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Retrieval Formats

Support formats for record and document retrieval

Retrieval Formats

The NRL may support retrieval of records and documents in a range of formats, this could include both unstructured documents and structured data.

The format of the referenced document/record is detailed in two meta-data fields:

  • Record format - describes the technical structure and the rules of the document/record
  • Record mime type - describes the data type of the document/record

See FHIR Resources & References for further detail on the data model.

The combination of these two meta-data fields describes to a Consumer system the type and structure of the content that will be returned. This gives the Consumer system the information it needs to know to render the referenced record. For example, whether the referenced content is a publicly accessible web page of contact details, an unstructured PDF document or specific FHIR profile. See below for further detail and the list of currently supported formats.

Supported Formats

The table below describes the formats that are currently supported:

Format Description
Contact Details (HTTP Unsecured) A publicly accessible HTML web page or PDF detailing contact details for retrieving a record.
Note that retrieval requests for contact details should be made directly and not via the SSP.
Unstructured Document An unstructured document e.g. PDF. The content-type of the document returned SHOULD be in the mime-type as described on the pointer metadata (DocumentReference.content[x].attachment.contentType).
For unstructured documents, Consumers and Providers SHOULD support PDF as a minimum.
An example API endpoint for handling unstructured documents can be seen in the CareConnect GET Binary specification (“Query 1 - Default Query” in section 1.1).

Please see the format code value set for the list of codes to use.

Note that the NRL supports referencing multiple formats of a record document on a single pointer, see below for details.

Multiple Formats

Multiple formats of a record or document can be made available through a single pointer on the NRL. For example a pointer can contain a reference to retrieve a record in PDF format and as a structured FHIR resource. Each format must be detailed in a separate content element on the DocumentReference (pointer).

Multiple Format Example

The example below shows a pointer for a Mental Health Crisis Plan that can be retrieved over the phone (using the contact details listed on the referenced HTML web page) and directly as a PDF document.

<DocumentReference>
    <id value="0353e505-f7be-4c20-8f4e-337e79a32c51-76009894321256642261"/>
    <meta>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/NRL-DocumentReference-1"/>
        <version value="1"/>
        <lastUpdated value="2016-03-08T15:26:00+01:00"/>
    </meta>
    <masterIdentifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7"/>
    </masterIdentifier>
    <status value="current"/>
    <type>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="736253002"/>
            <display value="Mental health crisis plan"/>
        </coding>
    </type>
    <class>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="734163000"/>
            <display value="Care plan"/>
        </coding>
    </class>
    <subject>
        <reference value="https://demographics.spineservices.nhs.uk/STU3/Patient/9876543210"/>
    </subject>
    <indexed value="2016-03-08T15:26:01+01:00"/>
    <author>
        <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/RGD"/>
    </author>
    <custodian>
        <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/RR8"/>
    </custodian>
    <relatesTo>
        <code value="replaces"/>
        <target>
            <identifier>
                <system value="urn:ietf:rfc:3986"/>
                <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.6"/>
            </identifier>
        </target>
    </relatesTo>
    <content>
        <attachment>
            <contentType value="application/pdf"/>
            <url value="https://spine-proxy.national.ncrs.nhs.uk/https%3A%2F%2Fp1.nhs.uk%2FMentalhealthCrisisPlanReport.pdf"/>
            <creation value="2016-03-08T15:26:00+01:00"/>
        </attachment>
        <format>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-FormatCode-1"/>
            <code value="urn:nhs-ic:unstructured"/>
            <display value="Unstructured Document"/>
        </format>
        <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-NRL-ContentStability-1">
            <valueCodeableConcept>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-ContentStability-1"/>
                    <code value="static"/>
                    <display value="Static"/>
                </coding>
            </valueCodeableConcept>
        </extension>
    </content>
    <content>
        <attachment>
            <contentType value="text/html"/>
            <url value="https://spine-proxy.national.ncrs.nhs.uk/https%3A%2F%2Fp1.nhs.uk%2FMentalhealthCrisisTeam"/>
            <creation value="2016-03-08T15:26:00+01:00"/>
        </attachment>
        <format>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-FormatCode-1"/>
            <code value="urn:nhs-ic:record-contact"/>
            <display value="Contact details (HTTP Unsecured)"/>
        </format>
        <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-NRL-ContentStability-1">
            <valueCodeableConcept>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-ContentStability-1"/>
                    <code value="static"/>
                    <display value="Static"/>
                </coding>
            </valueCodeableConcept>
        </extension>
    </content>
    <context>
        <period>
            <start value="2016-03-07T13:34:00+01:00"/>
        </period>
        <practiceSetting>
            <coding>
                <system value="http://snomed.info/sct"/>
                <code value="708168004"/>
                <display value="Mental health service"/>
            </coding>
        </practiceSetting>
    </context>
</DocumentReference>

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