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)
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.