Patient Identity Feed

A patient identity feed event is triggered when a record is added, updated, or merged in a source system. The new information is then fed to the PIX/PDQ Manager and specifically to the Master Index for cross-referencing and identification. Once master index processing is complete, a message is sent out to the domains that subscribe to master index updates. An event is also entered in the ATNA audit log.

Patient Identity Feed Processing Flow

Patient identity feeds are processed as follows. This can be seen in the figure Figure 1.

1. An event occurs in an HL7 messaging domain that creates a new record or updates or merges existing records.

2. The message is received by the HL7 Binding Component if it is HL7 v2, or by the HTTP Binding Component if it is HL7 v3.

3. The message is processed through the Normalized Message Router to one of the following BPEL processes, depending on which version of HL7 is being processed: IHEPixPdqV2BpelProcess (v2) or bpelPIXManager (v3).

4. The BPEL process maps the data and routes it to the MDM Facade EJB, which then sends it to the Master Index for processing.

5. The Master Index compares the data against its existing records and updates the database accordingly.

   The action taken by the Master Index is based on whether the new information constitutes a new patient record, updates an existing patient record, or merges two existing patient records. This is determined by the results of the matching algorithm. If a new record is added, the master index might mark the record as a potential duplicate of existing records if the matching probabilities fall within a defined range.

6. The BPEL process then generates an ACK or NACK response, which is sent back out to the originating domain.

7. The BPEL process generates the audit record of the transaction, which is stored in the ATNA repository.

Patient Identity Feed HL7 Message Types

In the HL7 v2 IHE framework, this type of event is known as an ITI-8 transaction. It is triggered by the following HL7 v2 events:

• A01: Inpatient admission

• A04: Outpatient registration

• A05: Inpatient preadmission

• A08: Update to an existing patient record

• A40: Patient record merge

In the HL7 v3 IHE framework, this type of event is known as an ITI-44. It is triggered by the following HL7 v3 events:

• PRPA_TE201301UV02: Patient registry record added (triggers a PRPA_IN201301UV02 message)

• PRPA_TE201302UV02: Patient registry record revised (triggers a PRPA_IN201302UV02 message)

• PRPA_TE201304UV02: Patient registry duplicates resolved (triggers a PRPA_IN201304UV02 message)

For audit purposes, these events are all identified as “Patient Record” events, with an event ID of 110110.