Patient (PS-BC)

Patient Profile

BC will use PanCanadian Patient Summary for Patient (PS-CA) Profile for now with the following difference.. 

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ1..1CodeableConceptBindingFixed Value
systemΣ1..1uri
valueΣ1..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
activeΣ ?!0..1boolean
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
textS Σ0..1string
familyS Σ0..1string
givenS Σ0..*string
prefixΣ0..*string
suffixΣ0..*string
periodΣ I0..1Period
telecomΣ I0..*ContactPoint
genderS Σ1..1codeBinding
birthDateS Σ1..1date
deceasedBooleanboolean
deceasedDateTimedateTime
addressΣ I0..*Address
maritalStatus0..1CodeableConceptBinding
multipleBirthBooleanboolean
multipleBirthIntegerinteger
photoI0..*Attachment
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
relationship0..*CodeableConceptBinding
name0..1HumanName
telecomI0..*ContactPoint
address0..1Address
gender0..1codeBinding
organizationI0..1Reference(Organization)
periodI0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
language1..1CodeableConceptBinding
preferred0..1boolean
generalPractitionerI0..*Reference(Organization | Practitioner | PractitionerRole)
managingOrganizationΣ I0..1Reference(Organization)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
otherΣ I1..1Reference(Patient | RelatedPerson)
typeΣ1..1codeBinding

 

 

BC Patient FHIR Profile for Patient Summary:

 

PS-CA has a specific Patient Profile.

In BC, we have Patient FHIR Profile provided by BC Client Registry (EMPI). There are differences between PS-CA and EMPI's Patient Profiles. EMPI is in line with Canadian Baseline's FHIR specifications.

  • name: EMPI's Patient Profile, this element is (0..*) (EMPI's (S) indicates it must be supported.) and according to EMPI team, it will always be provided, but PS-CA needs at least one name(1..*). According to Canada Health Infoway's FHIR SME suggestion, while it may appear optional in BC-EMPI or baseline, a restriction (through invariant) mandates the validator to generate an error message if the given or family name of a patient remains unpopulated. Consequently, we suggest adhering to the precedent set by PS-CA and treating this as an obligatory requirement (filling in the relevant fields wherever possible and marking them with 'unknown' or a comparable designation to indicate the absence of information in the IG).

  • identifier/MRN: EMPI does not explicitly define MRN. If it is considered as other identifiers, then there is a discrepancy around type. PS-CA requires type for MRN, but IdentifierCABaseline marked it as optional. Infoway suggests: if an identifier is specifically mentioned type as MRN, then it should be mapped to the MRN identifier with the fixed type value of MR. Otherwise, it should be mapped as all slices.

  • gender: Gender is required by PS-CA while it is marked as optional in EMPI (cardinality is 0..1). Though there is a tag (S) which binds the implementation to support. Infoway suggests if gender is provided, that will be mapped; otherwise should be set as "unknown." This would be compliant with PS-CA.

  • birthDate: BirthDate is required on PS-CA but optional in EMPI. EMPI tagged (S) as must be supported. Infowaysuggests upon a cursory review of the patient summary specifications, including PS-CA, PS-ON, and IPS, among others, it appears that all of them classify this element as mandatory. We propose filling the birthdate field to the fullest extent possible. This will ensure that PS-BC aligns with the patient profiles specified by PS-CA, International Patient Summary (IPS), and other jurisdictions. Per the FHIR specification, "For this element, it is expected to provide an estimated year as a guess, at least if the real DOB is unknown." If the estimation is impossible, a similar course of action (as name) can be pursued, such as designating a date like '1800-01-01' and clarifying this in the IG.

  • Deceased date: EMPI implements the deceased date time as a DateTime value. If the value exists, the Boolean should be set as true, and the value should be set as Deceased DateTime. The element has [x], which means that by choice, both Boolean and date-time values are acceptable. Either of these means the patient is deceased.