Event Notifications

This is intended as a strawman for comment.

This is proposing using HL7v2 Messaging (v2.4) as a basis for FHIR Messaging. This obviously aids compatibility in mixed economies.

The primaryFocus column indicates the main data items that are being exchanged and correspond to FHIR RESTful interactions e.g. Encounter message may become a POST /Encounter.

Initial focus is proposed to be on lightweight notifications , i.e payloads are minimal. It in not meant to be a mechanism for transferring data (so in Hl7v2 terms, push for focus on R Required and not O Optional segments).

Some workflow messages are included as they are being developed (prescription-order and pathology unsolicited-observations).

I’m tempted to add in patient-referral (focus ServiceRequest REF_I12) but feel that may add complication (plus needs a bit of Hl7v3 analysis)

Re notifications.

For a patient discharge, a patient-encounter message (reason discharge) would be sent.
It wouldn’t be a requirement to include clinical content (thats optional), however enough information has been sent to inform others of the discharge and enable them to query for further information.

If clinical information is required (say a discharge-letter), then that will be sent in the document-notification-content message as a document (I am also describing how NHSD transfer of care works here. openEHR documents can be sent using this method). This is also a FHIR messaging version of IHE MHD (this uses FHIR transactions which is a server API interaction method)

Again with the discharge letter, you can just send a notification which tells users you have created a document and how to retrieve it.