I'm building out a feature for our app that allows practitioners to search across a group of patients by a condition, medication, or observation code (i.e. SNOMED, RxNorm, LOINC, etc).
As far as I can tell, there wouldn't be a way to do this with a single FHIR request. A Patient
reference is always required for these resources which codes are attached to (https://fhir.cerner.com/millennium/dstu2/diagnostic/observation/
). Ideally we would like the following type of query to be available that just specifies the code but doesn't specify the patient:
Understandably, this might produce a large number of results, but I know Cerner can provide paginated results which we would be happy with. We could also limit the results to a certain date range.
The alternative solution we're considering is to get and insert each patient/code combination into our own tablespace and to make searches against that. We've experimented with bulk importing all observation/med/condition codes for a group of patients and found that these resources only support querying for one patient at a time. I just want to confirm that Cerner does not support getting these resources across multiple patients, such as the following:
Does Cerner have any plans to support either of these types of searches (either unspecified patient w/ codes or multi-patient search)? If not, would Cerner suggest investigating another form of importing bulk patient data (i.e. exported CCDAs) instead of planning to make a large number of requests for FHIR resources to get each patient's data individually? If we schedule a large import of data for many patients, I'm afraid that the 1000's of requests to a FHIR endpoint may get us rate throttled.