One Patient.link of type replaced-by whose merge has already been sent to the provincial client
registry. REPEATS: a record merged more than once carries one of these per merge that has been
sent.
Elements / Details
Every element this profile touches, with its full definition. Element names in the tables link here.
A replaced-by merge already sent to the provincial client registry
Definition
One Patient.link of type replaced-by whose merge has already been sent to the provincial client
registry. REPEATS: a record merged more than once carries one of these per merge that has been
sent.
The value is the surviving patient's reference as a plain string -- Patient/<id> -- and it is
compared literally against Patient.link.other.reference. It is a string rather than a Reference
because it is a marker matched against a reference that already exists on the record, not a second
way of pointing at the surviving patient. The link is the merge; this only says the registry has
been told about it.
READ IT AS A PAIR WITH Patient.link, AND READ THE ABSENCE. A replaced-by link with no
matching value here is a merge this EMR has recorded and the registry has not yet been sent. That
gap is the whole point of the element: it is what lets the integration find a merge still owing
transmission after the chart has already been updated. A consumer that reads only Patient.link
sees the merge and cannot tell whether the province knows about it; a consumer that reads only this
element sees the merges already reported and misses the ones outstanding.
It is not a merge status from the registry. Nothing here reflects what the registry did with
the merge afterwards, and nothing removes the value if the registry later disagrees.
MIGRATION. Nexus EMR writes this extension today at
http://services.well.com/fhir/pcr/replacedByInPcr (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.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Source of the definition for the extension code - a logical name or a URL.
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
The surviving patient's reference, as it appears on Patient.link.other.reference
Definition
The surviving patient's reference written as a plain string (Patient/<id>), matched literally against Patient.link.other.reference. NOT a Reference: it marks which of the record's existing replaced-by links has been sent to the registry.