Patient Identifier Cross-referencing for mobile (PIXm)
3.0.4 - Trial-Implementation International flag

This page is part of the IHE Patient Identifier Cross-referencing for Mobile (v3.0.4: Publication) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Artifacts Summary

Contents:

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

IHE ITI Patient Identifier Cross-referencing for mobile (PIXm) - Consumer (client)

The Patient Identifier Cross-reference Consumer Actor CapabililtyStatement expresses the requirements that can be utilized while being compliant.

IHE ITI Patient Identifier Cross-referencing for mobile (PIXm) - Manager (server)

The Patient Identifier Cross-reference Manager Actor CapabililtyStatement expresses the requirements that shall be provided.

  • using FHIR R4
  • using json and xml encoding
  • support for ITI-83 the $ihe-pix operation
  • support conditional update for [ITI-104]
  • support conditional delete for [ITI-104] if Remove Patient Option is supported
  • should use a security framework. Recommend ATNA, encouraged IHE-IUA or SMART-app-launch
IHE ITI Patient Identifier Cross-referencing for mobile (PIXm) - Source (client)

The Patient Identity Source Actor CapabililtyStatement expresses the requirements that can be utilized while being compliant.

  • using FHIR R4
  • using json or xml encoding
  • using conditional update for ITI-104
  • using conditional delete for ITI-104 if Remove Patient Option is supported
  • provide supported Patient profile for crosss-referencing for ITI-104
  • should use a security framework. Recommend ATNA, encouraged IHE-IUA or SMART-app-launch

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

Get Corresponding Identifiers Operation

The OperationDefinition defines the In and Output Parameters for the $ihe-pix operation

  • Input: sourceIdentifier, targetSystem and _format
  • Output: targetIdentifier, targetId

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Audit Event for PIXm Query by the Consumer

Defines constraints on the AuditEvent (AuditMessage) Resource to record when a PIXm Query Transaction happens, as recorded by the Patient Identifier Cross-reference Consumer.

  • Build off of the IHE BasicAudit Patient Query event
  • add the ITI-83 as a subtype
  • client is Patient Identifier Cross-reference Consumer
  • server is Patient Identifier Cross-reference Manager
  • entity slice for query parameters
  • eitity slice for a source patient identifier
  • yes both entities likely say the same thing, but one is specifically the patient identifier, and the other is in query parameter format
  • source is the client
Audit Event for PIXm Query by the Manager

Defines constraints on the AuditEvent (AuditMessage) Resource to record when a PIXm Query Transaction happens, as recorded by the Patient Identifier Cross-reference Manager.

  • Build off of the IHE BasicAudit Patient Query event
  • add the ITI-83 as a subtype
  • client is Patient Identifier Cross-reference Consumer
  • server is Patient Identifier Cross-reference Manager
  • entity slice for query parameters
  • eitity slice for a source patient identifier
  • yes both entities likely say the same thing, but one is specifically the patient identifier, and the other is in query parameter format
  • source is the server
Audit Event for Patient Identity Feed FHIR by the Manager that Creates a Patient

Defines constraints on the AuditEvent Resource to record when a Patient Identity Feed FHIR Transaction happens, as recorded by the Patient Identifier Cross-reference Manager.

  • This profile applies to the Patient Identity Cross-reference Manager actor in
  • Patient Identity Cross-reference Manager knows the requested conditional create is a create, so records this as an create.
  • Build off of the IHE BasicAudit PatientCreate event
    • A generic FHIR server might not distinguish an ITI-104
  • add the ITI-104 as a subtype
  • server is Patient Identifier Source
  • server is Patient Identifier Cross-reference Manager
  • entity slices for patient are required
    • filled with the identifier parameter value from the PUT
    • will be an identifier, not a reference
  • entity slice for the data
    • filled with the body of the PUT
    • will be the Patient resource presented
  • entity slice for transaction is available
Audit Event for Patient Identity Feed FHIR by the Manager that Updates a Patient

Defines constraints on the AuditEvent Resource to record when a Patient Identity Feed FHIR Transaction happens, as recorded by the Patient Identifier Cross-reference Manager.

  • This profile applies to the Patient Identity Cross-reference Manager actor in
  • Patient Identity Cross-reference Manager knows the requested conditional create is an update, so records this as an update.
  • Build off of the IHE BasicAudit PatientUpdate event
    • A generic FHIR server might not distinguish an ITI-104
  • add the ITI-104 as a subtype
  • server is Patient Identifier Source
  • server is Patient Identifier Cross-reference Manager
  • entity slices for patient are required
    • filled with the identifier parameter value from the PUT
    • will be an identifier, not a reference
  • entity slice for the data
    • filled with the body of the PUT
    • will be the Patient resource presented
  • entity slice for transaction is available
Audit Event for Patient Identity Feed by the Manager that Deletes a Patient

Defines constraints on the AuditEvent Resource to record when a Patient Identity Feed Transaction happens, as recorded by the Patient Identity Cross-reference Manager.

  • This profile applies to the Patient Identity Cross-reference Manager actor in
  • Build off of the IHE BasicAudit PatientDelete event
    • this will result in two .entity elements with the same logical information
  • add the ITI-104 as a subtype
  • client is Patient Identifier Source
  • server is Patient Identifier Cross-reference Manager
  • entity slices for patient are required
    • filled with the identifier parameter value from the DELETE
    • will be an identifier, not a reference
  • entity slice for the data
    • filled with the path of the DELETE
    • will be the Patient resource id presented
  • entity slice for transaction is available
Audit Event for Patient Identity Feed by the Source that Creates or Updates a Patient

Defines constraints on the AuditEvent Resource to record when a Patient Identity Feed Transaction happens, as recorded by the Patient Identity Source.

  • This profile applies to the Patient Identity Source actor in
  • Patient Identity Source records an Update as using a conditional create, so as to support update if exists else create.
  • Build off of the IHE BasicAudit PatientUpdate event
  • add the ITI-104 as a subtype
  • client is Patient Identifier Source
  • server is Patient Identifier Cross-reference Manager
  • entity slices for patient are required
    • filled with the identifier parameter value from the PUT
    • will be an identifier, not a reference
  • entity slice for the data
    • filled with the body of the PUT
    • will be the Patient resource presented
  • entity slice for transaction is available
Audit Event for Patient Identity Feed by the Source that Deletes a Patient

Defines constraints on the AuditEvent Resource to record when a Patient Identity Feed Transaction happens, as recorded by the Patient Identity Source.

  • This profile applies to the Patient Identity Source actor in
  • Build off of the IHE BasicAudit PatientDelete event
    • this will result in two .entity elements with the same logical information
  • add the ITI-104 as a subtype
  • client is Patient Identifier Source
  • server is Patient Identifier Cross-reference Manager
  • entity slices for patient are required
    • filled with the identifier parameter value from the DELETE
    • will be an identifier, not a reference
  • entity slice for the data
    • filled with the path of the DELETE
    • will be the Patient resource id presented
  • entity slice for transaction is available
IHE PIXm Query Parameters In

The StructureDefinition defines the Input Parameters for the $ihe-pix operation

  • Input: sourceIdentifier, targetSystem
IHE PIXm Query Parameters Out

The StructureDefinition defines the Output Parameters for the $ihe-pix operation

  • Output: targetId, targetIdentifier
PIXm Patient Profile example for additional Manager constraints

Example Profile StructureDefinition for describing additional Patient resource constraints (requiring birthDate) by the Patient Identifier Cross-reference Manager for performing its cross-referencing function.

  • requiring name and birthDate
  • mustSupport for identifier, birthDate, name, telecom, gender birthDate, address and managingOrganization
PIXm Patient constraints for Feed

Profile for describing elements which have to be accepted by the Patient Identifier Cross-reference Manager for performing its cross-referencing function.

  • requiring name
  • mustSupport for identifier, name, telecom, gender birthDate, address and managingOrganization

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Audit Example of ITI-104 Create at Manager

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 by the Patient Identifier Cross-reference Manager. The Feed resulted in a Create of a Patient given the feed content, as the given parameter did not previously exist.
Audit Example of ITI-104 Delete at Manager

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Delete by the Patient Identifier Cross-reference Manager
Audit Example of ITI-104 Delete at Manager

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Delete by the Patient Identifier Cross-reference Manager.
Audit Example of ITI-104 Delete at Source

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Delete by the Patient Identity Source
Audit Example of ITI-104 Delete at Source

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Delete by the Patient Identity Source
Audit Example of ITI-104 Update at Manager

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Update by the Patient Identifier Cross-reference Manager
Audit Example of ITI-104 Update at Source

Audit Event for Patient Identity Feed FHIR Transaction ITI-104 Update by the Patient Identity Source
Audit Example of ITI-83 at Consumer

Audit Event for PIXm Query Transaction ITI-83 by the Patient Identifier Cross-reference Consumer
Audit Example of ITI-83 at Manager

Audit Event for PIXm Query Transaction ITI-83 by the Patient Identifier Cross-reference Manager
Dummy Device example

Dummy Device example for completeness sake. No actual use of this resource other than an example target
Dummy Patient example

Dummy patient example for completeness sake. No actual use of this resource other than an example target
Example OperationOutcome - sourceIdentifier Patient Identifier not found

Example OperationOutcome resulting from a failure find a Patient
PIXm Query Response for source identifier

PIXm Query Response for Patient with source identifier in RED domain for Mohr Alice
PIXm Query Response for source identifier and target system specified

PIXm Query Response for Patient with source identifier in RED domain and query for BLUE domain for Mohr Alice
PIXm Query with source identifier

PIXm Query for Patient with source identifier in RED domain for Mohr Alice
PIXm Query with source identifier and target system

PIXm Query for Patient with source identifier in RED domain and query for BLUE domain for Mohr Alice
Patient Alice Mohr

Patient Mohr Alice with all domain identifiers, note: this is just a consolidated identifier example will all identifiers from all the domains equivalent to a golden patient, however a golden patient is not the scope of PIXm, see the IHE PMIR profile
Patient Alice Mohr (Blue)

Patient Mohr Alice in Blue Domain
Patient Alice Mohr (Green)

Patient Mohr Alice in Green Domain
Patient Alice Mohr (Red)

Patient Mohr Alice in Red Domain
Patient Alissa Mohr (Red)

Patient Mohr Alisa in Red Domain
Patient Maiden Alice (Red)

Patient Maiden Alice in Red Domain
Patient Mohr Maiden Resolved by Mohr Alice (Red)

Patient Mohr Maiden (Duplicate) Resolved by Mohr Alice Red Domain