Stream: CARIN IG for Blue Button®
Topic: CARIN BB Stu2 Search
Josh Lamb (Jan 27 2021 at 00:33):
[need to think this through some more]
Pat Taylor (Jan 28 2021 at 12:47):
@Josh Lamb In response to: "can we consider an agenda item to add: SHALL support on GET [base]/Patient?identifier={system|}[code] ? This should not have any implementation burden and will increase alignment with US Core patients. I hope that as the IG discussions develop we can help define some cross-system compatible identifiers (patient identifiers that will help locate a patient across systems). There are options for consumers to select and provide a voluntary "identity-proofed" value too, which is why I thought this will fit under CARIN."
A search by patient is not defined in the CARIN IG. The patientID is locked down after the member authenticates. The CARINBB search interface is EOB-centric, with all EOBs associated with the same patient. @Amol Vyas
Josh Lamb (Jan 28 2021 at 13:22):
Hi @Pat Taylor how will we get the FHIR ID?
Michele Mottini (Jan 28 2021 at 15:17):
From the token response using launch/patient (you implemented it!)
Josh Lamb (Jan 28 2021 at 16:19):
@Michele Mottini , sorry the question was misleading.
The goal of the PASS ID is to obtain an identifier that can be used to identify the same person in multiple systems (if they volunteer to use the ID). If we begin to include teh pass id as an identifier on patient, how can we use the PASS id to get a FHIR patient id?
Michele Mottini (Jan 28 2021 at 16:28):
in CARIN BB you don't / can't - it is all based on patient granting access to data and the client gets the FHIR patient id from the authorization flow
Josh Lamb (Jan 28 2021 at 16:35):
I know you can't (now), but I am attempting to brainstorm how to improve data flows, which is critical.
What we have now is a model that requires extreme user engagement to pull data. We have the pieces to make this work, just need to have a consensus on how we will exchange.
Michele Mottini (Jan 28 2021 at 16:37):
You'd need to change the authentication method, that would require trust relationships and business agreement - a non-starter at scale
Josh Lamb (Jan 28 2021 at 18:27):
HIPAA covered entities do not need BAA to perform a direct exchange on the consumer's request. We could pick up the phone, call each other, and fax the data if we wanted.
There is also efforts to create a trusted directory of payers and providers. The PASS ID can be a useful way to provide the missing identity piece. The question I am asking assume we have a few key challenges solved (trust and endpoint awareness and identity proofing). Now that we have this identity proofed id, how do we use it to make FHIR calls to multiple systems without multiple logins (to get the FHIR ID).
An OPEN ID Requirement plus the PASS ID and search on patient?_identitifier=passid|system is at least a reasonable sequence of events to enable data to flow from multiple systems.
Last updated: Apr 12 2022 at 19:14 UTC
