CDex Flow Chart

--- tags: CDEX title: CDex Flow Chart --- # CDex Flow Chart These example FlowCharts were created to assist the TestScript and Reference Implementation development team and are provided here to assist developers in implementing CDEX transactions. They are example only and actual workflows may differ from them. Individual flowcharts ( the text between the "'''") can be viewed using *flowchart.js*. flowchart.js is a flowchart DSL and SVG render that runs in the browser and terminal. For more information see https://flowchart.js.org/. Alternatively this page can be viewed on https://hackmd.io/. ## Attachments ### Client ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid oauth=>subroutine: Authentication and Authorization get_attach_data=>subroutine: Get Attachments data sign=>subroutine: Signature Needed: Bundle into provider signed Document Bundle unsolited_claim=>operation: unsolicited claim: provider assigns the tracking control number on the prior auth and submitted attachments unsolited_preauth=>operation: unsolicited pre-auth: provider assigns the tracking control number on the claim and submitted attachments solicited_claim=>operation: solicited claim: used payer assigned Claim control number solicited_preauth=>operation: solicited pre-auth: used payer assigned Claim control number get_reassoc_data=>subroutine: collect data for reassociation get_reassoc_data=>subroutine: supply other Data elements for reassociation to the Claim add_claim_param=>operation: AttachTo parameter = "claim" add_preauth_param=>operation: AttachTo parameter = "prior-authorization" invoke_operation=>subroutine: Provider invokes $submit-attachment operation to submit attachments to Payer http_200=>operation: Receive http 200 Success http_400=>operation: Receive Error response =/- OperationOutcome is_claim=>condition: Is the documentation for a Claim? is_solicited_claim=>condition: Is it in response to a request for additional information for a claim? is_solicited_preauth=>condition: Is it in response to a request for additional information by the payer? need_sig=>condition: Is a signature needed? is_signed=>condition: Is the attachment data already signed (e.g.,signed CCDA document?) post_ok=>condition: Is transaction successful? validate=>subroutine: Testscript: validation step(stub) st->get_attach_data->need_sig->is_claim is_claim(yes)->add_claim_param->is_solicited_claim(yes)->solicited_claim->get_reassoc_data->validate->oauth->invoke_operation->post_ok is_claim(no)->add_preauth_param->is_solicited_preauth(yes)->solicited_preauth->get_reassoc_data->validate->oauth->invoke_operation->post_ok is_claim(yes)->add_claim_param->is_solicited_claim(no)->unsolited_claim->get_reassoc_data->validate->oauth->invoke_operation->post_ok is_claim(no)->add_preauth_param->is_solicited_preauth(no)->unsolited_preauth->get_reassoc_data->validate->oauth->invoke_operation->post_ok need_sig(yes)->is_signed(yes)->is_claim need_sig(yes)->is_signed(no)->sign->is_claim need_sig(no,bottom)->is_claim post_ok(yes)->http_200->e post_ok(no)->http_400->bad_transaction ``` ### Server ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid request=>operation: Receive $submit-attachments http_200=>operation: Return http 200 Success http_400=>operation: Return 400+ Error response +/- OperationOutcome oauth_ok=>condition: Is client authenticated? req_ok=>condition: Is valid request? payload_ok=>condition: Is payload valid FHIR Object need_sig=>condition: Are signatures required? is_signed=>condition: Is attachment signed FHIR Document sig_ok=>condition: Is valid signature? validate=>subroutine: Testscript: validation step(stub) st->request->oauth_ok oauth_ok(yes)->req_ok oauth_ok(no)->http_400->bad_transaction req_ok(yes)->payload_ok req_ok(no)->http_400->bad_transaction payload_ok(yes)->need_sig payload_ok(no)->http_400->bad_transaction need_sig(yes)->is_signed need_sig(no,bottom)->http_200()->e is_signed(no)->sig_ok is_signed(yes,bottom)->http_200->e sig_ok(yes)->http_200->e sig_ok(no)->http_400->bad_transaction ``` ## Direct Query ### Client: ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid disc=>subroutine: Discovery of Patient FHIR_ID oauth=>subroutine: Authentication and Authorization Workflow search=>subroutine: Query for data http1=>operation: Receive http 200 Success + SearchBundle payload http2=>operation: Receive Error response =/- OperationOutcome search_ok=>condition: Query Successful? validate=>subroutine: Testscript: validation step(stub) need_sig=>condition: Are signatures required? sig_ok=>condition: Is valid signature? on SearchSet Bundle st->disc->oauth->search->search_ok search_ok(yes)->http1->validate->need_sig search_ok(no)->http2->bad_transaction need_sig(yes)->sig_ok need_sig(no,bottom)->e sig_ok(yes)->e sig_ok(no)->bad_sig ``` ### Server ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error request=>operation: Receive FHIR Query make_bundle=>subroutine: produce FHIR SearchSet Bundle sign=>subroutine: Signature Needed: organization signs SearchSet Bundle return_200=>operation: Return http 200 Success payload = Searchset Bundle return_400=>operation: Return 400+ Error response +/- OperationOutcome oauth_ok=>condition: Is client authenticated? req_ok=>condition: Is valid request? op_ok=>condition: Is operation successful? need_sig=>condition: Are signatures required? validate=>subroutine: Testscript: validation step(stub) st->request->oauth_ok oauth_ok(yes)->req_ok oauth_ok(no)->return_400->bad_transaction req_ok(yes)->make_bundle->op_ok req_ok(no)->return_400->bad_transaction op_ok(yes)->validate->need_sig op_ok(no)->return_400->bad_transaction need_sig(yes)->sign->return_200->e need_sig(no,bottom)->return_200->e ``` ## Task ### Cient ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid post=>subroutine: POST Task to Server post_ok=>condition: Is FHIR create transaction successful? Receive http 200 Success fetch_task_ok=>condition: Is FHIR read transaction successful? Receive http 200 Success fetch_data_ok=>condition: Is FHIR read transaction successful? Receive http 200 Success search_ok=>condition: Is FHIR search transaction successful? Receive http 200 Success is_polling=>condition: Client polling the Task? is_done=>condition: Is Task completed? is_notified=>condition: Subscription Notification that Task completed? is_contained=>condition: Is Task.output contained? need_sig=>condition: Is signature required? is_signed=>condition: Is attachment signed FHIR Document is_ok_sig=>condition: Is valid signature? disc=>subroutine: Discovery of Patient FHIR_ID create_task=>subroutine: Create Task resource to request Data fetch_task=>subroutine: Get completed Task from FHIR Server using FHIR read fetch_data=>subroutine: Get FHIR data referenced in Task.output using FHIR read search=>subroutine: Get Data referenced in Task.output using FHIR search validate_task1=>subroutine: Testscript: validation step(stub) validate_task2=>subroutine: Testscript: validation step(stub) validate_data=>subroutine: Testscript: validation step(stub) validate_searchset=>subroutine: Testscript: validation step(stub) validate_fhirdoc=>subroutine: Testscript: validation step(stub) poll=>subroutine: Polls Task subscribe=>subroutine: POST Subscription for Task Updates st->disc->create_task->validate_task1->post->post_ok post_ok(yes)->is_polling post_ok(no)->bad_transaction is_polling(yes)->poll->is_done is_polling(no)->subscribe->is_notified(yes)->fetch_task is_notified->fetch_task is_done(yes)->fetch_task->fetch_task_ok is_done(no)->poll fetch_task_ok(yes)->validate_task2->is_contained fetch_task_ok(no)->bad_transaction is_contained(yes)->need_sig is_contained(no,bottom)->fetch_data->fetch_data_ok fetch_data_ok(yes)->validate_data->need_sig fetch_data_ok(no)->bad_transaction need_sig(yes)->is_signed need_sig(no,bottom)->e is_signed(yes)->e is_signed(no)->bad_sig ``` #### Create Task Resource ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid in_data=>operation: Populate Task with Patient,date,owner,requester in_text=>operation: Add text to Task.input in_code=>operation: Add code to Task.input in_search=>operation: Add search string to Task.input in_sig=>operation: indicate signature required in_pou=>operation: Add POU to Task.input in_wq=>operation: Add Work Queue to Task.input in_reason=>operation: Add reason code or reference to Task.reasonCode/reasonReference is_text=>condition: Is free text request? is_code=>condition: Is coded request? is_pou=>condition: Add Purpose of Use Code? is_sig=>condition: Is Signature required? is_wq=>condition: Add Work Queue Code? is_formalauth=>condition: Is formal authorization needed? in_formalauth=>operation: Add reference to formal request resource (e.g.,CommunicationRequest or ServiceRequest) to Task.basedOn is_prov=>condition: Is Provenance needed? in_prov=>operation: Add request for provenance to request (as _include param to search string or free text) st->in_data->in_reason->is_text(yes)->in_text->is_sig is_text(no)->is_code(yes)->in_code->is_sig is_code(no)->in_search->is_sig is_sig(yes)->in_sig->is_pou is_sig(no,bottom)->is_pou is_pou(yes)->in_pou->is_wq is_pou(no,bottom)->is_wq is_wq(yes)->in_wq->is_formalauth is_wq(no,bottom)->is_formalauth is_formalauth(yes)->in_formalauth->is_prov is_formalauth(no,bottom)->is_prov is_prov(yes)->in_prov->e is_prov(no,bottom)->e ``` #### Subscription Flow ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid create_subsc=>subroutine: Create Subscription resource to notify When Task is completed, failed, or rejected post=>subroutine: POST Subscription for Task Updates oauth=>subroutine: Authentication and Authorization Workflow post=>subroutine: POST Subscription to Server post_ok=>condition: Is FHIR create transaction successful? get_notified=>inputoutput: Get notified Task status updated cancel_subsc=>subroutine: DELETE Subscription for Task Updates del_ok=>condition: Is FHIR delete transaction successful? st->create_subsc->oauth->post->post_ok post_ok(yes)->get_notified->cancel_subsc->del_ok post_ok(no)->bad_transaction del_ok(yes)->e del_ok(no)->bad_transaction ``` ### Server ```flow st=>start: Start e=>end: End (Happy Path) bad_transaction=>end: Transaction Error bad_sig=>end: Signature invalid request=>operation: Receive Task http_200=>operation: Return http 200 Success http_400=>operation: Return 400+ Error response +/- OperationOutcome get_data=>subroutine: Get requested data may require human intervention validate=>subroutine: Testscript: validation step(stub) update_taskout=>subroutine: update Task.out with external references to the data update_taskout_contained=>subroutine: Populate Task.contained with the requested data and reference it inTask.out status_completed=>operation: Change Task.status to "completed" status_failed=>operation: Change Task.status to "failed" sign=>subroutine: Signature Needed: Bundle into provider signed Document Bundle oauth_ok=>condition: Is client authenticated? req_ok=>condition: Is valid request? payload_ok=>condition: Is payload valid FHIR Object pou_ok=>condition: Is POU(and reason) appropriate use of data? need_sig=>condition: Are signatures required? is_signed=>condition: Is attachment signed FHIR Document sig_ok=>condition: Is valid signature? is_completed=>condition: Is successful in completing the request (requested data is available) is_contained=>condition: Is output data contained in the Task? st->request->oauth_ok oauth_ok(yes)->req_ok oauth_ok(no)->http_400->bad_transaction req_ok(yes)->payload_ok req_ok(no)->http_400->bad_transaction payload_ok(yes)->pou_ok(yes) payload_ok(no)->http_400->bad_transaction pou_ok(yes)->get_data->is_completed pou_ok(no)->http_400->bad_transaction is_completed(yes)->is_contained is_completed(no)->status_failed->status_failed->validate is_contained(yes)->update_taskout_contained->status_completed->validate is_contained(no)->update_taskout->status_completed->validate validate->need_sig need_sig(yes)->sign->http_200->e need_sig(no,bottom)->http_200->e ``` ## Signatures ### Creation ```flow st=>start: Start e=>end: End (Happy Path) get_cert=>subroutine: Obtain a digital certificate and keys from a third-party certificate authority (CA) prep_base64_Der=>operation: Prepare base64 DER Certifcate - it is Cert PEM file wihout the footer and header and line returns jws_header=>operation: Create JWS header to Attach to Bundle header = {"alg": "RS256","kty": "RS", "x5c": [base64 DER]} prep_bundle=>operation: Remove the id and meta element from Bundle to be signed canon_bundle=>operation: Canonicalize Bundle using IETF JSON Canonicalization Scheme (JCS) base64_url_bundle=>operation: base64_urlize the canonicalized bundle- this is the JWS payload. creat_sig=>operation: Create Signature using private key and RS256 algorithm to get the JWS compact serialization format using the header and paylaod as inputs detach=>operation: detached payload by removing the payload element from the JWS compact serialization format base64_jws=>operation: base64 the JWS (not base64_url!) add_sig=>operation: Append FHIR Signature element to the Bundle be signed st->get_cert->prep_base64_Der->jws_header->prep_bundle prep_bundle->canon_bundle->base64_url_bundle->creat_sig->detach detach->base64_jws->add_sig->e ``` ### Validation ```flow st=>start: Start e=>end: End (Happy Path) bad_sig=>end: Invalid Signature get_cert=>subroutine: Obtain digital public key from first certificate in JWS header "x5c" key (or get from sender) prep_bundle=>operation: Remove the id and meta element from Bundle to be signed canon_bundle=>operation: Canonicalize Bundle using IETF JSON Canonicalization Scheme (JCS). Signature using public key or Cert and RS256 algorithm reattach=>operation: Add payload to JWS compact serialization format decode_jws=>operation: decode base64 JWS (not base64_url!) rem_sig=>operation: Remove FHIR Signature element from the signed Bundle base64_url_bundle=>operation: base64_urlize the canonicalized bundle- this is the JWS payload. inspect_cert_info=>subroutine: Verify Issuer, Validity Dates, Subject, and KeyUsage of certificate info_ok=>condition: Certificate information OK (e.g., not expired)? verify_sig=>operation: Verify JWS is_valid=>condition: Signature validates? rem_sig->decode_jws->prep_bundle->canon_bundle canon_bundle->base64_url_bundle->reattach->get_cert->inspect_cert_info inspect_cert_info->info_ok(yes)->verify_sig->is_valid inspect_cert_info->info_ok(no)->bad_sig is_valid(yes)->e is_valid(no)->bad_sig ``` ## Testscripts ### Profile Validation ```flow st=>start: Start ts_o1=>subroutine: Testscript: validation step(stub) ts_cond1=>condition: Is Payload Valid? ts_e1=>end: Valid Payload ts_e2=>end: Invalid Payload st->ts_o1->ts_cond1 ts_cond1(yes)->ts_e1 ts_cond1(no)->ts_e2 ```

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