InterweaveLocation

FHIR Profile

The Notts Care Record will use the InterweaveLocation Resource Profile as published in the Interweave Implementation Guide
## **Notts Guidance** The goal for sharing of locations is not necessarily to build a detailed model of the real-world, but rather to provide a simple representation which is easy for Data Consumers to interpret and display. The purpose is to understand where a patient has been, give some insight into the type of services typically provided at that location, and provide contact details if further follow up is desired.

Hierachy

For some organisations (e.g. acute hospitals) locations will be hierarchical, therefore a 4-level model of site -> building -> ward -> room is proposed for those settings. An alterantive model would be to incorporate level/floor: site -> building -> floor -> ward could also be used if appropriate.

Name

A particular issue is making it easy and efficient for Data Consumers to understand the hierarchy. As such the location "name" (which is used in references) MUST be provided, and where relevent MUST relect the hiearchy without the need for Data Consumers to make multiple additional queries to follow a tree.

In practice this means the location name must incorporate the hierarchy. For example: "Queens Medical Centre: South Block: B Floor: Ward B47"

(In contrast just naming the location "Room xyz" is meaningless to a consumer without further queries to follow the references, trace the tree, and assemble these details for themselves every time)

Status

Status MUST be provided, and will normally be “active”, and only active locations should be used in new references. However it may be necessary to retain locations at other statuses (eg inactive) if they have already been used in references

Type

Type MUST be provided, and is used to indicate the type of services are typically provided at the location. The standard code list has some very generic entries (see below), these should cover most eventualities at a high level, however there are some useful more specific entries which might me more relevent to some locations that are used for specialist services.

Code       Display
HOSP Hospital
HU Hospital unit
ER Emergency room
RH Rehabilitation hospital
PTRES Patient's Residence
COMM Community Location
CSC Community Service Centre

Physical Type

Physical Type MUST be provided, the key ones from the standard code list that will be used in the Notts Care record are:

Code       Display       Definition
si Site A collection of buildings or other locations such as a site or a campus.
bu Building Any Building or structure. This may contain rooms, corridors, wings, etc. It may not have walls, or a roof, but is considered a defined/allocated space.
wa Ward A Ward is a section of a medical facility that may contain rooms and other types of location.
lvl Level A Level in a multi-level Building/Structure.
ro Room A space that is allocated as a room, it may have walls/roof etc., but does not require these.
ho House A residential dwelling. Usually used to reference a location that a person/patient may reside.

Must Support fields

In addition the following fields are "Must Support" - ie they must be populated where possible:

  1. Identifier - An identifier, over-and-above the name - to assist with more definitively identifying the location. Some locations will have an ODS site code, in which case this should be included, however most should use a local identifier (https://fhir.yhcr.nhs.uk/Id/local-location-identifier)
  2. Telecom - Eg phone and/or email details. Useful for getting in contact for further information
  3. Address - Must be provided if relevant (eg for Site and House). Not relevant for a Ward or Room. Just the current address for contact purposes, no history
  4. Managing Organisation - Must be provided for institutional locations i.e. site, ward etc. Note: this will often be the same as the provenance of the message, but not necessarily if external locations are being referenced
  5. Part Of - To describe the hierarchy - this is a reference to the parent location where relevant. Required to link room -> ward -> building -> site

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Points of note include:

  • Mode - this must always be "instance", and is preferably explicitly populated. "Instance" may be assumed if missing.
  • Alias and Description - May be useful to provide additional information. Description might include information to assist visitors in finding the location - eg if being used for appointments.