Description of use case on Spine via the FHIR® Reasonable Adjustments API

1 Remove Impairment

Although unlikely, Update Contention is possible. This scenario illustrates the case where Practitioners A and B try to remove a resource ‘at the same time’. ‘Optimistic locking’ is used, so A, who writes first ‘wins’.

Pre

  • Practitioner A reads Patient’s RARecord
  • Practitioner B reads Patient’s RARecord

  • Practitioner A updates Patient’s RARecord, Remove an Impairment ‘Mental Health Condition’ operation
    • Practitioner A commits update
      • ClientSystem captures and structures Provenance information as new Provenance (RARecord-Provenance-1) resource
      • ClientSystem contains new Provenance resource within CareConnect-RARecord-List-1 resource
      • ClientSystem marks Impairment List.entry element in CareConnect-RARecord-List-1 resource as deleted (xml) (json)
      • ClientSystem submits Update List (A)request (xml) (json)
        • ServerSystem submits Update List response (xml) (json)
  • Practitioner B updates Patient’s RARecord, Remove an Impairment ‘Mental Health Condition’ operation
    • Practitioner B commits update
      • ClientSystem submits Update List (B) request (xml) (json)
        • ServerSystem submits Update List (B) response (failure) (xml) (json)
      • ClientSystem reports failure, aborts.

2 Interaction Examples

2.1 Delete Condition A Resource - xml example

resource

Delete Condition List Resource A XML Example

<!-- DeleteExample-RemoveConditionListResource.xml -->
<List xmlns="http://hl7.org/fhir">
    <id value="130f416a-055d-4a5d-a453-2b7c2de3b57b"/>
    <meta>
        <versionId value="9554c538-1661-43b1-921b-efcbd2991c90"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-List-1"/>
    </meta>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            <meta>
                <versionId value="557ccfc3-0c78-48bf-aedd-70cc08af2ba1"/>
                <lastUpdated value="2018-07-23T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="active"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="1855002"/>
                    <display value="Learning Disability(s)"/>
                </coding>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            </target>
            <recorded value="2018-07-23T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="6be8bee9-e727-4564-a904-49507576f8be"/>
            <meta>
                <versionId value="62221f9b-22a0-4dc1-9c1a-c4231b38e819"/>
                <lastUpdated value="2018-07-25T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
                    </valueReference>
                </extension>
                <extension url="updated">
                    <valueReference>
                        <reference value="urn:uuid:a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="inactive"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="720821000000105"/>
                    <display value="Mental health condition(s)"/>
                </coding>
                <text value="Patient diagnosed with Stranger anxiety (disorder). Consider home-visit"/>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="fe71140b-3a30-45a3-b492-695b5f5e3717"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-24T10:01:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Provenance>
            <id value="a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-25T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.Y"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <status value="current"/>
    <mode value="changes"/>
    <title value="Reasonable Adjustment List"/>
    <code>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1094391000000102"/>
            <display value="Reasonable adjustments for health and care access"/>
        </coding>
    </code>
    <subject>
        <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
    <date value="2018-07-23T11:00:00+00:00"/>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:57f04652-6dd0-4135-a560-f9091b1b26fa"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:6be8bee9-e727-4564-a904-49507576f8be"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-25T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
        </item>
    </entry>
</List>

2.2 Delete Condition A Resource - json example

Delete Condition List Resource A JSON Example

{
  "resourceType": "Condition",
  "fhir_comments": [
    " json example AAJSONPlaceholder.json "
  ]
}

2.3 Update List Request - xml example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/List/130f416a-055d-4a5d-a453-2b7c2de3b57b HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+xml
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:List.write:1
If-Match: W/"9554c538-1661-43b1-921b-efcbd2991c90"

http body

Update List Request example XML Example

<!-- DeleteExample-RemoveConditionListResource.xml -->
<List xmlns="http://hl7.org/fhir">
    <id value="130f416a-055d-4a5d-a453-2b7c2de3b57b"/>
    <meta>
        <versionId value="9554c538-1661-43b1-921b-efcbd2991c90"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-List-1"/>
    </meta>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            <meta>
                <versionId value="557ccfc3-0c78-48bf-aedd-70cc08af2ba1"/>
                <lastUpdated value="2018-07-23T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="active"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="1855002"/>
                    <display value="Learning Disability(s)"/>
                </coding>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            </target>
            <recorded value="2018-07-23T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="6be8bee9-e727-4564-a904-49507576f8be"/>
            <meta>
                <versionId value="62221f9b-22a0-4dc1-9c1a-c4231b38e819"/>
                <lastUpdated value="2018-07-25T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
                    </valueReference>
                </extension>
                <extension url="updated">
                    <valueReference>
                        <reference value="urn:uuid:a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="inactive"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="720821000000105"/>
                    <display value="Mental health condition(s)"/>
                </coding>
                <text value="Patient diagnosed with Stranger anxiety (disorder). Consider home-visit"/>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="fe71140b-3a30-45a3-b492-695b5f5e3717"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-24T10:01:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Provenance>
            <id value="a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-25T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.Y"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <status value="current"/>
    <mode value="changes"/>
    <title value="Reasonable Adjustment List"/>
    <code>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1094391000000102"/>
            <display value="Reasonable adjustments for health and care access"/>
        </coding>
    </code>
    <subject>
        <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
    <date value="2018-07-23T11:00:00+00:00"/>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:57f04652-6dd0-4135-a560-f9091b1b26fa"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:6be8bee9-e727-4564-a904-49507576f8be"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-25T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:a2a5895b-9c52-4921-a0b6-7cdd28e941bf"/>
        </item>
    </entry>
</List>

2.4 Update List Request - json example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/List/130f416a-055d-4a5d-a453-2b7c2de3b57b HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+xml
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:List.write:1
If-Match: W/"9554c538-1661-43b1-921b-efcbd2991c90"

http body

Update List Request example JSON Example

{
  "resourceType": "Condition",
  "fhir_comments": [
    " json example AAJSONPlaceholder.json "
  ]
}

2.5 Update List Response - xml example

http response & headers

HTTP/1.1 200 OK
Date: Tue, 25 Jul 2018 11:00:03 GMT
Last-Modified:2018-07-25T11:00:02+00:00
ETag: W/"d65be6d8-128a-40f2-9a1d-b250d6485c6d”
Content-Type: application/fhir+xml

http body

Update List Response XML Example

<Condition xmlns="http://hl7.org/fhir">
    <id value="13aec731-02c5-42a2-b863-de889479e777"/>
    <meta>
        <versionId value="0bf0b49c-9dfb-4587-9931-0b4a00819229"/>
        <lastUpdated value="2018-07-24T10:00:02+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
    </meta>
    <contained>
        <Provenance>
            <id value="8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/13aec731-02c5-42a2-b863-de889479e777"/>
            </target>
            <recorded value="2018-07-24T10:05:33+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
            </valueReference>
        </extension>
    </extension>
    <clinicalStatus value="inactive"/>
    <category>
        <coding>
            <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
            <code value="issue"/>
            <display value="Issue"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
            <code value="720821000000105"/>
            <display value="Mental health condition(s)"/>
        </coding>
        <text value="Patient diagnosed with Stranger anxiety (disorder). Consider home-visit"/>
    </code>
    <subject>
        <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
</Condition>

2.6 Update List Response - json example

http response & headers

HTTP/1.1 200 OK
Date: Tue, 25 Jul 2018 11:00:03 GMT
Last-Modified:2018-07-25T11:00:02+00:00
ETag: W/"d65be6d8-128a-40f2-9a1d-b250d6485c6d”
Content-Type: application/fhir+xml

http body

Update List Response JSON Example

{
  "resourceType": "Condition",
  "fhir_comments": [
    " json example AAJSONPlaceholder.json "
  ]
}

2.7 Update List B Request - xml example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/List/130f416a-055d-4a5d-a453-2b7c2de3b57b HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 654321123456
ToASID: 987654456789
Content-Type: application/fhir+xml
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:List.write:1
If-Match: W/"9554c538-1661-43b1-921b-efcbd2991c90"

http body

Update List B Request example XML Example

<!-- DeleteExample-RemoveConditionListResourceB.xml -->
<List xmlns="http://hl7.org/fhir">
    <id value="130f416a-055d-4a5d-a453-2b7c2de3b57b"/>
    <meta>
        <versionId value="9554c538-1661-43b1-921b-efcbd2991c90"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-List-1"/>
    </meta>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            <meta>
                <versionId value="fb683813-da74-4990-9019-f1feb0752215"/>
                <lastUpdated value="2018-07-23T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="active"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="1855002"/>
                    <display value="Learning Disability(s)"/>
                </coding>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/57f04652-6dd0-4135-a560-f9091b1b26fa"/>
            </target>
            <recorded value="2018-07-23T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Condition xmlns="http://hl7.org/fhir">
            <id value="6be8bee9-e727-4564-a904-49507576f8be"/>
            <meta>
                <versionId value="62221f9b-22a0-4dc1-9c1a-c4231b38e819"/>
                <lastUpdated value="2018-07-25T11:00:00+00:00"/>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-RARecord-Condition-1" />
            </meta>
            <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
                <extension url="created">
                    <valueReference>
                        <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
                    </valueReference>
                </extension>
                <extension url="updated">
                    <valueReference>
                        <reference value="urn:uuid:6151145f-696a-470c-8cb4-a9abad123a3a"/>
                    </valueReference>
                </extension>
            </extension>
            <clinicalStatus value="inactive"/>
            <category>
                <coding>
                    <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ConditionCategory-1"/>
                    <code value="issue"/>
                    <display value="Issue"/>
                </coding>
            </category>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-ConditionCode-1"/>
                    <code value="720821000000105"/>
                    <display value="Mental health condition(s)"/>
                </coding>
                <text value="Patient diagnosed with Stranger anxiety (disorder). Consider home-visit"/>
            </code>
            <subject>
                <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
            </subject>
        </Condition>
    </contained>
    <contained>
        <Provenance>
            <id value="fe71140b-3a30-45a3-b492-695b5f5e3717"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-24T10:01:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Provenance>
            <id value="6151145f-696a-470c-8cb4-a9abad123a3a"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Condition/6be8bee9-e727-4564-a904-49507576f8be"/>
            </target>
            <recorded value="2018-07-25T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.Z"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <status value="current"/>
    <mode value="changes"/>
    <title value="Reasonable Adjustment List"/>
    <code>
        <coding>
            <system value="http://snomed.info/sct"/>
            <code value="1094391000000102"/>
            <display value="Reasonable adjustments for health and care access"/>
        </coding>
    </code>
    <subject>
        <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
    <date value="2018-07-23T11:00:00+00:00"/>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:57f04652-6dd0-4135-a560-f9091b1b26fa"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-23T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:8ce7de6b-1307-432d-8e96-ae6a613ca3e4"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:6be8bee9-e727-4564-a904-49507576f8be"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-24T10:01:00+00:00"/>
        <item>
            <reference value="urn:uuid:fe71140b-3a30-45a3-b492-695b5f5e3717"/>
        </item>
    </entry>
    <entry>
        <deleted value="false"/>
        <date value="2018-07-25T11:00:00+00:00"/>
        <item>
            <reference value="urn:uuid:6151145f-696a-470c-8cb4-a9abad123a3a"/>
        </item>
    </entry>
</List>

2.8 Update List B Request - json example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/List/130f416a-055d-4a5d-a453-2b7c2de3b57b HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 654321123456
ToASID: 987654456789
Content-Type: application/fhir+json
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:List.write:1
If-Match: W/"9554c538-1661-43b1-921b-efcbd2991c90"

http body

Update List B Request example JSON Example

{
  "resourceType": "Condition",
  "fhir_comments": [
    " json example AAJSONPlaceholder.json "
  ]
}

2.9 Update List B Response - xml example

http response & headers

HTTP/1.1 409 CONFLICT
Date: Tue, 25 Jul 2018 11:02:03 GMT
Content-Type: application/fhir+xml

http body

Read Fail Operation Outcome XML Example

<OperationOutcome xmlns="http://hl7.org/fhir">
    <id value="3ca2a2cb-b663-4ae9-b650-7cf4a23487ec"/>
    <meta>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Spine-OperationOutcome-1"/>
    </meta>
    <issue>
        <severity value="error"/>
        <code value="forbidden"/>
        <details>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/ValueSet/Spine-ErrorOrWarningCode-1"/>
                <code value="CONFLICT"/>
                <display value="Conflict"/>
            </coding>
        </details>
    </issue>
</OperationOutcome>

2.10 Update List B Response - json example

http response & headers

HTTP/1.1 409 CONFLICT
Date: Tue, 25 Jul 2018 11:02:03 GMT
Content-Type: application/fhir+json

http body

Read Fail Operation Outcome JSON Example

{
  "resourceType": "OperationOutcome",
  "id": "3ca2a2cb-b663-4ae9-b650-7cf4a23487ec",
  "meta": {
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/Spine-OperationOutcome-1"
    ]
  },
  "issue": [
    {
      "severity": "error",
      "code": "forbidden",
      "details": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/ValueSet/Spine-ErrorOrWarningCode-1",
            "code": "CONFLICT",
            "display": "Conflict"
          }
        ]
      }
    }
  ]
}