Import Admission, Discharge, and Transfer Patient Data

Import Admission, Discharge, and Transfer Patient Data Version

This topic discusses:	Links to related topics:
Overview Creating a .csv export file from your admissions system Importing the file into the system. Debugging import and update problems	Entering patient charges Exporting patient charges Purging obsolete information from the system
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Overview

The ADT (Admission, Discharge, and Transfer) Import feature allows you to bring files into the system from your admissions system as new patient data, as updated patient data, or as an instruction on what patient data to delete. You can run the import function from the system as often as you need to. The ADT import feature can be run, for example, whenever a particular hospital unit decides to enter its patient charges.

This topic focuses on ADT patient imports using .csv files. The system also provides an HL7 interface for ADP imports.
The ADT feature also provides Report Objects that you can use to create custom reports.

Security

Features are built into the system to ensure the privacy of electronic protected health information (ePHI), in compliance with HIPAA requirements. One applicable area is ADT patient record import.

On a User Profile, the Hide ePHI Data field determines whether a user can access patient data. When Hide ePHI Data is checked, a detailed series of restrictions apply to the user's access to ePHI records. Patient information in the ADT import feature is subject to restrictions governed by this User Profile field.

In sum, if Hide ePHI Data is checked, the user cannot access patient-identifying information.

The list of restrictions and examples is outlined in the ePHI documentation.

Note: All patient identifier fields in this document's figures contain fictional values, and are not associated with any actual individual.

Role Object

This feature is controlled by the "PatChg" role object.
- The minimal setting to display or work with ADT patient data is Modify.
- To download or delete ADT patient data, a setting of All is required.

Upload Process

When you upload patient data files from your admissions system, the system performs these steps:

Checks the file - The system verifies that the file is a patient data file, and determines if the file format is correct.
Reads the file - The system reads the file to determine the action(s) needed; for example, adding or changing a patient record. You set the actions in the import file's ADTACTION field for each patient record. See "How ADTACTIONs work."
Processes the file to add, delete, or change patient data in the system.

If the system cannot complete any step because of errors, it logs the errors. You can view the errors and correct them.

Purging Patient ADT Data

Since patient data can accumulate quickly, the system purges records for discharged patients.

Patient data is deleted five days after the patient's discharge date has been imported into the system.
However, for discharged patients, records with charges pending will not be deleted by purges.

Purges do not delete records for active patients, regardless of how long the records have existed.

Posting Charges Manually

If you need to post charges for a patient whose data have not yet been imported from your admissions system, you can add the data to the system using the Patient Charge Entry feature. The patient information is flagged as "not validated" and the system validates the patient (checks that the patient does exist) during the next patient charge export. When a patient is discharged, the hospital admissions system can update the system during the next import of patient data.

Using the ADT Import

The following steps cover the process of importing ADT patient records.

Creating and editing the .csv file

Generate a .csv export file using your admissions system utilities, or create the file manually. The file name must be unique.

Your admissions system may have a utility that can save records as .csv files. If so, create a .csv export file containing your patient information. Write the file to a directory that you can access with a spreadsheet or a text editor program. You will need to edit the file.
Alternately, open a new spreadsheet and populate it with the data that you will import into the system. Make sure that your spreadsheet program can save the file in .csv format.

Note: For editing the file, a text editor is preferable to a spreadsheet program. Spreadsheet programs (e.g., Excel) add commas for blank columns. The system cannot process trailing commas. Also, the spreadsheet column formats must match the formats expected by the system. Simply saving your file from the spreadsheet does not guarantee that the column formats will be correct. For this reason, editing and saving a .csv file as text is better.

Open the .csv file that you made in the previous step and edit it so that the format matches an Example File.

Important: Click BACK on your browser when you finish viewing the example files described in the next paragraph. Or, if you are using Internet Explorer tabs, close the tab. If you click File > Exit or File > Close, the system may also close.

Click update, add, or delete to see an Example File with each ADTACTION. Study the field descriptions, and structure your patient data accordingly.

Add Rows 1 and 2 to your data. Row 1 contains header information. Row 2 contains the name of each field in the order that the system expects.
Rows 3 and on are for your data.
Edit your data as needed.
Save your file (as type .csv) and close the spreadsheet program.

Reopen the spreadsheet in MS Notepad (or use another text editor) so that you can see the data as lines containing commas.
Add the following end-of-file marker after the last line of comma-separated data, on a line by itself:

<EOF>

Important: Your file must contain <EOF>, by itself, on the last line.

Save the file and close the text editor.

How ADTACTIONs work

The ADD and DELETE ADTactions add and delete patient data. Use ADD when a patient is newly admitted. The UPDATE ADTACTION updates patient data; for example, updating a Patient ID. DELETE manually deletes patient data; for example, in case of a data entry error.

Patient .csv file fields

The column name in bold following each column letter must be entered exactly as it appears in the list. The column letter is for reference only - do not enter it on the spreadsheet.

Table 1 - Patient Data CSV File Fields

Field

Entry

Row 1 - Header

Column A: PatADT

The word "PatADT" is required.

Column B: Customer ID

Your customer ID. (defined by the system). Contact customer support if you do not know your ID.

Column C: Time Stamp

The date of the import in MM/DD/YYYY format; e.g., 10/17/2001 for October 17, 2001.

Row 2 - Column Names (Enter the column names exactly as they appear below, e.g., DEPT in Column C.)

Column A: ORG

The Organization ID.

Column B: DEPT

The Department ID.

*Column C: ADTACTION

A required code that describes the action the system should take with the patient information: ADD the patient; DELETE the patient; or UPDATE - change information for the patient.

The ADT action may also be one of the following HL7 Trigger Event Codes:

HL7 Trigger	ADT Action
A01 A04 A05	Add
A03 A06 A07	Update
A23	Delete

*Column D: PATIENTID

The ID of the patient who is being added, deleted, or whose records are being updated. This field can have a maximum of 15 characters. Either Patient ID, Patient Account No, or both is required.

Column E: DOB

The patient's date of birth.

Column F: ADMISSIONDATE

The date when the patient was admitted. Required with ADD ADTACTION.

Column G: DISCHARGEDATE

The date when the patient was discharged, if discharge has happened. Always optional.

Column H: NEWPATIENTID

A new ID associated with the patient, if needed. (e.g., a newborn). 50 characters, max.
Always optional.

*Column I: PatientAccountNo

The hospital patient's account number. Either Patient ID, Patient Account No, or both is required.

*Column J: PatientClass

One of the following values is required:

E - Emergency
I - Inpatient
O - Outpatient
P - Preadmit
R - Recurring Patient
B - Obstetrics

Rows 3 and on: data records

Last Row: <EOF>

* indicates required field, or choice of required field.

To import patient data into the system

From the Materials Management main Contents, select Imports / Exports & Financials > ADT Patient Import. The list Imports for Base Import Type PatChg (ADT Patient Data) appears (Figure 1). The list contains patient data files that have been uploaded.

Figure 1 - List of ADT Patient Imports

Click New. The Import panel appears (Figure 2).

Figure 2 - Patient Data Import Panel

Enter the file that you wish to import in the File to Upload field.

Click Browse (on Microsoft IE or Edge) or Choose File (on Chrome) to locate the file.
Click on the file to select it.

At this step, you have a choice. You can work through the import process in two stages or in one stage. For new users of this feature, we recommend the two-stage approach.

The two-stage approach first loads the .csv file and validates it. Once the file has successfully loaded, you can import the information into the system.

- Select the box labeled Load and Verify, No Import.

- Click Submit. The system attempts to upload your file and validate it. If successful, the system sends you a message. If the system cannot upload your file and validate it, error messages appear. Read and close the error messages. Make changes as needed in your .csv file and try the upload again. Click here to read debugging information.

The Imports for Base Import Type PatChg appears.

- Click Refresh to see your file listed.

The one-stage approach loads and immediately processes the file records. This method is efficient if you are confident that your. csv file will not contain many errors.

- Click Submit. The system attempts to upload your file and validate it. The list Imports for Base Import Type PatChg appears.

- Click Refresh to see your file listed.

Review the import list entry for your file. The following fields provide useful status data:

Import Status Desc - The successful or unsuccessful status of the upload.

Errors: The .csv file could not be read or validated.

Ready for Processing: If you have used a two-stage upload, the file is ready for the second (update) step.

Processed - The number of data records processed out of the total uploaded. This number indicates how many of the import file records successfully performed their respective ADTACTIONs on patient records.

n of X: X is the number of data records uploaded and n is the number of records processed.

For a one-stage upload, this field indicates whether the system could make changes to its patient data using the imported file's records, and, if so, how many records processed successfully. 0 of X means that the system was not able to process any of the imported file's records. Click Menu > View Import Details. The Patient Data Import Details list appears, and you can review your data for errors.

For a two-stage upload, 0 of X is normal.

To complete processing of your import file

If you are using the one-stage approach, the system has run the processing step for you. You can review any errors, and begin fixing any problems.

If you are using the two-stage approach, you need to process the patient data file that you uploaded so that the appropriate changes are made to patient records. Do the following:

From the Materials Management main Contents, select Imports / Exports & Financials > ADT Patient Import. The Import List for Type PatChg appears (Figure 1).
Locate the file that you wish to process.
Click Menu > Reprocess. The system asks you to verify that you wish to reprocess the file.
Click Submit.

The system tells you how many patient records were successfully processed, and how many contained errors.
If you have no processing errors, then you are finished, and the Import Status Desc is Complete.
If you have errors, Import Status Desc contains the value Errors. See To debug your import file to correct the errors and click Menu > Reprocess again. You may need to make changes in your .csv file and re-import the file.

To debug your import file:

You can encounter errors at any or all of the stages of patient data import. Error messages provide information about problems with the .csv file. In most cases, you will wish to alter your .csv file. Rarely, you may need to change values in the system tables.

A. At the validation and reading stages:

Check that the file name and path are correct.
Make sure that the import file is a .csv file.
Verify that your file has the header line.
Check that you have included a line containing the correct column names, in the correct order, and that none are missing.
Check that the correct number of fields are in the import file for each record.
Review the ADTACTION values to make sure they are correct.
Check that the file contains <EOF> on the last line.

B. At the processing stage:

When you select Menu > Reprocess, the system attempts to update (add, or delete) data in its patient records using the imported data. The number of records successfully processed appears on the Import list, and errors in processing each record are logged. To see the errors:

Click Menu > View Import Details. The imported records appear.
Review the Processed field for each record to determine which have errors. Yes indicates that the record successfully updated, deleted, or added patient information. If the field is empty, the record has a problem, and the system could not process it.
Click View Errors to get a list of the problems with the record. In most cases, you will want to go back to the .csv file, correct the data, and re-import the file.

Since patient data can accumulate quickly, the system has two automatic purging cycles:

Patient data is deleted five days after the patient's discharge date has been imported into the system.
Patient records that do not have a discharge date and have not had patient update or charge activity for 90 days are automatically deleted.

The ADT feature also provides two Report Objects that you can use to create custom reports. For reports, from the Materials Management main Contents, select Reports > My Report Definitions.