Release
4
5
Administration
This
page
is
part
of
the
FHIR
Specification
(v4.0.1:
R4
(v5.0.0:
R5
-
Mixed
Normative
and
STU
)
).
This
is
the
current
published
version
in
it's
permanent
home
(it
will
always
be
available
at
this
URL).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
|
Work
Group
Patient
Administration
|
Standards Status : Informative |
The Administrative module covers the base data that is then linked into the other modules for clinical content, finance/billing, workflow, etc. It is built on the FHIR technology platform modules.
Before any clinical data can be recorded, the basic information of the patient must be recorded, and then often the basis of the interaction (such as an encounter).
Track
Resources
that
contain
details
of
people
involved
in
and
animals
that
are
either
receiving
healthcare,
the
basics
nearly
everything
else
references
care,
or
are
associated
with
these
subjects.
Many
other
resources
refer
back
to
these
as
either
the
subject
of
care,
or
are
somehow
involved
in
that
patient's
record.
| Name | Aliases | Description |
| Patient | SubjectOfCare Client Resident | Demographics and other administrative information about an individual or animal receiving care or other health-related services. |
| RelatedPerson | Information about a person that is involved in a patient's health or the care for a patient, but who is not the target of healthcare, nor has a formal responsibility in the care process. | |
| Person | Demographics and administrative information about a person independent of a specific health-related context. | |
| Group | Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization. |
Implementation Note: Patient linking should also be considered when evaluating searches with references to other resources. e.g. searching for a
patients'patient's conditions for a patient.
At present the specification does not define if the links should be also followed to include conditions that reference the linked patients too. We are currently seeking feedback on this.
Implementation Note: The Person resource may be used as a centralized register of people that may eventually be involved in healthcare, and could be used as the central core demographics register.
However, the fields/values in Person are duplicated in the other resources, and in many cases the Person resource will be hosted on external systems.
Most clinical activities occur grouped in some way. Long term care is typically covered by an EpisodeOfCare, whereas short term care is covered by encounters. Account associates the tracking of transactions back to a Patient (or other resource). Flag is just used to highlight a warning or other notification about a patient (or other resource)
| Name | Aliases | Description |
| EpisodeOfCare | Case Program Problem | An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time. |
| Encounter | Visit |
An
interaction
between
|
| Account | Cost center | A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc. |
| Flag | Barriers to Care, Alert | Prospective warnings of potential issues when providing care to the patient. |
Implementation Note: Resources shown with a dotted box are described in other sections of the specification:
CoverageandClaimare from the section on Finance .
Service Provider Directory resources are usually stored in the administration section of applications, and may even be synchronized from external systems.
| Name | Aliases | Description |
| Organization | A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc. | |
| Location |
Details
and
position
information
for
a
|
|
| Practitioner |
A
person
who
is
directly
or
indirectly
involved
in
the
provisioning
of
|
|
| PractitionerRole |
A
specific
set
of
Roles/Locations/specialties/services
that
a
practitioner
may
|
|
| HealthcareService |
The
details
of
a
healthcare
service
available
at
a
|
|
| Endpoint |
The
technical
details
of
an
endpoint
that
can
be
used
for
electronic
services,
such
as
for
web
services
providing
|
|
| OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship. | |
| InsurancePlan | Details of a Health Insurance product/plan provided by an organization. |
The Scheduling/Appointment resources permit the planning of encounters to occur and follow on with other clinical activities.
| Name | Aliases | Description |
| Schedule | Availability | A container for slots of time that may be available for booking appointments. |
| Slot | A slot of time on a schedule that may be available for booking appointments. | |
| Appointment | A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s). | |
| AppointmentResponse | A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection. |
When the scheduling resources need to identify the specific activity or service that is being scheduled, they may use either a HealthcareService or a coding to represent that activity.
Other assets are often registered in the administration system, and maintained as master files.
| Name | Aliases | Description |
| Device |
|
|
| DeviceDefinition |
|
|
| DeviceMetric |
Describes
a
measurement,
calculation
or
setting
capability
of
a
|
|
| Substance | A homogeneous material with a definite composition. |
Resources that capture information about research studies, and who is participating in them.
| Name | Aliases | Description |
| ResearchStudy | Clinical Trial | A scientific study of nature that sometimes includes processes involved in health and disease. For example, clinical trials are research studies that involve people. These studies may be related to new ways to screen, prevent, diagnose, and treat disease. They may also study certain outcomes and certain groups of people by looking at data collected in the past or future. |
| ResearchSubject | Study Subject | A ResearchSubject is a participant or object which is the recipient of investigative activities in a research study. |
Implementation Note: The episode and study properties are through standard extensions, and servers might not implement suitable search parameters on these extensions (still to be defined).
If an encounter has a mix of research and non research content, recommend creating 2 encounters in the system, however could derive that information Based on the presence of the extension on the obs/diagnosticreport/immunization etc. which then feeds to episodeofcare and onto account
Patient privacy is handled with security labels and tags in the Resource Meta property. This is the standard way in which that the FHIR specification provides this supporting information to a sub-system that implements it (which is not defined by FHIR).
One of the more common use cases is for marking a patient as being a celebrity .
Note that privacy considerations apply to Person, Practitioner and RelatedPerson records in addition to Patient's.
While Organization, Location, Device and other non-person-identifying records are generally subject to less stringent security precautions, such data must still be protected to avoid safety issues (e.g. someone maliciously changing the ingredients associated with a drug to cause/fail to cause alerts)
Devices can be linked to Patients. If this occurs, they must be protected as any other patient-linked element
For more general considerations, see the Security and Privacy module .
Administration Resources are cornerstone resources that are used by clinical and other domains of the FHIR Standard.
The Patient Administration is currently working through resources that support:
Many
of
the
administrative
resources
are
part
of
the
core
resources
that
most
systems
use
first
and
have
formed
the
basis
for
most
people's
first
experiences
with
FHIR.
However
this
limited
exposure
has
still
to
be
proven
in
all
contexts,
such
as
veterinary,
public
health
and
clinical
research.
FHIR
®©
HL7.org
2011+.
FHIR
Release
4
(Technical
Correction
#1)
(v4.0.1)
R5
hl7.fhir.core#5.0.0
generated
on
Fri,
Nov
1,
2019
09:37+1100.
QA
Page
Sun,
Mar
26,
2023
15:26+1100.
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