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Submit Encounter Package_

Owned by Oleg Brizhatiy
Last updated: Oct 15, 2022 by Serhii Boldin (SoE eHealth)
20 min read

Introduction

Web service "Submit Encounter Package" allows to transmit all the data collected during the encounter into eHealth DB using one single endpoint. I.e. all the data such as conditions, observations, allergy intolerances should be aggregated in one single data package in order to be registered in eHealth.

Specification

Apiary

Validation

Authorization

  1. Verify the validity of access token

    1. in case of error return 401 ('Access denied')

  2. Check user scope encounter:write in order to perform this action

    1. in case of error generate 403 response ('Invalid scopes')

Request validation

Note: No update operations are allowed. All IDs, submitted as PK, should be unique for eHealth. 

  1. Validate patient status

    1. db.patients.status for this patient must "active"

      1. in case of error return 409 - "Patient is not active"

  2. Validate request according to JSON Schema (link)

    1. Return 422 with list of validation errors in case validation fails 

  3. Validate Visit

    1. $.visit.id is unique

      1. in case of error return 422 - "Visit with such id already exists"

    2. $.visit.end is filled

      1. in case of error return - "End date of visit must be filled"

    3. Period Validation

  4. Validate DS

    1. Validate that  DS belongs to the performer of encounter

      1. validate that drfo from DS and party.drfo of performer matches

    2. Validate that performer of encounter is a current user 

      1. validate that one of users employee is a performer of encounter

      2. validate that client_id from token == PRM.performer.legal_entity

  5. Validate encoded signed content according to JSON Schema (link)

    1. Return 422 with list of validation errors in case validation fails

Validate Legal Entity Type

Validate legal entity from token: legal_entities.type should be in me_allowed_transactions_le_types and legal_entities.status =='active' 

Validate Encounter

Global validations

  1. Validate encounter id as a primary key (Primary Key Validation)

  2. Validate that the date is within acceptable limits

    1. $.encounter.date<= current_date

    2. $.encounter.date>=current_date-encounter_max_days_passed

  3. Validate "episode" is an active episode that belongs to the current patient

    1. $.encounter.episode.identifier.value is one of  ME.patinet{patient_id}.episodes{*}.id

      1. in case of error return 422 "Episode with such ID is not found"

    2. $.encounter.episode.identifier.value is an ID of an Episode that meets the requirements:

      1. ME.patient{patinet_id}.episodes{episode_id}.status = 'active'

        1. in case of error return 422 "Episode is not active"

      2. ME.patient{patinet_id}.episodes{episode_id}.managing_organization==token.client_id

        1. in case of error return 422 "Managing_organization in the episode does not correspond to user`s legal_entity"

  4. Validate "visit" is a visit that belongs to the current patient

    1. $.encounter.visit.identifier.value=$.visit.id  OR  ID of already existing Visit in ME.patient{patient_id}.visit.id

      1. in case of error return 422 "Visit with such ID is not found"

  5. Validate referrals

    1. As a referral it can be referenced electronic (registered in the system) OR paper service request

    2. Validate ($.encounter.incoming_referrals OR $.encounter.paper_referral) or none in request

    3. Validate incoming referrals as  References (Submit Encounter Data Package#Referencevalidation)

    4. Validate paper referral as Object (paper_referral)

    5. Validate incoming referrals that corresponds to $.encounter.incoming_referrals[*].identifier.value have:

      1. ..used_by_legal_entity.identifier.value==token.client_id OR null

        1. in case of error return 409 "Service request is used by another legal_entity"

      2. ..status==active or program_processing_status=in_progress (any status is valid in case program_processing_status= in_progress)

        1. in case of error return 409 "Invalid service request status"

      3. ..if program is defined program_processing_status=new, in_queue or in_progress

      4. check that service_request contains based_on parameter

        1. in case based_on present in service_request

          1. verify care_plan:

            1. It should be in active status

            2. Care plan's period end (if exist) should be greater than current date or equal.

          2. verify activity:

            1. It has activity.detail.kind=service_request; activity.detail.product_reference=service_id. 

            2. It has scheduled, in_progress status

        2. in case based_on not present in request skip previous validations.

  6. Validate performer

    1. $.encounter.performer.identifier.value is an ID of existing employee in PRM.Employees

      1. in case of error return "There is no Employee with such id"

    2. $.encounter.performer.identifier.value  == PRM.Employees.id where (PRM.Employees.status==`active`)

      1. in case of error return "Employee is not active"

    3. $.encounter.performer.identifier.value  == PRM.Employees.id where (PRM.Employees.legal_entity== client_id)

      1. "User can not create encounter for this legal_entity"

    4. validate employee type according to encounter.class - use config file (employee_encounter_classes)

      1. in case error return 409, "invalid employee type" 422, "Employee.type $type is forbidden for your encounter class"

    5. according to employee.type as stated in employee_encounter_types

      1. in case error return 422, msg "Employee.type $type is forbidden for your encounter type"

  7. division

    1. $.encounter.division.identifier.value must meet the following requirements

      1. PRM.division.status = "ACTIVE"

        1. in case of error return 409 "Division is not active " 

      2. PRM.division.legal_entity= token.client_id

        1. in case of error return 409 "User is not allowed to create encouners for this division"

  8. Validate supporting_info as References (Submit Encounter Data Package#Referencevalidation)

  9. Validate encounter.class  

    1. according to legal_entity.type - use config file (legal_entity_encounter_classes)

      1. in case error return 409, msg "Encounter.class $class is forbidden for your legal entity type"

    2. according to episode.type - use config file (episode_type_encounter_classes)

      1. in case error return 409, msg "Encounter.class $class is forbidden for your episode type"

    3. according to employee.type as stated in (employee_encounter_classes)

      1. in case error return 409, msg "Encounter.class $class is forbidden for your employee type"

  10. Validate encounter.type 

    1. according to encounter.class - use config file (encounter_class_encounter_types)

      1. in case error return 409, msg "Encounter.type $type is forbidden for your encounter class"

  11. Validate actions 

    1. Validate actions presence according to  encounter class validations

      1. in case error return '422', msg 'TBC'

    2. Defined in the system that corresponds to  encounter class validations

      1. in case error return '422', msg 'TBC'

  12. Validate action_references 
    Note. For encounter.action_references pass only "service", and the "service_group" does not pass

    1. Validate action_references presence according to  encounter class validations

      1. in case error return '422', msg 'At least one of action references, diagnostic reports or procedures should exist in encounter package'

    2. Validate code as a Reference(Submit Encounter Data Package#Referencevalidation)

    3. Validate action_references is in prm.services, has status ACTIVE and is_active = true

      1. in case error return '422', msg 'Service with such ID is not found'

      2. in case error return '422', msg 'Service should be active'

  13.  Validate diagnoses 

    1. Validate conditions as  References (Submit Encounter Data Package#Referencevalidation)

    2. Validate encounter has exactly one diagnosis where $.encounter.diagnoses[?(@.role.coding[0].code=="primary")]

      1. in case of error return 422 "Encounter must have exactly one primary diagnosis"

    3. Validate condition.id is in DB or in current Encounter package 

    4. Validate that each condition is active (verification_status != entered_in_error)

      1. in case of error return 409 "Conditions in diagnoses must be active"

    5. Validate that primary diagnosis defined in the system that corresponds to  encounter class validations

      1. in case of error "Primary diagnosis should be defined in {$.encounter.diagnoses[*].role.coding[*].system } system"

  14. Validate reasons

    1. Validate reasons presence according to  encounter class validations

      1. in case error return '422', msg 'Validation failed. You can find validators description at our API Manifest: Nebo #15 API Manifest · Apiary .', description 'can't be blank.

  15. Validate hospitalization 

    1. Validate hospitalization presence according to  encounter class validations

      1. in case error return 422, msg "Hospitalization block is forbidden for encounter.class = $encounter.class" 

    2. Validate all fields according to schemata

      1. destination

      2. discharge_disposition

      3. pre_admission_identifier

      4. admit_source

      5. re_admission

      6. discharge_department

    3. If encounter.type.code = "discharge" than encounter.hospitalization.admit_source is required, encounter.hospitalization.discharge_disposition is required, encounter.hospitalization.discharge_department is required

      1. in case error return 422, msg "<parameter> is required for encounter.type.code = "discharge"

    4. Validate destination is a valid legal_entity in prm with status is ACTIVE and is_active = true

      1. in case error return 422, "Legal entity is not active"

  16.  Validate patient_id for encounter.type == "patient_identity"

    1. $patient_id should exist in mpi.prepersons.id, have status =='ACTIVE' and is_active = true

      1. in case error return 'TBC', msg 'TBC'

  17. If incoming referrals exists and incoming_referral (service request) category not in ('transfer_of_care', 'hospitalization') and encounter.class in ("AMB", "INPATIENT") and encounter.type <>  "patient_identity" validate service for encounter.actions OR diagnostic_report.code OR procedure.code

    1. If service_requests.code.identifier.value is service, validate $resourse.code.identifier.value = service_requests.code.identifier.value

      1. in case error return 409, "Service in $resourse differ from service in service request"

    2. if service_requests.code.identifier.value is service_group, validate $resourse.code.identifier.value in (SELECT service_id from service_inclusions where service_group_id='service_requests.code.identifier.value')

      1. in case error return 409, "Service in $resourse differ from services in service request's service_group"

    3. Validate $resourse.service.is_active = true

      1. in case error return 409, "Service should be active"

  18. If patient is person - validate verification status:

    1. If encounter has incoming referral with service request, then skip this validation.

    2. Else check patient's verification_status is not equal to NOT_VERIFIED.

      1. in case NOT_VERIFIED - return error 409, "Patient is not verified"

Validations for encounter classes

 

Important

This validations is applicable for all encounter types except covid. Specific validations for covid encounter type described in separate page

 

Validation

PHC

AMB

INPATIENT

Validation

PHC

AMB

INPATIENT

employees.type

as stated in config file employee_encounter_classes

encounter.type

as stated in config file encounter_class_encounter_types

actions

  • at least one required

  • is in dictionary eHealth/ICPC2/actions

is absent in request

is absent in request

diagnoses

diagnoses.primary is a condition with code in dictionary "eHealth/ICPC2/condition_codes"

diagnoses.primary is a condition with code in dictionary "eHealth/ICD10_AM/condition_codes"

diagnoses.primary is a condition with code in dictionary "eHealth/ICD10_AM/condition_codes"

reasons

  • at least one required

  • is in dictionary eHealth/ICPC2/reasons

  • optional (if passed - must be in dictionary eHealth/ICPC2/reasons)

  • optional (if passed - must be in dictionary eHealth/ICPC2/reasons)

hospitalisation

is absent in request

is absent in request

if encounter.type == "discharge" - this block is mandatory

  • discharge_disposition is mandatory

  • discharge_department is mandatory

For other encounter types

  • optional

action_references

is absent in request

if encounter.type == "patient_identity" 

  • no validations

For other encounter types

  • one of must exist:

    1. action_references in encounter

    2. OR diagnostic report in package

    3. OR procedure in package

if encounter.type == "patient_identity" 

  • no validations

For other encounter types

  • one of must exist:

    1. action_references in encounter

    2. OR diagnostic report in package

    3. OR procedure in package

division

 

 

Division must be filled

Validate Conditions

  1. Validate conditions ids as  primary keys (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of conditions is a current encounter

    1. $.conditions[*].context.identifier.value == $.encounter.id

      1. in case of error return "Submitted context is not allowed for the condition"

  3. Validate code depending on encounter class

    1. if $.encounter.class = PHC - allowed both eHealth/ICPC2/condition_codes and eHealth/ICD10_AM/condition_codes

    2. if $.encounter.class in (AMB, INPATIENT) - allowed only eHealth/ICD10_AM/condition_codes

  4. Validate code.coding depending on the qty of codes

    1. Maximum one code from one dictionary (eHealth/ICPC2/condition_codes and eHealth/ICD10_AM/condition_codes) is allowed

      1. in case of error return 422 with msg "Only one code from one dictionary is allowed"

  5.  $.condition[*].onset_date>=current_date-condition_max_days_passed

    1. in case of error "Onset date must be greater than  {{current_date-condition_max_days_passed}}"

  6. $.conditions[*].onset_date <= current_date

    1. in case of error "Onset date must be in past"

  7. Validate that the date is within acceptable limits

    1. in case of error "Onset date must be in past"

  8. $.conditions[*].asserted_date <= current_date

    1. in case of error "Asserted date must be in past"

  9. $.conditions[*].evidences[*].detail[*].identifier.value is an ID of existing observation in MedicalEvents.Observations or one of $.observations[*]

    1. in case of error 409 "Observation with such id is not found"

  10. $.conditions[*].evidences[*].detail[*].identifier.value meet follownig conditions

    1. MedicalEvents.Observation.Patient == patient_id (from url)

      1. Error 409 "Evidence can not reference another patient"

    2. MedicalEvents.Observation.Status != "entered_in_error"

      1. Error 409 "Observation in "entered_in_error" status can not be used as an evidence"

  11. Validate asserter.

    1. $.conditions.asserter.identifier.value is an ID of one of users employee 

      1. in case of error return "Employee is not performer of encounter"

    2. according to logic Submit Encounter Data Package#Performer(asserter)validation

      1. check if asserter's employee_type == "ASSISTANT" then define allowed conditions from ASSISTANT_EMPLOYEE_CONDITIONS_ALLOWED

        1. in case condition code is not allowed for the employee_type - return 409 error ('Asserter has no required employee type to set condition code <code>') 

      2. if primary_source = true and code has eHealth/ICD10_AM/condition_codes dictionary value:

        1. define allowed specialities for ICD10_AM condition code using a set of chart variables ICD10_AM_<SPECIALITY_TYPE>_SPECIALITY_CONDITIONS_ALLOWED

        2. check if asserter's speciality in allowed specialities defined on previous step

          1. in case speciality not allowed for the condition code - return 409 error ('Asserter has no required speciality to set condition code <code>')

Validate Observations

  1. Validate observations ids as  primary keys (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of observation is a current encounter

    1. $.observations[*].context.identifier.value==$.encounter.id

      1. in case of error return "Submitted context is not allowed for the observation"

  3. Validate that the date is within acceptable limits

    1. $.observations[*].issued <= current_time

      1. in case of error return "Issued date must be in past"

    2. $.observations[*].issued>=current_date-observation_max_days_passed

      1. in case of error "Issued must be greater than  {{current_date-observation_max_days_passed}}"

  4. Validate performer(asserter)

  5. Validate$.observations[*].components[*].value_period as a Period

  6. Validate $.observations[*].value_quantity

    1. $.observations[*].value must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    2. $.observations[*].comparator can take the following values : [">", ">=", "=", "<=", "<"]

      1. in case of error return "value is not allowed in enum"

    3. $.observations[*].unit can take values from dictionary eHealth/ucum/units 

      1. in case of error return "value is not allowed in enum"

  7. Validate $.observations[*].value_codeable_concept

    1. $.observations[*].code validate that the code belongs to the dictionary system

      1. in case of error return "Value is not allowed in enum"

  8. Validate $.observations[*].value_boolean

    1. $.observations[*].value_boolean must be boolean type

      1. in case of error return "type mismatch. Expected boolean but got {entered type}"

  9. Validate $.observations[*].value_string

    1. $.observations[*].value_string must be string type

      1. in case of error return "type mismatch. Expected string but got {entered type}"

  10. Validate $.observations[*].value_sampled_data

    1. $.observations[*].data must be string type

      1. in case of error return "type mismatch. Expected string but got {entered type}"

    2. $.observations[*].origin must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    3. $.observations[*].period must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    4. $.observations[*].factor must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    5. $.observations[*].lower_limit must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    6. $.observations[*].upper_limit must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

    7. $.observations[*].dimensions must be with number type

      1. in case of error return "type mismatch. Expected number but got {entered type}"

  11. Validate $.observations[*].value_range

    1. $.observations[*].low must be with object type

      1. in case of error return "type mismatch. Expected object but got {entered type}"

    2. $.observations[*].high must be with object type

      1. in case of error return "type mismatch. Expected object but got {entered type}"

  12. Validate $.observations[*].value_ratio

    1. $.observations[*].numerator must be with object type

      1. in case of error return "type mismatch. Expected object but got {entered type}"

    2. $.observations[*].denominator must be with object type

      1. in case of error return "type mismatch. Expected object but got {entered type}"

  13. Validate $.observations[*].value_time

    1. $.observations[*].value_time must be with string type

      1. in case of error return "type mismatch. Expected string but got {entered type}"

  14. Validate $.observations[*].value_date_time

    1. $.observations[*].value_date_time must be with string type

      1. in case of error return "type mismatch. Expected string but got {entered type}"

  15. Validate diagnostic report is one of reports in the current package

    1. $.observations[*].diagnostic_report.identifier.value == one of $.diagnostic_report[*].identifier.value

      1. in case of error "Invalid reference"

  16. Validate $.observations[*].reaction_on

    1. check that the appropriate immunizations.status != "entered_in_error"

      1. in case of error return 409 "Immunization with status ‘entered_in_error’ can not be use"

  17. Validate $.observations.code

    1. if observations.code.coding[*].code value is included in chart variables 'OBSERVATION_CODES_WITH_<VALUE_TYPE>_REQUIRED', <value_type> field is mandatory

      1.  in case of error return 422 “This field is required for code = <code>“

Validate observations for encounter.type == "patient_identity" 

  1. EDP with type == "patient_identity" should have list of special observations. 

  2. Such list can contain limited set of codes, some of them are mandatory

code

M/O

code

M/O

height

M

weight

M

sex

M

stature

O

eye_colour

O

hair_ color

O

hair_length

O

beard

O

mustache

O

clothes

O

peculiarity

O

Validate Immunizations

  1. Validate immunizations ids as  primary keys (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of immunizations is a current encounter

    1. $.immunizations[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the immunization"

  3. Validate that the date is within acceptable limits

    1. $.immunizations[*].date <= current_time

      1. in case of error "Date must be in past"

    2. $.immunizations[*].date>=current_date-immunization_max_days_passed

      1. in case of error "Date must be greater than  {{current_date-immunization_max_days_passed}}"

  4. Validate performer according to the Rule 

  5. Validate that observation submitted as a detail of reaction is an existing observation that belongs to the current patient

    1. $.immunizations[*].reactions[*].detail.identifier.value is an ID of existing observation in ME.observations where (ME.observations.patient_id==patient_id from url) OR one of $.observations[*].id

      1. in case of error return 422 "There is no observation with such id"

Validate Allergy Intolerances

  1. Validate allergy intolerances ids as  primary keys (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of allergy_intolerances is a current encounter

    1. $.allergy_intolerances[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the allergy_intolerances"

  3. Validate asserter according to the Rule

  4. Validate that the date is within acceptable limits

    1. $.allergy_intolerances[*].onset_date_time<= current date_time

      1. in case of error "Onset date time must be in past"

    2. $.allergy_intolerances[*].onset_date_time>=current_date-allergy_intolerance_max_days_passed

      1. in case of error "Onset date time must be greater than  {{current_date-allergy_intolerance_max_days_passed}}"

  5. Validate that asserted_date is in past

    1. $.allergy_intolerances[*].asserted_date<= current date_time

      1. in case of error "Asserted date must be in past"

  6. Validate that last_occurrence is in past

    1. $.allergy_intolerances[*].last_occurrence<= current date_time

      1. in case of error "Last occurrence must be in past"

Validate Risk Assessments

  1. Validate risk assessment id as a primary key (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of risk_assessments is a current encounter

    1. $.risk_assessments[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the risk_assessments"

  3. Validate that asserted_date  is within acceptable limits

    1. $.risk_assessments [*].asserted_date<= current date_time

      1. in case of error "Asserted date  must be in past"

    2. $.risk_assessments [*].asserted_date>=current_date-risk_assessment_max_days_passed

      1. in case of error "Asserted date must be greater than  {{current_date-risk_assessment_max_days_passed}}"

  4. Validate performer according to the Rule

    1. validate performer is an active doctor from current legal_entity

      1. $..performer.identifier.value is an ID of existing employee in PRM.employee

        1. in case of error "Employee with such id is not found"

      2. $..performer.identifier.value == PRM.employees.id where (PRM.employees.status == "APPROVED" and PRM.employees.employee_type=="DOCTOR")

        1. "Employee is not an active doctor"

  5. Validate only one of these fields are filled: reason_reference , reason_codeable_concept

  6. Validate reason_reference as a Reference(Submit Encounter Data Package#Referencevalidation)

  7. Validate basis as a Reference(Submit Encounter Data Package#Referencevalidation)

  8. Validate when_period as a Period (Submit Encounter Data Package#period_validationPeriodValidation)

  9. Validate only one of the fields is filled: prediction.when_period or prediction.when_range

  10. Validate only one of the fields is filled: prediction.probability_decimal or prediction.probability_range

Validate Devices

  1. Validate device id as a primary key (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of devices is a current encounter

    1. $.devices[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the device"

  3. Validate that asserted_date  is within acceptable limits

    1. $.devices[*].asserted_date<= current date_time

      1. in case of error "Asserted date  must be in past"

    2. $.devices[*].asserted_date>=current_date-device_max_days_passed

      1. in case of error "Asserted date must be greater than  {{current_date-device_max_days_passed}}"

  4. Validate asserter according to the Rule

  5. Validate usage_period as a period (Submit Encounter Data Package#period_validationPeriodValidation)

Validate Medication Statement

  1. Validate medication statement id as primary key (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate that context of medication statement is a current encounter

    1. $.medication_statements[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the medication statement"

  3. Validate that asserted_date  is within acceptable limits

    1. $.medication statements[*].asserted_date<= current date_time

      1. in case of error "Asserted date  must be in past"

    2. $.medication statements[*].asserted_date>=current_date-medication statement_max_days_passed

      1. in case of error "Asserted date must be greater than  {{current_date-medication statement_max_days_passed}}"

  4. Validate asserter according to the Rule

  5. Validate based_on as a Reference(Submit Encounter Data Package#Referencevalidation) to OPS.medication_request

Validate Medication Administration

  1. Validate medication statement id as primary key (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate part_of 

    1. validate procedure or medication_administration is made for the same patient

      1. procedure.patient_id=@person_id

      2. medication_administration.patient_id=@person_id

        1. in case error return 409 "Procedure/Medication administration was made for another person"

    2. validate procedure or medication_administration is not in status `entered_in_error`

      1. in case error return 409, "Procedure/Medication administration is not active"

    3. if part_of.identifier.value is a procedure validate it is a procedure in DB or in payload

      • in case error return 422, "Procedure with such id is not found"

  3. Validate medication

    1. validate that medication is of type 'BRAND'

      1. in case error return 422, "Medication should be of type brand"

    2. medication corresponds to the INNM_DOSAGE medication from request.medication 

      1. "select count(*) from ingredients where parent_id=‘medication_administration.medication.id’ and medication_child_id = ‘medication_request.medication_id’ " >=1

        in case error return 422,  "Medication should correspond to the one in request"

  4. Validate that context of medication administration is a current encounter

    1. $.medication_administration[*].context.identifier.value == $.encounter.id

      1. in case of error "Submitted context is not allowed for the medication administration"

  5. validate performed_date_time <= now()

    1. in case error return 422, "performed_date_time should be in the past"

  6. Validate performer according to the Rule

    1. validate performer is an active doctor from current legal_entity

      1. $..performer.identifier.value is an ID of existing employee in PRM.employee

        1. in case of error "Employee with such id is not found"

      2. $..performer.identifier.value == PRM.employees.id where (PRM.employees.status == "APPROVED" and PRM.employees.employee_type in ("DOCTOR","SPECIALIST"))

        1. "Employee is not an active doctor"

  7. validate reason_references

    1. validate  Condition|Observation|DiagnosticReport as Reference

    2. validate Condition|Observation|DiagnosticReport is not in status "entered_in_error"

      1. in case error return 409, "Reason reference should be active"

    3. validate Condition|Observation|DiagnosticReport is made for the same person

      1. in case error return 409, "Reason reference was made for another person"

    4. validate Condition|Observation|DiagnosticReport exist in DB or in payload

      1. in case error return 422, "Condition|Observation|DiagnosticReport with such id is not found"

  8. Validate request

    1.  validate medication_request as a reference

    2. validate medication_request is in active status. medication_request.status='ACTIVE' and is_active=true

      1. in case error return 409, "medication request is not active"

    3. validate medication request is made for the same person

      1. in case error return 409, "medication request was made for another person"

    4. Validate medication_request.started_at < now()

      1. in case error return 409, "Medication request started at should be in the past"

  9. Validate dosage

Validate Diagnostic Report

  1. Validate diagnostic reports ids as primary keys (Submit Encounter Data Package#Primarykeyvalidation)

  2. Validate based_on as Reference(Submit Encounter Data Package#Referencevalidation)

  3. Validate that service_request, referenced as based_on, is

    1. in status is active or program_processing_status=in_progress (any status is valid in case program_processing_status= in_progress)

      1. in case of error return 409 "Invalid service request status"

    2. if program is defined than used_by_legal_entity==token.client_id OR null

      1. in case of error return 409 "Service request is used by another legal_entity"

    3. if program is defined than program_processing_status == new, in_queue or in_progress

    4. check that service_request contains based_on parameter

      1. in case based_on present in service_request

        1. verify care_plan:

          1. It should be in active status

          2. Care plan's period end (if exist) should be greater than current date or equal.

        2. verify activity:

          1. It has activity.detail.kind=service_request; activity.detail.product_reference=service_id. 

          2. It has scheduled, in_progress status

      2. in case based_on not present in request skip previous validations.

  4. category

    1. Validate that one of diagnostic reports categories corresponds to service category, that is references as code in DR

      1. $.diagnostic_report.category[?]=PRM.services.category where PRM.services.id=$.diagnostic_report.code.identifier.value

        1. in case of error return 422 "None of the diagnostic report categories matches with the service category"

  5. Validate code

    1. Validate code as Reference(Submit Encounter Data Package#Referencevalidation)

    2. If service_requests.code.identifier.value is service, validate $diagnostic_report.code.identifier.value = service_requests.code.identifier.value

      1. in case error return 409, "Service in diagnostic_report differ from service in service request"

    3. if service_requests.code.identifier.value is service_group, validate $diagnostic_report.code.identifier.value in (SELECT service_id from service_inclusions where service_group_id='service_requests.code.identifier.value')

      1. in case error return 409, "Service in diagnostic_report differ from services in service request's service_group"

    4. Validate diagnostic_report.service.is_active = true

      1. in case error return 409, "Service should be active"

  6. Validate effective_period as a period (Submit Encounter Data Package#period_validationPeriodValidation)

  7. Validate that issued is within acceptable limits

    1. $.diagnostic_reports[*].issued<= current date_time

      1. in case of error 422 "Asserted date  must be in past"

    2. $.diagnostic_reports[*].issued>=current_date-diagnostic_report_max_days_passed

      1. in case of error 422 "Issued must be greater than  {{current_date-diagnostic_report_max_days_passed}}" 

  8. Validate recorded_by as Employee (Submit Encounter Data Package#Employeevalidation)

  9. Validate encounter

    1. $.diagnostic_reports[*].encounter.identifier.value == $.encounter.id

      1. in case of error 409 "Invalid reference"

  10. Validate performer.identifier as Employee (Submit Encounter Data Package#Employeevalidation)

  11. Validate managing_organization is a current legal_entity

    1. $.managing_organization.identifier.value==token.client_id

      1. in case of error 409 "Managing organization does not correspond to user's legal entity."

  12. Validate result_interpreter.identifier as Employee (Submit Encounter Data Package#Employeevalidation)

  13. Validate result_interpreter.identifier is an employee with employee_type = DOCTOR or SPECIALIST

  14. Validate only One of the fields is filled:

    1. $.diagnostic_report[*].results_interpreter.reference OR $.diagnostic_report[*].results_interpreter.text

    2. $.diagnostic_report[*].performer.reference OR $.diagnostic_report[*].performer.text

  15. Validate primary_source

    1. If primary_source==true, then

      1. Managing organization MUST be filled

    2. If primary_source==false, then

      1. report_origin OR performer.text must be filled

      2. performer.reference must NOT be filled

      3. results_enterpreter.reference must NOT be filled

  16. If patient is person - validate verification status:

    1. If diagnostic report has based_on with service request, then skip this validation.

    2. Else check patient's verification_status is not equal to NOT_VERIFIED.

      1. in case NOT_VERIFIED - return error 409, "Patient is not verified"

Validate Procedures

  1. Validate by json schema

  2. Validate procedure id as primary key (Submit Encounter Data Package#Primarykeyvalidation)

  3. Validate code

    1. Validate code as Reference(Submit Encounter Data Package#Referencevalidation)

    2. Validate procedure.service.is_active = true

      1. in case error return 409, "Service is not active"

  4. Validate that service_request, referenced as based_on, is

    1. check that service_request contains based_on parameter

      1. in case based_on present in service_request

        1. verify care_plan:

          1. It should be in active status

          2. Care plan's period end (if exist) should be greater than current date or equal.

        2. verify activity:

          1. It has activity.detail.kind=service_request; activity.detail.product_reference=service_id. 

          2. It has scheduled, in_progress status

      2. in case based_on not present in request skip previous validations.

  5. Validate encounter

    1. $.procedure[*].encounter.identifier.value == $.encounter.id

      1. in case error return 409, "Submitted encounter is not allowed for procedure"

  6. Validate performed_date_time

    1.  performed_date_time is real

      1. in case error return 422, "Performed_date_time in invalid"

    2. performed_date_time <= now

      1. in case error return 422 "Procedure cannot be registered in future"

  7. Validate recorded_by

    1. Validate recorded_by as Reference(Submit Encounter Data Package#Referencevalidation)

    2. $..recorded_by.identifier.value is an ID of existing employee in PRM.employee

      1. in case of error  return 422, "Employee with such id is not found"

    3. Validate recorded_by is employee with status='APPROVED' and is_active= true and end_date is null or more than today

      1. in case error return 409, "This action is prohibited for current employee" 

    4. Validate employees.legal_entity_id=$managing_organization.identifier.value

      1. in case error return 409, "Employee should be from current legal entity"

  8. Validate asserter

  9. Validate division

    1. Validate division as Reference (Submit Encounter Data Package#Referencevalidation)

    2. $division is an ID in PRM.divisions

      1. in case return 422, "Division with such id is not found"

    3. division.status=ACTIVE and is_active=true

      1. in case error return 409, "Division is not active"

    4. division.legal_entity_id = $client_id or division.legal_entity_id=$managing_organization.identifier.value

      1. in case error return 409, "Division is not in current legal_entity"

  10. Validate managing_organization is a current active legal_entity with proper type

    1.  as Reference (Submit Encounter Data Package#Referencevalidation)

    2. $managing_organization is an ID in PRM.legal_entities

      1. in case return 422, "Legal entity with such id is not found"

    3. validate managing_organization status is 'ACTIVE' and is_active=true

      1. in case error return 422 ('Legal entity is not active')

    4. validate legal_entity type is in ('PRIMARY_CARE','MSP','MSP_PHARMACY','MSP_PHARMACY') (use `ME_ALLOWED_TRANSACTIONS_LE_TYPES` from charts)

      1. in case error return 422, "Legal entity with type $legal_entity.type cannot perform procedures"

    5. validate $managing_organization.identifier.value = $client_id

      1. in case of error 409 "Managing organization does not correspond to user's legal entity."

  11. Validate reason_references

    1. Validate reason_reference as a Reference (Submit Encounter Data Package#Referencevalidation)

    2. Validate reason_refernce.identifier.value is condition not in status `entered_in_error`

      1. in case error return 422, "Condition is canceled"

  12. Validate outcome

    1. validate outcome as a Reference (Submit Encounter Data Package#Referencevalidation)

    2. validate outcome.coding.object.system is in dictionary eHealth/procedure_outcomes

      1. in case error return 422, "outcome not in dictionary eHealth/procedure_outcomes"

  13. Validate complication_details

    1. validate complication_details as a Reference (Submit Encounter Data Package#Referencevalidation)

    2. validate complication_details.identifier.value refer to condition in the same encounter package

      1. in case error return 422, "complication_details does not correspond to condition in this encounter package"

  14. Validate category

    1. according to the dictionary 'eHealth/procedure_categories' - by schemata

    2. Validate that procedure category corresponds to service category, that is references as code in procedure

      1. $.procedure.category=PRM.services.category where PRM.services.id=$.procedure.code.identifier.value

        1. in case of error return 422 "Procedure category does not match with the service category"

  15. If patient is person - validate verification status:

    1. If procedure has based_on with service request, then skip this validation.

    2. Else check patient verification_status is not equal to NOT_VERIFIED.

      1. in case NOT_VERIFIED - return error 409, "Patient is not verified"

Validate Clinical impression

  1. Validate by json schema

  2. Validate clinical impression id as primary key (Primarykeyvalidation)

  3. Validate status

    1. Check that the code belongs to the dictionary system (eHealth/clinical_impression_statuses)

      • in case of error - return 422 ('value is not allowed in enum')

    2. Check it has value = completed

      • in case of error - return 422 ('value is not allowed in enum')

  4. Validate code

    1. Check that the code belongs to the dictionary system (eHealth/clinical_impression_patient_categories)

      1. in case of error - return 422 ('value is not allowed in enum')

    2. Validate code.coding depending on the qty of codes. Maximum one code is allowed

      1. in case of error - return 422 ('Only one code is allowed')

    3. Check by code.coding[0].code and code.coding[0].system active rules in rule_engine_rules collection

      1. in case any active rules present - check request only with following validations

      2. in case rule present in collection - check request with following validations and with additional from rule engine rule

  5. Validate description

    1. Check that value with string type

      1. in case of error - return 422 ('type mismatch. Expected string but got {entered type}')

  6. Validate encounter

    1. Check the value is valid reference on encounter resource

      • Check that value is an object with references of type encounter

        • in case of error - return 422 ('value is not allowed in enum')

    2. Check the value is valid reference on encounter resource

      • Check that $.clinical_impressions[*].encounter.identifier.value == $.encounter.id

        1. in case error - return 422 ('Invalid reference')

  7. Validate effective_period as a period (PeriodValidation)

    1. Validate value in the field $.effective_period

      • Check that $.effective_period.start <= encounter.date

        • in case of error - return 422 ('Start date must be in the past')

      • Check that $.effective_period.end >= $.effective_period.start

        • in case of error - return 422 ('End date must be greater than or equal the start date')

    2. Validate that $.effective_period.end is within acceptible limits

      • Check that $.effective_period.end <= current_time

        • in case of error - return 422 ('Date must be in past')

      • Check that $.effective_period.end >= current_date-clinical_impression_max_days_passed

        • in case of error - return 422 ('Date must be greater than {{current_date-clinical_impression_max_days_passed}}')

  8. Validate effective_date_time

    1. Check that field $.effective_date_time with string type

      1. in case of error - return 422 ('type mismatch. Expected string but got {entered type}')

    2. Check that field $.effective_date_time <= current_time

      1. in case of error - return 422 ('Date must be in past')

    3. Check that field $.effective_date_time >= current_date-clinical_impression_max_days_passed

      1. in case of error - return 422 ('Date must be greater than {{current_date-clinical_impression_max_days_passed}}')

  9. Validate assessor

    1. Validate assessor as Reference (Referencevalidation)

      1. $.assessor.identifier.value is an ID of existing employee in PRM.employee

        1. in case of error - return 422 ('Employee with such id is not found')

    2. Validate assessor is employee with status='APPROVED' and is_active= true and end_date is null or more than today

      1. in case of error - return 422 ('Invalid employee status')

  10. Validate previous

    1. Check the value is valid reference on clinical impression resource

      • Check that value is an object with references of type clinical_impression

        • in case of error - return 422 ('value is not allowed in enum')

      • Check that clinical impression is active (status is not entered_in_error)

        • in case of error - return 422 ('Clinical impression in "entered_in_error" status can not be referenced')

      • Check that clinical impression belongs to patient ($.subject)

        • in case of error - return 422 ('Clinical impression with such id is not found')

  11. Validate problems

    1. Check that value is an array with references of type condition

      • in case of error - return 422 ('value is not allowed in enum')

    2. Check that each condition is active (verification_status is not entered_in_error)

      1. in case of error - return 422 ('Condition in "entered_in_error" status can not be referenced')

    3. Check that condition belongs to the patient ($.subject)

      • in case of error - return 422 ('Condition with such id is not found')

  12. Validate finding

    1. Check that value is an array with objects

      1. Validate item_reference

        1. Check that value is an object with reference of resource condition, observation (further <Medical event resource>)

          1. in case of error - return 422 ('value is not allowed in enum')

        2. Check that <Medical event resource> is active (status is not entered_in_error)

          1. in case of error - return 422 ('<Medical event resource> in "entered_in_error" status can not be referenced')

        3. Check that each reference:

          1. is valid ME of defined type above

          2. belongs to the patient ($.subject)

            1. in case of error - return 422 (<Medical event resource> with such ID is not found')

        4. In case some resources present in active rule, check that they correspond to configured rule

          1. in case of error - return 409 ('Submitted patient category does not correspond to rule engine rule')

      2. Validate basis

        1. Check that value with string type

          1. in case of error - return 422 ('type mismatch. Expected string but got {entered type}')

  13. Validate supporting_info

    1. Check that value is an array with references of type episode_of_care, procedure, diagnostic report, encounter (further <Medical event resource>)

      1. in case of error - return 422 ('value is not allowed in enum')

    2. Check that <Medical event resource> is active (status is not entered_in_error)

      1. in case of error - return 422 ('<Medical event resource> in "entered_in_error" status can not be referenced')

    3. Check that each reference:

      1. is valid ME of defined type above

      2. belongs to the patient ($.subject)

        1. in case of error - return 422 (<Medical event resource> with such ID is not found')

    4. In case some resources present in active rule, check that they correspond to configured rule

      1. in case of error - return 409 ('Submitted patient category does not correspond to rule engine rule')

  14. Validate note

    1. Check that value with string type

      1. in case of error - return 422 ('type mismatch. Expected string but got {entered type}')

  15. Validate patient

    1. In case patient params present in active rule, get them through subject and check that they correspond to configured rule

      1. in case of error - return 409 ('Submitted patient category does not correspond to rule engine rule')

    2. In case medication dispense data presents in active rule, get medication dispense data in patient context (through subject) and check that it correspond to configured rule

      1. in case of error - return 409 ('Submitted patient category does not correspond to rule engine rule')

Primary key validation

  1. Validate that IDs of all submitted entities in the array are unique

    1. validate that $.{collection}[*].id from the payload are all unique among themselves

      1. in case of error return 409 "All primary keys must be unique"  

    2. validate there is no entity with such id in the corresponding Medical events collection

      1. in case of error return 422 "{Entity} with such id already exists"

Reference validation

This validation is used to validate references to medical events data from patient's collection. 

  1. Validate that $..identifier.value is an existing value from $..identifier.type.coding[0].code collection in DB and it belongs to the patient OR it is a value from corresponding collection in the current request 

    1. in case of errror return 422 "There is no {$..identifier.type.coding[0].code} with such id"

  2. Validate that this entity is not in status entered_in error

    1. in case of errror return 422 "Could not reference entity in status entered_in_error"

Example:

"identifier": { "type": { "coding": [ { "system": "eHealth/resources", "code": "observation" } ] }, "value": "9183a36b-4d45-4244-9339-63d81cd08d9c" } }

In this case validate that "9183a36b-4d45-4244-9339-63d81cd08d9c" is an existing observation from patients collection and it is not entered_in_error.

Performer(asserter) validation

  1. case $..primary_source==true

    1. $..performer(or $..asserter) must be filled

      1. in case of error "Performer (asserter) must be filled"

    2. $..report_origin must be absent

      1. in case of error "Report_origin can not be submitted in case primary_source is true" 

    3. validate performer(asserter) is a valid value from corresponding dictionary

      1. $..performer.identifier.type.coding[*].system == "eHealth/resources"

        1. in case of error "Submitted system is not allowed for this field"

      2. $..performer.identifier.type.coding[*].code=="employee"

        1. in case of error "Submitted code is not allowed for this field"

    4. validate performer(asserter) is a active employee from current legal_entity

      1. $..performer.identifier.value is an ID of existing employee in PRM.employee

        1. in case of error "Employee with such id is not found"

      2. $..performer.identifier.value == PRM.employees.id where (PRM.employees.status == "APPROVED" and PRM.employees.employee_type=="DOCTOR" or "SPECIALIST" or "ASSISTANT")

  2. case primary_source==false

    1. $..report_origin must be filled 

      1. in case of error "Report_origin must be filled"

    2. if $..primary_source==false then $..performer(asserter) must be absent

      1. in case of error "Performer(asserter) can not be submitted in case primary_source is false" 

    3. validate report_origin

      1. $..report_origin.coding[*].system == "eHealth/report_origins"

        1. in case of error "Submitted system is not allowed for this field"

Period Validation

  1. $..period.start <= current_dateTime

    1. in case of error return 422- "Start date must be in past"

  2. if $..period.end is filled:

    1. $..period.end > visit.period.start

      1. in case of error return 422 - "End date must be greater than the start date"

Employee validation

Users can not reference employees between different legal entities. Employee that is not in status `approved` can not be referenced as well.

  1.  $...identifier.value exists in PRM.employees

    1. in case of error 409 "Employee not found"

  2. $...identifier.value == PRM.employees.id where (PRM.employees.status == "APPROVED" and PRM.employees.legal_entity==token.client_id)

    1. in case of error 409 "Submitted employee is not an active employee from current legal entity"

Related care plan validation

  1. If entities (encounter.incoming_referral, procedure.based_on, diagnostic_report.based_on) has reference on service request and service_request[].activity.detail.quantity was set - check possibility to create EDP depending on service_request[].activity remaining quantity

    1. calculate the quantity of artifacts that are contained in the $.activity.outcome_reference by service_request.based_on[].activity[].id

    2. calculate the quantity of artifacts that are contained in the request and have a link to the service request

    3. compare quantity from outcome_reference with the artifact quantity

    4. check that difference is greater then or equal to zero

      1. in case of error return 409 "The total amount of the prescribed service quantity exceeds quantity in care plan activity"

Postprocessing

  1. Save signed_content to Media Storage

  2. Save data to corresponding collections in DBs

  3. Save link to the signed content to the encounter

  4. Enrich encounter.diagnoses:

    1. select condition.code from Medical Events DB(or from request body)  where condition.id==diagnoses[@].condition.identifier.value 

    2. set diagnoses[@].code = select 1

  5. Save diagnoses from encounter to episodes.current_diagnoses

    1. ME.patients.episodes.diagnoses = $.encounter.diagnoses 

  6. Add a record to the ME.patient.episodes{episode_id}.diagnoses_hstr

    1. date = current_date

    2. evidence = reference to encounter  ($.encounter.id)

    3. diagnoses = $.encounter.diagnoses 

  7. Set display_value to employees for all submitted objects

    1. Select PRM.parties.first_name, PRM.parties.second_name, PRM.parties.last_name from PRM.parties where (PRM.parties.id == (Select PRM.employees.party_id from  PRM.employees where PRM.employees.id== $.care_manager.identifier.value))

    2. ME.patients.encounters{encounter_id}.performer.display== Select 1

    3. ME.conditions{condition_id}.asserter.display == Select 1

    4. ME.observations{observation_id}.performer.display == Select 1

    5. ME.patients.immunizations{immunization_id}.performer.display == Select 1

    6. ME.patients.allergy_intolerance{ai_id}.asserter.display == Select 1

    7. ME.patients.devices{device_id}.asserter.display == Select 1

    8. ME.patients.medication_statements{ms_id}.asserter.display == Select 1

    9. ME.patients.risk_assessment{rs_id}.asserter.display == Select 1

    10. ME.patients.diagnostic_reports{dr_id}.performer.reference.display == Select 1

    11. ME.patients.diagnostic_reports{dr_id}.recorded_by.reference.display == Select 1

    12. ME.patients.diagnostic_reports{dr_id}.results_interpreter.reference.display == Select 1

  8. In case there are reactions ($.observations[?].reaction_on) in the request, update corresponding immunizations with the reactions:

    1. Set in ME.patient.immunization.reaction.detail $.observation.id as a reference
      note: $.observations[?].reaction_on should not be saved in observation, only in corresponding immunization

  9. Set display_value for legal_entities

    1. ME.patients.diagnostic_reports{dr_id}.managing_organization.display

  10. Set managing_organization for submitted observations, conditions, encounter

    1. ME.conditions{cond_id}.managing_organization=token.client_id

    2. ME.observations{observ_id}.managing_organization=token.client_id

    3. ME.encounters{encounter_id}.managing_organization=token.client_id

  11. In case encounter.incoming_referral was filled, set episode_origin to encounter

    1. Select episode where id== (select ME.encounter.episode.identifier.value where encounter.id==(select ME.service_requests.context.identifier.value where id==$.encounter.incoming_referral.identifier.value))

  12. In case diagnostic_reports.based_on was filled, set episode_origin to diagnostic report

    1. Select episode where id== (select ME.encounter.episode.identifier.value where encounter.id==(select ME.service_requests.context.identifier.value where id==$.diagnostic_reports.based_on.identifier.value))

  13. In case encounter.incoming_referral was filled set $.encounter.id to related to $.service_request activity[].outcome_reference

  14. In case procedures.based_on was filled set $.procedures.id to related to $.service_request $.activity[].outcome_reference

  15. In case diagnostic_reports.based_on was filled set $.diagnostic_reports.id to related to $.service_request activity[].outcome_reference

  16. Update $ .activity.status to in_progress if previous activity status was scheduled

  17. Update the $ .activity.remaining_quantity parameter by subtracting the quantity of artifacts that have a reference on service request that contains an $.based_on.[]activity

  18. Enrich encounter data with performer speciality:

    1. SELECT speciality -> 'speciality' FROM employees WHERE speciality ->> 'speciality_officio' = 'true' AND id = $.encounter.performer.identifier.value

    2.  Set encounter.performer_speciality as CodeableConcept type with system = SPECIALITY_TYPE

  19. In case encounter.clinical_impression was filled set $.context_episode_id to clinical_impressions data model (encounters.context.[].episode.value=clinical_impression.context_episode_id)

ЕСОЗ - публічна документація