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Interface Specification Localization Metadata Register - Fetch metadata [FHIR]

Disclaimer

This project and all associated code serve solely as documentation and demonstration purposes to illustrate potential system communication patterns and architectures.

This codebase:

  • Is NOT intended for production use
  • Does NOT represent a final specification
  • Should NOT be considered feature-complete or secure
  • May contain errors, omissions, or oversimplified implementations
  • Has NOT been tested or hardened for real-world scenarios

The code examples are only meant to help understand concepts and demonstrate possibilities.

By using or referencing this code, you acknowledge that you do so at your own risk and that the authors assume no liability for any consequences of its use.

Context

The GFModules project is a collection of applications that have the purpose of improving data exchange process between healthcare providers. The project is the technical implementation of various components of the 'Generieke Functies, lokalisatie en addressering' project of the Ministry of Health, Welfare and Sport of the Dutch government.

The Localization Metadata Register(LMR) is a component that should be provided or delegated by all healthcare providers. The LMR should provide metadata for a certain Pseudonym that is linked to a BSN in the LMR.

This interface description can be found at the github repository.

Summary

This interface enables applications in the Healthcare Provider domain to fetch metadata for a patient based on the Pseudonym which is retrieved from the PRS. (see Process). This interface is build on the HL7 FHIR Release 4 specification. The addition specified in this interface definition is the possibility to search for healthdata based on a Pseudonym.

Fetch metadata

Process

This interface is used in the following processes:

Authentication

All endpoints that are described here are only accessible behind mTLS with a valid UZI Server Certificate.

Endpoints

The LMR should set the display value of all linked resources to present all required information for the healthcare professional without the need of sequential queries to the LMR.

Dependend on the domain, the LMR should provide a search on Pseudonym on the following endpoints:

ImagingStudies (Beeld)

The LMR should provide a search on the ImagingStudy FHIR resource with the Pseudonym as an extra property to filter on.
Path http{s}://server{/path}/ImagingStudy/_search
Type GET
Query Parameters Pseudonym
JSON payload
Response codes 200, 422

Example CURL request:

curl -X 'POST' \
  'https://server/resource/ImagingStudy/_search?pseudonym=<<pseudonym>>' \
  -H 'accept: application/json' \
  -H 'Content-Type: application/json'
}'

Example response:

{
  "resourceType": "Bundle",
  "id": "37659c25-11b6-41ac-ae2d-213636f374ef",
  "type": "searchset",
  "total": 6,
  "entry": [
    {
      "resource": {
        "resourceType": "ImagingStudy",
        "id": "83479c26-a5ec-4a79-96b9-e721585ddcc9",
        "identifier": [
          {
            "system": "http://example.org/study",
            "value": "83479c26-a5ec-4a79-96b9-e721585ddcc9"
          }
        ],
        "status": "registered",
        "subject": {
          "reference": "Patient/fe3344a9-29a5-4897-b1ba-24c1e0c5ee49",
          "display": "Sten Timmermans"
        },
        "started": "2021-06-19T07:17:35.741755",
        "numberOfSeries": 1,
        "series": [
          {
            "uid": "67256967-0a44-4dc6-8155-91ab9ccd1538",
            "number": 0,
            "modality": {
              "coding": [
                {
                  "system": "http://example.org/modality",
                  "code": "US",
                  "display": "Ultrasound"
                }
              ]
            },
            "bodySite": {
              "concept": {
                "coding": [
                  {
                    "system": "http://example.org/body-site",
                    "code": "pelvis",
                    "display": "Bekken"
                  }
                ]
              }
            },
            "started": "2023-07-27T18:00:18.376874",
            "performer": [
              {
                "actor": {
                  "reference": "Practitioner/3137b5e0-9688-43b8-b9f2-b0ab70c50f9d",
                  "type": "Practitioner",
                  "display": "Dokter Bibber"
                }
              }
            ],
            "instance": [
              {
                "uid": "98f284cb-bdd4-40a3-ab20-39291c853272",
                "sopClass": {
                  "system": "http://example.org/sop-class",
                  "code": "DX",
                  "display": "Digital Radiography"
                },
                "number": 0,
                "title": "Knie kans schreeuwen gaan rok vroeger gelijk."
              }
            ]
          }
        ]
      }
    },
    {
      "resource": {
        ...
      }
    },
    {
      ...
    }
  ]
}

Pseudonym

A pseudonym send as a query parameter or as a json property is always serialized as a string

Discussions

Restrict returned properties of resource

To maximise the privacy of the patients the LMR should only return the properties that are defined in this interface definition which are required to give the healthcare professional enough metadata to have an idea about the information that is stored in the actual data storage.

Restrict other requests to metadata Register

Should the LMR also restrict requests to other (FHIR) endpoints of the LMR that are not required for requesting metadata?

When a source register also acts as a metadata register it is maybe difficult to set such restrictions for requests only for the LMR feature of a source register.