"}]},"isInherited":true,"source":{"_postman_id":"03182cfe-baac-4125-8146-dc0c131816d5","id":"03182cfe-baac-4125-8146-dc0c131816d5","name":"Carefluence OpenAPI R4","type":"collection"}}},{"name":"Security & Authorization Flow","item":[],"id":"df20beea-f026-4d22-81d7-5a2ba4ce9c3b","description":"Security
\nLike many RESTful APIs, the Carefluence OpenAPI R4 uses OAuth 2 for security. This means that when making calls to any resource with the Carefluence OpenAPI R4, you must pass a Bearer token. This token is passed in the Authorization Header.
\nAuthorization: Bearer 123.456.7890\n\n
To obtain a Bearer token, you must call an Authorization Server. The authorization server typically exposes two endpoints:
\n\nauthorize: typically used to confirm the user’s credentials \ntoken: used to obtain the Bearer token \n
\nAs per the FHIR specification, the Carefluence OpenAPI R4 supports both JSON and XML. However, for simplicity, we limit our examples to JSON.
\nAuthorization flow
\nThe Carefluence OpenAPI R4 uses OAuth 2 and Open ID Connect. It is based on the Smart Authorization description.
\nReferences:
\n\nThe authorization code grant type is the only grant type supported in this release because it is considered secure. Other grant types, such as implicit flow, may be supported in future as the standards evolve.
\nThe following diagram (from Smart) describes the authorization code flow:
\n
\nOnce the patient or provider (hereafter referred to as the user) launches the app, you must authenticate the user by calling the authorize endpoint on the authorization server used by the EHR.
\nDuring the authentication step, provide the app’s client_id, but not the secret.
\n\nNote that the examples here illustrate what is happening. It is not recommended that you code an OAuth client yourself. For suggestions on OAuth clients, see link.
\n
\nGET https://core.carefluence.com/cf.admin.core/connect/authorize?response_type=code&client_id=d34d06b8-63ff-414b-a93c-11dc998f54e1&redirect_uri=http://localhost:8000/launch.html&scope=launch openid profile\n\n
If you are developing a web client, you will use a URL pointing back to your website.
\nDuring the On Approval step, the user will be asked to log in. If they do not have credentials, they will be asked to confirm their identity before creating credentials. If this is the first time they have used the app, they will be asked to confirm that they want to use the application (authorizing the application).
\nAfter the user authenticates, you will receive an authorization code. You send the authorization code, along with the client_secret, to the token endpoint of the authorization server.
\nPOST https://core.carefluence.com/cf.admin.core/connect/token\n code f53e501a51f2909d1f7ac5dd0d148c46\n redirect_uri http://localhost:8000/launch.html\n client_id C85533AE-E3A4-455C-BE5C-DAC0F695408F\n scope patient/*.read\n client_secret supersecret\n grant_type authorization_code\n\n
The server returns the access token which the app then uses in subsequent calls to the API.
\n{\n \"access_token\" : 123.456.7890\n \"expires_in\": 1200,\n \"token_type\": \"Bearer\" \n}\n\n
Scopes
\nThe Carefluence OpenAPI R4 authorization server uses the scopes defined for Smart on FHIR.
\nConfidential and public clients
\nThe Carefluence OpenAPI R4 supports two type of clients: confidential clients and public clients.
\nConfidential clients are clients that can be trusted to keep the client_secret secure. Examples of confidential clients include:
\n\n- Web clients written as server side HTML and where the client secret is stored on the server
\n- Mobile clients written in the native technology of the platform
\n
\nPublic clients cannot be trusted to keep the secret safe.
\nUsing a refresh token
\nTo prevent a user from having to log in whenever the access token expires, use a refresh token. The refresh token will be valid for hours/days.
\nTo get a new access token, call the token endpoint of the authorization server and present your bearer token.
\nIf the bearer token has expired, you must call the authorization endpoint of the authorization server again so the user can login using their credentials.
\nAuthorization for patient access
\nCertain resources and operation on the Carefluence OpenAPI R4 are not specific to a patient. For example, searching for a patient.
\nHowever, most API calls are patient specific. For example, retrieving patient demographics or problems.
\nIn those cases the following authorization rules apply:
\n\n- If the user is a patient:
\n- They have access to their own data.
\n- They have access to patients for whom they are caregivers or guardian.
\n- They will not have access to the data for any other patients.
\n
\n \n- If the user is a provider or other EHR user:
\n- They only have access to patients they are authorized to see in their EHR.
\n- They do not have access to patients they are not authorized to see in their EHR.
\n- Apps do not have access to the “break glass” privilege escalation functionality.
\n
\n \n
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\nWe use Carefluence SMART Connect module for MFA and it is an optional add-on feature to the OpenAPI platform. When the Multi-factor authentication is turned ON, the following use cases are turned ON for the respective users.
\n\n- Use case 1 : API Administrators, when they login to the Carefluence Admin portal for API management, they will be sent a verification code via Email/text message and that needs to be keyed into the login page -> verification code to access the system.
\n- Use case 2 : Self-registered API developers, when they login to the Carefluence Admin portal for their App registration or to request token for their Applications, they will be sent a verification code via Email/text message and that needs to be keyed into the login page -> verification code to access the system.
\n- Use case 3 : Patients, when they are presented Authorization dialog with scopes to grant permission during the API calls, they are required to login prior to the Carefluence Admin portal to generate token for the API access further. In this workflow, they will be sent a verification code via Email/text message to the phone number or email that they registered in EHR, Carefluence platform matches the patient and accesses this information via OpenAPI. This verification code needs to be keyed into the login page to access the APIs further.
\n
\nNote: Carefluence SMART Connect module usage is an option when the OpenAPI platform is deployed in Microsoft Azure. But Carefluence OpenAPI R4 can work with other MFA providers as on needed basis of the customers and we support the above use cases irrespective of the MFA provider implemented in the project.
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\n- Once registered, developers can login and register their Applications
Developer Login - Carefluence \n
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\n\n\n\n| Code | \nMeaning | \n
\n\n\n\n| 200 | \nThe request was processed appropriately. | \n
\n\n| 400 | \nInvalid parameter. | \n
\n\n| 401 | \nThe request did not have a valid authorization token or none was provided. Obtain a valid authorization token and add it to the authorization header. | \n
\n\n| 403 | \nThe user is not authorized for the operation. The user may not have access to the patient, or an invalid scope was provided. | \n
\n\n| 4xx | \nAuthorization error. | \n
\n\n
\n
\nA response with a code in the 4xx or 5xx may contain addtional information in the form of a FHIR OperationOutcome.
\nFor example:
\n{\n \"resourceType\": \"OperationOutcome\",\n \"id\": \"101\",\n \"text\": {\n \"status\": \"additional\",\n \"div\": \"\\n W is not a recognized code for Gender.\\n \"\n },\n \"issue\": [\n {\n \"severity\": \"error\",\n \"code\": \"code-invalid\",\n \"details\": {\n \"text\": \"The code \\\"W\\\" is not known and not legal in this context\"\n },\n \"diagnostics\": \"Acme.Interop.FHIRProcessors.Patient.processGender line 2453\",\n \"location\": [\n \"/f:Person/f:gender\"\n ]\n }\n ]\n}\n\n
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\n\n- Authorization Service: Web-based SMART authorization and resource retrieval service developed on OAuth 2.0 specification.
\n- SMART Connect: Multi-factor Authentication & Application Single-Sign on and Security Options
\n- RESTful Resource API: Healthcare data (ie., Patient, Condition, Procedure, or Immunization) is securely hosted as resources on a web server. All of these resources can be searched and operations such as update, create or delete are implemented as specified by FHIR® R4 Standard.
\n- FHIR® Transformer: Server side component that takes CCDA or HL7 V2 messages as input and convert them into FHIR® resources accessible via RESTful Resource API.
\n- Embeddable Viewer Plugin: A default embeddable patient data viewer is provided and can be customized using CSS and XSLT.
\n- HL7 Interface Engine Plugin: Add-on modules to use with Mirth Connect as the HL7 interface engine.
\n- OpenAPI Database: Database agnostic storage for the Carefluence platform that is tested with MS SQL server. Based on the Carefluence implementation strategy, there is an option to choose Oracle, MySQL, or PostgreSQL.
\n- Authorization Database: MS SQL Server data store to manage OAuth tokens and client application registrations with their authorization statuses
\n- Cloud Native Hosting : Carefluence OpenAPI R4 is hosted in Microsoft Azure as App Services natively for our Development purposes. For our customers, the Azure reference implementation will be licensed to subscribe in their own Azure Account or lease ours.
\n- EHR Connectivity: Carefluence develop and maintain HL7 standards based adapters to connect with EHRs and normalize to FHIR R4 standards. Typically Carefluence professional services team will assess whether to use one of their standards based adapter or develop a custom adapter for the data exchange purposes.
\n
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\"valueAddress\": {\n \"city\": \"Revere\",\n \"state\": \"Massachusetts\",\n \"country\": \"US\"\n }\n },\n {\n \"url\": \"http://synthetichealth.github.io/synthea/disability-adjusted-life-years\",\n \"valueDecimal\": 1.2127307844815787\n },\n {\n \"url\": \"http://synthetichealth.github.io/synthea/quality-adjusted-life-years\",\n \"valueDecimal\": 77.78726921551842\n }\n ],\n \"identifier\": [\n {\n \"use\": \"usual\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v2-0203\",\n \"code\": \"MR\"\n }\n ]\n },\n \"system\": \"urn:oid:1.2.36.146.595.217.0.1\",\n \"value\": \"12345\",\n \"period\": {\n \"start\": \"2001-05-06\"\n },\n \"assigner\": {\n \"display\": \"Acme Healthcare\"\n }\n }\n ],\n \"active\": true,\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Chalmers\",\n \"given\": [\n \"Peter\",\n \"James\"\n ],\n \"suffix\": [\n \"Jr.\"\n ]\n },\n {\n \"use\": \"usual\",\n \"given\": [\n \"Jim\"\n ]\n },\n {\n \"use\": 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\n\n\n\nFirst Name Middle Name | \nPatient.name.given | \n
\n\n| Last Name | \nPatient.name.family | \n
\n\n| Previous Name | \nPatient.name | \n
\n\n| Suffix | \nPatient.name.suffix | \n
\n\n| US Core Birth Sex Extension | \nPatient.extension.BirthSex | \n
\n\n| Date of Birth | \nPatient.birthDate | \n
\n\n| US Core Race Extension | \nPatient.extension.race | \n
\n\n| US Core Extension Ethnicity | \nPatient.extension.ethnicity | \n
\n\n| Preferred Language | \nPatient.communication | \n
\n\n| Address | \nPatient.address | \n
\n\n| Phone Number | \nPatient.telecom | \n
\n\n
\n
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Allergy Intolerance response can be requested in JSON or XML format as per FHIR standard R4 version AllergyIntolerance - FHIR v4.0.1 (hl7.org) supports the following data elements*:*
\n\n\n\n| USCore Data Element | \nFHIR Resource Field | \n
\n\n\n\n| Substance(Drug class) | \nAllergyIntolerance.code(Snomed CT) | \n
\n\n| Substance(Medication) | \nAllergyIntolerance.code (RxNorm) | \n
\n\n| Reaction | \nAllergyIntolerance.reaction | \n
\n\n
\n
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\"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"15777000\",\n \"display\": \"Prediabetes\"\n }\n ],\n \"text\": \"Prediabetes\"\n },\n \"subject\": {\n \"reference\": \"urn:uuid:1f4b3e0c-3137-4fdd-a94f-0aaeb883074e\"\n },\n \"encounter\": {\n \"reference\": \"urn:uuid:5f57a4e2-fdef-460f-b43e-585cc2df455d\"\n },\n \"onsetDateTime\": \"1998-07-12T07:22:26-04:00\",\n \"recordedDate\": \"1998-07-12T07:22:26-04:00\"\n}"}],"_postman_id":"bbb3e52d-851b-41a8-8ff9-b81618ffc3b7"}],"id":"c9f3ab92-ae2c-430a-b3be-3d3b9d743b64","description":"This resource conforms to USCDI profile for 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\n\n\n\n| USCore Data Element | \nFHIR Resource Data | \n
\n\n\n\n| status | \nCondition.status | \n
\n\n| category | \nCondition.category (like health concerns, problems, and encounter diagnoses). | \n
\n\n| code | \nCondition.code (ICD-10-CM/Snomed) | \n
\n\n| patient | \nCondition.subject | \n
\n\n
\n
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Activities:
- Respiratory therapy
- Respiratory therapy
Care plan is meant to treat Acute bronchitis (disorder).
\"\n },\n \"status\": \"completed\",\n \"intent\": \"order\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/core/CodeSystem/careplan-category\",\n \"code\": \"assess-plan\"\n }\n ]\n },\n {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"53950000\",\n \"display\": \"Respiratory therapy\"\n }\n ],\n \"text\": \"Respiratory therapy\"\n }\n ],\n \"subject\": {\n \"reference\": \"urn:uuid:8a7c11ff-25f0-433e-882a-4f43b8fb7dc4\"\n },\n \"encounter\": {\n \"reference\": \"urn:uuid:e6a86d92-701c-42a7-a20a-ed6f2f8bcb4a\"\n },\n \"period\": {\n \"start\": \"2019-12-06T20:42:43-05:00\",\n \"end\": \"2019-12-20T20:42:43-05:00\"\n },\n \"careTeam\": [\n {\n \"reference\": \"urn:uuid:ea79f97d-3094-4f73-b348-d3ef216bf821\"\n }\n ],\n \"addresses\": [\n {\n \"reference\": \"urn:uuid:c7092770-8884-404a-b4ac-148612d2344b\"\n }\n ],\n \"activity\": [\n {\n \"detail\": {\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"304510005\",\n \"display\": \"Recommendation to avoid exercise\"\n }\n ],\n \"text\": \"Recommendation to avoid exercise\"\n },\n \"status\": \"completed\",\n \"location\": {\n \"reference\": \"urn:uuid:c65f7206-4c2f-4fb3-ab69-8e1181493164\",\n \"display\": \"HALLMARK HEALTH SYSTEM\"\n }\n }\n },\n {\n \"detail\": {\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"371605008\",\n \"display\": \"Deep breathing and coughing exercises\"\n }\n ],\n \"text\": \"Deep breathing and coughing exercises\"\n },\n \"status\": \"completed\",\n \"location\": {\n \"reference\": \"urn:uuid:c65f7206-4c2f-4fb3-ab69-8e1181493164\",\n \"display\": \"HALLMARK HEALTH SYSTEM\"\n }\n }\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"CarePlan\",\n \"id\": \"ff14b0f3-b6b2-407e-8b5c-1fb0cff1b41a\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"Care Plan for Care plan (record artifact).
Activities:
- Care plan (record artifact)
- Care plan (record artifact)
- Care plan (record artifact)
Care plan is meant to treat Drug overdose.
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- Respiratory therapy
Care plan is meant to treat Acute bronchitis (disorder).
\"\n },\n \"status\": \"completed\",\n \"intent\": \"order\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/core/CodeSystem/careplan-category\",\n \"code\": \"assess-plan\"\n }\n ]\n },\n {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"53950000\",\n \"display\": \"Respiratory therapy\"\n }\n ],\n \"text\": \"Respiratory therapy\"\n }\n ],\n \"subject\": {\n \"reference\": \"urn:uuid:8a7c11ff-25f0-433e-882a-4f43b8fb7dc4\"\n },\n \"encounter\": {\n \"reference\": \"urn:uuid:e6a86d92-701c-42a7-a20a-ed6f2f8bcb4a\"\n },\n \"period\": {\n \"start\": \"2019-12-06T20:42:43-05:00\",\n \"end\": \"2019-12-20T20:42:43-05:00\"\n },\n \"careTeam\": [\n {\n \"reference\": \"urn:uuid:ea79f97d-3094-4f73-b348-d3ef216bf821\"\n }\n ],\n \"addresses\": [\n {\n \"reference\": \"urn:uuid:c7092770-8884-404a-b4ac-148612d2344b\"\n }\n ],\n \"activity\": [\n {\n \"detail\": {\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"304510005\",\n \"display\": \"Recommendation to avoid exercise\"\n }\n ],\n \"text\": \"Recommendation to avoid exercise\"\n },\n \"status\": \"completed\",\n \"location\": {\n \"reference\": \"urn:uuid:c65f7206-4c2f-4fb3-ab69-8e1181493164\",\n \"display\": \"HALLMARK HEALTH SYSTEM\"\n }\n }\n },\n {\n \"detail\": {\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"371605008\",\n \"display\": \"Deep breathing and coughing exercises\"\n }\n ],\n \"text\": \"Deep breathing and coughing exercises\"\n },\n \"status\": \"completed\",\n \"location\": {\n \"reference\": \"urn:uuid:c65f7206-4c2f-4fb3-ab69-8e1181493164\",\n \"display\": \"HALLMARK HEALTH SYSTEM\"\n }\n }\n }\n ]\n}"}],"_postman_id":"4b4cf70c-c635-48f8-9d7b-4be7b568267c"}],"id":"fe3438c9-f8f2-469d-b399-4e0365bea01d","description":"This resource conforms to USCDI profile for CarePlan - refer to US Core CarePlan Profile. CarePlan response can be requested in JSON or XML format as per FHIR standard R4 version CarePlan - FHIR v4.0.1 (hl7.org) supports the data elements documented as Assessment and Plan of Treatment.
\n\n\n\n| USCore Data Element | \nFHIR Resource Data | \n
\n\n\n\n| narrative summary | \nCarePlan.text | \n
\n\n| status | \nCarePlan.status (like draft | \n
\n\n| intent | \nCarePlan.intent (like proposal | \n
\n\n| category | \nCarePlan.category | \n
\n\n| patient | \nCarePlan.subject | \n
\n\n
\n
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\n\n\n\n| USCore Data Element | \nFHIR Resource Data | \n
\n\n\n\n| patient | \nCareTeam.subject | \n
\n\n| participant role | \nCareTeam.participant[i].role (where i is the index of participant) | \n
\n\n| careteam member name | \nCareTeam.participant[i].member.name (where i is the index of participant) | \n
\n\n| careteam member identifier | \nCareTeam.participant[i].member.identifier | \n
\n\n| careteam member location | \nCareTeam.managingOrganization | \n
\n\n| careteam member telecom | \nCareTeam.telecom | \n
\n\n
\n
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Device response can be requested in JSON or XML format as per FHIR standard R4 version Device - FHIR v4.0.1 (hl7.org) supports the following data elements documented as Unique Device Identifier(s) for Patient's Implantable Device(s).
\n\n\n\n| USCore Data Element | \nFHIR Resource Data | \n
\n\n\n\n| code | \nDevice.type | \n
\n\n| patient | \nDevice.patient | \n
\n\n| UDI (optional) | \nDevice.udiCarrier.deviceIdentifier | \n
\n\n| manufacture date(optional) | \nDevice.manufactureDate | \n
\n\n| expiration date (optional) | \nDevice.expirationDate | \n
\n\n| lot number (optional) | \nDevice.lotNumber | \n
\n\n| serial number (optional) | \nDevice.serialNumber | \n
\n\n
\n
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\n\n| patient | \nDiagnosticReport.subject | \n
\n\n| time | \nDiagnosticReport.issued | \n
\n\n| reported time | \nDiagnosticReport.effective | \n
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\n\n| document category | \ndocumentReference.category | \n
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\n\n| MIME type | \ndocumentReference.content.Typeformat | \n
\n\n| document URL | \ndocumentReference.content.attachment | \n
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\n\n| Discharge Summary | \n18842-5 | \n
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