FHIR Chat · GG Comment: 2 facts for identifying people

Stream: smart/health-cards

Topic: GG Comment: 2 facts for identifying people

Josh Mandel (Sep 02 2021 at 15:21):

I believe that the DM profile for patient will be a problem in Australia, since the clinical standard here is three facts for identifying people, while the card only has two - name, dob. Why not include gender as at least allowed? (I may be wrong in my surmise; this may never qualify as clinical - I've given up predicting how these things play out)

We've heard significant trepidation about including "gender" as an attribute in these Health Cards (both in VCI community, and in WHO (see functional requirements -- sex "not needed" for vaccine verification). The prospect of preventing someone from verifying their vaccination status because of a misgendering, or introducing the evaluation of a person's gender into the context of vaccine verification, raises serious concerns that we wanted to avoid. (This is true especially because SMART Health Cards are designed to be used in the context of some existing identification; the aim has been to include just enough identity information to bind them.) If this is a show-stopper in the Australian context, that'd be good to understand; but it sounds like the jury is still out on that.

Paul Denning (Sep 02 2021 at 16:39):

Grahame Grieve said:

...

I believe that the DM profile for patient will be a problem in Australia, since the clinical standard here is three facts for identifying people, while the card only has two - name, dob. ...

http://hl7.org/fhir/uv/shc-vaccination/2021Sep/StructureDefinition-shc-patient-general-dm.html allows Patient.identifier in addition to name and dob

but http://hl7.org/fhir/uv/shc-vaccination/2021Sep/StructureDefinition-shc-patient-us-dm.html#tab-diff makes Patient.identifier 0..0

Grahame Grieve (Sep 02 2021 at 19:00):

https://www.safetyandquality.gov.au/sites/default/files/migrated/Standard5_Oct_2012_WEB.pdf page 10. 3 facts from:

patient name (family and given names)
date of birth
gender
address
medical record number
Individual Healthcare Identifier

Josh Mandel (Sep 02 2021 at 19:01):

So name, dob, and one of the identifiers would work, if this turns out to be considered a "clinical" use case (?)

Grahame Grieve (Sep 02 2021 at 19:02):

Given that, I don't think that AD profile should prohibit those things, because as you point out, there is a problem with including identifiers.

Grahame Grieve (Sep 02 2021 at 19:02):

prohibiting gender forces identifier. That sounds like a bad policy decision to me.

Josh Mandel (Sep 02 2021 at 19:02):

As Paul notes, for the US patient data minimizing profile, we don't have national healthcare identifiers and wanted to prevent over-sharing of identifiers baked into health cards.

Grahame Grieve (Sep 02 2021 at 19:03):

and the problems with gender don't exist in the Australian context in the same way, since you must have a registered gender anyway (move the problems around)