The HL7 2.5.1 immunization implementation guide lists 39 data elements for patient demographic information for use to identify unique patients. 7 Required (R), 22 Required if Exist (RE), 1 Conditional (C), 8 Optional (O) and 1 Not Applicable (NA).
| PATIENT DEMOGRAPHIC INFORMATION | ||
| Concept Name | Description | R/RE/O |
| Patient ID | Medical Record number, or other identifier (HL7 2.5.1 previously listed as “Medicaid Number”) | R |
| Patient ID Assigning Authority: | Assigning Authority ID (i.e., owning source)/Facility Name. The name may be vendor supplied. | R |
| Patient ID: Type (e.g., medical record number, IIS ID) | R | |
| Patient Name: First | R | |
| Patient Name: Middle | RE | |
| Patient Name: Last | R | |
| Patient Date of Birth | R | |
| Birth Time | O | |
| Patient Gender (Administrative Sex) | Looking for “Administrative Sex” – Statement in HL7 2.5.1 standard ‘Gender’ may be inconsistent with MU | R |
| Patient Multiple Birth Indicator | RE | |
| Patient Birth Order | If multiple birth indicator is checked – Conditional | C |
| Responsible Person Name: First | RE | |
| Responsible Person Name: Middle | RE | |
| Responsible Person Name: Last | RE | |
| Responsible Person Name: Relationship to Patient | RE | |
| Mother’s Name: First | RE | |
| Mother’s Name: Middle | RE | |
| Mother’s Name: Last | RE | |
| Mother’s Name: Maiden Last | RE | |
| Patient Address: Street | RE | |
| Patient Address: City | RE | |
| Patient Address: State | RE | |
| Patient Address: Country | RE | |
| Patient Address: Zip code | RE | |
| Patient Address: County of Residence | O | |
| Preferred Contact Information | NA | |
| Race | RE | |
| Ethnicity | RE | |
| Birthing Facility Name | RE | |
| Birthing Facility Location Address | RE | |
| Patient Birth State | RE | |
| Patient Primary Language | Important to Registry for managing follow-up | O |
| Patient Telephone Number | RE | |
| Patient Telephone Number Type (e.g., home, cell) | RE | |
| Patient E-mail Address | O | |
| Publicity Code | Level of privacy for recall (parent, family, patient only, etc.) | O |
| Protection Indicator | Whether the information can be shared with others including registry (opt-in, opt-out) and other clinicians – often state dependent | O |
| Protection Indicator Effective Date | Date of the decision about the protection level | O |
| Immunization Registry Status | Indication the patient is active or inactive in the practice | O |