REVIEW ON MASTER PATIENT INDEX, Lecture notes of Architecture

Download REVIEW ON MASTER PATIENT INDEX and more Lecture notes Architecture in PDF only on Docsity! Dental Research: An International Journal (DRIJ)Vol.1, No.1 37 REVIEW ON MASTER PATIENT INDEX Dr W.G Prabath Jayatissa Prof Vajira H W Dissanayake Dr Roshan Hewapathirane Post Graduate Institute of Medicine University of Colombo, Sri Lanka ABSTRACT In today's health care establishments there is a great diversity of information systems. Each with different specificities and capacities, proprietary communication methods, and hardly allow scalability. This set of characteristics hinders the interoperability of all these systems, in the search for the good of the patient. It is vulgar that, when we look at all the databases of each of these information systems, we come across different registers that refer to the same person; records with insufficient data; records with erroneous data due to errors or misunderstandings when inserting patient data; and records with outdated data. These problems cause duplicity, incoherence, discontinuation and dispersion in patient data. With the intention of minimizing these problems that the concept of a Master Patient Index is necessary. A Master Patient Index proposes a centralized repository, which indexes all patient records of a given set of information systems. Which is composed of a set of demographic data sufficient to unambiguously identify a person and a list of identifiers that identify the various records that the patient has in the repositories of each information system. This solution allows for synchronization between all the actors, minimizing incoherence, out datedness, lack of data, and a decrease in duplicate registrations. The Master Patient Index is an asset to patients, the medical staff and health care providers. 1. HISTORY OF MASTER PATIENT INDEX History goes way back to 1950’s when Automatic linkage of vital records by Newcombe (1) introduce how to bind the records through and get the unique combine records. There he tries to manage how to pair the surnames by using both father’s surname and mother’s maiden name. This article he suggested that the extent of efficiency of using surnames is more efficient than using the family group names to which two surnames are more efficient than one for identifying a family group has probably not been generally recognized. Design and implementation of a data base for medical records done in 1980’s by Larry & Fleming (2) of the College of Health University and the department of Computer Science of Florida in the United States of America. Larry and Colleen (1) suggested data base for the medical record first time in the history of the human kind. Those days computer systems were not developed as such today by their effort of trying to develop a health record system must be highly appreciated. The medical record has been identified as the source of data for a computerized medical information system. Larry & Colleen (1) suggested a design of a computerized database for structuring some of the data normally re-corded in the manual medical record. This design identifies objects of the health record which contain the computerized patient record. A method of transferring the computerized patient record to a low-cost method such as magnetic medium so calls old days large floppy disks and low volume hard disks at the time the patient is transferred from one health 38 care institute to another healthcare institution. Low-cost hardware features were used to implementation of the above-computerized patient record for a health care institutes. Dental Research: An International Journal (DRIJ)Vol.1, No.1 Figure 1 Use of Large Floppy Disk In 1980 In 1995 develop the National Patient Master Index (NPMI) in Singapore they have invented following things, Patients who are gone to the local hospital who has to take identification number will be detected so the duplication will have avoided (3). Federation of the personal identification services between enterprises by David W. Forslund (4) in year 2000 discuss about the managing the identities of persons within the particular organization or a domain (4). In 2012 Joffe E, Bearden CF (5), presented to the AIMA Annual Symposium about the implication for missed laboratory results following Duplicate patients in the system record. In August 2012 Sarvesh Jain (6) develop a prototype for Health Master Person Index for public use, he designed a detail architectural design to solve the problem with related to the patient data sharing in the different domain system. A high-level architecture of the Secure Open Enterprise Master Patient Index(SOEMPI) introduced by Toth and Durham (7) of University of Texas at Dallas introduce for the private patient record linkage. The latest implementation of master patient index in South Korea in 2015 introduce a Common Health Information Exchange (HIE) Platform with a national master patient index (8). 2. DUPLICATION OF PATIENTS IDENTITY In 1995 develop the National Patient Master Index (NPMI) in Singapore they have invented following things, Patients who are gone to the local hospital who has to take identification number will be detected so the duplication will have avoided (3). For the security and the safeguard for the sensitive information of the patient smartcard, thumbprint retinal scan was introducing but some used places were unable to maintain them properly due to excess cost. After all these considerations Singapore government decided to use National Registration Identification Card (NRIC). NPMI was open to both government and the private sector. All the hospitals were Dental Research: An International Journal (DRIJ)Vol.1, No.1 41 Minimum clinical dataset (MCDS) or the Minimum data set(MDS) is an important topic in healthcare information exchange platforms. There is no clear unified definition to MDS and this is poorly defined during the past few decades. The following definition is made for MDS. MDS is a coherent set of explicitly defined data elements in health care (23). MCDS is first introduced in the United State of America as the federally mandated process by the federal government for clinical assessment of all residents in health care. Commonly for Developing Minimum Clinical Datasets developer used consultants in different filled. While doing the discussion among these expert developers have to read through the literature reviews of former implementations and collect the existing clinical data set (8). Figure 3 Publications by Minimum Dataset Clinical Specialty (8) In August 2012 Sarvesh Jain (6) developed a prototype for Health Master Person Indexfor public use, he designed a detail architectural design to solve the problem with related to the patient data sharing in the different domain system. Integration infrastructure will provide the best software solution for interoperability of health information systems. This integrated health information system improves health data sharing and provides better health services to the patient by connecting multiple isolated health domains to external systems. During the prototype, development developer tried to minimize the duplication and introduce a solution for a unique identification method. If there are several different first names of a pediatric patient, the merging application will merge simply all of them. This merging method called as stacking (11). Some other MPI mergers determine the best accurate and mostly used scenarios. Also giving the chance for the manual record filtering using the expert on the filled. Intergraded systems much useful for the better healthcare but in some occasion, there was some adverse effect with these systems in 2004 Dr. J.T Finnell (12) published in his publication mentioned about the adverse effect following the mistreatment at the emergency departments. The patient comes with feature suggestive of anterior lateral STEMI to the emergency department that needs thrombolization with thrombolytic. Treating patient doctor gone through the system 42 and find the patient is treated for an intracranial hemorrhage(ICH) very recently. So, the doctor’s conclusion was that with the thrombolytic treatment patient may start bleeding intracranial again. Dental Research: An International Journal (DRIJ)Vol.1, No.1 43 He suggested not to thrombolysis and going for the interventional treatment. That treatment method is very expensive so the patient has to pay an extra amount of money in his old age. But after the intervention doctor gets to know that this patient was not treated for any ICH previously. This all due to the duplication of record in the system. Figure 4 Development Methodology for Minimum Clinical Dataset Piper Svensson Ranallo And Terrence J. Adam Figure 5 Development Methodologies for Minimum Clinical Dataset by Piper Svensson Ranallo And Terrence J. Adam. 46 6. DISCUSSION OF THE REVIEW Indexing of the patient going back to 1950 while the using of the modern technology and making it to work in a small place like in a computer took 3 decades. Main concern of the MPI developers were the introduction of the unique identification methods using unique identifier and then interoperability among the health information systems using HL7 based or XML based. As a major solution for the duplication lot of counties have introduce a unique card where all the demographic data as well as the clinical data are stored. Duplication correction is a main concern in the evolving MPI systems in the world. While some developed computation method like algorithms to solve this common problem. Development of the minimal clinical dataset is a major part involving the medical professional where the most suitable clinical data set should be taken as the data set. But in a complete electronic health record the overlapping of these data sets are more common. Getting all the systems of a health establishment to be synchronized in relation to their patients, will bring a greater value in the evaluation of a person's clinical condition, even if it is the patient's first contact with the health professional in. The MPI system in order to provide all these advantages has to implement the following basic functionalities: • Ability to add people • Ability to change existing data • Ability to add identifiers to an existing person • recognize equalities in records • Join two registers in one so respond to surveys posted to the repository with a list of possible outcomes; • synchronize associated systems • respond to all actions in real time and without human help. While aiming to mark an important step in the evolution of information systems. MPI cannot leave aside some important features • be self-contained, so that it can easily be implemented in any health facility; • be able to adapt to existing systems, not against the other; • use all standards defined and accepted by the community in order to achieve • communicate with all entities; • comply with all your basic functions, since no system is successful if it is incomplete. REFERENCES [1] H. B. Newcombe, J. M. Kennedy, S, J. Axford, A. P. James. Automatic linkage of vital records “Computers can be used to extract”follow-up“statistics of families from files of routine records.” [cited 2017 Mar 22]; Available from: https://www.cs.umd.edu/class/spring2012/cmsc828L/Papers/Newcombe59.pdf Dental Research: An International Journal (DRIJ)Vol.1, No.1 47 [2 Larry & C. Fleming. Design and implementation of a data base for medical records. [cited 2017 Mar 22]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203794/ [3 Tan LT, National Computer Board, Republic of Singapore. National Patient Master Index in Singapore. [cited 2017 Mar 22]; Available from: Int J Biomed Comput 1996 Jan;40(3):241-2. [4] D.W. Forslund. Federation of the personal identification services between enterprises. [cited 2017 May02] Availablefrom:https://www.ncbi.nlm.nih.gov/pubmed/?term=Federation+of+the+personal+identifica t ion+services+between+enterprises. [5] Joffe E, Bearden CF, Byrne MJ. Duplicate patient records—implication for missed laboratory results. [cited 2017 May 02] . Proc AMIA Annu Symp 20121269–75. [6] S.Jain. A Prototype Automated Resolution Service for Public-Health Master Person Index. [cited 2017 May 12] Available from: http://digitalcommons.usu.edu/gradreports/239 [7] C.Toth, E.Durham, M.Kantarcioglu, Y.Xue and B. Malin . SOEMPIA Secure Open Enterprise Master Patient Index Software Toolkit for Private Record Linkage. [cited 2017 May 22]; Available from https://www.ncbi.nlm.nih.gov/pubmed/25954421 [8] M. Lee, E.Heo, H.Lim, J.U Lee, , S. Weon, H Chae, H.Hwang, S. Yoo, Developing a Common Health Information Exchange Platform to Implement a Nationwide Health Information Network in South Korea. January21. [cited 2017 May 22]; Available from: Healthc Inform Res. 2015 Jan;21(1):21-9. doi: 10.4258/hir.2015.21.1.21. Epub 2015 Jan 31. Dental Research: An International Journal (DRIJ)Vol.1, No.1 [9] A.Pakalapati. A Flexible Consent Management System for Master Person Indices. [cited 2017 May 22];Available from:http://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=1193&context=gradreports [10] Piper A. Svensson-R, Terrence J. Adam. A Framework and Standardized Methodology for Developing Minimum Clinical Datasets. [cited 2017 May 22]; Available from: AMIA Jt Summits Transl Sci Proc. 2011;2011:54-8. Epub 2011 Mar 7. [11] Clyde, S.W. The Unique Records Portfolio. Public Health Information Institute,2006.[cited 2017 May 02];Available from:https://www.ncbi.nlm.nih.gov/pubmed/?term= Public/ Health/ Information Institute. [12] J.T Finnell.Connecting for Health. Flying Blind.[cited 2017 May 29]; Available from:http://www.markle.org/sites/default/files/flying_blind_0704.pdf. [13] Hillestad,James H.Bigelow,B.Chaudhry US health care system identity crisis was identified by the Richard.[cited 2017 July02];Available from http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG753.pd 48