EligibilityRequest real time flow

1

Hello,

I’d like to ask a question about what the workflow would be for a real time eligibility request functionality.

My understanding of the current flow is

  1. POST /EligibilityRequest - create EligibilityRequest resource and get back identifier
  2. GET /EligibilityResponse?request= - search for the EligibilityResponse that corresponds to the request

This flow works but is more tailored towards an asynchronous flow. In a synchronous, “real time” flow, I would like to submit an EligibilityRequest and directly get back an EligibilityResponse. Would the best practice way of doing this be to define a custom Operation?

Thanks in advance!

2

Yes. If you want to do an HTTP POST and get back the response directly, you’d need to use either a custom operation or a message (and operations would have lower overhead).

3

Thanks Lloyd. Perhaps this can be standardized in the future with an “official” operation, since submitting real time eligibility requests is a common workflow.

4

That’s certainly a possibility. Feel free to submit a “change proposal” (link at the bottom of each page in the spec) to suggest the inclusion of such an operation in FHIR R4.

5

Same type of operation would be useful for appointment as well…

6

Or you could simply use a conventional HTTP request-response exchange with the resource in the body. We intentionally haven’t documented within FHIR communication/exchange protocols (MLLP, WSI web services, ebxml, etc.) which are defined or adequately documented elsewhere.

7

I thought about that as well, but then would it be possible to describe that interaction in the CapabilityStatement?

8

Here is the snippet from my CapabilityStatement:

  <messaging>
    <endpoint>
      <protocol>
        <system value="http://hl7.org/fhir/message-transport" />
        <code value="http" />
      </protocol>
      <address value="http://www.pknapp.com/con14" />
    </endpoint>
    <reliableCache value="10000000000" />
    <documentation value="REST POST Request-Response." />
    <event>
      <code>
        <system value="http://hl7.org/fhir/message-events" />
        <code value="eligibility-check" />
      </code>
      <category value="consequence" />
      <mode value="receiver" />
      <focus value="EligibilityRequest" />
      <request>
        <reference value="http://hl7.org/fhir/StructureDefinition/EligibilityRequest" />
      </request>
      <response>
        <reference value="http://hl7.org/fhir/StructureDefinition/EligibilityResponse" />
      </response>
      <documentation value="Determine the Eligibility under a provided Coverage." />
    </event>
  </messaging>