Real time appointments and patient updates in cerner

[Neetoo Maurya]

Hi Experts,

Which API I can use to get/fetch real time appointments and patient updates happening in Cerner (at client end).

Real time appointments updated means appointment booked/cancel or reschedule directly in client Cerner system.

Patient updates means, if  merge of duplicate patients or inactivation of patient happening directly in client's Cerner system. 

Regards,

[Davis Christi (Cerner)]

Hello,

Thanks for reaching out.

Currently, we do not have any endpoint which can alert you that an update has happened, you would have to call the endpoint to retrieve the appointment and if the data has changed it would be reflected on the resource. To fetch the updated Appointment resource, you would have to retrieve the data using the retrieve by id endpoint or use any of the other available search parameters to fetch the appointments. You can find the documentation of the supported capabilities for R4 Spec here and for DSTU2 spec here.

For the patient merges/combines, again we do not have a mechanism to alert, but when you retrieve a patient and that entry has been combined we do let you know on the resource using a link field with a type that would specify that it has been replaced and would give you the new id. You can find the documentation on patient combines for R4 spec here and for DSTU2 spec here.

Thank you

Davis

[Neetoo Maurya]

Thanks for your response. 

Can you please confirm, if date parameter is provided as  &date=2019-09-04T13:00:00.000-05:00

, this means all the appointment booked after 4th September 1pm will be returned, can you please confirm? Also can you share end point url sample for GET /Appointment passing date and practitioner parameters.

Regards, 

[Max Philips (Cerner)]

Hi Neetoo,

Nope, that's not what will happen when the date parameter is provided without a prefix. Here's some information on how the FHIR specification defines date searches: http://hl7.org/fhir/DSTU2/search.html#date

We also have a note on fhir.cerner.com explaining this situation: https://fhir.cerner.com/millennium/dstu2/scheduling/appointment/#parameters

"The date parameter may be provided:

• once without a prefix and with a time component to indicate a specific date/time. (e.g &date=2016-07-04T13:00:00.000-05:00)"

Here's an example GET request with date and practitioner:

https://fhir-open.sandboxcerner.com/r4/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Appointment?practitioner=1314011&date=ge2014-01-01T00:00:00.000Z&date=lt2015-01-01T00:00:00.000Z

Thanks,

Max (Cerner)

[Neetoo Maurya]

Hi Max,

I am making below call as per your suggestion but I am getting Unprocessable entity error:

https://fhir-ehr.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Appointment?practitioner=2578010&date=ge2019-09-09T00:00:00.000Z&date=lt2019-09-10T00:00:00.000Z

x-request-id →ac745227504b43e108c7286b1cd15d64

I tried https://fhir-ehr.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Appointment?practitioner=1994021&date=ge2019-09-09T00:00:00.000Z&date=lt2019-09-10T00:00:00.000Z also and getting same error

x-request-id →c334a4650c024f7e8967c6e6d2d2269d

Can you please advise what is wrong here?

[Max Philips (Cerner)]

Hi Neetoo,

Those two requests were issued as POST requests. If you want to search for results, you need to issue HTTP GET requests, as mentioned above.

Thanks,

Max (Cerner)

[Neetoo Maurya]

Thanks Max, One more thing using such date parameter i.e. date=ge2014-01-01T00:00:00.000Z&date=lt2015-01-01T00:00:00.000Z will return appointment booked for this date and time range or appointment booked in this date/time range.

I mean appointment creation time will fall in this date/time range or appointment date/time of this range. What result will be returned. 

Thanks.

[Max Philips (Cerner)]

When searching for Appointments by date, they are filtered on FHIR Appointment.start.

You can verify this by inspecting this documentation from HL7 that indicates which fields various search parameters interact with: http://hl7.org/fhir/R4/appointment.html#search

Thanks,

Max (Cerner)

[Neetoo Maurya]

Thanks for your quick response Max. So my requirement is any appointment booked/cancel or modified with in some date/time range, I should be able to pull. 

So I just want to confirm, I can get result on apointment.start basis with this API but there is no way of getting appointments on the basis of appointment creation time. 

Regards,

[Max Philips (Cerner)]

I can get result on appointment.start basis with this API

Correct.

 

but there is no way of getting appointments on the basis of appointment creation time.

Correct.

If you want to process appointment creation times, Cerner's FHIR server does return Appointment.meta.lastUpdated, which when the Appointment has been created but not updated after creation, would be the appointment creation time. In other cases when the appointment has been created and updated after the fact, this field will not be the appointment creation time.

Thanks,

Max (Cerner)