HL7AU - FHIR WG : Practitioner Qualifications Draft Discussions

The Practitioner Qualification backbone element is intended to cover:

  • Formal Qualifications (e.g. Bachelor of Science, University of Melbourne, with Honours graduated in 1993, majoring in veterinary science, 3 year degree)
  • Registrations (e.g. AHPRA Registered Nurse, expiry date 2020-09-01) 
  • Training (e.g. Cert 3 Aged care, completed 2019-07-01)
  • License to practice (e.g. Member of the college of surgeons, start 2019-09-01, expiry date 2020-09-01)
    These often have associated rule that require people to maintain the currency of the required pre-requisites (e.g. keeping up to date with latest advances in the field etc)

Property

Formal
Qualification

Registration

Training

Licensing

IdentifierID issued by the issuer of the qualification (may not exist in many cases)

likely to exist

HPI-I, AHPRA Reg ID



Code

The example valueset included in the specification
http://hl7.org/fhir/v2/0360/2.7/index.html
 is really covering this use case

Nurse practitioner number

http://terminology.hl7.org/CodeSystem/v2-0203

AC Accreditation/Certification Identifier

ON Optometrist license number

Nurse practitioner number

period.startwhen was the qualification was conferred/graduated, and the practitioner now has this qualificationthe start of the registrationwhen the training was completedstart of license validity
period.endthis is typically not used, unless for some reason the qualification was revokedwhen registration expireswhen the training is valid untilwhen license expires
issuer.displaythe name of the institution that issued the qualification
the name of the issuer, or the training provider?issuer of the license
issuer.referenceif the institution was codified (often not used)


(ext) Specialty
likely includedpossibly here toohighly likely
(ext) where valid




the location/area/jurisdiction that the license is valid within.

e.g. state based license to practice

(ext) status
active, inactive, revoked, pending, unknownactive, inactive, revoked, pending, unknownactive, inactive, revoked, pending, unknown

Do we need a new Type property to indicate the type of qualification: qual, reg, train, licence etc...

Should the http://hl7.org/fhir/v2/0360/2.7/index.html valueset have levels in it? Is this the extra type level that would be in the property above, e.g. Bachelor Degree, Diploma, etc.

This is a good start on the issue, would like to pass the terminology parts of this problem to the Agency, HISA or someone else involved.

Does the difference between a testing provider and issuer of a certification make any difference, and does that need to be recorded? 

The VhDir also has some extensions on this backbone element: http://build.fhir.org/ig/HL7/VhDir/StructureDefinition-practitioner-qualification.html

(specifically the where valid and status extensions)

Use Case Pathologist:

  • Formal Qualification from university (Medical degree + specialty + RCPA fellowship)
  • Registration with AHPRA medical board as a pathologist
  • Member of RCPA (Royal College of Pathologists of Australasia)

Use Case General Practitioner:

  • Formal qualification from university
  • Registration with AHPRA as general practitioner
  • member of RACGP (optional?) - multiple levels of this too
  • registration? with CASA for performing aviation medicals?

Use Case Surgeon:

  • Formal qualification from university
  • Registration with AHPRA as surgeon
  • member of College of surgeons

Use Case for Registered Nurse:

  • Formal qualification from university (degree of nursing)
  • Registration with AHPRA as a nurse (possible endorsement of nurse practitioner)
  • Union membership? (there are multiple unions - this may not be recorded or a requirement)

Use case for an Aged Care Worker

  • Possible formal qualification
  • Appropriate Certificate of training

Note: There could be confusion around the difference between a registration and a license, would like to seek additional guidance on this to see if others have more detail that could assist.

How far outside the medical capacity would we consider using this information, e.g. Accounts and other such things in the Practice Management space?