Since 5.5 we have been having an issue
regarding account numbers. When they get changed in admissions due to rolling
the account or other manipulations the account numbers also change in radiology.
The problem here of course is that the film has been imprinted with the old
account number and the labels and documentation have been printed with the old
account number. Now we cannot lookup the account by entering in the old number
where we could previously.
Is anyone else experiencing the same
problem in 5.5?
Meditech tells us that it should never
have worked and that that was a bug in the system. (see response below.)
*************** (MEDITECH) - Jun 29, 2006 - 1612 EDT: Hi everyone. We had
previously tested this out in another 4.9 Canadian in-house directory and
observed the issue being reported here. The previous ER account number was no
longer linked with the new inpatient account number. As noted above in a
previous entry, Radiology is not maintaining this information, this is not an
issue in other modules as they are sharing the ADM/MRI patient census, where
this is still maintained with the patient information.
This portion of the issue/task has always been the case. We could not find any
evidence that Radiology ever maintained this, the reason we turned this to
development is because to do so would likely require a rewrite of how Radiology
handles account numbers.
One thing to keep in mind is that RAD is not, and never has been an account
specific module. Radiology, unlike many of the NPR applications, does not
separate exams in Profile by the account number they were ordered/performed on.
If a user goes into Profile, you see ALL exams that were entered on that
patient, their entire Medical Record for RAD data is consolidated.
Now, we looked a little further beyond this to what could have caused this to
just now be reported to us after the hospital has been operational with RAD
since about 03/31/1997.
In release 4.9 SR4/5.4 SR0 there was a bug DTS (7646) which addressed an issue
where Canadian hospitals could cancel accounts in ADM that had outstanding
issues in Radiology. This was happening because for certain ADM transactions,
when the information was processed by the Radiology Patient Filer, the exam
accounts were not being properly updated. ADM would see a patient with one
account number, Radiology in Profile would see the same, but, for specific exams
that were entered before the account number was changed in ADM, those exams
would still be filed with the old number. This allowed the rolled over account
to be incorrectly canceled.
It appears that the practice that the hospital has been using for the scenario
documented in this task was actually allowing a bug in the system to do its
work and for the Patient Filer to miss steps that it should have been taking.
This should explain why this appears to have been caused by the 5.5 update. The
Development Request that we have submitted is to evaluate if it is feasible for
Radiology to also maintain the old account number so that it will be possible to
use that number for a lookup into the new account.
