S: CAT sends unsolicited update
The following sequence diagram shows the messaging flow when CAT sends unsolicited update to the service request.
See Participants for more information.
Business Rules
Only Open Referrals Are Updated: A referral with a closed status in the Central RMS (that is, equivalent to
ServiceRequest.status"completed"or"revoked") is not updated. Only a referral with an open status in the Central RMS (equivalent toServiceRequest.status"active") is updated.Non-Updateable Information: Certain information on the referral cannot be updated in the Central RMS. Non-updateable information:
- Patient identifier and demographics that would change the subject of the referral
- Referring provider identifier and demographics that would change the requester of the referral
Element and Value
Refer to Primary Flow for DocumentReference, HealthcareService, Location, Patient, Practitioner, and PractitionerRole elements.
Step 2: CAT notifies Requester HCP of update to service request
See Step 12 in Primary Flow message flow with changes as below:
| Element | Value |
|---|---|
| Task.businessStatus | as previously assigned |
| Task.note | as appropriate |
| MessageHeader.reason | "service-request-updated-other" |
Step 3: CAT notifies Requester HCP of update to referral record
| Element | Value |
|---|---|
| Bundle.meta.extension.submissionMetadata | Metadata for: Submitting Site; EMR Vendor Name; EMR Product Name; Submission Implementation Guide (IG) Type; Submission Implementation Guide (IG) Version; Service Delivery Site; Authoring Provider ID |
| Bundle.id | UUID |
| Bundle.meta.lastUpdated | date/time |
| Bundle.meta.security | "R" |
| Bundle.identifier.value | UUID |
| Bundle.identifier.system | "urn:ietf:rfc:3986" |
| Bundle.type | "message" |
| Bundle.timestamp | current date/time |
| Bundle.entry:MessageHeader | MessageHeader |
| Bundle.entry:Focus | ServiceRequest |
| MessageHeader.id | UUID |
| MessageHeader.meta.lastUpdated | date/time |
| MessageHeader.eventCoding | "notify-update-service-record" |
| MessageHeader.destination.endpoint | Requester HCP EMR endpoint |
| MessageHeader.source.endpoint | CAT RMS endpoint |
| MessageHeader.reason | "service-request-updated-other" |
| MessageHeader.focus | ServiceRequest |
| ServiceRequest.id | UUID |
| ServiceRequest.meta.lastUpdated | date/time |
| ServiceRequest.identifier.value | provincial identifier |
| ServiceRequest.identifier.system | "https://fhir.alberta.ca/NamingSystem/ca-ab-eref-id" |
| ServiceRequest.identifier.use | "official" |
| ServiceRequest.status | "active" |
| ServiceRequest.intent | "proposal" |
| ServiceRequest.category | as received from Requester HCP or as updated by CAT |
| ServiceRequest.priority | as received from Requester HCP or as updated by CAT |
| ServiceRequest.priority.extension.subPriority | as received from Requester HCP or as updated by CAT |
| ServiceRequest.code | as received from Requester HCP or as assigned by CAT or as updated by CAT |
| ServiceRequest.subject.identifier.value | Patient identifier |
| ServiceRequest.subject.identifier.system | as appropriate |
| ServiceRequest.authoredOn | as received from Requester HCP |
| ServiceRequest.requester.reference | Request HCP UUID |
| ServiceRequest.requester.type | "PractitionerRole" |
| ServiceRequest.performer.identifier.value | 1) CAT identifier (HealthcareService) |
| ServiceRequest.performer.identifier.system | "https://fhir.alberta.ca/NamingSystem/ca-ab-eref-healthcare-service-id" |
| ServiceRequest.performer.extension.role | "central-intake" |
| ServiceRequest.performer.reference | 2) Performer HCP UUID |
| ServiceRequest.performer.type | "PractitionerRole" or "HealthcareService" |
| ServiceRequest.performer.extension.role | "receiving-provider" or "service-location" |
| ServiceRequest.reasonCode.text | as received from Requester HCP or as updated by CAT |
| ServiceRequest.supportingInfo | as received from Requester HCP or as updated by CAT |
| ServiceRequest.note.text | as received from Requester HCP or as updated by CAT |
| ServiceRequest.extension.referralTimestamp.extension.timestamp | date/time |
| ServiceRequest.extension.referralTimestamp.extension.timestampType | as previously assigned |
| ServiceRequest.extension.patientPreference.extension.preferenceType | "preferred" |
| ServiceRequest.extension.patientPreference.extension.preferenceValueType | as received from Requester HCP or as updated by CAT |
| ServiceRequest.extension.patientPreference.extension.preferenceValue | as received from Requester HCP or as updated by CAT |
Step 4: CAT sends unsolicited update from Requester HCP to Performer HCP
Same as Step 3 above with changes as below:
| Element | Value |
|---|---|
| MessageHeader.destination.endpoint | Performer HCP EMR endpoint |
| MessageHeader.source.endpoint | CAT RMS endpoint |
| ServiceRequest.performer.reference | Performer HCP UUID |
| ServiceRequest.performer.type | "PractitionerRole" or "HealthcareService" |