Updating a resource using patch

We’ve received a bit of pushback from the community regarding our proposal to use custom operations for updating the Patient in NHI upgrade project. But the development team really isn’t keen on using PUT updates of the complete resource – the main reason being that of ‘accidental’ data changes when the updater doesn’t return the parts of the resource that should remain unaltered. (Apparently, this is not uncommon with messaging based updates that are kind of similar).

I mentioned in that post that we didn’t really take a close look at PATCH updates – but a couple of days ago I saw this trail in the FHIR chat which is about a similar project (slightly different requirements) and thought I really should take a closer look at PATCH.

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Slicing with Forge

This is a ‘so I can remember how I did it later’ post.

Slicing in FHIR is where you take an element that can repeat and create ‘sub-lists’ which have specific values. The example in the spec involves slicing the Observation.component element to represent a Blood Pressure measurement where you want to record the systolic and diastolic values in a single observation.

In my example I wanted to create a slice on Patient.identifier as part of the work we’re doing for the NHI (National Health Identifier) interface. Because patients are frequently duplicated in the NHI registry, it’s common for a single person to have a number of different identifiers – the current ‘active’ one, and any number of ‘old’ ones – numbers that were assigned to duplicate entries than have been merged or linked (we call them dormant ones).

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