Patient.identifier.extension Health Number Version Code

PrescribeIT does have an extension (PHN-Version) on the identifier to capture the ON version.

Lloyd beat me to it!

The identifier actually identifies the health care system user. Theoretically, it stays the same for the entire lifetime of the user.

The version code validates (against a central authority, not by any sort of calculation) that the identifier is currently valid for billing purposes within the billing system of the issuer.

The identifier.value + system is globally unique and should always point to the same individual. The 'version' is used to verify that the credential they're displaying is current and to reduce chances of fraud.

A couple thoughts...
I'm thinking that it should not be limited to a number - it could be letters and digits.

I do agree it makes sense to be attached to the identifier, but...

Is the version code itself important? ie is "123456" plus "A12" different than "123456" plus "C32"? Or is just the identifier important?

When the two components are important together, it almost implies that the version should be attached to the identifier.value - to make sure they are always kept together.

If not always used together, then the version should be at the identifier level to allow identifer.value to not have the .version directly attached.

We don't use version in Alberta, but we do have a counter tracking how many cards have been issued for a PHN. But this number is not used for identity management...

Randy

Identifier is definitely the right place for it. My inclination is to actually propose it for a standard extension because health cards aren't the only types of identifiers that have 'versions'. (It's a similar concept to credit card number security codes - a unique number issued with the identifier that is used to establish that this is the 'current' identifier.)

Hi all,

Are any implementers or jurisdictions (other than Ontario) that are using the Health Number Version Code extension for Patient.identifier[JHN] slice? (as per simplifier.net/CanadianFHIRBaselineProfilesCA-Core/PatientProfile/~overview.)

In Ontario, our Health Cards are assigned a version number, in order to track reissued cards (expiration, lost, etc), while our Health Numbers are static.

As a side question, does it make sense for the Version Code to be an extension on Patient.identifier[JHN], or on Patient.identifier[JHN].value? Wondering from a modelling perspective which makes more sense. Theoretically the version shouldn't exist without the identifier.value itself, but that's also not a necessary condition/rule on how extensions should be modeled.