ACK Response Messages

ACK Response MessagesHL7 User Group Meeting

8/13/2015

Agenda

• Quick Review of the CDC IG Release 1.5 ACK Message

• Read actual ACK messages from IIS

• Provide a summary of current ACK analysis

The ACK per CDC IGSegments

The ACK per CDC IG – Cont’dMSA Segment

The ACK per CDC IG – Cont’dERR Segment

The ACK per CDC IG – Cont’dIn Summary

• MSA – Required (1..1)• Field 1 – R – (Ack Code - AA, AE, AR)• Field 2 – R – (ID from EHR-submitted MSH)• Field 3 – X – (Textual Message)

• ERR – RE (0..*)• Field 1 – X – (Error Code and Location)• Field 2 – RE – (Error Location in Submitted Message)• Field 3 – R – (HL7 Error Code – Table 0357)• Field 4 – R – (Severity of Error – I, W, E)• Field 5 – RE – (Application Error Code – SISC defined this table)• Field 6 – O – (Application Error Parameter – Not defined in CDC IG)• Field 7 – O – (Diagnostic Information – Not defined in CDC IG)• Field 8 – RE – (User Message – Locally specified informative text)

Key Coded Values in an ACK

• MSA-1 Acknowledgement Code• AA – Application Accept

• Message was accepted without error.• AE – Application Error

• Message was processed and errors are being reported.• AE is sent whenever an error is detected.

This may range from data that are ignored because they are not wanted to rejection of the entire message.

• AR – Application Reject• Message was rejected because one of the

following occurred: • Unsupported message type• Unsupported event code• Unsupported processing ID• Unable to process for reasons unrelated to

format or content

• ERR-4 Severity• I – Information

• Transaction successful, but includes returned information.

• W – Warning• Transaction successful, but there may be

issues. These may include non-fatal errors with potential for loss of data.

• E – Error• Transaction was not successful. The

application rejected data that it views as important. This could include required fields or the entire message. The sender should be alerted to review and correct the message.

AIRA Interop Testing ProjectACK Analysis

• Two messages were submitted to 20 IIS participating in the AIRA Interop Testing Project.

• AIRA first submitted a message which was accepted by the IIS.• Simple, clean message• 3 Immunizations

• Then AIRA removed data from one field and resubmitted.• Same Simple message, one field changed from populated to empty.

Our Job Today

• Pretend we are the EHR processing the ACK returned by the IIS

• For Each ACK Example, Ask yourself• What was wrong with the incoming message? • Did the IIS accept the message?• What MSA and ERR fields did you use to determine that?• Does the IIS expect the EHR to correct/resubmit?

The ACKsExample 1 of 9

MSH|^~\&||System C|TEST||20150715183728||ACK^V04^ACK_V04|7802135|P|2.5.1|||||||||

MSA|AA|2778764-I.02.05504.4872|Message had been sent to queue for updates.

Field CDC IG Standard IIS Actual

MSA-1 Required – AA, AE, or AR AA – Application Accept

MSA-3 X – Not Supported Message had been sent to queue for updates.

ERR RE No ERR Segment

• What was wrong with the incoming message?

• Was it accepted?

• What fields did you use to determine that?

• Does the IIS expect the EHR to correct/resubmit?


MSH|^~\&|^^|^^|^^|^^|20150715200933||ACK^|6616739034.100006979|P|2.5.1|

MSA|AA|6164186-I.02.05504.8715|Patient 6164186-I.02.05504 "Pembroke Madison" with 3 vaccinations accepted into vaccination staging table


MSA-1 Required – AA, AE, or AR AA – Application Accept

MSA-3 X – Not Supported Patient 6164186-I.02.05504 "Pembroke Madison" with 3 vaccinations accepted into vaccination staging table







MSH|^~\&||||XX-XXXXXX|20150723102057||ACK^V04^ACK|20150723102057|P|2.5.1

MSA|AE|4765640-I.02.05504.7451|message failed validation


MSA-1 Required – AA, AE, or AR AE

MSA-3 X – Not Supported message failed validation







MSH|^~\&|System A||||20150722142244||ACK^V04^ACK|2671551-I.02.05504.3847a|P|2.5.1|

MSA|AA|2671551-I.02.05504.3847a|

ERR|^^^1&WARNING: Missing Vaccine ID AND Text. One of these values is required. (RXA-5.1 and RXA-5.2 in HL7). Value: ID='null'. Text='null'. Coding System='null'~^^^2&WARNING: Unknown patient primary language (PID-15 in HL7). Value='eng'~^^^3&WARNING: Unknown Administered Code/Vaccine Type (RXA-5 in HL7). Value=''.|


MSA-1 Required – AA, AE, or AR AA

ERR-1 X – Not Supported ^^^1&WARNING: Missing Vaccine ID AND Text. One of these values is required. (RXA-5.1 and RXA-5.2 in HL7). Value: ID='null'. Text='null'. Coding System='null'~^^^2&WARNING: Unknown patient primary language (PID-15 in HL7). Value='eng'~^^^3&WARNING: Unknown Administered Code/Vaccine Type (RXA-5 in HL7). Value=''.

ERR-2 RE – Error Location <Empty>

ERR-3 R – HL7 Error Code <Empty>

ERR-4 R – Severity of Error <Empty>

ERR-5 RE – Application Error Code <Empty>

ERR-8 RE – User Message <Empty>






MSH|^~\&|SYSTEM D|SYSTEM D||AIRA|20150722174737||ACK|2312702-I.02.05504.6800|P|2.5.1

MSA|AA|2312702-I.02.05504.6800|Error Code - 026: Record Rejected. You must supply at least ONE immunization identifying code

ERR||RXA^1^5|101^Required field missing^HL70357



MSA-3 X – Not Supported Error Code - 026: Record Rejected. You must supply at least ONE immunization identifying code

ERR-1 X – Not Supported <Empty>

ERR-2 RE – Error Location RXA^1^5

ERR-3 R – HL7 Error Code 101^Required field missing^HL70357









MSH|^~\&|SYSTEM G|SYSTEM G||DEFAULT2|20150722163628.296||ACK|2788163-I.02.05504.3006|P|2.5.1

MSA|AA|2788163-I.02.05504.3006|WARNING: No client financial class values specified. PV1 segment ignored.

ERR||PV1^1^20|102^Data type error^HL70357

MSA|AA|2788163-I.02.05504.3006|WARNING: Inaccurate or missing observation value. No value stored.

ERR||OBX^2^3^0|204^Unknown key identifier^HL70357

… <cut for brevity> …

MSA|AA|2788163-I.02.05504.3006|Error: Record Rejected. You must supply at least ONE immunization identifying code.

ERR||RXA^1^5|101^Required field missing^HL70357

MSA|AA|2788163-I.02.05504.3006|WARNING: No insurance verification date sent for new administered immunization. Please verify insurance.

ERR|||^^HL70357

MSA|AA|2788163-I.02.05504.3006|DED_INV_FUNDING_SRC_EMPTY

ERR|||^^HL70357


MSA Segment is Required, but only 1 10 MSAs (Below is MSA and ERR of Interest)


MSA-3 X – Not Supported Error: Record Rejected. You must supply at least ONE immunization identifying code.












MSH|^~\&||||NIST|20150730121603||ACK^V04^ACK|20150730KS0000074624|P|2.5.1|||||||||||9999

MSA|AE|6638200I.02.05504.68

ERR||Rxa^0^5^1|101^Required field missing^HL70357|W|||RXA-5 (AdministeredCode) : Missing required value.|RXA-5 (AdministeredCode) : Missing required value.




ERR-2 RE – Error Location RXA^0^1^5


ERR-4 R – Severity of Error W


ERR-7 O – Diagnostic Information RXA-5 (AdministeredCode) : Missing required value.

ERR-8 RE – User Message RXA-5 (AdministeredCode) : Missing required value.






MSH|^~\&|SYSTEM F|SYSTEM F||ATEST|20150722020716.727||ACK|5129720-I.02.05504.846|P|2.5.1

MSA|AE|5129720-I.02.05504.846

ERR||RXA^1^5|101^Required field missing^HL70357|E||||Record rejected. You must supply at least ONE immunization identifying code






ERR-4 R – Severity of Error E


ERR-8 RE – User Message Record rejected. You must supply at least ONE immunization identifying code






MSH|^~\&|SYSTEM I|SYSTEM I||RI88150325|20150722045601||ACK^V04^ACK|7009322-I.02.05504.7354|P|2.5.1|||NE|AL|

MSA|AE|7009322-I.02.05504.7354|

ERR||RXA^1^5^1^1|101^REQUIRED FIELD MISSING^HL70357|E|7^REQUIRED DATA MISSING^HL70533|||RXA-5 ADMINISTRATION CODE IS MISSING|




ERR-2 RE – Error Location RXA^1^5^1^1

ERR-3 R – HL7 Error Code 101^REQUIRED FIELD MISSING^HL70357

ERR-4 R – Severity of Error E

ERR-5 RE – Application Error Code 7^REQUIRED DATA MISSING^HL70533

ERR-8 RE – User Message RXA-5 ADMINISTRATION CODE IS MISSING





Current Analysis (RXA-5 Empty) – MSA Segment20 IISMSA Segment Missing 1 MSA MultipleR (1..1) 0 17 3

MSA-1 AA AE ARR - Ack Code 9 6 5MSA-3 Valued EmptyX - Textual Message 11 9

Current Analysis (RXA-5 Empty) – ERR Segment20 IIS

ERR Segment Yes NoRE (0..*) 12 8

ERR-1 Valued EmptyX - Err Code & Loc. 2 10ERR-2 Empty RXA^0^5^1 RXA^5^1 RXA^1^5 RXA^1^5^1^1RE - Error Location 2 1 1 6 2ERR-3 Empty 101 102R - HL7 Error Code 2 9 1ERR-4 Empty I W ER - Severity 7 0 1 4ERR-5 Empty Valued - No Code 4 7RE - App Error Code 9 1 1 1ERR-6 Empty ValuedO - App Error Param 12 0ERR-7 Empty ValuedO - Diagnostic Info 11 1ERR-8 Empty ValuedRE - User Message 6 6

Current Analysis – Key ACK Fields by IIS20 IIS

Key ACK Fields Used by IIS Number of IIS Conforms to CDC IG

MSA-1; MSA-3 5- NO -

Uses MSA-3

MSA-1; ERR-1 2

- NO - Uses ERR-1;

Missing ERR-3 and ERR-4

MSA-1; ERR-2; ERR-3 1- NO -

Missing ERR-4

MSA-1; MSA-3; ERR-2; ERR-3 4

- NO - Uses MSA-3;

Missing ERR-4

MSA-1; MSA-3; MSA-6 2- NO -

Uses MSA-3 and MSA-6MSA-1 1 - Yes -

MSA-1; ERR-2; ERR-3; ERR-4 2 - Yes -MSA-1; ERR-2; ERR-3; ERR-4; ERR-5 3 - Yes -

Current Analysis – Structurally Conformant IIS6 IIS

MSA-1 ERR-2 ERR-3 ERR-4 ERR-5System 1 AE RXA^0^5^1 101 W EmptySystem 2 AR RXA^1^5^1^1 101 E Valued - No CodeSystem 3 AE RXA^5^1 102 E 4System 4 AE RXA^1^5 101 E EmptySystem 5 AE RXA^1^5^1^1 101 E 7System 6 AE

National IG• Current Processing Rules (Table 3-1) Needs more freedom for receiving systems

• Currently all Required fields are treated with equal importance • PID-1 (HL7 Set ID) and PID-7 (Date of Birth) are both equally important.

• The ACK has some ambiguities in the description• The word “Error” when written in various sections can mean several different things

• ERR Segment• Application Error (AE) in MSA-1• Error (E) Severity in ERR-4• The general English term error unrelated to HL7 Specifics

• What does “raise an error” really mean?

• The ACK has some limitations• In the example used today, The best ACKs noted that RXA-5 was missing.

• What about the rest of the RXA?• What about the entire Order Group? • What about the two good immunization in the message?

• AA, AE, AR and I, W, E have a limited set of combinations and sometimes make it difficult to discern what really occurred during processing.

Next Steps

• IIS• Come up to release 1.5

• 1 and only 1 MSA Segment per ACK• Stop using MSA-3 and ERR-1• Always use ERR-3 and ERR-4 when sending an ERR Segment

• AIRA• Work with SISC to develop best practice guidance on ACKs which meets 1.5

conformance

ACK Response Messages

Health & Medicine

Transcript of ACK Response Messages