Patient Master Identity Registry (PMIR)

Patient Master Identity Registry (PMIR) provides a RESTful patient identity management.

Summary

The Patient Master Identity Registry (PMIR) Profile supports the creating, updating and deprecating of patient master identity information about a subject of care, as well as subscribing to changes to the patient master identity, using the HL7 FHIR standard resources and RESTful transactions. In PMIR, “patient identity” information includes all information found in the FHIR Patient Resource such as identifier, name, phone, gender, birth date, address, marital status, photo, others to contact, preference for language, general practitioner, and links to other instances of identities. The “patient master identity” is the dominant patient identity managed centrally among many participating organizations (a.k.a., “Golden Patient Identity”).

This profile is intended for FHIR-only configurations without other underlying standards for patient master identity management.

Benefits

Beyond the basic create, retrieve, update, and delete transaction set, this profile addresses important patient safety issues related to cases where there are two or more patient master identities that have been established for the same person, thus it is not clear which identity is the “true” one. There is also a risk that health data (possibly conflicting) may be associated with each identity – and these disparate data, together, may need to be reconciled before a fully and accurate “health picture” can be developed for this person. These situations represent patient safety risks. This profile addresses how these multiple patient master identities can be merged into a single patient master identity, and how this merge flows down to data custodians so that they take appropriate actions. It is outside the scope of this profile to define how references to the deprecated patient master identity from other data should be handled.

Details

The Patient Master Identity Registry (PMIR) profile defines a Patient Identity Manager that can receive a Patient Identity Feed from a Patient Identity Source. The Patient Identity Manager will then maintain the Patient Master Identity and will send updates to any subscribers through the Patient Identity Feed. Patient Identity Subscribers can subscribe downstream systems to the Patient Identity Feed.

Patient Identity is comprised of all information identifying the patient, such as identifier, name, phone, gender, birth date, address, marital status, photo, others to contact, preference for language, general practitioner, and links to other patient identities.

Patient Master Identity is the patient identity that is considered dominant for a patient within a domain. An authority manages the patient master identity among many participants in the domain. The patient master identity is harmonized using business rules appropriate to the setting. (a.k.a., Golden Patient)

The Patient Identity Manager manages this domain that is represented by the base URL of this actor.

If multiple patient identities in the same patient identity domain are found to refer the same patient, these patient identities may be merged into a single surviving patient identity.

Systems Affected

• A system containing master patient data for a domain may receive the feed for updates on patient identity and send the updates through a feed to subscriber systems.
• A system with clinical data can subscribe to the feed to receive updates on patient identity.

Actors & Transactions:

Specification

Profile Status: Trial Implementation

Documents:

Additional Supplements: Appendix Z on HL7 FHIR

Underlying Standards:

• HL7 FHIR R4 http://hl7.org/fhir/R4
  • Bundle
  • MessageHeader
  • Patient
  • Subscription

See Also

Related Profiles

• Patient Demographics Query for Mobile (PDQm) provides a RESTful interface to a patient demographics supplier.
• Patient Identifier Cross-Reference for Mobile (PIXm) provides a RESTful interface to patient identifier cross-references.