Reference table
System of record
Sets out which system holds the authoritative copy of each data type when Pensieve runs alongside other hospital systems.
When Pensieve runs alongside a hospital's existing systems, each kind of data has one authoritative holder, called its system of record. This page sets out which system holds the authoritative copy of each data type, and how the other side keeps its copy in step.
A system of record is the one system that holds the authoritative copy of a data type. Every other system holds a copy that follows it.
One authoritative copy
A data type resolves to one system of record. Two systems each treating the same type as authoritative would let their copies drift apart unchecked; naming one holder keeps a single truth that the other follows. A write to a copied type travels back to the system of record, so the authoritative copy stays the source.
A single source per type
Each data type has one system of record. The other system holds a following copy, and a change to that copy flows back to the authoritative holder, so the two stay in step.
Shared functions
For the functions a hospital may run in either platform, the system of record is chosen when the connection is set up. The table below shows the common assignment.
| Data type | System of record | How the other system holds it |
|---|---|---|
| Patient demographics and identifiers | The system that runs registration | Receives updated demographics as they change |
| Encounters and visits | The system that runs admissions | Notified as a visit opens, moves and closes |
| Orders | The system where the clinician places the order | The fulfilling system receives the order and returns status |
| Lab results | The laboratory system that produces the result | The patient record holds the received, verified result against its order |
| Imaging studies | Pensieve, in the imaging store, once the study is received | The imaging source performs the study and sends it in. An archive the hospital keeps holds its own copy under the hospital's own retention |
| Charges and invoices | The system that runs billing | Receives charge events as chargeable work is recorded |
Imaging is the one shared function whose holder is not negotiated. Pensieve holds the bytes as well as the reference. The hospital's imaging source sends each study over its own authenticated path to the Pensieve imaging store, and the framed message channel carries only the study reference. The study the image study viewer reads, the study retention governs and the study an export delivers are all the copy Pensieve holds. Where a site keeps its own archive, that archive holds its own copy under the hospital's own retention, and Pensieve neither reads from it nor writes to it.
Data Pensieve holds
For the platform's own concerns, Pensieve is authoritative in every deployment. The record tool, Atlas, holds a patient's clinical record, and the imaging store holds the study pixels beside it. Only the platform decides access and writes the audit entry with each change. The hospital model lives in Nexus Manager.
| Data type | System of record | How a connected system sees it |
|---|---|---|
| The patient clinical record | Pensieve, in Atlas | An external record system receives the extracts a directive permits |
| Consent and directives | Pensieve | A connected system receives only what a directive permits |
| Access decisions and the access log | Pensieve | Held within Pensieve |
| The audit trail | Pensieve | Held within Pensieve |
| The hospital model | Pensieve, in Nexus Manager | An external directory can supply staff identities |
Assigning the record
The authoritative holder for a shared function other than imaging is agreed when a connection is configured in Westron. Gate holds a visit that Pensieve admits, Forge holds an order placed in Pensieve, and Vault holds a charge raised in Pensieve. Where an incumbent system keeps one of these functions, Pensieve receives its data and holds a following copy.
Common confusions
Can two systems both own patient demographics?
One system is named the system of record for demographics, and the other holds a following copy that updates as demographics change.
Where does a lab result's authority sit?
The laboratory system produces and owns the raw result. The patient record holds the received, verified copy tied to its order, so a clinician reads it beside the rest of the record.
Which system owns an imaging study?
Pensieve holds the images. The imaging source sends each study to the Pensieve imaging store, the image study viewer reads it from there, and an export delivers it as DICOM. Any copy the hospital keeps in its own archive is governed by the hospital, not by Pensieve.
Read how Pensieve runs alongside an existing system in coexisting with an existing system.