Stream: new zealand
Topic: HPI Practitioner
David Hay (Jun 07 2019 at 18:35):
We have a requirement to model Practitioner registrations in the HPI where a 'registration' means that a practitioner is formally recognized by a registration authority (like a medical or nursing council). The registration includes things like one or more scopes of practice or restrictions on practice - each of which has a description and a period of applicability.
The issue has arisen that as registration is not an existing node in Practitioner, we are faced with a 3 level extension (registration -> scope of practice -> description / date which doesn't seem implementer friendly.
An alternative might be to model the scope / restrictions as a referenced/contained resource (profiled Consent/Contract/Basic perhaps) though it could be argued that having to traverse a reference is as much work as a 3rd level of extension (though one they have to do already)...
Thoughts, comments or suggestions? The model is here if you want to take a look: http://nz.clinfhir.com/logicalModeller.html#$$$HpiPractitioner#ep7m7
Lloyd McKenzie (Jun 07 2019 at 19:00):
@Brian Postlethwaite
Brian Postlethwaite (Jun 07 2019 at 22:55):
In the Australian model the AHPRA registration sounds very similar.
There we've added an extension for the specialty, and the rest was OK.
Brian Postlethwaite (Jun 07 2019 at 22:56):
For AHPRA each specialty actually has a separate idententifier, to we repeat the registration (qualification)
David Hay (Jun 07 2019 at 23:40):
So you treat the qualification and the registration as the same? ie under Practitioner.qualification?
Brian Postlethwaite (Jun 08 2019 at 05:07):
Qualifications, certifications, registration, training, all under that one backbone, they aren't really all that different.
In the core we will be clarifying that text.
The other thing we _could_ consider would be extracting that out as a resource on its own, but don't know if that's too granular too.
David Hay (Jun 09 2019 at 15:44):
Thanks Brian - I'll refactor the model and see where that takes us. At least we won't be the first with a 3 level extension!
Brian Postlethwaite (Jun 09 2019 at 17:35):
And check the VhDir IG it has some extension specifically in that area too.
John Carter (Jul 15 2019 at 04:01):
Hi @David Hay I'm independently thinking about this question and came across this thread. What's your current thinking? the referenced model is not coming up for me.
I found a reference to 'scope of practice' in the VisionPrescription resource documentation (https://www.hl7.org/fhir/visionprescription.html), but no obvious info on how that scope of practice is communicated/verified.
David Hay (Jul 15 2019 at 04:19):
based on the feedback so far, we're taking a closer look at the PUT update rather than individual operations. wrt 'scope of practice, I assume that this means those individuals who can 'prescribe' glasses - eg an optometrist...
David Hay (Jul 15 2019 at 04:21):
btw - if you have an opinion in favour of operations - or PUT updates - then speak out! Now's the time for collecting vendor preferences...
John Carter (Jul 22 2019 at 04:02):
@David Hay regarding scope of practice, yes that's basically it. Even more specifically, it might be that one provider has a special endorsement to do sunglasses or contact lenses, and my use case is to discover that from a provider directory: "show me the nearest sunglasses prescriber"
Last updated: Apr 12 2022 at 19:14 UTC
