DRAFT Implementation Guide

This is for collaboration and discussion purposes and is subject to change.

North West Genomics Testing Workflow (GTW) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Patient Identifier Cross-referencing (PIX)

References

• A. Patient Identity Feed HL7 v2 [ITI-8] IHE Patient Identifier Cross-referencing (PIX) - Volume 1
• B. HL7 v2 A31 event definitions from NHS England HL7 v2 ADT Message Specification
• C. Patient Identity Feed HL7 FHIR [ITI-104] IHE Patient Identifier Cross-referencing for mobile (PIXm) - Volume 1

Overview

While the order is being fulfilled, patient demographics may change and systems involved in fulfilling the order require notification of these changes.

Actors and Transactions

Actor	Definition
Patient Identity Source	Commonly implemented by Patient Administration (PAS) or Electronic Patient Record (EPR) Systems
Patient Identifier Cross-reference Manager	For the purposes of this IG, this is either Order Filler or Automation Manager

IHE PIX/PIX(m) Actor Diagram

• The Patient Identity Source sends a IHE ITI-8/HL7 v2 A31 (or ITI-104/FHIR PUT (upsert)) event to the RIE
• The RIE forwards this event to the local Order Filler
• For external orders (how do we know this?), the RIE to NHS England’s Automation Manager Genomic Order Management System. At present this is:
  • Lookup up existing Patient via supplied identifiers (MRN or NHS Number) via a FHIR RESTful Search.
  • If a Patient record is found, then update the Patient record via a FHIR RESTful Update