Basics
For customers interested in the structured dataset underpinning our product suite (Care Summary, Risk Adjustment, and Quality Gap Closure), Connective Health offers a FHIR data product. The dataset is deduplicated, normalized, and curated using best-in-class data cleansing. The structure of Connective Health’s FHIR interactions and resources are all based on the FHIR R4 specification. Whenever possible, the resources will also implement the corresponding US Core 6.1.0 profile and will pass validations. The curation approach is not one-size-fits-all — instead, it is targeted and configurable. In cases where recency matters (e.g. encounters), there are time-based limits. In other cases (e.g. chronic diseases, medications), there are clinical rules to filter by relevance. In some cases, the dataset can stretch back more than twenty years — but only if clinically relevant and “clean”. In the event that the source data does not satisfy FHIR or US Core profile validations, we will generally still send it, allowing the customer final control over whether to ingest, correct, or disregard the data.Interaction Patterns
Push
Customer is able to have a FHIR bundle pushed to them:- S3 bucket (currently available)
- Azure (currently available)
- Google Cloud Storage (soon to be available)
Pull
Customer is able to request a FHIR bundle on demand (soon to be available).Bundles
Base element is a Bundle resource. All information has been deduplicated, normalized, augmented, and curated before transforming into FHIR format.FHIR IDs
Whenever practical, the FHIR ID will remain stable across bundles. The ID Fields column in the table below contains the elements used to determine whether a piece of clinical information (resource) has changed from one bundle to another.Patient Summary Bundle
| Resource | US Core Profile | Description | ID Fields | Limit |
|---|---|---|---|---|
| Patient | US Core Patient | Based on the patient being processed. Includes additional addresses, phone numbers, and email addresses found during network searches. | 1 | |
| AllergyIntolerance | US Core AllergyIntolerance | Based on Connective Health’s patient summary template, which excludes non-clinically relevant content such as “unclassified” allergies. | recordedDate, code, reaction.manifestation, reaction.severity | 1000 |
| CarePlan | US Core CarePlan | Based on Connective Health’s patient summary template. Includes reference to encounter. | period, description | 1000 |
| Encounter | US Core Encounter | Based on Connective Health’s patient summary template, which excludes older and less relevant encounters. | 1000 | |
| Immunization | US Core Immunization | Based on Connective Health’s patient summary template. Excludes immunizations with no date, due to FHIR requirements. | occurrenceDateTime, vaccineCode | 1000 |
| Observation (Labs) | US Core Diagnositic Report Lab | Includes all historical labs, not just what is on Connective Health’s patient summary template. | effectiveDateTime, code, value[x], valueQuantity.unit, referenceRange.low, referenceRange.high | 1000 |
| MedicationRequest (Medications) | US Core MedicationRequest | Includes all historical medications, not just what is on Connective Health’s patient summary template. Excludes medications with neither a code nor a name code, due to FHIR requirements. | authoredOn, medication[x], dosageInstruction.text, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.initialFill.quantity | 1000 |
| DocumentReference (Notes) | US Core DocumentReference | Includes reference to encounter. Configurable to show all historical notes or just those associated with an encounter on the PDF. If the latter, the notes truncation feature is enabled by default. | type, date, description | 1000 |
| Condition (Problems) | US Core Condition Problems Health Concerns | Includes all historical problems, not just what is on Connective Health’s patient summary template. | recordedDate, code, clinicalStatus | 1000 |
| Procedure | US Core Procedure | Based on Connective Health’s patient summary template. Includes reference to encounter. | performedDateTime, code, status | 1000 |
| DiagnosticReport | US Core DiagnosticReport | Based on Connective Health’s patient summary template. Represents imaging reports such as X-Rays, EKGs, etc. Includes embedded Observation Clinical Results. | effectiveDateTime, conclusion, code | 1000 |
| Observation | US Core Observation Clinical Result | Only returned as a contained resource. | N/A | |
| Observation | US Core Vital Signs | Includes all historical values of only the vital signs listed below. | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 |
| Observation | US Core BMI | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Body Height | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Body Temperature | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Heart Rate | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Pulse Oximetry | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Respiratory Rate | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Practitioner | US Core Practitioner | Only returned as a contained resource. | N/A | |
| Practitioner Role | US Core PractitionerRole | Only returned as a contained resource. | N/A | |
| Location | US Core Location | Only returned as a contained resource. | N/A |
Patient Everything Bundle
| Resource | US Core Profile | Description | ID Fields | Limit |
|---|---|---|---|---|
| Patient | US Core Patient | Based on the patient being processed. Includes additional addresses, phone numbers, and email addresses found during network searches. | 1 | |
| AllergyIntolerance | US Core AllergyIntolerance | Includes all allergies. | recordedDate, code, reaction.manifestation, reaction.severity | 1000 |
| CarePlan | US Core CarePlan | Includes all care plans, may include a reference to an encounter. | period, description | 1000 |
| Encounter | US Core Encounter | Includes all encounters. | 1000 | |
| Immunization | US Core Immunization | All immunizations. Excludes immunizations with no date, due to FHIR requirements. | occurrenceDateTime, vaccineCode | 1000 |
| Observation (Labs) | US Core Diagnositic Report Lab | Includes all labs. | effectiveDateTime, code, value[x], valueQuantity.unit, referenceRange.low, referenceRange.high | 1000 |
| MedicationRequest (Medications) | US Core MedicationRequest | Includes all medications. Excludes medications with neither a code nor a name code, due to FHIR requirements. | authoredOn, medication[x], dosageInstruction.text, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.initialFill.quantity | 1000 |
| DocumentReference (Notes) | US Core DocumentReference | Includes all clinical notes, may include a reference to an encounter. | type, date, description | 1000 |
| Condition (Problems) | US Core Condition Problems Health Concerns | Includes all problems. | recordedDate, code, clinicalStatus | 1000 |
| Procedure | US Core Procedure | Includes all procedures, may include a reference to an encounter. | performedDateTime, code, status | 1000 |
| DiagnosticReport | US Core DiagnosticReport | Represents imaging reports such as X-Rays, EKGs, etc. Includes embedded Observation Clinical Results. | effectiveDateTime, conclusion, code | 1000 |
| Observation | US Core Observation Clinical Result | Only returned as a contained resource. | N/A | |
| Observation | US Core Vital Signs | Includes all values of only the vital signs listed below. | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 |
| Observation | US Core BMI | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Body Height | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Body Temperature | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Heart Rate | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Pulse Oximetry | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Observation | US Core Respiratory Rate | effectiveDateTime, code, value[x], valueQuantity.unit | 5000 | |
| Practitioner | US Core Practitioner | Only returned as a contained resource. | N/A | |
| Practitioner Role | US Core PractitionerRole | Only returned as a contained resource. | N/A | |
| Location | US Core Location | Only returned as a contained resource. | N/A |