Nuances of message events

The message events are unique in their focuses, therefore, the focus(es) of each message event is the optimal way to highlight what each payload refers to. Additionally, a bundled message event may have more than one focus, and there is an importance in highlighting additional nuances which may be outside the obvious behaviour of the message events.

add-service-request

This message event is used in both v0.10.0 and v0.11.1 to send a new eReferral from Ocean to the receiving RMS target.

• Referral summaries and the original attachments sent when the eReferral is created can be retrieved from this bundle using the following methods:
  • The referral summary can be retrieved the endpoint described below: https://ocean.cognisantmd.com/public/fhirApiDocs.html#operation/referralReferenceLetter_1 and individual attachments can be retrieved from the endpoint described below: https://ocean.cognisantmd.com/public/fhirApiDocs.html#operation/DocumentReferenceBinary_1
  • A consolidated PDF with the referral summary and all attachments can be retrieved by appending ?attachments=true to the referral summary endpoint https://ocean.cognisantmd.com/public/fhirApiDocs.html#operation/referralReferenceLetter_1

notify-update-service-request

As previously indicated, this message event is used to communicate updates made on the eReferral. It typically relays updates from the RMS Source (Ocean) to the RMS Target (HIS/EMR). Here are some additional nuances to be aware of with this message event:

• Most actions except for creating an eReferral, sending a Communication, and cancelling an eReferral will send a notify-update-service-request message event to the receiving system.
• Any action taken on the eReferral either via the UI or the API and either by the sending provider or receiving provider/system will send a notify-update-service-request message event to the receiving system.

notify-add-appointment

This message event is used by the referral receiver to add appointments to eReferrals in Ocean using the FHIR APIs.

• This message event cannot be used to update appointments on an eReferral.
• It can be used to add multiple appointments on an eReferral by including multiple Appointment resources; and booking comments using the Appointment.Patientinstruction field.
  • When multiple appointments are added on the eReferral, there should be multiple focuses relative to the Appointment resources present.
• The eReferral can be moved directly into ‘Confirmed’ status in Ocean and put into the ‘Booking Confirmed’ folder in the Ocean portal if a Patient resource is referenced in the Appointment.participant.actor field and the Appointment.participant.status is set to accepted.
• The appointment medium (video, phone) can be specified in the Location.type field that is referenced by the Appointment.participant.actor field.
  • If the medium is unknown/unspecified or known to be in-person: Include a participant containing an actor with code "LOC", display "Clinic Location" and a reference to the listing's Location resource.
  • If the appointment is phone-based: Include a participant containing an actor with code "LOC", display "Phone Visit" and a reference "Location/X" to a Location with ID X in the Bundle. Set the Location's telecom to match the listing's phone number.
  • If the appointment is a home visit: Include a participant containing an actor with code "HH", display "Patient Location" and a reference "Location/X" to a Location with ID X in the Bundle. Set the Location's address to match the Patient's address if it is available.
  • If the appointment is at an alternate location: Include a participant containing an actor with code "LOC", display "Alternate Clinic Location" and a reference "Location/X" to a Location with ID X in the Bundle. The Location resource must contain an address, and its description should match the description of the alternate location e.g., "Alternate Clinic Visit Location: ___"

notify-update-process-request

This message event was introduced in v0.11.1 and can be used similarly to how the notify-update-appointment message event is used in v0.10.0.

• This can be used to update a Task or an Appointment.
• This is used to update the status and/or information on appointments with the MessageHeader.focus as the Appointment resource and not Task.

send-communication-from-requester and send-communication-from-provider

This message event is used in both v0.10.0 and v0.11.1 to send messages using the FHIR APIs on eReferrals.

• You should look for documents in the Communication resource rather than the DocumentReference when a message is sent via Ocean with an attachment.
• Messages sent from the receiving system to the referral sender via Ocean using the FHIR APIs will be presented in the Ocean UI as being from the receiver’s listing. i.e. if Dr. Jane Smith of ABC Medical Clinic is the referral recipient and sends a message from their EMR to the original referral sender via Ocean, the Messaging pane will display the message as simply being from ABC Medical Clinic.
• Ocean's APIs accept attachment/file sizes of up to 10 MB per file and up to a maximum of 50 MB of attachments to a referral. If the file size is too big, Ocean will return an error message and not process the entire payload.
• Messages can only be sent from the receiver through to APIs to the original sender of the referral.