PA Registry State Model

HL7 Administrative Registry Dynamic Model

The current HL7 V3 messaging standards for administrative registries are based on a (more or less) common dynamic model. It consists of three basic patterns:

1. Simple Notification
   • A Registry Informer sends information to one or more Registry Tracker application roles whenever a registry record is added or changed. The receivers have no stated responsibilities.
   • The Master File / Registry Event Notification RMIM describes the Registration Event for this interaction.
2. Query and Response
   • A Registry Query Placer sends a set of parameters to a Registry Query Fulfiller application role that is responsible for returning all records that match the parameters.
   • The Query by Parameter control act RMIM describes the query placement
   • The Registry Query Response RMIM describes how the matching Registration Events are returned
3. Request and Fulfillment
   • A Registry Request Placer sends a request for action to a Registry Request Fulfiller application role that is responsible for accepting or rejecting the request and informing the requestor of the result or reason for rejection.
   • The Master File / Registry Request Control Act RMIM describes the Registration Request
   • The Master File / Registry Event Notification RMIM describes the response when the registration request is accepted
   • For rejected request:
     • Patient Administration registries return the original request with the reason for the rejection returned as a Detected Issue in the Master File / Reg Request Control Act,Role Subject wrapper
     • PersonnelManagement registries return a Registry Event Notification and indicate that the request was rejected in the Acknowledgement type code in the A Application Acknowledgement transmission wrapper

Management of a registry can be described as state changes in a Registration Act.

Registry Event Notification RMIM

Simple Registry

As of 2010 the HL7 administrative registry domains only include notification messages for the following registration actions:

State Transition	From / To	Business Event
activate	null / active	active record added to registry
revise	active / active	active record revised in registry
nullify	normal / nullify	erroneous record in registry nullified
obsolete	normal / obsolete	duplicate record in registry registry replaced by newer record

The following diagram represents these actions as state transitions of a Registration Act.

Manage Records in Registry

A more comprehensive description of registry behavior would include the ability to set records in the registry as either temporarily or permanantly inactive. Here are some possible events to describe that:

State Transition	From / To	Business Event
activate	null / active	active record added to registry
complete	active / completed	active record is inactivated
reactivate	completed / active	inactivated record is reactivated
revise	active / active	active record revised in registry
suspend	active / suspended	active record is temporarily inactivated
resume	suspended /active	temporarily inactivated reacord is made active again
complete	suspended / completed	temporarily inactivated record is made permanatly inactive
revise	suspended / suspended	temporariy inactivated record is revised	complete	complete
nullify	normal / nullify	erroneous record in registry nullified
obsolete	normal / obsolete	duplicate record in registry registry replaced by newer record

Registry with verification process

The following diagram imagines a more complex state machine for a registry.

Envision a registry that follows a two step process for adding records to the official registry. Each candidate registration must pass certain business processes such as duplicate checking or credentials verification before it is processed into the official registry. The new, held, cancelled states can represent this:

State Transition	From / To	Business Event
create	null / new	pending record is submited to registry
activate	new / active	pending record satisfied business rules and is added as an active record to the registry
hold	new / held	pending record is pulled back from vetting process for exceptional processing
release	held /new	exceptional processing completed and pending record returned to normal vetting process
cancel	new / cancelled	pending record processing is stopped because the record failed the vetting process
cancel	held / cancelled	pending record rejected during exceptional processing
revise	new / new	pending record is revised

| active | null / active | active record added to registry |- |revise | active / active | active record revised in registry |- |nullify | normal / nullify | erroneous record in registry nullified |- |obsolete | normal / obsolete | duplicate record in registry registry replaced by newer record |}