Patient Master Identity Registry (PMIR), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.5.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.PMIR/ and changes regularly. See the Directory of published versions

Open and Closed issues

Significant changes from PMIR, Rev 1.3

• Removed inline UML text and moved it to images-source
• Removed constraint tables for link to profiled resource page
• Removed inline example and linked to current examples
• Added in MessageDefinition resources
• Added in CapabilityStatement resources
• Changed History bundle to be based off of the request.method
• Replaced Audit Event tables with profiled AuditEvents
  • Replaced queryParameters in ITI-94 audit with the subscription resource

Issues

Open Issues and Questions

• PMIR-1: HL7 Patient Administration workgroup is looking at better defining the patient merge/link functionality in FHIR. We will follow this work and collaborate with HL7 to keep these efforts aligned. See https://confluence.hl7.org/display/PA/Merge+Operation.

• PMIR-2: Should we include shall, should, or may for Provenance resources in the Mobile Patient Identity Feed transaction? This version doesn’t provide any guidance on Provenance, should it?

• PMIR-6: Should we include an option on the Patient Identity Registry to support the FHIR $match operation on patients? This would require an additional actor and transaction.

• PMIR-8: Should we require maintaining resource versioning information when updates are made to resources?

• PMIR-9: If other domain patient identities are included in the feed, should there be expected actions on the Patient Identity Registry or Patient Identity Consumer?

• PMIR-10: The security for the feed transaction is currently being debated in IHE and HL7. The mutual authentication solution in ATNA may be used. The IUA solution with OAuth identities may be used. These solutions aren’t straight-forward and resolution of IHE’s recommendation requires trial implementation feedback.

• PMIR-11: CP-ITI-1203 changed the name of a PMIR actor from “Patient Identity Manager” to “Patient Identity Registry” to better reflect the passive role that the actor plays in PMIR. There was a suggestion at that time to change the name of the profile from “Patient Master Identity Registry” to “Patient Master Identity Registration.” Should the profile be renamed?

• PMIR-12: As part of FHIR R5 or R4B update, should we look at the option of using a rest-hook for subscription channel.type?

Closed Issues

• PMIR-3: Should Subscription be an option or required on the Patient Identity Registry? Should the configurable feed destination be an option or required for Patient Identity Registry?
  • Subscription is required and there is no requirement for how a configurable feed destination is handled.
• PMIR-4: There is a new profile work item in ITI that would bind this profile and MHD into a FHIR based document sharing health information exchange.
  • That profile is Mobile Health Document Sharing(MHDS).
• PMIR-5: In some profiles demographics is used to cover all demographic information including identifiers. This profile uses identity to cover demographics and identifiers. Which term is most clear and should this profile use demographics instead of identity?
  • We have used identity to cover both identifiers and demographics as defined under the new glossary terms and in the Concepts section.
• PMIR-7: IHE has submitted a Change Request GF#23009 with HL7 to clarify their usage of link with RelatedPerson as recommended in this profile to allow for management of parent relationships to children.
  • Issue has been clarified.