We do something close to this in two connections like Jim describes, so it’s not what I’d call truly bidirectional.
Most of the logic is handled by the vendors for both systems. Here’s how it works:
The Practice Management-Scheduling system has a unique pool of patient account numbers assigned so that we can instantly differentiate the PM encounters from our acute care visits in the HIS.
Nothing happens at scheduling, but at check-in the PM system generates an A04 with a patient account number from the assigned pool.
The HIS receives the A04 and creates a visit with PM-generated account number.
The HIS immediately echoes out an A08 that returns the HIS’ internal guarantor and subscriber ID #s, which we reformat in an xlate to comform to the PM system’s numbering convention.
The PM system files the HIS internal ID#’s as external ID#s for PM so that we can update Guarantor and Coverage information in both directions. We don’t maintain visit info in both directions so the patient account number isn’t cross-referenced in this way.
Hope this helps.