ADT^A47 — Change Patient Identifier List
Change of an identifier in the PID-3 list. Typical French case: replacement of a provisional MRN with the definitive INS-NIR after qualification.
Purpose
A47 replaces, adds or removes identifiers in PID-3. Typical case in France: a patient registered with a provisional MRN in ER receives their INS-NIR after qualification (INSi e-service). A47 propagates the enriched identity.
Segment structure
Structure ADT_A30. MSH, EVN, PID (new list), MRG (old identifiers removed).
Real-world example
Patient Moreau Julie: replacement of a provisional MRN with MR100800 + INS-NIR:
MSH|^~\&|MPI|HOSP01|EHR|CLINIC02|20260518170000||ADT^A47^ADT_A30|MSG00047001|P|2.5.1|||AL|NE
EVN|A47|20260518170000|||MPI005^Updater^Identifier^^^MS.|REPLACE PROVISIONAL MRN WITH PERMANENT INS-NIR
PID|1||MR100800^^^HOSP^MR~280074512345678^^^ASIP^INS-NIR||MOREAU^JULIE^^^MS.||19890610|F
MRG|TMP100800^^^HOSP^MRAcknowledgment (ACK)
MSH|^~\&|EHR|CLINIC02|MPI|HOSP01|20260518170001||ACK^A47^ACK|ACK00047001|P|2.5.1
MSA|AA|MSG00047001Common errors
- Incomplete PID-3: A47 requires the full list of identifiers after modification, not a delta.
- Untyped identifiers: each identifier must carry its type (MR, INS-NIR, NHS, NPI).
- No AuditEvent: traceability mandatory.
Related ADT events
| Code | Trigger event | Description |
|---|---|---|
| A47 | Change Patient Identifier List | This page. |
| A46 | Change Patient ID | Change PID-2 (legacy usage). |
| A48 | Change Alternate Patient ID | Change PID-4. |
| A50 | Change Visit Number | Visit level. |