Patient Demographics

Capturing Patient Demographics is a core function of an Electronic Health Record system. Requirements for EHR demographic capture are described in the ONC (a)(5) criteria.

Demographic data can be input via multiple methods, for example via application user interface (UI), synchronized via integration or written via API.

The USCDI V2 data standard outlines specific technical requirements, you can see the profile on HL7.org.

Advanced Requirements

While some demographic data is straightforward to capture, some data require careful handling. The following is a summary of the requirements for complex data capture with guidance on ensuring correctness.

User Interface

Medplum provides React components for Patient demographics that fulfill demographic data collection requirements and can be embedded in your application to fulfill the requirements.

Capturing Aliases

The specification supports capturing aliases, and correct usage is beneficial for record keeping. The following name field on the FHIR Patient resource shows an example of how to represent maiden names, as an example.

"name": [
    {
      "given": [
        "Marge",
        "Jacqueline"
      ],
      "family": "Simpson",
      "period": {
        "start": "1980-01-01T00:00:00Z"
      },
      "use": "official"
    },
    {
      "given": [
        "Marge",
        "Jacqueline"
      ],
      "family": "née Bouvier",
      "period": {
        "end": "1980-01-01T00:00:00Z"
      },
      "use": "old"
    }
  ]

Demographic Data

Health record systems must manage common demographic data. It is important not to supply your own codes, but instead use the provided ValueSets as they relate to demographics. Correct use of value sets is crucial for correct reporting and interoperability. The following table shows references for common demographic value sets. Medplum supports these Value sets in our UI components, or you can build ValueSets into your own applications.

Category	Name	URL
Gender	Administrative Gender Value Set	https://hl7.org/fhir/R4/valueset-administrative-gender.html
Race	US Core Race Extension	http://hl7.org/fhir/us/core/StructureDefinition/us-core-race
Ethnicity	US Core ethnicity Extension	http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
Birth Sex	Birth sex Extension	http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex

Lifecycle

Managing and merging duplicate patient records should be part of all implementations, and is covered in detail Patient Deduplication Architectures.

EHRs require capturing cause of death for patients. It is recommended to record death event as Patient.deceased with the time of death. For cause of death, it is recommended to represent as an Observation with an ICD-10 or other appropriate ontology.

Common Identifiers

Common identifiers, such as Driver's License numbers or Social Security numbers should be captured on the Patient resource using name spaced identifiers. These are useful when querying data from a Health Information Exchange (HIE) or HIE Onramp.

The integration section has details on querying the exchanges.

Related Reading

• ONC (a)(5) official description and guide.
• Sample data see sample demographic data in accordance with USCDI.
• US Core Patient Profile
• US Core Patient react component on Storybook
• ONC Certification for Medplum
• (a)(5) User Testing Video on Youtube

caution

ONC (a)(5) certification is under development.