TEST: OHIE-CR-07-FHIR

Full Patient Registration

This test ensures that the Client Registry can properly store key fields related to patient demographics fields, and faithfully return them on subsequent queries using the fields stored within the CR ensuring that the CR properly supports the PDQm query parameters.

References

• Integrating the Health Enterprise Patient Master Identity Registry

• HL7 FHIR RelatedPerson Resource

• HL7 FHIR Patient Resource

• Integrating the Health Enterprise Patient Demographics Query for Mobile

Discussion

The IHE PDQm transaction is used in scenarios where demographics fields are used to locate candidate demographics entries to/from the client registry's central store. The Client Registry is expected to:

• Be capable of storing all demographics fields in the registration message within this test

• Perform matching on the provided demographics fields with the fields in its data store

• Apply appropriate modifiers to the search query parameters that allow a client to have control over the nature of matching.

Pre-Conditions

Prior to running this test ensure that the pre-conditions from TEST: OHIE-CR-02 and TEST: OHIE-CR-06 have been run.

Create ORGs Domain

The ORG domain is registered to support the identifiers given to organizations in the SanteDB instance.

<dataset id="ORG 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 Organization Domain</name>
      <domainName>ORG</domainName>
      <oid>2.16.840.1.113883.3.72.5.9.20</oid>
      <url>http://ohie.org/test/orgs</url>
      <isUnique>true</isUnique>
    </AssigningAuthority>
  </insert>
</dataset>

Create PROVIDERs Domain

The providers domain is registered to support the identifiers given to practitioners / providers.

In SanteDB this can be seeded with a dataset:

<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 Providers Domain</name>
      <domainName>PROVIDERS</domainName>
      <oid>2.16.840.1.113883.3.72.5.9.21</oid>
      <url>http://ohie.org/test/practs</url>
      <isUnique>true</isUnique>
    </AssigningAuthority>
  </insert>
</dataset>

Authenticate as TEST_HARNESS

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

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: 87
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

Register Flynn Full Profile

The test harness will register a patient into the client registry which has a complete demographics profile. The patient resource being registered has the following attributes:

• Identifier FHR-070 in domain http://ohie.org/test/test

• Official Name: Dr. (Prefix) Flynn Full (Given) Profile (Surname) III (Suffix)

• Alias: Dr. Profile

• Home Address: Unit 32 (Line) 123 Ontario St. (Line) , Beamsville (City), Lincoln (District), Ontario (State), Canada (Country), L0R2A0 (Postal Code)

• Workplace Phone: [phone]

• Home Email: [e-mail]

• Mobile: [phone]

• Gender: Male

• Birthdate: 1982-03-02

• Marital Status: Married

• Contact:

  • Insurance Company

  • Name: ACME Insurance Corp.

  • Organization: Organization/ohie-cr-07-10-fhir

• Contact:

  • Relationship: Next of Kin / Contact

  • Name: Allison Profile

  • Address: 123 Ontario St. Beamsville, Lincoln, Ontario, Canada L0R2A0

  • Gender: Female

• Communication: EN (Preferred), FR

• General Practitioner: Practitioner/ohie-cr-07-10-fhir

• Managing Organization: Organization/ohie-cr-07-10-fhir-emp

Additionally, the message has registration information for Flynn's insurance provider ACME Insurance, Flynn's Wife Allison Profile, Flynn's Practitioner Dr. Andrew Fudd, and his Managing Organization University Medical Centre.

{
  "resourceType": "Bundle",
  "type": "message",
  "entry": [
    {
      "fullUrl": "MessageHeader/ohie-cr-07-10-fhir",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "1",
        "eventUri": "urn:ihe:iti:pmir:2019:patient-feed",
        "source": {
          "endpoint": "http://ohie.org/test/test_harness"
        },
        "focus": [
          {
            "reference": "Bundle/ohie-cr-07-10-fhir"
          }
        ],
        "destination": [
          {
            "endpoint": "http://ohie.org/test/endpoint/Bundle"
          }
        ]
      }
    },
    {
      "fullUrl": "http://test.ohie.org/fhir/Bundle/ohie-cr-07-10-fhir",
      "resource": {
        "resourceType": "Bundle",
	   "id": "ohie-cr-07-10-fhir",
        "type": "history",
        "entry": [
          {
            "fullUrl": "http://test.ohie.org/fhir/Organization/ohie-cr-07-10-fhir-acme",
            "resource": {
              "resourceType": "Organization",
              "id": "ohie-cr-07-10-fhir-acme",
              "identifier": [
                {
                  "use": "usual",
                  "system": "http://ohie.org/test/orgs",
                  "value": "FHR-072"
                }
              ],
              "name": "ACME Insurance Providers Corp.",
              "address": [
                {
                  "use": "work",
                  "type": "physical",
                  "text": "321 James St. North Hamilton, Ontario, Canada, L8K5X2",
                  "line": [
                    "321 James St. North"
                  ],
                  "city": "Hamilton",
                  "state": "ON",
                  "postalCode": "L8K5X2",
                  "country": "CA"
                }
              ]
            },
            "request": {
              "method": "POST",
              "url": "Organization/ohie-cr-07-fhir-acme"
            }
          },
          {
            "fullUrl": "http://test.ohie.org/fhir/Organization/ohie-cr-07-fhir-mgr",
            "resource": {
              "resourceType": "Organization",
              "id": "ohie-cr-07-fhir-mgr",
              "identifier": [
                {
                  "use": "usual",
                  "system": "http://ohie.org/test/orgs",
                  "value": "FHR-073"
                }
              ],
              "name": "University Medical Centre"
            },
            "request": {
              "method": "POST",
              "url": "Organization/ohie-cr-07-fhir-mgr"
            }
          },
          {
            "fullUrl": "http://test.ohie.org/fhir/Practitioner/ohie-cr-07-fhir-pract",
            "resource": {
              "resourceType": "Practitioner",
              "id": "ohie-cr-07-fhir-pract",
              "identifier": [
                {
                  "use": "usual",
                  "system": "http://ohie.org/test/practs",
                  "value": "FHR-074"
                }
              ],
              "name": [
                {
                  "use": "usual",
                  "family": "Profile",
                  "prefix": [ "Dr" ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "[phone]",
                  "use": "mobile"
                }
              ],
              "address": [
                {
                  "use": "work",
                  "type": "both",
                  "text": "Unit 493, 5 West 9th Ave. Grimsby, Ontario, Canada",
                  "line": [
                    "5 West 9th Ave.",
                    "Unit 493"
                  ],
                  "city": "Grimsby",
                  "state": "ON",
                  "postalCode": "L4N3N4",
                  "country": "CA"
                }
              ]
            },
            "request": {
              "method": "POST",
              "url": "Practitioner/ohie-cr-07-fhir-pract"
            }
          },
          {
            "fullUrl": "http://test.ohie.org/fhir/Patient/ohie-cr-07-10-fhir-flyn",
            "resource": {
              "resourceType": "Patient",
              "id": "ohie-cr-07-10-fhir-flyn",
              "active": true,
              "identifier": [
                {
                  "use": "official",
                  "system": "http://ohie.org/test/test",
                  "value": "FHR-070"
                }
              ],
              "name": [
                {
                  "use": "official",
                  "family": "Profile",
                  "given": [
                    "Flynn",
                    "Full"
                  ],
                  "prefix": [ "Dr" ],
                  "suffix": [ "III" ]
                },
                {
                  "use": "usual",
                  "family": "Profile",
                  "prefix": [ "Dr" ]
                }
              ],
              "address": [
                {
                  "use": "home",
                  "type": "both",
                  "text": "123 Ontario St. Beamsville, Lincoln County, Ontario, Canada, L0R2A0",
                  "line": [
                    "123 Ontario St",
                    "Unit 32"
                  ],
                  "city": "Beamsville",
                  "district": "Lincoln County",
                  "state": "ON",
                  "postalCode": "L0R2A0",
                  "country": "CA"
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "[phone]",
                  "use": "work"
                },
                {
                  "system": "phone",
                  "value": "[phone]",
                  "use": "mobile"
                },
                {
                  "system": "email",
                  "value": "[e-mail]",
                  "use": "home"
                }
              ],
              "gender": "male",
              "birthDate": "1982-03-02",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M",
                    "display": "Married"
                  }
                ]
              },
              "multipleBirthBoolean": true,
              "contact": [
                {
                  "relationship": [
                    {
                      "coding": [
                        {
                          "system": "http://terminology.hl7.org/CodeSystem/v2-0131",
                          "code": "C"
                        }
                      ]
                    },
                    {
                      "coding": [
                        {
                          "system": "http://terminology.hl7.org/CodeSystem/v2-0131",
                          "code": "N"
                        }
                      ]
                    }
                  ],
                  "name": {
                    "use": "usual",
                    "family": "Profile",
                    "given": [
                      "Allison"
                    ]
                  },
                  "address": {
                    "use": "home",
                    "type": "both",
                    "text": "123 Ontario St. Beamsville, Lincoln County, Ontario, Canada, L0R2A0",
                    "line": [
                      "123 Ontario St",
                      "Unit 32"
                    ],
                    "city": "Beamsville",
                    "district": "Lincoln County",
                    "state": "ON",
                    "postalCode": "L0R2A0",
                    "country": "CA"
                  },
                  "telecom": [
                    {
                      "system": "phone",
                      "value": "[phone]",
                      "use": "mobile"
                    }
                  ]
                },
                {
                  "relationship": [
                    {
                      "coding": [
                        {
                          "system": "http://terminology.hl7.org/CodeSystem/v2-0131",
                          "code": "I"
                        }
                      ]
                    }
                  ],
                  "organization": {
                    "reference": "http://test.ohie.org/fhir/Organization/ohie-cr-07-10-fhir-acme",
                    "display": "ACME Insurance Corp."
                  }
                }
              ],
              "communication": [
                {
                  "language": {
                    "coding": [
                      {
                        "system": "urn:ietf:bcp:47",
                        "code": "en",
                        "display": "English"
                      }
                    ]
                  },
                  "preferred": true
                },
                {
                  "language": {
                    "coding": [
                      {
                        "system": "urn:ietf:bcp:47",
                        "code": "fr",
                        "display": "French"
                      }
                    ]
                  },
                  "preferred": false
                }
              ],
              "generalPractitioner": {
                "reference": "http://test.ohie.org/fhir/Practitioner/ohie-cr-07-fhir-pract",
                "display": "Dr. Andrew Fudd"
              },
              "managingOrganization": {
                "reference": "http://test.ohie.org/fhir/Organization/ohie-cr-07-fhir-mgr",
                "display": "University Medical Centre"
              }
            },
            "request": {
              "method": "POST",
              "url": "Patient/ohie-cr-01-10-fhir-flyn"
            }
          },
          {
            "fullUrl": "http://test.ohie.org/fhir/RelatedPerson/ohie-cr-07-10-fhir-wife",
            "resource": {
              "resourceType": "RelatedPerson",
              "id": "ohie-cr-07-10-fhir-wife",
              "identifier": [
                {
                  "use": "usual",
                  "system": "http://ohie.org/test/test",
                  "value": "FHR-071"
                },
                {
                  "use": "usual",
                  "system": "http://ohie.org/test/nid",
                  "value": "NID071"
                }
              ],
              "patient": {
                "reference": "http://test.ohie.org/fhir/Patient/ohie-cr-07-10-fhir-flyn"
              },
              "relationship": [
                {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                      "code": "WIFE"
                    }
                  ]
                }
              ],
              "name": {
                "use": "usual",
                "family": "Profile",
                "given": [
                  "Allison"
                ]
              },
              "address": [
                {
                  "use": "home",
                  "type": "both",
                  "text": "123 Ontario St. Beamsville, Lincoln County, Ontario, Canada, L0R2A0",
                  "line": [
                    "123 Ontario St",
                    "Unit 32"
                  ],
                  "city": "Beamsville",
                  "district": "Lincoln County",
                  "state": "ON",
                  "postalCode": "L0R2A0",
                  "country": "CA"
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "[phone]",
                  "use": "mobile"
                }
              ],
              "birthDate": "1985-05-10",
              "gender": "female"
            },
            "request": {
              "method": "POST",
              "url": "RelatedPerson/ohie-cr-07-10-fhir-wife"
            }
          }

        ]
      }
    }
  ]
}

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

Query By Patient Identifier

The test harness issues a query for patient demographics using the Patient's NID identifier

GET http://localhost:8080/fhir/Patient?identifier=http%3A%2F%2Fohie.org%2Ftest%2Ftest%7CFHR-070 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain a bundle with exactly 1 result
MUST		Match full demographics details outlined in Registration step
SHOULD		Return the master identity and have links to the local identities in one or more link elements

Retrieve Full Patient Profile

The test harness issues a query for patient demographics using the Patient's NID identifier and instructs the inclusion of all data

GET http://localhost:8080/fhir/Patient?identifier=http%3A%2F%2Fohie.org%2Ftest%2Ftest%7CFHR-070&_include=Organization%3AmanagingOrganization&_revinclude=RelatedPerson%3Apatient 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain a bundle with exactly 1 result
MUST		Match full demographics details outlined in Registration step
SHOULD		Return the master identity and have links to the local identities in one or more link elements

Query By Patient Name

The test harness issues a query for patient demographics using the Patient's family and given names.

GET http://localhost:8080/fhir/Patient?family=Profile&given=Flynn 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)

Alternate: The test harness issues a query for patient using an exact modifier

GET http://sut:8080/fhir/Patient?family=Profile&given%3Aexact=Flynn HTTP/1.1
Accept: application/fhir+json
Authorization: bearer XXXXYYYXXYX

Expected Behaviour

Requirement	Option	Description
MUST		Return a bundle in JSON format
MUST		Return HTTP code of 200 Created
MUST		Contain a bundle with exactly 1 result
MUST		Match full demographics details outlined in Registration step
SHOULD		Return the master identity and have links to the local identities in one or more link elements

Query By Approximate Birthdate

The test harness sends a query to the client registry requests results based on a given birth date.

GET http://localhost:8080/fhir/Patient?birthdate=ap1982 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain a result within the bundle with identifier matching FHR-070
MUST		Patient must match demographics details outlined in Registration step
SHOULD		Return the master identity and have links to the local identities in one or more link elements

Query By Combination of Parameters

This test is equivalent to OHIE-CR-15

The test harness sends a query to the client registry requests results based on a given birth date, family name, and given name .

Query By Name and Date Of Birth

GET http://localhost:8080/fhir/Patient?family=Profile&given=Flynn&birthdate=ap1982 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)

Query By Gender and Family Name

GET http://localhost:8080/fhir/Patient?family=Profile&gender=male 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)

Query By Gender and Date Of Birth

GET http://localhost:8080/fhir/Patient?birthdate=1982-03-02&gender=male 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain exactly 1 result within the bundle with identifier matching FHR-070
MUST		Patient must match demographics details outlined in Registration step
SHOULD		Return the master identity and have links to the local identities in one or more link elements

No-Result Queries

This test step ensures that the demographics query provider behaves appropriately when no results are found. The test harness sends a query for demographics which results in no matches:

GET http://localhost:8080/fhir/Patient?given=Profile&gender=other 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain exactly 0 entry elements
MUST		Contain a total element with value 0

Restricting Domains Returned

This step ensures that the PDQm provider implements the behaviour described in 3.78.4.1.2.4. The test harness sends a PDQm query and requests domains returned, and ensures that the SUT removes non-compatible domains.

GET http://localhost:8080/fhir/RelatedPerson?identifier=http%3A%2F%2Fohie.org%2Ftest%2Fnid%7CNID071 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 a bundle in JSON format
MUST		Return HTTP code of 200
MUST		Contain exactly 1 entry element
MUST		Entry element must contain exactly 1 identifier with value FHR-070
MUST		Entry element must not contain the TEST domain value of FHR-071
MUST		Contain a total element with value 1