participating organizations.

Workflow oriented API design

This implementation guide is based on the core principles of Clinical Order Workflow IG with a focus on the Task at Fulfiller.

The COW (clinical order workflow) focuses on making clinical data available by API to relevant actors and notifying the partners about task in contrast to sending the bundled data to the partner in commonly used 'fire-and-forget' mode.

The COW refers to the requestor, referrer, and prescriber as the Placer - the party who initiates the task, and the performer as the Fulfiller - the party the performs the requested service. As central element and business onject (also a FHIR resource) serves the CoordinationTask (resourceType Task) which links resources - inputs and outputs - between the participating parties and manages workflow patterns (i.e. states etc.)

The essentials of the Task at Fulfillers are illustrated in the following example:

Example Workflow

• The referring provider (Placer) creates a Service Request in their own environment, referencing additional information (patient demographics, medication, medical history, etc.).
• A minimal Task is created at the receiving provider (Fulfiller), referencing the Service Request and including authorization information (Consent).
• The Fulfiller gains access to restricted datasets from the Placer and can process the order further.
• The Task acts as the shared data object, linking datasets on both the Placer and Fulfiller sides and regulating access.
• The Fulfiller can add references to results (appointments, reports, etc.) in the Task, enabling the Placer to access results digitally.
• If needed, the data contract can be extended with a notification instruction to enable seamless integration.

sequenceDiagram
    title Process flow between Placer and Fulfiller
    actor Placer
    actor Fulfiller
    activate Placer
    Placer->>Placer: Create Service Request
    deactivate Placer
    rect rgb(191, 223, 255)
    Placer->>Fulfiller: Create Task
    activate Fulfiller
    Fulfiller->>Placer: Task Response
    deactivate Fulfiller
    end
    rect rgb(191, 223, 255)
    Fulfiller->>Placer: Request Resources
    activate Placer
    Placer->>Fulfiller: Resources Response
    deactivate Placer
    end
    alt optional
        rect rgb(191, 223, 255)
        Fulfiller->>Placer: Send Notification
        end
    end
    rect rgb(191, 223, 255)
    Placer->>Fulfiller: Request Results
    activate Fulfiller
    Fulfiller->>Placer: Results Response
    deactivate Fulfiller
    end