FHIR R4 - CoverageEligibilityRequest

FHIR R4 Resource - CoverageEligibilityRequest

OpenIMIS table - https://openimis.atlassian.net/wiki/spaces/OP/pages/814284890

FHIR R4 field

OpenIMIS field

notes

mapping status

FHIR R4 field

OpenIMIS field

notes

mapping status

patient

CHFID

 

mapped

item.category

ServiceCode or ItemCode

Item or Service code as defined in openIMIS

mapped

item.productOrService

Medical Item or Service type

Specify if the item is a Service or an Item

mapped

CoverageEligibilityRequest strategy change is mapped depending on the configuration set in openimis-be-api_fhir_r4_py/api_fhir_r4/apps.py file:

"R4_fhir_coverage_eligibility_config": { "fhir_serializer": "CoverageEligibilityRequestSerializer", "fhir_item_code": "item", "fhir_service_code": "service", "fhir_total_admissions_code": "total_admissions", "fhir_total_visits_code": "total_visits", "fhir_total_consultations_code": "total_consultations", "fhir_total_surgeries_code": "total_surgeries", "fhir_total_deliveries_code": "total_deliveries", "fhir_total_antenatal_code": "total_antenatal", "fhir_consultation_amount_code": "consultation_amount", "fhir_surgery_amount_code": "surgery_amount", "fhir_delivery_amount_code": "delivery_amount", "fhir_hospitalization_amount_code": "hospitalization_amount", "fhir_antenatal_amount_code": "antenatal_amount", "fhir_service_left_code": "service_left", "fhir_item_left_code": "item_left", "fhir_is_item_ok_code": "is_item_ok", "fhir_is_service_ok_code": "is_service_ok", "fhir_balance_code": "balance", "fhir_balance_default_category": "medical", "fhir_active_policy_status": ("A",) },

 

In "R4_fhir_coverage_eligibility_config" field, fhir_serializer need to be set that determines the CoverageElibilityRequest strategy.

"CoverageEligibilityRequestSerializer" is a default fhir_serializer.

Endpoint specification:

Example of endpoint URL:

http://localhost:8000/api_fhir_r4/CoverageEligibilityRequest/

Supported HTTP operation:

  • CREATE - used to request EligibilityService. The FHIR representation is converted to OpenIMIS python EligibilityRequest (link) which is used by the EligibilityService (link). List of supported fields can be found in the table which shows the mapping between OpenIMIS and FHIR. Should be used the POST HTTP method and the body as JSON representation (example can be found below).

    Note:

    • The EligibilityService is used to process the request (link).

    • The FHIR R4 CoverageEligibilityResponse will be returned as the outcome.. Example of the outcome can be found below.

    • Currently the outcome shows an exception, which will soon be corrected.

  • READ - the operation currently not supported

  • UPDATE - the operation currently not supported

  • DELETE - the operation currently not supported

Module configuration used by the endpoint:

Configuration key

Description

Default value

Configuration key

Description

Default value

default_audit_user_id

default value which will be used for 'audit_user_id' field

"default_audit_user_id": 1,

R4_fhir_coverage_eligibility_config

configuration of system and codes used to represent the specific codes used by eligibility endpoint

"R4_fhir_coverage_eligibility_config":{
"fhir_item_code":"item",
"fhir_service_code":"service",
"fhir_total_admissions_code":"total_admissions",
"fhir_total_visits_code":"total_visits",
"fhir_total_consultations_code":"total_consultations",
"fhir_total_surgeries_code":"total_surgeries",
"fhir_total_deliveries_code":"total_deliveries",
"fhir_total_antenatal_code":"total_antenatal",
"fhir_consultation_amount_code":"consultation_amount",
"fhir_surgery_amount_code":"surgery_amount",
"fhir_delivery_amount_code":"delivery_amount",
"fhir_hospitalization_amount_code":"hospitalization_amount",
"fhir_antenatal_amount_code":"antenatal_amount",
"fhir_service_left_code":"service_left",
"fhir_item_left_code":"item_left",
"fhir_is_item_ok_code":"is_item_ok",
"fhir_is_service_ok_code":"is_service_ok"
}

Example JSON representation of content:

{ "resourceType": "OperationOutcome", "issue": [ { "code": "exception", "details": { "text": "Method \"GET\" not allowed." }, "severity": "fatal" } ] }

 

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