Solution Architecture work stream

The link fhir.infoway-inforoute.ca/registry/NamingSystem isn't working for me, do I need some kind of special access?

Hello Everyone,

I'm wondering if anyone would be willing to lead the discussion today. I've got a conflicting meeting and won't be able to attend the call. I can open the Zoom meeting in advance, so please go ahead without me.


Everyone, please comment either on the forum or at the meeting on the proposed URI guidelines, which I've copied below.

URI guidelines
1. Base url for common public identifiers: fhir.infoway-inforoute.ca/registry/NamingSystem
2. Ids should be all all-lower-case-hyphen-separated
3. Ids should avoid abbreviations
4. Ids that are scoped by province/territory should be prefixed with the province/territory code - e.g. "ab-some-identifier"
5. Ids that are national in scope should be prefixed with "ca-" - e.g. "ca-some-identifier"
6. Words that make up the identifier should start from the general type and then get more specific. E.g. "on-license-driver" rather than "on-driver-license"
6a. Words should be consistent across identifiers when possible. I.e. Try to use "patient-health-number" if everyone else is using "patient-health-number"
7. Words should be expressed in the primary language of the province/territory that manages them
8. Words should not use accented characters

Thank you very much, Randy and Sisira. This is very helpful.

Hi,
As discussed during the call, we would like to give information on Newfoundland and Labrador Client Identifiers in the Provincial Client Registry.

The Provincial CR is the foundational component of the Newfoundland and Labrador Electronic Health Record. It serves as the linking key for multiple information systems within the Electronic Health Record (EHR). The Client Registry serves to identify individuals accessing the health system through a cross-referenced index of identifiers (e.g. MCP, Unit Number, etc.). The source systems connected with the Client Registry are:
(1) Department of Health and Community Services Medical Care Plan (MCP)
(2) Regional Health Authorities through their Meditech systems
(3) Client and Referral Management System (CRMS) – A legacy clinical information system used by community-based health service providers (4) Diagnostic Imaging - Picture Archiving and Communications System (DI-PACS)
(5) Pharmacies connected to the Drug Information System (around 200 pharmacies)
(6) Electronic Medical Record
(7) Vital Stats

The client identifiers by source system stored in the Provincial Client Registry:
(1) MCP - Medical Care Plan
(2) Unit Number - The identifier assigned by the Regional Meditech Systems for patients under care
(3) CRMS - Client Referral Management System
(4) Vital Stats identifier
(5) EMR MedAccess identifier
(6) Pharmacy identifier

The identifiers by type stored in the Provincial Client Registry (used with assigned OIDs):
(1) MCP Number- The number assigned by the Newfoundland and Labrador Medical Care Plan (a comprehensive plan of medical care insurance for residents of the province)
(2) Unit Number (Originally 9 Meditech instances and currently 4 Meditech instances after the consolidation)
(3) Out of Province Heath Card Numbers (12) (e.g. Alberta Personal health Number, Ontario Health Card Number, Nunavut Health Card Number, etc.)
(4) Citizenship and Immigration Canada Identifier
(5) Correctional Service Canada Identifier
(6) Canadian Forces Identifier
(7) Dep. Of Veterans Affairs Identifier
(8.) First Nation Identifier
(9) Royal Canadian Mounted Police Identifier
(10) Workers Compensation Board Identifier

Note: MCP is the Primary Identifier used for patient information search in the Provincial EHR. Others are alternate identifiers. In the EHR, Unit Number is used for patients who don’t have MCP. e.g. newborn babies, immigrants, patients of St-Pierre-Miquelon (a French archipelago situated near Newfoundland).

For example, CRMS identifier is used for immunization record purposes by the Regional Health Authorities (4 RHAs).

The Client Registry maintains an index of all identifiers that have been assigned to a particular individual across multiple, disparate information systems and links them to one unique internal identifier called EHR Client ID or ECID. The ECID facilitates client linkages between the Client Registry and other EHR data repositories. ECID is not visible to users.

Thanks,
Sisira (NLCHI).

As requested, this is the Alberta definition for a ULI:

"The ULI (Unique Lifetime Identifier) is a unique and permanent number assigned as an internal identifier by Alberta Health to all stakeholder persons of interest to the health system in Alberta. A stakeholder PERSON is a human being, alive or not, including stillborns, that encounter and/or are of interest to the health system in Alberta."

I'll post a list of some of our OIDs on the spreadsheet (on a new tab). Our registry is on share point and requires a login to access (not exactly the best option, but what we have at the moment...)

Hi Randy, welcome to the discussion. Your comments are exactly the kind of the feedback we are seeking from various jurisdictions. I agree with Lloyd's repose. Alberta related URIs you see in the Google Sheet are just a placeholder. We are not using them yet, but many projects might need to use real URIs for patient and practitioner identifiers from Alberta and other jurisdictions soon. So, this is important to have these defined correctly with a general consensus on the naming convention, base URI, etc. Your comments also emphasize a need to a visible registry of common public identifiers. If it's not in place or implementers don't know where to look, multiple projects would define the URIs for the same concept, leading to lack of interoperability or a need for multiple mappings. Unfortunately, unless we have a registry and governance in place, there is no way to avoid projects assigning and using duplicate URIs for common public identifiers under their own base URLs.

I'm leaning towards having URIs for all Canadian common public identifiers defined under Infoway's route to utilize their governance and maintenance resources and to have all these URIs resolvable using a FHIR queries. I'm leaning towards hyphens vs. camel case as my fear is that some open source and other libraries and web servers might not support case sensitivity of URLs. I might be wrong on this, but I don't think that 3-4 hyphens in the URI would be problematic.

Randy, please join our meeting today and every week on Fridays at 2-3 pm.