Find a Discharge Summary

Discharge summaries, typically sourced from EMRs via CCDAs or other document types, can be queried via DiagnosticReport resources. DiagnosticReport resources can also contain other documents, such as progress notes and radiology reports, as well as labs.

Contents

Retrieving Discharge Documentation by Valueset
Retrieving Other Common Report/Note Types
Searching for Text within Reports/Notes
Real-World Data Considerations

Retrieving Discharge Documentation by Valueset

Query the DiagnosticReport resource with code:in=https://rosetta.careevolution.com/subsets/LOINC-Component/Discharge summary note [Component],https://rosetta.careevolution.com/subsets/LOINC-Component/Discharge instructions [Component]
Documents will be returned in DiagnosticReport.presentedForm as Binary resources
- Binary resources are in base64 and must be decoded.
- Binary.contentType field often lists text/plain and sometimes other formats such as text/html or application/pdf.

Tip
The default FHIR response is to contain the content itself, rather than be wrapped the content in a Binary resource. If Binary.contentType lists one of the specific FHIR mime-types, if possible that type will be returned within a Binary resource.

Retrieving Other Common Report/Note Types

The following value sets can be used to filter a DiagnosticReport query:

Type	Query parameter (`code:in=`)
Note	`https://rosetta.careevolution.com/subsets/LOINC-Component/Note [Component]`
Progress Note	`https://rosetta.careevolution.com/subsets/LOINC-Component/Progress note [Component]`
PostOp Note	`https://rosetta.careevolution.com/subsets/LOINC-Component/Postoperative evaluation and management note [Component]`
Care Plan	`https://rosetta.careevolution.com/subsets/LOINC-Component/Plan of care note [Component]`
H&P	`https://rosetta.careevolution.com/subsets/LOINC-Component/History and physical note [Component]`

Tip
Find LOINC Components for report/note types by identifying a few target codes and noting the Components which most closely meet your needs on the LOINC search site: https://search.loinc.org/searchLOINC/search.zul. For more information on how to use value sets, review the Value Set Tutorial.

Searching for Text within Reports/Notes

A $text-search operation is available to search for any text string within all notes/documents available for an individual patient/member

Query DiagnosticReport?patient-id=[Patient GUID]&query=[TEXT STRING].
Response will contain 0:N DiagnosticReport resources with content which matches the [TEXT STRING].
Search works on all document formats and uses wildcards before and after [TEXT STRING] by default.

For example, for retrieving discharge documentation, you may use: GET https://[YOUR_FHIRPROVIDER_ENDPOINT]/DiagnosticReport?patient-id=[Patient GUID]&query=discharge GET https://[YOUR_FHIRPROVIDER_ENDPOINT]/DiagnosticReport?patient-id=[Patient GUID]&query=admission GET https://[YOUR_FHIRPROVIDER_ENDPOINT]/DiagnosticReport?patient-id=[Patient GUID]&query=instructions Note that separate queries are required for each exact-match string.

Real-World Data Considerations

Since reports/documents in source data are not consistently labeled, it is recommended to query DiagnosticReport with both value sets and with free-text to retrieve widest potential selection of discharge documentation.
Continuity of Care Documents (CCDs) do not typically include a stylesheet.
HIEBus does not typically have images or other multimedia content such as X-rays or EKGs.