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Patient Chart Service — Event Schemas

Status: populated Owner: TBD Last updated: 2026-04-17 Companion: Service Template · 04 Event-Driven · NAMING

All events follow the platform EventEnvelope schema (frozen by F01). NATS stream: PATIENT_CHART; subject format patient_chart.{aggregate}.{event}.v{N}. All events carry tenantId, patientId, and correlationId.

1. Produced events​

SubjectVersionRetention classSchema
patient_chart.problem.added.v1v1clinical-7y§2.1
patient_chart.problem.updated.v1v1clinical-7y§2.2
patient_chart.problem.resolved.v1v1clinical-7y§2.3
patient_chart.problem.inactivated.v1v1clinical-7y§2.4
patient_chart.problem.entered_in_error.v1v1clinical-7y§2.5
patient_chart.allergy.added.v1v1clinical-7y§3.1
patient_chart.allergy.updated.v1v1clinical-7y§3.2
patient_chart.allergy.inactivated.v1v1clinical-7y§3.3
patient_chart.allergy.entered_in_error.v1v1clinical-7y§3.4
patient_chart.vitals.recorded.v1v1clinical-7y§4.1
patient_chart.vitals.updated.v1v1clinical-7y§4.2
patient_chart.vitals.abnormal_flagged.v1v1clinical-7y§4.3
patient_chart.note.created.v1v1clinical-7y§5.1
patient_chart.note.updated_draft.v1v1operational-90d§5.2
patient_chart.note.signed.v1v1clinical-7y§5.3
patient_chart.note.cosign_requested.v1v1operational-90d§5.4
patient_chart.note.cosigned.v1v1clinical-7y§5.5
patient_chart.note.addendum_created.v1v1clinical-7y§5.6
patient_chart.note.entered_in_error.v1v1clinical-7y§5.7
patient_chart.note.ai_accepted.v1v1clinical-7y§5.8
patient_chart.chart.snapshot_exported.v1v1audit-3y§6.1
patient_chart.chart.item_opened.v1v1audit-1y§6.2
patient_chart.breakglass.invoked.v1v1audit-7y§7.1
patient_chart.sensitive_access.recorded.v1v1audit-7y§7.2

Retention classes defined in 04 Event-Driven Architecture.

2. Problem events​

2.1 patient_chart.problem.added.v1​

{
  "envelope": { "eventId": "evt_...", "eventType": "patient_chart.problem.added.v1", "occurredAt": "...", "tenantId": "ten_...", "correlationId": "...", "causationId": "..." },
  "data": {
    "problemId": "prb_...",
    "patientId": "pat_...",
    "encounterId": "enc_... | null",
    "code": { "codings": [{ "system": "...", "code": "...", "display": "..." }], "text": "..." },
    "clinicalStatus": "active",
    "verificationStatus": "confirmed",
    "onsetDate": "2024-06-12 | null",
    "severity": "mild|moderate|severe|null",
    "recordedBy": "prc_...",
    "recordedAt": "...",
    "version": 1
  }
}

2.2 patient_chart.problem.updated.v1​

data includes problemId, previousVersion, newVersion, patch: { code?, severity?, verificationStatus?, onsetDate? }, updatedBy, updatedAt.

2.3 patient_chart.problem.resolved.v1​

data includes problemId, version, abatementDate, reason?, resolvedBy, resolvedAt.

2.4 patient_chart.problem.inactivated.v1​

data includes problemId, version, reason?, inactivatedBy, inactivatedAt.

2.5 patient_chart.problem.entered_in_error.v1​

data includes problemId, reason, actor, at.

3. Allergy events​

3.1 patient_chart.allergy.added.v1​

{
  "envelope": { ... },
  "data": {
    "allergyId": "alg_...",
    "patientId": "pat_...",
    "substance": { "codings": [...], "text": "..." },
    "categories": ["medication"],
    "clinicalStatus": "active",
    "verificationStatus": "confirmed",
    "reactions": [{ "manifestation": [...], "severity": "moderate" }],
    "highestSeverity": "moderate",
    "recordedBy": "prc_...",
    "recordedAt": "...",
    "version": 1,
    "assertion": "none|nka|nkda"
  }
}

3.2 allergy.updated.v1, 3.3 allergy.inactivated.v1, 3.4 allergy.entered_in_error.v1​

Analogous to §2.2–2.5 with allergy shape.

4. Vitals events​

4.1 patient_chart.vitals.recorded.v1​

{
  "envelope": { ... },
  "data": {
    "vitalsSetId": "vit_...",
    "patientId": "pat_...",
    "encounterId": "enc_... | null",
    "collectionLocationId": "loc_... | null",
    "recordedBy": "prc_...",
    "recordedAt": "...",
    "method": "manual|device",
    "deviceId": "dev_... | null",
    "measurements": [
      { "observationId": "obs_...", "code": { "system": "http://loinc.org", "code": "8480-6" }, "value": 142, "unit": "mm[Hg]", "abnormalFlag": "H" }
    ]
  }
}

4.2 vitals.updated.v1​

data includes vitalsSetId, previousVersion, newVersion, measurementsPatch, reason.

4.3 vitals.abnormal_flagged.v1​

Fires per abnormal measurement; data: observationId, vitalsSetId, code, value, unit, flag, severity.

5. Clinical note events​

5.1 patient_chart.note.created.v1​

{
  "envelope": { ... },
  "data": {
    "noteId": "note_...",
    "patientId": "pat_...",
    "encounterId": "enc_... | null",
    "templateId": "soap.v1",
    "authorId": "prc_...",
    "createdAt": "...",
    "sectionCount": 4,
    "status": "draft",
    "version": 1
  }
}

5.2 note.updated_draft.v1 — incremental; retention short; sectionsChanged[] summary only (no body bytes).​

5.3 note.signed.v1 — data: noteId, signedBy, signedAt, signatureMethod, documentReferenceId? (if PDF generated).​

5.4 note.cosign_requested.v1 — data: noteId, requestedBy, cosignerId, dueBy?.​

5.5 note.cosigned.v1 — data: noteId, cosignerId, cosignedAt, outcome: approved|rejected.​

5.6 note.addendum_created.v1 — data: noteId, addendumId, authorId, reason, at.​

5.7 note.entered_in_error.v1 — data: noteId, reason, actor, at.​

5.8 note.ai_accepted.v1 — data: noteId, sectionKey, feature: "docassist"|"stt"|"summarize"|"templatefill", modelVersion, actor, acceptedAt, contentHash.​

6. Chart composition events​

6.1 chart.snapshot_exported.v1 — data: patientId, format, exportedBy, at, documentReferenceId?, purposeOfUse?.​

6.2 chart.item_opened.v1 — data: patientId, itemType, itemId, openedBy, at.​

7. Access events​

7.1 breakglass.invoked.v1 — data: accessId, patientId, reason, durationMinutes, actor, at.​

7.2 sensitive_access.recorded.v1 — data: accessId, patientId, segment, actor, at, policyResult.​

8. Consumed events​

EventProducerHandler action
registration.patient.merged.v1registration-serviceRewrite aggregate patientId references to surviving patient; emit problem.updated/allergy.updated as appropriate
registration.encounter.created.v1registration-serviceWarm encounter cache for banner
gdpr.subject_request.received.v1platformAnonymize author display fields; keep coded clinical content unless erasure-of-clinical-content is authorized

9. Schema registration & compatibility​

All envelopes register in the platform schema registry with JSON Schema. Breaking field removals require v2 subject and dual-publish for ≥ 14 days before v1 is retired.

10. Open Questions​

  • Should note.ai_accepted.v1 retention match clinical (7y) since it is part of the legal audit trail? Current proposal: yes — retention = clinical-7y.