Proposal 573 Update XPN Fields having Sequence-based Meaning

Update XPN Fields having Sequence-based Meaning Latest discussion paper in 2/12/08 minutes at http://www.hl7.org/library/committees/fm/minutes/2008_02_12%20FM%20Conf%20Call%20Minutes.zip" Short Description: Update XPN fields currently having sequence-based meaning. Justification: In the course of developing the US Realm v2.5.1 Lab Result Interoperability Specification, we discovered a number of fields in the chapter 3 segments that have sequence or position based meaning. We are seeking to have this out-dated method of data interpretation to be relaxed. The HL7 data types have provided a more robust method for several versions now for precisely distinguishing among iterations of fields associated with the XPN data type.

It is also the case that certain of the fields associated with the XPN data type, such as PID-5 Patient Name, have internally inconsistent definitions and also constrain the data type in a way not intended by the XPN definition in chapter 2.A. In addition to constraining the first iteration to legal name, the PID-5 reads as follows: “Repetition of this field is allowed for representing the same name in different character sets.” There appears to be no allowance for multiple names such as legal, artistic, alias etc.

This is a resubmission of a portion of the original joint proposal 511 from Quest Diagnostics and Kaiser Permanente.

See also related proposal # 570 Change XPN Component Optionality Revised. Note that there is some controversy regarding whether or not XPN.1 can be made required. At issue is how to handle a name when there is only 1 designation rather than a Family name and a Given name. Proposed Solution This applies to the following fields: PID-5 NK1-2 NK1-30 3.4.2.5 PID-5 Patient Name (XPN) 00108

Change current definition: Definition: This field contains the names of the patient, the primary or legal name of the patient is reported first. Therefore, the name type code in this field should be "L - Legal". Refer to HL7 Table 0200 - Name Type for valid values. Repetition of this field is allowed for representing the same name in different character sets. Note that "last name prefix" is synonymous to "own family name prefix" of previous versions of HL7, as is "second and further given names or initials thereof" to "middle initial or name." Multiple given names and/or initials are separated by spaces. To: Definition: This field contains one or more of the names of the patient. The XPN.7 Name Type Code, and not the order, conveys how the name should be interpreted. As of v2.7 Name Type Code is required. Refer to HL7 Table 0200 - Name Type for valid values. Specification of meaning based on iteration is deprecated. In addition to allowing repetition of this field for transmitting multiple names with different Name Type Codes, repetition also allows for representing the same name in different character sets based on the value in XPN.8 Name Representation Code. Multiple given names and/or initials are separated by spaces.

Change 3.4.5.2 NK1-2 Name (XPN) 00191 Definition: This field contains the name of the next of kin or associated party. Multiple names for the same person are allowed, but the legal name must be sent in the first sequence. If the legal name is not sent, then the repeat delimiter must be sent in the first sequence. Refer to HL7 Table 0200 - Name Type for valid values

To 3.4.5.2 NK1-2 Name (XPN) 00191 Definition: This field contains the name of the next of kin or associated party. As of v2.7 XPN.7 Name Type Code is required. The XPN.7, and not the order, conveys how the name should be interpreted. No assumption can safely be made on repetition sequence or order. Refer to HL7 Table 0200 - Name Type for valid values

Change: 3.4.5.30 NK1-30 Contact Person's Name (XPN) 00748 Definition: This field contains the names of the people to contact, depending on the value of the relationship defined in NK1-3 - Relationship. This field is typically needed when the NK1 is an organization. The legal name should be sent first in the sequence. Refer to HL7 Table 0200 - Name Type for valid values.

To: 3.4.5.30 NK1-30 Contact Person's Name (XPN) 00748 Definition: This field contains the names of the people to contact, depending on the value of the relationship defined in NK1-3 - Relationship. This field is typically needed when the NK1 is an organization. Refer to HL7 Table 0200 - Name Type for valid values. As of v2.7 XPN.7 Name Type Code is required. The XPN.7, and not the order, conveys how the name should be interpreted. No assumption can safely be made on repetition sequence or order.

Version 3 Implications TBD