contained Organization resources not recognized

[lcmaas]

Test Case: 1.2.02 Service Base URL List contains valid Endpoint resources

For Endpoint resources with contained Organization resources referenced in the managingOrganization element, the following failure message is returned:
"Endpoint with id: [id-here] does not have any associated Organizations in the Bundle."

While there is no separate Organization resource in the Bundle, there is a valid contained Organization resource within the Endpoint resource, which should be sufficient for this purpose.

[arscan]

Hi @lcmaas --

I'm sorry for the slow response.

We are following this language: "Organization details for each service base URL must be publicly published in Organization resource format according to the standard adopted in § 170.215(a)." and "Endpoint and Organization resources must be: (A) Collected into a Bundle resource formatted according to the standard adopted in § 170.215(a) for publication;"

We interpreted that as meaning that the Organization resources must be directly in the bundle (vs. provided as a partial contained element).

FHIR has a lot of flexibility and encourages profiling to limit variability within a given use cases. So even if it is valid FHIR to use contained resources here according to the base FHIR specification, there is value to constraining implementations down to a single representation for a use case to enable interoperability. Our interpretation of the language here is that it constrains implementations to just including resources within the bundle, vs. contained within other resources. But it is an interpretation because I can't find an explicit statement about this in the rule.

If you think it is important to allow this, I recommend providing feedback to ONC that describes why this flexibility is necessary so they can provide clarification one way or another and these tests would reflect their guidance.

[arscan]

Another issue here, perhaps more direct, is that the ONC requirements state:

[Organization resources must contain...] A reference, in the Organization.endpoint element, to the Endpoint resources containing service base URLs managed by this organization.

If you are providing Endpoint resources that 'contain' partial Organization resources that are linked via the Endpoint.managingOrganization element, it sounds like that relationship is the opposite direction from the requirements that these tests target (Endpoint -> Organization, instead of Organization -> Endpoint).

Please let me know if you disagree with any of this or think we got this wrong.