[MEDITECH-L] ADM/RAD Account problems

Fri, 07 Jul 2006 14:45:35 -0700 

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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. 
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