Document Reference Types

[Rob Rucker]

Hello,

For the DocumentReference resource, is it possible for a specific organization to customize which document types are returned by the resource? The documentation at https://fhir.cerner.com/millennium/dstu2/infrastructure/document-reference/ says that the list of document types "is one of the things we evaluate and implement as needed when we are making apps available at client sites."

-Rob Rucker

[FHIR Guy]

Yes, as I understand it. 

It's a mapping exercise at the specific client site. The way Millennium is built - there is a proprietary code value associated to a document type. To translate that value to an industry standard value (e.g. LOINC), there would be a mapping between the proprietary Millennium document code value and the industry standard value.

Max Philips does a good job outlining a similar question that substantiates my response, in FHIR Sandbox: https://groups.google.com/d/msg/cerner-fhir-developers/-AuOWymOFvo/9Wq3v8SjBAAJ

As a bonus, looks like you'll get both proprietary and industry standard values returning in the payload with the DocRef R4 API. https://fhir.cerner.com/millennium/r4/documents/document-reference/. 

"type": {
          "coding": [
            {
              "system": "https://fhir.cerner.com/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/codeSet/72",
              "code": "2820555",
              "display": "Progress Note-Physician",
              "userSelected": true
            },
            {
              "system": "http://loinc.org",
              "code": "11506-3",
              "userSelected": false
            }
          ],
          "text": "Progress Note-Physician"
        },

I'm sure the Cerner FHIR guys can comment more as well if I missed any context. 

---

[Max Philips (Cerner)]

Hi Rob,

Correct, codes returned in DocumentReference.type can (will) vary from client site to client site. The note you point out is an indication that during the onboarding of an app that consumes documents to a particular client site, Cerner will work with you to ensure that any workflows the app has can be satisfied with whatever codes that particular client uses.

Thanks for providing extra context FHIR Guy!

Thanks,

Max (Cerner)

[Max Philips (Cerner)]

Note also that these variations in DocumentReference.type are limited to clinical note documents.

[Rob Rucker]

Thanks for y'all's input!