HSI: patient identity and medical imaging interoperability

I contributed as a Freelance Functional Analyst to the evolution of the Integrated Health Record (HSI), working on two critical ecosystem capabilities: unique patient identification through MPI and diagnostic imaging interoperability using DICOM.

My role: Freelance Functional Analyst, Lamansys · Integrated Health Record (HSI)

The problem

HSI needed to manage clinical information coming from different institutions without losing the patient's unique identity. This required handling scenarios where a person could be validated, unvalidated, federated or temporarily registered, while preventing duplicate and fragmented clinical records. In parallel, diagnostic imaging studies were generated across different hospitals and devices, requiring integration with HSI while preserving traceability between patient, study and institution.

Discovery

My work focused on understanding and translating domain rules into functional system behavior. For MPI, I analyzed different patient search, matching and identity validation scenarios, as well as the states a person could have based on responses from RENAPER and the National Patient Federation service. For imaging, I contributed to the analysis of the DICOM module and the flows required to connect HSI, through an orchestrator, with diagnostic systems used by hospitals.

Decisions and trade-offs

Model the different patient identity states
The flow needed to represent different situations according to the person's validation level. I contributed to the functional analysis of Permanent, Permanent Unvalidated, Validated and Temporary states and the rules determining system behavior in each scenario.
Prioritize identification before creating a new patient
The flow covered identity searches, exact matches, partial matches and no-match scenarios before allowing a new patient record to be created. The functional goal was to reduce duplicates and prevent a person's clinical information from becoming fragmented.
Integrate imaging studies through DICOM
I contributed to the functional analysis of the imaging module to integrate studies generated by different diagnostic modalities, such as ultrasounds and CT scans, using DICOM as the interoperability standard.
Decouple institution-specific systems through an orchestrator
The architecture included an orchestrator between HSI and the systems used by different hospitals. I contributed to analyzing these integration flows so HSI could interoperate with different diagnostic solutions without depending directly on each institution's specific implementation.

Results

My contribution helped translate complex identity and interoperability rules into functional definitions for the development team. In MPI, I worked on patient search, matching, validation and status flows associated with RENAPER and the National Patient Federation service. In imaging, I contributed to the functional definition of DICOM flows and the integration between HSI and diagnostic systems across different institutions.

Key learnings

Working on HSI strengthened my ability to operate across business, domain and technology. In HealthTech, an integration is not only about connecting systems: it requires understanding what each data point represents, how its state changes, which system is responsible for validating it and how traceability is preserved as information moves across institutions.