Observation.Write Wound Measurements - 422 Unprocessable Entity

[Marc Ochsner]

Hi all,

I've been running into a 422 error that's still unresolved, after changing the content type to application/fhir+json. I was told by our representative to post on here if the request is still having issues, which it clearly is.

I'm trying to send 3 different observations, containing the wound measurement attributes "Length", "Width", and "Depth". I've been told this needs to be categorized as vital signs, and uses a code such as 39125-0 / Width:Len:Pt:Wound:Qn, which I believe were the LOINC codes that I'd requested to be mapped and was returned to me in an Excel sheet as existing.

Method: POST

RequestUri: 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Observation'

Headers:

{

  Accept: application/fhir+json

  Content: application/fhir+json

  Authorization: Bearer <redacted>

  Content-Type: application/fhir+json

  Content-Length: 556

}

Here is the payload:

{"resourceType":"Observation","status":"final","category":[{"coding":[{"system":"http://terminology.hl7.org/CodeSystem/observation-category","code":"vital-signs"}],"text":"Vital-signs"}],"code":{"coding":[{"system":"http://loinc.org","code":"39125-0","display":"Width:Len:Pt:Wound:Qn"}],"text":"Width:Len:Pt:Wound:Qn"},"subject":{"reference":"Patient/12724066"},"encounter":{"reference":"Encounter/97954406"},"effectiveDateTime":"2022-10-11T22:50:54.3907635-04:00","valueQuantity":{"value":5.2,"unit":"cm","system":"http://unitsofmeasure.org","code":"cm"}}

 

Response:

{"severity":"error","code":"invalid","details":{"text":"Unprocessable entity"}}

Any thoughts? Thanks in advance.

[Katey Kowal]

Hi Marc, 

Can you provide the client ID this call was made from, and the x-request or correlation ID for me to find the call/error and troubleshoot?

Thanks,

Katey

[Marc Ochsner]

Hi Katey,

There doesn't look to be a correlation ID that was returned - could that be because of the content-type I'm specifying (application/fhir+json)?

As for the Client ID making the request, it is 1bd6e085-a9dd-4b13-a3da-e6b8ee87e7f2. I have just submitted another request now at 10:25 AM ET, Nov 9th.

- Marc

[Marc Ochsner]

Ah, disregard! It was hidden in the header. Here is the x-request-id (just no correlation id, which I've seen in the body before I believe)

StatusCode: 422, ReasonPhrase: 'Unprocessable Entity', Version: 1.1, Content: System.Net.Http.HttpConnectionResponseContent, Headers:
{
  Transfer-Encoding: chunked
  Connection: keep-alive
  Date: Wed, 09 Nov 2022 15:24:52 GMT
  Cache-Control: no-cache
  Server-Response-Time: 907.670764
  Vary: Origin
  X-Request-ID: e7806e8f-30ff-45a8-bfe9-3458f3f4c6fe+4924_jxKa
  X-Runtime: 0.907611
  X-Cache: Error from cloudfront
  Via: 1.1 3ec7e9c692b1d4a7242f8470f755efa8.cloudfront.net (CloudFront)
  X-Amz-Cf-Pop: ATL59-P2
  X-Amz-Cf-Id: 2QJ3saoo5ukEq5f2_CYDkVOi0AmlexIxDwJS6Pft_WUXESi4hnTLXg==
  Content-Type: application/fhir+json; charset=utf-8
}

On Tuesday, November 8, 2022 at 6:19:17 PM UTC-5 katey...@cerner.com wrote:

[Aaron McGinn (Oracle Cerner)]

The Observation.code that was provided in the request is not configured/mapped in our public sandbox domain. What code were you using?

-Aaron (Oracle Cerner)

[Marc Ochsner]

Hey Aaron,

Earlier in the year, we've gotten confirmation that the "LOINC fields below here are supported inbound. I understood that the bolded were created within the sandbox as part of the program.

"Body Site" 39111-0 as "Body Site" or "Site"

"Width of Wound" 39125-0 as "Incision/Wound Width"

"Depth of Wound" 39127-6 as "Incision/Wound Depth"

"Length of Wound" 39126-8 as "Incision/Wound Length"

In the body, I'm formatting as below, per LOINC specifications:

"code":{

  "coding":[

    {

      "system":"http://loinc.org",

      "code":"39126-8",

      "display":"Length:Len:Pt:Wound:Qn"

    }

   ],

  "text":"Length:Len:Pt:Wound:Qn"

}

Is there another way that this should be formatted - possibly using the "Incision/Wound Length" for the display and/or text fields?
If so, similarly, for "Body Site" - how should that be formatted? "Body Site" or "Site"? Does it make a difference?

Thanks,
Marc