Integrating the Healthcare Enterprise

1. Integrating the Healthcare Enterprise Patient Administration Management (PAM) Profile Mike Henderson Eastern Informatics, Inc. IHE Interoperability Workshop

2. IHE IT Infrastructure5 Integration Profiles(UPDATE ME!) Retrieve Information for Display Retrieve Information for Display Enterprise User Authentication Enterprise User Authentication Patient Synchronized Applications Patient Synchronized Applications Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Synchronize multiple applications on a desktop to the same patient Synchronize multiple applications on a desktop to the same patient Provide users a single nameandcentralized authentication processacross all systems Provide users a single nameandcentralized authentication processacross all systems Patient Identifier Cross-referencing for MPI Patient Identifier Cross-referencing for MPI Consistent Time Consistent Time Coordinate time across networked systems Coordinate time across networked systems Map patient identifiers across independent identification domains Map patient identifiers across independent identification domains IHE Interoperability Workshop

3. Patient Administration ManagementAbstract / Scope • Coordinates exchange of patient registrations, updates, and movements for all clinical areas • Information may be received and processed by consumer applications in any clinical domain • Optionally allows unambiguous updating of historic patient movement events • Demographic and encounter tracking works in both inpatient and ambulatory care settings IHE Interoperability Workshop

4. Patient Administration Management Value Proposition • Optional support levels allow products to offer “light” or “rich” functionality • Aligns legacy IHE Radiology and IT Infrastructure transactions with the latest HL7 standard • Permits robust error reporting and automated exception processing • Standardizes on HL7 conformance structures • Reduces variance among vendor and implementor specification formats IHE Interoperability Workshop

5. Patient Administration Management Transaction Diagram IHE Interoperability Workshop

6. Patient Administration Management Actor Grouping Requirements IHE Interoperability Workshop

7. Patient Administration Management Standards Used HL7 Version 2.5 • ADT Registration, Update, and Patient Movement Trigger Events • Admission/registration • Merge, update, link/unlink • Movement management IHE Interoperability Workshop

8. Patient Administration Management Actors Patient Demographics Source • Definition • Responsible for maintaining demographics (name, address, etc.) about patient and related persons • Supplies new and updated information to Patient Demographics Consumer • Transaction Supported - Required • Patient Identity Feed [ITI-30] (as sender) IHE Interoperability Workshop

9. Patient Administration Management Actors Patient Demographics Consumer • Definition • Uses demographic information provided by the Patient Demographics Source about a patient • Transaction Supported – Required • Patient Identity Feed [ITI-30] (as receiver) IHE Interoperability Workshop

10. Patient Administration Management Actors Patient Encounter Source • Definition • Responsible for maintaining encounter information about a patient • Supplies new and updated information to the Patient Encounter Consumer • Must be grouped with either Patient Demographics Source or Patient Demographics Consumer • Transaction Supported - Required • Patient Encounter Management [ITI-31] (as sender) IHE Interoperability Workshop

11. Patient Administration Management Actors Patient Encounter Consumer • Definition • Uses patient encounter information provided by Patient Encounter Source • Transaction Supported - Required • Patient Encounter Management [ITI-31] (as receiver) IHE Interoperability Workshop

12. Patient Administration Management Transactions Patient Identity Feed [ITI-30] • Definition • Patient Demographics Source registers or updates patient • Forwards ID, address, NOK, guarantor, etc., to other systems implementing Patient Demographics Consumer • Options • Merge • Link/Unlink IHE Interoperability Workshop

13. Patient Administration Management Transactions Patient Encounter Management [ITI-31] • Definition • Patient Encounter Source registers or updates an encounter • Forwards encounter information to other systems implementing Patient Encounter Consumer • Location • Providers • Dates, times, etc. • Options • Inpatient/Outpatient Encounter Management • Pending Event Management • Advanced Encounter Management • Temporary Patient Transfer Tracking • Historic Movement Management IHE Interoperability Workshop

14. Patient Administration Management Encounter Management Options Inpatient/Outpatient Encounter Management • HL7 Trigger Events • Admit inpatient (A01/A11) • Register outpatient (A04/A11) • Discharge patient (A03/A13) • Update patient information (A08) • Pre-admit patient (A05/A38) • Change outpatient to inpatient (A06) • Change inpatient to outpatient (A07) • Transfer patient (A02/A12) IHE Interoperability Workshop

15. Patient Administration Management Encounter Management Options Pending Event Management • Additional HL7 Trigger Events • Pending admit (A14/A27) • Pending transfer (A15/A26) • Pending discharge (A16/A25) IHE Interoperability Workshop

16. Patient Administration Management Encounter Management Options Advanced Encounter Management • Additional HL7 Trigger Events • Change attending doctor (A54/A55) • Leave of absence (A21/A52) • Return from leave of absence (A22/A53) • Move account information (A44) • Merge patient ID list (A40) IHE Interoperability Workshop

17. Patient Administration Management Encounter Management Options Temporary Patient Transfers Tracking • Additional HL7 Trigger Events • Patient departing – tracking (A09/A33) • Patient arriving – tracking (A10/A32) IHE Interoperability Workshop

18. Patient Administration Management Encounter Management Options Historic Movement Management • Uses trigger events of any of the above options that have been adopted • Adds ZBE segment to contain a unique identifier for the movement • Standard segment pending adoption by HL7 • Adds Z99 trigger event to allow update of any movement information, based on unique ID in ZBE segment • Standard trigger event pending adoption by HL7 IHE Interoperability Workshop

19. More information…. • IHE Web site: http://www.IHE.net • Technical Frameworks: • ITI V1.1, RAD V5.5, LAB V1.1 • Technical Framework Supplements - Trial Implementation • May 2004: Radiology • August 2004: Cardiology, IT Infrastructure • Non-Technical Brochures : • Calls for Participation • IHE Fact Sheet and FAQ • IHE Integration Profiles: Guidelines for Buyers • IHE Connect-a-thon Results • Vendor Products Integration Statements IHE Interoperability Workshop