Patient reconciliation

Studies sometimes arrive with the wrong patient: a technologist picked the wrong worklist entry, or typed an ID by hand. A route with Patient reconciliation checks each study against its order in the worklist, and holds the ones that do not match, before they reach the PACS. Configuration › Routes › Patient reconciliation.

How a study is checked

The order is found by accession number, else by Study Instance UID.

The study	What happens
Same Patient ID, details match	Sent. Details the study lacks are filled in from the order.
Same Patient ID, other name, birth date or sex	The order’s details are taken (or, if the route says so, held).
Another Patient ID	Held.
Its order was cancelled	Held.
No order found	Held (or, if the route says so, sent as it is). Released by itself when its order arrives.

Names are compared on family and given name, ignoring case and punctuation, since one system often leaves out a middle name.

The queue

History › Reconciliation lists held studies across all nodes, with the patient as received, why it was held, and its series. Open one to see it next to its order, then:

• Fix the patient: type the details, or take them from its order or a worklist search;
• Split: release some series as a study of their own (a new Study Instance UID), and keep the rest held;
• Merge: give it another study’s Study Instance UID and patient;
• Release it as it is, or discard it.

Instances of a study that arrive after the decision get the same changes. Held studies stay on the node that received them, survive restarts, and raise an alert when a node has had studies waiting for over an hour.

The queue names patients: it is for history users, and every look is audited. Actions are administrators’ (with the history role), and audited without patient details.