The recent change that added the list of institutitons to the Patient resource (in the http://careevolution.com/fhirextensions#patientInstitutions custom extension) introduced a bug that could cause Patient searches either to crash (i.e. fail with error 500) or to return Patient resource listing more institutions than actually associated with the patient. Both issue applied only to non-merged endpoints - i.e. those returning a Patient resource for each underlying HIEBus patient record. Merged endpoints - i.e. returning a Patient resource for each HIEBus patient record group (that are the default) - did not present those issues.
(H/81619e4c, H/72bc710d)
Consumers 31.5.2, HIEBus 31.3.2
The recent change that added the list of institutitons to the Patient resource (in the http://careevolution.com/fhirextensions#patientInstitutions custom extension) introduced a bug that could cause Patient searches either to crash (i.e. fail with error 500) or to return Patient resource listing more institutions than actually associated with the patient. Both issue applied only to non-merged endpoints - i.e. those returning a Patient resource for each underlying HIEBus patient record. Merged endpoints - i.e. returning a Patient resource for each HIEBus patient record group (that are the default) - did not present those issues.
(H/81619e4c, H/72bc710d)
Consumers 31.5.1, HIEBus 31.3.0
Consumers 31.5.0, HIEBus 31.3.0
The data source has been added to the underlying data model for those three resources, new data might have it populated and reflected in the http://careevolution.com/fhirextensions#dataSource custom extension.
The change applies to all FHIR versions: DSTU2, STU3, R4.
(H/aa9a5ab6)
The data source has been added to the family member history data model, new data might have it populated and reflected in the http://careevolution.com/fhirextensions#dataSource custom extension.
The change applies only to FHIR R4, that is the only version that has the FamilyMemberHistory resource.
(H/187d1c82)
Consider the adjudication date if the creation date is missing in the underlying data.
(H/e7e9a0aa)
The adjudication date is a good proxy for when the explanation of benefit has been created
(H/c47435de)
The new http://careevolution.com/fhirextensions#medicationDispense-sequence custom extension contains the sequence number of the medication dispense within the claim (or ExplanationOfBenefit) it comes from.
(H/3fb48fdd)
The RelatedPerson resource (DSTU2, STU3, R3) has a new CodeableConcept custom extension http://careevolution.com/fhirextensions#patientAssociatedParty-contactType indicating the type of contact represented by the RelatedPerson resource - e.g. if it is the emergency contact for the patient.
(H/bf2f8144)
HIEBus has an internal 'access policy' concept associated to patients and encounters - controlling which users can see those resources and their associated data. Access policies are now mapped to security tags (meta.security elements) in the Patient and Encounter resources (all version). The tags have a fixed system http://careevolution.com/accesspolicyname and a value that is the access policy name.
HIEBus has an internal 'institution' concept - roughly corresponding to a health system or hospital. Each patient can be associated with one or more institutions - roughly the health systems or hospitals where they received care. This list is now mapped to the Patient custom extension http://careevolution.com/fhirextensions#patientInstitutions - each extension instance contains the code and (optional) name of the associated institution as a Coding element (with the code in code and the name in display).
(H/a84550bb)
HIEBus version 31 introduces a new 'feed' concept, indicating a source of data - that can be POSTing FHIR resources, an HL7v2 feed, importing C-CDAs, a custom driver reading a database etc. etc. Feeds are associated with the (pre-exisitng) 'record authority' concept, that is mapped to FHIR Organization resources.
Feeds are now mapped to the Endpoint R4 resource, and the record authority - feed reference is mapped to the Organization.endpoint element. There is also a new endpoint Organization search parameter, allowing associated endpoints (feeds) to be included in an Organization (record authorities) search.
(H/29f51dd1)
In some cases pharmacy ExplanationOfBenefit.item.sequence was 0, that is not conformant - now fixed.
(H/c04b10e5, H/4d380d88)
It was not present in Patient resources returned by 'merged' endpoints - i.e. those returning a Patient resource for each HIEBus person - aka record group (as opposed to 'non merged' endpoints returning a Patient resource for each HIEBus patient).
(H/ba29b636)
Consumers 31.4.1, HIEBus 31.2.1
Consumers 31.3.0, HIEBus 31.2.1
Bulk export of some resource type (MedicationAdministration, Specimen) resulted in a crash, now fixed.
(H/957d79a3)
Consumers 31.2.0, HIEBus 31.2.0
Coding elements can have custom extensions http://careevolution.com/fhirextensions#coding listing all the other corresponding codings known to the system (via mappings or because the underlying data supports more than one value), these extensions omitted codings that had the same code but different systems, this has now been fixed - all available codings are listed.
(H/d6653f0b)
Some reference search parameter can reference multiple different resource types - e.g. ExplanationOfBenefit.provider can reference Organization or Practitioner or PractitionerRole. In these cases it was necessary to specify a type modifier or use a URL when searching - e.g. [base]/ExplanationOfBenefit?provider=[id] failed, it was necessary to use [base]/ExplanationOfBenefit?provider:Practitioner=[id] or [base]/ExplanationOfBenefit?provider=Practitioner/[id].
This restriction no longer applies now to all search parameters for which there is only one possible implemented resource - so in the example above even if there are three possible reference resource types in the specification in our implementation only Practitioner references are possible, and so now a request like [base]/ExplanationOfBenefit?provider=[id] is accepted and [id] is automatically interpreted as a Practitioner id.
(H/dff6ac7a)
R4 only.
The underlying data model is new as well, so only new data (or data that has been migrated to the new data model) will show up in the resource.
(H/3a99e88f)
(H/e1fcc8f4)
The underlying data model now support multiple coded values and also a free text for the encounter class. These extra value are mapped to the http://careevolution.com/fhirextensions#coding (pre-existing) and http://careevolution.com/fhirextensions#text (new) extensions of Encounter.class element.
(H/abf2d37c, H/b1d77aec)
Consumers 31.1.0, HIEBus 31.0.0
Consumers 31.0.7, HIEBus 31.0.2
Consumers 31.0.6, HIEBus 31.0.2
Consumers 31.0.5, HIEBus 31.0.2
Consumers 31.0.4, HIEBus 31.0.2
Consumers 31.0.3, HIEBus 31.0.2
Consumers 31.0.2, HIEBus 31.0.2
In some cases pharmacy ExplanationOfBenefit.item.sequence was 0, that is not conformant - now fixed.
(H/c04b10e5, H/4d380d88)
Consumers 31.0.1, HIEBus 31.0.0
Consumers 31.0.0, HIEBus 31.0.0
ExplanationOfBenefit has different mapping depending on the target profile that are now displayed separately in its documentation page.
Also, resource documentation pages now include an index to their sections at the beginning (they can be quite long so that helps navigating them).
(C/0c2fd5bb)
Breaking change
Encounter.reasonCode is mapped to/from a new internal EncounterReasons table instead than to/from problems associated with the encounter.
The change can be disabled by system administrators to maintain compatibility if needed.
(H/1d8ecf7c)
unknownBreaking change
When there was no available underlying value a number of required code elements were populated with a default value even if the value-set did not have an available unknown value to use - so for example Encounter.class was set to AMB if there was no available class. Now these codes are left empty with a DataAbsentReason unknown extension.
The affected elements are AllergyIntolerance.verificationStatus, CarePlan.activity.detail.status, CarePlan.intent, Goal.status, Task.status, ExplanationOfBenefit.type, ExplanationOfBenefit.status, Condition.category, Condition.verificationStatus, Claim.type, Encounter.class, Coverage.status, Coverage.relationship.
The change can be disabled by system administrators to maintain compatibility if needed.
(H/36c14651)
Breaking change
They all got their data from Galileo, that is no longer used.
(H/fa4eb533)
Observation.valueQuantity with large values fixAttempts to POST Observations with a valueQuantity.value greater than 999,999,999 used to fail, now it is accepted.
(H/e82fa8d8)
The insured name, address, contact information etc. are now rendered in a contained Patient resource that is referenced by Coverage.subscriber. Previously they were rendered as custom extension, using a contained Patient is more standard. The custom extensions are preserved for backward compatibility.
When POSTing Coverage resource the system now also looks for a referenced contained Patient to get the insured details.
(H/1298a182)
Always populate supportingInformation.sequence
Don't output old Carin BB system URI in supportingInformation.code when it is not necessary for backward compatibility
Add data absent reason extension to total.amount when there is no value
(H/713e2590)
. . . for Coverage, Patient, Practitioner and Organization
(H/75d558c2)
This fixes potential out of memory errors when exporting lots of big DiagnosticReports or DocumentReferences
(H/4f73ef24)
The ExplanationOfBenefit mapping is now profile-specific, i.e. the underlying claim data is mapped to/from ExplanationOfBenefit differently depending on which of the Carin BB profile it corresponds to (inpatient, oral, outpatient, pharmacy, professional)
Update the care team codes in valueset http://hl7.org/fhir/us/carin-bb/STU2/ValueSet-C4BBClaimInstitutionalCareTeamRole.html. Add new rendering which replaces performing. Left rendering for backward compatibility.
Add service-start-date search parameter
supportingInfo updates:
http://hl7.org/fhir/us/carin-bb/STU2/CodeSystem-C4BBSupportingInfoType.html. Keeping in the old codes for backward compatibility.adjudication updates:
http://hl7.org/fhir/us/carin-bb/STU2/ValueSet-C4BBAdjudication.html and http://hl7.org/fhir/us/carin-bb/STU2/ValueSet-C4BBAdjudicationCategoryDiscriminator.html. Keeping in the old codes for backward compatibility.benefitpaymentstatus slice output to adjudication, keeping in total to maintain backward compatibility.benefitpaymentstatus and renderingnetworkstatus based on profile requirements.hsapaid to paidbypatienthealthaccount and denialreason to adjustmentreason. Keeping the old slices for backward compatibility.Documentation Updates:
In the Practitioner and (contained) Organization resources the npi identifier type system uri is now http://terminology.hl7.org/CodeSystem/v2-0203. Keeping also the old type system uri for backward compatibilty.
(H/97f43c0a)
Output files are created directly compressed instead of being first created uncompressed and then compressed.
(H/3edca3e2)
When the binding is extensible (for example R4 Encounter.class) if the underlying data cannot be mapped to the bound value set the Coding is now set to the available data as-is - previously it was not set. This mimics the existing behavior for CodeableConcepts bound to an extensible value set.
(H/a46f6900)
Breaking change
POSTed JSON data is processed with a new JSON parser that is around 8 times faster than the old.
The new parser is more restrictive (and more secure...) than the old one:
JSON using single quote as property and string delimiter is no longer accepted
Special characters (e.g. new lines) in JSON strings must always be properly escaped - previously they were also accepted as-is
Commas after the last element of an object or array now cause an error
(H/07512f0a)
Previously such resources where (wrongly) considered non-complaint and so not tagged with their US Core profile URL (and removed if the endpoint is in 'strict compliance' mode)
(H/49bf5546)
performer standard search parameter to the Observation resource(H/68198b5b)
Support the :iterate modifier for the _include parameter - see the specifications.
(H/412a9f29)
_lastUpdated standard search parameter to the DocumentReference resource(H/18c63cd4, H/daf037e6)
The profile URLs placed in the meta.profile elements now include the version number - e.g. http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|3.1.1 instead of http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance.
(H/e83bdc13)
reference search parameter to reference-conceptBreaking change
ValueSet reference is defined in the base specs to search by the code system, whereas what we search for is the entire system + code
(H/42087ee2)