Data Synchronisation rules

Patient data changed in the offline Communicare client is synchronised with the core Communicare database.

The Data Synchronisation Client will consider a health record changed if:
  • The clinical record has been opened for that patient since the last time the laptop was synchronised.
  • A clinical item has been recorded using the Data Entry Wizard since the last time the laptop was synchronised.
  • A patient's biographic details have been opened in the Patient Biographics since the last time the laptop was synchronised.
Note: You cannot delete clinical items from a patient's record in the offline client. The deletion of clinical items is not supported in the Data Synchronisation Client.

You can however, delete prescriptions, regular medications, letters, scanned documents, and investigation requests and results in the offline client.

Data Export Rules

The export mechanism will generate one XML file with the entire electronic record of a patient for each patient record that is deemed to have changed since the last time it was synchronised.

A summary is displayed when synchronisation is complete, showing how many records have been updated.
Example data synchronisation summary
The patient data that is exported to XML includes:
  • Patient Biographics (excluding patient status changes)
  • Clinical Items
  • Care Plans
  • Prescriptions
  • Documents
  • Progress notes
  • HIC claims
  • Investigation requests
The generated XML includes all reference table definitions for the exported clinical items, so that the electronic health record can be imported to another clinic. The reference data exported includes:
  • Encounter places used
  • Clinical Item Types used with the attached measurements and keywords
  • Providers used
Note: You cannot export investigation results, including data related to reviewing or other editing of results. You can read results but not receive or review results in the offline version of Communicare.

Data Import Rules

Electronic Health Records can arrive into Communicare in three ways:
  • Data Synchronisation Client uploading changed health records
  • Manual import of a patient from a different system
  • Updated Health Records coming from another server via Server to Server synchronisation
Regardless of how the electronic health record arrives into Communicare, a strict set of rules is always obeyed when importing the health record. In order to describe these rules we use the following conventions:
  • The XML file containing the record we are about to import is called "Source".
  • The Communicare database to which the record will be imported is called "Target".
  • The modified timestamp of a record in Source XML is called "SMT" and it is stored as a UTC value.
  • The modified timestamp of a record in Target database is called "TMT" and is stored as a UTC value.
These are the rules followed by the data import:
  • If a Source patient is not found in Target, then it will be inserted with the entire Health Record.
  • If a Source patient is found in Target and the SMT is greater than the TMT, then it will update Target patient.
  • If a Source patient is found in Target and the SMT is less than or equal to the TMT, then it will not update Target patient.
  • If a Source reference record is not found in Target, then it will be imported. If the record is from another Server, it will, in most cases be imported with a modified description that will contain the 'site id' of the originating site - 'A description' becomes 'A Description[XXX]' where XXX is the 'site id' of the Source Server.
  • Central data items distributed by Communicare are not updated and they will be matched based on primary key.
Additionally, there are rules which are applied to fields within a record:
  • If a Source field is null it will not be imported into Target (except for the case where the rule for patient encounter import below takes precedence above this rule).
Special rules apply when importing patient encounter data. This rule takes precedence above all other rules for patient encounter import.
  • The more advanced patient encounter record is retained, while the less advanced patient encounter record is thrown away. For example, if Source encounter has status Booked while the Target encounter has status Finished, no change is made to the target encounter. However, if Source encounter has status Finished while the Target encounter has status Booked, Target is overwritten with Source.
  • The rank of an encounter status from least advanced to most advanced is:
    1. Booked
    2. Cancelled
    3. Waiting
    4. Withdrawn
    5. Started, Paused, Finished are equally ranked
  • Only when the status of the encounter is the same for both Source and Target is the next rule applied.

Important Data Import Issues

Table 1. Data import issues and resolutions
Issue Resolution
Use of datasets with enrolment and exit items (e.g. HACC, Drug and Alcohol) Where items depend on a single enrolment and a single exit, make sure that the enrolment and exit items are recorded only once, preferably on the Server database.
Pregnancy starts Make sure that pregnancy starts for a specified pregnancy number are recorded only once.
Reference Tables Changes to reference tables are not imported during Data Synchronisation, hence editing reference tables is disabled.
Patient matching If a patient is added to the Source and the Target, the two records will be matched based on Name, Date of Birth and Sex. If these fail to match, a duplicate patient record is created. To avoid this situation, make sure this information is as complete and accurate as possible.
Note: Medicare number is not used in this matching process.