When storing patient contact details against the Patient Resource there are some specific business rules that need to be followed.

In the Patient profile there are two ways to store contact details. Each one has a specific use.

  • Patient.telecom
    • Should be used as the place to store primary contact information that has a direct relationship to the Patient
  • Patient.contact
    • Should be used to store contact details for third parties whose details can be used to contact the patient (e.g. a Parent)

Additionally there is a third way related contact details collected might be stored, however this has a very specific use and should not be used as a way to store third party contact details:

  • Patient.link(RelatedPerson)
    • Should be used to store a relationship to another individual (with their own separate set of contact details) who meets all of the following requirements:
      • has a personal or non-healthcare-specific professional relationship to the patient
      • who is not associated with the care delivery organization
      • who is allocated tasks specifically for the care of the Patient

Therefore a supplier system must also identify the relationship of the contact details to the patient. Then depending on that relationship those contact details must be recorded into the correct location according to the rules above.

Requirements for the Consumer, collecting and recording the contact details:

  • At least one set of contact details must be recorded against the patient
    • if the contact details are directly related/owned by the patient then the details must be stored as Patient.telecom
    • if the contact details belong to a 3rd party, they must be stored in the Patient.contact section
      • 3rd party contact details must include:
        • a relationship
        • a name
    • all contact details must record a rank:
      • the rank element is a positive integer value
      • Contacts are ranked with lower values coming before higher values (e.g. 1=highest)
      • rank does not necessarily follow the order in which the contacts are represented in the instance.
      • the rank value of 1 must be unique and not used more than once in a Patient profile.
      • rank values must use the following precedence:
        • the primary contact details (e.g. those that should be tried first) for the patient must always have a rank value of 1
        • if precedence for other contact details can be determined then rank values must reflect this
        • if no precedence can be determined then they can all be allocated the same value (e.g. 2)
  • At least one set of address details must be recorded against the patient
    • Patient.address must always be populated
    • third-party address details must be stored in the Patient.contact section with other contact details (e.g. telecom)

Requirements for the Provider, consuming the Patient resource and storing the contact details:

  • Contact details are obtained from:
    • Patient.telecom & Patient.address and / or
    • Patient.contact.telecom & Patient.contact.address
  • when specfic 3rd party contact details are displayed to a user, a name and a relationship must be displayed
  • at least the primary contact for the patient must be displayed to a user (indicated by a rank value of 1)
  • additional contacts should be displayed to the user if present with the precedence identified to the user (based on rank values)

Examples

The following examples show abridged Patient resources with only the pertinent contact elements included for illustration only (click to expand):

Patient with no 3rd party contact details 
  {
    "resourceType": "Patient",
    <-snip->
    "telecom": [
        {
            "system": "phone",
            "value": "01234 567 890",
            "use": "home",
            "rank": 1
        }
    ],
    <-snip->  
    "address": [
        {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
        }
    ],
    <-snip->
  }
Patient with only 3rd party contact details 
  {
    "resourceType": "Patient",
    <-snip->
      "address": [
        {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR",           
        }
      ],
      <-snip->
      "contact": [
        {
          "relationship": [
            {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v2/0131",
                  "code": "N"
                }
              ]
            }
          ],
          "name": {
            "family": "Smith",            
            "given": [
              "Jane"
            ]
          },
          "telecom": [
            {
              "system": "phone",
              "value": "01234 567 890",
              "rank": 1
            }
          ],
          "address": {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
            }
          },
          "gender": "female",          
      }
    ],     
    <-snip->
  }
Patient with own and 3rd party contact details 
  {
    "resourceType": "Patient",
    <-snip->
    "telecom": [
        {
            "system": "phone",
            "value": "01234 567 890",
            "use": "home",
            "rank": 1
        }
     ],
     "address": [
        {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
        }
      ],
      <-snip->
      "contact": [
        {
          "relationship": [
            {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v2/0131",
                  "code": "N"
                }
              ]
            }
          ],
          "name": {
            "family": "Smith",            
            "given": [
              "Jane"
            ]
          },
          "telecom": [
            {
              "system": "phone",
              "value": "01234 056 789",
              "rank": 2
            }
          ],
          "address": {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
            }
          },
          "gender": "female",          
      }
    ],     
    <-snip->
  }
Patient with own and two 3rd party contact details 
  {
    "resourceType": "Patient",
    <-snip->
    "telecom": [
        {
            "system": "phone",
            "value": "01234 567 890",
            "use": "home",
            "rank": 1
        }
     ],
     "address": [
        {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
        }
      ],
      <-snip->
      "contact": [
        {
          "relationship": [
            {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v2/0131",
                  "code": "N"
                }
              ]
            }
          ],
          "name": {
            "family": "Smith",            
            "given": [
              "Jane"
            ]
          },
          "telecom": [
            {
              "system": "phone",
              "value": "01234 056 789",
              "rank": 2
            }
          ],
          "address": {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
            }
          },
          "gender": "female",          
      },
      {
          "relationship": [
            {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v2/0131",
                  "code": "N"
                }
              ]
            }
          ],
          "name": {
            "family": "Smith",            
            "given": [
              "John"
            ]
          },
          "telecom": [
            {
              "system": "phone",
              "value": "01234 905 678",
              "rank": 2
            }
          ],
          "address": {
            "use": "home",
            "text": "123 High Street, Leeds LS1 4HR",
            "line": [
                "123 High Street",
                "Leeds"
            ],
            "city": "Leeds",
            "postalCode": "LS1 4HR"
            }
          },
          "gender": "male",          
      }  
    ],     
    <-snip->
  }