What is digital record retrieval?

Digital record retrieval enables your connection to the Carequality Interoperability Framework, a nationwide network of healthcare organizations comprising over 600K providers, 50K clinics, over 4,200 hospitals, and millions of patient records. Carequality facilitates the exchange of over 150M clinical summary documents every month between Carequality participants.

Instead of needing a business agreement with hundreds of individual organizations, you can use digital record retrieval to make one connection for access to records from any Carequality participant.

Direct connection with Carequality

You don't have to use digital record retrieval to have Carequality as one of your connections through Redox. But with digital record retrieval, we serve as your Carequality implementer and responder.

You can choose to be your own implementer and responder to connect with Carequality, but it may take a significant amount of time to get started. So if you don't want to reinvent the wheel, use our experience to get started with Carequality in a matter of days instead of months.

But if you must, learn how to be your own responder.

Benefits of digital record retrieval

  • Lightning-fast onboarding. Use our extensive experience to get to production and value within days. As your implementer, we complete your certification process, and our self-service wizard lets you set up digital record retrieval at your own pace.
  • Modern technology. Standards are hard—and get harder when you combine multiple types. Let us do the heavy-lifting by using our proven data models to get up and running.
  • Management and maintenance. We provide tools to help:
    • build out and grow your organization while staying in sync with the Framework;
    • protect you from sending invalid data; and
    • answer your questions.

Be a Carequality participant

As a Carequality participant, you can obtain information about a patient and their medical history, including clinical details like allergies, diagnoses, and medications, without connecting to each individual healthcare organization.

Carequality participants

Explore our network or use the Carequality search to review a list of current Carequality participants.

Since sharing is caring, you're required to share your data in return with other Carequality participants. Carequality has two foundational requirements to ensure that a patient's entire clinical history is available nationwide to retrieve:

  1. Mutual exchange: Carequality participants must respond to all incoming requests with a purpose of use of Treatment. An organization is only exempt from mutual exchange if they're a:
    • Government agency
    • On-paper organization
    • Emergency medical service
    • Specialty pharmacy
  2. Open exchange: Carequality participants must respond in a non-discriminatory fashion with no terms, fees, or conditions.

If your organization doesn't meet the exceptions mentioned above, you're required to respond to incoming requests with your unique clinical data.

What data is exchanged

The Framework supports the exchange of C-CDA documents, which is an industry-standard for exchanging patient and visit information.

The two primary types of supported documents are patient summaries and visit summaries. Patient summaries represent a current—or nearly current—snapshot of the patient’s chart while visit summaries contain a patient’s chart for a specific visit and are considered accurate as of the visit date.

Rules for returned data

The list below contains a summary of rules for returned data. Learn more details about HL7 standards.

  1. Each participant must populate these required sections with discrete data (Note: Participants may populate these with null if there is no relevant data or a participant doesn’t have the ability to include data):
    • allergies
    • intolerances
    • medications
    • problems
    • results
    • vital signs
  2. Each participant must include these required sections with either narrative or discrete data:
    • social history
  3. Each participant should include any of these optional sections with discrete data:
    • procedures
    • immunizations
    • advance directives
    • encounters
  4. Each participant should include any of these optional sections with either narrative or discrete data (Note: We don’t include all of these in the translated JSON, but they are included in the raw XML):
    • family history
    • functional status
    • medical equipment
    • payers
    • plan of treatment
    • social history
    • mental status
    • nutrition
  5. Participants may add any other valid CDA sections (or custom sections) at their discretion (Note: We don’t include all of these in the translated JSON, but they are included in the raw XML).

Use Redox as your implementer

We're a certified Carequality implementer. Implementers are approved to help organizations like yours connect to Carequality. Basically, we serve as your on-ramp to the Framework. With us as your implementer, you can start exchanging data across the Framework in a matter of days rather than months.

As your implementer, we complete the following steps for you:

  • Sign the Carequality Connected Agreement and be accepted by Carequality;
  • Develop legacy exchange technologies to facilitate exchange;
  • Test successfully with Carequality participants; and
  • Ensure that you comply with Carequality's rules for use of the Framework.

Use Redox as your responder

Being a Carequality participant can entail a high volume of incoming requests. These volumes are influenced by factors like your geographic location or the number of facilities within your organization.

Many Carequality participants automatically trigger outbound requests by running algorithms with radius-based searching around the patient’s address. So, rural areas may receive 10K–25K of these requests daily, whereas geographic areas with high population density—like the San Francisco Bay Area or New York metropolitan area—may see daily request volumes of up to 200K per location.

As your responder, we can shield you from this traffic and simplify your flow so that you only have to send new or updated information to us. We take care of the rest with the data you already have.

If you prefer to respond to incoming traffic yourself, you won't qualify for digital record retrieval pricing. Talk to a Redoxer to discuss options and pricing.

API limits

With digital record retrieval, you have a limit of 25K API calls per day and per location to the Framework. An API call is defined as sending a request via Redox that results in a response from the Framework—this includes searches for patients that don't return matches.

Included requests

These query requests are included in your total allowable amount per day:

  • PatientSearch.Query
  • ClinicalSummary.PatientQuery
  • ClicnicalSummary.DocumentQuery
  • ClinicalSummary.DocumentGet
  • Organization.New
  • Organization.Update
  • Organization.Query

To locate a patient and retrieve their documents, you need two API requests at a minimum (PatientSearch.Query and ClinicalSummary.PatientQuery). This means that you can locate up to 12.5K patients per day at most with digital records retrieval—so long as you don’t use any other requests. Given this, you can calculate whether that limit is sufficient depending on whether a patient may exist at multiple healthcare organizations within your geography.

Excluded requests

These query requests are excluded from your total allowable amount per day:

  • PatientSearch.LocationQuery
    • Why is this excluded: You may need to poll the endpoint a few times while waiting for it to reach a Success state.
  • ClinicalSummary.VisitPush
  • ClinicalSummary.PatientPush
  • PatientAdmin.NewPatient
    • Why is this excluded: As a Carequality participant, you're required share your unique data, which includes all new patients.
  • PatientAdmin.PatientUpdate
    • Why is this excluded: As a Carequality participant, you're required share your unique data, which includes updates to existing patients.
  • PatientAdmin.PatientMerge
    • Why is this excluded: As a Carequality participant, you're required share your unique data, which includes deleting duplicate patients (which you can accomplish by merging records).

Next steps