FHIR Subscription for Utilization Management

Publishers can use the FHIR Subscription data model to store subscription topics, subscriber details, the filters and parameters applied to a subscription, and other subscription details. When the event change occurs, it triggers a notification and a platform event is created as an Interoperability Topic Subscription Event record. Then, Mulesoft sends the notification to the subscriber’s endpoint. To learn more about the Mulesoft integration, see FHIR Subscription for Utilization Management.

Utilization Management has the prebuilt FHIR Subscription: Publish Platform Event flow which can be cloned and configured for your use case. With this flow, payer organizations can notify providers when the status of their submitted care request is updated from Pending Review to More Information Required. The provider receives notifications of the update in real time, enabling them to take timely actions to deliver patient care.

You can configure your own implementation to trigger the platform event and send notifications to subscribers as per your business needs.

• Prepare to Use FHIR Subscription for Utilization Management
  To use FHIR Subscription for Utilization Management, assign the required permisison sets and enable the feature in Setup.
• Clone and Configure the FHIR Subscription Flow
  To create a platform event when the case sub status of a care request extension record is updated, clone the FHIR Subscription: Publish Platform Event flow. Update the InteropTopicId and RecordTypeName constants in the flow to match your use case. Then, reference the flow in the Interoperbility Topic Trigger Criteria object.