xCaliber healthCare Data Mesh

Communication

Overview

The Communication API provides healthcare developers with a standardized interface to enhance real-time communication and collaboration within clinical workflows, facilitating seamless information exchange among healthcare professionals, patients, and systems. By integrating this API, developers can optimize care coordination, improve patient engagement, and ensure timely communication, ultimately enhancing the efficiency and effectiveness of healthcare delivery.

Use Cases

  • Care coordination between providers - Record communications like phone calls, messages to coordinate patient care activities across care team members.
  • Patient engagement - Log communications with patients like appointment reminders, test result notifications, telehealth visits.
  • Referral coordination - Track communications with specialists, ancillary providers as part of referrals.
  • Patient support - Record communications providing education, instructions, or emotional support to patients.
  • Adverse event reporting - Capture details of communications related to reporting adverse events.
  • Telehealth visits - Document virtual visit details including modality, conversations.
  • Nurse callbacks - Record details of nurses following up with patients after discharge

EHR Data Model

EHRSupported?Mapped Source Object
AthenaChart Alerts, Secure Messages
ElationMessage Thread, Thread Member, Message Thread
EpicN/A

Object Definition

{
  "resourceType": "Communication",
  "id": "example",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Patient has very high serum potassium</div>"
  },
  "identifier": [
    {
      "type": {
        "text": "Paging System"
      },
      "system": "urn:oid:1.3.4.5.6.7",
      "value": "2345678901"
    }
  ],
  "instantiatesUri": [
    "http://example.org/hyperkalemia"
  ],
  "partOf": [
    {
      "display": "Serum Potassium Observation"
    }
  ],
  "status": "completed",
  "category": [
    {
      "coding": [
        {
          "system": "http://acme.org/messagetypes",
          "code": "Alert"
        }
      ],
      "text": "Alert"
    }
  ],
  "medium": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationMode",
          "code": "WRITTEN",
          "display": "written"
        }
      ],
      "text": "written"
    }
  ],
  "subject": {
    "reference": "Patient/example"
  },
  "encounter": {
    "reference": "Encounter/example"
  },
  "sent": "2014-12-12T18:01:10-08:00",
  "received": "2014-12-12T18:01:11-08:00",
  "recipient": [
    {
      "reference": "Practitioner/example"
    }
  ],
  "sender": {
    "reference": "Device/f001"
  },
  "payload": [
    {
      "contentString": "Patient 1 has a very high serum potassium value (7.2 mmol/L on 2014-Dec-12 at 5:55 pm)"
    },
    {
      "contentReference": {
        "display": "Serum Potassium Observation"
      }
    }
  ],
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}

Data Fields

Data FieldTypeDescription
resourceTypeCommunicationThis is a Communication resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
implicitRulesuriA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
languagecodeThe base language in which the resource is written.
textNarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
containedBackboneElementThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
extensionExtensionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
modifierExtensionExtensionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
identifierIdentifierBusiness identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
instantiatesCanonicalcanonicalThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
instantiatesUriuriThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
basedOnReferenceAn order, proposal or plan fulfilled in whole or in part by this Communication.
partOfReferencePart of this action.
inResponseToReferencePrior communication that this communication is in response to.
statuscodeThe status of the transmission.
statusReasonCodeableConceptCaptures the reason for the current state of the Communication.
categoryCodeableConceptThe type of message conveyed such as alert, notification, reminder, instruction, etc.
prioritycodeCharacterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.
mediumCodeableConceptA channel that was used for this communication (e.g. email, fax).
subjectReferenceThe patient or group that was the focus of this communication.
topicCodeableConceptDescription of the purpose/content, similar to a subject line in an email.
aboutReferenceOther resources that pertain to this communication and to which this communication should be associated.
encounterReferenceThe Encounter during which this Communication was created or to which the creation of this record is tightly associated.
sentdateTimeThe time when this communication was sent.
receiveddateTimeThe time when this communication arrived at the destination.
recipientReferenceThe entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).
senderReferenceThe entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.
reasonCodeCodeableConceptThe reason or justification for the communication.
reasonReferenceReferenceIndicates another resource whose existence justifies this communication.
payloadBackboneElementText, attachment(s), or resource(s) that was communicated to the recipient.
payload.idstringUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
payload.extensionExtensionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
payload.modifierExtensionExtensionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
payload.contentStringstringA communicated content (or for multi-part communications, one portion of the communication).
payload.contentAttachmentAttachmentA communicated content (or for multi-part communications, one portion of the communication).
payload.contentReferenceReferenceA communicated content (or for multi-part communications, one portion of the communication).
noteAnnotationAdditional notes or commentary about the communication by the sender, receiver or other interested parties.

Extensions

NameURL

Operations & APIs

Communication-GET

Communication-POST

Communication ID-GET

Communication ID-PUT

Communication ID-DELETE