Stream: united states
Topic: Provider Directory State License Number
Jennifer Grill (Jan 06 2021 at 18:47):
Any suggestions on how to include a provider state license number? Most likely I will use Practitioner.identifier but unsure of the system uri. It was suggested to use type.txt to provide a description of both the type of license and the jurisdiction. Any other suggestions?
Also, I am looking for any other resources, groups, chats to join to become FHIR proficient for a provider directory
Thank you!
Vassil Peytchev (Jan 06 2021 at 19:25):
I think Practitioner.qualification is the proper place to record license details. From the definition:
For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certain locality.
Eric Haas (Jan 06 2021 at 19:38):
look at for example pdex plan net: https://build.fhir.org/ig/HL7/davinci-pdex-plan-net/StructureDefinition-plannet-Practitioner.html or the VHDIR spec
Jennifer Grill (Jan 06 2021 at 21:55):
Vassil Peytchev said:
I think Practitioner.qualification is the proper place to record license details. From the definition:
For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certain locality.
Thank you! Any suggestions on the system uri?
Lloyd McKenzie (Jan 07 2021 at 02:09):
@Eric Haas @Brett Marquard Is there any intention to start collecting URIs for key U.S. state and national identifier URIs somewhere - either U.S. Core or elsewhere? (It would be a really good idea...)
Eric Haas (Jan 07 2021 at 04:44):
I have brought this up before. There is a bunch of US Centric identifiers in the FHIR Specification. I am not sure the IG is the best place for this type of information however, but rather some sort central registry. Also creating system uris seems to be an area of some contention and I am not sure what the process is for that. @Rob Hausam may have more experience here.
Robert McClure (Jan 14 2021 at 00:56):
These are classic namingsystem things. Process is to talk to HTA but someone will need to do the work of creating them but HTA can reach out to the entity responsible to begin the process of determining identifiers and metadata.
Lloyd McKenzie (Jan 14 2021 at 04:56):
Except that we don't necessarily want the URLs to point to sites owned by the responsible organization - because many aren't capable of establishing permalinks. Also, we're probably talking about close to 1000 naming systems here. (Every state * every authoritative licensing/regulatory body for any medically affiliated practice - from acupuncture to veterinary medicine.) I'm pretty sure the HTA doesn't want to engage with that many organizations and try to drive all of those conclusions to a logical end. Plus, you'd end up with a completely inconsistent set of URLs - both within states and within disciplines. I'd strongly advise that you just define an algorithmic basis for defining HL7-hosted sids that you can use as canonical URLs for all of the possible license numbers that could exist. Then register all the ones that you know do exist. The NamingSystem instances can then have descriptions that point to whatever the sponsoring organization currently is and the appropriate website for that identifier (if any). It'll take a bit of discussion, but should be something you could get figured out in a few months. (Best of luck to the HTA getting even 1/4 of them landed in a year - and they wouldn't be anywhere close to implementer friendly.)
Jennifer Grill (Jan 14 2021 at 20:33):
According to the spec for the value set found here: http://hl7.org/fhir/R4/valueset-identifier-type.html#definition "MD Medical License number" so MD is the code used for Medical License . We were planning to use the state of jurisdiction and it works out well for the following DC example image.png
but for Maryland or for the cases that we don't have a state it could be confusing. MD could be Medical Doctor, Maryland, and/or in FHIR simply Medical License Number. Any suggestions on how to better represent this data: image.png
Thanks for you help and patience on these questions
Robert McClure (Jan 14 2021 at 21:59):
@Lloyd McKenzie
I'd strongly advise that you just define an algorithmic basis for defining HL7-hosted sids that you can use as canonical URLs for all of the possible license numbers that could exist. Then register all the ones that you know do exist. The NamingSystem instances can then have descriptions that point to whatever the sponsoring organization currently is and the appropriate website for that identifier (if any).
Agree. And HTA should be the entity to take on the approach. @Carol Macumber @Julie James , otherwise we consider this only happening in the USA, and it falls to CWG/USRSC which I doubt.
Michele Mottini (Jan 14 2021 at 22:08):
@Jennifer Grill The type of the identifier does not do much, what is needed is a unique system uri
Jennifer Grill (Jan 14 2021 at 22:26):
@Michele Mottini that was my earlier question and since there really is no unique system uri for each state's medical license number we are using the type identifier
Michele Mottini (Jan 14 2021 at 23:13):
Got it - but client would not be able to do much with the type, better to just invent your own system URIs
Jennifer Grill (Jan 14 2021 at 23:49):
@Michele Mottini Interesting! I need to think about this some more
Robert McClure (Jan 15 2021 at 00:14):
IF you make up a system URI then it needs to be shared - hence the approach Lloyd and I discussed. If you do things on your own things can get lost and be incomplete. But it's expedient...
Lloyd McKenzie (Jan 15 2021 at 00:48):
Identifier.type.text can't be used for computation. From type.coding, you can know that it's a license identifier, but not from what jurisdiction. The type.text just conveys that information to a human. To do a full computable match, a system is needed - and it needs to be one that everyone uses consistently - which is why there's a need for a process to determine (and publicly post) the URIs for all of the various license namespaces that exists. Until that happens, full computable matching isn't going to be possible.
Jake Metzman (Mar 23 2022 at 17:59):
@Jennifer Grill what solution did you end up going with for this? I'm facing a similar problem where I need to represent state license number in Pracititioner. Did you go with the solution of using https://hl7.org/fhir/ValueSet/identifier-type as system and text field to distinguish different states?
Jennifer Grill (Mar 28 2022 at 17:50):
@Jake Metzman - Hi Jake! We are using Practitioner.qualification.identifier. I hope that helps
Brendan Keeler (Mar 28 2022 at 18:38):
Adding on here. I have these three fields I'm trying to figure out how to encode into Practitioner.
"license": "G3455",
"license_state": "CA",
"credentials": "MD",
"specialty": "Family Medicine",
Reading this thread, it seems like license would be qualifications.identifier, license_state is covered by the PlanNet extension, MD could be qualifications.code.text, and speciality another qualifications.code.text. Is that right?
Lloyd McKenzie (Mar 29 2022 at 14:49):
@Brian Postlethwaite
Last updated: Apr 12 2022 at 19:14 UTC
