This is a repost of an article originally posted to the SAP Community Network.
Some Background Information A core capability of the Clinical System i.s.h.med is to manage clinical documents. Regardless of the representation and structure of the contents, clinical documents share a common set of administrative data, including crucial reference data: which patient, case, movement or service does this document belong to? One has to specify the document reference level when creating the so-called document category, and the system then ensures that a document that has to be assigned to a case can’t be created unless a case number is specified. During normal development and maintenance, most administrators tend to think of these reference levels as transitive: A case always specifies a distinct patient, a movement always uniquely identifies a case and so on. Unfortunately, that is not entirely true. It is possible to enter and process services that are assigned to a patient, but have not (yet) been assigned to a case. This might happen for example when planning services for a patient that will be readmitted in the future: The service is assigned to the patient, but nothing else. Normally, the user should only create documents and other clinical data after the admission has taken place and the case is created, but sometimes, things get mixed up. This lead to multiple documents that were created with reference to a patient and a service, but no case or movement reference, which in turn caused all kinds of subsequent problems.
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