Question
Ahmad Bukhtiar · Jan 26

Facility Registry in HealthShare - What is best practice?

Hi 

we are implementing HIE and wan to get expert opinion on facility registry setup. Below are some example and which method we should adapt.

3 EMRs sending u patient data (ADT, ORU etc) for 3 facility groups

Facility Group A (Has 20 branches locations, same MRN across all branches, each branch is registered with health department)

Facility Group B (Has 30 branches locations, same MRN across all branches, each branch is registered with health department)

Facility Group C (Has only one main branch single location and is registered with health department)

Facility Registry Setup Option - 1

1) Create 20+30+1= 51 records in Facility Registry for each Facility Location Name, with different Facility Code, 2) Create 51 Facility Consents, 3) Create 51 OIDs

2) On implementation side, tell each EMR to send MSH:4 with 51 different Facility Codes representing each Facility Location

3) On Clinical View side, when Doctor search patient, he/she can see Patient-X visited Group A- Branch 11 Name and Group-B Branch 9 Name

Facility Registry Setup Option - 2

1) Create 1+1+1= 3 records in Facility Registry for each Facility Group not Facility Location, 2) Create 3 Facility Consents, 3) Create 3 OIDs

2) On implementation side, tell each EMR to send MSH:4 with 3 different Facility Codes representing each Facility Group

3) On Clinical View side, when Doctor search patient, he/she can see Patient-X visited Group A (without branch name) and Group-B (without branch name)

Not sure if i put my question clearly enough and you have face similar situation which one must decide which path to take.  Any best practice or expert inputs are appreciated. 

Product version: HealthShare 2020.1
00
2 0 1 172
Log in or sign up to continue

Hi Ahmad,

Please see my summary below:

From the Management point of view, Option 2 is much preferred - less configuration, and as a result, less maintenance (also less work for your EHR Participants). One variable is Consent and the legal framework under which you are operating. Can doctors from the same Facility Group see patients belonging to different branches? How is Consent collected at these branches (does the medical staff collect consent per branch or is it understood that the information can be shared with doctors within the Facility Group)? Option 2 is only even possible because MRNs are the same within the Facility Group.

That said, there is one additional consideration which may end up a deal-breaker. If an ADT message for a patient in Facility Group A Branch 1 is processed, and then another ADT message (different ADT event) for the same patient is processed in Facility Group A Branch 2, unless the Medical Record is truly shared on the EMR side, you may have order issues. For example, ADT^A04 (register) is at Branch 1 and then the patient is discharged (A03), then patient goes to Branch B, there is an ADT^A04 (new register) and the patient is admitted and transferred to Inpatient (A06). So far, everything is OK because the patient cannot be in two branches at the same time but if there is a glitch and one of the Branches stops transmitting for a while (unlikely but possible) the order of events may get scrambled.

I hope this helps.