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Identifiers and Codes

The conventions described below are taken from several UK national HL7 specifications, including:

• NHS England HL7 v2 ADT Message Specification
• Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
• Digital Health and Care Scotland - (EH4001) CLINICAL DOCUMENT INDEXING STANDARDS
• IHE Europe Document Metadata (this contains references to NHS England Data Dictionary and Model)

Both guides are effectively merged in this guide and applied to both HL7 v2 and FHIR. The pattern used here is Canonical Data Mode, this can also be applied to other formats such as IHE XDS and DICOM.

v2 Segment	FHIR Resource	IHE XDS	National Guide
PID	Patient		NHS England (v2) and Digital Health and Care Wales (v2)
PV1	Encounter		NHS England (v2)
OBX	Observation
OBX (type = ED)	DocumentReference	DocumentEntry	Digital Health and Care Scotland and IHE Europe
ORC	ServiceRequest		Digital Health and Care Wales (v2)
OBR	DiagnosticReport		Digital Health and Care Wales (v2)

​This is also conformant with HL7 UK Core, which this extends.

The scope of this guide is the North West NHS region (for Genomics) and sits in the between English NHS Trusts (and their system suppliers) and NHS England.

Patient (PID) Identifiers

Only validated patient identifiers should be provided, unverified NHS Numbers are not permitted. At least one patient identifier be should be provided, the types supported are Medical Record Number (type=MR) and NHS Number (type=NH) (other types can be present). HL7 v2 PID.3 CX type and FHIR Patient.identifier have similar structures, see ConceptMap: Datatype CX to Identifier Map

Changes to v2 and FHIR:

Example

Conversion Table

Organisation	Assigning Authority - ODS Code (All)	Type (All)	System (FHIR)	OID (FHIR, v3 and IHE)	Alternate name
Alder Hey Children’s NHS Foundation Trust	RBS	MR
Liverpool Women’s Hospital NHS Foundation Trust	REP	MR
The Christie NHS Foundation Trust	RBV	MR
Manchester University NHS Foundation Trust	ROA	MR			Equivalent to internal v2 type = EPI

Encounter (PV1)

Organisation	Assigning Authority - ODS Code (All)	Type (All)	System (FHIR)	OID (FHIR, v3 and IHE)	Alternate name
Alder Hey Children’s NHS Foundation Trust	RBS	VN
Liverpool Women’s Hospital NHS Foundation Trust	REP	VN
The Christie NHS Foundation Trust	RBV	VN
Manchester University NHS Foundation Trust	ROA	VN

Observation (OBX)

DocumentReference (OBX type ED)

ServiceRequest

Organisation	Assigning Authority - ODS Code (All)	Type (All)	System (FHIR)	OID (FHIR, v3 and IHE)	Alternate name
Alder Hey Children’s NHS Foundation Trust	RBS	PLAC
Liverpool Women’s Hospital NHS Foundation Trust	REP	PLAC
The Christie NHS Foundation Trust	RBV	PLAC
Manchester University NHS Foundation Trust	ROA	PLAC
North West Genomic Medicine Service Alliance (GMSA)	699X0	FILL	https://fhir.nw-gmsa.nhs.uk/Id/FillerNumber

DiagnosticReport

Organisation	Assigning Authority - ODS Code (All)	Type (All)	System (FHIR)	OID (FHIR, v3 and IHE)	Alternate name
North West Genomic Medicine Service Alliance (GMSA)	699X0		https://fhir.nw-gmsa.nhs.uk/Id/GenomicReport

Specimen

Organisation	Assigning Authority - ODS Code (All)	Type (All)	System (FHIR)	OID (FHIR, v3 and IHE)	Alternate name
Alder Hey Children’s NHS Foundation Trust	RBS	SID
	RBS	ASCN
Liverpool Women’s Hospital NHS Foundation Trust	REP	SID
	REP	ASCN
The Christie NHS Foundation Trust	RBV	SID
	RBV	ASCN
Manchester University NHS Foundation Trust	ROA	SID
	ROA	ASCN
North West Genomic Medicine Service Alliance (GMSA)	699X0	SID	https://fhir.nw-gmsa.nhs.uk/Id/Specimen
	699X0	ASCN	https://fhir.nw-gmsa.nhs.uk/Id/AccessionIdentifier

Notes

To amend an entry in these tables, amend the table directly on this GitHub page https://github.com/nw-gmsa/R4/blob/main/input/pagecontent/identifiers.md and submit a pull request.

For NHS trusts with EPRs with FHIR REST APIs (e.g. EPIC, Oracle and Cerner), the FHIR system used here SHOULD be the same. An OID can be used instead of a FHIR system, this may be defined for use with IHE XDS.