New Zealand NHI IG
1.5.4 - Release

New Zealand NHI IG - Local Development build (v1.5.4) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Notes

XML and Json

Both XML and Json representations are supported, with the default being Json. A client can specify the representation it wants using the Accept HTTP header as described in the spec.

NHI representation

The NHI is represented in the Patient resource in the Patient.identifier element. Each patient has a single current (or active) NHI number, but can have multiple inactive NHI numbers - duplicate entries that have been merged and should no longer be used.

They are distinguished using the use element which has the possible values:

  • official - the active NHI
  • old - the dormant ones.

In the Json example below, ABC1234 is the current NHI, while DEF4567 and HIJ8900 are dormant ones that heve been merged.

...
  	"identifier": [
    {
      "use": "official",
      "system": "https://standards.digital.health.nz/id/nhi",
      "value": "ABC1234"
    },
    {
      "use": "old",
      "system": "https://standards.digital.health.nz/id/nhi",
      "value": "DEF4567"
    },
    {
      "use": "old",
      "system": "https://standards.digital.health.nz/id/nhi",
      "value": "HIJ8900"
    }
  	]
  	...

Patients GP

In the Patient resource, the patients usual GP is indicated by a reference to a PractitionerRole resource, which is a ‘linking’ resource that allows the NHI to indicate:

Element PractitionerRole element Target resource type HPI Identifier system
The usual GP PractitionerRole.practitioner Practitioner https://standards.digital.health.nz/id/hpi-person (CPN)
The General Practice to which they belong PractitionerRole.organization Organization https://standards.digital.health.nz/id/hpi-organisation
The location of the practice PractitionerRole.location Location https://standards.digital.health.nz/id/hpi-facility

The following diagram shows these relationships when the references are to resource instances (as would be provided by the HPI)

todo image here

As the HPI FHIR interface is not yet ready, this initial implementation is using an alternative form of referencing - the Logical Reference. This format means that the reference from PractitionerRole contains the identifier of resource, rather than it’s location on a FHIR server.

A ‘normal’ reference would look like this:

...
"generalPractitioner": [
    {
       "reference": "Practitioner/abc123"
    }
]
...

where the id of the practitioner (not their CPN identifier) is abc123. The client would need to retrieve the Practitioner resource to get the CPN. Note that there can be more than one GP - although the NHI supports only a single one.

The ‘logical’ reference looks like this:

...
"practitioner": {
    "type": "Practitioner",
    "identifier": {
      "system": "https://standards.digital.health.nz/id/hpi-person",
      "value": "hpiNum1"
    },
    "display": "Dr Marcus Welby"
  },
  ...

where the CPN is in the reference and not the id of the Practitioner. This has the advantage of including the CPN without requiring another call to the HPI, though does not include the other data about the Practitioner.

Contained

In this implementation, the PractitionerRole resource is not separate to the Patient resource - rather it is contained within the Patient resource.