Ontario Provincial Consent Override Interface HL7® FHIR® Implementation Guide v1.0.0-draft1
For a full list of available versions, see the Directory of published versions
Consent Create is the RESTful interaction used to perform a temporary consent override, as prescribed by Ontario legislation and regulations (PHIPA and HIPA). It aligns with the generic RESTful create operation defined in the FHIR core specification (https://hl7.org/fhir/R4/http.html#create).
This transaction involves sending a FHIR Consent resource to the PCOI microservice, to perform a temporary consent override for provincial EHR assets that are integrated with PCOI. The request is recieved by the PCOI microservice, and routed to the respective provincial EHR assets (called "Lines of Business" i.e. LOBs). The PCOI microservice will provide a response indicating which LOBs successfully perform consent overrides, and relay issues preventing LOBs from performing consent overrides.
The following diagram illustrates the high level interaction between a FHIR PCOI Client and FHIR PCOI microservice. The transaction will use the following pair of query and response:
Actor: FHIR PCOI RESTful Client
Role: Requests a temporary consent override for select provincial EHR assets, in accordance with Ontario legislation and regulations, providing identity information for the patient subject, practitioner and practitioner organization requesting the override, the reason for the override, and the lines of business for which override is requested. The FHIR PCOI RESTful Client processes the PCOI microservice response, identifying which provincial EHR assets have successfully applied a temporary consent override.
Actor: FHIR PCOI Microservice
Role: Processes the PCOI request message, and perform consent override for each of the requested provincial EHR assets. Returns the result of the consent override request for each requested provincial EHR asset, as well as any error messages from those assets.
This FHIR spec makes use of the following resource profiles:
PCOI Request
PCOI Response
The table below shows the allowed transactions for each profile and how they support FHIR endpoints, resources and their corresponding HTTP operations:
| Resource | Transaction | HTTP Operations | URL | Request Body Resource | Response Body Resource |
|---|---|---|---|---|---|
| Consent | Create | POST | [base]/Consent/ | Consent resource with contained Patient, Practitioner, Organization, RelatedPerson resources | OperationOutcome resource |
The interaction summary table below lists the HTTP status codes that may be returned for the query.
| Interaction | Content-Type | Body | Location | Versioning | Status Codes | Comments | |
|---|---|---|---|---|---|---|---|
| create | R | R: | Consent | N/A | N/A | 201,400,404,406,415,500 |
Examples of PCOI requests can be found below:
| Case | Scenario Description | HTTP Status Code | Response Payload |
|---|---|---|---|
| 1 | A valid Consent request is submitted and accepted by the PCOI service | HTTP 201 | Created. Returns the created resource. |
| 2 | POST operation contains incorrect header value for "Content-Type" - should be "application/fhir+json" | HTTP 400 | Bad Request. Returns an OperationOutcome resource indicating an issue. |
| 3 | Invalid Message Content | HTTP 422 | Unprocessable Entity. Returns an OperationOutcome resource indicating an issue. |
| 4 | PCOI Service validates the request but cannot return a valid response due to internal issues. | HTTP 500 | Internal Server Error. Returns an OperationOutcome resource indicating an issue. |
| 5 | Downstream system(s) did not return timely response. | HTTP 504 | Gateway Timeout. Return a comma-separated list of LOBs that did not return a response within the specified PCOI microservice timeout parameter. |
For additional Response Handling guidance, please see Response Handling