HL7-BULK-DATA-FHIR

HL7 Bulk Data FHIR async export ndjson population health.

Définition

FHIR Bulk Data Access key concepts : (1) Export operations : (a) $export at system level (export all FHIR data), (b) $export at Group level (export data for specific patient cohort defined as FHIR Group resource), (c) $export at Patient level (export data for single patient or list). (2) Asynchronous workflow : client issues POST $export request + receives 202 Accepted with Content-Location header pointing status endpoint, client polls status endpoint until processing complete (Status 200 + JSON response listing download URLs), client downloads ndjson files containing FHIR resources (one resource per line). (3) ndjson format : newline-delimited JSON, each line one FHIR resource, e.g., {Patient}\n{Observation}\n{Encounter}\n... efficient for streaming large datasets. (4) SMART Backend Services authorization : Bulk Data exports authorized via SMART Backend Services (JWT client assertion, no user context, system-to-system). (5) Resource type filtering : _type query parameter limits export to specific resource types (e.g., _type=Patient,Observation,Encounter). (6) _since filter for incremental exports. (7) Use cases : Population health analytics (aggregate clinical data across patients), Research datasets, Payer-to-Payer transitions (member changes plan, data follows via Bulk Data), HIE state-level public health reporting, Quality measure calculation HEDIS NQF. ONC HTI-1 Cures Act Final Rule mandates Bulk Data Access certification 2023+ ; CMS Interoperability Rule mandates payer Patient Access + Provider Directory + Payer-to-Payer Data Exchange 2025+ all FHIR Bulk Data based.

Origine

FHIR Bulk Data Access IG published 2020 par HL7 + Argonaut Project ; v2.0 published 2023 ; ONC HTI-1 Cures Act mandates 2023+.

Exemple en contexte

Population health analytics vendor requests bulk export from ACO (Accountable Care Organization) of all 50000 attributed patients: POST /Group/aco-123/$export?_type=Patient,Condition,Observation,MedicationRequest,Encounter authorized SMART Backend Services JWT, server returns 202 + Content-Location, vendor polls status until 200, vendor downloads ~50 ndjson files (one per resource type + chunked), analytics process for diabetes care gap identification.

Termes liés

• SMART on FHIR — authorization mechanism.