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As Claudius Metze mentioned in his Engineering a Business Process Platform for Healthcare Part 7 – the 2008 Year-end shipment on the Year-end shipment 2008, the Enterprise Services Bundles Patient Administration and Medical Activities, Patient Billing and Invoicing are now available. In this blog, I would like to focus on the possibility to support IHE profiles with the Patient Administration Bundle.

With this first set of services, we laid the focus on the IHE profiles Patient Administration Management (PAM) and Patient Demographics Query (PDQ). The following actors can actually be implemented with services out of this bundle:

  • Profile PAM: Transaction Patient Identity Feed (ITI-030); Actors Patient Demographics Consumer and Patient Demographics Supplier
  • Profile PDQ: Transaction Patient Demographics Query (ITI-21); Actor  Patient Demographics Supplier.

For the following sections, I chose one actor of each profile and described the different steps occuring in the SAP system to process the corresponding HL7 message.

Example of Patient Demographics Source within PAM
Imagine SAP Patient Management being the Patient Demographics Supplier within one Hospital, all other systems (lab system, radiology system, clinicals, etc.) being the Patient Demographics Consumer.

The picture below illustrates the actor assignment (SAP Patient Management in gold):

image

When a patient record is changed in SAP Patient Management, this information is sent out to the subscribed Patient Demographics Consumers. This is done through the following steps:

  • The event “Patient Master Data Changed” is triggered automatically;
  • This event calls the enterprise service “Inform on patient changed”;
  • The data returned by the enterprise service is mapped into the HL7 terminology in NetWeaver PI (still in the XML format);
  • An HL7 adapter translates the XML format into the HL7 message A31 (if version 2.x is used) and sends it using the MLLP protocol. (please keep in mind that the HL7 adapter is not part of our current portfolio).

Through the processing of the received data the Patient Demographics Consumer synchronizes its data with the central patient master record.
 

Example of Patient Demographics Source within PDQ

Imagine now, according to another IHE use case that a nurse wants to assign a patient to a bed and document this in his bedside equipment. To do so, she needs the patient identity information. Through the bedside equipment she queries the SAP Patient Management System in its role of Patient Demographics Supplier by indicating the patient’s name. In the list of patients, additional information to identify the patient is returned (for example, date of birth, gender). This allows the nurse to select the appropriate record and to feed the bedside equipment with the correct patient ID.

This is done in the following steps:

  • The HL7 message Q21 is sent through an HL7 adapter to SAP Patient Management.
  • The HL7 adapter transforms the version 2.x message into an XML format.
  • In NetWeaver PI the HL7 XML is mapped into the XML interface of the synchronous service “Find Patient by Basic Data”.
  • This service determines the patients matching the search criteria and returns them in a list.
  • The list goes the reverse way back (through PI and the HL7 adapter) to result in an HL7 K21 message.

The picture below shows the actors for PDQ:

image

Details on how to implement one of these actors can be found in the IHE configuration Guide.

The next blog in this series will an end-to-end integration demo by my colleague Jing Chen-Schirrmeister.

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