This page is part of the CH EPR mHealth (R4) (v3.0.0-ballot: Draft Ballot 1) based on FHIR 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

Patient Identity Feed FHIR [ITI-104]

Scope

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 Roles

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.

Referenced Standards

Patient Identifier Cross-referencing for mobile (PIXm), Rev. 3.0.0 – Trial-Implementation, November 8, 2021

Messages

Trigger Events

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.

Message Semantics

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 be conform to the PIXm Patient profile with the canonical url http://fhir.ch/ig/ch-epr-mhealth/StructureDefinition/ch-pixm-patient. The Patient Identifier Cross-reference Manager SHALL reference the PIXm Patient profile or a derived constrained profile as a supportedProfile in the CapabilityStatement.

If the patient is already registered in a community, the MPI-PID SHALL be provided as an identifier. The EPR-SPID as an identifier MAY be added. The birthname can be added with the ISO 21090 qualifier extension, the religion SHALL not be added.

Expected Actions Consumer played by Patient Identifier Cross-reference Manager

If the MPI-PID is provided as an identifier the Patient Identifier Cross-reference Manager SHALL use the MPI-PID to correlate the patient in the community.

Message Example

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

{
  "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"
    }
  ],
  "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"
    }
  }
}

Security Consideration

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 Incorporate Access Token [ITI-72] transaction of the IUA profile.