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Workflow Examples

You can retrieve external patient records at key points in your workflow by initiating a Patient360 retrieval. The following sequence shows how retrieval proceeds from identity matching through record ingestion, and what happens at each step in the process.Understanding this flow helps you plan when to trigger retrieval and how to incorporate the returned data into your system.

1. Initiate Retrieval

Your system initiates a $p360-retrieve operation using available patient demographics and identifiers, such as:

  • Patient name, date of birth, gender
  • Address and contact information
  • Internal patient ID or medical record number (MRN)

2. Patient Discovery

Patient360 performs patient discovery across connected networks:

  • IHE ITI-55 Patient Discovery is used for Carequality, eHealth Exchange (eHX), and TEFCA (if enabled).
  • CommonWell patient discovery and auto-enrollment occur automatically during retrieval.
  • Additional network-specific discovery occurs as applicable.

3. Identity Matching

Health Gorilla’s identity resolution engine evaluates candidate records:

  • Deterministic and probabilistic matching logic is applied.
  • If confidence is sufficient, external identities are linked internally for retrieval.
  • No manual enrollment or separate identity operations are required.

4. Document Query and Retrieval

Patient360 submits document queries to all linked endpoints:

  • IHE ITI-38 or network-specific document query transactions are used.
  • Structured FHIR data and unstructured documents are retrieved.

5. Data Normalization and Deduplication

Retrieved data undergoes several processing steps before it is included in the FHIR Bundle.

  • Clinical concepts are mapped to standard terminologies such as LOINC, SNOMED CT, RxNorm, and ICD-10.
  • Structured resources from disparate networks are deduplicated and merged to reduce redundancy and improve consistency.
  • Unstructured documents are referenced in DocumentReference resources with associated metadata.
  • Provenance and confidence metadata are added to support downstream processing and auditing.

6. Record Delivery

A unified FHIR Bundle is delivered to your system. It includes:

  • Patient, Encounter, Observation, Condition, Procedure, MedicationStatement, DocumentReference, and other relevant resources.
  • Metadata tags indicate data provenance and identity matching confidence.

The record can be used directly or further processed in your system. Delivery is typically asynchronous, with a webhook notification when results are ready. Synchronous response is available but not recommended for production use.

Example Query Patterns

  • To initiate retrieval use POST /fhir/R4/Patient/$p360-retrieve
  • To receive a Bundle (sync response or via webhook), use GET /fhir/R4/Bundle/{bundle_id}
  • To query specific resources from the Bundle, use GET /fhir/R4/Observation?patient={patient_id} or GET /fhir/R4/DocumentReference?patient={patient_id}

Summary

Patient360 automates the retrieval of external patient records:

  • Identity matching, network discovery, and record normalization occur as part of retrieval.
  • Retrieval is primarily asynchronous with webhook delivery; synchronous queries are supported but not recommended.
  • Connected networks include Carequality, CommonWell, eHealth Exchange (eHX), and TEFCA (if enabled).
  • Returned FHIR records are delivered in R4 format (preferred) or STU3 (legacy only).
  • You can trigger retrieval at any point in your workflow where external data is needed.

For best results, submit complete and accurate patient demographics with each $p360-retrieve request to improve matching success and record quality.