TEST: OHIE-CR-06-FHIR

Patient Identity Cross Referencing

This test ensures that the receiver registers patients in two different identity domains (TEST_Aand TEST_B ) and ensures that the receiver can appropriately cross reference the two identifiers in the identity domains using the IHE Patient Identity Cross Referencing (PIXm) transactions.

References

• Integrating the Health Enterprise Patient Master Identity Registry

• HL7 FHIR RelatedPerson Resource

• HL7 FHIR Patient Resource

• Integrating the Health Enterprise Patient Identity Cross Reference for Mobile

Discussion

The IHE PIXm transaction is used in scenarios where only cross-referenced identities are disclosed to callers. The transaction is implemented as an operation on the Client Registry and is invoked returning a collection of parameters which represent the cross referenced identities and no further patient information.

Pre-Conditions

Prior to running this test ensure that the pre-conditions from TEST: OHIE-CR-04 have been run.

Create NID Domain

The NID domain is a sample domain which is being used to simulate a globally assignable national identifier (such as a citizen card, etc.) which can be used by the receiver to eliminate fuzzy matching from this test case.

<dataset id="NID Domain" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns="http://santedb.org/data">
  <!-- TEST -->
  <insert skipIfError="false" skipIfExists="true">
    <AssigningAuthority xmlns="http://santedb.org/model">
      <name>OHIE NID TEST Domain</name>
      <domainName>NID</domainName>
      <oid>2.16.840.1.113883.3.72.5.9.9</oid>
      <url>http://ohie.org/test/nid</url>
      <isUnique>true</isUnique>
    </AssigningAuthority>
  </insert>
</dataset>

Authenticate as TEST_HARNESS_FHIR_A

The test harness authenticates against the SanteMPI IdP using a client_credentials grant for the test-harness-a account.

POST http://localhost:8080/auth/oauth2_token HTTP/1.1
Accept-Encoding: gzip,deflate
Content-Type: application/x-www-form-urlencoded;charset=UTF-8
Content-Length: 94
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)

grant_type=client_credentials&scope=*&client_secret=TEST_HARNESS&client_id=TEST_HARNESS_FHIR_A

Execute PIXm Query for Non-Existent Patient in TEST_A

The test harness sends an IHE PIXm query for a patient with identifier FHIRA-8767 to the receiver.

GET http://localhost:8080/fhir/Patient/$ihe-pix?sourceIdentifier=http%3A%2F%2Fohie.org%2Ftest%2Ftest_a%7CFHRA-060 HTTP/1.1
Accept-Encoding: gzip,deflate
Authorization: BEARER XXXXXXX
accept: application/fhir+json
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)

Expected Behaviour

Requirement	Option	Description
MUST		Return HTTP code of 404 NOT FOUND
MUST		Include an OperationOutcome entry in the response
MUST		Include have a detail with issue type not-found
SHOULD		Indicate the the identifier pair which is not found

Register New Patient Identity in TEST_A

The test harness sends an authenticated request to create a new patient with a new identifier in TEST_A domain. Patient details:

• Identifier FHRA-061 in http://ohie.org/test/test_a with use official

• Identifier NID061 in http://ohie.org/test/nid

• Name: JIM SMITH

• Gender: Male

• DOB: 1984-05-25

{
  "resourceType": "Bundle",
  "type": "message",
  "entry": [
    {
      "fullUrl": "MessageHeader/ohie-cr-06-20-fhir",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "1",
        "eventUri": "urn:ihe:iti:pmir:2019:patient-feed",
        "source": {
          "endpoint": "http://ohie.org/test/test_harness_b"
        },
        "focus": [
          {
            "reference": "Bundle/ohie-cr-06-10-fhir"
          }
        ],
        "destination": [
          {
            "endpoint": "http://ohie.org/test/endpoint/Bundle"
          }
        ]
      }
    },
    {
      "fullUrl": "Bundle/ohie-cr-06-10-fhir",
      "resource": {
        "resourceType": "Bundle",
        "type": "history",
        "entry": [
          {
            "fullUrl": "Patient/ohie-cr-06-10-fhir",
            "resource": {
		    "resourceType": "Patient",
		    "id": "ohie-cr-06-10-fhir",
		    "active": true,
		    "identifier": [
		      {
		        "use": "official",
		        "type": {
		          "coding": [
		            {
		              "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
		              "code": "PI"
		            }
		          ]
		        },
		        "system": "http://ohie.org/test/test_a",
		        "value": "FHRA-061",
		        "assigner": {
		          "display": "Test Harness A Patient Identity"
		        }
		      },
		      {
		        "use":"usual",
		        "system": "http://ohie.org/test/nid",
		        "value":"NID061"
		      }
		    ],
		    "name": [
		      {
		        "use": "official",
		        "family": "SMITH",
		        "given": [
		          "JIM"
		        ]
		      }
		    ],
		    "gender": "male",
		    "birthDate": "1984-05-25",
		  },
            "request": {
              "method": "POST",
              "url": "Patient/ohie-cr-06-10-fhir"
            }
          }
        ]
      }
    }
  ]
}

Expected Behaviour

Requirement	Option	Description
MUST	PMIR Only	Return MessageHeader with response.code = ok
MUST		Return HTTP code of 201 Created
SHOULD	PMIR Only	Include an OperationOutcome entry in the response
SHOULD		Include a Patient entry in response containing created patient
SHOULD		Include a link to the master identity with code refer

Execute PIXm Query Patient in TEST_A

The test harness sends an IHE PIXm query for a patient with identifier FHRA-061 to the receiver.

GET http://localhost:8080/fhir/Patient/$ihe-pix?sourceIdentifier=http%3A%2F%2Fohie.org%2Ftest%2Ftest_a%7CFHRA-061 HTTP/1.1
Accept-Encoding: gzip,deflate
Authorization: BEARER XXXXXXX
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)

Expected Behaviour

Requirement	Option	Description
MUST		Return HTTP code of 200 OK
MUST		Include a Parameters resource in the response
MUST		Have two parameters carrying the identifier in TEST_A and NID with parameter name of targetIdentifier
MUST		Include a parameter with name targetId which has a resource link to the created resource from the previous step.

Authenticate as TEST_HARNESS_FHIR_B

The test harness authenticates against the SanteMPI IdP using a client_credentials grant for the test-harness-a account.

POST http://localhost:8080/auth/oauth2_token HTTP/1.1
Accept-Encoding: gzip,deflate
Content-Type: application/x-www-form-urlencoded;charset=UTF-8
Content-Length: 94
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)


grant_type=client_credentials&scope=*&client_secret=TEST_HARNESS&client_id=TEST_HARNESS_FHIR_B

Register New Patient Identity in TEST_B

The test harness sends an authenticated request to create a new patient with a new identifier in TEST_B domain. Patient details:

• Identifier FHRB-062 in http://ohie.org/test/test_b with use official

• Identifier NID061 in http://ohie.org/test/nid

• Name: JIM SMITH

• Gender: Male

{
  "resourceType": "Bundle",
  "type": "message",
  "entry": [
    {
      "fullUrl": "MessageHeader/ohie-cr-06-20-fhir",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "1",
        "eventUri": "urn:ihe:iti:pmir:2019:patient-feed",
        "source": {
          "endpoint": "http://ohie.org/test/test_harness_b"
        },
        "focus": [
          {
            "reference": "Bundle/ohie-cr-06-20-fhir"
          }
        ],
        "destination": [
          {
            "endpoint": "http://ohie.org/test/endpoint/Bundle"
          }
        ]
      }
    },
    {
      "fullUrl": "Bundle/ohie-cr-06-20-fhir",
      "resource": {
        "resourceType": "Bundle",
        "type": "history",
        "entry": [
          {
            "fullUrl": "Patient/ohie-cr-06-20-fhir",
            "resource": {
		    "resourceType": "Patient",
		    "id": "ohie-cr-06-20-fhir",
		    "active": true,
		    "identifier": [
		      {
		        "use": "official",
		        "type": {
		          "coding": [
		            {
		              "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
		              "code": "PI"
		            }
		          ]
		        },
		        "system": "http://ohie.org/test/test_b",
		        "value": "FHRB-062",
		        "assigner": {
		          "display": "Test Harness B Patient Identity"
		        }
		      },
		      {
		        "use":"usual",
		        "system": "http://ohie.org/test/nid",
		        "value":"NID061"
		      }
		    ],
		    "name": [
		      {
		        "use": "official",
		        "family": "SMITH",
		        "given": [
		          "JIM"
		        ]
		      }
		    ],
		    "gender": "male"
		  },
            "request": {
              "method": "POST",
              "url": "Patient/ohie-cr-06-20-fhir"
            }
          }
        ]
      }
    }
  ]
}

Expected Behaviour

Requirement	Option	Description
MUST	PMIR Only	Return MessageHeader with response.code = ok
MUST		Return HTTP code of 201 Created
SHOULD	PMIR Only	Include an OperationOutcome entry in the response
SHOULD		Include a Patient entry in response containing created patient
SHOULD		Include a link to the master identity with code refer

Execute PIXm Query Patient using NID for TEST_A

The test harness sends an IHE PIXm query for a patient with identifier NID061 to the receiver and explicitly requests a resolve to TEST_A.

GET http://localhost:8080/fhir/Patient/$ihe-pix?sourceIdentifier=http%3A%2F%2Fohie.org%2Ftest%2Fnid%7CNID061&targetSystem=http%3A%2F%2Fohie.org%2Ftest%2Ftest_a HTTP/1.1
Accept-Encoding: gzip,deflate
Authorization: BEARER XXXXXXX
accept: application/fhir+json
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)

Expected Behaviour

Requirement	Option	Description
MUST		Return HTTP code of 200 OK
MUST		Include a Parameters resource in the response
MUST		Have one parameter carrying the identifier FHRA-061 in TEST_A
MUST		Include a parameter with name targetId which has a resource link to the created resource from the previous step.

Execute PIXm Query Patient using TEST_B for TEST_X

The test harness sends an IHE PIXm query for a patient with identifier FHRB-062 to the receiver asking for identities in TEST_X.

GET http://localhost:8080/fhir/Patient/$ihe-pix?sourceIdentifier=http%3A%2F%2Fohie.org%2Ftest%2Ftest_b%7CFHRB-062&targetSystem=http%3A%2F%2Fohie.org%2Ftest%2Ftest_x HTTP/1.1
Accept-Encoding: gzip,deflate
Authorization: BEARER XXXXXXX
accept: application/fhir+json
Host: localhost:8080
Connection: Keep-Alive
User-Agent: Apache-HttpClient/4.5.5 (Java/12.0.1)

Expected Behaviour

Requirement	Option	Description
MUST		Return HTTP code of 403 FORBIDDEN
MUST		Include an OperationOutcome resource in the response
MUST		Carry an issue type code-invalid
SHOULD		Include a description that indicates the domain which caused the error condition