Closed RichardTON closed 1 year ago
Review of profiles of Identifier in AU Base
Profile | Candidate codes | Problem | Effect |
---|---|---|---|
AU Accession Number | Required binding to valueset with code outside IdentifierType | Some conformant instances need two codings. For example, sending LACSN requires sending ACSN as well. | |
AU AHPRA Registration Number - A unique sequence of characters assigned to a health practitioner to indicate registration to practice in Australia | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU Care Agency Employee Identifier | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU Commonwealth Seniors Health Card Number | SB | Required value subsumed by one in IdentifierType | SB is needed |
AU CSP Registration Number | none | Required value subsumed by one in IdentifierType | PRN is needed |
AU Delivery Point Identifier | No probs | ||
AU DVA Number | JHN? | Required binding to valueset with code outside IdentifierType | JHN is needed |
AU Employee Number | No probs | ||
AU ETP Prescription Identifier | none | Required value subsumed by one in IdentifierType | PLAC is needed |
AU G-NAF Identifier | No probs | ||
AU Health Care Card Number | SB | Required value subsumed by one in IdentifierType | SB is needed |
AU HPI-I | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU HPI-O | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU IHI | JHN | Required value subsumed by one in IdentifierType | JHN is needed |
AU Insurance Member Number | No probs | ||
AU Local Dispense Identifier | No probs | ||
AU Local Order Identifier | No probs | ||
AU Local Prescription Identifier | none | Required value subsumed by one in IdentifierType | PLAC or FILL is needed, what if it is unknown which applies? Maybe then neither PLAC nor FILL is needed. |
AU Local Report Identifier | No probs | ||
AU Location Specific Practice Number | No probs | ||
AU Medical Record Number | No probs | ||
AU Medicare Card Number | JHN | Required value subsumed by one in IdentifierType | JHN is needed |
AU Medicare Provider Number | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU NATA Accreditation Number | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU NATA Site Number | No probs | ||
AU National Provider Identifier At Organisation | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU PAI-D Identifier | ? | Might be a UDI | |
AU PAI-O Identifier | none | Required value subsumed by one in IdentifierType | PRN is needed |
AU PBS Prescriber Number | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU Pensioner Concession Card Number | SB | Required value subsumed by one in IdentifierType | SB is needed |
AU Pharmacy Approval Number | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
AU Residential Aged Care Service Identifier | PRN | Required value subsumed by one in IdentifierType | PRN is needed |
The boundary between SB and JHN is unclear. See Jira thread Identifier Type Codes. Some of the SBs and JHNs in the table above may need changing.
Subsumption in Identifier Type Codes is problematic. See https://jira.hl7.org/browse/UP-331
@RichardTON the WG session identified that some of the above were not applicable. and further outcomes for this. Please update this concern and progress.
@RichardTON discussed in PAWG https://confluence.hl7australia.com/display/PA/2022-07-06+Minutes
Further review of profiles of Identifier in AU Base
Identifier.type in Core has an extensible binding to IdentifierType value set.
PRN is for local provider numbers, and is not intended for identifiers that are widely recognised.
JHN is for sub-national identifiers.
SB identifies individuals (persons, organisations) not entitlements.
Identifier type profiles requiring changes:
Updated review of profiles of Identifier in AU Base
Profile | Assessment | Effect |
---|---|---|
AU Accession Number | According to https://jira.hl7.org/browse/FHIR-37739 "LACSN is a type of ACSN so ACSN would be the appropriate code to send and LACSN could also be sent if desired". | Some conformant instances need two codings. Sending LACSN requires sending ACSN as well. I suggest drop LACSN from the profile |
AU AHPRA Registration Number | This is skill specific, so not a provider and thus not PRN. No others relevant. | none |
AU Care Agency Employee Identifier | Not always providers, so not PRN. No others relevant. | none |
AU Commonwealth Seniors Health Card Number | This is national, not state/province based, so is not JHN. This identifies an entitlement, not a person, so is not SB. Nothing else relevant. | none |
AU CSP Registration Number | CSPs supply IT services, no health related services, so not PRN. Nothing else relevant. | none |
AU Delivery Point Identifier | Identifies an address. Nothing relevant. | none |
AU DVA Number | This is national, not state/province based, so is not JHN. This identifies an entitlement, not a person, so is not SB. Nothing else relevant. | none |
AU Employee Number | Nothing relevant. | none |
AU ETP Prescription Identifier | The identifier is allocated by middleware, not the source system, so not PLAC. Nothing else relevant. | none |
AU G-NAF Identifier | Identifies an address. Nothing relevant. | none |
AU Health Care Card Number | This is national, not state/province based, so is not JHN. This identifies an entitlement, not a person, so is not SB. Nothing else relevant. | none |
AU HPI-I | This is national, not local/jurisdictional, so not PRN. No others relevant. | none |
AU HPI-O | This is national, not local/jurisdictional, so not PRN. No others relevant. | none |
AU IHI | This national, not state/province based, so is not JHN. This can only be used for healthcare, so is not SB. No others relevant. | none |
AU Insurance Member Number | Identifies an insurance member. Nothing relevant. | none |
AU Local Dispense Identifier | Identifies a dispensing. Nothing relevant. | none |
AU Local Order Identifier | FILL and PLAC are parents. FGN and PGN are not children of any parent | none |
AU Local Prescription Identifier | Could be a placer's or a filler's, not definitely PLAC or FILL, so is neither. Nothing else relevant. | none |
AU Local Report Identifier | Identifies a report. Nothing relevant. | none |
AU Location Specific Practice Number | Identifies a site. Nothing relevant. | none |
AU Medical Record Number | MR is a parent. | none |
AU Medicare Card Number | This national, not state/province based so is not JHN. This may identify a set of 1 to 4 persons, so is not an SB. This identifies an entitlement, not a person, so is not SB. No others relevant. | none |
AU Medicare Provider Number | This is location and skill specific, so not a provider and thus not PRN. No others relevant. | none |
AU NATA Accreditation Number | Identifies an approval or license, so not a provider and thus not PRN. No others relevant. | none |
AU NATA Site Number | Identifies a site. Nothing relevant. | none |
AU National Provider Identifier At Organisation | This is national, not local/jurisdictional, so not PRN. No others relevant. | none |
AU PAI-D Identifier | Not a UDI. No others relevant. | none |
AU PAI-O Identifier | Not a provider and thus not PRN. No others relevant. | none |
AU PBS Prescriber Number | Identifies an approval or license, so not a provider and thus not PRN. Not always a medical doctor so not MD. No others relevant. | none |
AU Pensioner Concession Card Number | This is national, not state/province based, so is not JHN. This identifies an entitlement, not a person, so is not SB. Nothing else relevant. | none |
AU Pharmacy Approval Number | Identifies an approval or license, so not a provider and thus not PRN. Not a medical doctor so not MD. No others relevant. | none |
AU Residential Aged Care Service Identifier | Identifies a service provided by a provider, so not a provider and thus not PRN. No others relevant. | none |
Apart from LACSN in AU Accession Number, none of the codes in any of the profiles above is subsumed by a code in IdentifierType value set.
Originally posted by @oridashi in https://github.com/hl7au/au-fhir-base/issues/737#issuecomment-1212593785
- can we have narrative around AU Base IdentifierType being a non-hierarchal codesystem therefore we have specific codes defined for specific identifiers and will by choice chose an appropriate
As IdentifierType CodeSystem is a V2 code system, there is no defined hierarchy to the values. (See comment by Ted Klein in UP-331.) This does not mean that there is no subsumption. (See resolution in FHIR-37739.) None of the identifiers profiled above use codes subsumed by codes in IdentifierType value set.
Subsumption will need to be assessed in future profiles of Identifier.
AU Accession Number problem moved to #748
Need a narrative statement that 203 codesystem is NOT hierachial - leave ACSN and LACSN are not related.
There is a problem with the use of extensible bindings in AU Base.
When an element has an extensible binding to a value set, conformant instances must include a value from that value set if one is appropriate. R4's description of extensible includes
The CI build of R5 has new wording for extensible with the same meaning. Related Zulip threads include Extensible binding of Identifier.type and Vocabulary WG survey on FHIR extensible binding strength.
This has not been made obvious in some HL7 AU Base profiles, they imply that it is enough to use a code from an extended version of the value set.
For example, Encounter.class in R4 is bound extensibly to V3 Value SetActEncounterCode. This includes the code VR. In AU Base Encounter class is bound to a value set with extra codes. All of the extra codes are subsumed by VR, so all conformant instances with one of the new codes need to also include VR, and there is no hint of this in the profile, or in the examples.
This problem also applies to many of the AU Base profiles of Identifier, as Identifier.type in Core has an extensible binding to IdentifierType. Note that the descriptions of the codes have been updated between R4 and R4B.
The descriptive parts of the profiles and examples need to be updated so that implementers are not misled.
See also https://jira.hl7.org/browse/FHIR-37739