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Overview

Bulk Medication History is the FHIR representation of the medication fill and prescription history returned for a population of patients. It is produced after a customer submits a patient population using one of the Medication History request APIs (patient panel load or bulk file load). The correlationId returned from that original request ties the resulting FHIR data back to the request that produced it. Unlike the Patient Everything and Patient Summary outputs, this data is not wrapped in a single Bundle resource. Instead, following the HL7 Bulk Data Access approach, resources are grouped by resource type and written out as newline-delimited JSON (NDJSON) files — one resource per line, one file per resource type (for example, all MedicationRequest resources for the whole population are written to a single file).

Delivery

Bulk Medication History files are pushed to customer cloud storage using the same mechanisms described in Delivery (S3, Azure, and soon Google Cloud Storage). Webhook notification of delivery completion is planned for this output but is not yet available — today, delivery is push-only with no accompanying webhook event.

Resources Included

OperationOutcome usage

OperationOutcome appears in two distinct situations in this output, rather than representing a single consistent concept:
  1. Incomplete medication record — if a medication record from the source system is missing its history source qualifier, it does not contain enough information to build the resources above. An OperationOutcome with severity information is emitted in its place instead of any medication resources for that record.
  2. Patient-level error — if the original patient population request encountered an error while trying to locate or process a specific patient, that error is surfaced as a separate OperationOutcome, unrelated to any specific medication.
See the OperationOutcome resource page for the exact fields populated in each case.

Stable IDs

Unlike the Patient Everything and Patient Summary bundles, IDs in this output are not consistently stable across resource types. The table below summarizes what determines each resource’s ID, and whether that leads to deduplication across the population being processed. See FHIR IDs for background on why stable IDs matter.