DocumentReference

A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), clinical notes, scanned paper, and non-patient specific documents like policy text.

http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-documentreference.html

A Document Reference can represent many different PDFs generated in Canvas:

  • A Letter that has been faxed or printed from the patient’s chart.
  • All documents uploaded via Data Integration and linked to a Patient. This includes Lab Reports, Imaging Reports, Referral Reports, Clinical, and Administrative Documents.
  • POC Lab Command’s committed on the Patient’s chart
  • Clinical Notes representing a PDF of each locked note. This also includes superseded versions on notes.
  • Any Educational Material committed on a patient’s chart.
  • Any Invoices generated for a patient.
get
/DocumentReference/{id}

DocumentReference read

Path Parameters

id required
string
The unique identifier for the DocumentReference

Response Payload Attributes

resourceType
string

The FHIR Resource name.

id
string

The identifier of the document reference.

identifier
array[json]

Other identifiers for the document.

Click to view child attributes
system
string

The namespace for the identifier value.

Value Options Supported:
  • http://schemas.canvasmedical.com/fhir/document-reference-identifier
value
string

The identifier value that is unique.

status
enum [ current | superseded | entered-in-error]

The status of the document reference.

  • Letters and POC Lab Reports will always have a status of current.
  • Documents uploaded in Data Integration will have a status of current when created. If a document is removed from the patient’s chart, it will have a status of entered-in-error.
  • For Clinical Note documents, the status will be current if it is the latest PDF of the locked note. If it is an older version due to a practitioner unlocking/ammending the note, the status will be superseded. If the note is deleted on the patient’s chart, the status will be entered-in-error.
  • For Educational Material, the status will be current if the command is committed. If the command was entered-in-error in the chart, the status will also be entered-in-error.
  • For Invoices, the status will be current if it is a latest version or an adhoc invoice. The status will be entered-in-error if there was a problem generating or sending out the invoice to the patient. The status will be superseded if an automated invoice gets archived as it is older than the invoice interval defined Constance Config in Settings.
type
json

A coding for the type of document.

Click to view child attributes
coding
array[json]

Identifies where the definition of the code comes from.

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://loinc.org
code
string

The code value.

Value Options Supported:
  • codes supported in Data Integration (see link at top of page).
  • 51852-2 (Letters)
  • 34895-3 (Educational Material)
  • 94093-2 (Invoices/Itemized Bill)
display
string

The display name of the coding.

text
string

Plain text representation of the type of document.

category
array[json]

The categorization of the document.

Click to view child attributes
coding
array[json]

Identifies where the definition of the code comes from.

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://schemas.canvasmedical.com/fhir/document-reference-category
code
string

The code value.

Value Options Supported:
  • clinical-note
  • correspondence
  • educationalmaterial
  • imagingreport
  • invoicefull
  • labreport
  • patientadministrativedocument
  • referralreport
  • uncategorizedclinicaldocument
subject
json

Who/what is the subject of the document.

Click to view child attributes
reference
string

The reference string of the subject in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".

type
string

Type the reference refers to (e.g. “Patient”).

date
date

When this document reference was created.

author
array[json]

Who and/or what authored the document.

  • For letters, it is the practitioner who signed the letter determined by the practitioner dropdown in the UI when creating the letter.
  • For Lab Reports the author will be the practitioner who linked the report to the patient in Data Integration or if it the report has been reviewed, it will be the practitioner who committed a Lab Review. If the lab report that came through Health Gorilla was automtically linked to a Patient, there will be no author.
  • For POC Lab Reports, the author will be the practitioner who committed the command in the patient’s chart.
  • For Clinical and Administrative submitted through Data Integration, the author will be the practitioner who linked the doc to the patient in Data Integration.
  • For Educational Material docs, the author will be the practitioner who originated the command on the patient’s chart
  • For Invoices, the author will either be the practitioner who asked for the invoice when invoice was created adhoc or it will be Canvas Bot if the invoice was automtically generated.
  • There are no authors on Imaging Reports or Clinical Notes.
custodian
json

Organization which maintains the document.

Click to view child attributes
reference
string

The reference string of the custodian in the format of "Organization/00000000-0000-0000-0002-000000000000".

type
string

Type the reference refers to (e.g. “Organization”).

content
array[json]

Document referenced

Click to view child attributes
attachment
json

Where to access the document

Click to view child attributes
contentType
string

Mime type of the content, with charset etc.

url
string

URI where the data can be found. Please note that urls may have an AWSAccessKeyId and an Expires attribute. By default documents stored in AWS S3 will expire 10 minutes after the response payload is returned.

format
json

Format/content rules for the document

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem
code
string

The code value.

Value Options Supported:
  • urn:ihe:iti:xds:2017:mimeTypeSufficient
display
string

The display name of the coding.

Value Options Supported:
  • mimeType Sufficient
context
json

Clinical context of document.

  • For clinical note documents, the context will contain information about the encounter associated with the note if applicable.
  • For POC Lab Reports or Educational Material documents, the context will contain information about the encounter of the note the commands were committed with if applicable.
  • For Lab Reports that have a Lab Review committed in a note, the context will have information about any encounter associated with that note.
Click to view child attributes
encounter
array[json]

Context of the document content

Click to view child attributes
reference
string

The reference string of the encounter in the format of "Encounter/879b35fd-3bc2-4ccd-98d7-954dd9b6d0a9".

type
string

Type the reference refers to (e.g. “Encounter”).

period
json

Time of service that is being documented

Click to view child attributes
start
datetime

Starting time with inclusive boundary of the encounter

end
datetime

End time with inclusive boundary, if not ongoing of the encounter

Responses

200 OK
Request was successful.

Errors

401 Unauthorized
The request requires user authentication.
403 Forbidden
The request requires user authorization.
404 Not Found
The requested resource was not found.

Query Parameters

_id
string

A Canvas-issued unique identifier

category
string

Categorization of document. Filters by the code and/or system under category.coding attribute. You can search by just the code value or you can search by the system and code in the format system|code (e.g http://schemas.canvasmedical.com/fhir/document-reference-category|labreport).

date
date

Filter by the date the document was created. See Date Filtering for more information.

patient
string

The patient reference associated to the document in the format Patient/a39cafb9d1b445be95a2e2548e12a787.

status
string

The status of the document reference

Search Values Supported:
  • current
  • superseded
  • entered-in-error
subject
string

The patient reference associated to the document in the format Patient/a39cafb9d1b445be95a2e2548e12a787. Can be used interchangeably with the patient parameter.

type
string

Kind of document (LOINC if possible). Filters by the code and/or system under type.coding attribute. You can search by just the code value or you can search by the system and code in the format system|code (e.g http://loinc.org|11502-2).

Response Payload Attributes

resourceType
string

The FHIR Resource name.

type
string

This element and value designate that the bundle is a search response. Search result bundles will always have the Bundle.type of searchset .

total
integer

The number of resources that match the search parameter.

link
array[json]

Attributes relevant to pagination, see our Pagination page for more detail.

Click to view child attributes
relation
enum [self|first|next|last]

The relation of the page search

url

The search url for the specific relation

entry
array[json]

The results bundle that lists out each object returned in the search

Click to view child attributes
resource
json

The attributes specific to the resource type, see the Attributes section below

Attributes

resourceType
string

The FHIR Resource name.

id
string

The identifier of the document reference.

identifier
array[json]

Other identifiers for the document.

Click to view child attributes
system
string

The namespace for the identifier value.

Value Options Supported:
  • http://schemas.canvasmedical.com/fhir/document-reference-identifier
value
string

The identifier value that is unique.

status
enum [ current | superseded | entered-in-error]

The status of the document reference.

  • Letters and POC Lab Reports will always have a status of current.
  • Documents uploaded in Data Integration will have a status of current when created. If a document is removed from the patient’s chart, it will have a status of entered-in-error.
  • For Clinical Note documents, the status will be current if it is the latest PDF of the locked note. If it is an older version due to a practitioner unlocking/ammending the note, the status will be superseded. If the note is deleted on the patient’s chart, the status will be entered-in-error.
  • For Educational Material, the status will be current if the command is committed. If the command was entered-in-error in the chart, the status will also be entered-in-error.
  • For Invoices, the status will be current if it is a latest version or an adhoc invoice. The status will be entered-in-error if there was a problem generating or sending out the invoice to the patient. The status will be superseded if an automated invoice gets archived as it is older than the invoice interval defined Constance Config in Settings.
type
json

A coding for the type of document.

Click to view child attributes
coding
array[json]

Identifies where the definition of the code comes from.

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://loinc.org
code
string

The code value.

Value Options Supported:
  • codes supported in Data Integration (see link at top of page).
  • 51852-2 (Letters)
  • 34895-3 (Educational Material)
  • 94093-2 (Invoices/Itemized Bill)
display
string

The display name of the coding.

text
string

Plain text representation of the type of document.

category
array[json]

The categorization of the document.

Click to view child attributes
coding
array[json]

Identifies where the definition of the code comes from.

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://schemas.canvasmedical.com/fhir/document-reference-category
code
string

The code value.

Value Options Supported:
  • clinical-note
  • correspondence
  • educationalmaterial
  • imagingreport
  • invoicefull
  • labreport
  • patientadministrativedocument
  • referralreport
  • uncategorizedclinicaldocument
subject
json

Who/what is the subject of the document.

Click to view child attributes
reference
string

The reference string of the subject in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".

type
string

Type the reference refers to (e.g. “Patient”).

date
date

When this document reference was created.

author
array[json]

Who and/or what authored the document.

  • For letters, it is the practitioner who signed the letter determined by the practitioner dropdown in the UI when creating the letter.
  • For Lab Reports the author will be the practitioner who linked the report to the patient in Data Integration or if it the report has been reviewed, it will be the practitioner who committed a Lab Review. If the lab report that came through Health Gorilla was automtically linked to a Patient, there will be no author.
  • For POC Lab Reports, the author will be the practitioner who committed the command in the patient’s chart.
  • For Clinical and Administrative submitted through Data Integration, the author will be the practitioner who linked the doc to the patient in Data Integration.
  • For Educational Material docs, the author will be the practitioner who originated the command on the patient’s chart
  • For Invoices, the author will either be the practitioner who asked for the invoice when invoice was created adhoc or it will be Canvas Bot if the invoice was automtically generated.
  • There are no authors on Imaging Reports or Clinical Notes.
custodian
json

Organization which maintains the document.

Click to view child attributes
reference
string

The reference string of the custodian in the format of "Organization/00000000-0000-0000-0002-000000000000".

type
string

Type the reference refers to (e.g. “Organization”).

content
array[json]

Document referenced

Click to view child attributes
attachment
json

Where to access the document

Click to view child attributes
contentType
string

Mime type of the content, with charset etc.

url
string

URI where the data can be found. Please note that urls may have an AWSAccessKeyId and an Expires attribute. By default documents stored in AWS S3 will expire 10 minutes after the response payload is returned.

format
json

Format/content rules for the document

Click to view child attributes
system
string

The system url of the coding.

Value Options Supported:
  • http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem
code
string

The code value.

Value Options Supported:
  • urn:ihe:iti:xds:2017:mimeTypeSufficient
display
string

The display name of the coding.

Value Options Supported:
  • mimeType Sufficient
context
json

Clinical context of document.

  • For clinical note documents, the context will contain information about the encounter associated with the note if applicable.
  • For POC Lab Reports or Educational Material documents, the context will contain information about the encounter of the note the commands were committed with if applicable.
  • For Lab Reports that have a Lab Review committed in a note, the context will have information about any encounter associated with that note.
Click to view child attributes
encounter
array[json]

Context of the document content

Click to view child attributes
reference
string

The reference string of the encounter in the format of "Encounter/879b35fd-3bc2-4ccd-98d7-954dd9b6d0a9".

type
string

Type the reference refers to (e.g. “Encounter”).

period
json

Time of service that is being documented

Click to view child attributes
start
datetime

Starting time with inclusive boundary of the encounter

end
datetime

End time with inclusive boundary, if not ongoing of the encounter

Responses

200 OK
Request was successful.

Errors

400 Bad Request
The request was invalid or cannot be otherwise served. An accompanying error message will explain further.
401 Unauthorized
The request requires user authentication.
403 Forbidden
The request requires user authorization.
  • curl --request GET \
         --url 'https://fumage-example.canvasmedical.com/DocumentReference/<id>' \
         --header 'Authorization: Bearer <token>' \
         --header 'accept: application/json'
    
  • import requests
    
    url = "https://fumage-example.canvasmedical.com/DocumentReference/<id>"
    
    headers = {
        "accept": "application/json",
        "Authorization": "Bearer <token>"
    }
    
    response = requests.get(url, headers=headers)
    
    print(response.text)
    
  • {
        "resourceType": "DocumentReference",
        "id": "6f60ed1c-a6b3-4791-99f0-f618704e33d1",
        "status": "current",
        "type": {
            "coding": [
                {
                    "system": "http://loinc.org",
                    "code": "94093-2",
                    "display": "Itemized bill"
                }
            ]
        },
        "category": [
            {
                "coding": [
                    {
                        "system": "http://schemas.canvasmedical.com/fhir/document-reference-category",
                        "code": "invoicefull"
                    }
                ]
            }
        ],
        "subject": {
            "reference": "Patient/f3d750f5d77d403c96baef6a6055c6e7",
            "type": "Patient"
        },
        "date": "2021-10-27T00:00:00+00:00",
        "author": [
            {
                "reference": "Practitioner/4150cd20de8a470aa570a852859ac87e",
                "type": "Practitioner"
            }
        ],
        "custodian": {
            "reference": "Organization/00000000-0000-0000-0002-000000000000",
            "type": "Organization"
        },
        "content": [
            {
                "attachment": {
                    "contentType": "application/pdf",
                    "url": "https://canvas-client-media.s3.amazonaws.com/training/invoices/f3d750f5d77d403c96baef6a6055c6e7_20211027_193132.pdf?AWSAccessKeyId=xxxx&Signature=xxxx&Expires=xxxx"
                },
                "format": {
                    "system": "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
                    "code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
                    "display": "mimeType Sufficient"
                }
            }
        ]
    }
    
  • {
      "resourceType": "OperationOutcome",
      "issue": [
        {
          "severity": "error",
          "code": "unknown",
          "details": {
            "text": "Authentication failed"
          }
        }
      ]
    }
    
  • {
      "resourceType": "OperationOutcome",
      "issue": [
        {
          "severity": "error",
          "code": "forbidden",
          "details": {
            "text": "Authorization failed"
          }
        }
      ]
    }
    
  • {
      "resourceType": "OperationOutcome",
      "issue": [
        {
          "severity": "error",
          "code": "not-found",
          "details": {
            "text": "Unknown DocumentReference resource '9b814d81-fb56-456b-a46d-c67fdaaec2ac'"
          }
        }
      ]
    }
    
  • curl --request GET \
         --url 'https://fumage-example.canvasmedical.com/DocumentReference?subject=Patient/cfd91cd3bd9046db81199aa8ee4afd7f&status=current&type=http://loinc.org|11502-2' \
         --header 'Authorization: Bearer <token>' \
         --header 'accept: application/json'
    
  • import requests
    
    url = "https://fumage-example.canvasmedical.com/DocumentReference?subject=Patient/cfd91cd3bd9046db81199aa8ee4afd7f&status=current&type=http://loinc.org|11502-2"
    
    headers = {
        "accept": "application/json",
        "Authorization": "Bearer <token>"
    }
    
    response = requests.get(url, headers=headers)
    
    print(response.text)
    
  • {
        "resourceType": "Bundle",
        "type": "searchset",
        "total": 12,
        "link": [
            {
                "relation": "self",
                "url": "/DocumentReference?patient=Patient/c0df2c04a0e64b46ba7fe3f836068e49&_count=50&_offset=0"
            },
            {
                "relation": "first",
                "url": "/DocumentReference?patient=Patient/c0df2c04a0e64b46ba7fe3f836068e49&_count=50&_offset=0"
            },
            {
                "relation": "last",
                "url": "/DocumentReference?patient=Patient/c0df2c04a0e64b46ba7fe3f836068e49&_count=50&_offset=0"
            }
        ],
        "entry": [
            {
                "resource": {
                    "resourceType": "DocumentReference",
                    "id": "4b640065-ae64-4775-b5a8-8264314cf5fc",
                    "status": "current",
                    "type": {
                        "coding": [
                            {
                                "system": "http://loinc.org",
                                "code": "94093-2",
                                "display": "Itemized bill"
                            }
                        ],
                        "text": "Itemized bill"
                    },
                    "category": [
                        {
                            "coding": [
                                {
                                    "system": "http://schemas.canvasmedical.com/fhir/document-reference-category",
                                    "code": "invoicefull"
                                }
                            ]
                        }
                    ],
                    "subject": {
                        "reference": "Patient/c0df2c04a0e64b46ba7fe3f836068e49",
                        "type": "Patient"
                    },
                    "date": "2024-02-24T00:00:00+00:00",
                    "author": [
                        {
                            "reference": "Practitioner/5eede137ecfe4124b8b773040e33be14",
                            "type": "Practitioner"
                        }
                    ],
                    "custodian": {
                        "reference": "Organization/00000000-0000-0000-0002-000000000000",
                        "type": "Organization"
                    },
                    "content": [
                        {
                            "attachment": {
                                "contentType": "application/pdf",
                                "url": "https://canvas-client-media.s3.amazonaws.com/training/invoices/c0df2c04a0e64b46ba7fe3f836068e49_20240224_124702.pdf?AWSAccessKeyId=AKIAQB7SIDR7EI2V32FZ&Signature=WtfvJWbBgc50VgekeqrUDTPsyHk%3D&Expires=1709072108"
                            },
                            "format": {
                                "system": "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
                                "code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
                                "display": "mimeType Sufficient"
                            }
                        }
                    ]
                }
            },
            {
                "resource": {
                    "resourceType": "DocumentReference",
                    "id": "5a0cf7ae-bd88-4f04-bd7e-60a33e5e2824",
                    "status": "current",
                    "type": {
                        "coding": [
                            {
                                "system": "http://loinc.org",
                                "code": "11502-2",
                                "display": "Laboratory report"
                            }
                        ],
                        "text": "Laboratory report"
                    },
                    "category": [
                        {
                            "coding": [
                                {
                                    "system": "http://schemas.canvasmedical.com/fhir/document-reference-category",
                                    "code": "labreport"
                                }
                            ]
                        }
                    ],
                    "subject": {
                        "reference": "Patient/c0df2c04a0e64b46ba7fe3f836068e49",
                        "type": "Patient"
                    },
                    "date": "2024-02-22T00:00:00+00:00",
                    "author": [
                        {
                            "reference": "Practitioner/4150cd20de8a470aa570a852859ac87e",
                            "type": "Practitioner"
                        }
                    ],
                    "custodian": {
                        "reference": "Organization/00000000-0000-0000-0002-000000000000",
                        "type": "Organization"
                    },
                    "content": [
                        {
                            "attachment": {
                                "contentType": "application/pdf",
                                "url": "https://canvas-client-media.s3.amazonaws.com/training/dummy_BLseNPP.pdf?AWSAccessKeyId=AKIAQB7SIDR7EI2V32FZ&Signature=uBuEZpbxcCg4w9hZ6hAXLJxMGe8%3D&Expires=1709072108"
                            },
                            "format": {
                                "system": "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
                                "code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
                                "display": "mimeType Sufficient"
                            }
                        }
                    ],
                    "context": {
                        "encounter": [
                            {
                                "reference": "Encounter/879b35fd-3bc2-4ccd-98d7-954dd9b6d0a9",
                                "type": "Encounter"
                            }
                        ],
                        "period": {
                            "start": "2024-02-22T23:10:12.409838+00:00"
                        }
                    }
                }
            },
            {
                "resource": {
                    "resourceType": "DocumentReference",
                    "id": "b9f82cd0-6644-4b3f-a9d1-7585c3e71498",
                    "status": "entered-in-error",
                    "type": {
                        "coding": [
                            {
                                "system": "http://loinc.org",
                                "code": "18748-4",
                                "display": "Diagnostic imaging study"
                            }
                        ],
                        "text": "Diagnostic imaging study"
                    },
                    "category": [
                        {
                            "coding": [
                                {
                                    "system": "http://schemas.canvasmedical.com/fhir/document-reference-category",
                                    "code": "imagingreport"
                                }
                            ]
                        }
                    ],
                    "subject": {
                        "reference": "Patient/c0df2c04a0e64b46ba7fe3f836068e49",
                        "type": "Patient"
                    },
                    "date": "2024-02-21T00:00:00+00:00",
                    "custodian": {
                        "reference": "Organization/00000000-0000-0000-0002-000000000000",
                        "type": "Organization"
                    },
                    "content": [
                        {
                            "attachment": {
                                "contentType": "application/pdf",
                                "url": "https://canvas-client-media.s3.amazonaws.com/training/document_annotations/blob_FeMcbYv?AWSAccessKeyId=AKIAQB7SIDR7EI2V32FZ&Signature=7V8KwSeZlPCCJiiarAHK55IW4pI%3D&Expires=1709072108"
                            },
                            "format": {
                                "system": "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
                                "code": "urn:ihe:iti:xds:2017:mimeTypeSufficient",
                                "display": "mimeType Sufficient"
                            }
                        }
                    ]
                }
            }
            {
                "resource": {
                    "resourceType": "DocumentReference",
                    "id": "51a49fef-eb67-4b8d-a992-b3dd9e754dea",
                    "status": "current",
                    "type": {
                        "coding": [
                            {
                                "system": "http://loinc.org",
                                "code": "51852-2",
                                "display": "Letter"
                            }
                        ],
                        "text": "Letter"
                    },
                    "category": [
                        {
                            "coding": [
                                {
                                    "system": "http://schemas.canvasmedical.com/fhir/document-reference-category",
                                    "code": "correspondence"
                                }
                            ]
                        }
                    ],
                    "subject": {
                        "reference": "Patient/c0df2c04a0e64b46ba7fe3f836068e49",
                        "type": "Patient"
                    },
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