Not able to add Patient resource in Appointment resource

Sahil Bhanot

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Aug 2, 2018, 10:45:23 AM8/2/18

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Hi All,

As per the requirement in the project, need to add the patient resource in Appointment before sending it to the FHIR server. In FHIR we can send any resource in a resource.

When i am serializing a patient resource in an Appointment, it is getting added but when i am deserializing it, the patient resouce is lost and only appointment is left.

I am using the HAPI FHIR(hapi-fhir-structures-dstu3 version:2.5 and hapi-fhir-base version:2.3).

Could anyone help in this regard or there is any other way to implement this solution. Any pointers would be appreciated.

Thanks and Regards,

Sahil Bhanot

James Agnew

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Aug 2, 2018, 11:32:15 AM8/2/18

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Hi Sahil,

A couple of points:

* You should not mix versions of HAPI FHIR between the modules, that is almost guaranteed to cause issues. You should also use the latest version, as you are using a version that is over a year old.

* If you can create a *very brief* code snippet that shows how to reproduce your issue, that will improve your chances of finding a solution. If your issue is with deserialization, a simple code block showing a parse of a string version of your resource would be a good example of such a snippet. Please see our wiki for tips on this.

Cheers,

James

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Sahil Bhanot

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Aug 3, 2018, 7:34:22 AM8/3/18

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Dear James,

Thanks a lot for your quick response.

I have tried with the latest version of HAPI FHIR i.e. 3.4.0 but still facing the same situation. I would explain the whole scenario, you could explain me better where I am committing the mistake or misinterpreting the thing.

To an Appointment resource, I am adding the Patient resource by addContained function illustrated as below:

Appointment appointmentFhir = new Appointment();

appointmentFhir.addContained(fhirPatient);

When I am debugging the code, I could see it clearly that in contained(ArrayList) in Appointment object contains the Patient resource, but when I am parsing the Appointment resource to String with the FHIR JSON parser, no patient resource is present:

String appointment = ctx.newJsonParser().encodeResourceToString(appointmentFhir);

I have booked an Appointment in the public FHIR server "http://hapi.fhir.org/baseDstu3" and the Appointment ID is "4649900". When I am searching the Appointment on the server, It also doesn't contain the Patient resource.

Call to the FHIR server is made:

outcome = client.create().resource(appointmentFhir).encodedJson().execute();

Alternate way is that I have added an extension and put the patient resource in String format, but it is not an appropriate way to achieve this.

Kindly let me know, where I am missing. It is a showstopper for me. Help would be really appreciated.

Let me know, if anything else is required for understanding the issue.

Thanks and Regards,

Sahil Bhanot

Kevin Mayfield

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Aug 3, 2018, 8:14:55 AM8/3/18

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Are you adding the patient to the actual appointment e.g. something like this

appointment.addParticipant().setActorTarget(fhirPatient);

Not sure if that works but you would need to point the appointment to the contained patient.

James Agnew

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Aug 3, 2018, 9:34:35 AM8/3/18

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Contained resources are not valid unless there is a reference to them from the outer resource. That is why they are being dropped by HAPI FHIR.

There are some examples here on how to use contained resources: http://hapifhir.io/doc_resource_references.html#Contained_Resources

Cheers,

James

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Sahil Bhanot

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Aug 3, 2018, 9:45:11 PM8/3/18

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Dear Kevin,

I am adding the patient resource as "appointmentFhir.addContained(fhirPatient);". But there is no reference to Patient resource from Appointment, it is not working.

Could you help me in provided how to provide a reference as studying from "http://hapifhir.io/doc_resource_references.html#Contained_Resources", I am able to add Appointment in Patient but my requirement is to add Patient in Appointment resource.

Thanks in advance,

Sahil

Sahil Bhanot

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Aug 3, 2018, 9:49:22 PM8/3/18

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Thanks James for the reference link. But unfortunately from the link, I understood to add any resource in Patient.

Unfortunately, I am not able to add the Patient in Appointment(not able to provide the reference). I tried putting patient reference via extension in Appointment but it didn't work.

Could you help me, how I can provide a reference for the inner resource(Patient) to the outer one(Appointment).

Thanks and Regards,

Sahil

Kevin Mayfield

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Aug 4, 2018, 4:11:37 AM8/4/18

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This works.

Appointment appointment = new Appointment();
patient.setId("#1");
appointment.addContained(patient);
appointment.addParticipant().setActor(new Reference("#1"));
System.out.println(parser.setPrettyPrint(true).encodeResourceToString(appointment));

The patient is a participant in the Appointment.

However this depends what your use case is It’s not likely you are going to use a contained Patient resource in a patient. (The reasoning behind this: contained resources are normally incomplete resources), if you have complete resource then it should be a separate resource and the appointment references it). For a messaging system, this means the Patient and Appointment would be in the same Bundle and may look like this:

Bundle bundle = new Bundle();

patient.setId("#1");
Appointment appointment = new Appointment();
appointment.addParticipant().setActor(new Reference("#1"));
bundle.addEntry().setResource(appointment);

bundle.addEntry().setResource(patient);

System.out.println(parser.setPrettyPrint(true).encodeResourceToString(bundle));

Which results in:

Notice neither the Patient or Appointment uses contained resources. (if you want to see these try this reference implementation: http://yellow.testlab.nhs.uk/ccri/

<entry>

<actor>

</actor>

</participant>

</Appointment>

</resource>

</entry>

<entry>

<meta>

</meta>

</coding>

</valueCodeableConcept>

</extension>

</coding>

</valueCodeableConcept>

</extension>

</identifier>

</identifier>

</identifier>

<name>

</name>

</telecom>

</telecom>

</address>

</address>

</address>

</address>

</address>

</coding>

</maritalStatus>

</generalPractitioner>

</managingOrganization>

</Patient>

</resource>

</entry>

</Bundle>

You’ll notice the Appointment references the Patient.

if this is on a RESTful API then the code becomes

appointment = new Appointment();
appointment.setId("1");
appointment.addParticipant().setActor(new Reference("Patient/1"));

System.out.println(parser.setPrettyPrint(true).encodeResourceToString(appointment));

and the appointment looks like this:

<actor>

</actor>

</participant>

</Appointment>

. If your trying to send a message then if the Patient is a complete resource (not a partial patient resource), I would rewrite it this way:

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Sahil Bhanot

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Aug 9, 2018, 5:13:11 AM8/9/18

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Dear Kevin,

Thanks a lot . I was just missing the # in the id, while creating the reference to the resource.

My requirement was to send the Patient data along with the Appointment and this contained placeholder is best suited for this requirement.

Again Thanks for desired help.

Cheers,

Sahil

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