New Zealand NES IG - Local Development build (v1.4.0-SNAPSHOT) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Create Enrolment

Create Enrolment for Patient

The Create Enrolment operation is initiated by a user who needs to create a new Enrolment with a health provider for the provision of a health service to a patient.

Create Enrolment processing steps:

1. A FHIR Client sends a POST request to the NES EpisodeOfCare endpoint with a payload containing the NesEnrolment resource to be created, excluding ids
2. The request is validated - ALT: Validation failure. Operation Outcome resource returned
3. The Enrolment is created in the EEE database and an ID is assigned
4. A newly created NESEnrolment, including its ID, is returned to the client

Create Enrolment Request Example

create Enrolment request

Behaviour

• FHIR Create Enrolment operation received by the system
• Requester identity checked to make sure they are valid and have correct permission set.
• Enrolment record is validated.
• The patient identity is validated.
• The request is checked against existing enrolment records for the patient to make sure the changes requested complies with the relevant enrolment Business and Attribute Rules.
• If all the attributes / items in the Enrolment record are correct
  • A new enrolment record is created in NES with the details populated in the request.
  • If required any enrolments are ended.
• If checks result in an error at any point, processing will stop and an Operation Outcome resource returned.
• If the request results in an existing Patient Provider enrolment ending, a notification will be created.
  • Organisations use the Common ‘Get Notifications’ request to check for new notifications of changes.
  • We won’t send a notification if the enrolment is with the org that actions the request.

Business Rules

• A Create Enrolment request must include:
  • A valid enrolling organisation (HPI-Organisation-id),
  • A valid service facility (HPI-Facility-id) (WCTO excluded).
  • Enrolment status
  • Enrolment type, and
  • Contained Patient resource

• A Create Enrolment request may include a valid practitioner (HPI-person-id / CPN)

• A Create Enrolment request must not include:
  • id or identiter (the id = identifier and is set by the service)
  • qualified encounter
  • re-enrolment date
  • expiry date (This is set by the service
    • FLS:
      • Nomination (future scope).
      • Enrol (set to three years from creation date).
      • Pre-enrol (set to three months from creation date).
    • FLS-NF (does not expire / set to a constant)
    • LMC (set to 6 weeks from baby’s birthdate)
    • WCTP (set to the child’s 5th birthday)
  • owning Organisation (set by the service to the hpi-Organisation-id of the requestor)
  • termination reason code
  • period
    • start (set by the service to the operation date)
    • end (only set when a record is ended)
• The Contained Patient resource must be a valid patient that includes at minimum the:
  • Live NHI
  • Patient name
  • Patient date of birth

• A request must not enrol a Patient with a Provider for a Health Service when an active enrolment for the specific Health Service exists for that patient with that Provider.

• The enrolment start date will be the date the request is processed to create the enrolment.

FLS Specific Rules

• A Patient must not be pre-enrolled for Health Service if an active enrolment exists for that Health Service for that patient.

• A request to enrol a patient for a health service must not be actioned if an enrolment (enrolled or pre-enrolled) has already been accepted on that date.

• A Patient must have a maximum of one active enrolment (enrolled or pre-enrolled) with a GP / PHO for Primary Care.

• A Patient must be less than three months old at the date of enrolment to pre-enrol with a GP Practice / PHO.

Create Enrolment Errors

Error Scenario	Error Code	Error Message	HTTP Status code
Missing HPI-Organisation-id in request	EM07201	HPI-Organisation-id is a required field	422 Unprocessable entity
Missing HPI-Facility-id in request	EM07201	HPI-Facility-id is a required field	422 Unprocessable entity
Missing Enrolment status in request	EM07201	Enrolment status is a required field	422 Unprocessable entity
Missing Enrolment type in request	EM07201	Enrolment type is a required field	422 Unprocessable entity
Missing Patient resource in request	EM07201	Patient resource is a required field	422 Unprocessable entity
NHI provied is dormant	EM02004	The NHI Identifier provided is dormant. This record cannot be updated	422 Unprocessable entity
Patient identity information does not match Patient NHI supplied	EM02008	The Patient identity information does not match Patient NHI supplied	422 Unprocessable entity
NHI number supplied supplied cannot be found.	EM02002	NHI number supplied supplied cannot be found.	422 Unprocessable entity
HPI-Organisation-id supplied cannot be found.	EM02002	HPI-Organisation-id supplied cannot be found.	422 Unprocessable entity
HPI-Facility-id supplied cannot be found.	EM02002	HPI-Facility-id supplied cannot be found.	422 Unprocessable entity
hpi-person-id (CPN) supplied cannot be found.	EM02002	hpi-person-id (CPN) supplied cannot be found.	422 Unprocessable entity
An enrolment for <1> already exists for this patient with the requested organisation	EM11003	An enrolment already exists for this patient with the requested organisation	422 Unprocessable entity
An enrolment has already been recorded for this patient today	EM11006	An enrolment has already been recorded for this patient today	422 Unprocessable entity
A patient must not have more than one active enrolment for a health service	EM11005	A patient must not have more than one active enrolment for a health service	422 Unprocessable entity
This patient is older than three months, and cannot be pre-enrolled	EM11007	This patient is older than three months, and cannot be pre-enrolled	422 Unprocessable entity