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Patient Information Reconciliation as seen in PACS
                                                                                                                                              PATIENT INFORMATION RECONCILIATION
About the PIR Service and its match to the IHE workflow

PIR extends Scheduled Workflow by providing the means to match images acquired for an unidentified patient (for example, during a
trauma case) with the patient's registration and order history. In the example of the trauma case, this allows subsequent reconciliation of
the patient record with images acquired (either without a prior registration or under a generic registration) before the patient's identity
could be determined. Enabling this after-the-fact matching greatly simplifies these exception-handling situations.
Systems involved in this integration profile are:
1. Enterprise-wide information systems that manage patient registration and services ordering (ADT/registration system, HIS)
2. Radiology departmental information systems that manage department scheduling (RIS) and image management/archiving (PACS)
Acquisition modalities

Scheduled Workflow (IHE)                                                 Patient Information Reconciliation

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                                                                                                     BUSINESS SUMMARY
HL7 Messages and Integration Adapters                                       Business Process Model
HL7 Message                     cOS       RIS/HIS                    PACS
ADT A01                               R             R

A19 (Query)                           R             R                  R

A08 (Update)                    S/R            S/R                     R

ORM                                   S             S                  R

ORR                                   R             R                   S
(1) S – Source
(2) R - Recipient

Organizational Structure                                                    Summary

        Clinical Operating System

       PACS/RIS                cOS Party                Reconciliation
       Adapter                   Service                   Service

 RIS       HIS      Image   Patient
                                                                                                                                                               MASTER PATIENT INDEX SERVICE
Master Patient Index Service
Data Element Definition
•Enterprise identification number
          •Primary identifier used by the enterprise to identify the patient across facilities (e.g., the enterprise number or corporate number )
•Facility identifier
          •Primary identifier used by the enterprise to identify the facility contributing data to the EMPI (e.g., the facility code)
•Internal patient identification
          •Primary identifier used by the facility to identify the patient at admission (e.g., the medical record number)
•Person name
          •Legal name of patient or person, including surname, given name, middle name or initial, name suffixes (e.g., Junior, IV), prefixes (e.g., Father,
•Date of birth (Unique)
          •Patient or person's date of birth. Year, month, and day of birth are entered (e.g., YYYYMMDD). It is essential that the year of birth be recorded
          as four numbers, not just the last two numbers
          •Gender of patient (e.g., male, female, unknown/not stated)
          •Race of patient. Race is a concept used to differentiate population groups largely on the basis of physical characteristics transmitted by
          descent. Races currently used by the federal government for statistical purposes are American Indian/Eskimo/Aleut, Asian or Pacific Islander,
          black, white, other, and unknown/not stated
          •Ethnicity of the patient. Ethnicity is a concept used to differentiate population groups on the basis of shared cultural characteristics or
          geographic origins. Ethnic designations currently used by the federal government for statistical purposes are Hispanic origin, not of Hispanic
          origin, and unknown
•Residence (Unique)
          •Address or location of patient’s usual residence. Components include the street address, other designation (e.g., apartment number), city,
          state or province, zip or postal code, country, type of address (e.g., permanent, mailing)
•Alias/previous/maiden name
          •Any names by which the patient has been known other than the current legal name, including nicknames, maiden name, previous name that
          was legally changed, etc.
•Social Security number (Unique)
          •Personal identification number assigned by the US Social Security Administration
•Telephone number
          •Telephone number at which the patient can be contacted. This may be a home or business telephone number or the telephone number of a
          friend, neighbor, or relative

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