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6  Using Registration Data from the Patient Identities Query Response in a Subsequent Observation Reporting Query

An NHIN query client may choose not to obtain the results, reports, and/or medications from all registrations, only from selected ones. To support this type of query, NHIN queries recognize the <IdentifyPatient> attribute within the query <EvaluationSettings>. When <IdentifyPatient> is set to “no," the query must already contain one or more fully identified patient registrations, usually from the response to a previous Patient Identities query. Let us define how such a combination of queries and responses might look.

First, the client makes a Patient Identities query, just like the one described in the Patient Identities Query Message section of this paper. For brevity, we do not repeat that sample query here.  Refer to the Sample Patient Identities Query Message Dialogue section for that example.  Suppose that the NHIN client now determines that it wants the results and reports stored for the MADEUP-8 medical record number rather than the results and reports stored for all identified medical record numbers. The NHIN client constructs the Observation Report Query listed below.  Note that the PID segment included in this query message is identical to the PID segment returned in the Patient Identities Query response.  The response to this query is like any other Observation Reporting Query response.

Sample Query:

<soapEnv:Body>
<nhin:EvaluationSettings>
        <nhin:IdentifyPatient>no</nhin:IdentifyPatient>
</nhin:EvaluationSettings>
<nhin:Query>

<QBP_Z01 xmlns="urn:hl7-org:v2xml" >
        <MSH>
                        <MSH.1/>
                        <MSH.2/>
                        <MSH.3>
                                        <HD.1>Query Application Name</HD.1>
                        </MSH.3>
                        <MSH.4>
                                        <HD.1>ST ELSEWHERE HOSPITAL</HD.1>
                        </MSH.4>
                        <MSH.5>
                                        <HD.1>Target ISB</HD.1>
                        </MSH.5>
                        <MSH.6>
                                        <HD.1>Target SNO Name</HD.1>
                        </MSH.6>
                        <MSH.7>
                                        <TS.1>200506171410</TS.1>
                        </MSH.7>
                        <MSH.9>
                                        MSG.1>QBP</MSG.1>
                                        <MSG.2>Z01</MSG.2>
                                        <MSG.3>QBP_Z01</MSG.3>
                        </MSH.9>
                        <MSH.10>123456789</MSH.10>
                        <MSH.11>
                                        <PT.1>P</PT.1>
                        </MSH.11>
                        <MSH.12>
                                        <VID.1>2.4</VID.1>
                        </MSH.12>
        </MSH>
        <QPD>
                        <QPD.1>
                                        <CE.1>Z01</CE.1>
                                        <CE.2>Observation Reporting Query</CE.2>
                                        <CE.3>NHIN Query Code</CE.3>
                        </QPD.1>
                        <QPD.2>Q123456</QPD.2>
                        <QPD.3>
                                        <CE.1>RES</CE.1>
                                        <CE.2>result</CE.2>
                                        <CE.3>0048</CE.3>
                        </QPD.3>
                        <QPD.5>
                                        <CE.1>LABORATORY</CE.1>
                                        <CE.2>Laboratory</CE.2>
                                        <CE.3>NHIN_0001</CE.3>
                        </QPD.5>
                        <QPD.6>
                                        <TS.1>19980810</TS.1>
                        </QPD.6>
                        <QPD.8>LATEST</QPD.8>
        </QPD>
        <PID>
                        <PID.1></PID.1>
                        <PID.2></PID.2>
                        <PID.3>
                                        <CX.1>MADEUP-8</CX.1>
                                        <CX.4>
                                                        <HD.1>ST ELSEWHERE HOSPITAL Medical Record Numbers</HD.1>
                                                        <HD.2>MEDICAL RECORD NUMBER</HD.2>
                                                        <HD.3>ST ELSEWHERE HOSPITAL</HD.3>
                                        </CX.4>
                                        <CX.5>MR</CX.5>
                                        <CX.6>
                                                        <HD.1>ST ELSEWHERE HOSPITAL</HD.1>
                                        </CX.6>
                        </PID.3>
                        <PID.5>
                                        <XPN.1>
                                                        <FN.1>THOMSON</FN.1>
                                        </XPN.1>
                                        <XPN.2>MARCUS</XPN.2>
                        </PID.5>
                        <PID.7>
                                        <TS.1>19090630</TS.1>
                        </PID.7>
                        <PID.8>M</PID.8>
                        <PID.11>
                                        <XAD.3>BOSTON</XAD.3>
                                        <XAD.4>MA</XAD.4>
                                        <XAD.5>02171</XAD.5>
                        </PID.11>
        </PID>
        <RCP>
                        <RCP.1>I</RCP.1>
                        <RCP.2><CQ.1>10</CQ.1></RCP.2>
        </RCP>
</QBP_Z01>

</nhin:Query>
</soapenv:Body>