New Versions of Ocean's HL7 FHIR eReferral APIs and SMART Launch

FHIR v0.11.1

Ocean offers HL7 FHIR eReferral APIs based on the Ontario HL7 FHIR eReferral Implementation Guide v0.10.0. These have been used to integrate over 20 different vendor systems in order to enable referral receivers to manage referrals within their point-of-services systems.

Ontario has released v0.11.1 of the implementation guide, which includes support for integration with Ontario Health's digital health assets, such as OTN eConsult. Ocean will be building v0.11.1 APIs to enable Ontario Ocean users to send and manage eConsults within Ocean without having to log into the OTN eConsult platform.

OceanMD recognizes the investment its integrating partners have made to date and will continue to offer and maintain the v0.10.0 APIs. These APIs will be available to integrators that have already begun development.

As of October 2023, new integrators that have not already initiated development to the v0.10.0 APIs will be strongly encouraged to develop to the v0.11.1 APIs to leverage the improvements in modeling and validation that have been incorporated into it.

SMART $everything

Clinicians appreciate the ability to single-sign-on into Ocean's Healthmap with the patient in context. When they select a referral target, the patient's demographics are pre-populated for them, saving time and avoiding typographical errors.

Many point-of-service systems have already leveraged the SMART framework to launch Ocean as a SMART app to accomplish this.

Two improvements to Ocean's existing SMART app launch have been identified:

  1. Because Ocean encrypts PHI, it is necessary to have the Shared Encryption Key (SEK) passed in the SMART sequence to avoid requiring the user to enter the SEK in order to decrypt the PHI. In the current implementation, the SEK is passed as a parameter in the JWT token (in step 9 of the sequence described in the Ocean SMART App Launch Overview). While this is compliant with the OAuth protocol, it is an extension from other SMART apps. It also means that each site's SEK has to be programmed individually into the SMART launch sequence.
  2. It would be beneficial to referral senders if the SMART launcher could provide additional clinical data and attachments (as FHIR resources) during the contextual launch sequence beyond

Ocean will be updating its SMART launch sequence in September 2023 to incorporate these two improvements.

  1. Implementers will be able to specify that Ocean should retrieve the SEK from the site's Cloud Connect module as part of the SMART allow-list setup. This will eliminate the need to extend existing SMART designs with the SEK.
  2. Implementers will also be able to specify that Ocean should request access to the FHIR $everything endpoint. The FHIR server can determine the breadth (which FHIR resources) and depth (how far back in time) should be provided to Ocean.

Because these are both breaking changes, Ocean will support both SMART launch sequences so that there is no impact to live integrations. Vendors intending to use the newer version of the SMART launch should explicitly state this when sharing their SMART allowlist parameters so that the correct sequence will be setup by the Ocean Support team.

Questions regarding these announcements can be submitted to the OceanMD Support team.

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