Stream: CARIN IG for Blue Button®
Topic: Codeset System URI
Suma Addagadde (Mar 13 2021 at 16:44):
@Pat Taylor , @Amol Vyas , @Nagarjuna Sanivarapu , @Zak Guler , @Suma Vishnumoorthy , @Shailesh Prabhu
We would like to keep a generic system URL in the JSON mapping response, and not show our company domain within the system URL for codesets. Would it be ok to default all our system URL to have http://hl7.org/fhir/codesetvalue
please let us know if this would be acceptable from compliance and IG perspective
an example would be as depicted below where in the system/value structure, we need to depict a system URL that we would like to keep it generic.
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB"
}
]
},
"system" : "http://hl7.org/fhir/codesetvalue",
"value" : "1234-234-1243-12345678901"
}
Pat Taylor (Mar 13 2021 at 18:28):
@Corey Spears
Amol Vyas (Mar 13 2021 at 22:01):
Suma Addagadde said:
Pat Taylor , Amol Vyas , Nagarjuna Sanivarapu , Zak Guler , Suma Vishnumoorthy , Shailesh Prabhu
We would like to keep a generic system URL in the JSON mapping response, and not show our company domain within the system URL for codesets. Would it be ok to default all our system URL to have http://hl7.org/fhir/codesetvalue
please let us know if this would be acceptable from compliance and IG perspectivean example would be as depicted below where in the system/value structure, we need to depict a system URL that we would like to keep it generic.
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB"
}
]
},
"system" : "http://hl7.org/fhir/codesetvalue",
"value" : "1234-234-1243-12345678901"
}
@Suma: Thanks for the feedback. I believe you are talking about Identifier.value. While the Identifier.type is set to be a common concept (bound to the common "C4BB Claim/Patient/... Identifier Type" value sets), the value of the Identifier (i.e. Identifier.value) will almost always be specific to your implementation. For example, the value in the "Member/Claim... Id" column in your Facets Member/Claim... table. You can populate Identifier.system to elaborate on the value's specificity i.e. qualify it under your system-specific namespace (for example, "http://bcbsnc.com/fhir/Member/Identifier/Facets4"). Having said that, I can see an argument to not make Identifier.system, MustSupport-ed, especially when Identifier.type is already MustSupport-ed.
A possible scenario where you might want to provide a Identifier.system anyway is when you might have more than one source of truth for a domain (for example, more than one membership system of record row for the same member - due to same members across different version configurations, different LOBs, etc). In this case you would create another Identifier with the same Identifier.type=MB but a different Identifier.system (for example, "http://bcbsnc.com/fhir/Member/Identifier/Facets7.5"). Again, a payer may also/instead choose to expose the master/unique member identifier (i.e. Identifier.type=UM) across all configurations/LOBs.
@Pat Taylor , @Corey Spears : Lets talk about the MustSupport flag on the Identifier.system in our next huddle.
Suma Addagadde (Mar 15 2021 at 18:34):
Thank you Amol for the detailed clarification. This is very helpful
As a follow-up, for the below configuration, although this is specific to our implementation, would it be ok to configure the system URL as a generic URL such as "http://hl7.org/fhir/codesetvalue"
Are we deviating from compliance by using a URL that does not have bcbsnc.com?
},
"system" : "http://hl7.org/fhir/codesetvalue",
"value" : "1234-234-1243-12345678901"
}
Michele Mottini (Mar 15 2021 at 19:41):
If that's you own system it is better if it uses a URL you control (that ideally should resolve to a page with details about that system). For sure it should not references hl7.org
Suma Addagadde (Mar 16 2021 at 03:27):
Thanks Michele
Amol Vyas (Mar 16 2021 at 10:05):
@Suma: While you could theoretically put any uri in Identifier.system, it is really meant to capture Identifier.value's source. Some examples you can consider for FHIR system uri's for Identifier.value: "https://www.bcbsnc.com", "https://www.bcbsnc.com/fhir/identifiers", "https://www.bcbsnc.com/fhir/patientidentifier", etc.
Also, please note that the MustSupport flag and 1..1 cardinality for C4BBPatient's Identifier.system, are really coming from USCore Patient. As indicated above, honoring these two requirements should not be a heavy lift for CARIN IG implementers.
Last updated: Apr 12 2022 at 19:14 UTC
