I try to construct one system that manages some hospitals(medical organization- whatever.), and their patients, practitioners … e.t.c. all via FHIR R4.
and now I am considering the following situation.
- The doctor who works at hospital A, can be a patient at hospital B
- A doctor named C also work in both hospitals A and B, taking time apart.
- Of course, patients can visit to various hospitals (A, B, wherever.)
In these cases, my system needs to connect the entities together.
Can I know the formal and universal way with your experiences?
Additional 1 : From my search, the most likely associated with this case in FHIR resource is “Person” (especially the link attribute). Is there an example of a system that intensively manages that “Person”?
Additional 2 : Large projects such as “hapi-fhir” include concepts such as *EMPI, **MPI, ***MDM, e.t.c… - Are those related to my topic? (even character ‘P’ means patient.)
*EMPI : Enterprise Master Patient Index
**MPI : Master Patient Index
***MDM : Master Data Management
Additional 3 : I also investigated the “oid” (object identifier / ISO-oriented) system. Can this help my topic? : Can HL7 official OID Registry affect the logic of solving my case? (like in identifier attribute…)
I have a lot of worries for a long time, and I need sincere help.
Thank you for your interest.
If you want to link across Patient, Practitioner (and maybe RelatedPerson), Person is your best bet. Recognizing that different Practitioner records and Patient records actually refer to the same human being - especially across hospitals - is an advanced feature not commonly supported by most systems. It’s also something that carries a lot of privacy considerations. Person allows you to maintain a shared set of demographic information you can propagate to the various other records and also allows you to create linkages that assert that “this is all the same human being”.
EMPI and MPI are in the same place, but they’re primarily about maintaining a single Patient resource that is either used directly or replicated across systems. MPI and EMPI systems don’t generally link to Practitioners. MDM systems can be used for Practitioners, Locations, Organizations and various other types of data.
In general, we try to avoid using OIDs with FHIR, preferring meaningful URLs, or at least URIs. While you can use OIDs as part of a URI, they’re not meaningful to developers and aren’t resolvable, so they’re not nearly as useful. OIDs used to be required when using CDA, so there are some systems that carry those forward into the FHIR world. If you’re starting from scratch, you’re better off defining a meaningful URI - and even if you’re porting from CDA, the recommendation is define a meaningful URI and map rather than carrying OIDs across into the FHIR world. Your developers and testers will thank you…
Thank you for letting me know and checking. Now I understand clearly, and I can specify the next goal.
By adding person to my system schema, I want to build an intermediate system to function like MDM.
If I face another problem, I will come to ask for your valuable advice.
Thank you very much.
(To others who are reading this; please feel free to reply if you have any other comments or detailed examples/codes. I am constantly receiving alarms.)