1. Introduction

The Patient Safety Information Exchange (PSIE), developed by the Los Angeles County Department of Public Health (LACDPH), is designed to improve communication about multi-drug resistant organism (MDRO) infections.

1.1 Purpose

  • Enable PSIE to share its MDRO patient list with LANES.
  • Facilitate LANES to match incoming admission data with the MDRO registry.
  • Ensure LANES sends admission messages back to PSIE.
  • Notify admitting facilities to implement isolation precautions.

1.2 Scope

This guide outlines:

  • Sharing MDRO patient data via FHIR Bundles.
  • Admission matching by LANES.
  • Sending real-time notifications from PSIE to facilities.

2. Data Exchange Resources

2.1 FHIR Bundle

The FHIR Bundle serves as the container for data exchange, with the following key resources:

2.1.1 MessageHeader

  • Metadata about the message (e.g., source, destination, and event type).

2.1.2 Patient

  • Name: Required
  • Date of Birth: Required
  • Address: Optional

2.1.3 Encounter

  • Admission Date: Required
  • Discharge Date: Optional
  • Visit ID: Required

2.1.4 Organization

  • Facility Name: Required
  • Facility NPI: Required

3. Workflow

3.1 Step 1: MDRO Patient List Sharing

  • PSIE sends a FHIR Bundle to LANES containing:
    • Patient demographics (name, DOB, address).
    • MDRO condition details.

3.2 Step 2: Admission Matching at LANES

  • LANES matches incoming admission data against the MDRO list.

3.3 Step 3: Notification

  • LANES sends a FHIR Bundle for matched patients back to PSIE.
  • PSIE sends a real-time alert to admitting facilities.

3. Workflow

3.1 Step 1: MDRO Patient List Sharing

PSIE sends a FHIR Bundle containing:

  • Patient demographics (name, DOB, address).
  • MDRO condition details.

3.2 Step 2: Admission Matching at LANES

LANES matches incoming admission data against the PSIE-provided MDRO list.

3.3 Step 3: Notification

  • LANES sends a FHIR Bundle back to PSIE for matched patients.
  • PSIE sends a real-time alert to admitting facilities.

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