Retrieve a patient's record in structured format

Introduction

The GP Connect API requires that a solution for forwards and backwards compatibility is developed as there is the potential for multiple versions of the GP Connect API to be implemented by consumers and providers.

Forwards and backwards compatibility

Forwards compatibility

Forwards compatibility is the scenario where a consumer requests a higher version of the API than the provider supports. This requires that a provider MUST be able to warn a consumer when they don’t support a requested parameter or part parameter.

In this scenario, providers MUST respond in the following way:

• return a 200 OK HTTP status code to indicate successful retrieval of a patient’s structured record
• Include FHIR® resources for supported parameters
• as part of the returned bundle, include a single OperationOutcome with an issue for each unsupported parameter or part parameter where:
  • issue.code = not-supported
  • issue.severity = warning
  • issue.details.coding.system = https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1
  • issue.details.coding.code = NOT_IMPLEMENTED
  • issue.details.coding.display = Not implemented
• Where it’s an unsupported parameter the following MUST be supplied:
  • issue.details.text = <parameter-name> is an unrecognised parameter`
  • issue.diagnostics = <parameter-name>
• Where it’s an unsupported part parameter the following MUST be supplied:
  • issue.details.text = <parameter-name>.<part-parameter-name> is an unrecognised parameter
  • issue.diagnostics = <parameter-name>.<part-parameter-name>

The example shows a fully populated OperationOutcome for a request where the includeConsultations and includeProblems parameters weren’t supported:

{
  "resource": {
    "resourceType": "OperationOutcome",
    "id": "8b679981-e9be-4e37-b103-799295a6aec8",
    "meta": {
      "profile": [
        "https://fhir.nhs.uk/STU3/StructureDefinition/GPConnect-OperationOutcome-1"
      ]
    },
    "issue": [
      {
        "severity": "warning",
        "code": "not-supported",
        "details": {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1",
              "code": "NOT_IMPLEMENTED",
              "display": "Not implemented"
            }
          ],
          "text": "includeConsultations is an unrecognised parameter"
        },
        "diagnostics": "includeConsultations"
      },
      {
        "severity": "warning",
        "code": "not-supported",
        "details": {
          "coding": [
            {
              "system": "https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1",
              "code": "NOT_IMPLEMENTED",
              "display": "Not implemented"
            }
          ],
          "text": "includeProblems is an unrecognised parameter",
        },
        "diagnostics": "includeProblems"
      }
    ]
  }
}

Note: where no valid parameters are provided in a request, an OperationOutcome with a severity of error MUST to be returned as specified in the error handling section

Providers MUST report unsupported parameters at the least granular level, that is, unsupported part parameters MUST only be reported when their top level parameter is supported.

Consumers MUST check for the presence of an OperationOutcome resource as specified above to check for incomplete data as a result of unsupported parameters. These warnings MUST be displayed to users to warn them that information is missing.

The following table gives an overview of which parameters are supported in each version of the GP Connect API:

Specification version	Parameters
1.2.x	includeMedication
	↳ includePrescriptionIssues
	↳ medicationSearchFromDate
	includeAllergies
	↳ includeResolvedAllergies
1.5.x	includeMedication
	↳ includePrescriptionIssues
	↳ medicationSearchFromDate
	includeAllergies
	↳ includeResolvedAllergies
	includeConsultations
	↳ consultationSearchPeriod
	↳ includeNumberOfMostRecent
	includeProblems
	↳ includeStatus
	↳ includeSignificance
	includeImmunisations
	↳ includeNotGiven
	↳ includeStatus
	includeUncategorisedData
	↳ uncategorisedDataSearchPeriod
	includeInvestigations
	↳ investigationSearchPeriod
	includeReferrals
	↳ referralSearchPeriod
	includeDiaryEntries
	↳ diaryEntriesSearchDate

Consumers MAY determine programmatically which parameters have been implemented by the provider using the following process:

• Get the FHIR® capability statement from the provider’s Access Record Structured FHIR server
• Locate the value in CapabilityStatement.operation[name=’gpc.getstructuredrecord’].definition.reference, this will be a reference to an OperationDefinition
• Perform a HTTP GET to the value that was retrieved in the previous step
• The parameters that are supported by the provider will be listed in OperationDefinition.parameters

To illustrate how forwards compatibility works, the following example has been included:

• Retrieve consultations, problems, medications and allergies from a provider on version 1.2.4 of the GP Connect API

Backwards compatibility

Backwards compatibility is the scenario where a consumer requests a lower version of the API than the provider supports. The GP Connect APIs have been developed to be backwards compatible by following the rules for backwards compatibility that are defined in the FHIR® specification.

Consumers are required to ignore unexpected elements and process data that they understand. They MUST alert users to the fact that some information couldn’t be displayed as it isn’t supported.