This specification conforms to FHIR®© R4
MedCom CareCommunication
Table of contents
Note: Clinical guidelines for application and use cases are available in both Danish and English. The remaining documentation will solely be in English.
This page presents MedCom’s CareCommunication standard (Danish: Korrespondancemeddelelse). In time, this standard will replace the existing standards DIS91 and XDIS91. The purpose of the standard is to support secure digital communication between social care, the psychiatric area and the somatic sector. CareCommunication standard enable communication of personally identifiable information and is typically used for ad hoc communication. However, the CareCommunication must only be used in areas where no other MedCom standard is available, and it must not be used for cases with an acute nature.
1 Standard documentation
The standard documentation below provides the necessary content to understand the needs for CareCommunication, the role of the CareCommunication, what to implement and how to get a MedCom Certificate. The standard documentation for CareCommunication includes:
- Clinical guidelines for application
- Use cases
- Technical Specifications in terms of the relevant IG’s and clinical introduction to the content of the IG
- Governance for CareCommunication
1.1 Clinical guidelines for application
The clinical guidelines for application are the foundation for the CareCommunication standard. It describes the clinical needs for the CareCommunication, the requirements for the content of the standard and how the standard supports the business requirements. It is the primary textual part of the documentation for CareCommunication. It is important for both implementers and business specialists to understand the clinical guidelines for application to ensure that the implemented standard supports the requirements.
Below, the clinical guidelines for application can be found (the information is in Danish):
Danish: Sundhedsfaglige retningslinjer for anvendelse
Note: Clinical guidelines for application in English are in preparation. As soon as they are ready, they will be published.
1.2 Use cases
Use cases describe the different scenarios in which a standard support. For a certain real-world scenario, it describes the requirements for the content of a message. The purpose of the use cases is to ensure a coherent implementation and use of CareCommunication. The descriptions are targeted IT system vendors and the people responsible for the implementation in regions and municipalities.
Note: Use cases for CareCommunication in English, are currently in preparation. As soon as they are, ready they will be published.
1.3 Technical specification
The technical specifications for the MedCom CareCommunication is composed by profiles from two basis IG’s and from one terminology IG. Links to the IG’s are listed below:
The link below gives an overview of the included profiles, what their purpose is, and which elements the system should support. Furthermore, the structure of the standard is described and supported with examples in different degrees of technical skills.
Click here to read an introduction to the technical specifications.
1.4 Governance for CareCommunication
Governance describes the general rules which FHIR messages must obey to. The general governance for FHIR messaging can be found here, whereas governance for the use of CareCommunication can be found here.
Further, some recommendations for implementing the CareCommunication standard has been developed. The page recommends how to run a household on the send and received CareCommunications. These are not required to follow, only for recommendation and inspiration.
Click here to read an introduction to the technical specifications.
2 Test and certification
Certification of a system implies both an approved test protocol and a run trough of TouchStone test scripts. TouchStone describes an infrastructure that allows automated test and validation against the IG’s developed by MedCom.
Click here to read the general description of MedCom’s test and certification process.
Test scripts and examples are currently in preparation. As soon as they are ready, they will be published.
Sending a CareCommunication
- Test protocol in English (docx)
- TouchStone Test scripts- link will be provided soon
Receiving a CareCommunication
- Test protocol in English (docx)
- TouchStone Test scripts - link will be provided soon
3 Conversion service
In the period of transition from EDIFACT and OIOXML (DIS91/XDIS91) to FHIR (CareCommunication), a conversion service (Danish: Konverteringsløsning) will be made available by the VANS vendors. Documentation about the service and the preconditions can be found in this section. Figure 1 illustrates the flow of the communication messages when a XDIS91 is sent by the sender. The service will support conversion of a CareCommunication message including attachments, where the attachment is sent in a XBIN01.
The service concerns only conversion between OIOXML and FHIR. For this reason, messages sent in EDIFACT must be converted to OIOXML before conversion to FHIR. Conversion will only be performed when the sender and receiver doesn’t support the same standard format.
The service is intended to be available from November 2024 to April 2026. The requirements for the service are made in collaboration the national working group, it-vendors and VANS vendors.
3.1 Use cases and rules
The following document includes preconditions for the conversion, use cases describing the flow of events, rules concerning to mapping.
Use cases and rules in Danish (pdf)
3.2 Mapping of messages
The follow documents describe mapping of the communication messages and receipts. For the communication messages mapping to/from XDIS91 and XBIN01 and to/from CareCommunication is described. For the receipts mapping to/from XCTL (01, 02, 03) to/from Acknowledgement is described. Both mandatory and optional elements in the standards are included and if relevant, a comment is added.
Mapping of communication messages (XDIS91/CareCommunication) (xlsx)
Mapping of acknowledgement messages (XCTL/Acknowledgement) (xlsx)
3.3 Examples
The table below includes examples of the mapping illustrating four different flows.
| Flow | From sender to VANS | From VANS to receiver |
|---|---|---|
| 1 | XDIS91 XBIN01 |
CareCommunication |
| 2 | XCTL03 for XDIS91 XCTL03 for XBIN01 |
Acknowledgement |
| 3 | CareCommunication | XDIS91 XBIN01 |
| 4 | Acknowledgement | XCTL03 for XDIS91 XCTL03 for XBIN01 |
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Support or contact
MedCom is responsible for this page. If you have any questions regarding this page, please contact fhir@medcom.dk or write to MedCom's stream on Zulip.Version of this documentation
The version of this documentation is: Version 3.0.3. You can find the release note of the version here."FHIR® is the registered trademark of HL7 and is used with the permission of HL7. Use of the FHIR trademark does not constitute endorsement of this implementation guide by HL7, nor affirmation that this content is conformant to the various applicable standards"