There is an ASTM standard E-1714 on the properties of a Universal health Identifier. The VA used this standard in creating its MPI interoduced in 1997. Congress is the agent that has proscribed a UHID in absence of controls on security, privacy, confidentiality. There has not been adequate discussion of UHIDs and unique patient identification processe in healthcare enterprises; a recent article in Modern Physician has noted lack of compliance with HIPAA Security requirements so progress on that aspect will be required before any dialog will be entertained in Congress. Agresssive work of the health professional disciplines with ONCHIT to get active dialog on the practice business processes involved in health information architectures and their implementation in information products and services (such as an agressive presentation by the VistA community on how the design and implemented VistA architecture can address these general - as opposed to just VA/federal - requirements would open eyes and begin dialog; how about the VistA participation at TEPR in May as a start, since VistA will have a presence there?) would be a key step. Also arrange a VistA presentation the AHIMA (as well as at the HIMSS) professional association meetings on this topic. Some of us are working on other health professional specialty forums for such presentation. It will be probably be true that it will take the "Howling Mob" to break the "Waiting for Godot" mindset - the key is how to do this as gracefully as possible. I ahappen to believe that the VistA community has the best lever at this time and am awaiting information on the VistA working group addressing this issue.

On Thu, 17 Feb 2005, Thurman Pedigo wrote:

Sadly, after 20 years of debate we have no Universal Healthcare Identifier
(UHID). http://www.hipaanet.com/jhitaexecutive.htm
http://www.healthdatamanagement.com/html/PortalStory.cfm?type=hipaa&DID=1103
4
It's difficult to see how we can go forward with an effective nationwide EMR
without that standardization. Somehow, this issue needs insertion in the
national rhetoric. For now it looks as though VA is ahead of the pack. Does
anyone have new insight on how we can anticipate the eventual UHID?

Thanks,

thurman



-----Original Message-----
From: [EMAIL PROTECTED] [mailto:hardhats-
[EMAIL PROTECTED] On Behalf Of Kevin Toppenberg
Sent: Thursday, February 17, 2005 10:03 AM
To: hardhats-members@lists.sourceforge.net
Subject: Re: [Hardhats-members] Adding / Editing patients
snip

You are not the only one needing to use a patient
number other than SSN.  Most offices use a patient
serial number (aka chart number or record number).
There is a standard add on file that addresses this, I
seem to remember its name to be IHS PERSON file or
something... but I can't find it in my system right
now.  In my system, I created an extra field in my
PATIENT file, and put our record number in that.  If
you are wanting to add extra fields etc, you would do
well to ask Cameron for a numberspace and namespace,
so that future updates don't clobber your changes to
the system.

Good luck.


Kevin


--- Usha Kiran <[EMAIL PROTECTED]> wrote:

Hi
I had a different problem but somewhat relating to
the one you specified.

According to the scenario here, the patients are
identified by an OPD number
(which is a combination of two fields TYPE OF
PATIENT and a serial number).
I wanted the registration procedure to ask the OPD
number to identify the
patient and not the name, etc.. I was partly
successful in doing it. That
is, I was able to make the procedure ask for OPD
number but could not
override the basic details of a patient, required by
VistA, while adding a
new one. It would never go to the ScreenMan form
before taking the NAME,
DATE OF BIRTH, SSN, etc. in roll and scroll mode.

Is there any way of overriding/editing this set of
required fields?

Usha
----- Original Message -----
From: "Kevin Toppenberg" <[EMAIL PROTECTED]>
To: "Hardhats Sourceforge"
<hardhats-members@lists.sourceforge.net>
Sent: Monday, February 14, 2005 6:33 AM
Subject: [Hardhats-members] Adding / Editing
patients


Hey all,

I have some code to offer othes here (if they want
it), and some thoughts and questions.

First, I wrote some custom code that bulk-created
patient records in the PATIENT file.  I ported
over
around 70,000 patients. Now, as I use these
patients,
I am finding that some tweeking needs to be
done...
ie. completing the records etc. So I have been
trying
to decide how best to edit this data.  I am
comfortable now doing it directly in Fileman.  But
that wouldn't be good for my receptionists.  So I
looked at the DG REGISTER... menus.  And there I
ran
into the same problem that Nick was having about
the
system trying to connect to the MPI.  Plus, it was
getting to way too many questions (i.e. it was
getting
ready to admit a patient into the hospital),
rather
than just editing the patient record.

So I have cut, pasted, and trimmed down this code
(originally from DGREG.m) to make the following
function.  It can be called with a parameter=1 if
adding new patients is to be allowed.  Here is the
code.  And FYI, it uses a standard VistA screenman
based system of editing.  (Questions below)

EDITPT(AddOK)
  ;"Purpose: Ask for patient name, and allow
editing
;"Input: AddOK: if 1, adding new patients
allowed
  ;"Result: none

do LO^DGUTL
set DGCLPR=""
new DGDIV set DGDIV=$$PRIM^VASITE

if DGDIV>0 set
%ZIS("B")=$piece($get(^DG(40.8,+DGDIV,"DEV")),U,1)

kill %ZIS("B")
if '$data(DGIO),$piece(^DG(43,1,0),U,30) do
        . set %ZIS="N",IOP="HOME"
        . do ^%ZIS

A do ENDREG^DGREG($get(DFN))
        do  if (Y<0) goto EditDone
        . W !!
        . if $get(AddOK)=1 do
        . . set DIC=2,DIC(0)="ALEQM"
        . . set DLAYGO=2
        . else  do
        . . set DIC=2,DIC(0)="AEQM"
        . . set DLAYGO=0
        . kill DIC("S")
        . do ^DIC
        . kill DLAYGO
        . if Y<0 quit
        . set (DFN,DA)=+Y
        . set DGNEW=$P(Y,"^",3)
        . new Y
        . do PAUSE^DG10
        . do BEGINREG^DGREG(DFN)
        . if DGNEW D NEW^DGRP

if +$get(DGNEW) do
. ;" query CMOR for Patient Record Flag
Assignments
if NEW patient and
. ;" display results.
. if $$PRFQRY^DGPFAPI(DFN) do DISPPRF^DGPFAPI(DFN)

set (DGFC,CURR)=0
set DA=DFN
        set DGFC="^1"
        set


VET=$select($data(^DPT(DFN,"VET")):^("VET")'="Y",1:0)

set %ZIS="N",IOP="HOME" do ^%ZIS set DGELVER=0 ;"do EN^DGRPD ;"if $data(DGRPOUT) do goto A ;". do ENDREG^DGREG($G(DFN)) ;". do HL7A08^VAFCDD01 ;". kill DFN,DGRPOUT

;"do HINQ^DG10
if $D(^DIC(195.4,1,"UP")) if ^("UP") do ADM^RTQ3

do REG^IVMCQ($G(DFN))  ;" send financial query

      set DGRPV=0
      do EN1^DGRP

EditDone
quit


OK, the next issue I need to solve is the actual addition of a NEW patient (i.e. LAYGO). If I
supply a
new name of a patient, it asks if I want to add a
new
patient. If I say YES, it goes into roll and
scroll
mode, asking many more questions than my setting
needs, and only comes back to the screenman
("nicer")
editing screens after aborting with a "^" (and, oh
by
the way, you have to know how many questions you
have
to answer before jumping out, or the record is not
created).

So It seems that an input template might help
here.
But how would I tell ^DIC to use an input template
in
event of Laygo?

Thanks
Kevin



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