Change Log

This page provides a list of changes to the CA:FeX implementation guide specification since its last release.

CA:FeX 2.2.0-DFT-Ballot

• Created the CA:FeX Home page with introductory content for the guide
• Updated the project background page with additional context
• Migrated content from the CA:FeX v2.1.0 DFT-Ballot (Infoscribe) to Simplifier, including:
  • Use Cases and diagrams → Use Cases
  • Sequence Diagrams → Sequence Diagrams
  • Actor Mapping to Interoperability Specification section → Actor Mapping to Interoperability Specification, now updated as Interoperability Recommendations Tables, with prescriptive conformance language removed and implementation best practices emphasized
• Reorganized CA:FeX content pages under new top-level sections: Business Context, Technical Context, and Actor and Conformance Options
• Added a Technical Overview page for CA:FeX
• Created the Technical Actors and Actor Options pages under the Actor and Conformance Options section
• Merged the "Declaring Conformance" and "Must Support Requirements" pages into a unified Conformance Requirements page
• Updated Conformance Requirements to reflect distinct technical actors and exchange options.
• Added CA:FeX Server Capability Statements to reflect different actors and options
• Removed clinical-type and clinical-date as supported search parameters (no longer part of base FHIR)
• Updated Option C documentation to reflect a single-resource exchange pattern
• Added clear conformance expectations for all supported CA:FeX operations
• Clarified expectations around CA:FeX profiles and extensions to better highlight that referenced resources may be exchanged as base FHIR resources
• Merged response handling content into the RESTful API Interactions page
• Updated $docref guidance with additional context on using patient.id vs patient.identifier

CA:FeX 2.1.0-DFT-Ballot

• Document Exchange: Updated Notes section to contain content better placed here for context
• Document Exchange: added line at beginning of page to indicate awareness of Data Exchange page
• Data Exchange: added line at beginning of page to indicate awareness of Data Exchange page
• Security: UDAP/OAuth clarification, included IUA as potential grouping
• Response Handling: trimmed down details to encourage visiting FHIR R4 page for details

CA:FeX 2.1.0-DFT-preBallot

• Updated Project Background with additional context
• Added more links to relevant FHIR specifications on FHIR Exchange Paradigm page
• Removed FHIR descriptions to emphasize reference to FHIR specification pages and removed interactions not the focus of CA:FeX
• Revised Document Exchange page by adding Actors, Transactions and Actor Options to help reflect expectations for implementers
• Revised Data Exchange page by adding Actors and Transactions to help reflect expectations for implementers
• Removed $document from Operations page as it is not referenced by CA:FeX transactions (may be considered for the future)

CA:FeX 2.0.0 DFT - Ballot Reconciliation

• Added $generate-metadata as an optional operation while keeping Bundle as mandatory. Servers SHOULD create a DocumentReference when a Bundle is created.
• Emphasized that $summary is the preferred mechanism for creating patient summaries due to its efficiency, while $docref is more generic and $document is more specialized and less commonly used. Systems SHOULD support $summary and MAY support $docref.
• Removed language indicating _include could be used with $docref to return referenced documents in the response (_include can only be applied on operations with type _query).
• Provided best practice guidance for DocumentReference to store 'data' as a separate resource instance (e.g., Binary, Bundle) and link it from the DocumentReference.
• Added new security sections "Exchange Security" and "CA:FeX Cross Profile Considerations".
• Changed SHALL conformance expectation to SHOULD for all resources in Capability Statement (CS).
• Marked content summarizing core specification rules as informative summaries, clarifying that the base specification prevails in case of conflicts.
• Updated/created chained SearchParameters by adding the 'chain' element and updated their use in CapabilityStatement to reflect type (reference) and chain hierarchy (e.g., cafex-bundle-composition-status added to Bundle, Composition-status added to Composition).
• Added composition.category as a supported SearchParameter under the Composition (for use in Bundle.Composition chain)
• Created CA:FeX SearchParameters that extend base definition (and US Core) to add :exact modifier requirement to string parameters (e.g., patient name, name.given, etc.) in alignment with written requirements on Search Parameters and Capability Statements pages to reflect technical corrections applied against SearchParameters & Server CapabilityStatement (e.g., reflecting Include/revInclude statements).
• Technical corrections including updating the Server CapabilityStatement to reflect requirements in the narrative on Capability Statements (e.g., inclusion of MedicationStatement interactions)

CA:FeX 2.0.0 DFT-Ballot

• Ported information from CA:FeX 1.0.0 Trial Implementation into new Simplifier Guide Structure.
• Defined CA:FeX 2.0.0. DFT Scope and provided clarity on the Relationship to Other Specifications.
• Provided guidance on FHIR Exchange Paradigms and defined CA:FeX Exchange Patterns, for example - single/multiple resource(s) exchange framework.
• In Document Exchange, Added transactions CA:FeX 2B and CA:FeX 3B to define interactions with Hybrid Repositories (e.g., repositories that support both native FHIR Documents and legacy Binary documents).
• Added Data Exchange page to cover guidance on how CA:FeX Transactions requirements for exchanging individual resources are enforced through the CA:FeX CapabilityStatement.
• Highlighted best practices in privacy, security, and authentication on the Security.
• Added
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  pages to provide and guidance on how implementers can demonstrate and declare conformance.
• Defined CA:FeX Server CapabilityStatement and Search Parameters.
• Identified key functional Operations.
• Developed supportive human readable descriptions of server requirements on the Capability Statements page.
• Separated Response Handling information from RESTful API Interactions to form a new
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  page.
• Updated Profiles and Extensions page to include pointers to CA Core project.
• Updated Search Parameters page to include new custom search parameters to support retrieval of documents using chaining on Bundle