This page is part of the US Core (v8.0.0: STU8) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Patient Data Feed Additional Resources

Page standards status: Informative

Overview

This page outlines additional resources that may be supported by Servers implementing the Patient Data Feed. These resources are not required for the current implementation but are considered valuable for a more comprehensive patient data feed. Servers may support any subset of these resources and filters based on their capabilities and use cases.

Optional Resources Table

The following table outlines additional resources that Servers may support for the Patient Data Feed:

Resource	Required-Support Triggers	Required-Support Filters	Recommended-Support Filters
AllergyIntolerance	feed-event	patient trigger
CarePlan	feed-event	patient category trigger
CareTeam	feed-event	patient trigger
Condition	feed-event	patient category trigger	code
Coverage	feed-event	patient trigger
Goal	feed-event	patient trigger
Immunization	feed-event	patient trigger
MedicationDispense	feed-event	patient type trigger
MedicationRequest	feed-event	patient trigger
Patient	feed-event	_id trigger
Procedure	feed-event	patient trigger	code
QuestionnaireResponse	feed-event	patient trigger
RelatedPerson	feed-event	patient trigger
ServiceRequest	feed-event	patient category trigger	code
Specimen	feed-event	patient trigger

Guidance for feed-event Trigger Implementation

When implementing the feed-event trigger for these optional resources, Servers should consider the following guidance:

• AllergyIntolerance:
  • Initial allergy or intolerance information becomes available
  • Clinical status or verification status changes
  • Criticality is updated
  • Reaction information is added or modified
• CarePlan:
  • Initial care plan details become available
  • Care plan status changes (e.g., from 'draft' to 'active')
  • Goals or activities are added, modified, or completed
• CareTeam:
  • Initial care team information becomes available
  • Team members are added or removed
  • Roles or responsibilities of team members change
  • Care team status is updated
• Condition:
  • Initial condition information becomes available
  • Clinical status or verification status changes
  • Condition severity or stage is updated
• Coverage:
  • Initial coverage information becomes available
  • Coverage status changes
  • Policy details are modified
  • Beneficiary or payor information is updated
• Goal:
  • Initial goal information becomes available
  • Goal status changes
  • Target dates or values are modified
  • Achievement status is updated
• Immunization:
  • Initial immunization record is created
  • Immunization status is updated (e.g., from 'in-progress' to 'completed')
  • Additional dose information is added
• MedicationDispense:
  • Initial medication dispense record is created
  • Dispense status changes
  • Quantity is modified
• MedicationRequest:
  • Initial medication request is created
  • Status changes (e.g., from 'active' to 'completed' or 'stopped')
  • Dosage instructions are modified
• Patient:
  • Demographic information is modified
  • Contact details are updated
  • Marital status changes
  • Death information is recorded
• Procedure:
  • Initial procedure information becomes available
  • Procedure status changes (e.g., from 'in-progress' to 'completed')
• QuestionnaireResponse:
  • Initial questionnaire response is recorded
  • Answers are modified or added
  • Status changes (e.g., from 'in-progress' to 'completed')
• RelatedPerson:
  • Initial related person information is recorded
  • Relationship type or period changes
  • Contact information or address is modified
  • Active status is updated
• ServiceRequest:
  • Initial service request is created
  • Request status changes
  • Ordered item or service is modified
  • Scheduled date or performer is updated
• Specimen:
  • Initial specimen information is recorded
  • Specimen status changes
  • Collection details are modified

This guidance illustrates how the feed-event trigger might be applied to the additional resources. Implementers will document specific criteria for when feed-event notifications are sent based on their system's capabilities and clinical relevance.

Future Enhancements

As the FHIR community continues to develop and standardize subscription-related features, this list of additional resources may be updated, and resources may graduate from this list to the Required Resources Table 1.

Implementers are encouraged to provide feedback on their experiences with these additional resources to help shape future versions of this specification to align with real-world experience.