Upcoming Enhancements: Patient Email Notifications and Communicating the Request Submitter and Authorizer


OceanMD will be introducing two integration-related enhancements in the March 21st Ocean release:

1. Patient email notifications

Currently, FHIR-integrated sites must include the patient's email address in the Patient resource of the message-event payload to signal to Ocean that a patient email notification should be sent.   We have received input from several integrators that they would prefer to use the email address that was submitted by the requestor (because they have received consent from the patient for it to be used for Ocean communications) and that Ocean follow its internal model for patient notifications.  

The March 21st release will include a configuration option to support this and it will be the default for all net-new sites that add an integration.  For backwards compatibility, all existing integrated sites will continue to follow the current model (of sending the email address in the FHIR payload) until the new configuration option has been modified. 


2. Inclusion of both request submitter and authorizer information in the FHIR payload

Ocean currently only sends the referrer information of the most senior clinician involved in the request in the FHIR payload.  However, many Ocean referral and consults involve another actor that submits the request on behalf of the clinician.  In this case, there is a request authorizer and a request submitter.  Examples can include a medical secretary, physician assistant and resident that is submitting the referral under the supervision of a staff physician and an independently-practicing nurse practitioner sending a MRI order with the authorization of an physician.  The FHIR iGuide business rules section states " the referral authorizer is captured by ServiceRequest.requester, and may also be mapped onto MessageHeader.author when submitting the referral. The referral submitter is captured by MessageHeader.sender."   Below are examples of how the submitter and authorizer information will be populated in the payload:





Physician Assistant PA sending referral under physician Dr. D PA Dr. D Dr. D
Resident R sending referral under physician Dr. D R Dr. D Dr. D
Nurse Practitioner NP sending referral (ordering an MRI) under authorizing physician Dr. Digley NP Dr. D Dr. D
Medical Secretary MOA sending referral as a delegate under Dr. D MOA Dr. D Dr. D


Upon the March 21st release, where relevant, the request submitter's information will be added to Ocean FHIR payload for both v0.10.0 and v0.11.1.   This will follow the business rules above, as well as introduce a third Practitioner and PractitionerRole resource into the bundle (for the submitter, the authorizer and the receiver).

Integrators are encouraged to review their implementations to ensure that they are populating their POS fields accordingly.    There will also be an opportunity to perform regression tests in Ocean's staging.cognisantmd.com environment between March 19 - 20th.   


Please contact Ocean Support team with any questions or concerns. 



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