References

The NRL-DocumentReference-1 resource is the data model used for the pointers held on the NRL. This page outlines the population guidance for the pointer data model, referencing the associated FHIR resources and ValueSets.

Identifiers

Logical Identifier

Uniquely identifies the pointer within the NRL. Used by providers to supersede, update or delete pointers.

Additional Guidance

The format of the pointer identifier (ID) is under the control of the NRL service and the client should not make assumptions about the structure of the identifier.

If the pointer was ever to be migrated to a different NRL service instance then it is possible that its ID might change to avoid clashes with pointers on the target NRL service.

Master Identifier

The master identifier is an optional identifier generated by the provider; it can be thought of as a business identifier but must be unique within the boundary of the NRL.

A unique master identifier MUST be used for each pointer:

• Once a master identifier has been used in the creation of a pointer, the same master identifier value MUST NOT be re-used with another pointer.
• ‘Superseding’ a pointer requires a new unique master identifier value to be used.
• Master identifiers from deleted pointers MUST NOT be used again for new or superseding pointers.

It is recommended that the scope of the master identifier’s uniqueness extends beyond the NRL service, ideally as a globally unique business identifier using an OID or UUID; this is helpful in scenarios where provider merge, or where a migration of the NRL is required. In this case, the values for system and value should match the following pattern (see the FHIR identifier registry for more details and the FHIR specification for some examples):

The NRL guarantees that no two pointers for the same patient (identified by NHS number) will have the same master identifier. It is the responsibility of the provider to ensure the master identifiers it creates are unique across all pointers for a patient (ideally all patients). Should a provider attempt to create a pointer with an identical master identifier to an existing pointer for the same patient, the request will be blocked.

Patient

The patent’s NHS Number to which the pointer relates.

Pointer Metadata

FHIR Profile

The URI of the FHIR profile the resource conforms to, indicating the version of the pointer model.

Additional Guidance

The FHIR profile which the pointer conforms to will be indicated in this metadata attribute to enable consumers to support the different versions of the pointer model. Major changes to the pointer model will be reflected in the NRL DocumentReference FHIR profile, using the naming convention NRL-DocumentReference-[major_version].

Pointer Owner

ODS code for the pointer’s owner organization.

Pointer Status

The status of the pointer.

Additional Guidance

Only pointers with the current status will be available to consumers.

Pointer Versioning

Metadata used to track the current version of a pointer.

Related Pointer

Relationship referencing the previous version of a pointer, which has been superseded.

Additional Guidance

For further detail on superseding a pointer, see the Supersede interaction page.

Information Metadata

Information Category

A high-level category of the information, from a set of supported categories.

Information Type

The clinical type of the information. Used to support searching to allow consumers to make sense of search results containing many pointers.

For further information on which types are supported, see the Supported Pointer Types page.

Clinical Setting

Describes the clinical setting in which the information was recorded.

Information Owner

ODS code for the information owner organization.

Period

Optional information detailing the period the record is/was active.

Information Creation Date

The date and time (on the provider’s system) that the information was created, for static records.

Additional Guidance

The information creation date is specific to each format of the record that is referenced on the pointer. Where the creation date is included and multiple formats are referenced, the creation date must be set for each individual format.

Retrieval Information

Retrieval URL

Absolute URL for the location of the information on the provider’s system and/or a service that allows you to look up information based on the provider url, e.g. a web page with service contact details.

Retrieval Format

Describes the technical structure and rules of the information such that the consumer can pick an appropriate mechanism to handle the retrieved information.

For further information on which formats are supported, see the Supported Formats on the Information Retrieval Overview page.

Retrieval MIME Type

Describes the type of data such that the consumer can pick an appropriate mechanism to handle the information.

Information Stability

Describes whether the information content at the time of the request is dynamically generated or is static.

Examples

JSON Example

A JSON example of a DocumentReference resource is displayed below:

{
  "resourceType": "DocumentReference",
  "id": "c037a0cb-0c77-4976-83a1-a5d2703e6aa3-23325861873450086113",
  "meta": {
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/NRL-DocumentReference-1"
    ]
  },
  "status": "current",
  "type": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "736253002",
        "display": "Mental health crisis plan"
      }
    ]
  },
  "class": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "734163000",
        "display": "Care plan"
      }
    ]
  },
  "subject": {
    "reference": "https://demographics.spineservices.nhs.uk/STU3/Patient/9876543210"
  },
  "indexed": "2016-03-08T15:26:01+01:00",
  "author": [
    {
      "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/RGD"
    }
  ],
  "custodian": {
    "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/RR8"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "url": "https://p1.nhs.uk/MentalhealthCrisisPlanReport.pdf",
        "creation": "2016-03-08T15:26:00+01:00"
      },
      "format": {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/NRL-FormatCode-1",
        "code": "urn:nhs-ic:unstructured",
        "display": "Unstructured Document"
      },
      "extension": [
        {
          "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-NRL-ContentStability-1",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://fhir.nhs.uk/STU3/CodeSystem/NRL-ContentStability-1",
                "code": "static",
                "display": "Static"
              }
            ]
          }
        }
      ]
    }
  ],
  "context": {
    "period": {
      "start": "2016-03-07T13:34:00+01:00"
    },
    "practiceSetting": {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "708168004",
          "display": "Mental health service"
        }
      ]
    }
  }
}

XML Example

An XML example of a DocumentReference resource is displayed below:

<DocumentReference xmlns="http://hl7.org/fhir">
  <id value="c037a0cb-0c77-4976-83a1-a5d2703e6aa3-23325861873450086113" />
  <meta>
    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/NRL-DocumentReference-1" />
  </meta>
  <status value="current" />
  <type>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="736253002" />
      <display value="Mental health crisis plan" />
    </coding>
  </type>
  <class>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="734163000" />
      <display value="Care plan" />
    </coding>
  </class>
  <subject>
    <reference value="https://demographics.spineservices.nhs.uk/STU3/Patient/9876543210" />
  </subject>
  <indexed value="2016-03-08T15:26:01+01:00" />
  <author>
    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/RGD" />
  </author>
  <custodian>
    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/RR8" />
  </custodian>
  <content>
    <attachment>
      <contentType value="application/pdf" />
      <url value="https://p1.nhs.uk/MentalhealthCrisisPlanReport.pdf" />
      <creation value="2016-03-08T15:26:00+01:00" />
    </attachment>
    <format>
      <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-FormatCode-1" />
      <code value="urn:nhs-ic:unstructured" />
      <display value="Unstructured Document" />
    </format>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-NRL-ContentStability-1">
      <valueCodeableConcept>
        <coding>
          <system value="https://fhir.nhs.uk/STU3/CodeSystem/NRL-ContentStability-1" />
          <code value="static" />
          <display value="Static" />
        </coding>
      </valueCodeableConcept>
    </extension>
  </content>
  <context>
    <period>
      <start value="2016-03-07T13:34:00+01:00" />
    </period>
    <practiceSetting>
      <coding>
        <system value="http://snomed.info/sct" />
        <code value="708168004" />
        <display value="Mental health service" />
      </coding>
    </practiceSetting>
  </context>
</DocumentReference>