Procedure with Notes

[Randy Hunsaker]

Hi,

I'm trying to test retrieval and display of Procedure resources and associated Note resources.  I've tried all of the test patients (except Whoopi Goldberg as her login/password isn't documented) and none of them seem to return Note resources with their Procedure resources.  Can you add some Note resources to the test patients?

Thanks,

Randy

[Randy Hunsaker]

Any comments from Cerner on this?

Thanks,

Randy

[Kathy Pickering (Cerner)]

Hi Randy -  Please try Wilma Smart patient id 4342008 and procedure id 38186575.

- Kathy 

[Randy Hunsaker]

Hi Kathy,

Thanks for the response.  I tried that patient and procedure, but the FHIR resource data I received did not seem to contain any notes.  Here's a correlation Id:

Raw Request: "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure?patient=4342008"

X-Request-Id: c3775bf2-b22a-11e8-a20e-d3532d6d21b9

Any help you can provide is appreciated.

Thanks,

Randy

[Randy Hunsaker]

Here's another attempt with a bit more detail:

Raw Request: "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure?patient=4342008"

X-Request-Id: 4e472dbe-b22d-11e8-b497-dff183c3f109

Response Body:

 "resourceType": "Bundle",
 "id": "f0596a0b-9209-418e-9907-f6ed592fe86d",
 "type": "searchset",
 "total": 3,
 "link": [{
 "relation": "self",
 "url": "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure?patient=4342008"
 }
 ],
 "entry": [{
 "fullUrl": "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure/36530557",
 "resource": {
 "resourceType": "Procedure",
 "id": "36530557",
 "meta": {
 "versionId": "1",
 "lastUpdated": "2017-09-28T15:34:40.000Z"
 },
 "text": {
 "status": "generated",
 "div": "\u003Cdiv\u003E\u003Cp\u003E\u003Cb\u003EProcedure\u003C/b\u003E\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ESubject\u003C/b\u003E: SMART, WILMA\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ECode\u003C/b\u003E: Renal angiogram\u003C/p\u003E\u003Cp\u003E\u003Cb\u003EStatus\u003C/b\u003E: Completed\u003C/p\u003E\u003C/div\u003E"
 },
 "subject": {
 "reference": "Patient/4342008",
 "display": "SMART, WILMA"
 },
 "status": "completed",
 "code": {
 "coding": [{
 "system": "http://snomed.info/sct",
 "code": "420013002",
 "display": "Fluoroscopic angiography of renal artery (procedure)"
 }
 ],
 "text": "Renal angiogram"
 },
 "performedDateTime": "2017-02-03T00:00:00.000-06:00",
 "encounter": {
 "reference": "Encounter/4027909"
 }
 }
 }, {
 "fullUrl": "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure/38186575",
 "resource": {
 "resourceType": "Procedure",
 "id": "38186575",
 "meta": {
 "versionId": "3",
 "lastUpdated": "2018-09-06T22:23:21.000Z"
 },
 "text": {
 "status": "generated",
 "div": "\u003Cdiv\u003E\u003Cp\u003E\u003Cb\u003EProcedure\u003C/b\u003E\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ESubject\u003C/b\u003E: SMART, WILMA\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ECode\u003C/b\u003E: Appendectomy\u003C/p\u003E\u003Cp\u003E\u003Cb\u003EStatus\u003C/b\u003E: Completed\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ELocation\u003C/b\u003E: TEST LOCATION GROUP\u003C/p\u003E\u003C/div\u003E"
 },
 "subject": {
 "reference": "Patient/4342008",
 "display": "SMART, WILMA"
 },
 "status": "completed",
 "code": {
 "coding": [{
 "system": "http://snomed.info/sct",
 "code": "80146002",
 "display": "Appendectomy (procedure)"
 }
 ],
 "text": "Appendectomy"
 },
 "_performedDateTime": {
 "extension": [{
 "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
 "valueCode": "unknown"
 }
 ]
 },
 "encounter": {
 "reference": "Encounter/4275906"
 },
 "location": {
 "reference": "Location/25334551",
 "display": "TEST LOCATION GROUP"
 }
 }
 }, {
 "fullUrl": "https://fhir-myrecord.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/Procedure/37154555",
 "resource": {
 "resourceType": "Procedure",
 "id": "37154555",
 "meta": {
 "versionId": "1",
 "lastUpdated": "2018-09-06T22:23:04.000Z"
 },
 "text": {
 "status": "generated",
 "div": "\u003Cdiv\u003E\u003Cp\u003E\u003Cb\u003EProcedure\u003C/b\u003E\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ESubject\u003C/b\u003E: SMART, WILMA\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ECode\u003C/b\u003E: Surgery, elective\u003C/p\u003E\u003Cp\u003E\u003Cb\u003EStatus\u003C/b\u003E: Completed\u003C/p\u003E\u003C/div\u003E"
 },
 "subject": {
 "reference": "Patient/4342008",
 "display": "SMART, WILMA"
 },
 "status": "completed",
 "code": {
 "text": "Surgery, elective"
 },
 "performer": [{
 "actor": {
 "reference": "Practitioner/1314011",
 "display": "Dickey, Doug"
 }
 }
 ],
 "performedDateTime": "2017-11-29T00:00:00.000-06:00",
 "encounter": {
 "reference": "Encounter/4027909"
 }
 }
 }
 ]
}

Thanks,

Randy

[Jenni Syed (Cerner)]

Hi Randy,

We don't expose notes or "comments" to patients and it looks like you're accessing it via patient or patient proxy. If you access via the open endpoint, you would see the practitioner view of the resource.

Regards,

Jenni

[Randy Hunsaker]

Thanks Jenni.  I'll try from the open endpoint.  It might be helpful to update the documentation on the Procedure resource to indicate that the Notes won't be returned, even in valued, for patient access.

Thanks,

Randy

[Jenni Syed (Cerner)]

Yes, we probably need a common section, as this and a few other rules filter what patients see a bit. This is consistent across resources (eg: for comments that aren't related to instructions to the patient, none of the resources will contain those details when the patient accesses the data). Those are relatively easy to describe.

There are also scenarios in which privacy takes a part along with legal rules and can limit fields. EG: for adolescents, when accessed by a proxy (eg: parent) there are legal rules that dictate that the proxy cannot see some "sensitive" information. These types of rules would be hard to describe specifically as there are different laws and regulations in different countries, regions, and states/provinces. However, we should call out that it can vary.

~ Jenni

[Randy Hunsaker]

Yeah, that makes sense.  Thanks for the clarification.

-Randy