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question-circle How to represent Health Card Number and other identifiers in the Patient Identifier

  • Posts: 2
6 years 11 months ago #2645 by Yaroslav Hradowy
Thank you, I understand.

Does Ontario have the naming standards for organizations (HSPs) where MR identifier is being assigned. In this example we have a system definition for HSP application as:

infoway-inforoute.ca/fhir/NamingSystem/ca-on-uhn-mrn

I can understand that this is UHN, But we have multiple orgs we are receiving data from. It seems there is no provider registries that include HSPs in Ontario. What to do in this case if we want to integrate with eHealth Ontario portals?

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  • Posts: 15
7 years 2 hours ago #2617 by Fang Cao
Hi. We have published a FHIR specification for Ontario provincial client registry (PCR) that may give you an idea how to implement patient identifiers. You can access it at ehealthontario.on.ca/en/standards/view/provincial-client-registry-fhir

Here is a snippet of identifiers in the patient example. The system of the identifier is a URI. Same thing can be done for EMPI identifier. We don't support HCN version code at this point. If you need to support it, you can use extension. Hope this helps.
"identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/v2/0203",
            "code" : "JHN"
          }
        ],
        "text" : "Ontario PHN"
      },
      "system" : "http://ehealthontario.ca/API/FHIR/NamingSystem/ca-on-patient-hcn",
      "value" : "1234567"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/v2/0203",
            "code" : "MR"
          }
        ],
        "text" : "UHN MRN"
      },
      "system" : "http://infoway-inforoute.ca/fhir/NamingSystem/ca-on-uhn-mrn",
      "value" : "1244566"
    }
  ],

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  • Posts: 2
7 years 1 day ago - 7 years 1 day ago #2608 by Yaroslav Hradowy
I'm new to the FHIR. We are checking into how to expose our assessment data stored in repository to other systems using FHIR Rest API. First i'm trying to define the major FHIR resources to be used in exchange. One of them is the Patient. Having trouble to properly define the Identifier element.

We have three types of identifiers:
- Health Card Number - HCN (that could be from Ontario, BC, or other province)
- Organizations' Medical Record Number
- Our own application repository EMPI number

Health Card Number:

From the FHIR web site I understand that the presentation for HCN could be like that:

<identifier>
<use value="official"/>
<type>
<coding>
<system value="hl7.org/fhir/v2/0203"/>
<code value="JHN"/>
<!-- Jurisdictional health number (Canada): see www.hl7.org/fhir/v2/0203/index.html -->
</coding>
</type>
<system value="???"/>
<value value="3334442226"/>
</identifier>
How to represent a system value to define that the HCN is from Ontario (or any other province)?

Medical Record Number - MRN:

using the same approach the type-code from v2/0203 is "MR". But system element definition is a question. In this case system represents the organization's application. We use our own internal organization (HSP) numbering (there is no any common master organization list in continuing care sector in Ontario), and we use three fields to identify HSP's application: HSP id, HSP application number, document (assessment) type. How this kind of system can be defined in FHIR?

EMPI number:

There is no code for that identifier type in v2/0203 table. How can we encode our own EMPI application in the system element? Should we create some kind of extension?

This kind of guidance specific to Canada will be very useful for the FHIR implementers in Canada.

Regards.
Last edit: 7 years 1 day ago by Yaroslav Hradowy.

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