Merging and Unmerging Records: merge and unmerge

Overview

We use a hybrid merge strategy that combines elements of both the golden record and survivor record approaches:

• You have to select one of the existing records as the survivor.
• You can optionally edit its data using fields from the other records before completing the merge.

Currently, only manual merging is supported. However, the system is designed to support automatic merging in the future.

The unmerge operation allows reversing a previous merge by restoring the original source record and its relationships based on audit data, ensuring no permanent data loss if a merge was done by mistake.

This page provides key information about using $merge and $unmerge . For full API details, refer to our Swagger documentation .

Merge Operation

$merge

The merge operation can be initiated either through the MPI user interface or by using the API.

To perform it via the API, send the $merge request, for example:

POST /fhir/Patient/$merge
Content-Type: application/json

{
  "targetPatient": {
    "reference": "Patient/0"
  },
  "sourcePatient": {
    "reference": "Patient/3"
  },
  "resultPatient": {
    "name": [
        {
            "given": ["Robert"],
            "family": "Alan"
        }
    ]
  }
}

Where:

• targetPatient – the patient record selected as the survivor. After the merge, this record remains active and contains the resulting data.
• sourcePatient – the patient record being merged into the survivor. After the merge, this record will be removed.
• resultPatient – optional. Provides updated data for the survivor (for example, if you want to correct a name, address, or any other field during the merge). If omitted, the survivor record remains unchanged, except for linked resources and identifiers that are merged automatically.

The response returns a merge-id used for audit and tracking:

{
  "merge-id": "b71dc614-7a1c-44b8-a727-027cbee3466a"
}

How Merging Works

When a merge request is processed, the system performs several steps to ensure data consistency and auditability:

1. 1.
   Verifies the match weight exists
2. 2.
   All related resources are found and updated
3. 3.
   A merge record is created with status and match weight
4. 4.
   All changes are logged for audit purposes
5. 5.
   The target patient is updated with merged data
6. 6.
   The source patient is deleted
7. 7.
   The merge ID is returned to the client

The diagram below shows the full process flow:

sequenceDiagram
    participant Client
    participant MPI as MPI Service
    participant DB as Database
    participant MPIDB as MPI DB

    Client->>MPI: merge-patient(source, target, result)
    MPI->>DB: find-match-weight(source, target)
    alt No match weight found
        MPI-->>Client: Error: No match weight
    else Match weight exists
        MPI->>DB: find-resources-by-patient-id(source)
        Note over MPI,DB: Find all related resources<br/>(Encounters, Specimens, etc.)
        
        MPI->>MPIDB: create patient_merge record
        Note over MPI,DB: Generate merge_id<br/>Set status=COMPLETED<br/>Store match_weight
        
        loop For each related resource
            MPI->>MPIDB: log resource update
            MPI->>DB: update resource patient reference
        end
        
        MPI->>MPIDB: log target patient update
        MPI->>MPIDB: log source patient deletion
        
        MPI->>DB: update target patient
        Note over MPI,DB: Update with merged identifiers<br/>and result resource
        
        MPI->>DB: delete source patient
        MPI->>DB: delete non-duplicate record
        
        MPI-->>Client: Return merge_id
    end

Unmerge Operation

If a merge was performed incorrectly, it can be reversed using the unmerge operation.

This operation restores the original source patient and re‑links all related resources based on audit information collected during the merge.

If any linked resources were created after the merge, the operation also provides a way to manually reassign them to the appropriate patient.

$unmerge-preview/{id}

Before performing an unmerge, you should preview what will be changed using the Unmerge Review endpoint. This endpoint returns a list of encounters created after the merge, which may need to be manually reassigned during the unmerge process.

To get the list of after-merge linked resources via API, send the $unmerge-preview request, for example:

POST /fhir/Patient/$unmerge_preview/1
Content-Type: application/json

Where 1 is the merge ID returned by the $merge operation you want to undo.

Example response:

{
  "target-id": "patient-123",
  "source-id": "patient-456",
  "new-encounters": [
    {
      "id": "encounter-789",
      "resource": {
        "resourceType": "Encounter",
        "status": "finished",
        "class": {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "AMB",
          "display": "ambulatory"
        }
      }
    }
  ]
}

Where:

• target-id – the patient ID of the survivor record after the merge.
• source-id – the patient ID of the merged (source) record that will be restored.
• new-encounters – list of encounters created after the merge that may need to be manually reassigned when performing an unmerge.

$unmerge

As well as the merge operation, the unmerge operation can be initiated either through the MPI user interface or by using the API.

To perform the unmerge via the API, send the $unmerge request, for example:

POST /fhir/Patient/$unmerge
Content-Type: application/json

{
  "merge-id": "1",
  "encounters-and-patient-ids": [
    {
      "patient-id": "patient-456",
      "encounter-ids": [
        "encounter-123"
      ]
    }
  ]
}

Where:

• merge-id – the unique identifier of the merge operation to be reversed.
• encounters-and-patient-ids – optional mapping of encounters created after the merge that need to be manually reassigned:
  • patient-id – the patient to whom encounters should be linked after the unmerge.
  • encounter-ids – list of encounters that should be re‑linked to this patient.
    This ensures that any encounters created post‑merge are correctly redirected when restoring the original patient records. You can get the list of post-merge encounters via $unmerge-preview/{id} request.

How Unmerging Works

Processing an unmerge request follows a specific workflow designed to safely restore previously merged data:

1. 1.
   The system retrieves the original merge logs
2. 2.
   Source and target patient information is extracted
3. 3.
   Encounters are grouped by patient ID
4. 4.
   Resources that need to be reverted are identified
5. 5.
   Patient references are updated for selected encounters and other linked resources
6. 6.
   Original resources are restored from merge logs
7. 7.
   The merge record is removed
8. 8.
   Patients are marked as non-duplicates
9. 9.
   The operation is completed

The diagram below shows the full process flow:

sequenceDiagram
    participant Client
    participant MPI as MPI Service
    participant DB as Database
    participant MPIDB as MPI DB

    Client->>MPI: unmerge(merge_id, encounters_and_patient_ids)
    MPI->>MPIDB: find-merge-log(merge_id)
    Note over MPI,MPIDB: Get source and target patient logs
    
    MPI->>MPIDB: get-source-and-target-logs(merge_logs)
    MPI->>MPIDB: group-by-patient-id(encounters_and_patient_ids)
    Note over MPI,MPIDB: Group encounters by patient ID
    
    MPI->>MPIDB: get-resources-logs-to-revert(merge_logs)
    Note over MPI,MPIDB: Get all resources that need to be reverted
    
    MPI->>DB: update-encounters-and-related-resources
    Note over MPI,DB: Update patient references<br/>for selected encounters
    
    MPI->>DB: revert-old-resources
    Note over MPI,DB: Restore original resources<br/>from merge logs
    
    MPI->>MPIDB: remove-merge(merge_id)
    Note over MPI,MPIDB: Delete merge record
    
    MPI->>MPIDB: mark-as-non-duplicate
    Note over MPI,MPIDB: Prevent future matches<br/>between these patients
    
    MPI-->>Client: Unmerge completed