PCR Registered Extension

Canonical	../StructureDefinition/pcr-registered
Status	draft · 1.26.0
Base	Extension (constraint)
Context	Patient (element)
Source	FSH · JSON

Whether the provincial client registry holds this patient, as far as this EMR has been able to establish by sending it.

Overview

Set true once the registry has accepted an add for the patient, and also when the registry refuses that add as a duplicate of a client it already holds -- both outcomes mean the same thing for a reader, which is that the registry has a record. It is not set from a read of the registry and it is never set speculatively.

Absent and false mean the same thing: not known to be in the registry. The value is only ever written true; nothing writes false, so a reader should treat the absence of this extension as the negative case rather than looking for one.

This is not a statement about the patient. It says nothing about whether a person is registered provincially, whether their coverage is valid, or whether the registry's record agrees with this one. It records the state of one outbound transmission, and a consumer reading it as a clinical or administrative fact about the patient has read something it does not say.

It gates provincial reporting that depends on the registry. Estate surfaces that must not send a provincial message about a patient the registry has never seen -- an appointment arrival, for instance -- wait on this flag rather than sending and being refused. That is why it is stamped on the chart at all rather than kept in the integration's own store: the surfaces that need it read the patient, not the integration.

MIGRATION. Nexus EMR writes this extension today at http://services.well.com/fhir/pcr/exists (FHIR-381): that address is live in stored patient records and in code, and is under migration to the canonical declared here. Write the canonical; when reading, match both addresses exactly -- the two share no segment, so a suffix rule does not reach the pre-migration one.