A DocumentReference resource is used to describe a document that is made available to a healthcare system. A document is some sequence of bytes that is identifiable, establishes its own context (e.g., what subject, author, etc. can be displayed to the user), and has defined update management. The DocumentReference resource can be used with any document format that has a recognized mime type and that conforms to this definition.

0. References

1. Read

Return a single DocumentReference for the specified id.

All requests SHALL contain a valid ‘Authorization’ header and SHALL contain an ‘Accept’ header. The `Accept` header indicates the format of the response the client is able to understand, this will be one of the following application/json+fhir or application/xml+fhir.

1.1. Response

A full set of response codes can be found here API Response Codes. FHIR Servers SHALL support the following response codes:

200 successful operation
404 resource not found
410 resource deleted

Search for all problems and health concerns for a patient. Fetches a bundle of all DocumentReference resources for the specified patient.

All requests SHALL contain a valid ‘Authorization’ header and SHALL contain an ‘Accept’ header. The `Accept` header indicates the format of the response the client is able to understand, this will be one of the following application/json+fhir or application/xml+fhir.

2.1. Search Parameters

This implementation guide outlines some suggested search parameters for the DocumentReference resource in the table below. To be conformant, provider systems are required to implement all of the SHALL parameters. Provider systems may implement the full list of search parameters for the DocumentReference resource (HL7 FHIR STU3 DocumentReference).


Name Type Description Conformance Path
created date Document creation time SHOULD DocumentReference.created
patient reference Who/what is the subject of the document SHOULD DocumentReference.subject
(Patient)
period date Time of service that is being documented SHOULD DocumentReference.context.period
setting token Additional details about where the content was created (e.g. clinical specialty) SHOULD DocumentReference.context.practiceSetting
type token Kind of document (SNOMED CT preferred) SHOULD DocumentReference.type

Systems SHOULD support the following search combinations:

  • patient + type + period

2.1.1. date

See date for details on this parameter. ‘date’ can be used multiple times as a search parameter

GET [baseUrl]/DocumentReference?patient=1&date=ge2010-01-01&date=le2011-12-31

Return all DocumentReference resources that have a date greater than or equal to 1st Jan 2010, a date less than or equal to 31st Dec 2011 and Patient with a logical id of 1.

2.1.2. patient

See reference for details on this parameter. The patient parameter can be used two ways:

This SHALL be supported for all endpoint provider systems.

id is the logical id of the patient on the server which can be obtained by a Patient resource query.

GET [baseUrl]/DocumentReference?patient=42

Return all DocumentReference resources for Patients with a logical id of 42

This SHOULD be supported by middleware systems (e.g. enterprise application integration (EAI) and the enterprise service bus (ESB)) and MAY be supported for endpoint provider systems.

system is a uniform resource identifier which defines which CodeSystem the identifer belongs to. For NHS Number this would be https://fhir.nhs.uk/Id/nhs-number and code would be the NHS Number.

GET [baseUrl]/DocumentReference?patient.identifier=https://fhir.nhs.uk/Id/nhs-number|9876543210

Return all DocumentReference resources for Patients with a NHS Number of 9876543210

2.1.3. period

See date for details on this parameter. ‘period’ can be used multiple times as a search parameter

GET [baseUrl]/DocumentReference?patient=1&period=ge2010-01-01&period=le2011-12-31

Return all DocumentReference resources that have a period greater than or equal to 1st Jan 2010, a date less than or equal to 31st Dec 2011 and Patient with a logical id of 1.

2.1.4. setting

See token for details on this parameter.

GET /DocumentReference?patient=1&setting=http://snomed.info/sct|893061000000109

Return all DocumentReference resources that have a setting with a type of 'Cardiology service (qualifier value)' and Patient with a logical id of 1.

2.1.5. type

See token for details on this parameter.

GET /DocumentReference?patient=1&type=http://snomed.info/sct|373942005

Return all DocumentReference resources that have a type with a type of 'Discharge summary (qualifier value)' and Patient with a logical id of 1.

2.2. Search Response

If the search fails (cannot be executed, not that there is no matches), the return value is a status code 4xx or 5xx with an OperationOutcome.

If the search succeeds, the return content is a Bundle with type = searchset containing the results of the search as a list of resources in a defined order. The result list can be long, so servers MAY use paging. If they do, they SHALL use this Paging method for breaking the list into pages if appropriate. The server MAY also return an OperationOutcome resource with additional information about the search; if one is sent it SHALL NOT include any errors, and it shall be marked with an entry mode of include.

A full set of response codes can be found here API Response Codes. FHIR Servers SHALL support the following response codes:

200 successful operation
404 resource not found
410 resource deleted

3. Example

3.1 cURL

Return all DocumentReference resources for Patient with an id of 1173, the format of the response body will be xml. Replace ‘baseUrl’ with the actual base Url of the FHIR Server.

curl -X GET -H 'Accept: application/xml+fhir' -H 'Authorisation: BEARER [token]' -v 'https://data.developer.nhs.uk/ccri/STU3/DocumentReference?patient=1173'

3.2 Explore the Response

Explore the response in XML & JSON on the Reference Implementation below

Reference Implementation

XML Patient id search RI viewer
JSON Patient id search RI viewer
Tags: rest fhir documents api noccprofile