Software Bulletin

Impact / Cautionary / Advisory / Low
Title / Merging patient records that are linked to multiple PAS systems
Release: / Release/Version: 06.04
01.06.12(h) / Healthcare Software Syst.
Ref. No, 0205633
Problem / There is an issue with duplicate record merging on CRIS. The issue is that the link between the PAS record and the CRIS patient record is not moved to the active CRIS record during the merge.
This is particularly evidentin DataCentre environments and sites with multiple PAS systems (including Locally Deployed) but it could still be an issue at single Trust and PAS sites.Duplicate CRIS patient records which have been created at different Trusts and merged can leave some of the PAS patients left linked to the non active merged CRIS record.
During a normal merge on CRIS the user chooses which patient should have each hospital number.However the link between PAS and CRIS records is not determined by which patient has the hospital number.
For example, if you have 2 patient records that are duplicates, and
CRIS PatientX is linked to PAS Patient A at Trust 1
CRIS PatientY is linked toPAS Patient B at Trust2
CRIS patient X is merged toCRIS Patient Y - making Patient Y the ‘Active / Lead Patient’
N.B. whenever CRIS patient X is loaded once theyhave beenmerged, CRIS will automatically load CRIS patient Ybecause X has been merged to Y.
However, as a result of this issue once X has been merged to Y at either Trust, whenever an order or a demographic change is applied to the PAS Patient A at Trust 1 then these will still be applied to CRIS patient X even though this patient is no longer active in CRIS. This will mean that the orders added at Trust 1 are not usable if you select CRISPatient X or Y and the demographic changes made on the PAS at trust 1 will not be applied to the active/lead CRIS Patient Y.
When CRIS patient X or Y is selected at Trust 1 CRIS patient Y is automatically loaded. However this is not linked to a PAS record at Trust 1 and CRIS will not suggest a potential PAS match to link to because the matching PAS record at Trust 1 is already linked to the now defunct CRIS record X.
In summary, although Trust1’s hospital number(s)has been moved to and is displayed on CRIS patient Y’s record, any future updates from Trust1's PAS’will not update the active/lead patient record on RIS or PACS.
ORDER COMMS SITES
If one Trust has multiple PAS interfaces and uses Order Comms, failure to use the proposed ‘merging workaround’would result in outstanding orders for PAS Patient X not being displayed on the Active / Lead CRIS Patient Y record.
MERGES PRIOR TO THIS BULLETIN
If the traditionally recommended method has already been used when Patient Y re-attends at Trust1, CRIS will not prompt to create a PAS link as the link is already established against the duplicate CRIS Patient X record.
Resolution / This is resolved in 01.06.12(i)
Workaround / A merge should not be performed until all affected sites have unlinked their PAS records from the duplicate records.
Each site involved needs to undertake this separately as you can only link/unlink from your own PAS.
Having done this the duplicate merge can be undertaken as per the traditionally recommended method.However each site must then re link their own PAS record to the ‘Lead’ Patient and check their PACS to ensure any future PAS updates correctly update the Lead CRIS/PACS Patient.
To facilitate this, the Trust undertaking the merge should supply all other affected Trusts with relevant Lead CRIS numbers as loading the record will then invoke the linking process.
Distribution List: / Fujitsu Services, Computer Sciences Corporation and Locally Deployed Sites.
Comments: / Trusts should follow the above merging process until they are upgraded to 01.06.12(i)
It will be necessary to identify and amend patient records that have been merged previously.
HSS will produce a script that will identify merged records and reinstate the PAS links correctly.
Sites should contact their support helpdesks if they believe that their patient records may be affected by this issue
Issue Date: / 10 April 08 / Time: / 12.30
Originator: / Helen Richards / Emma Savage Mady / David Hall

CF – Service BulletinPage 1 of 219/3/2007