Care Coordination and 360 Referrals (Proof of Concept)
0.1.0 - proof-of-concept United Kingdom flag

Care Coordination and 360 Referrals (Proof of Concept) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Query Existing Data [PCC-44]

Mobile Query Existing Data [PCC-44] (IHE QEDm) - a Clinical Data Consumer queries a Clinical Data Source for structured data: problems, allergies, medications, observations, results, immunisations, procedures and encounters. In the EU Health Data API these are the Resource Consumer and Resource Access Provider.

References

Interaction

sequenceDiagram
    participant C as Clinical Data Consumer<br/>Resource Consumer
    participant S as Clinical Data Source<br/>Resource Access Provider
    C ->> S: GET [base]/{Resource}?patient={id}&...
    S -->> C: Bundle (searchset)
Actor Health Data API In the closed loop
Clinical Data Consumer Resource Consumer Referral Recipient triaging; virtual ward team; Referral Initiator reviewing an outcome
Clinical Data Source Resource Access Provider Shared care record, Single Patient Record (planned), GP record (GP Connect Access Record: Structured), trust EPR

Find the Patient

The patient is found first by NHS Number (IHE PDQm ITI-78 / Health Data API Patient search):

Queries

Search parameters are those of the Health Data API Resource Access Provider.

Use in the closed loop Query
Active problems before triage GET [base]/Condition?patient={id}&clinical-status=active
Allergies GET [base]/AllergyIntolerance?patient={id}&clinical-status=active
Current medication GET [base]/MedicationStatement?patient={id}&status=active, GET [base]/MedicationRequest?patient={id}&status=active
Recent results GET [base]/DiagnosticReport?patient={id}&date=ge2026-01-01, GET [base]/Observation?patient={id}&category=laboratory
Vital signs and remote monitoring GET [base]/Observation?patient={id}&category=vital-signs&date=ge2026-10-06
Physical activity (exercise referral) GET [base]/Observation?patient={id}&code=http://loinc.org|89574-8
Recent hospital and virtual ward stays GET [base]/Encounter?patient={id}&date=ge2026-01-01
Immunisations GET [base]/Immunization?patient={id}

QEDm also covers procedures, which the Health Data API Resource Access Provider does not list - To confirm.

Expected Actions

  • The Clinical Data Source returns the matching resources it holds and is allowed to share; an empty result does not mean the patient has none.
  • The Clinical Data Consumer SHOULD show the source and date of each item. With the QEDm Provenance Option a resource can be traced to the document it came from (IHE mXDE), for example the medications in an HL7 Europe HDR discharge report.
  • Data read through QEDm supports decisions; it is not filed into the consumer's record unless a clinician chooses to (reconciliation).

Relationship to the Workflow

360X step QEDm use
Referral Request [PCC-55] Recipient reads problems, medications, allergies and results instead of receiving them; the referral's supportingInfo can reference the resources that matter
Triage, information requested Recipient checks the record before asking the referrer
Virtual ward monitoring Care team reads observations from the monitoring platform or shared record
Referral Outcome [PCC-57] Referrer reads the structured data behind the outcome (e.g. new diagnoses, medication changes)