app Challenge | Showing app against Sandbox/Powerchart

[Carl Osborne]

Hello, 

I am in preparation of submitting an application for consideration into the code app challenge.

My application isn't one that is embedded into Powerchart.  Its what you could call a stand-alone application that works "with" Powerchart.   The app is listed as a "System" app and doesn't have the button to navigate to the sandbox or even into PowerChart.

My question is, when recording the demonstration of the app, along with real-time screens of functionality, how should we demo the app against the sandbox and/or PowerChart? as the rules state, we should.  Another question, is that we have gone through various Patients i.e. Smart, Peterson, Johnson etc.. and I can't find a Patient that has an entire workup done i.e. Vital Signs, Condition, Med Statement, Med Order, Immunization, Allergies etc.. Is there a Patient, I can use that has a full workup to use as my demo Patient for the app challenge?

Carl.

--

Carl Anthony Osborne

Electronic Health Record Mobile Application Developer
app@ehrconsultantforhire.com | 240.467.4323 direct | carl.anthony.osborne Skype
web - https://www.ehrconsultantforhire.com/ehr-solutions

CONFIDENTIALITY NOTICE: This message and any included attachments are from Carl Anthony Osborne, Electronic Health Record Mobile Application Developer and are intended only for the addressee. The information contained in this message is confidential and may constitute inside or non-public information under international, federal, or state securities laws. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail.

[Yegor Hanov (Cerner)]

Hi, Carl!

For the purposes of the demo, please focus on the value provided by your solution.  If it is a standalone app and can be demonstrated without the need to launch the EHR, that is fine.  Focus on the unique value proposition of your app and you will be in good shape.

We are happy to help you find a patient or stage one if we can't find everything you need with existing data set.  Just to be sure we are on the same page about what you mean by an "entire workup", can you provide more specific information on what data your application consumes and an ideal demo patient setup for you?

Thanks for reaching out.  We look forward to seeing your submission for the challenge.

Thanks,

-Yegor (Cerner)

[Carl Osborne]

Good Morning,

Thank you, Yegor for replying back so quickly.  While testing the application over several months, I have been through a number of Patients in the domain that either don't have full vital signs entered or a Patient that doesn't have a complete chart.  I am looking for a Patient to demo the application, that has full Vitals, Allergies, Procedures, Lab Tests, Conditions, Medication Statement/Orders/Administered, Social History and Patient Information documented.  Granted I can find each of those on random Patients, and maybe that's a way to show how we navigate from chart to chart.  But ultimately, I would like to see all of this information on one Patient.

Thank you.

Carl.

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[Kathy Pickering (Cerner)]

Hi Carl -  Dolly Smart, patient id 5168007, and Wilma Smart, patient id 4342008, are 2 patients with all the data you requested.  Dolly has limited documentation where Wilma has more documentation. 

-  Kathy

[Carl Osborne]

Thanks Kathy!  I used Wilma before and didnt see everything but will check again.

Carl

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Carl Anthony Osborne

Electronic Health Record Mobile Application Developer
app@ehrconsultantforhire.com | 240.467.4323 direct | carl.anthony.osborne Skype
web - https://www.ehrconsultantforhire.com/ehr-solutions

CONFIDENTIALITY NOTICE: This message and any included attachments are from Carl Anthony Osborne, Electronic Health Record Mobile Application Developer and are intended only for the addressee. The information contained in this message is confidential and may constitute inside or non-public information under international, federal, or state securities laws. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail.

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[ke...@phrhero.com]

Hello Kathy, We've recently imported Wilma's json file from the sandbox to our dev environment and we're not seeing any actual clinical data besides demographic info. We're looking for the following.

Allergies, Health History, Lab Results, Medications, Problems, Procedures, Immunization, Vitals. 

If the values are indeed present can you help identify exactly where?

"{"resourceType":"Patient","id":"4342008","meta":{"versionId":"184","lastUpdated":"2018-12-14T19:46:59.000Z"},"text":{"status":"generated","div":"<div><p><b>Patient</b></p><p><b>Name</b>: SMART, WILMA</p><p><b>DOB</b>: Mar 16, 1947</p><p><b>Administrative Gender</b>: Female</p><p><b>Marital Status</b>: Married</p><p><b>Status</b>: Active</p></div>"},"extension":[{"url":"http://fhir.org/guides/argonaut/StructureDefinition/argo-ethnicity","extension":[{"url":"ombCategory","valueCoding":{"system":"http://hl7.org/fhir/v3/Ethnicity","code":"2186-5","display":"Not Hispanic or Latino","userSelected":false}},{"url":"text","valueString":"Not Hispanic or Latino"}]}],"identifier":[{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR","display":"Medical record number","userSelected":false}],"text":"MRN"},"system":"urn:oid:2.2.2.2.2.2","value":"10000891","period":{"start":"2018-09-19T15:58:40.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"MR","display":"Medical record number","userSelected":false}],"text":"MRN"},"system":"urn:oid:1.1.1.1.1.1","value":"10002700","period":{"start":"2016-06-22T20:25:56.000Z"}},{"use":"usual","type":{"text":"Messaging"},"system":"urn:oid:2.16.840.1.113883.3.13.8","value":"65DBEC0B8D154E3488FA5FFE9AC7713F","period":{"start":"2017-12-01T16:54:17.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:687F29DD-69DD-4DE5-ACB1-FD8A2241EF3A:PRINCIPAL:LQ4SG3D28BY","period":{"start":"2017-09-26T05:00:00.000Z","end":"2019-01-02T05:00:00.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.8","value":"9494949494","period":{"start":"2017-09-26T05:00:00.000Z","end":"2019-01-02T05:00:00.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"urn:cerner:identity-federation:realm:687f29dd-69dd-4de5-acb1-fd8a2241ef3a:principal:LQ4Sg3D28BR","period":{"start":"2016-11-01T10:00:00.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:687F29DD-69DD-4DE5-ACB1-FD8A2241EF3A:PRINCIPAL:LQ4SG3D28BR","period":{"start":"2016-11-01T10:00:00.000Z"}},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:DEA7C75B5602A16A00BF980B3DF70E29"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:20A8C75B4900A689D48A72837BF7618B"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:E783C85B410291C9F63855A0609B051F"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:4488C85B3102744477F87768F0C84049"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:6088C85B78004913B151BA7615AAF455"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userSelected":false}],"text":"Federated Person Principal"},"system":"urn:oid:2.16.840.1.113883.3.13.6","value":"URN:CERNER:IDENTITY-FEDERATION:REALM:2E882EFF-FA72-4882-ADC8-A685F7D2BFA6:PRINCIPAL:8088C85BCC02239D3CB1F9FE4CC1DAFD"},{"use":"usual","type":{"coding":[{"system":"http://hl7.org/fhir/v2/0203","code":"AN","display":"Account number","userS

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[Max Philips (Cerner)]

Hi,

That JSON is a FHIR Patient: http://hl7.org/fhir/DSTU2/patient.html. Indeed, that model only contains demographic information.

Try using Wilma's patient id in queries to other resources to load other information about her.

Allergies are in AllergyIntolerance. Social History, Lab Results, and Vitals are in Observation. Medications are in MedicationAdministration/MedicationOrder/MedicationStatement. Problems are in Condition. Immunizations are in Immunization.

Check out https://fhir.cerner.com/millennium/dstu2/ to see which resources Cerner's sandbox exposes.

Thanks,

Max (Cerner)

[John Huynh]

Hi Max,

Is this how we would go about querying for Wilma's information?

`curl -i -H "Accept: application/json+fhir" https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Patient/4342008`

It looks like the json we get back is rather... obfuscated.  We can't go through the secure sandbox either because the SMART app MUST be launched from the code console, and that only allows you to login as one of the selected patients with demographics and logging in as "portal/portal". I've tried entering "wilma_smart/Cerner01" as the username and password too but that gives a "wrong username/password" error. So how can we get Wilma's information through the secure sandbox if the SMART app requires us to use one of the pre-selected patients from the drop down menu? 

[Max Philips (Cerner)]

Hi John,

That request is a Patient read, and you will only see the same information returned as Kenny noted earlier in this thread. You will need to query other resources to get other information. Try some of these:

https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?patient=4342008

https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Observation?patient=4342008

etc.

Continue to set the Accept header for all requests you send.

There should not be any obfuscation applied to the returned JSON. Can you be more specific about what you are seeing in that regard?

When you are logging in while launching via the code console, you should test with portal/portal for the Millennium login. If your application is registered as a provider application, you do not need to use Wilma's patient access login. If you did register your application as a patient application, you'd need to use a patient access login (a different login screen would be presented for patient access).

Once a provider logs in to your application, you can query for Wilma's information either by selecting her in the launch dialog and reading the patient out of the access token to know who to query for, or letting your app find patients itself and drive off that information (i.e. the application would first query patients by name, and a user would pick one, and that patient id would drive the other queries the app makes).

Thanks,

Max (Cerner)

[John Huynh]

Hey Max,

Thanks for the reply! Yea those endpoints work but it's a bit tedious to send 10 requests to different resource endpoints for one patient? I'm creating a patient application for the patient to see all of their health information. For our patient application, the code console doesn't pop up a window to login after I select a patient from the launch dialog and click "Next". It just shows a username and password. I was thinking I might have to use Oauth's username and password authentication flow? Or was there suppose to be a pop up window to login just like there is for the provider app?

John Huynh
University Of California, Los Angeles 2015
B.S. Chemical Engineering Focus in Math

(408)655-5398

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[Max Philips (Cerner)]

Hi John,

If an endpoint existed that could return everything about a patient, the responses it gave could (would) be monstrous! Further, HL7 has broken out its resource models so each can be specific to the data it handles: http://hl7.org/fhir/DSTU2/resourcelist.html. Check Cerner's FHIR server metadata to see which resources we implement: https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/metadata

Can you share your application's name, app id, or list of scopes you've registered?

Thanks,

Max (Cerner)

[John Huynh]

Hi Max,

Ah I see, that makes sense... wish there was like a "summary" endpoint for patients though so I wouldn't have to make 10+ network requests! Also, I would like to provide my application's information but it seems like the site has a new UI and something is wrong with it:

Once that's fixed, will there be a portal to sign in with the username and password provided for Wilma?

[Kol Kheang (Cerner)]

Hi John,

We've a defect with the navigation and the overlay right now with the site.  We're currently working on a new version of the navigation which will resolve this issue that you're seeing.  As of now, you can resolve this issue by maximizing your browser so that everything is fully visible.  You should be able to see and access your apps again after that.

For portal sign in for Wilma, you can access this Google Doc: https://docs.google.com/document/d/1yQXPHs5cqFuoBg6A1SW0495lUpNHb5cPoRlX28TRcck

Sincerely,

Kol

[John Huynh]

Ah thanks Kol!

Maximizing the browser did fix the problem. For reference Max, the app id is: 251b959a-352e-43f6-b722-c25f2ce5afef, and I checked every possible scope to have read/write access. How do I use the username and password for Wilma? There's no portal that pops up where I can sign in with her credentials.

[Max Philips (Cerner)]

Hi John,

You'll need to launch patient-facing apps outside of the Code developer portal.

Thanks,

Max (Cerner)

[John Huynh]

Hi Max,

I've investigated that as well, but everything I've read so far shows me that I need a launch page which is launched from the Code developer portal and uses the ISS and laundId. Is there a document I can read for launching patient-facing apps outside of the code console? 

[Michele Mottini]

Is there a document I can read for launching patient-facing apps outside of the code console? 

It is the standard SMART stand alone lauch: http://hl7.org/fhir/smart-app-launch/#standalone-launch-sequence 

  - Michele

  CareEvolution Inc

[Max Philips (Cerner)]

Thanks Michele!

John, here is some extra documentation from Cerner's SMART on FHIR app tutorial as well: https://engineering.cerner.com/smart-on-fhir-tutorial/#standalone-app-launch-for-patient-access-workflow

Thanks,

Max (Cerner)

[John Huynh]

Oh my, I'll give that a shot! Thanks so much, you guys are amazing.

John Huynh
University Of California, Los Angeles 2015
B.S. Chemical Engineering Focus in Math

(408)655-5398

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