Patient.identifier issues

1

We have some questions regarding Patient.identifier. We don’t have any type of information that’s specified in Valueset-identifier-type - FHIR v4.0.1 , that’s why we decided to identify patients with a compound identifier {plan_code}:{subscriber_id}, where

  • plan-code is a unique plan ID number, which identifies the plan, to which the patient is assigned
  • subscriber-id is an id for insured (patient) assigned by the plan (it is unique within the plan)

For example, if plan_code = MED and subscriber_id = 12345 then patient.identifier.value = MED:12345.

In case if a patient changes the plan, one more identifier will be added (with an appropriate period) which will specify their new plan and subscriber_id.

Question#1: Would this approach work?
Question#2: Can we specify patient.identifier.system as
patient.identifier.system =“urn:myOrganizationName:plan-code:subscriber-id” ?

Question#3: Do we need to register this system value (urn:myOrganizationName:plan-code:subscriber-id) in the HL7 OID registry or any other registries?

Thank you

2

Also, consider cases/frequency when the patient was eligible on one plan, switched to another plan, and then was switched back to the first plan at a later date. For example, in the 28th largest state, this happens frequently for Medicaid beneficiaries on X12-832.

3

Hello David, thank you for your response. I really appreciate your assistance. Yes, we considered those cases as you explain adding Patient.identifier.period to each Patient.identifier. Could you please tell me if my patient.identifier.system (urn) is correct in structure (Question#2)?

kind regards
Andrey

4

URN namespaces need to be registered with IANA to ensure uniqueness. So, while you could theoretically register your company name, you can’t just use it without registering it. See Uniform Resource Name - Wikipedia