Details of the FHIR® resources which make up the payload for the Online Consultation Report use case.
Please refer to Send Document - Payload structure for a definition of the payload structure to be used to fulfil the Online Consultation use case.
The following sections describe the resources which form the payload. These are the resources that will be present as entries of the ITK-Document-Bundle resource, which acts as a container for the payload.
A message example is provided which illustrates these requirements to aid understanding.
Resource population requirements
The following requirements identify the data elements that MUST or SHOULD be populated when generating the payload. Data items not explicitly referenced in this section can be populated if the source system has captured this information, and the resource being populated supports it.
Composition resource
| GPCM-SD-OC-001 | a Composition resource profiled to CareConnect-Composition-1 resource MUST be present in the payload |
The following requirements describe how the Composition resource is populated:
| GPCM-SD-OC-002 | Composition.status MUST contain fixed value final |
| GPCM-SD-OC-003 | Composition.type MUST contain the SNOMED code 149951000000107 (Patient information received using general practice online consultation system (finding)) |
| GPCM-SD-OC-004 | Composition.date MUST contain the date/time the message was created |
| GPCM-SD-OC-005 | Composition.confidentiality MUST contain the fixed value N (Normal), or R (Restricted) if the consultation is classed as confidential |
| GPCM-SD-OC-006 | Composition.title MUST contain the fixed value Online consultation report |
| GPCM-SD-OC-007 | Composition.text MUST contain a summary of request in the following format:Online consultation report for {Patient Name}, NHS Number {NHS Number}, Version {Version Number} |
| GPCM-SD-OC-008 | Composition.subject MUST contain a reference to Patient resource profiled to CareConnect-Patient-1 |
| GPCM-SD-OC-009 | Composition.author MUST contain a reference to one or more of the following resources:
|
| GPCM-SD-OC-010 | Composition.custodian MUST contain a reference to the sender Organization resource profiled to CareConnect-Organization-1 |
| GPCM-SD-OC-011 | Composition.relatesTo MUST contain the UUID of the previous message if a replacement document is being sent |
| GPCM-SD-OC-012 | Composition.section.entry MUST reference a binary document which provides a report of the full online consultation in PDF format profiled to ITK-Attachment-Binary-1 |
Additional input elements
Message senders MAY include additional binary documents in the payload as each expressed as an additional instance of the composition.section as described in Send Document - payload structure.
| GPCM-SD-OC-013 | where binary documents are included in the payload in addition to the Online Consultation Report, the message receiver MUST process these according ensuring all attachments remain in the context of the encounter information delivered to downstream systems |
| GPCM-SD-OC-014 | when displaying the Online Consultation Report in the practice workflow/task list, the message receiver MUST display Online consultation report for {Patient Name}, NHS Number {NHS Number}, Version {Version Number} |
| GPCM-SD-OC-015 | the message receiver MUST make any attachments included with the Consultation Report available to the end user |
Patient resource
| GPCM-SD-OC-016 | as described in Send Document - Payload structure, the payload MUST contain a patient resource describing the patient |
The CareConnect-Patient-1 in the payload is populated as follows:
| GPCM-SD-OC-017 | the NHS Number of the patient MUST be specified in the nhsNumber slice of the identifier element |
| GPCM-SD-OC-018 | the name of the patient MUST be present in the single instance of the name element where name.use is set to official |
| GPCM-SD-OC-019 | the date of birth of the patient MUST be specified in YYYY-MM-DD format in the birthDate element. Birth time is not required |
| GPCM-SD-OC-020 | values specified in the patient resource for surname, date of birth and NHS Number MUST match those specified in MESH metadata Mex_To (for the MESH API) or To_DTS field (for the MESH client) as described in MESH message configuration |
Organization resource
| GPCM-SD-OC-021 | as described in Send Document - Payload structure, the payload MUST contain an organization resource describing the sender organisation (the originating organisation) |
The CareConnect-Organization-1 resource present in the payload is populated as follows:
| GPCM-SD-OC-022 | the odsOrganisationCode slice of the identifier element MUST contain the ODS code |
| GPCM-SD-OC-023 | the name element MUST contain the name of the organisation |
| GPCM-SD-OC-024 | the telecom element MUST contain the telephone number of that organization. i.e. where telecom.system is set to a fixed value of phone, and telecom.value contains the telephone number |
Practitioner resource
The CareConnect-Practitioner-1 resource present in the payload is populated as follows:
| GPCM-SD-OC-025 | the SDS User ID of the practitioner MUST be present in the sdsUserID slice of the identifier element |
| GPCM-SD-OC-026 | the name of the practitioner MUST be present in the single instance of the name element where name.use is set to official |
| GPCM-SD-OC-027 | telephone contact details MUST be present if available in the telecom element. i.e. telecom.system is set to a fixed value of phone, and telecom.value contains the telephone number |
RelatedPerson resource
The CareConnect-RelatedPerson-1 in the payload is populated as follows:
| GPCM-SD-OC-028 | the name of the related person MUST be present in the single instance of the name element |
| GPCM-SD-OC-029 | the date of birth of the related person MUST be specified in YYYY-MM-DD format in the birthDate element. Birth time is not required |
| GPCM-SD-OC-030 | telephone contact details MUST be present if available in the telecom element |
Device resource
The ITK-Device-1 resource present in the payload is populated as follows:
| GPCM-SD-OC-031 | a SNOMED code describing the type of device MUST be present in the type element |
| GPCM-SD-OC-032 | the manufacturer of the device MUST be present in the manufacturer element |
Encounter resource
The CareConnect-Encounter-1 in the payload is populated as follows:
| GPCM-SD-OC-033 | the status element MUST contain a fixed value of finished |
| GPCM-SD-OC-034 | the type element MUST contain a valid SNOMED code for the type encounter being sent, for example 149971000000103 (Encounter using general practice online consultation system (procedure)) |
| GPCM-SD-OC-035 | the subject element MUST reference the Patient profile representing the Patient who is the subject of the encounter |
| GPCM-SD-OC-036 | the participant element SHOULD reference the Practitioner profile or the RelatedPerson profile if applicable |
| GPCM-SD-OC-037 | the priority element SHOULD reference a priority code, by default this value should be R meaning routine |
| GPCM-SD-OC-038 | the period element SHOULD be populated with the start and end time of the encounter captured in the source system |
| GPCM-SD-OC-039 | the serviceProvider element SHOULD contain a reference to the organisation responsible for the encounter |
List/Observation resource
The CareConnect-List-1 in the payload is populated as follows:
| GPCM-SD-OC-040 | a List containing references to all Observation resources that are captured MUST be populated if coded Observations are being sent. The List resource in FHIR is used to manage collections of resources. |
| GPCM-SD-OC-041 | the status element MUST contain a fixed value of current |
| GPCM-SD-OC-042 | the mode element MUST contain a fixed value of snapshot |
| GPCM-SD-OC-043 | the title element MUST contain the display element from the code field |
| GPCM-SD-OC-044 | the code element MUST contain 826501000000100 - Miscellaneous record |
| GPCM-SD-OC-045 | the subject element MUST reference the Patient profile representing the Patient against whom the data was recorded |
| GPCM-SD-OC-046 | the entry.item element MUST be populated to reference each Observation in the message |
Each CareConnect-Observation-1 in the payload is populated as follows:
| GPCM-SD-OC-047 | the status element MUST contain a fixed value of preliminary if unchecked by a clinician, or final |
| GPCM-SD-OC-048 | the category element SHOULD contain high level category that represents the data in the Observation |
| GPCM-SD-OC-049 | the code element MUST contain a clinical code that represents the data in the Observation |
| GPCM-SD-OC-050 | the subject element MUST reference the Patient profile representing the Patient against whom the data was recorded |
| GPCM-SD-OC-051 | the issued element MUST contain an audit trail timestamp representing when the data was recorded |
| GPCM-SD-OC-052 | to ensure the Observation can be identified as patient entered data, the performer element MUST contain a reference to patient resource of the patient completing the Online Consultation |
| GPCM-SD-OC-053 | the value[x] element SHOULD contain the value of the Observation |
| GPCM-SD-OC-054 | the component element SHOULD be populated if recording a pair of results |
Questionnaire resource
The CareConnect-Questionnaire-1 in the payload is populated as follows:
| GPCM-SD-OC-055 | the status element MUST contain a fixed value of active |
| GPCM-SD-OC-056 | the version element SHOULD contain the business version of the questionnaire |
| GPCM-SD-OC-057 | the name element SHOULD contain the name of the questionnaire |
| GPCM-SD-OC-058 | the title element SHOULD contain the title of the questionnaire |
| GPCM-SD-OC-059 | the date element SHOULD contain the date the questionnaire was last updated |
| GPCM-SD-OC-060 | the description element SHOULD contain a human readable description of the questionnaire |
| GPCM-SD-OC-061 | the effectivePeriod element SHOULD contain the period when the questionnaire is expected to be used |
| GPCM-SD-OC-062 | the item elements MUST be completed to contain the questions and sections of the questionnaire |
QuestionnaireResponse resource
The CareConnect-QuestionnaireResponse-1 in the payload is populated as follows:
| GPCM-SD-OC-063 | the status element MUST contain a fixed value of completed |
| GPCM-SD-OC-064 | the subject element MUST reference the Patient profile representing the Patient against whom the data was recorded |
| GPCM-SD-OC-065 | the authored element SHOULD contain an audit trail timestamp representing when the data was recorded |
| GPCM-SD-OC-066 | a set of item elements MUST contain the full online consultation questionnaire details |
| GPCM-SD-OC-067 | the item.linkId element MUST contain a pointer specific to the questionnaire |
| GPCM-SD-OC-068 | the item.text element MUST contain the question being asked |
| GPCM-SD-OC-069 | the item.answer.value[x] element MUST contain the answer being given by the patient |
| GPCM-SD-OC-070 | the item.answer.value[x].valueReference element SHOULD contain a reference to a resource, if applicable |
ReferralRequest resource
The CareConnect-ReferralRequest-1 in the payload is populated as follows:
| GPCM-SD-OC-071 | the status element MUST contain a fixed value of unknown |
| GPCM-SD-OC-072 | the intent element MUST contain a fixed value of order |
| GPCM-SD-OC-073 | the priority element SHOULD reference a priority code. A mapping is applied to the priority codes to align it to the e-Referral Service priority types. This MUST be populated where the source system has a referral priority which matches the e-Referral Service priority codes or can be mapped to those priority codes. If there is a priority code for the referral but it is incompatible with the e-Referral Service priorities, this element MUST be excluded and the priority MUST be supplied in the note element. |
| GPCM-SD-OC-074 | the subject element MUST reference the Patient profile representing the Patient who is the subject of the referral |
| GPCM-SD-OC-075 | the context element SHOULD reference the Encounter within which the referral was recorded |
| GPCM-SD-OC-076 | the requester element SHOULD reference the details of the person, practitioner or organisation responsible for the decision to refer the patient or, if is not attributed specifically, then populate with the recorder |
| GPCM-SD-OC-077 | the requester.agent element MUST reference one of the following:
|
| GPCM-SD-OC-078 | the recipient element SHOULD be populated with the practitioner and/or organisation the patient has been referred to, if that is recorded in a suitable coded format |
| GPCM-SD-OC-079 | the reasonCode element SHOULD be populated with the source system’s main coded entry for the referral |
| GPCM-SD-OC-080 | the description element SHOULD be populated with a free text description associated with the referral |
| GPCM-SD-OC-081 | the supportingInfo element SHOULD contain a reference to the referral letter(s) and any other supporting documents or resources which are not covered by other more specific elements, for instance this could include reference to linked observations |
DocumentReference resource
The CareConnect-DocumentReference-1 in the payload is populated as follows:
| GPCM-SD-OC-082 | the status element MUST contain a fixed value of either current, superseded or entered-in-error |
| GPCM-SD-OC-083 | the type element MUST contain a coded entry that references the type of document, this SHOULD be taken from SNOMED refset 1127551000000109. Other classifications should be sent as text. |
| GPCM-SD-OC-084 | the subject element MUST reference the Patient profile representing the Patient who is the subject of the document |
| GPCM-SD-OC-085 | the author element SHOULD reference one of the following:
|
| GPCM-SD-OC-086 | the content element MUST contain details about the document being referenced |
| GPCM-SD-OC-087 | the context element SHOULD contain details about the clinical context of the document being referenced |
AllergyIntolerance resource
The CareConnect-AllergyIntolerance-1 in the payload is populated as follows:
| GPCM-SD-OC-088 | the extension[encounter] element SHOULD contain a reference to an associated encounter |
| GPCM-SD-OC-089 | the extension[allergyEnd] element MUST contain the date the allergy or intolerance was recorded as resolved, if the clinicalStatus is set to resolved. |
| GPCM-SD-OC-090 | the extension[allergyEnd].endReason element MUST contain the reason why the allergy or intolerance has been resolved. In exceptional cases where for legacy data there is no endReason recorder in the system then this MUST be populated with the text ‘No information available’. |
| GPCM-SD-OC-091 | the clinicalStatus element MUST be populated with active for all active allergies, or resolved for resolved allergies. |
| GPCM-SD-OC-092 | the verificationStatus element MUST contain a fixed value of unconfirmed. |
| GPCM-SD-OC-093 | the type element SHOULD be set to allergy for reactions which are allergenic in nature (immunological), a value of intolerance MAY be used to indicate adverse reactions (not immunologic in nature). Where the type is unknown the type element may be omitted. |
| GPCM-SD-OC-094 | the category element MUST use medication for all drug allergy types, environment for all non-drug allergies. The other values in the ValueSet (food and biologic) MUST NOT be used. |
| GPCM-SD-OC-095 | the criticality element SHOULD used to distinguish between life-threatening (high) and non-life-threatening (low) potential as well as unable-to-assess. It MAY be used in addition to severity within the reaction element to express severity - for example, systems that support a severity of life-threatening MAY set criticality to high. |
| GPCM-SD-OC-096 | the criticality element SHOULD used to distinguish between life-threatening (high) and non-life-threatening (low) potential as well as unable-to-assess. It MAY be used in addition to severity within the reaction element to express severity - for example, systems that support a severity of life-threatening MAY set criticality to high. |
| GPCM-SD-OC-097 | the code element MUST contain the causative agent such as food, drug or substances that has caused or may cause an allergy, intolerance or adverse reaction in this patient. |
| GPCM-SD-OC-098 | the patient element MUST contain a reference to the Patient who has, or had, the allergy or intolerance specified. |
| GPCM-SD-OC-099 | the onset.DateTime element SHOULD contain a date when allergy/intolerance first manifested. Currently restricted to values of dateTime for GP Connect. |
| GPCM-SD-OC-100 | the assertedDate element MUST contain a the datetime the record was believed to be true. |
| GPCM-SD-OC-101 | the recorder element MUST contain a reference to who recorded the allergy. |
| GPCM-SD-OC-102 | the asserter element SHOULD contain a reference to the source of the information about the allergy. |
| GPCM-SD-OC-103 | the lastOccurrence element SHOULD contain the date and/or time of the last known occurrence of a reaction event. |
| GPCM-SD-OC-104 | the note element SHOULD contain all text associated with the AllergyIntolerance including user-entered notes and qualifiers is grouped together and expressed in this field, which ensures unmapped coded values or qualifiers are not lost. MUST be used to contain any textual data relevant to the allergy. |
| GPCM-SD-OC-105 | the reaction.manifestation element SHOULD contain the reaction resulting from the allergy/intolerance as a code. |
| GPCM-SD-OC-106 | the reaction.description element SHOULD contain the textual description of the manifestation where no code is available. |
| GPCM-SD-OC-107 | the reaction.severity element SHOULD contain severities of Mild, Moderate, Severe are mapped directly to the ValueSet. Map life threatening to Severe and populate criticality with high. |
| GPCM-SD-OC-108 | the reaction.exposureRoute element SHOULD contain the route by which exposure to the substance causing the reaction occurred. Utilise the dm+d route codes. |
FamilyMemberHistory resource
The CareConnect-FamilyMemberHistory-1 in the payload is populated as follows:
| GPCM-SD-OC-109 | the status element MUST contain a fixed value of either partial, completed, entered-in-error, or health-unknown |
| GPCM-SD-OC-110 | the patient element MUST contain a reference to the Patient that the history is about. |
| GPCM-SD-OC-111 | the relationship element MUST contain a coded entry describing the nature of the relationship between the patient and the related person being described in the family history. |
| GPCM-SD-OC-112 | the reasonReference element SHOULD reference one of the following:
|
| GPCM-SD-OC-113 | the note element SHOULD contain all text associated with the related person. |
| GPCM-SD-OC-114 | the condition element SHOULD contain the details of the condition that the related person had. |
Task resource
The CareConnect-Task-1 in the payload is populated as follows:
| GPCM-SD-OC-115 | the status element MUST contain a fixed value of requested. |
| GPCM-SD-OC-116 | the statusReason element SHOULD contain a code to identify the reason for the current status. |
| GPCM-SD-OC-117 | the intent element MUST contain a fixed value of either proposal, plan, or order, to distinguish whether the task is a proposal, plan or full order. |
| GPCM-SD-OC-118 | the priority element SHOULD contain a fixed value of either normal, urgent, asap, or stat. |
| GPCM-SD-OC-119 | the code element SHOULD contain codes to identify what the task involves. These will typically be specific to a particular workflow. |
| GPCM-SD-OC-120 | the for element SHOULD contain a reference to the Patient. |
| GPCM-SD-OC-121 | the context element SHOULD contain a reference to the Encounter which this task originated. |
| GPCM-SD-OC-122 | the requester.agent element SHOULD reference one of the following:
|
| GPCM-SD-OC-123 | the owner element SHOULD contain a reference a resource responsible for the task execution. |
| GPCM-SD-OC-124 | the reason element SHOULD contain details explaining why the task is needed. |
| GPCM-SD-OC-125 | the note element SHOULD contain comments made about the task. |
| GPCM-SD-OC-126 | the restriction element SHOULD be populated if there are any limitations on what parts of the referenced request should be actioned. |
| GPCM-SD-OC-127 | the input element SHOULD contain additional information that may be needed in the execution of the task. |
| GPCM-SD-OC-128 | the output element SHOULD contain any outputs produced by the task. |
Consent resource
The CareConnect-Consent-1 in the payload is populated as follows:
| GPCM-SD-OC-129 | the status element MUST contain a fixed value of either proposed, active, or rejected. |
| GPCM-SD-OC-130 | the category element SHOULD contain a classification of the type of consent found in the statement. |
| GPCM-SD-OC-131 | the patient element MUST contain a reference to the Patient the consent applies to. |
| GPCM-SD-OC-132 | the period element SHOULD contain a the period this consent applies to. |
| GPCM-SD-OC-133 | the consentingParty element SHOULD contain a reference to who is agreeing to the policy and exceptions. |
| GPCM-SD-OC-134 | the action element SHOULD contain any actions controlled by this consent. |
| GPCM-SD-OC-135 | the source[x] element SHOULD reference the source from which the consent was taken. |
| GPCM-SD-OC-136 | the policy element SHOULD contain any policies covered by this consent. |
| GPCM-SD-OC-137 | the purpose element SHOULD contain the context of activities for which the agreement is made. |
| GPCM-SD-OC-138 | the datePeriod element SHOULD contain timeframe for data controlled by this consent. |
| GPCM-SD-OC-139 | the data element SHOULD contain the data controlled by this consent. |
| GPCM-SD-OC-140 | the except element SHOULD contain any exceptions to the base policy of this consent. An exception can be an addition or removal of access permissions. |
Location resource
The CareConnect-Location-1 in the payload is populated as follows:
| GPCM-SD-OC-168 | the identifier element MUST contain a Site ODS code to identify the organization at site level. |
| GPCM-SD-OC-169 | the status element MUST contain a fixed value of active. |
| GPCM-SD-OC-170 | the name element MUST contain the name of the location used by humans. |
| GPCM-SD-OC-171 | the type element SHOULD contain the type of function being performed at this location. |
| GPCM-SD-OC-172 | the telecom element MUST contain the telephone number of that location. i.e. where telecom.system is set to a fixed value of phone, and telecom.value contains the telephone number |
| GPCM-SD-OC-173 | the address element SHOULD contain the physical address of the location |
Resource optionality and cardinality
The following table lists the optionality and cardinality for each resource:
| Resource | Optionality | Cardinality |
|---|---|---|
| ITK-Document-Bundle | Mandatory | 1..1 |
| CareConnect-Composition-1 | Mandatory | 1..1 |
| ITK-Attachment-Binary-1 | Mandatory | 1..* |
| CareConnect-Patient-1 | Mandatory | 1..1 |
| CareConnect-Organization-1 | Mandatory | 1..1 |
| CareConnect-Practitioner-1 | Required | 0..1 |
| CareConnect-RelatedPerson-1 | Required | 0..1 |
| ITK-Device-1 | Required | 0..* |
| CareConnect-Encounter-1 | Optional | 0..* |
| CareConnect-List-1 | Optional | 0..* |
| CareConnect-Observation-1 | Optional | 0..* |
| CareConnect-Questionnaire-1 | Optional | 0..* |
| CareConnect-QuestionnaireResponse-1 | Optional | 0..* |
| CareConnect-ReferralRequest-1 | Optional | 0..* |
| CareConnect-DocumentReference-1 | Optional | 0..* |
| CareConnect-AllergyIntolerance-1 | Optional | 0..* |
| CareConnect-FamilyMemberHistory-1 | Optional | 0..* |
| CareConnect-Task-1 | Optional | 0..* |
| CareConnect-Consent-1 | Optional | 0..* |
| CareConnect-Location-1 | Optional | 0..* |
