ADT Feed and middleware

ADT lists are challenging to maintain.  I would recommend using the account number as patient identifier whenever possible as this does assist with posting the result to the correct encounter.  Partnering with the EMR team to encode the account number in barcode labels (inpatient and ambulatory) assists with using correct identifier as the account numbers are difficult to find  and manually enter into a POCT device.  You could also work with your middleware vendor to make rules to manage ADT - eg. setting auto discharge times based on patient class.

We spent a lot of time/meetings on this in the past 6 months after converting over to Telcor/QML and Epic.
We engaged the ADT team, registration and Telcor to help us clean up what was coming in and how patients were being discharged.
Telcor gave is a summary list of all the patients in the ADT database by patient class.  Then we had to determine what each class represented and if it was a inpatient or outpatient class type... and determine how they were being discharged or like you said, blocked from being added altogether.

class examples:
code:     class               type
IP  = Inpatient            Inpatient        ADT feed sends discharge message
RAD = Radiology     Outpatient       auto discharged after 24 hours


Many patient classes ended up getting automatic default discharge dates added to them.

Due to registration errors and miscellaneous it is still acknowledged that the ADT list in QML will still have to be cleaned up periodically, annually?  every 2 years?