Profiles & Operations Index > Operation: Search Patient Summary

Operation: Search Patient Summary

The Search Patient Summary operation issues a parameterized query that results in a searchset Bundle that contains all Patient Summary Document Bundles that match the search parameters (a searchset Bundle of document Bundles). This operation supports retrieval of a set of instances using the following search criteria:

Query Search Parameters Description Usage Note Example
composition.patient.identifier This parameter specifies an identifier associated with the patient who is the subject of this Patient Summary. This use of patient.identifier follows the FHIR Chaining Parameters search methodology. Generally this would be the patient's jurisdictional health number, but in some cases might be an alternative identifier such as MRN or ECID. Should include both system and value. [Base]/Bundle?composition.patient.identifier=https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn|1234-56789
timestamp This parameter specifies when this Patient Summary was created. See FHIR http://hl7.org/fhir/R4/search.html#date for use of the date search type. Applied directly on bundle, does not require chaining. [Base]/Bundle/_search?timestamp=2022-01-11T14:30:00+01:00
composition.type This parameter specifies the type of document. This use of composition.type follows the FHIR Chaining Parameters search methodology. Will be fixed to 60591-5 for patient summary. [Base]/Bundle/_search?composition.type=http://loinc.org|60591-5
composition.status This parameter specifies the status of the Patient Summary document, e.g. "final" or "entered-in-error". This use of composition.status follows the FHIR Chaining Parameters search methodology. A status of "entered-in-error" indicates a Patient Summary that has been invalidated. [Base]/Bundle/_search?composition.status=final
_lastUpdated This parameter can be used to select resources based on the last time they were changed This parameter considers the value found in Resource.meta.lastUpdated. Note that the server always provides this value, and clients have no control over a resource's last updated date. [Base]/Bundle/_search?_lastUpdated=ge2024-04-10T15:29:22.658+00:00
_sort (_sort=[-]timestamp) This parameter can be used to specify sorting criteria. It can be used to sort in either ascending or descending order. The optional "-" prefix indicates descending order. This allows the sorting of search results based on the creation date of the Patient Summary [Base]/Bundle/_search?_sort=-timestamp
_count This parameter specifies how many search results should be returned in a single page. If there is no _count in the search request, the server will use a configurable default page size, e.g. 50 [Base]/Bundle/_search?_count=10

Scope

This transaction involves a request by an Ontario Patient Summary Document Consumer for a set of Patient Summary documents matching the specified search criteria. The request is received by the Ontario Patient Summary Responder which returns a Bundle containing the matching Patient Summary Compositions.

For example, an Electronic Medical Record (EMR) user is seeing a new patient and wants to see a list of Patient Summaries available for that patient. The EMR uses the patient information held in the EMR to query the repository for any Patient Summary documents that exist for that patient. The repository returns a Bundle of any matching Patient Summaries which is then displayed to the EMR user as a list. The EMR or other PoS system is responsibile for listing the available patient summaries for the user to review; this is not an aspect of the query operation its

Interaction Diagram

Search PSON

Actor: Ontario Patient Summary Document Consumer

Role: Requests a set of Patient Summary documents from the Ontario Patient Summary Document Responder based on specified search criteria.

Actor: Ontario Patient Summary Document Responder

Role: Returns a search result Bundle containing Patient Summary documents that match the search criteria specified by the Ontario Patient Summary Document Consumer.

Specification

This specification is based on the FHIR R4 Search operation.

Patient Summary Search Request

The Search operation will return a searchset Bundle resource containing the Patient Summary Compositions (as document Bundles) that match the specified search criteria. The Patient Summary Search Request supports both GET and POST; PS-ON prefers the use of POST to avoid putting PHI in request URLs.

GET [base]/Bundle?([parameters]{&_format=[mime-type]})

POST [base]/Bundle/_search{?&_format=[mime-type]}

Patient Summary Search Response

A Patient Summary Search Response may contain either:

  • a searchset Bundle containing zero or more Patient Summary Composition dococument Bundles matching the search criteria. Each Patient Summary document Bundle will include all resources referenced by the Composition resource; no _include search parameter will be required. see note below
  • OperationOutcome resource

note: to return a lightweight response that does not include all referenced resources, please see the Fetch DocumentReference operation page to return only DocumentReference resources

Example Search Queries

Search by Patient Identifier

[base]/Bundle?composition.patient.identifier=https%3A%2F%2Ffhir.infoway-inforoute.ca%2FNamingSystem%2Fca-on-patient-hcn|1234567890

Search for Summaries for a Specified Patient Created in 2020 or Later

[base]Bundle?composition.patient.identifier=https%3A%2F%2Ffhir.infoway-inforoute.ca%2FNamingSystem%2Fca-on-patient-hcn|1234567890&timestamp=ge2020

Expected Behavior

See Response Handling page for additional response handling behaviour.

Legend
code = OperationOutcome.issue.code
severity = OperationOutcome.issue.severity
details.coding.code=OperationOutcome.issue.details.coding.code
details.coding.display=OperationOutcome.issue.details.coding.display
details.text = OperationOutcome.issue.details.coding.text


HTTP Status Scenario Description severity code details.coding.code details.coding.display details.text
200 OK At least one Patient Summary matching the specified search criteria is found HTTP 200 OK. Returns a search result Bundle containing Patient Summary compositions (document Bundles) that match the search criteria. The document Bundles will be comprised of a Composition bundle entry, and all other referenced FHIR resources (e.g. Patient, Condition, AllergyIntolerance) as subsequent bundle entries.
200 OK At least one Patient Summary matching the specified search criteria is found, but there is a consent block that prevents disclosure of patient data. Returns an OperationOutcome resource indicating that there is a consent block on the patient's record that prevents disclosure of patient data. warning suppressed
200 OK No Patient Summaries matching the specified search criteria are found. Returns an search result Bundle with zero search results. Also returns an OperationOutcome resource with a warning indicating no summaries were found. warning not-found
400 Bad Request Missing security token error required Missing required security token: PIN
400 Bad Request POST operation contains incorrect header value for "Content-Type" - should be "application/fhir+json" error invalid
400 Bad Request When there was syntactical error such as a missing or invalid header, a missing or invalid URL parameter, a request body that can't be parsed or doesn't conform to the basic FHIR JSON/XML syntax rules, etc. Returns an OperationOutcome resource indicating an issue. The client must fix the request and try again. error invalid Will vary depending on the error
401 Unauthorized Failed authentication error security Authorization is required for the interaction that was attempted
406 Not Acceptable The Accept header requested a format that the server does not support error not-supported
422 Unprocessible Entity FHIR validation errors such as invalid code, wrong date format, or violation of LOB defined business rules Will vary depending on the error Will vary depending on the error OH-defined error code OH-defined errror message
429 Too Many Requests Rate Limit error throttled Too Many Requests
500 Internal Server Error Patient Summary API validates the request but cannot return a valid response due to internal issues. fatal exception Internal Error
503 Service Unavailable Indicates that the services has been temporarily taken down (on purpose)
504 Gateway Timeout Downstream system(s) did not return timely response error timeout