Patient Institution Residence Key - DICOM

This is a discussion on Patient Institution Residence Key - DICOM ; I am looking for the key that represents if a patient is an inpatient or an outpatient. I believe the key I am looking for is (0038,0400) LO # Patient's Institution Residence. Code: (0010,0010) PN [] (0038,0400) LO [] (0032,1060) ...

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Thread: Patient Institution Residence Key

  1. Patient Institution Residence Key

    I am looking for the key that represents if a patient is an inpatient
    or an outpatient. I believe the key I am looking for is (0038,0400) LO
    # Patient's Institution Residence.

    Code:
    (0010,0010) PN []
    (0038,0400) LO []
    (0032,1060) LO [] # 8, 1
    RequestedProcedureDescription
    (0040,0100) SQ # 250, 1
    ScheduledProcedureStepSequence
    (fffe,e000) na (Item with explicit length #=2) # 242, 1
    Item
    (0040,0002) DA [20060130]
    (0038,0400) LO []
    (fffe,e00d) na (ItemDelimitationItem for re-encoding) # 0, 1
    ItemDelimitationItem
    (fffe,e0dd) na (SequenceDelimitationItem for re-encoding) # 0, 1
    SequenceDelimitationItem


    How can I change this query to represent the data I am looking for?

    FYI: I am using OFFIS DICOM Tools - FINDSCU.


  2. inpatient or outpatient, Current Patient Location, was Re: Patient Institution Residence Key

    zenig wrote:
    > I am looking for the key that represents if a patient is an inpatient
    > or an outpatient. I believe the key I am looking for is (0038,0400) LO
    > # Patient's Institution Residence.


    You might also look in Current Patient Location (0038,0300) from the
    Visit Status Module, which in IHE is defined to be populated by the HL7
    V2 Assigned Patient Location item 00133 from ORM PV1:3.

    It depends of course on whether your MWL SCP is configured to
    populate this field.

    David


  3. Re: inpatient or outpatient, Current Patient Location, was Re: Patient Institution Residence Key

    The really only fool proof way, and even then its not really fool
    proof, is to receive the HL7 ADT messages (real ones that really do
    track Admit, Transfers, and Discharges, not those namby pamby
    registration messages) and keep a database with the patient admission
    state & location. Add patients to the database on Admits, change their
    location on transfers, delete them from the database on discharges

    If the patient is not in the database of the admitted when you want to
    know, they aren't an inpatient (most of the time). If you're not in
    the position to receive those messages and you don't have access to the
    current patient location attribute (or not wanting to get that
    complicated), the requesting service (0032,1033) is also a pretty
    strong clue for a hueristic. Hospital services are either inpatient or
    outpatient. Except sometimes, patients in some services has a
    signficant probably of changing to an inpatient after the order was
    entered -- like from the emergency or urgent care service.

    MWL attribtes tend to be a point in time capture of what the patient
    looked like when the order was entered/ scheduled especially if the MWL
    provider is different from the patient management provider (eg. RIS
    rather than HIS).

    All this points to the need for someone to be tracking those ADTs. No
    guarantee your MWL SCP is going to supply patient location or
    requesting service on the worklist. Patient location is at least a
    required query return key in the IHE profile but that doesn't mean its
    populated or accurate (as far as "at the time you want to know") . If
    both requesting service and current patient location are on the
    worklist and are in-patient locations (e.g. ward of some sort), you've
    got an even higher probability they're an inpatient

    Why do you need to know and when will you be asking? Close to the time
    of acquisition or sometime later? The longer it is afterwards, the more
    likely the MWL data is not going to be accurate. The usual reason is so
    the PACS can preroute images to a workstation in the inpatient ward or
    a webserver can populate a review/rounds worklist for the ward. If
    you're wanting to know after the exam has been read, you have a much
    higher probability the data is stale


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