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After release 2024.4

Setting PracticeSettingCode metadata

The PracticeSettingCode is set based on the specialty of an organization.

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The document metadata described here are those prepared in the IHE XDS.b DocumentEntry structure cf. XDS Metadata for Document Profile, Danish Profile, consisting of a number of attributes.

For the most part, document metadata attributes associated with a document reflects values within the document. Notably, there are the following two exceptions:

  • DocumentEntry attribute practiceSettingCode - which reflects the clinical specialty in which the document was authored. The eHealth Infrastructure uses an organisational specialty, as described below.

  • DocumentEntry attribute healthcareFacilityTypeCode - which reflects the organisational unit type

Determining the Organisational Context

The organisational context to use as source for the two document metadata attributes depends on the FHIR resource type which served as the primary driver of the document content:

  • For FHIR Observation and FHIR QuestionnaireResponse resources, the FHIR Organization is the one referenced from the ClinicalImpression.assessorOrganization

...

  • of the

...

  • FHIR ClinicalImpression

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  • approving document sharing.

  • For

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  • FHIR Appointment resources, the FHIR Organization is the one referenced in

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  • Appointment.responsibleOrganization

...

  • .

The specialty used depends on the source of the organization and thus the context.

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Determining the practiceSettingCode Attribute Value

Whether a FHIR Organization specialty is primary or regular is determined from the Organization.

Info

After release 2024.4

  • If the FHIR Organization is from the municipal source (imported from the municipal registry FK Organisation) then the above organizational tree is traversed to find the nearest acceptable specialty which is also a primary specialty in any of the related SOR organizations, determining the specialty possibly involves traversing the FHIR Organization tree (with municipal source), and using the specialty/specialties (expected to be) registered in the related SOR imported FHIR Organization.

    • An acceptable specialty is one included in IHE XDS ValueSet https://buildehealth.fhirsundhed.org/ig/fut-infrastructure/implementation-guide/dk/fhir/ValueSet-dk-ihe-practicesettingcode-vs.html.If an acceptable primary specialty is encountered where only

    • Starting with the Organization resource identified in the organisational context (see above):

      • If the corresponding SOR imported Organization has a single primary specialty which is acceptable, it is used.

      • If the corresponding SOR imported Organization has a single primary specialty which is

      defined

      • unacceptable,

      then

      • the document

      sharing will use that specialty

      • registrering is terminated.

      • If

      an unacceptable primary specialty or an organization with

      • the corresponding SOR imported Organization has multiple primary specialties

      are encountered

      • ,

      then

      • the document

      sharing is abandoned for the given resource

      • registrering is terminated.

      • if the corresponding SOR imported Organization has no specialty/specialties, the parent Organization of the municipal source Organization is considered.

    • If no acceptable or unacceptable primary specialty is found (and no multiple primary specialties have been encountered), then specialty has been determined, a fallback value for municipal source Organization specialty is used (currently . Currently the fallback is configured to code=2903041000005106, system=http://www.snomed.org/, display=det kommunale omsorgs-, social- og sundhedsområde).

If the

...

FHIR Organization has SOR source (has been imported from SOR), then the first primary specialty found on that specific

...

Organization is used, if no primary specialty is present the first regular specialty is used.

The determined specialty code is validated against the IHE XDS ValueSet https://ehealth.sundhed.dk/fhir/ValueSet-dk-ihe-practicesettingcode-vs.html . When valid, the value is used, otherwise the document registering is terminated.

Determining the healthcareFacilityTypeCode Attribute Value

The value of Organization.type is validated against the IHE XDS ValueSet https://ehealth.sundhed.dk/fhir/ValueSet-dk-ihe-healthcarefacilitytypecode-vs.html . When valid, the value is used, otherwise the document registering is terminated.