Concept explainer
Coexisting with an existing system
Describes how Pensieve runs alongside an existing hospital system, how data flows between them, and where each one stays authoritative.
A hospital already runs on systems it can neither expose to the internet nor replace overnight. Pensieve runs alongside them. orophin, the on-site bridge, connects to the machines and software the hospital already owns, data flows both ways, and each side stays authoritative for the data it holds.
The constraint
A hospital's lab analysers, imaging archive, pharmacy software and incumbent record system sit on the internal network, and most stay unreachable from outside it. Replacing them together carries operational risk that few hospitals accept. Pensieve enters beside them: the bridge speaks the protocols those systems already use and opens one authenticated path outward, so integration adds a platform while leaving what works in place.
How data flows
Data crosses in both directions through the bridge. An inbound message from a hospital system is framed by the bridge and carried to Pensieve, which parses it, maps its codes to the platform's coding, authorises the write, records it, and writes the audit entry in the same step. An outbound instruction, such as an order to a fulfilling system or a status update, travels the reverse path: Pensieve hands it to the bridge, and the bridge delivers it to the external system. The bridge frames messages; the platform parses and decides. Imaging takes a separate path. The hospital's imaging source sends each study over its own authenticated path direct to the Pensieve imaging store, and the framed channel carries only the study reference.
Where authority sits
Each data type has one system of record, and coexistence rests on that discipline. Pensieve is authoritative for the clinical record, consent, the access decision and the audit trail; an incumbent system may stay authoritative for registration, encounters or billing. A write to a copied type travels back to its owner, so the record keeps a single source. The system of record page sets out the assignment for each data type.
Two shapes of coexistence
Pensieve holds the patient record and orders, and the hospital's lab, imaging and pharmacy systems feed it. A result produced in the laboratory system is received against its order, an imaging study is sent to the Pensieve imaging store and shown in the viewer, and a chargeable order raises its charge in Pensieve. The feeders keep their local work, and Pensieve holds the record.
A phased move
A hospital can bring functions into Pensieve one at a time. While a function stays with an external system, Pensieve holds a following copy and treats that system as authoritative. When the hospital moves the function across, Pensieve becomes the system of record and the external copy follows or retires. The staging is a sequence of connection changes rather than a single cutover.
Mapping between formats
An external system speaks its own message formats and code sets. Field mapping and terminology mapping are configured in Westron and run inside the platform, where an external system's codes are mapped to the platform's clinical coding. A code that lacks a mapping is set aside in a resolution queue for a person to map, so an unrecognised code is surfaced for a decision rather than guessed.
An outsourced lab
A clinic without its own laboratory or imaging sends the work to a partner. Where the partner runs on Pensieve too, its results and imaging sync back to the matching order and update its state. Where the partner runs on other software, the order is placed and the result is added to the record later, by upload or manual entry.
What coexistence needs
A working coexistence rests on the following.
- A bridge on the hospital network, connected to the systems it serves.
- A connection configured for each external system in Westron.
- A system of record agreed for every shared data type.
- Field and terminology mappings in place for each connection.
Read the integration anti-patterns before wiring a connection.