Provincial Client Registry (PCR) HL7 FHIR® Contribution Implementation Guide v1.0.0-draft1
For a full list of available versions, see the Directory of published versions
Patient Update provides a RESTful approach to maintaining an existing Patient's Record within PCR based on changes to demographic and identifying information submitted by a Contributor. In a Patient Update request, updated patient information is provided to PCR, which validates the submission and evaluates the changes against existing patient identities using contributor authority, survivorship, source authority, and identity management rules. PCR assesses the submitted updates in accordance with governance and stewardship policies to determine how the information should be applied to the Patient's Record.
In the PCR Patient Update operation, the request must contain a Patient resource populated with the updated information for the individual being maintained. The completeness, accuracy, and authority of the information provided directly influence PCR's ability to appropriately apply the requested changes while preserving patient identity integrity and data quality. PCR records the source contribution, updates the Patient's Record in accordance with established governance policies, and maintains auditability, lineage, and stewardship controls to ensure patient information remains accurate, current, and trusted across connected healthcare organizations.
NOTE: FHIR's Conditional Update is not allowed at this time. Contributors must search for the patient in PCR to get the Patient id before performing an update.
PUT: Patient Update
Actor: Contributor
Role: Submits a Patient Contribution resource to the PCR.
Actor: PCR Role: Receives, authenticates, validates, and stores incoming patient information from the Contributor.
The FHIR IR specification is based on the HL7 FHIR R4 Update operation.
Patient Update Request
The update interaction is performed by an HTTP PUT command as shown:
PUT [base-submit]/Patient/$id or PUT [base-submit]/Patient?{search parameters}
Patient Update Response
Example Update Patient Request
HTTP Method:
PUT
Headers:
Content-Type: application/fhir+json
Address:
[base-submit]/Patient/1234567
Message Body:
Example Validation Failure
HTTP Response: 400 Bad Request
Message Body:
Example Patient Not Found
HTTP Response: 404 Not Found
Message Body:
Example Version Conflict
HTTP Response: 412 Precondition Failed
Message Body:
| Outcome | Header HTTP Response | Payload OperationOutcome | Expected Handling |
|---|---|---|---|
| Patient updated | 200 OK | Yes | Return the updated Patient resource, updated ETag, and version metadata. |
| Validation failure | 400 Bad Request | Yes | Return computable validation details and expression path where applicable. |
| Patient not found | 404 Not Found | Yes | Indicate that the referenced Patient id does not exist or cannot be resolved. |
| Unauthorized | 401 Unauthorized or 403 Forbidden | No | |
| Governance or survivorship conflict | 409 Conflict | No | |
| Version conflict | 412 Precondition Failed | Yes | Indicate version mismatch when If-Match or version-aware update control fails. |
| Service failure | 5xx Server Error | No |