Example Usage Scenarios:

The following are example usage scenarios for this profile:

• Query for a patient's work history
• Record or update past or present jobs belonging to a patient

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Observation Must Have:

1. a status
2. a code for job history
3. a patient
4. the job code or text

Each Observation Must Support:

1. a category code of "social-history"
2. when the job occurred
3. a code for the job history industry
4. the industry code or text

Profile Specific Implementation Guidance:

• Additional codes that translate or map to the Observation code or category codes are allowed. For example:
  • providing both a local code and a LOINC code
  • providing a more specific code, a SNOMED CT concept, or a system-specific code
• For the current job, omit observation.effectivePeriod.end to indicate it is ongoing.
• When the industry is known, but the occupation is not, use the value "unknown" from the DataAbsentReason Code System. However, when the occupation is known but the industry is not, omit the industry Observation.component. The guide provides examples for both scenarios.
• In the Quick Start section below, you can find instructions on searching for Occupations (Jobs) by patient, date, and other core search parameters. Refer to the FHIR search specification for more advanced queries using Observation.
• Refer to the Occupational Data for Health (ODH) FHIR IG to convey additional details; data elements, such as Employer; or different topics, such as Usual (Longest-Held) Work.

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the IE Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only IE Core Profiles (Profile Only Support) are not required to support these interactions. See the IE Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• See the Scopes Format section for a description of the SMART scopes syntax.
• See the Search Syntax section for a description of the IE Core search syntax.
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

IE Core Scopes

Servers providing access to social history data SHALL support these IE Core SMART Scopes:

• resource level scopes: <patient|user|system>/Observation.rs

• granular scopes: <patient|user|system>.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category|social-history

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the combination of the patient and category search parameters:

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory

   Example:

   1. GET [base]/Observation?patient=1134281&category=social-history

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = laboratory (how to search by reference and how to search by token)

2. SHALL support searching using the combination of the patient and code search parameters:
   • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)

   GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Observation?patient=1134281&code=http://loinc.org|11341-5

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). SHOULD support search by multiple report codes. The Observation code parameter searches `Observation.code only. (how to search by reference and how to search by token)

3. SHALL support searching using the combination of the patient and category and date search parameters:
   • including support for these date comparators: gt,lt,ge,le
   • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Observation?patient=555580&category=social-history&date=ge2018-03-14T00:00:00Z

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = laboratory (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and category and status search parameters:
   • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/Observation?patient={Type/}[id]&category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Observation?patient=1134281&category=social-history&status=final

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category = laboratory and status (how to search by reference and how to search by token)

2. SHOULD support searching using the combination of the patient and category and _lastUpdated search parameters:
   • including support for these _lastUpdated comparators: gt,lt,ge,le
   • including optional support for AND search on _lastUpdated (e.g._lastUpdated=[date]&_lastUpdated=[date]]&...)

   GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&_lastUpdated={gt|lt|ge|le}[date]{&_lastUpdated={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Observation?patient=555580&social-history&_lastUpdated=ge2024-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and _lastUpdated. See the IE Core General Guidance page for Searching Using lastUpdated. (how to search by reference and how to search by token and how to search by date)

3. SHOULD support searching using the combination of the patient and code and date search parameters:
   • including optional support for OR search on code (e.g.code={system|}[code],{system|}[code],...)
   • including support for these date comparators: gt,lt,ge,le
   • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]Observation?patient=555580&code=http://loinc.org|11341-5&date=ge2019-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s). SHOULD support search by multiple report codes. (how to search by reference and how to search by token and how to search by date)