A18/A34 ancillaries handle unvalued demo data

We are implementing A18/A34 MRN merge transactions. Our HIS sends demographic data on the A18 which represents the data from the ‘old’ or ‘ source’ patient record. Not sure why. If anything, we’d like to see the new values (example: name changes on marriage – we’d like to see the new name).

We’re probably tilting at windmills asking for the new data to be sent in the A18. So when we pass the message on to our ancillaries, we remove the demographic data from the PID segment. We expected that if the field is not valued, the ancillary will not attempt any kind of data manipulation (I recall other discussions here where a ‘deletion’ is specifically indicated by certain syntax).

However, a couple of ancillaries are treating the non-valued field as a delete operation – or maybe – they are looking at it differently and just creating a brand new patient record with the new MRN and not copying the demo data in their systems from old to new record, but actually attempting to populate the new record’s demo data from the incoming A18’s PID.

What is the experience out there regarding ancillaries processing A18s/A34s? Do they copy the existing data over to a new record, or do they pull the data from the A18? Does it work differently if they already have the old and new MRN records in their system? We find it works correctly if that is the case.

Peter