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Organization, Patient, and Device identifiers

Three resources anchor everything else in a Nexus EMR store: the Organization that operates the clinic, the Patient records it holds, and the Device representing the EMR software itself. This page covers what their identifiers carry.

For the general rules on identifiers, references and canonical URLs, see Nexus EMR Identifiers and References.

No identifier system is mandated

Start here, because it is the rule that governs all three: no Nexus EMR profile mandates a canonical identifier system. Every profile declares identifier as 0..*, recommends a business identifier, and leaves the system to the sender:

A business identifier is recommended but not required; no specific canonical system is mandated.

Carry the identifier the source system already assigns, under whichever system URI genuinely identifies it. Where a governed system exists (a provincial health number, a regulator's licence number, LOINC), use that rather than inventing one.

Organization

Represents the healthcare organization operating an EMR installation.

  • identifier.system: no mandated value. In practice the store uses https://fhir.apps.health/NamingSystem/organization-identifier.
  • identifier.value: a stable string identifying the installation.
"identifier": [
  {
    "system": "https://fhir.apps.health/NamingSystem/organization-identifier",
    "value": "cedarbrook-clinic"
  }
]

Organization identifiers are global: the value must be unique across every installation, because it is what distinguishes one clinic's data from another's.

Patient

Patient identifiers are assigned by the source EMR and are only unique within it, so carry them under a system that says where they came from.

Prefer, in order:

  1. A governed external system, where the patient has an identifier in one. A provincial health number is the common case, and the OLIS Implementation Guide collects canonical URIs for provincially assigned identifiers.
  2. https://fhir.apps.health/NamingSystem/patient-mrn for a medical record number.
  3. The source system's own identifier system, where one is published.

Where a local code has no recognized system at all, the profile permits a raw-code fallback: see Raw codes from source systems.

Device

Represents the EMR software installed at the clinic, as distinct from the legal entity that operates it. The Organization is the clinic; the Device is the product running there.

Use the NexusEmrCoreEmrDevice profile. As with every other resource, no identifier system is mandated.

See also