ECM (Enhanced Care Management) API

Enhanced Care Management (ECM) is a California DHCS program for high-acuity patients requiring intensive care coordination. The ECM API provides comprehensive endpoints for managing ECM patients, activities, communications, and compliance reporting.

Overview

The ECM subsystem enables care coordinators to manage high-complexity patients with authorization tracking, activity documentation, and compliance reporting. Key capabilities include importing Member Information Files (MIF), tracking authorizations, generating PRTF reports, and documenting patient activities and communications.

Key Concepts

Member ID (CIN)

The member_id field uniquely identifies ECM patients and is sometimes referred to as a CIN (Client Index Number). This identifier is used to match patients across MIF imports and authorization files.

Activity Types

ECM activities track all interactions with patients. The system supports the following activity types:

Activity Type	Description
`task`	A task assigned to a care coordinator
`note`	A general note about the patient
`sms`	An SMS message sent to or received from the patient
`call`	A phone call with the patient
`email`	An email sent to the patient
`in_person_appointment`	An in-person meeting with the patient

Event Types

Events are generated from activities and used for PRTF report generation:

Event Type	Description
`sms`	SMS communication event
`call`	Phone call event
`task`	Task completion event
`email`	Email communication event
`appointment`	Appointment event
`meeting`	Meeting event

Activity Status

Activities can have the following statuses:

Status	Description
`created`	Activity has been created but not completed
`complete`	Activity has been completed
`cancelled`	Activity has been cancelled

Lead Care Managers

ECM patients are assigned Lead Care Managers for coordination:

Role	Description
`oLCM`	Outreach Lead Care Manager - handles initial outreach
`iLCM`	Intensive Lead Care Manager - handles intensive care coordination

API Sections

The ECM API is organized into the following sections:

Admin ECM Endpoints

Administrative endpoints for managing ECM data and generating reports:

Patients - Manage ECM patient records and eligibility
Activities - View and manage patient activities
MIF Imports - Import Member Information Files
Authorizations - Import and manage authorization files
PRTF Reports - Generate DHCS compliance reports
Form C Submissions - Manage Form C assessments
Lead Care Managers - Assign and manage care managers

Clinic ECM Endpoints

Clinical endpoints for care coordinators to document patient interactions:

Activities - Create and manage patient activities
Communications - Send SMS and initiate calls
Form C - Submit Form C assessments

Authentication

All ECM endpoints require authentication via the X-User-Token header:


X-User-Token: your_token_here

Admin endpoints additionally require administrative privileges (admin role).

Common Response Formats

Success Response


{
  "message": "Operation completed successfully",
  "data": { ... }
}

Error Response


{
  "errors": ["Error message 1", "Error message 2"]
}

Paginated Response


{
  "items": [...],
  "pagination": {
    "current_page": 1,
    "total_pages": 10,
    "total_count": 250,
    "per_page": 25
  }
}