InterweavePractitioner

FHIR Profile

Notts Guidance

The goal for sharing of Practitioners is not to build a detailed model of the staffing index, but to provide more deatils about the individuals ivolved in / referenced by, clicinal processes and activities.

Name

MUST be provided, and to indicate who the practitioner is. Only a single name is supported and within that the Family Name is mandatory. (Note that in addition, Given Name, Prefix, and Suffix are considered "Must Support").

Identifier

MUST be populated to formally identify the practitioner. Care Connect highlights the SDS User Id and SDS Role Profile identifiers, however this does not provide complete coverage. Additional professional codes which may be used include:

• https://fhir.hl7.org.uk/id/gmp-number (General Medical Practitioner)
• https://fhir.hl7.org.uk/id/gmc-number (General Medical Council / Consultant Code)
• https://fhir.hl7.org.uk/id/nmc-number (Nursing and Midwifery Council)
• https://fhir.hl7.org.uk/id/gphc-number (General Pharmaceutical Council Code)
• https://fhir.hl7.org.uk/id/hcpc-number (Health and Care Professional Council Code)

Or as a last resort if no other professional identifier:

• https://fhir.yhcr.nhs.uk/Id/local-practitioner-identifier (Local identifier)

Must Support fields

In addition the following fields are "Must Support" - ie they must be populated if relevant and known:

1. Active - Essential if not active. Good practice to always populate anyway. Will normally be 'true', and only active Practitioners should be used in new references. However it may be necessary to retain those where active=false (i.e. inactive) if they have already been used in references

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:

1. Telecom - It could useful to provide a contact phone number and/or email if at all possible – this could be a duty number where it is inappropriate to share the individual contact deatils.
2. Qualifications - These are useful if known, to provide information above-and-beyond just the identity of the practitioner - e.g. about what role they might be performing. See further discussion below.

Further notes on Practitioner vs PractitionerRole, and Qualifications

"PractitionerRole" describes the practitioner in the context of an actual role they are fulfilling, and so is in many ways a more useful concept than the basic "Practitioner" FHIR Resource. It caters for individuals who do more than one role, providing extra information about the nature of a specific involvement, and can capture contact details relevant to that role.

HOWEVER the PractitionerRole resource is little used in FHIR STU3. This has been addressed in FHIR R4, which allows use of a PractitionerRole throughout as an alternative to Practitioner. However for now, in STU3, use of the Practitioner resource is the main requirement - and really the only option.

The best substitute in the Practitioner resource appears to be the "qualifications" section - with the opportunity here to provide information about the practitioner's speciality. Thus at least indicating the kind of role they are likely to perform. This can therefore be populated if known.

See example below where the qualification element has been used to show that a worker from the Local Authority is a Social Care specialist (i.e. as opposed to an Occupational Therapist):

{
    "resourceType": "Practitioner",
    "id": "567890",
    "meta": {
        "profile":  [
            "https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-Practitioner",
            "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1"
        ]
    },
    "identifier":  [
        {
            "system": "https://fhir.yhcr.nhs.uk/Id/local-practitioner-identifier",
            "value": "567890"
        }
    ],
    "active": true,
    "name":  [
        {
            "family": "Watson",
            "given":  [
                "Sam"
            ]
        }
    ],
    "qualification":  [
        {
            "code": {
                "text": "Social Care Practitioner"
            }
        }
    ]
}