Stream: patient administration WG
Topic: Distributed Patient Record
Yuval Romm (Feb 23 2022 at 19:41):
Hello to all. This is my first post on this channel.
My health system (Northwell Health) is in the process of converting our HIE data into FHIR. Our HIE maintains a hub-and-spoke architecture of our hospitals and ambulatory practices. The "hub" is our patient index and the "spokes" are individual hospitals/practices.
Current capabilities:
- This model allows us to view the FULL aggregated patient record or PARTIAL by selecting specific sources to look at.
- Demographics could conflict/change over time and we need to maintain clarity on each source's demographics data for a patient.
As we transition to FHIR we want to maintain the above two capabilities. How would we design our FHIR resource architecture for patients?
Options:
- Use Person resource as the "golden record" version of the aggregated demographics and link to the resource ALL relevant Patient resources with clinical data hanging off each of those?
-
Manage 1 "formal" Patient resource ALONG WITH Patient.link (replaces) records with individual source demographics.
Clinical data will ALL be under the "formal" patient record with possible tags pointing to the source Patient record for filtering purposes. -
Something else?
Would love to have an on-camera zoom/Teams meeting to get this group's understanding of the pros, cons, and general challenges.
Thank you!
René Spronk (Feb 25 2022 at 14:05):
This probably a good topic for the #implementers channel given that its scope is much wider than just patient administration, this being an architectural design question.
What you maintain at the hub need not be what you expose to a FHIR client. If there is a strong use case for #2, go for #2. Otherwise, keep things simple by using #1.
Last updated: Apr 12 2022 at 19:14 UTC
