IE (Ireland) Core Implementation Guide - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Open Issues (Requires Clarification)

Items that the HIQA drafts, or other authoritative sources available to this PoC, do not settle. Nothing here is invented. Where the IG needs a value in the meantime, it uses a clearly named placeholder and points back to this list. Issues about ePrescription and eDispensation only are now tracked in IE Medication Events (hl7-ie/medication-events), which keeps the same numbers.

ID	Topic	What is unclear	Source	Placeholder / interim handling	Owner to ask
OI-001	IG Publisher QA	Partly resolved (Phase 9). Publisher 2.3.4 and validator 6.10.4 are installed and pinned by SHA-256. On this build host the Publisher stops with a NullPointerException in its HTML inspector (this.rc is null) on both main and this branch, so it produces no QA counts here	Phase 1, 9	Validator QA (scripts/qa/validate_all.py) is the CI gate with a ratcheting baseline (35; main 48). CI also runs the Publisher on Linux with Jekyll and reports its QA (not yet a gate)	Project owner (confirm the Publisher QA in CI, then make it a gate)
OI-002	IHI format	HIQA says "18 or 10-digit". How the forms relate (legacy vs current, check digit) is not stated	EP/PS 1.3.1	Accept ^[0-9]{18}$ or ^[0-9]{10}$	HSE (IHI Register)
OI-003	Identifier system URIs	No HSE-published FHIR system URIs for IHI, PPSN, PCRS schemes, NePS or PSI. The current sid/* URIs are minted under this IG's canonical	EP/PS 1.3, 2.6, 2.8, 3.1	Keep the IG-minted URIs, marked "placeholder" in the NamingSystem description	HSE / NePS team
OI-004	SNOMED CT Irish edition module	The brief says 11000220105. The HSE CTS reports 1601000220105. Anonymous $lookup fails on both; tx.fhir.org does not host the IE edition	—	Keep 1601000220105 (what the HSE CTS serves). Update 27 Sept 2026: the Irish Edition is published in the SNOMED International browser as MAIN/SNOMEDCT-IE (release 2026-09-21, the NMPC base publication date); confirm the module id there	HSE CTTO terminology team
OI-005	Ethnicity classification	Resolved (Phase 7): the CodeSystem now carries the CSO Data Standard for Ethnicity v1.0 (7 Feb 2025) codes. Still open: whether HIQA intends that standard, and whether the CSO will publish a FHIR CodeSystem	PS 1.4.10; PS p. 15 names CSO as a source	Keep the CS scoped to the Patient Summary; verify in Phase 7	CSO / HIQA
OI-006	Anomalies in the HIQA drafts	"Mandatory 0..n" (EP 1.6.x.4.2/3, PS 13.3.2, 15.2.1, 19.1.12.x); "Required 1..1" (PS 16.2); numbering (PS 4.4.6, PS 6.3.11.1, EP 3.6.1); PS 6.3 Medication 0..1; Table 3 numbering differs from the dataset	See docs/audit/baseline.md I-01	Mandatory-inside-an-optional-cluster is read as "1..1 if the parent is present"	HIQA (consultation feedback)
OI-007	Coded values in general	HIQA: "Coded values have not yet been specified in this standard"	EP p. 18, PS p. 15	Bindings chosen from recognised standards, labelled as IE Core choices	HIQA
OI-008	PPSN in health records	The legal basis and limits for using the PPSN as a health identifier. HIQA includes it (Required), but PPSN use is restricted by statute	EP/PS 1.3.2	Slice with no MustSupport	DoH / DPC / HIQA
OI-009	Electronic signature format	Moved to IE Medication Events (ADR-009); kept here for reference. HIQA EP 2.13 says only "electronic or digital signature". Signature format (e.g. AdES/JAdES), eIDAS assurance level and who verifies it (NePS or NCPeH) are not stated	EP 2.13	Provenance.signature with the FHIR signature-type code; no format constraint	HSE NePS / DoH
OI-010	Cross-border Bundle tag	Moved to IE Medication Events (ADR-009); kept here for reference. Resolved (Phase 8): the unsourced tag http://ehealth.ec.europa.eu/fhir/tag#xt-ehr was removed from every payload; a cross-border prescription claims IECoreBundleEPrescriptionCrossBorder in meta.profile (ADR-003)	input/examples/*.json	—	n/a
OI-011	Mother's former surnames	PS 1.4.6 asks for all former surnames of the mother (0..*); the HL7 extension holds one maiden name. Unclear whether HIQA means birth surname only	PS 1.4.6	IE extension IECoreMothersFormerSurname 0..* (ADR-002)	HIQA
OI-012	Stricter-than-HIQA constraints	Moved to IE Medication Events (ADR-009); kept here for reference. authorizingPrescription 1..1 (HIQA 6.5 Required 0..1); dosageInstruction.text 1..1 (HIQA 5.1 Optional); dispenseRequest.quantity 1..1 per the brief (HIQA 3.5.7 Required 0..1)	ADR-003	Kept as deliberate safety deviations, raised in feedback. Procedure.performed[x] to be relaxed to 0..1 in Phase 6	HIQA
OI-013	Healthcare facility address enforcement	HIQA EP/PS 2.9 (Mandatory, with postcode, line, county and country Mandatory). Enforcing it on the base IECoreOrganization would also constrain payers and foreign organisations; enforcing it only on the prescriber's or dispenser's facility needs the Bundle to identify which Organization is the facility	EP/PS 2.9	MS on the base; rows kept Partial	IE Core (design, next iteration)
OI-014	Exempt medication item	Moved to IE Medication Events (ADR-009); kept here for reference. HIQA EP 4.11 does not say what the item is exempt from	EP 4.11	Boolean extension IECoreExemptMedicationItem, experimental	HIQA
OI-015	Cross-border signature direction	Moved to IE Medication Events (ADR-009); kept here for reference. HIQA EP 2.13 makes the signature a legal requirement for prescriptions issued in another EU Member State and dispensed in Ireland; IE Core requires it in both directions for symmetry	EP 2.13	IECoreBundleEPrescriptionCrossBorder requires it in both directions	HIQA / NePS
OI-016	IE clinical profiles vs EPS entry profiles	EPS types Patient Summary entries to EU Base / EPS profiles (e.g. allergyIntolerance-eu-core, procedure-eu-eps). IE Core clinical profiles derive from base R4, so the IE Composition cannot narrow entries to them. HIQA Required MustSupport on IE clinical profiles therefore applies only to entries that also claim the IE profile	ADR-004	Guidance: PS entries SHALL conform to the EPS entry profiles and SHOULD also claim the IE Core profile. A follow-up ADR should decide whether to re-parent IE clinical profiles on EU Base core profiles	IE Core (next iteration)
OI-017	PS 6.3.9 Dose (Mandatory)	Enforcing dose 1..1 on MedicationStatement would reject "as directed" statements where only free-text dosage is known	PS 6.3.9	dose[x] MS, not 1..1; raised in the consultation feedback	HIQA
OI-018	NMPC FHIR code system URI and refsets	Partly resolved (27 Sept 2026): NMPC codes are SNOMED CT Irish Extension concept IDs, publicly checkable in the NMPC Meds Catalogue; the examples now use 17 verified NMPC VMP codes (docs/hiqa-2026/nmpc-verification.csv) and the placeholder code system is retired. Still open: the catalogue does not show refset IDs, so the NMPC level refsets (660371000220109 VMP, 660391000220105 VMPP, 660381000220107 AMP, 660401000220107 AMPP) and mapping refsets (690021000220108 HPRA, 680441000220106 ATC) remain unverified; check them in the SNOMED International browser (Irish Edition) or the HSE CTS	EP 4.1, 4.3	NMPC ValueSets stay experimental until the refsets are confirmed	HSE CTTO / NMPC
OI-019	Terminology review of non-HIQA ValueSets	After ADR-007, some ValueSets outside the HIQA scope are thin (e.g. pregnancy intent = Unknown only; smoking, alcohol, care-team roles, discharge disposition lost wrong codes)	ADR-007	Kept minimal and correct; no guessed codes	IE Core terminology owner
OI-020	OIDs for Irish identifiers in CDA	The CDA samples used unsourced sub-OIDs of 2.16.840.1.113883.2.16.1 for the IHI, PPSN, IMC and documents, a DICOM OID (1.2.840.10008.2.16.4) as the eIDAS identifier root, and an unverified German OID. No assigned OIDs for these Irish identifiers were found	ADR-006	CDA samples use the HL7 example OID arc 2.16.840.1.113883.19 and say so in a header comment	HSE / HL7 Ireland (OID registration)
OI-021	County in addresses	address.state is a string, but IE Core binds it (extensible) to a coded county ValueSet (WH, D, …). HIQA EP/PS 1.2 treats the county as text, so every example raises a binding warning	EP/PS 1.2	Examples use the county name (HIQA); the binding is left for a follow-up decision (drop it, or document codes vs names)	IE Core
OI-022	SNOMED CT Irish edition on public terminology servers	tx.fhir.org does not host the Irish edition (module 1601000220105), so the validator cannot check the 5 ValueSets that filter on it (medication codes, NMPC VMP/VMPP/AMP/AMPP): 5 validator errors that only the HSE CTS can clear	OI-004, OI-018	Reported as known validator errors; not counted as defects in the examples	HSE CTTO
OI-023	HPRA authorisation numbers in FHIR	No FHIR code system or identifier system URI for HPRA authorisation numbers is published. Earlier drafts used https://www.hpra.ie/drug-catalogue, which is a web page, not a code system	EP 4.1	Removed from pages and payloads; carry the number in Medication.identifier once a system is agreed	HPRA / HSE CTTO
OI-024	Local Docker build	The docker-compose.yml ig-builder service uses node:20, which has no Ruby/Jekyll, so the IG Publisher cannot render pages locally in Docker. CI installs Jekyll 4.4.1	Phase 9	Build in CI, or install Ruby and Jekyll locally	Project owner
OI-025	Future canonical domain	fhir.hl7.studio (with /ie paths) is a conceptual domain registered by the author, not an HL7 or HSE domain. Moving the canonical is breaking and needs an ADR. "HL7" is a registered trademark of Health Level Seven International; check whether its use in a domain name needs HL7's permission	Phase 9	Canonical unchanged (hl7-ie.github.io); plan and DNS records on the HL7 Registry Guidance page	Project owner / HL7 International
OI-026	Cross-border patient identifier system	The pages and alias comments cited urn:oid:1.3.6.1.4.1.12559.11.10.1.3.1.42.1 as "the eHDSI OID for the eIDAS patient identifier" with no source; the arc appears to hold eHDSI value-set OIDs (independent review R-06)	EHDS / eHDSI	Marked unverified on the pages; not used by any profile or HIQA example	National Contact Point / eHDSI
OI-027	Controlled-drug rules HIQA leaves open	Moved to IE Medication Events (ADR-009); kept here for reference. (a) The first instalment of a Schedule 2/3 instalment prescription must be dispensed within 14 days of issue (EP 3.5.9.1 guidance): a dispensing-time check, not expressible on the MedicationRequest. (b) Whether 'Number of instalments' (EP 3.5.12) is required on every Schedule 2/3/4 Part 1 prescription or only on instalment prescriptions. (c) The MDA schedule itself is a placeholder code system (OI-007)	EP 3.5.9.1, 3.5.12, 4.2.3	ie-rx-cd-2 allows two months when instalments are stated; ie-rx-cd-3 requires the number of instalments for Schedule 2/3/4 Part 1 (conservative). Decision (project owner, 24 Sept 2026): keep both conservative readings until HIQA clarifies (consultation feedback EP-3)	HIQA / Department of Health
OI-028	Allergy statement completeness at dispensing	Moved to IE Medication Events (ADR-009); kept here for reference. HIQA requires the allergy statement on the prescription; it does not say whether the pharmacy must re-confirm it at dispensing (the scenario 5 decline depends on it)	EP 1.6, 6	Not modelled	HIQA
OI-029	Simplifier guide rendering	The IG pages use IG Publisher features (Liquid includes, {:.grid}, links to generated artefact pages, Mermaid). Whether a Simplifier guide renders them is untested, and a Simplifier upload has not been tried (no account in this work)	ADR-008	Package route documented; the guide is optional and links back to GitHub Pages	Project owner (first Simplifier release)
OI-030	Health Services Provider Identifier (HSPI)	The Health Identifiers Act 2014 (s.13–14) defines one identifier type, kept in one register with Parts for individuals (A, C, D) and organisations (B, E). The Act sets no format and names no FHIR system. Whether the HSE issues individual and organisation HSPIs from one number range, the format, and the system URI(s) are not published	Health Identifiers Act 2014; HIQA health identifiers FAQ (2017)	Two placeholder systems, HSP-I (sid/hsp-i, Practitioner) and HSP-O (sid/hsp-o, Organization); optional slices, no format rule (ADR-006 addendum)	HSE (HSPI register) / Department of Health