FHIR Bulk Data API spec compliance

[Branden Rauch (CareEvolution)]

Hello,

I've been working the BCDA test server and I have some concerns about the the server implementation not following the FHIR bulk data API specifications.

The bulk data API spec says that all support FHIR resource type data files should be generated through calling '/Patient/$export' but the BCDA test server only outputs provides Patient resources from '/Patient/$export'. To get ExplanationOfBenefit resources you have to make a separate call to '/ExplanationOfBenefit/$export'. Same with Coverage resources at '/Coverage/$export'. This forces the client implementation to be significantly more complex and does not align with other bulk data server implementations. Instead, why not provide all supported types through '/Patient/$export' like the bulk data API spec describes? If the client does not need all the supported types they could and use the '_type' query parameter filter, which was proposed by the bulk data API spec to limit the types to only those desired.

Also, the resource ndjson data files are currently not compliant the bulk data API spec. Each FHIR resource is wrapped inside of another object under its 'resource' property:

{"resource":{"address":[{"district":"999","postalCode":"99999","state":"34"}],"birthDate":"1999-06-01","extension":[{"url":"https://bluebutton.cms.gov/resources/variables/race","valueCoding":{"code":"1","display":"White","system":"https://bluebutton.cms.gov/resources/variables/race"}}],"gender":"unknown","id":"-19990000002901","identifier":[{"system":"https://bluebutton.cms.gov/resources/variables/bene_id","value":"-19990000002901"},{"system":"https://bluebutton.cms.gov/resources/identifier/hicn-hash","value":"ff8171ed25f7434378d985d060f87044c9588b88bcaf6e68b88a8294a44596b5"}],"name":[{"family":"Doe","given":["Jane","X"],"use":"usual"}],"resourceType":"Patient"}}

{"resource":{"address":[{"district":"999","postalCode":"99999","state":"42"}],"birthDate":"1999-06-01","extension":[{"url":"https://bluebutton.cms.gov/resources/variables/race","valueCoding":{"code":"1","display":"White","system":"https://bluebutton.cms.gov/resources/variables/race"}}],"gender":"unknown","id":"-19990000002902","identifier":[{"system":"https://bluebutton.cms.gov/resources/variables/bene_id","value":"-19990000002902"},{"system":"https://bluebutton.cms.gov/resources/identifier/hicn-hash","value":"b8d5ce7125a2c6de00b437b829707133024d3abe29bda7b8d0367ae9a88aae05"}],"name":[{"family":"Doe","given":["Jane","X"],"use":"usual"}],"resourceType":"Patient"}}

The resource objects should output directly, not wrapped inside of another object. The wrapper object is not necessary...it looks like it also provides a 'resourceType' property but we already know what resource type the file contains prior to downloading it (from the job output).

Thanks,

Branden Rauch

[Terrance Bell]

Thanks Branden for reaching out. I've shared your concerns with the rest of the development team and we'll be sure to follow up with you on this issue. Thanks for the feedback and keep it coming!!

Terrance Bell
Software Engineer

email tb...@fearless.tech
cell 410.271.4503
office 8 Market Place #304, Baltimore

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