[Question - Technical] Call ServiceRequest to get GuidanceResponse not standard

[NathanPeeters]

The call ServiceRequest => GuidanceResponse isn't standard regarding FHIR as well as API standard. In fact, the initial call was to have a GuidanceRequest which lead to a guidanceResponse but FHIR didn't create a guidanceRequest yet.

=> To check with José what we can do about this issue.

[LionelCremer]

Why doesn't PSS server expose a custom endpoint that could return a GuidanceResponse resource?

Here an example of steps:

1. We could design an OperationDefinition on the implementation guide of PSS.

For example:

  "resourceType": "OperationDefinition",
  "id": "radiology-guidance-request",
  "url": "https://www.ehealth.fgov.be/standards/fhir/pss/OperationDefinition/radiology-guidance-request",
  "version": "1.0.0",
  "name": "RadiologyGuidanceRequest",
  "status": "active",
  "kind": "operation",
  "description": "Evaluates radioloy options based on patient details including age, gender, pregnancy status, and contrast allergy.",
  "code": "radiology-guidance-request",
  "parameter": [
    {
      "name": "age",
      "use": "in",
      "min": 1,
      "max": "1",
      "documentation": "Age of the patient",
      "type": "integer"
    },
    {
      "name": "gender",
      "use": "in",
      "min": 1,
      "max": "1",
      "documentation": "Gender of the patient",
      "type": "code"
    },
    {
      "name": "pregnancyStatus",
      "use": "in",
      "min": 0,
      "max": "1",
      "documentation": "Pregnancy status, required if patient is female",
      "type": "boolean"
    },
    {
      "name": "contrastAllergy",
      "use": "in",
      "min": 0,
      "max": "1",
      "documentation": "Indicates if the patient has an allergy to contrast materials",
      "type": "boolean"
    }
  ],
  ...
}

2. The PSS server can add this operation to his CapabilityStatement.

3. The clients can request the following endpoint /RadiologyGuidanceRequest Example: POST /RadiologyGuidanceRequest

   {
   "resourceType": "Parameters",
   "parameter": [
   {
     "name": "age",
     "valueInteger": 34
   },
   {
     "name": "gender",
     "valueCode": "male"
   },
   {
     "name": "pregnancyStatus",
     "valueBoolean": false
   },
   {
     "name": "contrastAllergy",
     "valueBoolean": true
   },{
     "name": "indication",
     "valueCodeableConcept": {
       "coding": [
         {
           "system": "https://snomed.info/sct",
           "code": "25064002",
           "display": "Headache"
         },
         {
           "system": "http://hl7.org/fhir/sid/icd-10",
           "code": "R51",
           "display": "Headache"
         }
       ],
       "text": "Headache"
     }
   },
   {
     "name": "indication",
     "valueCodeableConcept": {
       "coding": [
         {
           "system": "https://snomed.info/sct",
           "code": "275277000",
           "display": "Post-traumatic amnesia"
         },
         {
           "system": "http://hl7.org/fhir/sid/icd-10",
           "code": "R41.3",
           "display": "Other amnesia"
         }
       ],
       "text": "Post-traumatic amnesia"
     }
   }
   ...
   ]
   }

4. The PSS server reply with a GuidanceResponse.

Here is a sequence diagram to explain the interaction between the EDP, PSS an QSI:

Here is a diagram to resume the proposed solution:

This solution :

• is highly flexible
• is very simple
• will reduce the quantity of resources to be managed and interpreted by PSS (=> low maintenance)

[NathanPeeters]

Possibility to be confirmed with José next week : Instead of sending a serviceRequest, Post a custom endpoint guidanceRequest (+ questionnaireResponse in payload) and reply with guidanceResponse.