CH Health Dossier (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 1.0.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-health-dossier/ and changes regularly. See the Directory of published versions

Patient Identity Feed FHIR [ITI-104]

This section describes the national extension for the Swiss Health Dossier to the Patient Identity Feed FHIR [ITI-104] transaction defined in the PIXm profile published in the IHE IT Infrastructure Technical Framework Trial Implementation “Patient Identifier Cross-referencing for mobile”.

Scope

In the Swiss Health Dossier, the Patient Identity Feed FHIR transaction ensures that different systems can update the patient contact information.

Actor Roles

Actor: Patient Identity Source
Role: Provides notification to the Patient Identifier Cross-reference Manager for any patient identification related events including: creation, updates, merges, etc.
Actor: Patient Identifier Cross-reference Manager
Role: Serves a well-defined set of Patient Identification Domains. Based on information provided in each Patient Identification Domain by a Patient Identity Source Actor, it manages the cross-referencing of patient identifiers across Patient Identification Domains.

Referenced Standards

1. Patient Identifier Cross-referencing for mobile (PIXm), Rev. 3.1.0
2. This PIXm Profile is based on Release 4 of the emerging HL7® FHIR® standard.

Messages

Only the Revise Patient Message is supported by this extension, for an Add Patient or a Resolve Duplicate Patient message an error SHALL be returned.

Request

Trigger Events

The Revise Patient message is triggered when the patient information is revised within a Patient Identity Source (e.g., change in patient address, etc.).

Message Semantics

The same message semantic apply as in 2:3.104.4.1.2 and 2:3.104.4.2.2 Message Semantics.

The identifier request parameter SHALL be the EPR-SPID.

The patient data (see Patient example) SHALL conform to the PIXm Patient Feed profile. Only contact address data may be revised (addresss and telecom).

The EPR-SPID SHALL be added to Patient.identifier.

Expected Actions

The Patient Identifier Cross-reference Manager will update the contact information of the patient (address and telecom) with the provided data in the request. Any other provided data elements SHALL be ignored by the Patient Identifier Cross-reference Manager.

Message Example

Update Patient Franz Muster to add address and contact information:

PUT http://example.com/Patient?identifier=urn:oid:.16.756.5.30.1.127.3.10.3|761337610000000002 HTTP/1.1
Accept: application/fhir+json
Content-Type: application/fhir+json
traceparent: 00-0af7651916cd43dd8448eb211c80319c-b7ad6b7169203331-00

{
  "resourceType" : "Patient",
  "identifier" : [
    {
      "system" : "urn:oid:2.16.756.5.30.1.127.3.10.3",
      "value" : "761337610000000002"
    }
  ],
  "name" : [
    {
      "family" : "Muster",
      "given" : [
        "Franz"
      ]
    },
    {
      "family" : "Muster",
      "_family" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier",
            "valueCode" : "BR"
          }
        ]
      }
    }
  ],
  "gender" : "male",
  "birthDate" : "1995-01-27",
  "telecom" : [
    {
      "system" : "phone",
      "value" : "tel:+41 32 321 61 11",
      "use" : "home"
    },
    {
      "system" : "email",
      "value" : "franz.muster@example.org"
    },
  ],
  "address" : [
    {
      "type" : "both",
      "line" : [
        "Leidensweg 10"
      ],
      "city" : "Specimendorf",
      "postalCode" : "9876",
      "country" : "CH"
    }
  ]
}

Response

See https://hl7.org/fhir/R4/http.html#cond-update for response.

CapabilityStatement Resource

The CapabilityStatement resource for the Patient Identity Source is PIXm Patient Identity Source.

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

Security Consideration

The transaction SHALL be secured by Transport Layer Security (TLS) encryption and server authentication with server certificates.

The transaction SHALL use client authentication and authorization using an extended access token defined in IUA conveyed as defined in the Incorporate Access Token [ITI-72] transaction.

The actors SHALL support the traceparent header handling, as defined in Appendix: Trace Context.

Security Audit Considerations

Patient Identity Source Audit

The Patient Identity Source SHALL record an audit event according to CH Audit Event for [ITI-104] Patient Identity Source (example).

Patient Identifier Cross-reference Manager Audit

The Patient Identifier Cross-reference Manager SHALL record an audit event according to:

CH Audit Event for [ITI-104] Patient Identifier Cross-reference Manager / Update patient (example).