Patient Access Clinical Data API - Implementation Template (US Core)

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Use case

The Centers for Medicare & Medicaid Services (CMS) finalized on May 1st, 2020, its Interoperability and Patient Access Final Rule on patient access to health data. The new CMS rule promises to help payers achieve a seamless flow of health information to patients and providers, with stronger privacy and security measures to protect personal health information.

The rule enables patients to have better access to their health information, improves interoperability, and drives innovation, while reducing the burden on payers and providers. Patients can now be aware of their health information for better care and improved patient outcomes. With data being available conveniently and securely among payers, providers, and patients, CMS hopes to achieve real coordinated care, improved health outcomes, and reduced costs.

API-led architecture


Implementation templates included

See the RAML asset for the API specification.

AllergyIntoleranceA record of a clinical assessment of an allergy or intolerance; a propensity, or a potential risk to an individual, to have an adverse reaction on future exposure to the specified substance, or class of substance.
CarePlanCarePlan is one of the request resources in the FHIR workflow specification, which are used in many areas of healthcare with a variety of scopes.
CareTeamThe CareTeam includes all the people, teams, and organizations who plan to participate in the coordination and delivery of care for a single patient or a group (such as a married couple in therapy or a support group).
ConditionCondition resource is used to record detailed information about a condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.
CoverageThe Coverage resource is intended to provide the high-level identifiers and descriptors of an insurance plan, typically the information which would appear on an insurance card, which may be used to pay, in part or in whole, for the provision of health care products and services.
DeviceThis resource is an administrative resource that tracks individual instances of a device and their location.
DiagnosticReportA diagnostic report is the set of information that is typically provided by a diagnostic service when investigations are complete.
DocumentReferenceThe scope of a document is any serialized object with a mime-type, so includes formal patient centric documents (CDA), clinical notes, scanned paper, and non-patient specific documents like policy text.
EncounterA patient encounter is further characterized by the setting in which it takes place. Amongst them are ambulatory, emergency, home health, inpatient and virtual encounters.
GoalA Goal in health care services delivery is generally an expressed desired health state to be achieved by a subject of care (or family/group) over a period or at a specific point of time.
ImmunizationThe Immunization resource is intended to cover the recording of current and historical administration of vaccines to patients across all healthcare disciplines in all care settings and all regions
LocationA Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations.
MedicationThe Medication resource allows for medications to be characterized by the form of the drug and the ingredient (or ingredients), as well as how it is packaged.
MedicationRequestThis resource covers all type of orders for medications for a patient.
ObservationObservations are a central element in healthcare, used to support diagnosis, monitor progress, determine baselines and patterns and even capture demographic characteristics
OrganizationThis resource may be used in a shared registry of contact and other information for various organizations or it can be used merely as a support for other resources that need to reference organizations, perhaps as a document, message or as a contained resource.
PatientThis Resource covers data about patients and animals involved in a wide range of health-related activities
PractitionerPractitioner covers all individuals who are engaged in the healthcare process and healthcare-related services as part of their formal responsibilities and this resource is used for attribution of activities and responsibilities to these individuals.
PractitionerRolePractitionerRole covers the recording of the location and types of services that Practitioners are able to provide for an organization.
ProcedureThis resource is used to record the details of current and historical procedures performed on or for a patient.


Published by
MuleSoft Solutions
Published onOct 12, 2023
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