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[Gnumed-devel] Lab import (data) matching

From: James Busser
Subject: [Gnumed-devel] Lab import (data) matching
Date: Sun, 03 Feb 2008 13:47:28 -0800

Before we can develop something configurable in which GNUmed installations can define their rules for matching, we would have to figure out the kinds of requirements.

In the case of having "unique" outgoing reference numbers that could be returned to GNUmed and assist a "match", I think such numbers may not always be enough, by themselves, for two reasons.

The first is that there is a possibility of human transcription error when such numbers are not always scanned. For example, even though in Germany it may be that the lab provides the stickers whose numbers are to be entered in GNUmed but in other countries it could be possible in GNUmed for the praxis to generate its own incremental unique request_ids (in clin.lab_request) and if this gets printed on paper, the workers at lab reception would need to input the number.

The second is because there may not be a 1:1 correspondence between the tests requested and the results that are returned. In Canada, I provide a patient with (normally) a single piece of paper on which I have for example written:
- hematology profile
- lipid profile
- urine screen
where each of the above really represents a "compound" request which will generate multiple component results. Conveniently the GNUmed table clin.lab_request seems to already recognize that any request as being able to include multiple items.

Also the results will not all be available at the same time, and there will be a workflow to consider how partial results get handled (for example the lab provides confirmation that a test has been requested, but this test may not be done as frequently as the others and so that result may not be available until a future pick-up.

Back to the matching, the potential match fields could be

request_id (GNUmed's internal ID for the request of interest, may be unique) lab_request_id (ID this request had internally at the lab, may or may not be unique) fk_test_org (which in Canada could be different lab companies and different branches) ... therefore in Canada we can not know if any fk_test_org we would put in will be correct ... also the above will have no value when we were *copied* results on a patient

        patient surname
        patient given names
        patient date of birth
        patient sex/gender
        patient account number (health insurance or other health number)
        patient account type / identifier
        patient external_id (if we store the lab's id for this patient)
        patient other demographics (address, phone, postal)
        requestor of the test (where the person is a member of the praxis)
copy-to doctor for the test (where the person is a member of the praxis)

The biggest problem to matching is usually variants of the first or middle names or exchanges between them e.g.
        Smith, Ann Marie
        Smith, Annie M
        Smith, Marie
        Smith, A Mary
can be different forms of the same person.

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