Transitions of Care Legacy API
Transitions of Care addresses the level of care that is appropriate when a patient is transitioned from an acute care setting. It includes an algorithm that optimizes post-acute care uses and mitigates readmission risk, which maximizes value to clinical staff.
Retrieve Transitions of Care Information
Example Request
require 'httparty'
HTTParty.post(
'https://cernerdemo.programs.healtheintent.com/api/populations/0a9cc467-094c-403a-84d0-35604e1e418c/toc',
headers: { 'Content-Type' => 'application/json', 'Authorization' => 'Auth Header' },
body: {empi_ids: ['0655eafe-a71e-3b55-8258-2a51f43b14fc', '00e4fd48-efe7-301c-89bb-5f6d77312373']}.to_json
)
curl -H 'Authorization: <auth_header>' -H 'Content-Type: application/json' -X POST -d '{"empi_ids":["0655eafe-a71e-3b55-8258-2a51f43b14fc","00e4fd48-efe7-301c-89bb-5f6d77312373"]}' https://cernerdemo.programs.healtheintent.com/api/populations/0a9cc467-094c-403a-84d0-35604e1e418c/toc
Example Response
{
"toc":[
{
"person_id": "97555771",
"encounter_id": "38353077",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"empi_id":"emp-id-1",
"recommended_toc_location":"Home w/Home Health",
"readmission_risk_reduction":"",
"supporting_facts":[
{
"name":"antibiotics",
"type":"medications",
"value":"yes"
}
{
"name":"intravenous_medication",
"type":"medications",
"value":"yes"
},
{
"name":"snf_admit_source",
"type":"utility",
"value":"no"
},
{
"name":"toileting_ability_current",
"type":"discharge_metrics",
"value":"INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL"
},
{
"name":"toileting_ability_previous",
"type":"discharge_metrics",
"value":"INTERPRETATION_OF_ABILITY_ASSISTED_QUAL"
},
{
"name":"walking_ability_current",
"type":"discharge_metrics",
"value":"INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL"
},
{
"name":"walking_ability_previous",
"type":"discharge_metrics",
"value":"INTERPRETATION_OF_ABILITY_ASSISTED_QUAL"
}
]
}
]
}
POST https://{tenant}.programs.healtheintent.com/api/populations/{population_id}/toc
Retrieves the Transitions of Care information for one or more patients.
Path Parameters
| Parameter | Description |
|---|---|
| population_id | The Oracle Health Data Intelligence population ID. |
Request Message Body
| Name | Type | Description |
|---|---|---|
| empi_ids | array: string |
A JSON array of patient IDs in the Health Data Intelligence population. A maximum of 100 IDs can be specified in a single request. |
Responses
| Status | Type | Description |
|---|---|---|
| 200 | Transition Of Care Information | A collection of transitions of care details and supporting facts. |
| 400 | string |
Bad Request |
| 401 | string |
Unauthorized |
| 403 | string |
Forbidden |
| 404 | string |
Not Found |
Retrieve Transitions of Care Batch Information
Example Request
require 'httparty'
HTTParty.get(
'https://cernerdemo.programs.healtheintent.com/api/populations/0a9cc467-094c-403a-84d0-35604e1e418c/toc/versions/201912151105:201912151105:0?start=0&limit=25?',
headers: { 'Authorization' => '<auth_header>' },
)
```
```shell
curl -H 'Authorization: <auth_header>' -H 'Content-Type: application/json' -X GET -d https://cernerdemo.programs.healtheintent.com/api/populations/0a9cc467-094c-403a-84d0-35604e1e418c/toc/versions/201912151105:201912151105:0?start=0&limit=25?
```
> Example Response
```json
{
"transitions_of_care": [
{
"empi_id": "f72878aa-5f47-3bcb-a72a-3a934567947b",
"version_id": "201912151105:201912151105:f72878aa-5f47-3bcb-a72a-3a934567947b",
"person_id": "97555771",
"encounter_id": "38353077",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Long-term Acute Care",
"readmission_risk_reduction": "3",
"supporting_facts": [
{
"name": "age_in_years",
"value": "20",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "365",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "ec53ae2f-856f-322d-94d4-9a3aea5c614a",
"version_id": "201912151205:201912151205:ec53ae2f-856f-322d-94d4-9a3aea5c614a",
"person_id": "112343717",
"encounter_id": "41090387",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Home Health",
"readmission_risk_reduction": "0",
"supporting_facts": [
{
"name": "age_in_years",
"value": "22",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "1",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "f72878aa-5f47-3bcb-a72a-3a934567947b",
"version_id": "201912151205:201912151205:f72878aa-5f47-3bcb-a72a-3a934567947b",
"person_id": "97555771",
"encounter_id": "38353077",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Clinical Review",
"readmission_risk_reduction": "3",
"supporting_facts": [
{
"name": "age_in_years",
"value": "20",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "365",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "ec53ae2f-856f-322d-94d4-9a3aea5c614a",
"version_id": "201912151305:201912151305:ec53ae2f-856f-322d-94d4-9a3aea5c614a",
"person_id": "112343717",
"encounter_id": "41090387",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Rehab",
"readmission_risk_reduction": "0",
"supporting_facts": [
{
"name": "age_in_years",
"value": "22",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "1",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "4ca638fd-a92b-3ae2-946b-174f1067bcf2",
"version_id": "201912151505:201912151505:4ca638fd-a92b-3ae2-946b-174f1067bcf2",
"person_id": "126072762",
"encounter_id": "41089744",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "0",
"supporting_facts": [
{
"name": "age_in_years",
"value": "18",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "2",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "58600802-f381-3aa9-88c3-e056a60e4dc2",
"version_id": "201912151505:201912151505:58600802-f381-3aa9-88c3-e056a60e4dc2",
"person_id": "126073639",
"encounter_id": "41090411",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "0",
"supporting_facts": [
{
"name": "age_in_years",
"value": "28",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "1",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
},
{
"name": "temperature",
"value": "4.5",
"type": "vitals"
}
]
},
{
"empi_id": "9fd91580-bf07-3c62-aac1-14a5f83756bf",
"version_id": "201912151905:201912151905:9fd91580-bf07-3c62-aac1-14a5f83756bf",
"person_id": "141000134",
"encounter_id": "41119321",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "0",
"supporting_facts": [
{
"name": "age_in_years",
"value": "22",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "1",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "43f5f0e7-3b5b-3e03-8ef6-7c1d00a98e81",
"version_id": "201912160705:201912160705:43f5f0e7-3b5b-3e03-8ef6-7c1d00a98e81",
"person_id": "2161615",
"encounter_id": "34898153",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "2",
"supporting_facts": [
{
"name": "age_in_years",
"value": "67",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "216",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "a7d6a235-5b9f-3c96-a468-e91bfdf01d44",
"version_id": "201912160705:201912160705:a7d6a235-5b9f-3c96-a468-e91bfdf01d44",
"person_id": "118719579",
"encounter_id": "34661793",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "1",
"supporting_facts": [
{
"name": "age_in_years",
"value": "38",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "365",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
},
{
"empi_id": "a7d6a235-5b9f-3c96-a468-e91bfdf01d44",
"version_id": "201912160805:201912160805:a7d6a235-5b9f-3c96-a468-e91bfdf01d44",
"person_id": "118719579",
"encounter_id": "34661793",
"partition_id": "511d71b2-c065-4799-a0e4-7039086f95d3",
"recommended_toc_location": "Skilled Nursing Facility",
"readmission_risk_reduction": "1",
"supporting_facts": [
{
"name": "age_in_years",
"value": "38",
"type": "demographics"
},
{
"name": "antibiotics",
"value": "no",
"type": "medications"
},
{
"name": "length_of_stay",
"value": "365",
"type": "utility"
},
{
"name": "snf_admit_source",
"value": "no",
"type": "utility"
}
]
}
],
"total_count": 10,
"more_results": false,
"total_results": 10
}
```
`GET https://{tenant}.programs.healtheintent.com/api/populations/{population_id}/toc/versions/{version_id}`
Retrieves the list of Transition of Care information for a specific version
#### Parameters
|Parameter|In|Type|Required|Default|Description|Accepted Values|
|---|---|---|---|---|---|---|
|population_id|path|string|true|N/A|The Health Data Intelligence population ID.|-|
|version_id|path|integer|true|0:0:0|Document Version information | nominaltime:processingversion:empiId |
|start|query|integer|false|0| start version of the document|
|limit|query|integer|false|250|Number of the documents to be returned.|
#### Responses
Status | Type | Description
------ | ---- | -----------
200|[Transition Of Care Information](#transition-of-care-information)|A collection of transitions of care details and supporting facts.
400|`string`|Bad Request
401|`string`|Unauthorized
403|`string`|Forbidden
404|`string`|Not Found
Transition of Care Information
| Name | Type | Description |
|---|---|---|
| empi_id | string |
The ID of the person in the Health Data Intelligence population. |
| recommended_toc_location | string |
The location recommended for transition or discharge of the patient. |
| readmission_risk_reduction | string |
The percentage of the amount of risk changed if the patient is discharged to the recommended location. Note: This field is deprecated. |
| supporting_facts | array |
An array of the supporting facts for the transition of care information. |
TOC Supporting Fact
The supporting_facts array contains the fields below. See the TOC Supporting Facts List section for more information about the possible supporting facts.
| Name | Type | Description |
|---|---|---|
| name | string |
The name of the supporting fact. |
| value | string |
The value of the supporting fact. |
| type | string |
The type or category of the supporting fact. |
TOC Supporting Facts List
The following table provides details about each supporting fact for transitions of care:
| Name | Description | Possible Values | Example Object |
|---|---|---|---|
antibiotics |
The antibiotic medications or ingredients that were started after the start of the encounter. | yes, no |
{"name": "antibiotics","type": "medications","value": "yes"} |
intravenous_medication |
The intravenous medications that were started after the start of the encounter. | yes, no |
{"name": "intravenous_medications","type": "medications","value": "yes"} |
toileting_ability_current |
Indicates a clinical finding of toileting ability after the start of the encounter, for example, INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL or INTERPRETATION_OF_ABILITY_ASSISTED_QUAL. |
– | {"name": "toileting_ability_current","type": "discharge_metrics","value": "INTERPRETATION_OF_ABILITY_ASSISTED_QUAL "} |
toileting_ability_previous |
Indicates a clinical finding of toileting ability before the start of the encounter but in the past year, for example, INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL or INTERPRETATION_OF_ABILITY_ASSISTED_QUAL. |
– | {"name": "toileting_ability_previous","type": "discharge_metrics","value": "INTERPRETATION_OF_ABILITY_ASSISTED_QUAL "} |
walk_ability_current |
Indicates a clinical finding of walking ability after the start of the encounter, for example, INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL or INTERPRETATION_OF_ABILITY_ASSISTED_QUAL. |
– | {"name": "walk_ability_current","type": "discharge_metrics","value": "INTERPRETATION_OF_ABILITY_ASSISTED_QUAL "} |
walk_ability_previous |
Indicates a clinical finding of walking ability before the start of the encounter but in the past year, for example, INTERPRETATION_OF_ABILITY_DEPENDENT_QUAL or INTERPRETATION_OF_ABILITY_ASSISTED_QUAL. |
– | {"name": "walk_ability_previous","type": "discharge_metrics","value": "INTERPRETATION_OF_ABILITY_ASSISTED_QUAL "} |
snf_admit_source |
The qualifying encounter with an admittance source of TRANSFER_FROM_SNF. |
yes, no |
{"name": "snf_admit_source","type": "utility","value": "yes"} |