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3.2.46 ADT/ACK - change external ID (event A46)

A change has been done at the external identifier level. That is, a PID-2-patient ID (external ID) has been found to be incorrect and has been changed.

An A46 event is used to signal a change of an incorrectly assigned external ID value. The "incorrect source external ID" value is stored in the MRG segment (MRG-4-prior patient ID-external) and is to be changed to the "correct target external ID" value stored in the PID segment (PID-2-patient ID-external).

The external ID involved in identifying the person may or may not represent a patient, who may or may not have accounts, which may or may not have visits. An A46 (change external ID) event A46 is intended for changing the value of the external identifier without affecting other subordinate identifiers. Any other subordinate identifiers that were previously associated with the "incorrect source external ID" are now associated with the "correct target external ID". Specification of these other subordinate identifiers is not required to be provided.

This event and the message syntax do, however, allow for the specification of "new subordinate identifiers" (in addition to the PID-2-patient ID(external ID) identifier). For those environments that may require changes to these other subordinate identifiers because of this A46 (change external ID) event, it is required that the old and new identifiers be a "tightly coupled" pair.

Since this event is a change at the PID-2-patient ID (external ID) identifier level, PID-3-patient ID (internal ID) and MRG-1-prior patient ID - internal ID are not required.

See Section 3.5.2, "Merging patient/person information," for a discussion of issues related to the implementation of change messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A31 (update person information) event be used in conjunction with this message. However, all PID data associated with the new External ID are treated as updated information.

ADT ADT Message Chapter
MSH  Message Header  2
EVN Event Type  3
PID Patient Identification  3
[PD1] Additional Demographics  3
MRG  Merge Information   3
ACK General Acknowledgment Chapter
MSH Message Header  2
MSA Message Acknowledgment  2
[ ERR ] Error  2

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