Identify Patient/Encounter/Procedure resource in FHIR

[Mrigendra Kumar]

Hi Team,

Can you please provide your inputs to the below questions

Question1

We are trying to find an identifier which is common between CAMM and Millennium, which can be used to  identify a patient from FHIR

Question2

To perform an encounter level search, we need encounter id and patient id. Do we have any information in ORMs using which we can directly fetch encounter information from FHIR?

Question3

Is there a way to identify a procedure resource in FHIR millennium server by using the information from HL7 order ? 

At present we have the following in HL7

1. OrderID/PlacerOrderNum

2. AccessionNumber/FillerOrderNumber

3. MRN(PID3)

Question4

Can we identify a patient resource by accession number/ patient id which comes from DICOM?

Thanks,
Mrigendra

[Aaron McGinn (Cerner)]

These questions are at least partially overlapping, so I'll try to give the typical workflow and let me know if there is anything I didn't cover!

You will typically take the MRN to search by Patient identifier [1]. You can then use this to search for Encounter [2]. You would then have to match manually based on the FIN to find the specific encounter you needed. There is also not a great way to match for Procedures. You would search Procedure by the Patient [3] or find the order by searching ServiceRequest [4].

Those that monitor this forum do not support HL7 functionality so may not be able to answer your more detailed questions about it.

[1] https://fhir.cerner.com/millennium/r4/individuals/patient/#parameters

[2] https://fhir.cerner.com/millennium/r4/encounters/encounter/#parameters

[3] https://fhir.cerner.com/millennium/r4/general-clinical/procedure/#parameters

[4] https://fhir.cerner.com/millennium/r4/care-provision/service-request/#parameters

-Aaron (Cerner)

[Mrigendra Kumar]

Hi Aaron,

Thank you for the response.

Could you please clarify one more item.

Patient can be identified with MRN but can it also be identified by accession number ?

Note: At present accession number we are getting through DICOM from CAMM and also we get from HL7 order

Thanks,

Mrigendra

[Aaron McGinn (Cerner)]

Unfortunately, we do not currently have a way to find the Patient through an accession number. We also do not return this detail on the ServiceRequest order, so there would be no way to parse it on your side either.

-Aaron (Cerner)

[Mrigendra Kumar]

Hi Aaron,

Thanks for your answer. Could you please provide few more clarifications.

We know MRN and Assigning Authority can be used to fetch patient from FHIR. However can SiteID and MRN be also used to fetch a patient from FHIR ? (I suppose not, but just confirming)

From one of Cerner Sites we are getting CMRN. Is this the same as MRN? if not,  Can this be used instead of MRN to fetch patient from FHIR?

Thanks,

Mrigendra

[Aaron McGinn (Cerner)]

The MRN and CMRN are both treated as identifiers and can therefore be searched by [1] in the same manner.

[1] https://fhir.cerner.com/millennium/r4/individuals/patient/#parameters

-Aaron (Cerner)

[Mrigendra Kumar]

Hi Aaron,

Thanks for your response.  One more question below.

Does Cerner supports MPI based patient search for the FHIR server?

Thanks,

Mrigendra

[Aaron McGinn (Cerner)]

It is something that would have to be configured by the client, but any identifiers added to a patient in the system can potentially be searched by.

-Aaron (Cerner)