Search for a patient’s documents

Search for a patient's documents

Use case

Search for a patient’s documents from a GP practice.

We assume an understanding of FHIR REST and search features. For further information with regards to the features described in this page see http://hl7.org/fhir/STU3/search.html.

Security

GP Connect utilises TLS Mutual Authentication for system level authorization
GP Connect utilises JSON Web Tokens (JWT) to transmit clinical audit and provenance details

Search parameters

Provider systems SHALL support the following search parameters:

Name	Type	Description	Paths
`created`	`date` or `dateTime`	Creation/Edit datetime of the document.	`DocumentReference.created`
`author`	`token`	Who and/or what authored the document.	`DocumentReference.author`
`description`	`string`	Keyword based search	`DocumentReference.description` + `DocumentReference.type`

Note: The supported search parameters MUST be included in the Access Document FHIR capability statement.

Important: GP Connect does not support searching for documents based on a practitioner author. The author search parameter MUST only be used to search by an organisation author using an ODS code

Important: The type and facility parameters have been removed from the API. These will be reinstated in the future when provider systems contain the metadata to support them. The original release of the Access Documents capability contained type and facility parameters which could be used to search for types of clinical document and the types of clinical settings where they were created. These have been removed while the quality of the metadata in provider systems around these items improves. They will be reinstated at the point that they can be supported.

_include parameters

Provider systems SHALL support the following include parameters:

Name	Description	Paths
`_include= DocumentReference:subject:Patient`	Include `Patient` resources referenced within the returned `DocumentReference` resources	`DocumentReference.subject`
`_include= DocumentReference:custodian:Organization`	Details of organisations that are custodians for the documents that are returned in DocumentReference resources
`_include= DocumentReference:author:Organization`	Details of organisations that authored the documents that are returned in DocumentReference resources
`_include= DocumentReference:author:Practitioner`	Details of who/what authored the documents that are returned in DocumentReference resources
`_revinclude:recurse= PractitionerRole:practitioner`	Include `PractitionerRole` resources referenced from matching `Practitioner` resources	`DocumentReference.author:Practitioner`

Consumer systems MUST send the following parameters to reduce the number of API calls:

_include=DocumentReference:subject:Patient
_include=DocumentReference:custodian:Organization
_include=DocumentReference:author:Organization
_include=DocumentReference:author:Practitioner
_revinclude:recurse=PractitionerRole:practitioner

Consumer systems MAY send the following parameters in the request:

created
author
description

When using the ‘created’ parameter, consumers MUST do the following

to search for a lower boundary of a date:
- a single created parameter with a date prefixed by ge should be supplied
to search for a upper boundary of a date:
- a single created parameter with a date prefixed by le should be supplied
to search between two dates:
- two created parameters should be supplied
  - a single created parameter with a date prefixed by ge
  - a single created parameter with a date prefixed by le

Prerequisites

Consumer

The consumer system:

SHALL have previously resolved the organisation’s Access Document FHIR endpoint base URL through the Spine Directory Service
MUST have previously traced the patient’s NHS Number using the Personal Demographics Service or an equivalent service

API usage

Interaction diagram

Request

FHIR® relative request

GET /Patient/[id]/DocumentReference?[_include=DocumentReference:subject:Patient]
                      [&_include=DocumentReference:custodian:Organization]
                      [&_include=DocumentReference:author:Organization]
                      [&_include=DocumentReference:author:Practitioner]
                      [&_revinclude:recurse=PractitionerRole:practitioner]
                      {&created=[search_prefix]creation_date}
                      {&author=[OrgTypeCodeSystem]|[OrgTypeCode]}
                      {&description=[document_title]}

FHIR® absolute request

GET https://[proxy_server]/https://[documents_provider_server]/[documents_fhir_base]/Patient/[id]/DocumentReference?[_include=DocumentReference:subject:Patient]
                      [&_include=DocumentReference:custodian:Organization]
                      [&_include=DocumentReference:author:Organization]
                      [&_include=DocumentReference:author:Practitioner]
                      [&_revinclude:recurse=PractitionerRole:practitioner]
                      {&created=[search_prefix]creation_date}
                      {&author=[OrgTypeCodeSystem]|[OrgTypeCode]}
                      {&description=[document_title]}

Request headers

Consumers MUST include the following additional HTTP request headers:

Header	Value
`Ssp-TraceID`	Consumer’s Trace ID (a GUID or UUID)
`Ssp-From`	Consumer’s ASID
`Ssp-To`	Provider’s ASID
`Ssp-InteractionID`	`urn:nhs:names:services:gpconnect:documents:fhir:rest:search:documentreference-1`

Example HTTP request headers:

Accept: application/fhir+json;charset=utf-8
Content-Type: application/fhir+json;charset=utf-8
Ssp-TraceID: 629ea9ba-a077-4d99-b289-7a9b19fd4e03
Ssp-From: 200000000115
Ssp-To: 200000000116
Ssp-InteractionID: urn:nhs:names:services:gpconnect:documents:fhir:rest:search:documentreference-1

Payload request body

n/a

Error handling

The provider system MUST return a GPConnect-OperationOutcome-1 resource that provides additional detail when one or more data field is corrupt or a specific business rule/constraint is breached.

The table below shown common errors that may be encountered during this API call, and the returned Spine error code. Please see Error handling guidance for additional information needed to create the error response or to determine the response for errors encountered that are not shown below.

Errors returned due to query parameter failure MUST include diagnostic information detailing the invalid query parameter.

Error encountered	Spine error code returned
A patient could not be found with the patient id provided	`PATIENT_NOT_FOUND`
The request is for the record of an inactive or deceased patient	`PATIENT_NOT_FOUND`
The request is for the record of a non-Regular/GMS patient (i.e. the patient’s registered practice is somewhere else)	`PATIENT_NOT_FOUND`
The patient’s NHS number in the provider system is not associated with a NHS number status indicator code of ‘Number present and verified’	`PATIENT_NOT_FOUND`
The request is for a sensitive patient	`PATIENT_NOT_FOUND`
The patient has dissented to sharing their clinical record	`NO_PATIENT_CONSENT`
The author query parameter contains an identifier other than an ODS code	`INVALID_PARAMETER`
The request does not contain the mandatory _include parameters	`INVALID_PARAMETER`
GP Connect is not enabled at the practice (see Enablement)	`ACCESS DENIED`
The Access Document capability is not enabled at the practice (see Enablement)	`ACCESS DENIED`

Request response

Response headers

HTTP/1.1 200 OK
Cache-Control: no-store
Content-Type: application/fhir+json; charset=utf-8
Date: Sun, 07 Aug 2016 11:13:05 GMT
Content-Length: 1464

Payload response body

Provider systems MUST:

return a 200 OK HTTP status code to indicate successful search of a patient’s documents
return a Bundle
return the following resources in the Bundle:
- Patient matching the NHS Number sent in the body of the request
- Organization matching the patient’s registered GP practice, referenced from Patient.generalPractitioner
- Organization matching the organisation serving the request, if different from above, referenced from Patient.managingOrganization
- Practitioner matching the patient’s usual GP, if they have one, referenced from Patient.generalPractitioner
- PractitionerRole matching the usual GP’s role
- Practitioner resources for supplementary actors
- PractitionerRole resources for the roles of supplementary actors
- DocumentReference resources conforming to the CareConnect-GPC-DocumentReference-1 profile that match the supplied search criteria
  - where the created parameter has been supplied and DocumentReference.created doesn’t exist, DocumentReference.indexed MUST be used instead
  - where the ‘description’ parameter has been supplied, both DocumentReference.description and DocumentReference.type MUST be searched
- Organization resources for supplementary actors

Payload response examples

Examples of the payload requests and responses can be found here:

Documents - FHIR® examples