Stream: implementers
Topic: Patient Identifier (MRN) encoding
Egbert Algra (Jun 16 2016 at 19:33):
What is the recommended way of representing the Patient MRN and issuer of identity in fhir? Options I see are
1. Use the Identifier.system to identify the issuer of identity,
<identifier>
<system value="Organization/SomeOrganizationIdentifier" />
<value value="1234" />
</identifier>
2. Identifier contains only MRN, and Refernce to Organization resource defines the identity scope,
<reference value="Organization/spark1" />
(where the referenced Organization is the issuer of identity)
3. both or any of the above.
Abbie Watson (Jun 16 2016 at 19:41):
Both of them are valid interpretations of the spec. From a practical standpoint, system has been more useful on a day-to-day basis than the assigner reference lookup.
Grahame Grieve (Jun 16 2016 at 20:51):
they are differnt. system identifies the uniqueness scope of the identifier. It's the most important in that regard
Grahame Grieve (Jun 16 2016 at 20:52):
assigner indicates who issued the identifier. That's mostly the same as the orgnization associated with the system url - and .e.g registered using NamingSystem.
Grahame Grieve (Jun 16 2016 at 20:53):
but it's not always the same: maybe the original definer of the system has been bought out or merged, and the assigner isn't the same as the definer - that's one condition where the assigner is not the same as that implied by the system
Grahame Grieve (Jun 16 2016 at 20:53):
another case is distributed identifier systems (typically, national identifiers), where the assigner is tracked for audit/integrity purposes.
Grahame Grieve (Jun 16 2016 at 20:54):
but mostly, the assigner isn't that important
Egbert Algra (Jun 16 2016 at 20:56):
Thanks for the responses. How would one encode the issuer identifier in the 'system' par the identifier? Say the Organization identifier is MCA-ZK. How does one reflect this in a uri?
1. urn:MCA-ZK (this may not resolve to a valid urn for some organization identifiers)
2. http://some.issuer.of.identity.namespace/Organization/MCA-ZK
3. MCA-ZK (just the text)
4. other?
Grahame Grieve (Jun 16 2016 at 20:57):
"he Organization identifier is MCA-ZK." - in what context? is that a v2 CX identifier component?
Egbert Algra (Jun 16 2016 at 21:06):
It might be a v2 CX identifier, it could be an alternate identifier also
Grahame Grieve (Jun 16 2016 at 21:08):
Identifier.assigner is a Reference(Organization). So you must have some conversion process - look up table or something - that knows how to convert to MCA-ZK to a valid reference to an Organization resource that describes the right Organization
Egbert Algra (Jun 16 2016 at 21:10):
Say given the reference to the right Organization fhir resource that issued identity to the Patient. How does the Organization resource content flow into the 'system' part of the Patient identifier?
Grahame Grieve (Jun 16 2016 at 21:14):
that's another lookup table, usually. Some human has to determine what the right system value is
Last updated: Apr 12 2022 at 19:14 UTC
