Patient and Clinician Demographics in the API responses

e-Referral Service (e-RS) e-Referral Service FHIR API
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1

In A005:

Why don’t I get demographics for the “Extension-eRS-AttachedBy” person?

Why don’t I get patient demographics?

Because this information is not available, I have to be accredited to the SDS and PDS.

BaRS includes these in their messages so it’s clearly possible.

Also, the patient demographics are in the Clinical Information Document so why not the message?

2

Hi @jim.brock,

Patient Demographic information is not owned by the e-RS and should be sourced directly from PDS using Personal Demographics Service - FHIR API.

The e-RS does not store Patient Demographics information, so would itself have to look this up via PDS.

Similarly we do not surface Healthcare Worker/Professional information, for this you use Healthcare Worker - FHIR API (or Spine Directory Service - LDAP API).

See 1.5 Identify additional NHS services you may need in our API integration process Design documentation.

Regards,

Adam.

3

Hi Adam,

This is the stock answer and I’m well aware. It begs the question then, how is BaRS able to send us patient and clinician demographics? You are sending the information in the Clinical Information Summary so you are publishing demographics there, why not in the message?

The fact that we have to be PDS and SDS accredited is a huge undertaking and completely unnecessary when you have the information.

I think anyone who wants to undertake eRS integration should be very aware of these limitations and what the requirements are.

4

Hi Jim,

I’m not an expert in the BaRS API but from what I understand the BaRS and e-RS APIs follow a slightly different pattern with regards to patient demographics, but fundamentally they both require the caller to fetch the patient demographics (at some point). However, in the BaRS case it is the sender (e.g. creator of a referral) that does the lookup and provides it in the request, which is then later echoed back when retrieved.

When a referral is created via e-RS the sender is not required to provide the patient demographic information, only the NHS Number. However, there is an expectation (enforced by the SCAL) the sender will do a PDS lookup to confirm the patient details.

Then when someone fetches the referral (i.e. your use case) via e-RS we only provide the NHS Number and the caller is required to look this up in in PDS if they want demographics information.

You are sending the information in the Clinical Information Summary so you are publishing demographics there, why not in the message?

The e-RS is doing a PDS search each time the Clinical Information Summary is produced. It provides a snapshot of the patients details for the purposes of the PDF.

The e-RS does not return the demographics information as:

  1. The e-RS does not own this information, PDS does.
  2. The e-RS does not know what demographic information is actually required by the caller. In some cases it wont be required so looking it up for every request would be extremely wasteful.
  3. The demographics information would only be valid at the point of the call, clients would not be able to rely upon this information for future decisions.

The fact that we have to be PDS and SDS accredited is a huge undertaking and completely unnecessary when you have the information.

I think anyone who wants to undertake eRS integration should be very aware of these limitations and what the requirements are.

Section 1.5 Find other NHS services within the e-RS API design documentation outlines the requirements for PDS and SDS lookups.

I hope the above answers your question.

Regards,

Adam.