Setup and Test

[jiahaochua]

Hi,
I am working on a project to integrate OpenMRS with a MPI, and would like to test it with your CR under the OpenHIE architecture. I am trying to set up a simple demo/proof of concept, and do not quite understand how to do so. I'm sorry if I don't quite understand the documentation, but I think it is not quite clear how to set up the OID registrar for a demo.

I plan to test it with PIX Admit and Update queries, and PDQ Find Candidates query to check for similar patients, could I know if there are example queries that I can use to test and compare against what I am sending from OpenMRS?

Thanks for help,
Jiahao

[justin-fyfe]

Hello,

The primary purpose of the master patient index is to cross reference identities from third party systems. Each of these are called an "assigning authority", and are assigned three attributes for tracking:

OID - The globally unique namespace identifier for the assigning authority. Usually for a project you need to get a PEN (Private Enterprise Number) from IANA, or if you already have one, divide the existing OID for your project
URL - The globally unique URI whereby the assigning authority is defined
Authority Name - A local (but unique) namespace assigned to the authority for use in HL7v2 (PIX) messages

The oid registrar is where this information is configured, basically each patient identity feed and each identifier provided by that feed needs to have a corresponding authority to assign identifiers. So, if you have a system called EMR_A, you would need to configure an OID:

Name: EMR_A
OID: 1.2.3.45.3.5.3.4.2.3.2 
Note: EMR A In Facility B
URL: http://myproject.org/emrs/emr_a
AssigningAuthorityName: EMR_A
AssigningDevFacility: EMR_A|FACILITY_B
AutoFillCX4: False 

Your AssigningDevFacility needs to match the MSH-3 and MSH-4 (sending device, sending facility) of the system which is originating the message. Typically in a PIX patient identity feed this is configured on the EMR. Only that EMR will be able to assign new identifiers or merge identifiers in that domain.

You use the AutoFillCX4 if you want the MPI to automatically fill the CX4 (universal ID) of identifiers based on the sending information. You will only use this option if your patient identity feed sends ADT messages but does not populate the assigning authority. For example, if EMR_A sent:

MSH|^~\&|EMR_A|FACILITY_B|....
PID|||30495||SMITH^JOHN

Then the MPI would fill that to:

MSH|^~\&|EMR_A|FACILITY_B|....
PID|||30495^^^EMR_A&1.2.3.45.3.5.3.4.2.3.2&ISO||SMITH^JOHN

Note that setting is only used for backwards compatibility with older ADT feeds.

You can configure whatever OID, URL, and name you want for your pilot however whatever information is setup on the MPI must match the information sent by the patient identity feed or else you may receive an error that the device is not permitted to assign identifiers or is missing a primary identifier from their domain.

Cheers

[justin-fyfe]

Also, on a side note, if you are looking to integrate OpenMRS quickly with the MPI you can look at this extension: https://github.com/justin-fyfe/openmrs-module-openhie-client/tree/master

There is also a backport for OpenMRS 1.8.2.

Also note that the MEDIC CR does not require OpenHIE to operate, you can operate the software in a variety of HIE environments.

[jiahaochua]

Hi,
Thanks so much for the response. Could I know if it is able to work with OID encoded UUIDs? I am trying to test it based on your suggestions and am getting an error.

I have setup an OID with the following settings:

Name: OpenMRS
OID: 2.25.212283553061960040061731875660599129565
Note: OpenMRS ID
URL: urn:oid:2.25.212283553061960040061731875660599129565
AssigningAuthorityName: OpenMRS
AssigningDevFacility: OpenMRS|Demo
AutoFillCX4: False
CustodialDeviceId:
CustodialDeviceName:
CustodialOrgName:
GloballyAssignable: False
HL70396Name:
IsMergeSurvivor: False
IsUniqueIdentifier:False
OIDType: ISO

I am then sending the following message using Hapi Testpanel:

MSH|^~\&|OpenMRS|Demo|EOS|Fake Jurisdiction|20180716175918||ADT^A01^ADT_A01|5c81ea77-d774-4533-869c-d3c153bfa864|P|2.3.1|||AL
PID|||1234A^^^2.25.212283553061960040061731875660599129565&2.25.212283553061960040061731875660599129565&ISO||test^test^^^^^L|L

I get the following response with several errors:

#Received 2018-07-16 10:17:55.0400
MSH|^~\&|EOS|Fake Jurisdiction|OpenMRS|Demo|201807161517||ACK^A01|b8697e8d-5f62-4102-bace-93028dbc6d75|P|2.3.1
MSA|AR|5c81ea77-d774-4533-869c-d3c153bfa864
ERR|^^^101&Required field missing&&&MSGE078 : Patient must carry at least one identifier from the registered provider organization~^^^207&Application internal error&&&MSGE00A : Cannot process invalid message

Could I know if there is anything wrong with my setup? Also, how do we setup the client registry to automatically generate IDs for a specific identifier domain?

As for the OpenMRS Integration, we currently have a demo in testing that is able to send and receive PIX/PDQ messages for HL7v2. It is currently working with OpenHIM and OpenEMPI but we are exploring other MPIs to check compatibility. If successful we will merging our changes into the OpenMRS Reference App.

Thanks again for your help.

[justin-fyfe]

Hi,

Your PID-3 should be one of the following:

1234A^^^OpenMRS
1234A^^^&2.25.212283553061960040061731875660599129565&ISO
1234A^^^OpenMRS&2.25.212283553061960040061731875660599129565&ISO

Since CX.4 structure is:

NAMESPACE^UNIVERSAL^UNIVERSAL_TYPE

For generating identifiers for a particular domain, you need to write a function that listens on the persistence layer. I believe this can be done by implementing: IClientNotificationService in a DLL and implementing the NotifyRegister() function. Currently version 1.x of the MPI only supports one implementation of this interface (which unfortunately means that you can't combine this with the PIX ITI-10 update notification handler). We are currently working on v2.0 of the MPI software which uses .NET events and JavaScript based triggers for this very reason. Unfortunately v2.0 won't be completed until end of September 2018.

Cheers
-Justin

[jiahaochua]

Hi again,
I tried the following and still got back errors:
PIX Query:

#Sent 2018-07-18 13:17:29.0741
MSH|^~\&|OpenMRS|Demo|EOS|Fake Jurisdiction|20180716175918||ADT^A01^ADT_A01|5c81ea77-d774-4533-869c-d3c153bfa866|P|2.3.1|||AL
PID|||1234A^^^OpenMRS||test^test^^^^^L|L

Response:

#Received 2018-07-18 13:17:29.0934
MSH|^~\&|EOS|Fake Jurisdiction|OpenMRS|Demo|201807181817||ACK^A01|ef481eee-d54d-48cb-b976-5a38e5818dc1|P|2.3.1
MSA|AR|5c81ea77-d774-4533-869c-d3c153bfa866
ERR|^^^101&Required field missing&&&MSGE078 : Patient must carry at least one identifier from the registered provider organization~^^^207&Application internal error&&&MSGE00A : Cannot process invalid message

PIX Query:

#Sent 2018-07-18 13:18:29.0622
MSH|^~\&|OpenMRS|Demo|EOS|Fake Jurisdiction|20180716175918||ADT^A01^ADT_A01|5c81ea77-d774-4533-869c-d3c153bfa822|P|2.3.1|||AL
PID|||1234A^^^&2.25.212283553061960040061731875660599129565&ISO||test^test^^^^^L|L

Response:

#Received 2018-07-18 13:18:29.0805
MSH|^~\&|EOS|Fake Jurisdiction|OpenMRS|Demo|201807181818||ACK^A01|df835226-d126-49ba-9463-1afd4cd89e43|P|2.3.1
MSA|AR|5c81ea77-d774-4533-869c-d3c153bfa822
ERR|^^^101&Required field missing&&&MSGE078 : Patient must carry at least one identifier from the registered provider organization~^^^207&Application internal error&&&MSGE00A : Cannot process invalid message

PIX Query:

#Sent 2018-07-18 13:27:29.0920
MSH|^~\&|OpenMRS|Demo|EOS|Fake Jurisdiction|20180716175918||ADT^A01^ADT_A01|3c81ea77-d774-4533-869c-d3c153bfa822|P|2.3.1|||AL
PID|||1234A^^^&2.25.212283553061960040061731875660599129565&ISO||test^test^^^^^L|L

Response:

#Received 2018-07-18 13:27:30.0108
MSH|^~\&|EOS|Fake Jurisdiction|OpenMRS|Demo|201807181827||ACK^A01|f68dc72a-255b-4e6a-a80d-711907f173a6|P|2.3.1
MSA|AR|3c81ea77-d774-4533-869c-d3c153bfa822
ERR|^^^101&Required field missing&&&MSGE078 : Patient must carry at least one identifier from the registered provider organization~^^^207&Application internal error&&&MSGE00A : Cannot process invalid message

Any ideas what could be the underlying issue?

Also, it is great to hear that the MPI is still in active development and look forward to the v2.0.

Thanks,
Jiahao

[justin-fyfe]

Well, at first I thought it may that MSH-10 was duplicated between requests (as MSH-10 is used for execute-once control which means duplicates will not actually be executed). But it appears that your MSH-10 is being randomly generated each request...

I will duplicate your configuration and try sending your message to see what the error may be.

Just to confirm, you are using 1.2 of the client registry?

[jiahaochua]

I have disabled Message Persistence to ensure that duplicates are not an issue, and have been manually changing MSH-10 to be safe. These messages are being sent from HAPI Test Panel, is it possible there are compatibility issues?

As for my configuration, I am currently running 1.1.2 as that had the bundled installer. Is there a bundled installer for 1.2? If so I can try out 1.2.
The CR is running on a Windows Server 2016 Essentials VM through VMWare Workstation Pro if it is of any help.

[justin-fyfe]

Ah, that may be an issue.

You can actually run the 1.2 standalone installer and it should upgrade your 1.1.2 install. The only thing that needs to be done is a find/replace in our ClientRegistry.exe.config to update all references of 1.1.2 to 1.2 (since the .NET assembly compatibility won't load references to 1.1.x when the DLLs have a version of 1.2.x).

Cheers
-Justin

[jiahaochua]

I shall try that now and update you as soon as I can.

[justin-fyfe]

I would take a backup of C:\Program Files (x86)\Mohawk College\Client Registry before doing the upgrade, just in case you need to revert the changes.

[jiahaochua]

Oops I forgot to take a backup, but there is nothing important on there, I can always load Medic CR from scratch if needed.

I ran the installer, but am unable to find any reference to 1.1.2 in the ClientRegistry.exe.config file. Is it possible that something went wrong in the install?

I tested sending the PDQ from HAPI Test Panel regardless, and still get the exact same error.

[jiahaochua]

As I was looking through the ClientRegistry.exe.config file, I noticed that it has a recoord of all the registered OIDs in the system. Is this list supposed to automatically update each time you edit in the GUI configurator? Or does it only update at specific points? Some entries that I have added to the OID registrar in the GUI do not appear in this config file.

[justin-fyfe]

Oh yeah, sorry... The documentation is not very good with that. In order for any changes to go from the UI to the config file you have to press "Apply Changes" which will save the config file and restart the service for you.

[jiahaochua]

I'm afraid I do not see any "Apply Changes" button in the UI, are you referring to the "Configure Options" button?

Also, I noticed that a lot of the buttons appear to be missing in Windows Server.
Windows 10 for comparison:

Windows Server

As can be seen the window does not have the "Ok" or "Cancel" buttons.
Is this just an issue with my install? or is this a known issue?