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Change Log

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Change Management Overview

Sequoia maintains change control for all assets related to this project, including to this document, the software described by this document, and the associated operational environments (people, processes, and systems). The following sections document the information needed by implementers in terms of change management. Certain information, such as actual environmental access base URLs is confidential and not documented here.

Documentation Changes

Date Version Author Summary
2018-06-29 1.2 DRAFT Eric Heflin Organization.id updated documentation, pervasive editorial changes, added this change log, new YAML docs, added delete behavior docs, reorganized document structure,added best practices,added test patient docs (not implemented yet by software),added internal doc links, added external (HL7 FHIR) references,updated best practices, updated the server version to 1.0.1, improved TLS description, other software changes
2017-10-23 1.1 DRAFT Eric Heflin, Louis Alonozo Added documentation for CRUD operation, operational monitoring, and UDDI functions.
2017-04-12 1.01 DRAFT Eric Heflin Added new element indicating if a given Initiating Gateway or Responding Gateway supports policy assertions. Added value set definitions.
2017-02-01 1.0 DRAFT Author: Eric Heflin Reviewers: Theresa Wiebold, Dawn Van Dyke, Didi Davis, Matt Blackmon Initial release.

Software Changes

  1. Added Organization.type Values The Organization.type value set was defined for the Sequoia Healthcare Directory with following four additional values. Note that the Carequality values of Implementer and Connection are distinct from the eHealth Exchange values of Participant and Subparticipant. Thus inspecting the Organization.type value is one supported method to discern between a Carequality directory entry and an eHealth Exchange directory entry. Organizations implementing this directory specification are advised that additional extensions may be added to the FHIR structure, and/or to the Organization.type fields in the future. Currently only one instance of Organization.type is allowed, it is required, it must not repeat, it is limited the the value set defined in this document. In the future, these optionality and cardinality rules may change to reflect, for example, that an organization is both a Carequality Implementer and another type of organization such as a CommonWell Member, or an eHealth Exchange Participant. See also:https://hl7.org/fhir/codesystem-organization-type.html and https://hl7.org/fhir/stu3/organization.html . For eHealth Exchange Organizations:
... ...

For Carequality Organizations:

... ...

Informative Note: This value is enforced for both the eHealth Exchange and Carequality in the RESTful post and update operations. For Carequality, this value is required and enforced by the Excel to YAML converter. For the eHealth Exchange, this value is required and enforced by the XML to YAML converter. This value is also now returned in the XML and JSON responses from the Sequoia Healthcare Server in response to queries. Post and update operations must supply the Organization.type element. This is a new element that formerly was not being returned by the server.

  1. Change Organization Active Element To Align with FHIR STU3 Referencing: https://hl7.org/fhir/stu3/organization.html This formerly unenforced value, which exists directly under Organizational resources, will use the FHIR STU3 definition of this element. This results in a data type change from an unconstrained string value, to a FHIR Boolean data type (as per https://hl7.org/fhir/stu3/datatypes.html#boolean). Examples before this change:
... ... ... ...

Examples after this change:

... <active value=true/> ... ... <active value=false/> ...

In XML, this element is returned as quoted string with exactly and only one of true or false. In JSON, this is returned as a value of true or false, as an unquoted Boolean variable. This is enforced identically for both the eHealth Exchange and Carequality for XML and Excel file imports and RESTful post and update. This value is returned from the Sequoia Healthcare Directory in queries. By default, only active directory entires are returned in response to queries. If the client software is seeking to return inactive directory entries, it must use a query parameter that includes active=false in order for the query to return an Organization that has an active value of false. See also Delete

  1. Update value set for the EndPoint.connectionType element The value in the Carequality Excel file is EndPoint0?-SupportedTransactions.connectionType maps to the FHIR data Previously, this value was not enforced in the directory. It is now enforced to one of two values as per http://hl7.org/fhir/stu3/valueset-endpoint-connection-type.html. Note that other values may be added to this specification in the future, such as hl7-fhir-rest:
    • ihe-xcpd
    • ihe-xca Example before this change:

Examples after this change:

This value is enforced the same for eHealth Exchange and Carequality for file import from XML and Excel as well as from RESTful post and update operations.

  1. Enforce Organization.EndPoint Name Value Set Referencing http://hl7.org/fhir/stu3/endpoint-definitions.html#Endpoint.name. Previously the EndPoint name value was not enforced. Now it is enforced as per the documentation. Note that this list may be expanded in the future. These values are enforced for both the eHealth Exchange and Carequality and stored using the case shown below. The value sets are different from the eHealth Exchange and Carequality in some cases. As per http://www.ihe.net/Technical_Framework/upload/IHE_ITI_Suppl_XCA_Rev2-1_TI_2010-08-10.pdf IHE Transaction Number Formal Name Sequoia Directory Entry IHE ITI-55 Cross Gateway Patient Discovery Patient Discovery IHE ITL-56 Patient Location Query Patient Location Query IHE ITI-38 Cross Gateway Query Query for Documents IHE ITI-39 Cross Gateway Retrieve Retrieve Documents eHealth Exchange Value Set Administrative Distribution Document Submission Patient Discovery Patient Discovery Deferred Request Patient Discovery Deferred Response Query for Documents Retrieve Documents Carequality Value Set Patient Discovery Patient Location Query Query for Documents Retrieve Documents Examples before this change: <address value="https://conform.xyz.com/PatientDiscovery"/>

Example after this change: <address value="https://conform.xyz.com/PatientDiscovery"/> Informative note: The value (containing the URL) is unchanged by this constraint and must be a valid eHealth Exchange or Carequality end point.

  1. Clarify Mapping of Multiple eHealth Exchange UDDI States of Coverage Currently the eHealth Exchange UDDI allows entries to express multiple states of coverage by placing multiple keyedReference tModelKey iso3166 values in the UDDI. This will be mapped to multiple organization entries in the FHIR data structure, where the parent organization will be pointed to, using FHIRs part of element, by the lower level Organizations. Data providers are strong encouraged to provide not only the state of coverage, but also each address where that organization has a service location (such as an owned practice, clinical, hospital, lab, etc.) Example in UDDI format:

Example of an eHealth Exchange Equivalent in FHIR Format: ... <address> ... <state value=US-NY> ... </address> ... <address> ... <state value=US-NY> ... </address> ... <address> ... <state value=US-TX> ... </address>

... <state value=US-OR> ...

  1. eHealth Exchange UDDI Description and Carequality DisplayName Field Reference: http://hl7.org/fhir/stu3/domainresource.html In the legacy eHealth Exchange UDDI directory, there is a value in the XML data structure called that is used to provide a narrative about the organization. This value was not in the prior version of the Carequality directory entries but has been added as a new optional Carequality data element labeled Org->DisplayName. If the value is present in the source UDDI) directory it will be mapped to an Organization object DomainResource element as an Organization.text value. Example after this change:
This is a sample description.
  1. Change Organization Telecom Name The Organization.telcom element has been renamed to Organization.telecom to be consistent with STU3 as can be seen at http://hl7.org/fhir/stu3/organization.html, http://hl7.org/fhir/stu3/organization-definitions.html#Organization.telecom and http://hl7.org/fhir/stu3/datatypes.html#ContactPoint. Previously, the Organization.telecom.ContactPoint.system value set was not required or enforced. Now the Organization.telecom.ContactPoint.system value is MUST be specified exactly one time inside the Organization.telecom.ContactPoint structure, and the Organization.telecom.ContactPoint.system structure value set will be enforced and it MUST have one of the values listed at http://hl7.org/fhir/stu3/valueset-contact-point-system.html. The ContactPoint element is being removed to align with FHIR STU3.
    • phone
    • fax
    • email
    • pager
    • url
    • sms The value of Organization.telecom.ContactPoint.system MUST NOT be other. This value set is enforced for the RESTful post and update operations and for Excel and XML to YAML import utilities. Implementers of this guide are strongly encouraged to work with the community to define new values for this element if/as needed. Example before this change:

Example after this change:

This is enforced equally for the eHealth Exchange and Carequality directories and in the Excel to YAML and the XML to YAML import tools, and the RESTful post and update operations.

  1. Update Contact Name Structure Update the structure to align with FHIR STU3 by moving the Organization.contact.name element from enclosed text to text assigned to the value attribute as per http://hl7.org/fhir/stu3/organization.html and http://hl7.org/fhir/stu3/datatypes.html#HumanName The Organization.contact.name element MUST contain exactly one Organization.contact.name.given element, and it MUST contain exactly one Organization.contact.name.family name element. The Organization.contact.text element MAY be present but is optional. Example before this change:
Corbin Test

Example after this change:

  1. Update Organization Position to an Extension The Sequoia directory needs to represent a latitude and longitude for Organizations in order to provide for geographical address functions (such as mapping, and radius based searching). Currently the Organization.address resource directly contains a FHIR Position data type. This is being updated to use a FHIR extension called OrgPosition Example before this change:

Example after this change:

  1. Changed partOf Structure to Align with FHIR STU3 Previously the Organization.partOf element was structured with an additional reference element. This has been removed as per http://hl7.org/fhir/stu3/references.html Example before change:
... ...

Example after change:

... ...
  1. EndPoint payloadMimeFormat Renamed to be Consistent with FHIR STU3 The former element Organization.EndPoint.payloadMimeFormat has been renamed to Organization.EndPoint.payloadMimeType. See http://hl7.org/fhir/stu3/endpoint.html and http://hl7.org/fhir/stu3/endpoint-definitions.html#Endpoint.payloadMimeType for more information. Example before this change:

Example after this change:

  1. Organization.id is now a constant value, which is the OID component of that systems HomeCommunityID value. See 8.1. Organizational ID and Identifier for detailed information.
  2. Delete operations on Organizations dont remove that Organization resource from the database; they mark it as logically deleted by setting Organization.active to false. See Delete for detailed information.
  3. Test Patients In order to facilitate testing, organizations SHOULD include test patients into the Sequoia Healthcare Directory. See Synthetic Test Patients for detailed information.
  4. Added a version tag to the emitted XML server comments. If no tag is present, then the server is version 1.0.0. As of this writing the server version is 1.0.1, which also corresponds to the new base URL as per the 10.4. Operational Environment Changes.
  5. The server now enforces the Organization.lastUpdated value for RESTful PUT and POST commands (to update or create Organizations) and sets this value to the current server time in UTC.
  6. All times are now stored and returned in ISO8601 format, using UTC.

Operational Environment Changes

Date Author Summary
2018-06-29 Eric Heflin Implemented the 10.3. Software Changes. note that Synthetic Test Patients documented but are not yet implemented, updated the server version from 1.0.0 to 1.0.1 in the base URL for the alpha and beta servers, as well as for the emitted version information in the server header. Added OrganizationCount and PatientCount to the YAML file header.
2018-07-02 Eric Heflin Carequality Excel directory file now has the following changes: Org-ID is a new value that is derived from Org-Identifier. Org-Status is now enforced. Org-Type is now enforced. Endpoint??-DisplayName is now enforced against a value set. Endpoint??-SupportedTransactions is now enforced to a value set. Org-DisplayName is a new optional text value. Org-Type and Org-CarequalityType have been switched (clarified).
2018-08-27 Eric Heflin The Excel file has been manually quality assured and a pervasive number of changes have been made. A delta file showing the before and after values is being provided to all impacted live Implementers. All lastUpdated dates have been changed to 2018-08-27 to reflect these changes. All country values are now set to "USA" ISO format as per this document. This change impacted almost all organizations in the spreadsheet.
2018-10-31 Eric Heflin As per the associated operational notice, the production environment was changed to decommission the prior production directory, to update the stage and dev directories, and to decommission the beta and alpha

Process Changes

Date Author Summary
2018-07-02 Eric Heflin Staff have remediated issues in the current production Excel Carequality directory file to align it with the updated Excel format. From this date forward, Carequality Implementers are expected to provide new and updated data in a conformant format. See here for more detailed information.

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