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Capability Statements

ESMD FHIR Server CapabilityStatement

This CapabilityStatement outlines the specific functionality, resources, and security configurations supported by the esMD FHIR server. The document describes the server's capabilities in handling various healthcare transactions, specifically within the context of esMD (Electronic Submission of Medical Documentation). Below are the key sections and their roles:

General Metadata

• url: Defines the canonical URL where the CapabilityStatement can be accessed. This URL provides a central point for the esMD FHIR server's capabilities.
• version, name, title, and status: Identifies the version of the server's configuration, its official name, and whether it is active. This helps to track and manage the evolution of the server's functionality.
• date: Indicates when the CapabilityStatement was last updated, ensuring that clients know the current state of the server.
• description and purpose: These fields provide a clear overview of the server's objectives, detailing how it handles medical documentation, including submission, retrieval, and validation. It also highlights the security features like OAuth2 and IP whitelisting.

Security

• security:
  • OAuth2 is implemented for client authentication and authorization, ensuring that only authorized entities can access the esMD FHIR server.
  • IP Whitelisting: Adds an additional layer of security by allowing only requests from specific, authorized IP addresses. This ensures that the server is protected from unauthorized access, even if OAuth2 credentials are compromised.

RESTful API Mode

• rest.mode: Defines the server's role as a FHIR server, indicating that it provides RESTful APIs for interacting with healthcare data.
• rest.documentation: Describes the esMD FHIR server's primary functions, including the support of electronic medical documentation submissions, retrievals, and validations.

Resources

The server supports various resources essential to esMD workflows, each with specific profiles, interactions, and extensions.

1. Bundle Resource: Transaction Bundle
   • Profile: Esmd-BundleSubmission
   • Function: Handles transaction bundles for esMD submissions, allowing multiple resources (List, DocumentReference, Binary) to be grouped into a single transaction.
   • Supported Profiles:
     • Esmd-ListSubmissionSet
     • Esmd-DocumentReference
     • Esmd-Binary
   • Extensions: This Bundle resource does not include extensions, as Bundle resources generally do not support DomainResource extensions.
2. List Resource: Embedded in Transaction Bundle
   • Profile: Esmd-ListSubmissionSet
   • Function: Handles the grouping of document submissions within a transaction bundle, supporting several custom esMD extensions such as Esmd-Ext-UniqueId, Esmd-Ext-ParentUniqueId, and Esmd-Ext-SplitNumber.
   • Extensions: Various extensions provide additional metadata to the List resource, including UniqueId, ClaimId, OrganizationId, and IntendedReceipient.
3. DocumentReference Resource: Embedded in Transaction Bundle
   • Profile: Esmd-DocumentReference
   • Function: Represents the actual medical document being submitted in the esMD process. The resource includes esMD-specific metadata and validation requirements.
   • Extensions: The Esmd-Ext-UniqueId extension is used to ensure each document has a globally unique identifier.
4. Binary Resource: Embedded in Transaction Bundle
   • Profile: Esmd-Binary
   • Function: Manages the binary content of medical documents (e.g., PDFs or images) within the esMD workflow.
   • Extensions: The Esmd-Ext-UniqueId ensures each Binary resource has a unique identifier.
5. Bundle Resource: Service Registration Bundle
   • Profile: Esmd-BundleServiceRegistration
   • Function: Handles the service registration for esMD, managing practitioner registration bundles.
   • Supported Profile: Esmd-Practitioner
6. Practitioner Resource: Embedded in Service Registration Bundle
   • Profile: Esmd-Practitioner
   • Function: Manages practitioner information within the esMD service registration bundle. This resource adheres to the Esmd-Practitioner profile and contains various esMD-specific extensions like Esmd-Ext-ActionRequested, Esmd-Ext-ServiceCode, and Esmd-Ext-NPI.
   • Search Parameters: Supports search parameters for organizationId, uniqueId, and statusCode, allowing clients to locate specific practitioner records efficiently.
7. Bundle Resource: Delivery Confirmation Bundle
   • Profile: Esmd-BundleDeliveryConfirmation
   • Function: Manages delivery confirmation bundles for esMD submissions, ensuring that documents are delivered and acknowledged by the provider.
   • Supported Profile: Esmd-ListDeliveryConfirmation
8. List Resource: Embedded in Delivery Confirmation Bundle
   • Profile: Esmd-ListDeliveryConfirmation
   • Function: Supports tracking of document delivery and confirmation, using extensions like Esmd-Ext-LetterId, Esmd-Ext-TransactionId, and Esmd-Ext-DeliveryDateTime.
9. List Resource: Retrieve All Notifications
   • Profile: Esmd-FindListTransactionNotification
   • Function: Retrieves notifications related to esMD transactions, using search parameters like organizationId, uniqueId, and statusCode to filter the results.
   • Extensions: Includes extensions such as Esmd-Ext-UniqueId, Esmd-Ext-TransactionId, and Esmd-Ext-StatusCode.
10. DocumentReference Resource: Find DocumentReference
    • Profile: Esmd-FindDocumentReference
    • Function: Retrieves DocumentReference resources based on specified search parameters and extensions. This helps clients find specific esMD document submissions using identifiers and other metadata.

Search Parameters

Several search parameters are defined across multiple resources to support efficient querying:

• organizationId: A token search parameter used to search by the sender's OID.
• uniqueId: A token search parameter for locating resources based on a unique identifier.
• statusCode: A token search parameter that allows filtering resources by their current status.

Extensions

The esMD FHIR server makes extensive use of custom extensions to handle specific requirements in the esMD workflow. These extensions add additional metadata and functionality to the resources, ensuring that esMD-specific information is captured and processed correctly.

• Common Extensions:
  • Esmd-Ext-UniqueId: Provides a globally unique identifier for resources.
  • Esmd-Ext-ClaimId: Tracks the claim ID for each document submission.
  • Esmd-Ext-OrganizationId: Identifies the sender's organization using an OID.
  • Esmd-Ext-StatusCode: Tracks the status of a resource or transaction in the esMD workflow.

Summary

This CapabilityStatement provides a detailed description of the esMD FHIR server's capabilities, including supported resources, profiles, security mechanisms, and custom esMD extensions. It ensures that electronic medical documentation is handled securely and efficiently, with clear search and retrieval capabilities, alongside robust validation through profiles and extensions. The combination of OAuth2, IP whitelisting, and specific metadata extensions ensures that the esMD FHIR server meets the high security and operational standards required for handling sensitive healthcare transactions.