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Multidisciplinary Meeting

Rofim supports end-to-end automation for scheduling cases in an MDM session. This lets you keep the hospital EHR as the system of record while using Rofim to conduct the MDM. The following features are available:

  • Adding a case to an MDM
  • Auto-populating questionnaires
  • Attaching documents to the case
  • Retrieving Questionnaires (fRCP)

The diagram below summarizes how the MDM interfaces work.

You can push a case into an MDM in three ways:

  1. Via an ims flow. The patient is then created in Rofim and can be scheduled by the secretariat into a session.
  2. Via an SIU flow. The patient is created if missing and is scheduled into an MDM session. The physician or secretariat must then fill in the clinical data in the Questionnaire (fRC).
  3. Via a CDAR2 N3 flow. The patient is created if missing, scheduled into an MDM session, and the data embedded in the CDAR2 N3 payload is used to populate the Questionnaire (fRC) automatically.

Scheduling a patient in an MDM

To route the case to the correct MDM session, Rofim must receive the pathway or family identifier in the incoming messages. The facility therefore needs a mapping between the Rofim pathway and family IDs and the appointments held in the EHR.

Via a CDAR2 N3

DataValue
Supported formatCDAR2 N3
Supported inbound messagesCDAR2 N3
Message typePOST
API endpointbase_url/rcp/cdar2

Using a CDAR2 N3 flow lets you create the patient, add the case to the MDM session, and auto-fill the Questionnaire (fRCP).

Prerequisites to insert a patient case into the session:

  • The session already exists in Rofim.
  • Only one session exists in the given family or pathway for the date provided in the questionnaire.

If the MDM session is not found on that date for the specified family or pathway, Rofim creates a patient note containing the CDAR2 questionnaire as an attachment. That lets you manually insert the patient into a session using that MDM questionnaire.


Case insertion flowchart (CDAR2)

The flowchart below details the steps needed to insert a case into a session.

Flowchart for inserting a patient case via CDAR2 N3


CDAR2 field reference

The table below lists the required elements, all of which live inside ClinicalDocument.

Data

Field

Format

Required

Notes

Physician identifier (RPPS)

participant[typeCode='REFB'] .associatedEntity[classCode='PROV'] .id[root='1.2.250.1.71.4.2.1'] @extension

String

Yes

RPPS of the physician who submitted the case. Visible to MDM participants in Rofim and returned through the report retrieval interface.

MDM lead physician identifier (RPPS)

participant[typeCode='RESP'] .associatedEntity[classCode='PROV'] .id[root='1.2.250.1.71.4.2.1'] @extension

String

Yes

RPPS of the MDM lead physician. Visible to MDM participants in Rofim and returned through the report retrieval interface.

Department or service

component.componentOf .encompassingEncounter .id[@root='rofim.rcp.networkId'] @extension

String

Conditional

Rofim network ID. If present, the patient is created under that department or service.

Pathway or family ID

component.componentOf .encompassingEncounter .id[@root='rofim.rcp.famFilId'] @extension

String

Yes

ID of the family or pathway where the patient must be scheduled.

MDM start date

component.componentOf .encompassingEncounter .effectiveTime.low@value

Date

Yes

MDM session date (YYYYMMDD, for example 20190218). Used to place the case in the correct session.

Case unique identifier

setId@root

String

Yes

Case identifier defined on the facility side. Needed to update the case later.

Patient IPP/Patient ID

recordTarget.patientRole .id[@root='FINESS']@extension

String

Yes

Patient IPP/Patient ID within the facility. The id element’s root attribute must use the facility’s FINESS number.

Patient NSS

N/A

String

No

The national social security number cannot be populated through CDAR2 N3.

Patient INS

recordTarget.patientRole .id[@root='1.2.250.1.213.1.4.8'] @extension

String

No

The id element’s root attribute must be "1.2.250.1.213.1.4.8".

Patient given name

recordTarget.patientRole .patient.name.given

String

Yes

Patient first name.

Patient birth name

recordTarget.patientRole .patient.name .family[@qualifier='BR']

String

Yes

Patient birth last name.

Patient usual name

recordTarget.patientRole .patient.name .family[@qualifier='SP']

String

Yes

Patient current last name.

Patient sex

recordTarget.patientRole .patient .administrativeGenderCode

String

Yes

Expected values: M or F.

Patient date of birth

recordTarget.patientRole .patient .birthTime@value

Date

Yes

YYYYMMDD (for example 19730416).

Patient phone number

recordTarget.patientRole .telecom[@use='MC]@value

String

No

Uses the MC telecom entry. The number must follow the E.164 format, for example +33601010101.

Patient email address

recordTarget.patientRole .telecom@value

String

No

Populate when @value starts with mailto:.

Patient street address

recordTarget.patientRole .addr.streetName

String

Conditional

The address must be either fully populated or left blank (all PID.11.* fields provided together).

Patient postal code

recordTarget.patientRole .addr.postalCode

String

Conditional

Patient city

recordTarget.patientRole .addr.city

String

Conditional

Patient country

recordTarget.patientRole .addr.country

String

Conditional

⚠️

Localization
References such as FINESS numbers, French phone formats, and CDAR2 country codes reflect the French context and may require adaptation for other regions.

❗️

If the email or phone number format is invalid, the patient is rejected and the case is neither created nor scheduled in the MDM.

Via an SIU

Data

Value

Supported format

HL7 2.5 to HL7 2.7

Supported inbound messages

  • SIU 12 to add MDM cases and create patients in Rofim.
  • SIU 13 to change the session (not implemented yet).
  • SIU 15 to cancel the MDM slot (not implemented yet).

Message type

POST

API endpoint

base_url/rcp/siu

The SIU flow creates the patient and adds the case to the MDM session. Any fields not detailed here (notably patient demographics) must comply with the Patient demographic data specification.

The SIU message must populate the following data:

DataFieldFormatRequiredNotes
Case submitter identifier (RPPS)AIP.3.1StringYesRPPS for the physician who submitted the case. Visible to MDM participants in Rofim and returned through the report retrieval interface. Taken from the first AIP segment (AIP.1 == 1).
Lead physician identifier (RPPS)AIP.3.1StringNoRPPS for the lead physician. Visible to MDM participants in Rofim and returned through the report retrieval interface. Taken from the second AIP segment (AIP.1 == 2).
Department or serviceAIL.3.9StringConditionalRofim network ID. If present, the patient is created under that department or service.
Pathway or family IDAIL.3.4StringYesID of the family or pathway where the patient must be scheduled.
MDM start dateSCH.11.4Date/TimeYesMDM start date and time in UTC. Only the date is used to assign the session (time is ignored).
Case unique identifierSCH.2.1StringYesCase identifier defined on the facility side.
MSH|^~\&|AXIGATE|AXIGATE|||20250408154719||SIU^S12^SIU_S12|43228|P|2.5|||||FR|8859/15|FRA
SCH|59384|59384||||RCP_IHU_P_CX_IH_67d443f1bdfe7d0fb1eabdd4^RCP -Infertilité|||15|Min|^^^20250408165500^20250408171000|||||||||10003425302^MANSION ADM^Fredéric ^^^^^^^L^^^RPPS|||||PLANNED
TQ1|1|||||15^Min|20250408165500|20250408171000|R
PID|||5100001073^^^^PI||TEST^TEST^^^M.^^L||19501104000000|M||||||||||||||||||||||N||PROV
PV1|1|O|8154||||||||||||||||
RGS|1
AIS|1||RCP_IHU_P_CX_IH_67d443f1bdfe7d0fb1eabdd4^RCP -Infertilité|20250408165500|0|Min|15|Min
AIL|1||8154^^^67d443f1bdfe7d0fb1eabdd4^^^^^67d441a5bdfe7d0fb1eaad51|||20250408165500|0|Min|15|Min
AIP|1||10100094977^Infertilité -^CO^^^^^^^L^^^RPPS|||20250408165500|||15|Min
TODO
TODO

Attaching documents to the case

DataValue
Supported formatHL7 2.5 to HL7 2.7
Supported inbound messagesORU, MDM, or OUL
Message typePOST
API endpointbase_url/rcp/doc

Documents are added to a patient note and can be viewed during the MDM.

Key data

The table below lists the expected SIU field mapping:

Data

Field

Format

Required

Notes

Case unique identifier

PV1.50.1

String

No

Case identifier in the MDM where the document must be attached. Must match SCH.2.1 in the SIU flow or the setId.@root value when created via CDAR2 N3.

File name

OBX.3.1

String

Yes

Display name shown in Rofim.

Department or network identifier

MSH.5.1

String

Conditional

Service or network identifier. Must match the value used when the patient was created.

Patient IPP/Patient ID

PID.3.1

String

Yes

Use PID.3.1 when PID.3.5='PI'. Must match the patient's IPP/Patient ID.

File

OBX.5.5

String

Yes

OBX.5.5 when OBX.2.1 equals any of:

  • ED
  • RP
  • FIC
  • The file must be a PDF encoded in base 64.

N/A

OBX.5.1

String

Yes

Not used.

N/A

OBX.5.2

String

Yes

Must be Application.

N/A

OBX.5.3

String

Yes

Must be PDF.

N/A

OBX.5.4

String

Yes

Must be Base64.

Unique document identifier

TXA.12

String

No

Lets you overwrite an earlier document version.

📘

If the Case unique identifier field is missing, the document is stored in a new patient note instead. A clinician must then manually attach it to the MDM case.

Message examples

MSH|^~\&|DaVinci|MIPS|665458c6e55fcb3ce37040c6|MIPS|20250325141632||OUL^R22|P25006368_20250325141632|P|2.5||||||8859/15
EVN||20250325141632|20250325141632
PID|1||2345^^^LIS||XXXX^XXXXX||19600829|F|||&XXXXX^^XXXXXX^^12345|||||||2345678765||||||||||||N
PV1||I|||||||||||||||||125146142
ORC|SC||P25/006368||CM||^^^20250317143845^^R||20250325141632|||CRUN^CRUTU^XXXXXX-XXXXX||||20250314135522|||R
OBR|1|^DAVINCI|P25/006368^20250320140758|HIS_PDFReport^^Glims^HIS_PDFReport^^DaVinci||20250313135500|20250314135542|20250325092717||||||||CRUN^CRUTU^XXXXXX-XXXXXX|||||||||F|||||||XXXX&XXXXX&XXXXX
OBX|1|ED|HIS_PDFReport^^DaVinci^HIS_PDFReport^^DaVinci||JVBERi0xLjQNJeLjz9MNMSAwIG9iago8PAovVHlwZS9FeHRHU3RhdGUKL1NBIGZhbHNlCi9TTSAwLjAyCi9UUjIgL0RlZmF1bHQKPj4KZW5kb2JqCjIgMCBvYmoKWy9EZXZpY2VSR0JdCmVuZG9iagozIDAgb2JqCjw8L0ZpbHRlci9GbGF0ZURlY29kZS9MZW5ndGggMzI0Nz4+CnN0cmVhbQp42r1b244juQ1976/wD9iju6qAhQG32x0kb0EGyEOQp002T9lgMv8PhBRJiaqSbXmSDQaYrtaVIg8PqUt/+d2f7OEf39++XOHnz9/fvsE/.......vSW5mbyAzNiAwIFIKPj4Kc3RhcnR4cmVmCjE1NDk3MAolJUVPRgo=||||||F|||20250325092717
TODO
TODO

Retrieving MDM reports

DataValue
Supported formatHL7 2.7
Supported outbound messagesMDM or ORU
Message typeGET
API endpointbase_url/rcp/report/retreive

Each completed case generates a Questionnaire (fRCP) that the EHR can retrieve. The endpoint returns every report added since the previous call.

Responses consist of an XML file containing every HL7 message encoded in base 64. The XML structure is:

<message>
  <content>HL7 ORU or MDM #1 encoded in B64</content>
  <content>HL7 ORU or MDM #2 encoded in B64</content>
  <content>HL7 ORU or MDM #3 encoded in B64</content>
  ...
</message>

The MDM or ORU message contains the Questionnaire (fRCP) PDF encoded in base 64, plus additional metadata that simplifies downstream processing in the EHR. Key fields are listed below.

Key data

Data

Field

Format

Required

Notes

Case submitter identifier

PV1.7

String

Yes

Populated with the first and last name plus RPPS of the physician who submitted the case to the MDM session.

Lead physician identifier

PV1.8

String

Yes

Populated with the first and last name plus RPPS of the lead physician for the MDM session.

Unique document identifier

TXA.12

Structure

Yes

MDM reports can be updated and delivered multiple times (for example when the questionnaire changes). The TXA.12 field identifies the document being updated. Format:

  • TXA.12.1: String "FRCP_ID"
  • TXA.12.2: String "ROFIM"
  • TXA.12.3: Rofim unique ID for the Questionnaire (fRCP)
  • TXA.12.4: String "UUID"

MDM label

TXA.13

Structure

Yes

Provides the session label, which can help customize file naming. Format:

  • TXA.13.1: String "RCP_NAME"
  • TXA.13.2: String "ROFIM"
  • TXA.13.3: Session name ID
  • TXA.13.4: String "L"

Message example

<?xml version="1.0" encoding="UTF-8"?>
<message>
  <content>
    TVNIfF5+XCZ8Uk9GSU18Uk9GSU18QVhJR0FURXxBWElHQVRFfDIwMjUwNDAxMTMwNTAyfHxNRE1e...d016UUtKU1ZGVDBZS3x8fHx8fEZ8fHwyMDI1MDQwMTEzMDUwMg==
  </content>
  <content>
    TVNIfF5+XCZ8Uk9GSU18Uk9GSU18QVhJR0FURXxBWElHQVRFfDIwMjUwNDAxMTMwNTAyfHxNRE1e...d016UUtKU1ZGVDBZS3x8fHx8fEZ8fHwyMDI1MDQwMTEzMDUwMg==
  </content>
</message>
<?xml version="1.0" encoding="UTF-8"?>
<message/>
MSH|^~\&|ROFIM|ROFIM|AXIGATE|AXIGATE|20250401130502||MDM^T02^MDM_T02|3840|P|2.5|||||FRA|UTF-8|FRA
EVN|T02|20250401130502
PID|1||2100054546^^^APHM IPP^PI||DUPONZZZ^FFFICTIF||19341010|M|||^^^^^||^^^||||||NC||||
PV1|1|O|||||10102078838^Audrey^Médecin^^^^^^ASIP-SANTE-PS&1.2.250.1.71.4.2.1&ISO^D^^^RPPS
TXA|1|CR|PDF|20250401130502||20250401130502|20250401130502|20250401130502||||FRCP_ID^ROFIM^67da8696f56896e0720d8bcf^UIID|RCP_NAME^ROFIM^3C - Dermatologie - Oncologie cutanée^L|||rcp_questionnaire_DUPONZZZ-F_01042025.pdf|AU||AV
OBX|1|ED|CR^rcp_questionnaire_DUPONZZZ-F_01042025.pdf||rcp_questionnaire_DUPONZZZ-F_01042025.pdf^^CR^Base64^JVBERi0xLjQKJdPr6eEKMSAwIG9iago8PC9UaXRsZSAoYWJvdXQ6YmxhbmspCi9DcmVhdG9yIChNb3ppbGxhLzUuMCBcKFgxMTsgTGludXggeDg2XzY0XCkgQXBwbGVXZWJLaXQvNTM3LjM2IFwoS0hUTUwsIGxpa2UgR2Vja29cKSBIZWFkbGVzc0Nocm9tZS8xMzQuMC4wLjAgU2FmYXJpLzUzNy4zNikKL1Byb2R1Y2VyIChTa2lhL1BERiBtMTM0KQovQ3JlYXRpb25EYXRlIChEOjIwMjUwNDAxMTEwNTAxKzAwJzAwJykKL01vZERhdGUgKEQ6MjAyNTA0MDExMTA1MDErMDAnMDAnKT4+CmVuZG9iagozIDAgb2JqCjw8L2NhIDEKL0JNIC9Ob3JtYWw+PgplbmRvYmoKNiAwIG9iago8PC9DQSAxCi9jYSAxCi9MQyAwCi9MSiAwCi9MVyAxCi9NTCA0Ci9TQSB0cnVlCi9CTSAvTm9ybWFsPj4KZW5kb2JqCjEwIDAgb2JqCjw8L04gMwovRmlsdGVyIC9GbGF0ZURlY29kZQovTGVuZ3RoIDI5Nj4.....gMTIyIDAgUgovSW5mbyAxIDAgUj4+CnN0YXJ0eHJlZgoxMzIwMzQKJSVFT0YK||||||F|||20250401130502

Updated 4 months ago