Meaningful Use 3 Workflows

The EV Web Access API meets the Meaningful Use 3 Application Access Requirements. This section shows the API queries that are used to fulfill the following Application Access Workflows.

  • Patient Selection Request
  • Data Category Request
  • All Data Request

Patient Selection Request

Search for patient by MRN=MRN-QD97G59: 
https://greathospital.com:8100/sites/123/Patient?identifier=http://hl7.org/fhir/v2/0203|MRN-QD97G59
Search for patient by first name, last name, and date of birth: 
https://greathospital.com:8100/sites/123/Patient?given=Jay&family=Bishop&birthdate=1956-02-21
The id for the specific patient instance is encoded within the response. See the id highlighted in yellow below. 
{
    "resourceType": "Bundle",
    "type": "searchset",
    "total": 1,
    "link": [
        {
            "relation": "self",
            "url": "https://greathospital.com:8100/sites/123/Patient?family=BISHOP"
        }
    ],
    "entry": [
        {
            "fullUrl": "https://greathospital.com:8100/sites/123/Patient/1",
            "resource": {
                "resourceType": "Patient",
                "id": "1",
                "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Patient</b></p><p><b>Name</b>: BISHOP, Jay</p><p><b>Gender</b>: Male</p> <p><b>BirthDate</b>:1956-02-21</p><p><b>Identifiers</b>:</p><p><b>Medical record number</b>: MRN-6WP64S3</p> <p><b>Communication:</b></p><p><b>Primary Language</b>: Burmese</p> <p><b>General Practitioners:</b></p></div>"
                },
                "extension": [
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/us-core-race",
                        "extension": [
                            {
                                "url": "ombCategory",
                                "valueCoding": {
                                    "system": "http://hl7.org/fhir/v3/Race",
                                    "code": "1516-4",
                                    "display": "Zuni"
                                }
                            },
                            {
                                "url": "ombCategory",
                                "valueCoding": {
                                    "system": "http://hl7.org/fhir/v3/Race",
                                    "code": "2106-3",
                                    "display": "White"
                                }
                            }
                        ]
                    },
                    {
                        "url": "http://hl7.org/fhir/StructureDefinition/us-core-ethnicity",
                        "extension": [
                            {
                                "url": "ombCategory",
                                "valueCoding": {
                                    "system": "urn:oid:2.16.840.1.113883.6.238",
                                    "code": "2186-5",
                                    "display": "Not Hispanic or Latino"
                                }
                            }
                        ]
                    }
                ],
                "identifier": [
                    {
                        "use": "usual",
                        "type": {
                            "coding": [
                                {
                                    "system": "http://hl7.org/fhir/v2/0203",
                                    "code": "MR"
                                }
                            ],
                            "text": "Medical record number"
                        },
                        "system": "http://hl7.org/fhir/v2/0203",
                        "value": "MRN-6WP64S3"
                    }
                ],
                "name": [
                    {
                        "text": "BISHOP, Jay",
                        "family": "BISHOP",
                        "given": [
                            "Jay"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1956-02-21",
                "communication": [
                    {
                        "language": {
                            "text": "Burmese"
                        },
                        "preferred": true
                    }
                ]
            },
            "search": {
                "mode": "match"
            }
        }
    ]
}

Data Category Request

After retrieving the patient id from the Patient Selection Request it can be used to query the clinical data for that patient. In the below queries we will use a patient id of 1.

Search for patient by MRN=MRN-QD97G59: Retrieve the patient demographics, including the race and ethnicity. 
https://greathospital.com:8100/sites/123/Patient/1
Retrieve the patient visit encounter data. 
https://greathospital.com:8100/sites/123/Encounter?patient=1
Retrieve the patient problem list data. 
https://greathospital.com:8100/sites/123/Condition?patient=1
https://greathospital.com:8100/sites/123/Condition?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Condition?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient procedures performed data. 
https://greathospital.com:8100/sites/123/Procedure?patient=1
https://greathospital.com:8100/sites/123/Procedure?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Procedure?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient smoking status data. 
https://greathospital.com:8100/sites/123/Observation?patient=1&code=72166-2
https://greathospital.com:8100/sites/123/Observation?patient=1&code=72166-2&date=2017-05-30
https://greathospital.com:8100/sites/123/Observation?patient=1&code=72166-2&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient vital signs data. 
https://greathospital.com:8100/sites/123/Observation?patient=1&category=vital-signs
https://greathospital.com:8100/sites/123/Observation?patient=1&category=vital-signs&date=2017-05-30
https://greathospital.com:8100/sites/123/Observation?patient=1&category=vital-signs&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient lab results data. 
https://greathospital.com:8100/sites/123/Observation?patient=1&category=laboratory
https://greathospital.com:8100/sites/123/Observation?patient=1&category=laboratory&date=2017-05-30
https://greathospital.com:8100/sites/123/Observation?patient=1&category=laboratory&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient goals data. 
https://greathospital.com:8100/sites/123/Goal?patient=1
https://greathospital.com:8100/sites/123/Goal?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Goal?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient immunization data. 
https://greathospital.com:8100/sites/123/Immunization?patient=1
https://greathospital.com:8100/sites/123/Immunization?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Immunization?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient assessment and treatment plan data. 
https://greathospital.com:8100/sites/123/CarePlan?patient=1
https://greathospital.com:8100/sites/123/CarePlan?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/CarePlan?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient health concerns data. 
https://greathospital.com:8100/sites/123/Condition?patient=1
https://greathospital.com:8100/sites/123/Condition?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Condition?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient home medication data. 
https://greathospital.com:8100/sites/123/MedicationStatement?patient=1
https://greathospital.com:8100/sites/123/MedicationStatement?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/MedicationStatement?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient administered medication data. 
https://greathospital.com:8100/sites/123/MedicationAdministration?patient=1
https://greathospital.com:8100/sites/123/MedicationAdministration?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/MedicationAdministration?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient medication order and prescription data. 
https://greathospital.com:8100/sites/123/MedicationRequest?patient=1
https://greathospital.com:8100/sites/123/MedicationRequest?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/MedicationRequest?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient allergy data. 
https://greathospital.com:8100/sites/123/AllergyIntolerance?patient=1
https://greathospital.com:8100/sites/123/AllergyIntolerance?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/AllergyIntolerance?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient medical device data. 
https://greathospital.com:8100/sites/123/Device?patient=1
https://greathospital.com:8100/sites/123/Device?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/Device?patient=1&date=ge2017-06-07&date=le2017-06-08

All Data Request

After retrieving the patient id from the Patient Selection Request it can be used to query the C-CDA R2.1 Continuity of Care Document for that patient. In the below queries we will use a patient id of 1.

Retrieve the reference to the patient C-CDA document. 
https://greathospital.com:8100/sites/123/DocumentReference?patient=1
https://greathospital.com:8100/sites/123/DocumentReference?patient=1&date=2017-05-30
https://greathospital.com:8100/sites/123/DocumentReference?patient=1&date=ge2017-06-07&date=le2017-06-08
Retrieve the patient C-CDA document using the document reference. 
https://greathospital.com:8100/sites/123/Binary/CDA_827550c4-7ebe-43fa-ad2f-aa18c8ebbf44

Clinical Data Set Mapping

The following table shows the mapping between the Meaningful Use 3 Common Clinical Data Set elements to the corresponding FHIR Resource.

Common Clinical Data SetFHIR ResourceFHIR Specification Reference
Patient Demographics including Name, Sex, Date of Birth, Race, Ethnicity, Preferred LanguagePatientPatient
Smoking StatusObservationObservation
ProblemsConditionCondition
MedicationsMedicationRequest, MedicationStatementMedicationRequest, MedicationStatement
Medication AllergiesAllergyIntoleranceAllergyIntolerance
Laboratory TestsProcedureRequestProcedureRequest
Laboratory Values(s)/Result(s)ObservationObservation
Vital SignsObservationObservation
ProceduresProcedureProcedure
Care Team Member(s)CareTeamCareTeam
ImmunizationsImmunizationImmunization
Unique Device Identifier(s) for a Patient’s Implantable Device(s) DeviceDevice
Assessment and Plan of TreatmentCarePlanCarePlan
GoalsGoalGoal
Health ConcernsConditionCondition

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