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Patient

Implementation guidance for populating and consuming the FHIR Patient resource

Introduction

Links to the definitions of the Patient resource within the specifications covered within this guidance.

  • Patient resource within STU3
  • Patient resource within CareConnect
  • Patient resource within R4

Minimum Viable Product (MVP)

Elements marked as MVP denote those recommended to be required for an MVP for the target use case.

Elements  
id MVP
identifier MVP
identifier (nhsNumber) MVP
active  
name MVP
telecom  
gender MVP
birthDate MVP
deceased  
address  
maritalStatus  
multipleBirth  
photo  
contact  
communication  
generalPractitioner  
managingOrganization  
link  
animal  
other CareConnect extensions  

Patient elements

id

Data Type: Id
Required / Cardinality: Required 0..1
Version Support: STU3 R4
Description: Logical id of this artifact.

Is is recommended that the logical id is the local patient identifier issued and managed within the Trust for the patient. This will typically be different to the patient’s national NHS Number.

identifier

Data Type: Identifier
Required / Cardinality: Required 0..*
Version Support: STU3 R4
Description: Business identifier for this patient.

For an STU3 or R4 implementation record the patient’s NHS Number as an identifier.

  • The Patient.identifier.use should be “official”
  • The Patient.identifier.type should be “MR”
  • The Patient.identifier.value must be the patient’s NHS Number
  • The Patient.identifier.period can be omitted unless there is a known validity period for the NHS Number

For a CareConnect implementation the identifier (nhsNumber) extension should be used for the patient’s NHS Number.

Additionally an implementation can populate an additional identifier to record any local patient identifier that is necessary for local business process interoperability.

identifier (nhsNumber)

Data Type: Identifier
Required / Cardinality: Required 0..1
Version Support: CareConnect
Description: The patient's NHS number.

Business required for a CareConnect implementation as an STU3 extension to record the patient’s NHS Number.

active

Data Type: boolean
Required / Cardinality: Optional 0..1
Version Support: STU3 R4
Description: Whether this patient's record is in active use

The element is not required for an MVP implementation.

name

Data Type: HumanName
Required / Cardinality: Required 0..*
Version Support: STU3 R4
Description: A name associated with the patient.

A single full name, that is the patient’s official name, must be recorded as a complete string within name.text.

The composite name elements of name.prefix, name.given and name.family should be included if available. The complete string used for name.text must be the concatenation of these three elements separated by a single whitespace character.

telecom

Data Type: ContactPoint
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: A contact detail for the individual

The element is not required for an MVP implementation.

gender

Data Type: code
Required / Cardinality: Required 0..1
Version Support: STU3 R4
Description: A gender associated with the patient.

Business required as a key patient demographic for patient identification.

birthDate

Data Type: date
Required / Cardinality: Required 0..1
Version Support: STU3 R4
Description: The date of birth for the individual.

Business required for two reasons;

  • Key patient demographic for patient identification
  • Can influence the medication dispensing decision process, e.g. paediatric medication

deceased[x]

Data Type: boolean or dateTime
Required / Cardinality: Optional 0..1
Version Support: STU3 R4
Description: Indicates if the individual is deceased or not.

The element is not required for an MVP implementation.

address

Data Type: Address
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: An address for the individual.

The element is not required for an MVP implementation.

The hospital Patient Administration System (PAS) will have a record of the patient address but this information is not required to be shared with the hospital pharmacy system to support the dispensing process.

maritalStatus

Data Type: CodeableConcept
Required / Cardinality: Optional 0..1
Version Support: STU3 R4
Description: Marital (civil) status of a patient.

The element is not required for an MVP implementation.

multipleBirth[x]

Data Type: boolean or integer
Required / Cardinality: Optional 0..1
Version Support: STU3 R4
Description: Whether patient is part of a multiple birth.

The element is not required for an MVP implementation.

photo

Data Type: Attachment
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: Image of the patient

The element is not required for an MVP implementation.

contact

Data Type: BackboneElement
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: A contact party (e.g. guardian, partner, friend) for the patient.

The element is not required for an MVP implementation.

communication

Data Type: BackboneElement
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: A spoken language which may be used to communicate with the patient about his or her health.

The element is not required for an MVP implementation.

A local implementation may wish to consider using this element if multi-lingual dispensing instructions are generated within the pharmacy.

generalPractitioner

Data Type: Reference
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: Patient's nominated primary care provider.

The element is not required for an MVP implementation.

managingOrganization

Data Type: Reference
Required / Cardinality: Optional 0..1
Version Support: STU3 R4
Description: Organization that is the custodian of the patient record.

The element is not required for an MVP implementation.

Data Type: BackboneElement
Required / Cardinality: Optional 0..*
Version Support: STU3 R4
Description: Link to another patient resource that concerns the same actual person.

The element is not required for an MVP implementation.

animal

Data Type: BackboneElement
Required / Cardinality: Optional 0..1
Version Support: STU3
Description: This patient is known to be an animal (non-human).

The element is not required for an MVP implementation.

This element has been removed from the FHIR R4 standard.

other CareConnect extensions

A number of additional extensions to STU3 were added to the CareConnect standard. All these extensions are not required for an MVP implementation.

  • extension (ethnicCategory)
  • extension (religiousAffiliation)
  • extension (patient-cadavericDonor)
  • extension (residentialStatus)
  • extension (treatmentCategory)
  • extension (nhsCommunication)
  • extension (birthPlace)
  • extension (nominatedPharmacy)
  • extension (deathNotificationStatus)
Tags: design

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