Stream: implementers
Topic: Representing a patient's PCP
Shobana (May 31 2019 at 18:35):
Hi, I am a FHIR newbie working on converting EHR data that is in CSV files to FHIR.
In one of these csv files, I have a patient id along with their PCP's name, NPI number and a "Spec" which has values like "Family Medicine". My initial thought was to model these as Patient and Practitioner, where I would have patient.generalPractitioner point to the Practitioner resource. However, there does not seem to be a way to represent the PCP relationship there. Please correct me if I am wrong.
I am now considering modeling this as Patient, Practitioner and PractitionerRole. What is the right way to configure the references across those 3 resources? For example, should patient.generalPractitioner point to Practitioner or PractitionerRole?
p.s. @Lloyd McKenzie since you had specific recommendations on the "PractitionerRole.Practitioner" thread about this.
Lloyd McKenzie (May 31 2019 at 19:10):
Patient has a "generalPractitioner" element that lets you link a Patient to PractitionerRole. PractitionerRole can then point to Practitioner
Shobana (May 31 2019 at 19:35):
Ok, thanks. I will then create a Patient resource for each patient and create both PractitionerRole and Practitioner for each of the PCPs and have them referenced as Patient->PractitionerRole->Practitioner.
Next question, what is the right way to represent their NPI? I found 2 ways of doing this:
"identifier": [
## Option 1
{
"system": "https://npiregistry.cms.hhs.gov/",
"value": "1234567890"
},
## Option 2
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "NPI"
}
]
},
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567890"
},
],
Are they both correct? Is one more correct than the other?
Lloyd McKenzie (May 31 2019 at 19:37):
The first is fine. The second may be more useful to systems that don't recognize the Identifier.system
Shobana (May 31 2019 at 19:48):
Hopefully last question on this - would the right way to represent the "Family Medicine" be to assign the Snomed ct code for Family Practice (419772000) to PractitionerRole.specialty?
Lloyd McKenzie (May 31 2019 at 20:07):
It's impressively right :)
Most implementers would just shove the string value into Practitioner.specialty.text. (Though I'd encourage you to send the text element too for fall back.)
Last updated: Apr 12 2022 at 19:14 UTC
