• System. PKB assigns each patient a UUID. This is unique across the entire PKB system, and can be used to identify a patient independently of their links to any country, organisation or team.
• National. A national identifier is an identifier that identifies a patient within a given country, such as an NHS number.
• Local. A local identifier is an identifier which identifies a patient uniquely for a sender, but not outside that sender. An example would be a hospital number. A local identifier can be associated with either a PKB Organisation or a PKB Team.

System identifiers

In order to send through the PKB ID, you need to provide:

• an Assigning Authority of: PKB
• an Identifier Type Code of: PI

National identifiers

In order to send through a national ID, you need to supply the Assigning Authority and Identifier Type Code as detailed in the table below.

 

Identifier Name	Country	Assigning Authority	Identifier Type Code	Status Code
NHS Number *	GB-ENG, GB-WLS	NHS	NH	In addition, note that the NHS number can optionally include a status code, as defined in the NHS Data Dictionary. If present, the status code is supplied with the identifier type code, in the format NH{status:XX} where XX is the status code. There must be no space between “NH” and the status code. Since the status code is optional, “NH” remains a valid identifier type code. For example: NH{status:01}
CHI Number *	GB-SCT	NHS Scotland	NH
Health and Care Number *	GB-NIR	DHSSPS	NH
Individual Health Identifier	IE	HSE	NI
SSN	US	USA	NI
SIN	CA	CA	NI
HKID	HK	HK	NI
BSN	NL	NL	NI
Krankenversichertennummer	DE	DE	NH
Civil ID	KW	KW	NI

* A note about NHS-Type Numbers. The following 3 National ID Types are drawn from the same numbering scheme, but with non-overlapping ranges. PKB considers them to be separate types. It is the responsibility of the sender to ensure the correct AA/TC values are sent.

• CHI Number (Scotland): 010 101 0000 to 311 299 9999
• Health and Care Number (Northern Ireland): 320 000 0010 to 399 999 9999
• NHS Number (England and Wales): 400 000 0000 to 999 999 9999

Local identifiers

You will need to agree with PKB what local identifiers you would like to send through.

Each PKB Organisation or PKB Team can be associated with multiple local identifier types, and each patient can be associated with multiple ID values for each local identifier type.

AA wildcarding

A local ID type can have a wildcard for the Assigning Authority (but not the Type Code). If this is configured, then an HL7 identifier will be assigned to this type if the TC matches, regardless of the provided AA value.

Restrictions & scope

The scope of AA/TC pairs for local IDs is the whole PKB Organisation. All AA/TC pairs for a PKB Organisation (and for all PKB Teams within that PKB Organisation) must be unique across the PKB Organisation.

In addition, a Type Code can only be used with a wildcarded Assigning Authority if that Type Code is not used by any other local ID within the PKB Organisation (or any PKB Teams within that PKB Organisation).

A local ID AA/TC pair must not match the AA/TC pair for any national ID.

The scope of a local ID is always the entire PKB Organisation which contains it. As such, a team-level HL7 connection can read and write local IDs of a type associated with another PKB Team (providing it is within the same PKB Organisation).

Matching

Once all the provided identifiers have been assigned to their corresponding types, PKB will attempt to match them to an existing medical record.

Hard matching

Hard Matching refers to the process of identifying a medical record based on the values of the identifiers provided.

National and Local Identifiers are case sensitive.

Soft matching

Soft Matching is an optional process allowing for stricter upstream system (LAB/PAS/etc.) data validation based on the following demographic fields. The more soft matched fields enabled the more stringent the upstream validation. If a message does not pass based on any of the enabled soft match criteria but does pass the hard match based on patient identifier the message will be placed in the HL7 review queue to be managed by the organisation administrator.  Demographic-based soft matching is not applicable to messages which create a new patient record or update the demographics of an existing patient record (i.e. ADT A28/A31).

• Surname
• The soft matching process ignores case sensitivity and the use of whitespace, e.g Smith will match to smith  .
• Forename
• Forename (full): The provided and known forename values are matched in their entirety, e.g. jo does not match joanne
• Forename (short): The provided and known forename values are matched up to the length of the shorter of the two, e.g. jo does match joanne
• Forename (initial): The provided and known forename values are matched just on the initial letter, e.g. jo does match janet
• In all cases the soft matching process ignores case sensitivity and strips whitespace from the start or end.
• Date of Birth
• Inclusion of any whitespace(s) in this field value is not supported.
• Gender
• Postal Code
• The soft matching process ignores case sensitivity and the use of whitespace, e.g TS1TER will match to tS 1 T er.

NHS number status checking

Some messages cannot be soft-matched based on demographics.

• When creating a new medical record there is no prior demographic information to match against.
• When updating the demographic information on an existing medical record we must allow the message to change the existing demographic data, rather than match what is already stored.

Instead, PKB can optionally configure an interface to soft-match these messages based on the NHS number status. If this option is enabled, and an NHS number is provided, then PKB will check that the status is present and equal to “01” before creating or updating the medical record. If the check fails, then:

• If the target medical record does not exist, PKB will ignore the NHS number and behave as if it had not been provided.
• If the target medical record does exist, PKB will queue the message as needing manual review. A human must then manually confirm that the unverified demographic changes are correct.

In addition, if this option is enabled then an NHS number must be provided to update the demographics information of a medical record that already has an NHS number associated with it.

Auto Create

By default, medical records for new patients are created upon receipt of an A28 or A31 message only. PID segments for other message types that do not match a medical record will return an error. If you would like to disable this strict record checking, such that a new medical record is created whenever an unmatched PID is received (in any message) then we can configure this for you. However, you will still need to send an A28 or A31 to update the demographic details about each patient.

Workflow

The diagram below demonstrates our matching workflow.