low level details for the care connect patient 'id' element

Identifier Implementation Guide

Use case

This specification describes a single use case.

Element Usage

Care Connect uses the Patient.Identifier element and creates two independent sliced elements that can capture a patients identifier as either a national identifier (NHS Number) or an alternative local identifier.

NHS Number Identifier

Type name Data Type Description
Slice identifier Identifier A unique national and/or local identifier for a patient
Complex identifier#1 [nhsNumber] Identifier The patient NHS Number.
Extension nhsNumberVerificationStatus CodeableConcept An extension with a required valueset that determines the status of the NHS number allocated to the patient.
  • ‘nhsNumber’ MUST be used where available. This is the primary identifier for a patient registered with a GP practice geographically located in England, Wales or Northern Ireland.
  • The NHS number MUST consist of a 10 digit numeric value.
  • Hyphenation in the number MUST NOT be used.
  • Spaces between numbers MUST NOT be stored.
  • The namespace for the nhsNumber MUST be defined as http://fhir.nhs.net/Id/nhs-number
  • The nhsNumber MUST be stored as a string value
  • A local identifier MAY be used in addition to the NHS number.

NHS Number Verification Status

CareConnect NhsNumberVerificationStatus extension profile:

http://hl7.org.uk/CareConnect-NhsNumberVerificatnStatus-1-Extension.structuredefinition.xml

Consumers SHALL use the NHS Number Verification Status where nhsNumber is used as the primary patient identifier.

The extensions uses the following valueset:

http://hl7.org.uk/CareConnect-NhsNumberVerificationStatus-1.valueset.xml

This valueset comprises of codes from the NHS data Dictionary: NHS Number Status Indicator Code which can be viewed at NHS Number Status Indicator Code

NHS Status Indicator Codes

Code Display
01 Number present and verified
02 Number present but not traced
03 Trace required
04 Trace attempted - No match or multiple match found
05 Trace needs to be resolved - (NHS number or patient detail conflict)
06 Trace in progress
07 Number not present and trace not required
08 Trace postponed (baby under six weeks old)

Example of correct usage

Usage Element examples Comments
Tick nhsNumber 4025561234 Patients 10 digit NHS number stored as a string

Examples of incorrect usage

Usage Element examples Comments
Cross nhsNumber 402 556 1234 NHS number must not store spaces in the number
Cross   402-556-1234 NHS number must not use hyphenation in the number

The language in which the patient wishes to communicate. Only one language can be used captured here.

On the wire XML example

<identifier>
	<extension url="http://hl7.org.uk/fhir/CareConnect-NhsNumberVerificationStatus-1-Extension">
		<valueCodeableConcept>
			<coding>
			 <system value="http://hl7.org.uk/fhir/ValueSet/CareConnect-NhsNumberVerificationStatus"/>
			 <code value="01"/>
			 <display value="Number present and verified"/>
			</coding>
		</valueCodeableConcept>
	</extension>
	<system value="https://fhir.nhs.uk/Id/nhs-number"/>
		<value value="1352465790"/>
</identifier>

On the wire example in JSON

{
  "identifier": {
    "extension": {
      "-url": "http://hl7.org.uk/fhir/CareConnect-NhsNumberVerificationStatus-1-Extension",
      "valueCodeableConcept": {
        "coding": {
          "system": { "-value": "http://hl7.org.uk/fhir/ValueSet/CareConnect-NhsNumberVerificationStatus" },
          "code": { "-value": "01" },
          "display": { "-value": "Number present and verified" }
        }
      }
    },
    "system": { "-value": "https://fhir.nhs.uk/Id/nhs-number" },
    "value": { "-value": "1352465790" }
  }
}

Error Handling

The provider system SHALL return an error if:

  • the nhsNumber is invalid (i.e. fails NHS Number format and check digit tests).
  • the nhsNumber is not associated with a NHS Number Status Indicator Code

Other Identifiers

Provider systems MAY use alternative patient identifiers in addition to the nhsNumber sliced element.

Type name Data Type Description
Slice identifier Identifier A unique national and/or local identifier for a patient
Complex identifier#2 [other] Identifier Alternative identifers for a NHS patient.
  • other MUST NOT be used in place of an NHS Number
  • Providers MAY uses multiple local identifiers where it is appropreiate
  • Providers MAY use other in addition to nhsNumber`
  • The namespace for the other MUST be populated when identifier is used
  • The other MUST be a populated string value

Examples

On the wire example XML

<identifier>
	<system value="http://fhir.nhs.uk/Id/local-identifier"/>
		<value value="MRT12345"/>
</identifier>

On the wire example JSON

{
  "identifier": {
    "system": { "-value": "http://fhir.nhs.uk/Id/local-identifier" },
    "value": { "-value": "MRT12345" }
  }
}

Error Handling

The provider system SHALL return an error if:

TODO

Tags: profile design