On Int example patient 9449310424 is marked as Superseded
Looking at the responses on INT for this example, it doesn’t appear to indicate patient is superseded.
How would I know I know this is patient is superseded?
I’m presuming superseded means:
the patients NHS number has been changed. If this is the case the old number should be present in the response in FHIR Patient.identifier with marked with something like ‘old’ (or use Patient.link).
the patient has been identified as a duplicate or mis matched, in that case the old NHS number should be present in FHIR Patient.link with the old number.
If we don’t know the old number (and this is what superseded is meaning), we can potentially not present a patients full record to clinicians and this maybe a safety issue.
I would say “superseded” means, there are two (or more records) for a given person. And if one uses any of the NHS numbers that relate to the superseded records, one would receive the “superseding” record.
So if a PDS record is superseded, when calling GET /Patient/<superseded number>, the response body will be of superseding record.
In this way, one could identify that the NHS number they have refers to a superseded record by observing the returned NHS number in Patient.id is not the one used in the original request.
We’re working with several EHR systems via FHIR api’s and so we’re becoming strict on our domain model. So what I’m doing in the NHS England facade is convert the response to this and use link to indicate it has been replaced.
