CODEWITHSUNDEEP
oauth-2.0hl7-fhirappointmentsmart-on-fhir
SaraOK
SaraOK

Reputation: 1

Epic FHIR: Missing 'Appointment' encounter class from Epic Encounter API integration

We are doing an integration using Epic's FHIR APIs. Health systems use a third-party app in the Epic Connection Hub to share data with us via FHIR APIs. They go through an implementation guide to set up a background user and enable a list of security points. We've had a number of successful integrations, but in several instances, the Encounter API is not sending us 'Appointment' classes (e.g., Encounter.class.display = "Appointment"). NOTE - We're not querying the Appointment resource, but the Encounter resource. We do get data from the Encounter API, just not all of it.

In Epic's FHIR data, we'll consistently receive encounters categorized as 'Support OP Encounter', 'HOV', 'Admission', 'Discharge', or 'Preadmission'. 'Appointment' is the encounter class for most formal outpatient care, like an Office Visit. We've received Appointments in other integrations - so it seems like a health system-specific configuration issue.

One health system resolved it, but they couldn't explain how. I believe it's related to their Cadence or Ambulatory security points or service area, but we're not sure. The current health system we're working with says they double-checked their security points and they're all enabled.

So far we've had the health systems:

We re-queried CSNs (Epic's encounter IDs) that we know are internally Appointment classes, and they were still inaccessible via FHIR.

Any ideas where the health system could re-configure? Thank you!

Upvotes: 0

Views: 232

Answers (1)

Ashavan
Ashavan

Reputation: 987

I'm skeptical that it's actually "missing" or that this was resolved in any way by that one health system.

In Epic, appointments start off with a class of Appointment at the time of scheduling, but they undergo a process called encounter conversion that changes the class to something more specific once the visit starts. What you are seeing (e.g., Support OP Encounter, HOV) is the more specific class because an Encounter resource in Epic is a visit that has started.

You will see some Encounters where the class is Appointment; these have not undergone encounter conversion but have undergone a different process called redirection, which essentially points a secondary appointment to a main visit. The "fix" at the one health system may have simply been you seeing a redirected appointment.

Upvotes: 0

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