This track focuses on FHIR based RESTFUL exchange of orders from an EHR to a supplier or supplier HIT (or Hub) and the ability to update the order after order fulfillment.
Ability to define a Post-Acute FHIR based Order (PAO) for DME and Home Health Services to facilitate order exchange between the ordering provider and the DME supplier or the Home Health Agency.
Test: To send a message bundle with a Task, Subscription, Order (e.g. DeviceRequest) and supporting documentation). The receiver (supplier, service provider, HUB) is able to receive it, respond back to the message, instantiate the Task, and has the ability to respond back to the ordering provider’s subscription with an alert or Task order when the Task is updated. We also want to test the ability to exchange an updated and cancel for the order or cancel the order.
- Test an Implementation Guide (https://build.fhir.org/ig/HL7/dme-orders/index.html)
Submitting Work Group/Project/Accelerator/Affiliate/Implementer Group
Post-acute Order Workgroup (for Orders and Observations)
Proposed Track Lead
Kenneth Hodel, Apria Healthcare, firstname.lastname@example.org
Billy Waldrop, Vorro Health, email@example.com
Jeremy Reagan, Vorro Health, firstname.lastname@example.org
Nandini Ganguly, ScopeInfoTechInc, email@example.com
SME: Zane Schott, firstname.lastname@example.org
SME: Robert Dieterle, email@example.com
- FHIR R4
Specification(s) this track uses
Implementation Guide Link: https://build.fhir.org/ig/HL7/dme-orders/index.html
Artifacts of focus
Clinical input requested (if any)
Patient input requested (if any)
EHR vendors, DME suppliers or DME order management systems and home health agency technology suppliers . If interested please email us at firstname.lastname@example.org.
Zulip chat link for this session: https://chat.fhir.org/#narrow/stream/236612-DME-Orders.20on.20FHIR
A track orientation was hosted on Aug 17th (12 to 1:00 pm ET). To listen to the recording, please CLICK HERE.
Role 1: Order creation system – creates and send FHIR based orders for DME and/or Home Health Services (should prepare in advance but may build at connectathon)
Role 2: Order receiving system – receives and interprets the FHIR based orders for DME and/or Home Health Services (should prepare in advance but may build at connectathon)
Role 3: Intermediary routing system – receives order and routes it to the correct endpoint – may convert order to other format based on capability of the final endpoint (should prepare in advance but may build at connectathon)
Working on (2) Scenarios with multiple steps for basic order content, advanced order content, and ability to support clinical attachments
Scenario 1 Step 1: Home Oxygen Order
Action: Create an POA order message bundle for Home Oxygen Therapy including PAO DeviceRequest Profile as the basis for the order and sending it to the processmessage endpoint of the supplier or intermediary.
Success Criteria: Receiving a valid order bundle for Home Oxygen using the PAO DeviceRequest profile
Bonus point: None
Scenario 1 Step 2: Responding to the message bundle with an appropriate status
Success Criteria: Sender receiving a confirmation of the status of the order in response to the initial submission
Scenario 1 Step 3: Responding to the subscription with an appropriate notification
Success Criteria: Sender receiving a subscription notification when the status of the order (task) changes
Scenario 2 Step 1-3: Home Oxygen Order
Same steps as for the Home Oxygen Order but focused on Home Health using the PAO ServiceRequest profile
Bonus Point: include documentation for the order in the order bundle (suggestion is to include specific resources that support the order of Home Oxygen (e.g. condition, observation, encounter)
Use basic Aegis test scripts for the R4 release
Security and Privacy Considerations
Identify any expectations around security (e.g. will TLS, mutual-TLS, OAuth, etc. be required to participate)
Track Report Out
What was the track trying to achieve?
Goal: Ability to define a Post-Acute FHIR based Order (PAO) for DME to facilitate order exchange between the ordering provider and the DME supplier or rendering provider.
Test: To create a FHIR based exchange with a Task triggered by an Ordering Provider. The receiver (supplier, service provider, HUB) is able to receive it, acknowledge the message, instantiate the Task, request the required resources to complete the order, and has the ability to respond back to the ordering provider’s subscription with an alert or Task order when the Task is updated.
- Needed to clarify FHIR Messaging vs RESTful FHIR Exchange
- Assumptions are missing concerning the capabilities of the Ordering Provider
- Need further clarification concerning the actual data being exchanged in each step of the workflow
- Clarify ability to implement ordering and supply capability as to how to connect a FHIR server to existing systems
- Needed to clarify workflow with respect to use of task and subscription
- Include complete sets as examples in the Implementation Guide for a STU balloting in Jan 2020
- Complete examples, value sets and all exchanges (initial order, update, cancel etc.)
- Create scenarios and examples for inclusion of relevant order review events (e.g. prior authorization, appropriate use)
- Test examples with other participants to ensure they work with multiple systems
- Work with EHR systems (e.g. Epic, Cerner) to generate directly or via a SMART application the appropriate message bundles as the ordering provider
- Plan and conduct additional virtual Connectathons