CH EPR FHIR (R4)
4.0.0-ballot - ballot
This page is part of the CH EPR FHIR (R4) (v4.0.0-ballot: DSTU 4 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
This section describes the national extension for the Swiss EPR to the Patient Identity Feed FHIR [ITI-104] transaction defined in the IUA profile published in the IHE IT Infrastructure Technical Framework Trial Implementation “Patient Identifier Cross-referencing for mobile”.
This transaction communicates patient information, including corroborating demographic data, after a patient’s identity is established, modified or merged or after the key corroborating demographic data has been modified.
Actor: Patient Identity Source
Role: Provides notification to the Patient Identifier Cross-reference Manager for any patient identification related events including: creation, updates, merges, etc.
Actor: Patient Identifier Cross-reference Manager
Role: Serves a well-defined set of Patient Identification Domains. Based on information provided in each Patient Identification Domain by a Patient Identity Source Actor, it manages the cross-referencing of patient identifiers across Patient Identification Domains.
The Add Patient message is triggered when a new patient is added to a Patient Identity Source. The Revise Patient message is triggered when the patient information is revised within a Patient Identity Source (e.g., change in patient name, patient address, etc.). A Resolve Duplicate Patient message is triggered when the Patient Identity Source does a merge within its Patient Identification Domain.
The same message semantic apply as in 2:3.104.4.1.2 and 2:3.104.4.2.2 Message Semantics.
The patient data (see Patient example) SHALL conform to the PIXm Patient Feed profile.
The Patient Identifier Cross-reference Manager SHALL reference the PIXm Patient Feed profile or a derived
constrained profile as a supportedProfile
in the CapabilityStatement.
The EPR-SPID as an identifier SHALL be added. The birthname can be added with the ISO 21090 qualifier extension, the religion SHALL not be added.
Add Patient Franz Muster:
PUT http://example.org/fhir/Patient?identifier=urn:oid:2.16.756.888888.3.1|8734 HTTP/1.1
Accept: application/fhir+json
Content-Type: application/fhir+json
traceparent: 00-0af7651916cd43dd8448eb211c80319c-b7ad6b7169203331-00
{
"resourceType" : "Patient",
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR"
}
]
},
"system" : "urn:oid:2.16.756.888888.3.1",
"value" : "8734"
},
{
"system" : "urn:oid:2.16.756.5.30.1.127.3.10.3",
"value" : "the EPR-SPID value"
}
],
"name" : [
{
"family" : "Muster",
"given" : [
"Franz"
]
},
{
"family" : "Muster",
"_family" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
"valueCode" : "BR"
}
]
}
}
],
"gender" : "male",
"birthDate" : "1995-01-27",
"managingOrganization" : {
"identifier" : {
"system" : "urn:oid:2.51.1.3",
"value" : "7601000201041"
}
}
}
See https://hl7.org/fhir/R4/http.html#cond-update for response.
The CapabilityStatement resource for the Patient Identity Source is PIXm Patient Identity Source.
The CapabilityStatement resource for the Patient Identifier Cross-reference Manager is PIXm Patient Identifier Cross-reference Manager.
TLS SHALL be used. This national extension enforces authentication and authorization of access to the Patient Identifier Cross-reference Manager using the IUA profile with basic access token. Consequently the Patient Identity Feed FHIR [ITI-104] request must authorize using the [ITI-72] transaction of the IUA profile.
For the traceparent
header handling refer to Trace Context header.
The Patient Identity Source shall record a PIXm Feed Source Audit Event Log. Audit Example for a PIXm Feed transaction from source perspective.
The Patient Identifier Cross-reference Manager shall record audit events: