I am not sure if this is the correct place to post but I have a question about a strange configuration situation we have which results in numerous inbound HL7 messages to be manually resolved.
Problem:
Numerous HL7 messages come in and are not automatically resolved due to a "multiple matches were found" condition (Link Logic error attached)
Reason:
Back in 2005 we opened an Ambulatory Surgery Center (ASC) where we do procedures on patients who have been referred from our parent company of Tallahassee Neurological Clinic. We spoke with GE and decided (with their blessing) that we could put the patients in the system a second time with a different Location of Care so we could use the EMR portion of CPS for both businesses since the patients and doctors are the same.
Thoughts and details:
This problem is growing as we add more electronic interfaces (Electronic Prescriptions and labs for now). TNC has three "Locations of care" called TN, NS, and PMC. Attached is a HL7 message which shows that "PMC" appears in the message but that information is not utilized to defeat the "multiple matches" condition. We do not currently utilize the "ASC" location of care for any HL7 messaging but that should also be a possibility as it is set up in the system as such.
A while back I did speak with GE Support about this but was told that we would always have to manually resolve these things. It is very easy to manually resolve these, but it is time consuming and I can't help but think how stupid this is to have to do this manually since this HL7 stuff is defined rigidly and consistently. There should be no issue of liability but I feel like that answer from support was influenced by a lawyer.
Possible Solution:
Tell the Link Logic system to ignore the ASC Location of care when attempting to resolve patients. We do not have interfaces set up for the ASC location of care anyway.
Better Solution:
Utilize the Location of Care field so that the "multiple match" condition would be mitigated with the "location of care" making them unique.
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Sample Link Logic error showing "PMC" notation in the LOC field
In this example, the patient "Simpson, Homer" would exist in the CPS database twice. His information is the same in both databases; once in the location of care called "PMC", and also in the Location of Care, "ASC"
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MSH|^~\&|eScriptMessenger||||20170316082312||ORU|1|P|2.3
/-/ Error: No existing data could be found to match incoming data, Multiple matches were found. lastName: Simpson, firstName: Homer, SocSecNo: 568470008 , dateOfBirth: 05/12/1955, Sex: M, Account: 123456789, SubAccount: , LOC: PMC, middleName: , Suffix: , Prefix: , Title: , CareProvider: NRiviera, AttendingDoctor: Riviera MD Nick E, (Patient) [PID|1|123456789|123456789||Simpson^Homer^||19550512|F|||742 Evergreen Terrace^^Portland^OR^970356995^||||||||], Start at: 58, End At: 165, Line in file: 1 \-\
PID|1|123456789|123456789||Simpson^Homer^||19550512|F|||742 Evergreen Terrace^^Portland^OR^970356995^||||||||
PV1|1|R|PMC||||JRiviera^Riviera MD^Nick^E
OBR|1|||^eRx Request for PROTONIX 40MG TABLETS||20170316072254|20170316072254|||||||||PMNURSE||RX||||20170316072254|||F
OBX|1|ST|ESM_RR^ESM_RR||WL3374115835520170316062254`PROTONIX 40MG TABLETS`40``30 Tablet`30`TAKE 1 TABLET BY MOUTH EVERY DAY``1`1`03/16/2017`01/04/2017` Kwik-E-Mart 03374*`5412240331`00008084181``PROTONIX 40MG TABLETS [BMN] Quantity: 30 Tablet Instructions: TAKE 1 TABLET BY MOUTH EVERY DAY||||||F|||20170316082312.297
NTE|1|NTE-2|Provider Name: Riviera MD, Nick E~ Provider Phone: 555-NICK~ Provider Address: 44 Bow Street ~ Provider City: Portland~ Provider State: OR~ Provider Zip: 970354675~~ Patient Name: Simpson, Homer ~ Patient DOB: 05/12/1955~ Patient Sex: F~~ Medication: PROTONIX 40MG TABLETS [BMN]~ NDCNUM: 00008084181~ Instructions: TAKE 1 TABLET BY MOUTH EVERY DAY~ Quantity: 30 Tablet~ Refills: 1~ Written Date: 03/16/2017~ Transaction ID: WL3374115835520170316062254~ Date of Request: 20170316072254~~ Pharmacy: Kwik-E-Mart 03374*~ Last Fill Date: 01/04/2017~ Pharmacy Phone: 5415550331~ Pharmacy Notes: ~~ Drug Dispensed: PROTONIX 40MG TABLETS [BMN]~ Quantity: 30 Tablet~ Instructions: TAKE 1 TABLET BY MOUTH EVERY DAY~ Refill(s): 1~ Notes: ~ Written Date: 03/16/2017~~ Pharmacy Address: 100 E MAGNOLIA ~ Pharmacy City: Portland~ Pharmacy State: OR~ Pharmacy Zip: 97055|
Any thoughts would be appreciated
Mike Zavolas
Tallahassee Neurological Clinic
Posted : March 16, 2017 3:12 am
