CH EPR FHIR (R4)
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CH EPR FHIR (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-epr-mhealth/ and changes regularly. See the Directory of published versions

Mobile Patient Identifier Cross-reference Query [ITI-83]

This section describes the national extension for the Swiss EPR to the Mobile Patient Identifier Cross-reference Query [ITI-83] transaction defined in the IUA profile published in the IHE IT Infrastructure Technical Framework Trial Implementation “Patient Identifier Cross-referencing for mobile”.

Scope

The Mobile Patient Identifier Cross-reference Query is used by an app in the Swiss EPR to query with the local identifier the MPI and get the corresponding MPI-PID and the EPR-SPID identifier for the patient.

Actor Roles

Actor: Patient Identifier Cross-reference Consumer
Role: Queries the Patient Identifier Cross-reference Manager for the MPI-PID and EPR-SPID.
Actor: Patient Identifier Cross-reference Manager
Role: Resolves the local ID sent with the request to the MPI-PID and EPR-SPID.

Referenced Standards

  1. Patient Identifier Cross-referencing for mobile (PIXm), Rev. 3.0.3
  2. This PIXm Profile is based on Release 4 of the emerging HL7® FHIR® standard.

Messages

Interaction Diagram for [ITI-83]Patient Identifier Cross-reference ConsumerPatient Identifier Cross-reference ManagerGet Corresponding IdentifiersResponse

Get Corresponding Identifiers message

Message Semantics

The message semantics is the same as defined in 2:3.83.4.1.2 with a restriction on the targetSystem query Parameter:

GET [base]/Patient/$ihe-pix?sourceIdentifier=[token]&targetSystem=[uri]{&_format=[token]}
$ihe-pix Message HTTP query Parameters
Query parameter Name Cardinality Search Type Description Swiss National Extension
Input Parameters        
sourceIdentifier 1..1 token The Patient identifier search parameter that will be used by the Patient Identifier Cross-reference Manager to find cross matching identifiers associated with the Patient Resource. See Section 2:3.83.4.1.2.1. No further refinement.
targetSystem 2..2 uri The Assigning Authorities for the Patient Identity Domains from which the returned identifiers shall be selected. See Section 2:3.83.4.1.2.2. SHALL be the Assigning authority of the community and the EPR-SPID.
_format 0..1 token The requested format of the response from the mime-type value set. See ITI TF-2: Appendix Z.6. No further refinement.

See the PIXm Find patient matches OperationDefinition and the CH PIXm IN Parameters Profile (with its example: PIXm Parameters Query Input).

Message Example

Query for a patient with a local id of 123 by AssigningAuthority oid 1.2.3 which resides in a community where the Assigning Authority is oid 5.6.7 and the MPI-PID and EPR-SPID are requested:

GET [base]/Patient/$ihe-pix?sourceIdentifier=urn:oid:2.999.1.2.3|123&targetSystem=urn:oid:2.999.5.6.7&targetSystem=urn:oid:2.16.756.5.30.1.127.3.10.3 HTTP/1.1
Accept: application/fhir+json
traceparent: 00-0af7651916cd43dd8448eb211c80319c-b7ad6b7169203331-00

Response message

Message Semantics
$ihe-pix Message response
Parameter Cardinality Data Type Description
FHIR Parameters Resource      
targetIdentifier 0..2 Identifier The identifier found. Constraints to include the assigning authority as specified in ITI TF-2: Appendix E.3.
targetId 0..1 Reference(Patient) The URL of the Patient Resource

See Output Parameters example (and the corresponding profile) as response to the Mobile Patient Identifier Cross-reference Query.

Target Domain not recognized

If the targetSystem is not restricted to the Assigning authority of the community and the EPR-SPID, then the following failure shall be returned:

HTTP 403 (Forbidden) is returned as the HTTP status code.

An OperationOutcome Resource is returned indicating that the Patient Identifier Domain is not recognized in an issue having:

Attribute Value
severity error
code code-invalid
diagnostics “targetSystem not found”

See Input Parameters example (and the corresponding profile) for the Mobile Patient Identifier Cross-reference Query.

CapabilityStatement Resource

The CapabilityStatement resource for the Patient Identifier Cross-reference Consumer is PIXm Patient Identifier Cross-Reference Consumer.

The CapabilityStatement resource for the Patient Identifier Cross-reference Manager is PIXm Patient Identifier Cross-reference Manager.

Security Consideration

TLS SHALL be used. This national extension enforces authentication and authorization of access to the Patient Identifier Cross-reference Manager using the IUA profile with basic access token. Consequently the Mobile Patient Identifier Cross-reference Query [ITI-83] request must authorize using the [ITI-72] transaction of the IUA profile.

The traceparent header is required, as described in Trace Context header.

Security Audit Considerations

Patient Identifier Cross-reference Consumer Audit

The Patient Identifier Cross-reference Consumer shall be able to record a PIXm Query Consumer Audit Event Log. Audit Example for a PIXm Query transaction from consumer perspective.

Patient Identifier Cross-reference Manager Audit

The Patient Identifier Cross-reference Manager shall be able to record a PIXm Query Manager Audit Event Log. Audit Example for a PIXm Query transaction from manager perspective.