Stream: implementers
Topic: Source System Duplicate Patient Record Indicator
David Reeves (Aug 19 2020 at 18:56):
Our source systems sometimes have duplicate patient records by mistake, but we want to load just the current record into our ODS. In such a case, we need an indicator so users know there may be additional information in the source system.
The source system records have Alerts (Flags in FHIR) which will be loaded, but I am considering adding extensions to the Patient resource to be extra cautious around this. The extensions would be something like parisDuplicateRecordFlag, profileDuplicateRecordFlag & pixalereDuplicateRecordFlag (for our three source systems). They would be set to True for any patient with a duplicate record in that source system, and they would also be mustSupport and isModifier.
Does this make sense, or is there a better way?...
Vassil Peytchev (Aug 19 2020 at 19:00):
Why not use Patient.link?
David Reeves (Aug 19 2020 at 20:04):
We want to ensure we only ever have one record per patient in our ODS, with the expectation that will greatly simplify things.
Vassil Peytchev (Aug 19 2020 at 20:28):
You can have a single record and use the link to be a logical reference, with link.other.identifier.system identifying the system where the duplicate is, and link.other.identifier.value the identifier of the duplicate. This way you avoid the need for extensions.
David Reeves (Aug 19 2020 at 20:34):
Thanks Vassil, I like this idea, but it needs to be very, very noticeable if a patient has a duplicate record in the source system, because it could contain important clinical information. This is why both records in the source system have an Alert (Flag). Can such a link be mustSupport and isModifier, and be made always present with the Patient record. That is our biggest concern.
David Reeves (Aug 19 2020 at 20:38):
FYI, most duplicate records in our source systems are merged into one active record, but some cannot be merged (at least not without too much time and effort, often of a physician). If they are merged we can simply disregard the duplicate record in our ODS, so this only applies to records that cannot be merged.
Vassil Peytchev (Aug 19 2020 at 21:53):
isModifier is not something you need for this case, because you are not modifying the meaning of the Patient resource. A profile can make Patient.link be "mustSupport".
Last updated: Apr 12 2022 at 19:14 UTC
