Setting Up External Systems

Imprivata PatientSecure integrates with the electronic medical record (EMR) application used in your installation.

The hospital system defines one or more EMR (electronic medical record) applications that you are integrating with PatientSecure.

To add a system:

  1. In the Admin Console, go to Settings > External Systems and Patient Identifiers.

    The External Systems and Patient Identifiers page opens.

  2. Click Add System.

    The Add/Edit Systems dialog opens.

  3. Type a display name (case-insensitive, up to 30 characters) in the System Name box.

  4. Select a System Type from the drop-down list.

    To add an EMR:

    1. Enter an HL7 source value in the HL7 Source Value box, which identifies the hospital system in HL7.

      This value may only contain alphanumeric, '-', or '_' characters. Single quotes and spaces are not supported.

    2. (Optional) Click Configure HL7 Processor Settings to configure specific HL7 settings for this system.

      HL7 services (HL7 Listener, HL7 Processor, and HL7 Sender) keep the patient data in your Imprivata PatientSecure database in sync with the data in your EMR application.

      For more information, see Configuring HL7 Messaging

      CAUTION: Use caution when making changes to your HL7 configuration. It is the backbone of your Imprivata PatientSecure installation.

      To configure the HL7 settings for your hospital system:

      1. From the Admin Console menu, select Settings > External Systems and Patient Identifiers.

        The Add/Edit System page opens.

      2. Under the HL7 Source Value field, click Configure HL7 Processor Settings.

        The HL7 Processor Settings page for your hospital system opens.

      3. Review the HL7 values for the following source locations:

        First Name Location The default setting is PID.5.2.
        Last Name Location The default setting is PID.5.1.
        Sex Location The default setting is PID.8.
        Date of Birth Location The default setting is PID.7.

      4. Review the default date format: yyyyMMdd.

        For information on date format options, see "Custom Data and Time Format Strings" on the Microsoft Developer Network website.

      5. Review the default Identifier settings:

        Strip Leading Zeros on Identifiers

        The default setting is OFF.

        Click the On/Off slider to toggle the setting.
        Identifier Location

        The default setting is PID.3.
        Has Repetition Based PIDs The default setting is Yes.
        Position of Tag within PID Repetition

        The default setting is 4.
        Position of Identifier within PID Repetition The default setting is 1.
        Default PID TAG The default entry is blank.

      6. Add, edit or delete identifier settings for a location:

        • To add an identifier setting, click Add a new Identifier Setting above the Identifier Settings table on the right. Click the √ (check mark) at the end of the row to save your changes, or click x to remove it.

        • To edit an identifier setting, click the row. Click the √ (check mark) at the end of the row to save your changes, or click x to reset the field.

        • To delete an identifier setting, click at the end of the row. You see a caution message. To delete the identifier setting, click Delete Permanently.

      8. Review the merge settings:

        Merge Identifier Field Location The default setting is MRG.1.
        Has Repetition Based Merge Identifiers

        The default setting is ON.

        Click the ON/OFF slider to toggle the setting.

        NOTE: If the setting is OFF, you can change the Default Merge Tag setting.
        Position of Identifier within Merge Repetition The default setting is 1.
        Position of Tag within Merge Repetition

        The default setting is 4.

        Default Merge Tag

        If the Has Repetition Based Merge Identifiers setting is ON (default), the setting is grayed and unavailable.

        If the Has Repetition Based Merge Identifiers setting is OFF, select an HL7 tag assigned to the hospital system from the drop-down list.

        To clear your changes and start over with the latest saved settings, click Reset.

      9. Click Save.

      10. To return to the Edit Hospital System page, click Back.

        IMPORTANT: Save any changes to the HL7 Processor Settings page before you leave it.

    Only one of each EMPI type is supported.

    To configure EMPI settings:

    1. Select Initiate or Verato from the EMPI drop-down list.

    2. In the Username box, enter the username for the EMPI system.

    3. In the Password box, enter the password for the EMPI system.

    4. In the Web services URL box, enter the URL of the EMPI web service.

    5. For integration with Verato Universal MPI, click Import certificate to upload the certificate you obtained from Verato.

      1. Click Browse to the location of the certificate (*.pfx) file you received from Verato.

      2. In the Certificate password box, enter the passphrase for the certificate.

    6. Click Add new to add a new patient identifier.

    For more information on configuring the integration with Verato Universal MPI, see Integrating PatientSecure with Verato Universal MPI.

    To configure FHIR service settings:

    1. Select FHIR from the System type drop-down list.

    2. Select Epic or Cerner from the EMR drop-down list.

    3. From the FHIR version drop-down list, select the FHIR release number that applies to your EMR system:

      • For Epic, select STU3 or R4, depending on the version of FHIR supported by your release of Epic.

      • For Cerner, the default of R4 is selected.

    4. In the Account ID box, enter the account identifier with the FHIR service.

    5. In the Password box, enter the password for the FHIR service.

    6. In the Client ID box, enter the client identifier with the FHIR service.

    7. In the Web service URL box, enter the URL of the FHIR web service.

    8. For Epic, configure the following settings:

      1. Enable the SSN required to create patient in Epic setting if your Epic workflows require a Social Security number to be entered when create a patient.

        1. Type a default value in the Default SSN value if patient does not provide SSN box.

          This value is used when the registrar does not know the patient's actual SSN at the time of patient creation but the EMR workflow requires a placeholder SSN. The default value is 000-00-0000.

      2. In the Default department ID to create patient in Epic box, enter the department ID to pass to the Epic FHIR API.

      3. In the Default department type to create patient in Epic box, enter the department type to pass to the Epic FHIR API.

    9. Click Add new to add a new patient identifier.

    Configure messages sent from hospital HL7 systems to PatientSecure.

    To configure HL7 - Inbound settings:

    1. In the Port box, specify the port for inbound data. The default setting is 2244.

    2. In the Source system location box, enter the HL7 value for the source location. This value matches the hospital system sending the HL7 message.

      The value is usually MSH.3.

    Configure messages sent from PatientSecure to hospital HL7 systems.

    To configure HL7 - Outbound settings:

    1. In the Host box, enter the host name or IP address of the host where HL7 messages will be sent.

    2. In the Port box, specify the port for outbound data.

    3. In the Receiving facility box, specify the receiving facility. This value populates the outbound HL7 header segments, usually MSH.6.

    4. In the Receiving application box, specify the application. This value populates the outbound HL7 header segments, usually MSH.5.

Add patient identifiers based on your external system.

To add an EMR patient identifier:

  1. In the Name box, enter the name that identifies the EMR system in the Imprivata PatientSecure database.

    NOTE:

    Identifiers are case-sensitive.

    TIP: Review the name carefully. Once you save the patient identifier, you cannot change its name.

  2. Enter a name that be visible to users working with the application in the Display Tag box.

  3. Enter a name that will be used in API calls in the API Tag box.

  4. Enter a name that will be referenced in inbound HL7 messages in the HL7 Tag box.

    NOTE: Epic Integration and Epic Kiosk support a single patient identifier. For more information, see Epic Integration Settings.

  5. Click the √ (check mark) at the end of the row to save the patient identifier, or click x to remove it.

To add an EMPI patient identifier:

  1. Select a patient identifier name from the Name drop-down list.

  2. In the EMPI Tag box, enter a name that will be visible to users working with the application.

    NOTE:

    EMPI identifiers are case-sensitive.

  3. Select Enterprise ID to indicate that the identifier is an enterprise ID.

  4. Click Additional Information to indicate the number of leading zeros to prepend to the patient identifier prior to querying the EMPI.

    Example:

    When Imprivata PatientSecure stores MRN as '3333' and the EMPI stores the MRN as '003333', you would set the value to 2 to add two leading zeros. Similarly, setting the value to a negative number (-2) removes leading zeros.

  5. Click the √ (check mark) at the end of the row to save the patient identifier, or click x to remove it.

To add a FHIR patient identifier:

  1. Select the patient identifier from the ID Name drop-down list.

  2. In the FHIR ID Tag box, enter a name that will be visible to users working with the application.

  3. In the FHIR ID Type box, enter a FHIR ID type. The FHIR ID Type indicates which format PatientSecure will use when supplying a FHIR ID.

  4. For Cerner, to configure additional active patient identifiers:

    1. Click Add in the Additional OID column. The Additional OID info dialog opens.

    2. In the System box, enter a value for the system.

    3. In the Code box, enter a value for the code, and click Save.

  5. Click the √ (check mark) at the end of the row to save the patient identifier, or click x to remove it.

This section is for configuring a Cerner FHIR system only.

To map an organization:

  1. In the Organization Mapping section:

    • Select the organization name from the Organization name drop-down list. This organization name is the name as created in PatientSecure that is mapped to the Cerner Organization, and may contain the facility name.

    • Select the facility name from the Facility Name drop-down list, or select All Departments. This is useful when some facilities under the same organization have different Cerner Organization IDs.

    • Select the single department name from the Department Name drop-down list, or select All Departments. This is useful when some departments in the same facility have different Cerner Organization IDs.

  2. In the Cerner Organization ID box, enter the Cerner Organization ID to be matched against the organization in PatientSecure.

  3. In the EHR Source ID box, enter the EHR Source ID that determines which Cerner Domain is used with the APIs.

To edit an external system and patient identifiers:

  1. From the Admin Console menu, select Settings > External Systems and Patient Identifiers.

  2. Locate the system in the Systems list, and then click the row.

    The Add/Edit System page opens.

  3. To edit the system, edit the appropriate settings.

  4. Review the patient identifier fields.

    If a indicator appears in the row, the patient identifier is used in more than one hospital system.

    The patient identifier name is grayed and unavailable. You cannot change it.

  1. Click the √ (check mark) at the end of the row to save your changes, or click x to reset the fields.

  2. Click Save.

To delete a patient identifier:

  1. From the Admin Console menu, select Settings > External Systems and Patient Identifiers.

  2. Locate the hospital system in the Systems list, and then click the row.

    The Add/Edit System page opens.

  3. Locate the patient identifier in the list.

  4. To remove the patient identifier from Imprivata PatientSecure, click at the end of the row.

    IMPORTANT: Use caution when deleting a patient identifier. All of the data and records associated with the identifier will be removed permanently from Imprivata PatientSecure.

    CAUTION: Do not click Delete in the bottom-right corner of the page, as this will remove the entire hospital system from Imprivata PatientSecure.

  5. To confirm, click Confirm Delete.

  6. Click Save.

To delete an external system:

  1. From the Admin Console menu, select Settings > External Systems and Patient Identifiers.

  2. Locate the hospital system in the Hospital Systems list, and then click the delete icon at the end of the row.

  3. IMPORTANT: Use caution when deleting a hospital system. All of the data and records associated with the system will be removed permanently from Imprivata PatientSecure.

  4. To confirm, click Confirm Delete.

    The External Systems and Patient Identifiers page opens. The deleted hospital system has been removed from the list.