Map CareEvolution MedicationAdministration.ScheduledTime to/from Immunization.Date / Immunization.occurence (#3338)
ScheduledTime is required in CareEvolutiondata model, and it is what we really use as the immunization date-time.
MedicationAdministration.DoseStartTime is still mapped from FHIR and to FHIR for compatibility.
Add the http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision extension to ExplanationOfBenefit, mapping CareEvolution Claim.Revision (#3381)
Modifying existing ExplanatonOfBenefit and DiagnsticReport resulted in supporting information and result elements being added to the existing one, now they correctly replace them (#3428)
Better auto-generated documentation (#3539)
Map CareEvolution Claim.InNetwork to ExplanationOfBenefit (CarinBBPayerBenefitStatus) (#3544)
ExplanationOfBenefit: add the x12 coding system (https://x12.org/codes/claim-adjustment-reason-codes) for denial reason codings (#3592)
ExplanationOfBenefit: remove the allowedunits adjudication slice, it was populated erroneously (#3592)
Improvements to provider index support (#3353)
Add the PractitionerRole resource
Add the _id search parameter to Organization and Practitioner
Add the address search parameter to Organization
Add the name search parameter to Practitioner
Support :exact for all string search parameters
Add the MappingConfiguration option IgnoreAssigningAuthorityWhenCreatingIdenfierSystems to allow for outputting Identifier without assigning authority in the System Uri. Add the assigning authority to the Identifier.assigner. (#3488)
Updated and added System Uris output for Carin Stu1 related coding systems (#3486)
https://www.nubc.org/CodeSystem/PointOfOrigin, https://www.nubc.org/CodeSystem/PointOfOrigin-NewBorn, and https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit for NUBC coding systemshttp://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets for HCPCS coding systemBreaking change:
DRG coding system uri updated:
from: http://www.cms.gov/ms-drg to: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software.
NUBC coding system uris updated:
from: http://www.nubc.org/TypeOfBill to: https://www.nubc.org/CodeSystem/TypeOfBill
from: http://www.nubc.org/PatientDischargeStatus to: https://www.nubc.org/CodeSystem/PatDischargeStatus
from: http://www.nubc.org/RevenueCodes to: https://www.nubc.org/CodeSystem/RevenueCodes
diagnosis element (#3418)class when the code element is null (#3401)R4 Condiction.clinicalStatus is now not populated if verificationStatus=entered-in-error (as per US Core specifications) (#3378)
Added an extension to the R4 ExplanationOfBenefit and Claim resources (http://careevolution.com/fhirextensions#explanationOfBenefit-claimRevision and http://careevolution.com/fhirextensions#claim-revision respectively) containing the claim revision number (#3381)
Added server support for more signing algorithms for backend authentication: RS256, RS384, RS512, ES384, ES512 (previously it was just RS256)
Added pause intervals and sort overrides to Bulk Export (#3349)
Update ExplanationOfBenefit and Claim resource mapping To FHIR to always map 1 to the item.sequence for medications and continue to map the CE identifier in the extension (#3355)
Fixed the ExplanationOfBenefit SupportingInfo valueset codings to remove old codings (placeofservice and admitsrc) from the Carin system uri. They still exist but are now listed under the old carin system uri and the careevolution system uri. (#3354)
explanation-of-benefit) and an ExplanationOfBenefit resource reference extension to Claim derived resources (#3347). This includes the Condition, Procedure, MedicationDispense, and Immunization mappers and handlers.Add mapping for new claim fields to R4 ExplanationOfBenefit and all Claim resources (#3289)
total and adjudication elements. prAuthRef element.insurance.coverage.identifier element. It will be used to try to find an associated insurance that may exist within the patient's record group.Fix USCore profile uri, fix EOB R4 serviced data type, and supportingInfo sequence output (#3322)
serviced[x] date output so that it outputs correct data type required by Carin Stu1. Will now output servicedDate or servicedPeriod.supportingInfo sequence to ensure they are sequential.Searching on date elements (eg Patient.birthdate) now correctly ignores the time part of the search parameter, previously the time part was still considered (#3309)
Breaking change: date and date-time searches using the sa and eb operators use strict greater-than and less-than comparisons, so date-times that are identical to the search parameter no longer match.
Map new CE ClaimServiceCaregivers concept to ExplanationofBenefit and Claim resources (#3269)
These map to the care-team element and the item (claimService) caregivers will contain the corresponding careTeamSequence as needed.
Bulk export update to allow connections from authorized AWS servers (no access key ID or secret key needed) (#3290)
Map new CE ClaimSupportingInformation concept to ExplanationofBenefit and Claim resources (#3270)
This concept will map to the supportingInfo element.
Update ExplanationofBenefit resource to map data absent unknown when missing data in insurance, insurer, and coverage.subscriberId (#3304)
Condition, Procedure, MedicationDispense and Immunization resources that come from a claim that is entered-in-error are now tagged as entered-in-error as well (#3305)
Map new CE ClaimServiceCaregivers concept to Immunization resources (#3308)
These claimServiceCaregivers will map to the performer element.
Updates to the DiagnosticReport and Observation Resources searching when using category=laboratory (#3263)
Now queries only CE LabObservations (does not query CE Observations) concepts and does not map category=laboratory for Observations.
Map new CE concepts claim.totalAllowed and medication.properties to Claim, ExplanationofBenefit, and MedicationDispense resources (#3261)
Updates to Bulk Export, better patient filtering and cleanup of files on S3 (#3252)
Update meta tags for blinded mode, set to PSEUDED for returned resources (#3256)
For R4: Update profiling to support Carin Stu1 profiles. Add Profiling to the capability statement (#3216)
payment.type to data absent unknown if no Claim.status (#3225)Support blinded mode (#3211)
Data returned by FHIR for users that have the BlindedMode role are automatically blinded
Support multiple values for string search parameters (#3130)
When using multiple value the system uses exact matching, not starts-with.
Support US Core Medication List - fetching all medications for the R4 MedicationRequest resource (#3147).
This change adds the ability to search, create, and update self reported medications via the R4 MedicationRequest resource. There are no site configuration requirements for this feature to store/fetch self reported medication orders. The medication orders with Priority terms equal to the CareEvolution MedicationStatement term will indicate self reported medication. To include additional patient self reported medication orders not posted via Fhir, configure the GetMedicationStatementTermSubset in the MappingConfiguration and add the Order Priority terms to that subset.
ne, sa, eb, ap operators for date search parameters (#3110)Condition.asserter populated for all resources, including those coming from claim data (#3043)
Added the OperationDefinition resource (#3064)
Add Implementation to the Capability Statement (#3091)
Support SMART access scopes (only in version 28 or higher) (#3012)
Better documentation (#3038)
Update all patient reference search parameters to support missing=true (was not allowed previously). Add link reference search parameter to Person resource (#3030)
Fix the DocumentReference resource to support revinclude/include searches (#3063)
Add to ExplanationOfBenefit R4 resource, all remaining CE Claim data elements not mapped as extensions (#3019)
Update ExplanationOfBenefit R4 resource for CarinBB STU1 (leaving old uri/codes for backward compatibility as needed for our sites) (#3055)
adjudication header level to output if we have a non payment reason codePolling updated to not import duplicate orders from Epic (#3061)
Update to the FHIR CapabilityStatement for all versions
implementation.description which is mapped from the FHIR mapping configuration Site URI value for the FHIR endpoint. (#3091)Fix chained searches using the PatientId identifier. (#3077)
Added validation to identifiers to detect NPI values. (#3080)
Add to Condition resource (all versions) asserter when mapping ClaimProblem use CaregiverRelationships with RelationshipTypeTerm equal to CareEvolution.AdmittingPhysician term. (#3043)
Support multiple value sets in token search parameters using the :in and :not-in modifiers (#3016)
Added a per-endpoint configurable time-out for internal SQL search queries. Requests that hit the time-out fails with an error 500 and a Internal time-out processing the request error message (#2996)
R4 MedicationAdministration fix: use dosage.rateQuantity instead of dosage.rateRange that is not conformant (265db950edbd6f46c010b41cbb2b4a6ae036eed2)
R4 Polling for Claim and ExplanationOfBenefit resource fix: Will now warn when missing the procedure component (instead of exception). (#2997)
Breaking Change (changes persistence of ClaimProcedures)
Condition.VerificationStatus defaults to unconfirmed (R4) or unknown (STU3 & DSTU2), previously it was left empty if not specified in the underlying data (#2978)
Including AuditEvent:agent in an AuditEvent search caused a crash, now includes the referenced Person resources as expected (#2978)
Map Encounter classHistory (#2985)
Changes/Additions to R4 ExplanationOfBenefit to support CarinBB specification (#2979).
Add the provider reference search parameter.
Breaking Change (changes existing search parameter)
type token search parameter. The search parameter now expects the search values in the http://hl7.org/fhir/R4/valueset-claim-type.html valueset.Map referrals to the FHIR Basic resource (#2952)
To search referrals use GET [base]/Basic?code=referral& . . .
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claim-type",
"code": "pharmacy"
},
{
"system": "http://fhir.careevolution.com/codes/Facets/ClaimType",
"code": "P"
}
],
"text": "pharmacy"
},
to:
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claim-type",
"code": "pharmacy"
},
{
"system": "http://fhir.careevolution.com/codes/Facets/ClaimType",
"code": "P"
},
{
"system": "http://fhir.careevolution.com/codes/FhirCodes/ClaimType",
"code": "pharmacy"
}
],
"text": "pharmacy"
},
Changes/Additions to R4 ExplanationOfBenefit to support CarinBB specification (#2963, #2893, #2949, #2931)
Breaking Changes (changes existing mappings)
Claim.Type code matches 'pharmacy', ignores system.careteam, mapping no longer looks for a resourceReference.identifier and creates a caregiver. It will now map to Claim.CaregiverRelationships only if resource reference returns a valid caregiver. Previously all caregivers in Claim.CaregiverRelationships would be mapped to careteam. Now only caregivers with relationship type terms that map to terms in the FhirCodes termnamespace (terms in these valuesets: http://build.fhir.org/ig/HL7/carin-bb/CodeSystem-C4BBClaimCareTeamRole.html and https://terminology.hl7.org/1.0.0//CodeSystem-claimcareteamrole.html) will appear in careteam. Look to payee and provider fhir elements for caregivers with relationship type terms mapped to Terms.CaregiverRelationshipType.PayToProvider and Terms.CaregiverRelationshipType.ClaimProvider.supportingInfo and it maps to these claim concepts Claim.AdmitType, Claim.AdmitSource, Claim.Drg, Claim.AdmitDate, Claim.DischargeDate, Claim.BillClass, Claim.FacilityType, Claim.PatientStatus, Medication.RefillNumber, Medication.DaysSupplied, Medication.DispenseAsWritten, and Medication.Term (if isGeneric and toFhir only). Previously Medication.RefillNumber, Medication.DaysSupplied were mapped to the quantity extensions. Previously Claim.BillClass would map from a CMSBlueButton type code from the type fhir element.adjudication, it maps to Claim.TotalCharges, Claim.TotalPaid, Claim.TotalPatientPaid, Claim.NonPaymentReason, ClaimService.AmountPaid, ClaimService.AmountClaimed, ClaimService.PatientPaid, ClaimService.Units, Medication.AmountPaid, and Medication.AmountBilled. Previously amount fields were mapped based on supporting specific Blue Button extension urls.total, it maps to the Claim.TotalCharges, Claim.TotalPaid, and Claim.TotalPatientPaid. Previously it mapped total to a propertybag.Update payment, it maps to Claim.TotalPaid, Claim.Status (toFhir only), Claim.PaidDate. Previously it only mapped to Claim.TotalPaid.
A Note About Mapping Claim Amounts:
When mapping FromFhir: the payment, total, and adjudication elements can each contain information that we map to the claim TotalCharges, TotalPaid, PaidDate, TotalPatientPaid, and NonPaymentReason fields. Since none of the elements are required, the mapper tries to get data from each element for mapping. First it tries to get data from payment (as it has most info about payment and date). Then it looks at total and lastly at adjudication.
When mapping ToFhir: the payment and total are always mapped to fhir and adjudication only if no line item adjudication exists.
Update diagnosis, remove old CMS BB logic that looks for a packageCode instead of a diagnostic code in resource. Maps to ClaimProblem as before.
procedure, now supports procedureCodeableConcept or procedureReference (when polling). Add type mapping to Procedure.Type. If no fhir data exists, will persist 'undefined' term to Procedure.Type. Previously Procedure.Type was not mapped from fhir, it was constant and would always be 'undefined'.Remove all Blue Button extensions. These include extensions in the following elements: billablePeriod, facility, item, item.quantity, and at the resource level.
Additive Changes
meta.profile it equals http://hl7.org/fhir/us/carin-bb/StructureDefinition/CARIN-BB-ExplanationOfBenefitprovider and payee These map to Claim.CaregiverRelationships, caregivers with relationship type terms mapped to Terms.CaregiverRelationshipType.PayToProvider and Terms.CaregiverRelationshipType.ClaimProvider.focal to insurance, it is always true.sequence to item. insurer as contained resource, it maps to Claim.InsuranceID.outcome element.Changes to Claim R4 (to align better with above EOB mappings) (#2963, #2893, #2949, #2931)
Breaking Changes (changes existing mappings)
careteam. These map to Claim.CaregiverRelationships, for caregivers with relationship type term mapped to terms in the FhirCodesAlternate1 termnamspace (this valueset: https://terminology.hl7.org/1.0.0//CodeSystem-claimcareteamrole.html). Previous versions mapped careteam to extensions.insurance maps to Claim.InsuranceID and insurance.focal is always true.Update procedure, now supports procedureCodeableConcept or procedureReference (when polling). Add type mapping to Procedure.Type. If no fhir data exists, will persist undefined term to Procedure.Type. Previously Procedure.Type was not mapped from fhir, it was constant and would always be 'undefined'.
Additive Changes
insurer as a contained resource. maps to Claim.InsuranceID.Map Procedure.VerifiedByCaregiverID to/from FHIR R4 Procedure.asserter and to/from the corresponding standard Reference extension http://hl7.org/fhir/4.0/StructureDefinition/extension-Procedure.asserter in FHIR DSTU2 and STU3 (#2954)
Map Encounter.Drg field to/from the CodeableConcept extension http://careevolution.com/fhirextensions#encounter-drg (#2953)
Clear LabReport.LabReportContent when mapping from FHIR DiagnosticReport - previously it was an empty array, that got exported as System.Byte[] in Standard Data Output (#2951)
Map Encounter.AdmissionType to/from FHIR Encounter.priority (DSTU2, STU3 and R4) (#2935)
Map Claim.CreatedDate (that is a new addition to the data model) to/from FHIR Claim.created and ExplanationOfBenefit.created (STU3 and R4) (#2900)
Map Claim.StartDate and Claim.EndDate to/from FHIR R4 Claim.billablePeriod. Previously FHIR Claim.billablePeriod was mapped to/from properties instead, Claim.StartDate was mapped to Claim.created and Claim.EndDate was mapped to an extension, Breaking change (#2900)
CarePlan.care-team: reference - it was token, Encounter.reason-reference: reference - it was token, telecom: token - it was string (#2843)Map Procedure.Status to/from FHIR Procedure.status (DSTU2, STU3 and R4) (#2859)
Map Procedure.Properties to/from the http://careevolution.com/fhirextensions#properties extension (DSTU2, STU3 and R4) (#2859)
Medication.AmountBilled to/from FHIR R4 ExplanationOfBenefit.item.net and Claim.item.net (#2839)
Implemented the bulk export _typeFilter and _elements parameters (#2845)
Support multiple sort parameters, and automatically add a sort by id to all the other sorts, to ensure a stable sort order even when the main sort field has the same value for multiple resources. (94d5efc77e7182aedba8ddf2f65f173fcc916ae5)
Add the ExplanationOfBenefit.service-date search parameter (STU3 and R4), it searches by ExplanationOfBenefit.billablePeriod corresponding to Claim.StartDate and Claim.EndDate internally (5ad543f76d056a71e41b4cd65626e119b569d264)
Date-time search fixes. Breaking change (#2836)
The date-time search using equality on periods (eg encounter admit and discharge) was not correct: it wrongly matched open-ended periods.
The date-time search using le (less than or equal) and ge (greater than or equal) on periods did not work correctly: they matched periods overlapping the search interval instead of contained in it.
Added the ExplanationOfBenefit.type search parameter (STU3 and R4), it searches by ExplanationOfBenefit.type corresponding to Claim.ClaimType internally (312f5f761c8e9d12a72185d39b68d42a59eb8eee)
Added the Binary resource (#2807)
It maps Report.ReportContent + Report.ReportFormat, LabReport.LabReportContent + LabReport.LabReportFormat and DemographicPicture.Picture + DemographicPicture.MimeType. It is a read-only resource and supports only the 'read' interaction, no searches. As per FHIR specifications it returns the JSON or XML representation of the FHIR Binary resource when the client explicitly ask for it using either the 'Accept' header or the _format query parameter, but in all other cases it returns the raw binary data, that is more efficient.
If the user issuing a FHIR request has access to the Binary resource then DiagnosticReport.presentedForm, Practitioner.photo, Patient.photo, Person.photo use URL to the corresponding binary resource instead of embedding the binary data base64-encoded directly in the resource. This is in general more efficient. Note that this is a breaking change for user that have by default access to all resources. User that have been granted access to only specific resources typically do not have access to Binary (it did not exist), so they'll still see the same data.