DFT Ballot - This specification is currently in ballot review and subject to change. It is not ready for limited roll-out or production level use. For a full list of available versions, see the Directory of published versions
Actor Options
CA:FeX offers four options for health information exchange. Implementers can select one or more depending on their context.
| Actor Option | Description | Exchange Type |
|---|---|---|
| A. Bundle Option | Exchange of data using /Bundle endpoint |
Document Exchange |
| B. Metadata Option | Exchange of data through metadata resources | Document Exchange |
| C. Single Resource Option | Exchange of data using FHIR single resource endpoints | Data Exchange |
| D. Summary Option | Exchange of document using $summary operation |
Document Exchange |
Transaction Naming Convention
CA:FeX uses a consistent numbering convention for transactions to convey the type of interaction:
| Transaction Number | Interaction Type | Example |
|---|---|---|
| CA:FeX-1 | Submit Data | CA:FeX-1A, CA:FeX-1B |
| CA:FeX-2 | Search Data | CA:FeX-2A, CA:FeX-2B |
| CA:FeX-3 | Retrieve Data | CA:FeX-3A, CA:FeX-3B |
Conformance: Actors and Transactions
Actors must support all required (R) transactions for CA:FeX conformance which is further described by the CA:FeX CapabilityStatements.
The CapabiliityStatements are structured to describe the system expectations for each Actor in each Option.
Bundle Option (A)
This Option caters to implementers who need a relatively simple way to exchange clinical documents as self-contained FHIR Document Bundles using FHIR RESTful create, search, and read interactions on the /Bundle endpoint.
| Actor | Transaction | Endpoint | Optionality |
|---|---|---|---|
| Data Source | Submit FHIR Document [CA:FeX-1A] | /Bundle |
R |
| Data Consumer | Search FHIR Document [CA:FeX-2A] | /Bundle |
R |
| Retrieve FHIR Document [CA:FeX-3A] | /Bundle |
R | |
| Data Recipient | Submit FHIR Document [CA:FeX-1A] | /Bundle |
R |
| Data Responder | Search FHIR Document [CA:FeX-2A] | /Bundle |
R |
| Retrieve FHIR Document [CA:FeX-3A] | /Bundle |
R |
Description:
- Submit FHIR Document [CA:FeX-1A]: Uses FHIR Create interaction for a Bundle (usually FHIR Documents).
- Search FHIR Document [CA:FeX-2A]: Uses FHIR Search interaction with parameters.
- Retrieve FHIR Document [CA:FeX-3A]: Uses FHIR Read interaction.
Metadata Option (B)
This Option addresses the needs of implementers who want a more flexible approach to FHIR document exchange that separates metadata management and discovery from the retrieval of the full document content.
| Actor | Transaction | Endpoint | Optionality | Notes |
|---|---|---|---|---|
| Data Source | Generate Metadata [CA:FeX-1B] | $generate-metadata |
R | Based on MHD |
| Data Consumer | Fetch DocumentReference [CA:FeX-2B] | $docref |
R | Based on IPA |
| Retrieve Document [CA:FeX-3B] | /Bundle, /Binary |
R | ||
| Data Recipient | Generate Metadata [CA:FeX-1B] | $generate-metadata |
R | Based on MHD |
| Data Responder | Fetch DocumentReference [CA:FeX-2B] | $docref |
R | Based on IPA |
| Retrieve Document [CA:FeX-3B] | /Bundle, /Binary |
R |
Description:
- Generate Metadata [CA:FeX-1B]: Uses
$generate-metadatato submit a document and generate a DocumentReference. - Fetch DocumentReference [CA:FeX-2B]: Uses
$docrefto get DocumentReferences. - Retrieve Document [CA:FeX-3B]: Uses
/Bundleor/Binaryto retrieve content.
Single Resource Option (C)
This Option caters to needs for exchanging individual clinical data points of FHIR resources using standard FHIR RESTful principles.
| Actor | Transaction | Endpoint | Optionality |
|---|---|---|---|
| Data Source | Submit Resource [CA:FeX-1C] | /<type> |
R |
| Data Consumer | Search Resource [CA:FeX-2C] | /<type> |
R |
| Retrieve Resource [CA:FeX-3C] | /<type> |
R | |
| Data Recipient | Submit Resource [CA:FeX-1C] | /<type> |
R |
| Data Responder | Search Resource [CA:FeX-2C] | /<type> |
R |
| Retrieve Resource [CA:FeX-3C] | /<type> |
R |
Description:
- Submit Resource [CA:FeX-1C]: FHIR Create interaction for a single resource.
- Search Resource [CA:FeX-2C]: FHIR Search interaction with parameters.
- Retrieve Resource [CA:FeX-3C]: FHIR Read interaction using resource ID.
Summary Option (D)
This Option addresses the need for a streamlined and efficient approach to accessing the most relevant and current patient summary information. It utilizes an international standard for exchanging the International Patient Summary (IPS).
| Actor | Transaction | Endpoint | Optionality | Notes |
|---|---|---|---|---|
| Data Consumer | Retrieve Patient Summary [CA:FeX-3D] | /Patient/$summary or /Patient/[id]/$summary |
R | Based on IPS |
| Data Responder | Retrieve Patient Summary [CA:FeX-3D] | /Patient/$summary or /Patient/[id]/$summary |
R | Based on IPS |
Description:
- Retrieve Patient Summary [CA:FeX-3D]: Uses
$summaryoperation on the Patient endpoint to retrieve a summary document.
Mapping Use Cases to Transactions
| Use Case ID | Transaction Used |
|---|---|
| UC-01 | CA:FeX-1A Submit FHIR Document |
| UC-02 | CA:FeX-2A Search FHIR Document |
CA:FeX-3A Retrieve FHIR Document |
|
| UC-03 | CA:FeX-1C Submit Resource |
| UC-04 | CA:FeX-2C Search Resource |
| UC-05 | CA:FeX-2B Fetch DocumentReference |
CA:FeX-3B Retrieve Document |