Argonaut Data Query Implementation Guide Version 1.0.0

This is the current officially published version of The Argonaut Data Query Implementation Guide Version 1.0.0. For list of available versions, see the Directory of published versions

Argonaut Data Query Implementation Guide

The Argonaut Data Query Implementation Guide is based upon the core FHIR DSTU2 API and it documents:

  • Security and Authorization
  • Data element query of the ONC Common Clinical Data Set
  • Document query of static documents

Use Cases

This specification describes four use cases and sets search expectations for each. For complete details and background, see Use Cases for the Argonaut Project.

  1. Patient uses provider-approved web application to access health data
  2. Patient uses provider-­approved mobile app to access health data
  3. Clinician uses provider­-approved web application to access health data
  4. Clinician uses provider­-approved mobile app to access health data

Note, the Common MU Data Set referenced in the Use Cases is now the ONC 2015 Common Clinical Data Set .

Security


Argonaut uses SMART on FHIR authorization for apps that connect to EHR data. For details, see SMART on FHIR Authorization Guide and the Argonaut Sprint Definitions.

Data Element Query


The Argonaut data element query IG is intended to meet the 2015 Edition certification criterion for Patient Selection 170.315(g)(7) and Application Access – Data Category Request 170.315(g)(8). They were created for each of the 2015 Edition Common Clinical Data Set. Where applicable they are based on the HL7 U.S. Data Access Framework (DAF) FHIR DSTU2 Implementation Guide. However, the Argonaut use case and requirements per resource are a subset of those of the DAF implementation guide.

The table below lists the FHIR Resources used for the corresponding 2015 Edition Common Clinical Data Set (CCDS) Data elements:

No CCDS Data Element FHR Resource
(1) Patient Name Patient
(2) Sex Patient
(3) Date of birth Patient
(4) Race Patient
(5) Ethnicity Patient
(6) Preferred language Patient
(7) Smoking status Observation
(8) Problems Condition
(9) Medications Medication, MedicationStatement, MedicationOrder
(10) Medication allergies AllergyIntolerance
(11) Laboratory test(s) Observation, DiagnosticReport
(12) Laboratory value(s)/result(s) Observation, DiagnosticReport
(13) Vital signs Observation
(14) (no longer required) -
(15) Procedures Procedure
(16) Care team member(s) CarePlan
(17) Immunizations Immunization
(18) Unique device identifier(s) for a patient’s implantable device(s) Device
(19) Assessment and plan of treatment CarePlan
(20) Goals Goal
(21) Health concerns Condition

The Argonaut Profiles for each of the data element queries is listed below. Each profile defines the minimum mandatory elements, extensions and terminology requirements that MUST be present. Requirements and guidance are given in the profile narrative summary. A formal hierarchical table that presents a logical view of the content in both a differential and snapshot view is also provided along with references to appropriate terminologies and examples.

Note on Searches based on a date or date range:

  1. Allergies, Immunizations, Medications, Problems and Health Concerns, UDI, Smoking Status do not require a date range search since a system should return all relevant resources.
  2. Date range search requirements are included in the Quick Start section for the following resources - Vital Signs, Laboratory Results, Goals, Procedures, and Assessment and Plan of Treatment.

Document Query


The Argonaut Document Query Implementation guide defines how a provider or patient can retrieve a patient’s existing clinical document - specifically, transition of care and patient summary C-CDA CCD documents required for Meaningful Use. However other document formats, such as PDF, can be retrieved too. These are exposed in FHIR using a DocumentReference Resource: to index/search for them. This guide provides the minimal requirements to fetch a URL link to either a) patient’s existing documents which have been indexed or b) a “virtual” documents such as a CCD that could be created “on-demand”.

The Document itself can be subsequently retrieved using the link provided from the DocumentQuery search results. The link could be, for example, a FHIR endpoint (FHIR STU3) to a Binary Resource or some other document repository. The details of how to retrieve the document are not covered in this guide.

Use Case

Patient or Provider search for a patient’s Documents

Example Search

  • Locate a patient’s CCD document from a recent or current encounter

Assumptions and Preconditions

  • Initial search for a reference to a document instead of documents itself (retrieval of actual document is a two-step process)
  • Documents may or may not already exist and be indexed prior to the search
  • Document references may be created “on-demand” when requested
  • Documents may be created “on-demand” when requested
  • Details of document retrieval is out of scope

Requirements

The Argonaut DocumentReference Profile defines the minimum mandatory elements, extensions and terminology requirements that MUST be present. Requirements and Guidance are given in a simple narrative summary. A formal hierarchical table that presents a [logical view: of the content in both a differential and snapshot view is also provided along with references to appropriate terminologies and examples.