Unable to create Observation "Internal service error from resource store" (R4)

[Raghavan Chandrabalan]

Hi Cerner team,

I've been unable to create/POST any Observations to the public sandbox, and the response I have been receiving is an "Internal service error from resource store" OperationOutcome. The X-Request-Id for one of my attempts is 69a9fd0f-c575-4ac5-b366-a5a2ff609971+8410, which was for a slightly modified version of the example Observation at http://fhir.cerner.com/millennium/r4/clinical/diagnostics/observation/#example-2. I have also attempted to send one with/without the performer and encounter fields, but I get the same response.

Are there any issues with the resource I'm sending that would be causing this?

I have been successful in creating a MedicationRequest (X-Request-Id: ba5350f7-6efd-400d-a8c1-67da0261e72c+4911), so the error seems to be specific to the way I'm sending Observations.

It looks like some of the documentation for vital signs support is at https://wiki.cerner.com/pages/releaseview.action?spaceKey=reference&title=Understand%20Supported%20Vital%20Signs%20in%20the%20FHIR%20Observation%20Resource, but we've been unable to access it since our company does not have a Client Number for registration. If the wiki would help with troubleshooting please let me know how/if we may gain access to it.

Thank you,

Raghavan

[Fenil Desani (Cerner)]

Hello Raghavan,

Can you please provide the POST body?

Thanks,
Fenil

[Raghavan Chandrabalan]

The POST body is:

{
    "resourceType": "Observation",
    "status": "final",
    "category": [
        {
            "coding": [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "vital-signs",
                    "display": "Vital Signs"
                }
            ],
            "text": "Vital Signs"
        }
    ],
    "code": {
        "coding": [
            {
                "system": "http://loinc.org",
                "code": "8331-1"
            }
        ],
        "text": "Temperature Oral"
    },
    "subject": {
        "reference": "Patient/12724066"
    },
    "performer": [
        {
            "extension": [
                {
                    "valueCodeableConcept": {
                        "coding": [
                            {
                                "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                "code": "LA",
                                "display": "legal authenticator"
                            }
                        ],
                        "text": "legal authenticator"
                    },
                    "url": "http://hl7.org/fhir/StructureDefinition/event-performerFunction"
                }
            ],
            "reference": "Practitioner/12742069"
        }
    ],
    "effectiveDateTime": "2020-04-03T19:21:00.000Z",
    "issued": "2020-04-03T19:21:40.000Z",
    "valueQuantity": {
        "value": 37.2,
        "unit": "degC",
        "system": "http://unitsofmeasure.org",
        "code": "Cel"
    },
    "interpretation": [
        {
            "coding": [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                    "code": "N",
                    "display": "Normal"
                }
            ]
        }
    ],
    "referenceRange": [
        {
            "low": {
                "value": 35.8,
                "unit": "degC",
                "system": "http://unitsofmeasure.org",
                "code": "Cel"
            },
            "high": {
                "value": 37.3,
                "unit": "degC",
                "system": "http://unitsofmeasure.org",
                "code": "Cel"
            },
            "type": {
                "coding": [
                    {
                        "system": "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
                        "code": "normal",
                        "display": "Normal Range"
                    }
                ],
                "text": "Normal Range"
            }
        }
    ]
}

Being sent for patient "Nancy SMART", and the X-Request-Id is 611c6274-ea5a-4fc6-af8e-9aa61e810d20+5759

[Raghavan Chandrabalan]

Has there been any progress regarding this issue? If any additional info from us may help, or if there are any leads/docs for us to look into in the meantime, please let me know

Thank you,

Raghavan

[Fenil Desani (Cerner)]

Can you give one more try?

[Raghavan Chandrabalan]

Still getting the same error

[Fenil Desani (Cerner)]

Can you please provide the X_Request-Id of the recent failure?

[Raghavan Chandrabalan]

Sure, it's 345c7289-98ef-4b03-b3fd-2e5cfe79224f+2900

[Fenil Desani (Cerner)]

I'm taking a look!

[Alexander Goel]

Hi Fenil,

We were wondering if you made any progress on this or had any more questions. We've got our MedicationRequests working, but haven't made any progress on the Observations. Do you think it's an issue with our LOINC Code representation or something else?

Alex