Prevent New Duplicates Caused by Order Interfaces

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One of the many challenges that labs and radiology groups face today is preventing new duplicates from entering their system when they receive outside orders.  They’re reliant on whatever demographic information their customers send them to identify whether or not the patient on the order already exists in the system where the patient needs to be registered. Often the demographics don’t match so a duplicate gets created.  When existing records are located, another challenge is maintaining the integrity of the data in the target system with patient information of questionable quality coming from lots of different sources.  

Getting person matching and mastering right is key to assembling complete data for every patient without creating duplicates in the target system.  Occam identifies common records across data sources even when demographic information is missing or wrong and links them together by assigning an enterprise identifier. Occam’s Master Data Management (MDM) functionality provides the ability to master the patient data, by protecting newer data in the target system from being overwritten with stale data from the outside, and to master insurance.

Inputs and Outputs

Occam takes in and maintains a copy of the list of patients contained in each source system, usually via an HL7 feed.  Only data that is useful for identification needs to be loaded.  In healthcare, the core data elements are name, date of birth, home address and phone numbers.  Social security numbers are helpful when available as are email addresses, and driver’s license numbers.  

Any EMPI links that have already been established can also be imported.  This saves the data integrity team from having to potentially re-work ‘Maybe’ matches that were previously verified and saves Occam’s Research Automation module from making unnecessary calls to LexisNexis (click here for more information).

As patient records are saved to or updated in Occam, it continuously looks for matches and assigns an enterprise ID to each record.  If two records match, they are given the same Occam ID, thereby linking them together.  The Occam ID is one of the outputs provided by Occam.  

Golden Record

Another output that can be generated is a Golden Record.  The Golden Record is an amalgamation of the best and most current demographic information for the patient across all data sources and is part of Occam’s MDM functionality.  


Gatekeeper is another component of Occam’s MDM functionality and it tracks registration changes on a field-by-field basis for each data source so that when it is time to push a change from one system to another, missing and outdated information will be updated in the target system while current information is protected.

Insurance Mapping

Mastering insurance is another component of Occam’s MDM functionality.  Maps are created between the insurance from the source system and the insurance dictionaries from the target system.  Once the maps are created, every order that comes in from the data source after that will automatically have the insurance translated to the corresponding insurance dictionary entry from the target system.  If insurance mapping is active in Occam, then the target system insurance is returned as output.  


There are two integration methods for how Occam can be incorporated into your data flow and it really depends on when the matching needs to occur.  These methods are referred to as Post-Integration and Pre-Integration.

In Post-Integration, the matching and enterprise ID assignment occurs AFTER the data has landed in your transactional systems.  The data can be loaded into Occam via flat-file, API or HL7.  It can be done in either real-time or batch but is generally done in batch.  

In Pre-Integration, the matching and enterprise ID assignment occurs BEFORE the data has landed in your transactional systems.  In Pre-Integration, the data is generally loaded in real-time via API or HL7.  Pre-integration is the method typically used with labs but a combination of both may be appropriate depending on your needs.

Task Management

Not every match can be automated, and they need a human to do additional research before it can be established if the records belong to the same person or not. Those that can’t be automated are referred to as ‘Maybe’ matches and tasks are created in Occam for each one.  Occam provides a robust workflow for the data integrity team to make the necessary identity decisions for each task.  Once a task has been completed, Occam generates an integration action so that the HL7 integration engine knows to reprocess the order. 

Additional Resources

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