STU 2 Ballot

This page is part of the Data Access Framework (v1.6.0: STU 2 Ballot 1) based on FHIR v1.6.0. . For a full list of available versions, see the Directory of published versions

D.17.0 U.S. Data Access Framework (DAF) Patient Profile

D.17.0.1 Scope and Usage

This profile sets expectations for use of the Patient resource within the DAF FHIR IG. This profile identifies which core data elements, extensions, vocabularies and value sets must be Supported by DAF actors. For the definition of Supported please refer to DAF FHIR IG. The data elements identified by the profile are based on ONC 2014 Edition S&CC and DAF use cases. The mappings between the ONC 2014 Edition S&CC data elements and DAF data elements are captured in the table below, where the first column identifies the ONC 2014 Edition S&CC data element name, the second column maps the ONC 2014 Edition S&CC data elements to DAF data elements which are derived from ONC 2014 Edition S&CC standards and DAF use cases and lastly the third column identifies the mapping to FHIR resources and attributes.

D.17.0.2 Meaningful Use Data Element Mapping

The DAF-Patient profile mapping to Meaningful Use data elements and FHIR Resources are as shown below. For an overview of how the DAF profiles and data elements were derived from ONC 2014 Edition S&CC please refer to DAF FHIR IG data mapping section.


Meaningful Use Data Element Name Mapping to Priority DAF Data Elements FHIR Resource Mapping
Patient Name Patient Name Patient.name
Sex Gender Patient.gender
Date of Birth Date of Birth Patient.birthDate
Race Race Patient.extension(us-core-race)
Ethnicity Ethnicity Patient.extension(us-core-ethnicity)
Preferred Language Preferred Language Patient.communication.preferred
Patient Identifiers Patient.identifier
Multiple Birth Indicator Patient.multipleBirthBoolean
Birth Order Patient.multipleBirthInteger
Mother's Maiden Name Patient.extension(patient-mothers-maiden-name)
Address Patient.address
Telephone Patient.telecom
Marital Status Patient.maritalStatus
Birth Place Patient.extension(birthplace)
Religious Affiliation Patient.extension(religion)
Guardian Patient.contact

D.17.0.3 Boundaries and Relationships

This profile relies on the following other profiles:

  • US Core which defines common properties related to Patient such as race and ethnicity.
  • Patient Extensions defines other extensions such as birthPlace, patient-mothers-maiden-name which are used by the profile
  • FHIR Extensibility defines how extensions can be applied to FHIR resources and data types. Specifically the data-absent-reason extension can be used to code data elements with missing information when appropriate. See DAF FHIR IG for additional guidance.

D.17.0.4 Content

Profiles:
DAF-PatientDefines constraints and extensions on the patient resource for use in querying and retrieving patient demographic information.

D.17.0.4.1 Search Parameters

The full list of supported patient search parameters are can be accessed at DAF Requestor conformance expectations and DAF Responder conformance expectations.

D.17.0.4.2 Example Usage Scenarios

The following are example usage scenarios for the DAF Patient profile:

  • Query for a Patient demographic information using Medical Record Number (MRN), which is a type of identifier. The MRN is identifiable by identifier.system and may be location specific.
  • Query for a Patient demographic information using first name, last name etc.
  • Query for Patients based on race, ethnicity, gender etc.
  • Query for Patients based on geographical area such as city, state, postalCode information
  • Query for Patients less than 5 years of age
  • Query for Patients between ages of 25 and 50

D.17.0.4.3 Profile specific implementation guidance

Implementers need to be mindful of the following during their implementation

    Patient Identifiers: Patient Identifiers are represented as part of the Patient.identifier data element. Identifiers must be scoped using a URI data type represented within the Patient.identifier.system element. If systems are using OID's to scope their patient identifiers, then OID's can be converted to URI's per RFC-3001. However, systems are encouraged to adopt parallel URIs and map to allow the benefits of human readability and resolvability. Since DAF profiles deal with queries of Patient data, identifiers play a critical role in identifying the right resources to be queried and returned.

    Representing Patient Names: Patient Names are represented using the HumanName datatype. Per the FHIR specification, the first name is represented using the first occurrence of the element HumanName.given element. Middle names and other parts of the name can be represented using subsequent occurrences of the HumanName.given element.

    Specifying multiple race codes: Many systems may capture race codes at a very granular level which can be rolled up to higher level race codes such as "Asian", "White" etc. In cases where these systems intend to include these granular race codes in addition to the higher level race codes permitted by the value set they can do so by using the coding element which can be repeated as many times as needed within the race element.

    Capturing BirthPlace: Many systems may only capture the birth place as a city name, or a state name or a county name instead of using a highly structured Address data type. In these cases these systems should use the address.text field to record the birth place.

    See DAF FHIR IG for implementation guidance common to all profiles.