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Importance and Requirements

Contributing data back to Health Information Exchange (HIE) networks is a critical requirement for all our customers. This bidirectional flow of information ensures that the HIE ecosystem remains up-to-date and valuable for all participants.

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Key Points:

  1. Mandatory Requirement: Data contribution back to the HIE networks is not optional. It’s a fundamental obligation for all customers using our services.

  2. Timeframe: Data must be contributed back soon after a patient has an encounter with a provider and the data is ready to be made available. This ensures that the HIE network has timely access to the most recent patient information.

  3. Consequences of Non-Compliance: Failure to comply with the data contribution requirement may result in revocation of access to the HIE network. This could significantly impact your ability to access and utilize crucial health information.

There is an exception to contributing data back through Metriport which applies to customers that are working with facilities that are already connected to the networks and contributing data back. These would be registered as “OBO” or “On Behalf Of” facilities.

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How to Contribute Data

To facilitate the data contribution process, we provide two primary endpoints that customers can use to submit data back to the HIE networks:

  • Create Patient Consolidated

    • Use this endpoint to create or update consolidated patient records.

  • Document Upload URL

    • This endpoint is used for uploading clinical documents related to patient encounters.

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Example Resource to Contribute

Customers can upload various types of FHIR R4 resources to contribute data back to the HIE networks. Here’s an example of a Bundle providing an Encounter resource and related references:

{
  "id": "XXXXX-XXXXXX-XXXXXX-XXXXXX",
  "resourceType": "Bundle",
  "type": "collection",
  "entry": [
    {
      "resource": {
        "resourceType": "Encounter",
        "id": "XXXXX-XXXXXX-XXXXXX-XXXXXX",
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "HH",
          "display": "home health"
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "308335008",
                "display": "Patient encounter procedure"
              }
            ],
            "text": "Primary care visit"
          }
        ],
        "subject": {
          "reference": "Patient/<existing-patient-id>"
        },
        "participant": [
          {
            "individual": {
              "reference": "Practitioner/XXXXX-XXXXXX-XXXXXX-XXXXXX"
            }
          }
        ],
        "period": {
          "start": "2023-06-15T09:00:00Z",
          "end": "2023-06-15T09:30:00Z"
        },
        "reasonCode": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "185345009",
                "display": "Encounter for symptom"
              }
            ],
            "text": "Annual check-up"
          }
        ]
      }
    },
    {
      "resource": {
        "resourceType": "Practitioner",
        "id": "XXXXX-XXXXXX-XXXXXX-XXXXXX",
        "identifier": [
          {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "9941339108"
          }
        ],
        "name": [
          {
            "family": "Smith",
            "given": ["John", "A."],
            "prefix": ["Dr"]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "+1 (555) 123-4567",
            "use": "work"
          },
          {
            "system": "email",
            "value": "john.smith@example.com",
            "use": "work"
          }
        ],
        "address": [
          {
            "use": "work",
            "type": "both",
            "line": ["123 Medical Center Dr"],
            "city": "Anytown",
            "state": "CA",
            "postalCode": "12345",
            "country": "USA"
          }
        ],
        "gender": "male",
        "birthDate": "1970-03-15",
        "qualification": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0360",
                  "code": "MD",
                  "display": "Doctor of Medicine"
                }
              ]
            },
            "period": {
              "start": "1995-05-01"
            },
            "issuer": {
              "reference": "Organization/XXXXX-XXXXXX-XXXXXX-XXXXXX"
            }
          }
        ]
      }
    },
    {
      "resource": {
        "resourceType": "Organization",
        "id": "XXXXX-XXXXXX-XXXXXX-XXXXXX",
        "identifier": [
          {
            "system": "http://hl7.org/fhir/sid/us-npi",
            "value": "1234567890"
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "Example Medical Center",
        "telecom": [
          {
            "system": "phone",
            "value": "+1 (555) 987-6543",
            "use": "work"
          },
          {
            "system": "email",
            "value": "info@examplemedicalcenter.com",
            "use": "work"
          }
        ],
        "address": [
          {
            "use": "work",
            "type": "both",
            "line": ["456 Hospital Avenue"],
            "city": "Anytown",
            "state": "CA",
            "postalCode": "12345",
            "country": "USA"
          }
        ],
        "contact": [
          {
            "purpose": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/contactentity-type",
                  "code": "ADMIN",
                  "display": "Administrative"
                }
              ]
            },
            "name": {
              "use": "official",
              "family": "Johnson",
          "given": ["Sarah"],
          "prefix": ["Ms"]
            },
            "telecom": [
              {
                "system": "phone",
                "value": "+1 (555) 789-0123",
                "use": "work"
              },
              {
                "system": "email",
                "value": "sarah.johnson@examplemedicalcenter.com",
                "use": "work"
              }
            ]
          }
        ]
      }
    }
  ]
}

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Tips when Contributing

  • All Patient references must point to the Metriport patient ID the data is being upload for in this example it’s subject.reference in the Encounter resource.
  • All other references must point to a resource that’s available within the same Bundle or one that has been previously uploaded.
  • You can’t upload the same resource with the same ID twice in the same Bundle, this will result in a conflict error.
  • All resources must be valid FHIR R4 resources.
  • Ultimately, anything that would be useful and is clinically relevant to another provider should be contributed.
    • This includes, but is not limited to, diagnoses, treatments, medications, and any significant findings from the encounter.