Patient Merge

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Written by Sam Habiel. Questions? http://groups.google.com/group/hardhats.

Intro

Patient Merge is a complex piece of software. Be sure to read the manual. This will provider an overview of how to use it with WV. I still get errors here and there due to the way WV has some fields that point to routines that don't exist.

Patient Merge Use Issues with WV

There are few WV-related issues with Patient Merge that first need to be resolved.

  • Due to various issues on how the MPI Parameters and the Local Site are set-up, the software may try to contact the MPI to resolve a merge, and fail to merge as a result. The actual issue should be present in any WV installation that uses the site number of 050; as the MPI thinks when comparing ICN's that start with 50 (from 050) that they are national since 050 isn't the same 50. An MPI bug to be sure, but why bother?
  • Patch XT*7.3*113 takes away the ability for the local site to search the patient file for duplicates, and relegates that ability only to the Central MPI.
  • X-ref ALK3 in file 15 on the Merge Status field has a bug in it. A completed merge (Merge Status = Merged) does not delete the ALK index entry. Thus, the IHS patient lookup routine erroneously says that the patient is a potential duplicate patient even though the patient has been merged already. I am not sure where the bug lies (IHS patient lookup or the Patient Merge software), but the ALK x-ref documentation says it's supposed to be deleted when it's merged.

I created a patch to resolve these issues and you can find it here. This patch depends XT*7.3*113, as it fixes a change in that patch.

Prerequisite Set-up Before Using Patient Merge

Your user has to have access to the XDR MAIN MENU Menu.

Your user has to have the following keys:

  • XDR (for day to day use of Patient Merge)
  • XDRMGR (for Manager Operations: doing the actual merge, Site Parameters)

Patient Merge Set-Up on VISTA

You need to set-up your site parameters first. If you want to be able to merge patients immediately, you need to set DAYS BEFORE FINAL VERIFY and DAYS BETWEEN VERIFY AND MERGE to zero, otherwise you will have to wait before being able to merge patients. This is done as a precaution. Once patients are merged, there is no way to unmerge them.

XDR MAIN MENU > Manager Utilities > Edit Site Parameters

Select Manager Utilities Option: edt  Edit Site Parameters

Select DUPLICATE RESOLUTION FILE TO BE CHECKED: PATIENT  
         ...OK? Yes//   (Yes)

PtMergeSiteParam.png

Patient Merge Use on VISTA

If you have a couple of duplicate patients and are sure about them, you can do a quick merge as follows. This is not the preferred scenario.

   XDRO   Operations ...
   XDRU   Utilities ...
   XDRM   Manager Utilities ...

Select Duplicate Resolution System Option: <b>XDRU</b>  Utilities
Duplicate Resolution Utilities Menu



   ADD    Add Verified Duplicate Pair
   CMP    Check Merge Process Status (reverse order)^M
   CHCK   Check Pair of Records to see if Duplicates^M
   DSS    Display Search Status^M
   EDIT   Edit the Status Field of a Duplicate Record^M
   FIND   Find Potential Duplicates for an Entry in a File^M
   VAL    Identify Potential Merge Problems^M
   PRNT   Print List of File Duplicates^M
   SCAN   Scan Possible Duplicates^M
   TSF    Tally STATUS and MERGE STATUS Fields^M
   VIEW   View Duplicate Record Entries^M

Select Utilities Option: ADD  Add Verified Duplicate Pair
Add entries from which File: PATIENT    

* No potential duplicate threshold % check will be calculated for PATIENTS
Select PATIENT: ZZ
   1    ZZ LAB,TEST                         M 11-04-1970 749110470P
                                                                        10000001
   2    ZZ LAB,TESTTHREE                    F 03-03-1950 749030350P
                                                                        10000033
   3    ZZ LAB,TESTTWO                      M 11-04-1988 749110488P
                                                                        10000011
   4    ZZ PATIENT,TEST ONE          <A>    F 01-24-1945 000003322      1
   5    ZZ PATIENT,TEST THREE        <CA>   M 01-15-1968                3
ENTER '^' TO STOP, OR
CHOOSE 1-5: 
   6    ZZ PATIENT,TEST TWO          <A>    M 12-25-1957                2
   7    ZZ WRONG,PATIENT                    F 01-01-2001          
                                                                       456552077
          <Unresolved potential duplicate>
   8    ZZ,WRONG                            M 06-06-1961 458414058
                                                                       458414058
                                                                        45841405
8
   9    ZZANDERSON,BRANDON                  M 04-09-1988 468992445
                                                                       468992445
          <Unresolved potential duplicate>
   10    ZZBARNES,ZZJUSTON                  M 01-01-2001 016996491
                                                                       016996491
ENTER '^' TO STOP, OR
CHOOSE 1-10: ^
Select PATIENT: 


   ADD    Add Verified Duplicate Pair
   CMP    Check Merge Process Status (reverse order)
   CHCK   Check Pair of Records to see if Duplicates
   DSS    Display Search Status
   EDIT   Edit the Status Field of a Duplicate Record
   FIND   Find Potential Duplicates for an Entry in a File
   VAL    Identify Potential Merge Problems
   PRNT   Print List of File Duplicates
   SCAN   Scan Possible Duplicates
   TSF    Tally STATUS and MERGE STATUS Fields
   VIEW   View Duplicate Record Entries

Select Utilities Option: ADD  Add Verified Duplicate Pair
Add entries from which File: PATIENT

* No potential duplicate threshold % check will be calculated for PATIENTS
Select PATIENT: ZZ
   1    ZZ LAB,TEST                         M 11-04-1970 749110470P
                                                                        10000001
   2    ZZ LAB,TESTTHREE                    F 03-03-1950 749030350P
                                                                        10000033
   3    ZZ LAB,TESTTWO                      M 11-04-1988 749110488P
                                                                        10000011
   4    ZZ PATIENT,TEST ONE          <A>    F 01-24-1945 000003322      1
   5    ZZ PATIENT,TEST THREE        <CA>   M 01-15-1968                3
ENTER '^' TO STOP, OR
CHOOSE 1-5: 1
  ZZ LAB,TEST                               M 11-04-1970 749110470P
                                                                        10000001
    Another  PATIENT: 
ZZ PATIENT,TEST THREE
                                     <CA>   M 01-15-1968                3

You will be adding the following pair of records to the duplicate record file:

     RECORD1:  ZZ PATIENT,TEST THREE
     RECORD2:  ZZ LAB,TEST


Type <Enter> to continue or '^' to exit:   Ok, continuing, hold on ...

         RECORD1 contains fewer data elements, usually this would indicate
                 that this record would be merged INTO the other.

Determine if these entries ARE or ARE NOT duplicates.

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

****  NAME                    "ZZ LAB,TEST"            "ZZ PATIENT,TEST THR
                                                       EE"

      SEX                     MALE                     MALE

****  DATE OF BIRTH           11/04/1970               01/15/1968


                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      MARITAL STATUS                                   UNKNOWN

      OCCUPATION                                       "UNEMPLOYED"

      CHECK FOR DUPLICATE     YES                      YES



                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      SOCIAL SECURITY NUMB    "749110470P"             
      ER                                               

      PSEUDO SSN REASON       NO SSN ASSIGNED          

      REMARKS                 "[PATIENT DIED ON 07     
                              /14/11]"                 


                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      PLACE OF BIRTH [CITY                             "MIAMI"
      ]                                                

      PLACE OF BIRTH [STAT                             FLORIDA
      E]                                               


                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      WHO ENTERED PATIENT     ADMINISTRATOR,SYSTEM     

      DATE ENTERED INTO FI    3/25/11                  
      LE                                               

      STREET ADDRESS [LINE                             "123 ANYWHERE"
       1]                                              

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      ZIP+4                                            46123

      CITY                                             "AVON"

      STATE                                            INDIANA

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      ZIP CODE                                         "46123"

      COUNTY                                           063

      ADDRESS CHANGE DT/TM                             7/24/05 17:37:52

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      ADDRESS CHANGE SOURC                             VAMC
      E                                                

      ADDRESS CHANGE SITE                              BAD POINTER VALUE IN
                                                        FILE

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      ADDRESS CHANGE USER                              STARTUP,SYSTEM

      K-NAME OF PRIMARY NO                             "CLAUSE,SANTA"
      K                                                

      K-RELATIONSHIP TO PA                             "FRIEND"
      TIENT                                            

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      K-ADDRESS SAME AS PA                             NO
      TIENT'S?                                         

      MOTHER'S MAIDEN NAME                             "NITWIT,"

      SERVICE CONNECTED?      NO                       NO

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      EMPLOYMENT STATUS                                UNKNOWN

      COVERED BY HEALTH IN                             NO
      SURANCE?                                         

      PERIOD OF SERVICE                                OTHER REIMBURS. (NON
                                                       -VET)

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      DATE OF DEATH           7/14/11 17:28:14         

      DEATH ENTERED BY        WHITLOW,LACHERYL         

      SOURCE OF NOTIFICATI    INPATIENT AT VAMC        
      ON                                               

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      DATE OF DEATH LAST U    7/14/11 17:28:14         
      PDATED                                           

      LAST EDITED BY          WHITLOW,LACHERYL         

****  PRIMARY ELIGIBILITY     EHR PATIENT              REIMBURSABLE INSURAN
      CODE                                             CE

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

****  PRIMARY LONG ID         "10000001"               "--"

      PRIMARY SHORT ID        "0001"                   

      NAME COMPONENTS         2                        2

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      K-NAME COMPONENTS                                2

****  LABORATORY REFERENCE    8                        3

      TYPE                    VISTA OFFICE EHR         VISTA OFFICE EHR

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      INTEGRATION CONTROL     500004122                500000002
      NUMBER                                           

      ICN CHECKSUM            "432992"                 "140241"

****  COORDINATING MASTER     INTRACARE HOSPITAL S     OFFICE OF INFORMATIO
      OF RECORD               YSTEM                    N SRV CNTR

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      LOCALLY ASSIGNED ICN    YES                      YES

****  CMOR ACTIVITY SCORE     310                      110

      SCORE CALCULATION DA    8/27/11                  8/27/11
      TE                                               

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

      VETERAN (Y/N)?          NO                       NO

****  KEENE PERSONAL ACCT     "123456"                 "343234"

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

PATIENT ELIGIBILITIES         1 entry                  1 entry

DISPOSITION LOG-IN DATE/T     1 entry                  1 entry

KEENE ADMISSION ACCOUNT N     1 entry                  ---

                              RECORD1 [#33747]         RECORD2 [#3]
                              ZZ LAB,TEST              ZZ PATIENT,TEST THRE
                                                       E
                              CMOR SCORE = 310         CMOR SCORE = 110
----------------------------------------------------------------------------

     Select one of the following:

          V         VERIFIED DUPLICATE
          N         VERIFIED, NOT A DUPLICATE
          U         UNABLE TO DETERMINE
          H         HEALTH SUMMARY
          R         REVIEW DATA AGAIN
          S         SELECT/REVIEW OVERWRITES

Select Action: HEALTH SUMMARY// VERIFIED DUPLICATE


                    RECORD1 [#33747]         RECORD2 [#3]
                    ZZ LAB,TEST              ZZ PATIENT,TEST THREE

     Select one of the following:

          1         RECORD1 INTO RECORD2
          2         RECORD2 INTO RECORD1

Which record (1 or 2) should be MERGED INTO the other record: RECORD1 INTO RECOR
D2// 

Do you want to ADD another pair (Y/N)? NO

After you add a verified duplicate, then you approve it for merge in the Operations Menu.


Duplicate Resolution Operations Menu



   APP    Approve verified duplicates for merging
   VPD    Verify Potential Duplicates
   ADR    Ancillary Data Review

Select Operations Option: app  Approve verified duplicates for merging

1  Entries are awaiting approval for merging  Return to continue...

  1     ZZWRONG,PATIENT                   --                [26877]
        ZZ WRONG,PATIENT                  --                [4949]

Select entries to approve them for merging:  (1-1): 1

After you approve the merge, then you schedule a job to merge it from the Manager's menu.

Duplicate Manager Utilities Menu



   EDT    Edit Site Parameters
   LIST   List File Entries Identified in Preliminary Scan
   SCN    Preliminary Scan of File for Errors
   PRGM   Purge Merge Process File
   RES    Restart a Merge Process
   SCH    Schedule Process to Merge Verified Duplicates
   SRCH   Start/Halt Duplicate Search
   STOP   STOP an Active Merge Process

Select Manager Utilities Option: SCH  Schedule Process to Merge Verified Duplica
tes

1  Entries Ready to be included in merge
This process will take a **LONG** time (usually over 15 hours, and sometimes
considerably longer), but you CAN stop and restart the process when you
want using the options.  OK? YES


Name for Merge Process: MERGE 20110827
START DATE/TIME: NOW  (AUG 27, 2011@12:06:54)

Merge process 'MERGE 20110827' for Verified Duplicates in File 2 scheduled
as task 400609.

To see whether the merge process completed or not, here is how you do it.

Duplicate Resolution Utilities Menu



   ADD    Add Verified Duplicate Pair
   CMP    Check Merge Process Status (reverse order)
   CHCK   Check Pair of Records to see if Duplicates
   DSS    Display Search Status
   EDIT   Edit the Status Field of a Duplicate Record
   FIND   Find Potential Duplicates for an Entry in a File
   VAL    Identify Potential Merge Problems
   PRNT   Print List of File Duplicates
   SCAN   Scan Possible Duplicates
   TSF    Tally STATUS and MERGE STATUS Fields
   VIEW   View Duplicate Record Entries

Select Utilities Option: CMP

                                                       Current   Current
Merge Set             Start    Stat   Last Chk  Phase  File      Entry

MERGE 20110827      08/27 12:06  C  08/27 12:07
  DATA CHECKING     08/27 12:06  C  08/27 12:06
  LAB SERVICE       08/27 12:06  C  08/27 12:06
  INTEGRATED BILL   08/27 12:06  C  08/27 12:06
  ACCOUNTS RECEIV   08/27 12:06  C  08/27 12:06
  FEE BASIS         08/27 12:06  C  08/27 12:06
  ICR - IMMUNOLOG   08/27 12:06  C  08/27 12:06
  NDBI              08/27 12:06  C  08/27 12:06
  ENROLLMENT APPL   08/27 12:06  C  08/27 12:06
  PATIENT FILE      08/27 12:06  C  08/27 12:06
      THREAD 2      08/27 12:06  C  08/27 12:06
      THREAD 3      08/27 12:06  C  08/27 12:07

If you ever see ** NO PAIRS LEFT **, it means that your patient merge failed.