# Update Patient Demographic Record Workflow

## Overview

This transaction allows the Point-of-Service (PoS) systems to update a patient record in the client registry. The following sequence diagram shows the steps involved.

| **Workflow Maturity**         | <p><img src="https://lh5.googleusercontent.com/Vp6XBRGu-U_Dmd5EKNpCZvEEum0CxOcHOj9NgHh8UMMNLMlXHmLcUE_YWueDRr4uqWLzpPfzSBLJ2k33XQIelLypjQ4wyrD17-t33GtLa8fFxW9AYDvXhiJmBl4VaLgKDg" alt=""></p><p> <strong>Mature</strong></p> | <ul><li>Workflow is defined and ARB approved</li><li>Workflow is supported by mature standards</li><li>One or more OpenHIE implementations of this workflow exist in one or more countries</li></ul>                                                                                                                                                                                                       |
| ----------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Standards\*                   |                                                                                                                                                                                                                               | ADT^A08 - [IHE ITI-8](https://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_TF_Vol2a.pdf) Transactions                                                                                                                                                                                                                                                                                                   |
| Assumptions and Prerequisites |                                                                                                                                                                                                                               | <ul><li>The Point-of-Service system is a trusted application known by the HIE and it is registered with the interoperability layer to be able to send and receive data securely (<a href="https://wiki.ohie.org/display/documents/Common+message+security+workflow">Common message security workflow</a>).</li><li>The Patient to be updated is assumed to already exist in the Client Registry.</li></ul> |
| Actors                        |                                                                                                                                                                                                                               | <ul><li>PoS - The point of care system that captures patient identifiers, is responsible for sending the identifiers to the HIE.</li><li>IL - Mediates the transactions between the PoS system and the Client Registry.</li><li>CR - Manages patient demographics and identifier details.</li></ul>                                                                                                        |

## **Interaction Description**

The following is a description of the interaction steps.

![](https://lh3.googleusercontent.com/LPkYsrvX4ygNHxQwkssyYliNGHGUBuyDo9h4TXrP4cHC6881jdodNXLynSaNWCqZz4Khhosk7o4H2NKpjTDcV83DW_2xoIhWCOiteO5mbb_Ch-V7mmlEbTBcwfAHXJhz4A)

| **#** | Interaction                 | Data                                                                                                                                                                                                                          | Transaction Options                                                                                                                                                                        |
| ----- | --------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| 1     | Update patient              | The format of the message is specified by the ITI-8 IHE PIX v2 transaction and takes the form of an HL7v2.3.1 A08 message. The message may include both identifiers and demographic attributes for the patient to be updated. | <p>PIF ITI-8 transaction ADT^A08</p><p><a href="https://wiki.ohie.org/display/documents/Patient+Identity+Feed+IHE+ITI-8+Transactions">Patient Identity Feed IHE ITI-8 Transactions</a></p> |
| 2     | Update patient              | The message from the Point-of-Service system is passed directly through to the CR by the IL.                                                                                                                                  | PIF ITI-8 transaction ADT^A08 [Patient Identity Feed IHE ITI-8 Transactions](https://wiki.ohie.org/display/documents/Patient+Identity+Feed+IHE+ITI-8+Transactions)                         |
| 3     | Acknowledge patient updated | The response message is an HL7 ACK. See ITI TF-2x: C.2.3, "Acknowledgment Modes" for definition and discussion of the ACK message.                                                                                            | PIF ITI-8 transactions HL7 ACK [Patient Identity Feed IHE ITI-8 Transactions](https://wiki.ohie.org/display/documents/Patient+Identity+Feed+IHE+ITI-8+Transactions)                        |
| 4     | Acknowledge patient updated | The message from the CR is passed directly through to the PoS by the IL.                                                                                                                                                      | PIF ITI-8 transactions HL7 ACK [Patient Identity Feed IHE ITI-8 Transactions](https://wiki.ohie.org/display/documents/Patient+Identity+Feed+IHE+ITI-8+Transactions)                        |

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