Stream: inferno
Topic: Identifier in Organization Resource
Lakshmi Bhamidipati (Feb 25 2021 at 17:10):
Hello,
Is it required to always display an NPI for an Organization instance as the tool states -
"Could not find identifier, identifier.system, identifier.value, address.country, Organization.identifier:NPI in the 1 provided Organization resource(s)"
OR
Can the organization have any other system and value? The Reference Server has organization instances with identifier set to
{
"system": "https://github.com/synthetichealth/synthea",
"value": "5d4b9df1-93ae-3bc9-b680-03249990e558"
}
OR
At least one of the organizations must have an NPI?
In the reference server data, one of the organizations has an NPI, the others do not.
"identifier": [
{
"system": "https://github.com/synthetichealth/synthea",
"value": "56090ab7-1f97-37ff-a434-194f9c6e5510"
},
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "9999999999"
},
{
"system": "urn:oid:2.16.840.1.113883.4.7",
"value": "9999999999"
}
]
I am assuming there MUST be an identifier in every instance for the test cases to pass; We can't use DataAbsentReason system and value = "Unknown".
I appreciate your feedback on this.
Yunwei Wang (Feb 25 2021 at 17:18):
According to US Core 3.1.1
Each Organization must support:
An identifier
SHALL support National Provider Identifier (NPI) for organizations
SHOULD support Clinical Laboratory Improvement Amendments (CLIA) for laboratories.
There are two level of MS here:
Organzation.identifier and Organization.identifier:NPI
Th server shall demonstrate that it support these elements when the data exist.:
1) There must be at least one Organization resource having Organzation.identifier
2) Organzaiton.identifier may have multiple identifiers from different systems. At least one Organization having one identifier using NPI.
Robert Scanlon (Feb 25 2021 at 17:45):
How I think about it: You must provide at least one example of an Organization with an NPI filled out to prove you support sending that data. You do not need to provide an identifier (NPI or otherwise), on every Organization, because the profile does not require that.
Robert Scanlon (Feb 25 2021 at 17:46):
And you don't have to use a data absent reason on that field if you don't have that data, because it has a cardinality of 0..1.
Robert Scanlon (Feb 25 2021 at 17:47):
If you cannot get the test to pass by sending a mix of organizaitons with/without NPI, let us know, I believe that would be a bug.
Lakshmi Bhamidipati (Feb 25 2021 at 18:02):
@Yunwei Wang @Robert Scanlon - Thank you for your replies. I think I am finally getting the hang of "Must Support" ... It means that the system should demonstrate the ability to send data for at least one of the resource instances. In this case, if my patient belongs to multiple practices in an EHR system (in FHIR speak - organization), then at least one of the practices should have an NPI, the others need not. @Robert Scanlon - Regarding your comment of getting a test to pass by sending a mix of organizations... the reason I asked is because the Inferno reference server Organization tests show some of the organization instances belonging to https://github.com/synthetichealth/synthea system and the last organization is represented by 3 IDS - an ID belonging to the synthea system , an NPI and an OID
Robert Scanlon (Feb 25 2021 at 18:15):
In this case, if my patient belongs to multiple practices in an EHR system (in FHIR speak - organization), then at least one of the practices should have an NPI, the others need not
Yes. We will look at every single Organization you have referenced anywhere for evidence that you can fill in that field.
Robert Scanlon (Feb 25 2021 at 18:34):
Any time you see 'must support' think: system-level requirement, not resource-level requirement. These automated tests choose to verify that system-level requirement with "show me at least one valid example, anywhere". There could be other ways of verifying that requirement.
Robert Scanlon (Feb 25 2021 at 18:38):
One other thing to note: you can provide multiple patient ids, and we will look across every single patient record you have provided for that evidence. So only one Organization referenced by one of the patient records needs to have that field. We do that in case it is difficult to construct a single patient in your system that exhibits all of the must support fields. There are a lot!
Lakshmi Bhamidipati (Feb 25 2021 at 18:58):
Good to know. Thank you!
Lakshmi Bhamidipati (Mar 01 2021 at 21:46):
@Robert Scanlon - One of my practitioner tests is failing with this error - Could not find Practitioner.identifier:NPI in the 2 provided Practitioner resource(s). (Since my previous question is related to Identifier, I am using this message to an Identifier:NPI related question.) Both the practitioner s in the test have an NPI. So I am not sure why I am getting the error. Any thoughts. The response for both the resources is as follows -
{
"resourceType": "Practitioner",
"id": "1",
"identifier": [
{
"system": "http://hl7.org.fhir/sid/us-npi",
"value": "1104857435"
}
],
"name": [
{
"family": "provider",
"given": [
"Api"
]
}
],
"telecom": [
{
"system": "phone",
"value": "7573232332",
"use": "mobile"
}
]
}
Robert Scanlon (Mar 02 2021 at 13:50):
I think you have a typo on the system, it should be http://hl7.org/fhir/sid/us-npi
Last updated: Apr 12 2022 at 19:14 UTC
