Patient Administration Management

Patient Administration Management (PAM) enables applications to share accurate patient demographic data within and between acute care settings as well as between those and ambulatory healthcare providers.

Summary

The PAM profile specifies two transactions to fulfill two great missions among applications cooperating in healthcare:

Patient Identity Feed: Maintain consistency of patient demographics (i.e. patient identitification, full identity and persons related to the patient) across applications operating in acute care settings as well as in the ambulatory environment.
Patient Encounter Management: Coordinate the exchange of patient account, encounter and location information within and between acute care settings.

These two transactions provide sets of event-triggered messages, notifying the creation and update of patient administrative data. Each transaction involves a pair of (Supplier, Consumer) Actors. Transaction Patient Identity Feed operates in a centralized manner (one Supplier application providing a number of Consumers).
Transaction Patient Encounter Management can work in centralized mode as well as in peer to peer mode (Several applications cooperating as peers, each one playing alternatively Supplier and Consumer roles). Transaction Patient Encounter Management can be self contained in a sense that the Patient Encounter Supplier sends both patient encounter information and patient identity and demographics information (in the context of the encounter data) to the Patient Encounter Consumer. In addition, this transaction also allows the Patient Encounter Supplier to send messages to the Patient Encounter Consumer for patient identity maintenance in the encounter context, including patient update and identity merge.

Benefits

Supports Efficiency of Patient Care

Prevents manual data entry errors by ensuring that each piece of patient data or encounter data is entered only once and made available to any application that needs it.
Supports a better cooperation between clinical, administrative and ancillary applications, based on a common patient identification and accurate patient demographics.
Notifies in real time applications of acute care settings with patient arrivals, movements and departures, planned or effective, which globally improves the efficiency of the services provided by the teams running these applications.
Synchronizes the correction of human errors (merge or update patient records, update patient transfer) between all the applications that have been affected by these errors.

Details

The Patient Administration Management (PAM) Integration Profile is to be leveraged by IHE domain profiles. It ensures that the applications involved in the (health services provision or document sharing) workflow of a particular domain, rely on synchronized and accurate patient demographic and encounter data.

Use cases and Transactions

Patient Identity Management Use Case is covered by Transaction Patient Identity Feed, which supports the following notifications both in acute care and ambulatory environment:

Creation of a new patient demographic record with patient identifier assigned, full identity, related actors (doctor, guarantor, next of kin), qualification of the reliability of the patient identity (e.g. unknonwn/default date of birth).
Creation of a temporary identification and record for an unknown patient.
Update patient demographic record.
Merge two patient demographic records into one.
Link or Unlink two patient demographic records.

Patient Encounter Management Use Case is covered by Transaction Patient Encounter Management, which supports the following sets of notification messages in the context of acute care settings:

Basic mandatory subset: Create, update or close inpatient/outpatient encounter ; update patient information ; Merge patient records.

Inpatient/outpatient encounter management option: Pre-admit inpatient, change patient class, transfer, and the cancellations thereof.
Pending Event Management Option: Pending admit, transfer or discharge, and the cancellations thereof.
Advanced Encounter Management Option: Manage leaves of absence, changes of attending doctor, updates of account.
Temporary Patient Transfers Tracking Option: Tracks patient moves to and from temporary locations such as radiotherapy, scanner, EKG, and dialysis.
Historic Movement Management Option: Adds the capability to cancel or update safely any Movement. The major interest of this option is to enable healthcare provision applications to link their acts to the proper patient situation and location.

Messaging standard

The two transactions of this profile leverage the ADT message structures of the standard HL7 v2.5. Each of these message structures is triggered by and notifies a real world event regarding patient administration.

Systems Affected

Systems involved in this profile are:

Enterprise-wide information systems that manage patient registration (i.e., admit-discharge-transfer /registration system) patient administrative records, patient accounts, encounters, movements. These systems are the providers of patient demographics, identifiers and encounter data.
Standalone systems run by ambulatory care providers will consume patient demographics and identifiers.
Healthcare provision applications in acute care settings consume patient demographics and identifiers, and can be both consumers and suppliers of encounter data.
Healthcare ancillary applications in acute care settings consume both demographics and encounter data.

Actors & Transactions:

Specification

Profile Status: Final Text

Documents: IHE IT Infrastructure Technical Framework Version 4 or later

Vol. 1 - Section 4 (PAM profile overview, use cases, actors, transactions, options, groupings)
Vol. 2:

Section 3.30: Transaction Patient Identity Feed
Section 3.31: Transaction Patient Encounter Management
Appendix C: HL7 Profiling Conventions
Appendix E: Usage of CX Data Type in PID-3 - Patient Identifier List
Appendix N: Common HL7 Data Types
Appendix P: Examples of messages

Underlying Standards:

HL7

Patient Administration Management

Contents