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Document Replacement

Replacement Semantics for Transfer of Care Documents


The Transfer of Care documents allow for replacement of a previously sent document. This replacement is at a whole document level in that, the original document is replaced by a new one and the old document is only kept for audit purposes. A sender may choose to send a new replacement document for a number of reasons, for example:

  • The original document contained an error - identified after the document sent
  • The sender has more up to date or complete information - the original is correct but further information is now available to make the document more complete or detailed

Receivers of replacement documents MUST process the replacement document and archive the replaced document.

When the new document cannot be processed then:

  • The receiver of the new document SHOULD mark the original and replacement document as null and void and report a error to the sender using the ITK Response message and appropriate code see ITK3 response codes for further information.
  • The sender of the new document SHOULD mark the original and replacement document as null and void once it receives the ITK3 Response indicating that the replacement document could not be processed.

Points to Note about eDischarge Replacements

  • Replacements MAY be done more than once and the new document always refers to the previous document, multiple replacements SHOULD be avoided due to complexity of maintaining the audit trail etc.
  • Replacement documents SHOULD be sent within 24 hours of the original document.

FHIR Elements Used for Replacement

  • Composition.identifier@value on old document - UUID of original document
  • Composition.identifier@value on new document - UUID of new document
  • Composition.relatesTo.code@value fixed value of “replaces” - added to the new document
  • Composition.relatesTo.targetIdentifier@value = UUID of original document - added to the new document

Example of Use of relatesTo Element

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Tags: design

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