Inbound ADT to Source of Truth

Keith,

We have one inbound source of messages to our Patient Management System. I was not involved with that integration so I cannot relate what was analyzed there.

However, we are in the beginnings of deploying a new system and it is possible this system allows inbound messages for the purpose of adjusting demographics, schedules, etc. from foreign systems.

So here are my current thoughts on this:

   If the ‘system of truth’ passes the received messags through its validation, etc. rules AND provides a reply indicating the transaction was applied or was rejected with an indication of the error then I would say the ‘system of truth’ is properly designed to handle updates from foreign systems.

   If the foreign system will accept the response from the ‘system of truth’ and then report that to the user who provided the data so that it can be corrected if in error or at least noted that the data was rejected AND if the foreign system will suspend the cahnge to its system until it receives the appropriate positive response, then I would say the foreign system is properly designed to interchange with the system of truth.

I suspect I would be hard pressed to find both systems following the basics expressed above and unless both systems do something along those lines, I see potential data integrity issues.

Those are my thoughts at this time.

Since we don’t use our EMR (Cerner) for registration or billing, we have to have inbound ADT/Reg/Demo.  It’s not ideal by any means.

We use Allscripts/Eclipsys for hospital ADT and Epic for physician office registration.  The Epic MPI product Identity helps maintain integrity of one-patient-one-record across all systems to some extent.  But we’re pediatric, with the data quality issues that come along with that — low SSN collection rate, lots of name changes and incorrect birth dates.

We’re small — about 200 beds and 20 physician offices.  MRN combines and clean up require ~2 FTEs.  So, it’s managed, but not pretty.

Keith,

What type of data from the external lab systems would you be receiving that did not originate from your EMR, other than perhaps the external system’s patient ID?

We have our MPI as McKesson STAR feeding ADT to our EMR Cerner Millennium.

We’re considering billing as well.