Executive Summary
This article outlines a list of tools for designing a Master Patient Index (MPI) (also known as a client registry) or other registries as part of an interoperable health information exchange. It incorporates examples of previously implemented projects in a variety of jurisdictions which can be used in determining requirements and producing specifications for an organization's own client registry.
Companion Articles
A Guide to Planning a Health Information Exchange (HIE)
Implementing a Master Patient Index
What is an MPI?
A Master Patient Index (MPI)—also referred to as a patient registry or client registry— is an electronic database that holds demographic information on every patient who receives healthcare services. The MPI aims to accurately match and link records by uniquely identifying individuals to maintain consistent and accurate information about each patient. This is accomplished by storing information such as name, date of birth, gender, etc., and assigning everyone a unique identifier. This allows personal healthcare records to be shared with different hospitals, rehab facilities, pharmacies or other healthcare providers that may need access to one’s medical records in a secure, timely and cost-effective manner.
When constructing an MPI there are business requirements, use cases, interoperability standards and workflow documents, functional and non-functional requirements, integration test cases and load and performance test cases that must be considered.
Business Requirements
Example tools for business requirements:
- Design Specification & Analysis Report (detailed list outlined on page 9)
- Colorado Office of eHealth Innovation Master Patient Index and Master Provider Directory (business needs were identified throughout the C-SHIMS document and/or identified through interviews with various stakeholders on page 10)
Use Cases
- RHEA Rwanda Project (Key Use Cases for the POC applications using the HIX layer outlined on page 16)
- Massachusetts eHealth Institute has developed an online toolkit that aids in the design and structure of a use case for a Health Information Exchange.
Interoperability standards and workflows documents:
The following examples come from the Open EMPI Entity Edition Documentation and can be used to help draft required documents:
- Health Informatics Standards Infrastructure for Rwanda
- RHEA Interaction Sequences with the Client Registry
- Test Cases for Compliance with PIX and PDQ HL7v2 Profiles
- PIX/PDQ HL7v3 Requirements Overview
Functional requirements
The tools listed below are good examples of MPI functional requirements:
- Colorado Office of eHealth Innovation Master Patient Index and Master Provider Directory (functional requirements are needed to support a master patient index on page 18)
- Regional Health Information Exchange (RHIE) (contains analysis of stakeholders, scenarios, elicitation methods, list of requirements)
Non-functional requirements
Examples include:
- Performance Requirements Specification
- Regional Health Information Exchange (RHIE) (contains analysis of stakeholders, scenarios, elicitation methods, list of requirements)
Test Cases
Integration:
Defining the actors and the supported transactions they are involved in
Load and Performance:
OpenEMPI's load testing method and results can be used as a reference.
- Rwanda Client registry
- RHEA Integration Interface Specification for OpenEMPI/Client Registry
- Fundamentals for Building a Master Patient Index/Enterprise Master Patient Index
- Data quality maintenance of the Patient Master Index (PMI)
- Brief for Colorado eHealth Commission: Master Patient Index (MPI)
- MPI Integrity: The Foundation for Patient Safety and Quality Care
- Healthcare analytics essentials: The master patient index
- Master Patient Index (MPI): Are we there yet? MPI Records Challenges at the Primary Care Clinic of North Texas
- Master Data Management Within HIE Infrastructures: A Focus on Master Patient Indexing Approaches
