Thursday, 17 April 2014

Implementation Experience in Indian Hospital - 1

This is one of few surprising and exciting experience from my recent integration assignment when I was implementing an EMR product in an Indian Hospital.
I will share few of these in different posts. This one is related to ADT & SIU workflow handling.

EMR is implemented in Hospital OPD for clinical workflow i.e. view calendar, chart patient, prescription etc.

The patient registration & scheduling for OPD would still happen in HIS and on each such event, corresponding HL7 message would be pushed to EMR from HIS.
Suppose we received a SIU-S12 for appointment booking in EMR, the same should be reflected in doctor's calendar in EMR. The SIU message had these main segments PID, SCH, RGS, AIL and AIP.
Now, when the patient shows up in OPD staff creates a visit for patient in HIS, the ADT-A01 comes to EMR. The ADT message had these main segments PID, PV1

As, the source of both the events is HIS, there was no way in EMR to link the ADT & SIU so that, whenever doctor selects particular patient on his calendar in EMR the chart for same visit of patient should come up.
To handle this we negotiated (HIS & EMR) to use optional PV1 segment in SIU.
PV1 segment in SIU contains a unique number in PV1-5 which is available at time of scheduling as well as registration in HIS. So in EMR we used this number to link the SIU & ADT of same patient visit.

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