HL7 Interface Specification - Merge · HL7 messages related to HL7 Interface 1.2 are mentioned in...

HL7 Interface Specification EVMS System Release 5.30.5

85000-0818A

NOTICE – Confidentiality Statement

© 2000-2006 Emageon Inc. 1200 Corporate Drive, Suite 200, Birmingham, AL 35242 | Support: 888-EMAGEON. The information contained herein is confidential and is the sole property of Emageon Inc. None of the information may be reproduced, copied, and/ or re-distributed electronically, manually, or otherwise to any person without advance written permission from Emageon, except as may be expressly authorized by contracts or other agreements between Emageon and its customer. Emageon is a registered trademark and Enterprise Visual Medical System (EVMS) is a trademark of Emageon Inc. Other trademarks or service marks referred to herein are the property of their respective owners.

HL7 Interface Specification System Release 5.30.5

CONTENTS

1 INTRODUCTION............................................................................................................ 3 1.1 Purpose.....................................................................................................................................................3

1.2 Related Documents...............................................................................................................................3

2 IMPLEMENTATION....................................................................................................... 4

3 COMMUNICATION PROFILE ....................................................................................... 5

4 HL7 IMPLEMENTATION............................................................................................... 6 4.1 Version ......................................................................................................................................................6

4.2 Message Delimiters...............................................................................................................................6

4.3 Processing Rules ...................................................................................................................................7

4.4 Original Acknowledgement Mode .....................................................................................................8 4.4.1 Rejection Messages..............................................................................................................................9 4.4.2 Error Messages ......................................................................................................................................9

5 HL7 MESSAGES ......................................................................................................... 10 5.1 Patient Update ......................................................................................................................................11 5.1.1 ADTÂ08 — update patient information .......................................................................................11 5.1.2 ADTÂ40 — merge patient - patient identifier list .....................................................................13

5.2 Procedure Scheduled.................................................................................................................................15 5.2.1 ORMÔ01 — general order message...........................................................................................15

5.3 Procedure Update................................................................................................................................19 5.3.1 ORM Ô01 — general order message .........................................................................................19

6 UNSOLICITED OBSERVATION ................................................................................. 23 6.1 ORU^R01 ...............................................................................................................................................23

PROPRIETARY AND CONFIDENTIAL. VERIFY CORRECT DOCUMENT REVISION PRIOR TO USE. 85000-0818A of 24


1 Introduction

1.1 Purpose This document describes the HL7 Interface v. 1.2 based on the IHE Year 3 Technical Framework.

1.2 Related Documents The following documents are related to the HL7 Interface 1.2 Specification document:

• NEMA 2003, The DICOM Standard: Parts 1 – 14.

• Integrated Healthcare Enterprise (IHE) Technical Framework Year 3, revision 5.5 dated November 20, 2003. This document is available at: http://www.rsna.org/IHE.

• HL 7 Standard version 2.3.1. This document is available at: http://www.hl7.org


http://www.rsna.org/IHE

http://www.hl7.org/


2 Implementation

HL7 Interface 1.2 is implemented as a single application entity. Its main functionality is to facilitate HIS/RIS/PACS integration by converting HL7 messages to DICOM Data Sets. The interface implementation is in accordance with IHE Year 3 Technical Framework.

The HL7 Interface 1.2 handles Procedure Scheduled, Patient Update and Procedure Update IHE-defined transactions from HIS/RIS and updates the necessary Emageon products accordingly. Table 2.1 summarizes supported IHE transactions and their corresponding HL7 messages.

Table 2.1 – Supported IHE Transactions

IHE Transactions HL7 Messages

Procedure Scheduled ORMÔ01 (general order message)

Patient Update ADTÂ08 (update patient information) ADTÂ40 (merge patient - patient identifier list)

Procedure Update ORMÔ01 (general order message)

The HL7 Interface 1.2 is administered with a remote administrative application.



3 Communication Profile

HL7 v. 2.3.1 recommends Minimal Lower Layer Protocol (LLP) to provide an interface between the HL7 application and the network. Lower Layer Protocol is any protocol residing in OSI layers one to four. These protocols package, route, verify, and transmit datagrams. A prime example of one of the protocols is TCP/IP. HL7 Interface 1.2 implements TCP/IP Minimal LLP and operates in a TCP/ IP network environment.

HL7 messages should conform to the HL7 Minimal LLP block format as follows:

• HL7 message starts with 0x0B and ends with 0x1C and 0x0D.

• Each HL7 segment is terminated by 0x0D.



4 HL7 Implementation

4.1 Version HL7 Interface 1.2 supports HL7 version 2.3.1 as specified by IHE Year 3 Technical Framework.

4.2 Message Delimiters HL7 Interface 1.2 uses the delimiter values in Table 4.1 as specified by IHE Year 3 Technical Framework.

Table 4.1 – Delimiter Values

Delimiter Value

Segment Terminator <cr>

Field Separator |

Component Separator ^

Subcomponent Separator &

Repetition Separator ~

Escape Character \



4.3 Processing Rules HL7 Interface 1.2 implements Original Acknowledge Mode. Upon receiving an HL7 message, HL7 Interface 1.2 implements original acknowledgment rules as follows:

1. Accepts the message.

2. Validates it against the following criteria, in addition to Message Delimiters:

Field IHE Notes

MSH-3-sending application

Namespace ID is the only sub component used in HD data type. This field is required.

MSH-4-sending facility Namespace ID is the only sub component used in HD data type. This field is required.

MSH-5-receiving application


MSH-6-receiving facility


MSH-9-message type As defined by HL7 v2.3.1. This field is required.

MSH-10-message control ID

Unique identifier used to relate the response to the initial message. This field is required.

MSH-11-processing ID The value should be the literal P.

MSH-12-version ID The value should be the literal 2.3.1. This field is required.

If any of these fields fail, the HL7 Interface 1.2 generates a reject message with AR in MSA-1-acknowledgment code.

3. If the message passes validation, HL7 Interface 1.2 maps the message to DICOM Data Set and sends it to the necessary Emageon EVMS products. The next action of the HL7 Interface 1.2 is conditional based on one of the following scenarios:

• If mapping the message and sending a Data Set to Emageon products passes, HL7 Interface 1.2 generates a successful response with AA in MSA-1-acknowledgment code.

• If mapping the message and sending a Data Set to Emageon products fails due to error in the message content or format, HL7 Interface 1.2 generates a reject message with AR in MSA-1-acknowledgment code.

• If an unexpected error happens during this process that is not related to the message content or format (e.g., hard disk out of space), HL7 Interface 1.2 generates a reject message with AR in MSA-1-acknowledgment code.

4. HL7 Interface 1.2 sends an ACK message to the initiator.



4.4 Original Acknowledgement Mode In all responses described above, HL7 Interface 1.2 implements the following acknowledgement message grammar:

ACK General Acknowledgement HL7 v. 2.3.1 Chapter

MSH Message Header 2

MSA Message Acknowledgement 3

With the following fields value:

MSH Segment

SEQ Element Name Value

1 Field Separator |

2 Encoding Characters ^~\&

3 Sending Application MSH-5 Receiving Application from received message.

4 Sending Facility MSH-6 Receiving Facility from received message.

5 Receiving Application MSH-3 Sending Application from received message.

6 Receiving Facility MSH-4 Sending Application from received message.

7 Date/Time Of Message

Time stamp when the message is sent

9 Message Type Event: ACK Type: Message Type of the received message.

10 Message Control ID Same value from the received message.

11 Processing ID P

12 Version ID 2.3.1



MSA Segment

SEQ Element Name Item #

1 Acknowledgment Code

Possible values: AA, AE, AR

2 Message Control ID MSH-10 Message Control ID from the received message.

3 Text Message Error description, if any

4.4.1 Rejection Messages

Rejection messages usually result from an unexpected exception, so the server logs a comprehensive message detailing the reason of rejection. Due to the nature of the exception, it is inadequate to send it in the MSA-3 Text Message. Instead, a descriptive message will be sent. The interface log should be consulted for full details.

4.4.2 Error Messages

Error messages usually result from message format or context. An MSA-3 Text Message will have a detailed description of the error.




5 HL7 Messages

HL7 messages related to HL7 Interface 1.2 are mentioned in Section 4 - Implementation. This section depicts each message grammar based on IHE Year 3 Technical Framework, describes required fields and HL7 fields to DICOM data elements mapping. An ACK message is sent to the initiator upon receiving any of these messages. Since a MSH segment is common to all messages, it will not be provided in the message’s semantics. Segment fields required by IHE Year 3 Technical Framework will not be provided in this document. Since the interface required fields are a subset of IHE Year 3 Technical Framework, this document only discusses fields related to the interface. HL7 messages are grouped based on IHE Transaction naming convention.

In describing messages semantics, the following conventions are used:

• Position (sequence within the segment) - Position of the data field within the segment. In the message semantics tables this information is provided in the column labeled SEQ.

• Optionality - Whether the field is required, or optional, the designations are: R - Required. O - Optional. In the message semantics tables, this information is provided in the column labeled OPT.

• Repetition - Whether the field may repeat. The designations are: Empty - No repetition. Y - The field may repeat an indefinite (or site-determined) number of times. In the message semantics tables, this information is provided in the column labeled RP/#.

• Value - The value, which is mapped to DICOM data element, is one of the following: <number> - The number indicates the field SEQ. It means the entire field is mapped into DICOM data element. <number.number> - The first part indicated the fields SEQ and the second indicate the component within that SEQ. For example to refer to a patient last name within a patient name in the PID segment: 5.1.


5.1 Patient Update 5.1.1 ADT^A08 — update patient information

Message Grammar

ADT ADT Message HL7 v. 2.3.1 Chapter #


EVN Event Type 3

PID Patient Identification 3

PV1 Patient Visit 3

[ {OBX} ] Observation/Result 7

[ {AL1} ] Allergy Information 3



ADT^A08 Message Semantics

Segment SEQ OPT IHE/ Archive

RP/# HL7 Data Type

HL7 Element Name

DICOM Data Element (group, element) Name (VR) = Value

EVN 2 R/O TS Recorded Date/Time

3 R/R Y CX Patient Identifier List

(0010, 0020) Patient ID (LO) = 3.1 (0010, 0021) Issuer of Patient ID (LO) = 3.4 (0010, 1000) Other Patient ID (LO) = 3.1 repetition

5 R/R XPN Patient Name (0010, 0010) Patient Name (PN) = 5

6 O/O XPN Mother’s Maiden Name

(0010, 1060) Mother Birth Name (PN) = 6

7 O/O TS Date/Time of Birth (0010, 0030) Patient Birth Date (DA) = 7 (date part) (0010, 0032) Patient Birth Date (TM) = 7 (time part)

8 O/O IS Sex (0010, 0040) Patient Sex (CS) = 8

10 O/O CE Race (0010, 2160) Patient Ethnic Group (SH) = 10

11 O/O XAD Patient Address (0010, 1040) Patient Address (LO) = 11

18 R/O CX Patient Account Number

(0038, 0010) Admission ID (LO) = 18.1 (0038, 0011) Issuer of Admission ID (LO) = 18.4

26 O/O CE Citizenship (0010, 2152) Region of residence (LO) = 26

PID

27 O/O CE Veterans Military Status

(0010, 1080) Military Rank (LO) = 27

3 O/O PL Assigned Patient Location

(0038, 0300) Current Patient Location (LO) = 3

8 O/O XCN Referring Doctor (0008, 0090) Referring Physician’s Name (PN) = 8

PV1

15 O/O IS Ambulatory Status (0010, 21c0) Pregnancy Status (US) = 15, if equal to “B6”



Segment SEQ OPT RP/# HL7 HL7 DICOM Data Element IHE/ Archive

Data Type

Element Name (group, element) Name (VR) = Value

16 O/O IS VIP Indicator (0040, 3001) Confidentiality Constrain on Patient Date (LO) = 16

3 R/O CE Observation Identifier

3.2 = “Body Weight” or “Body Height”

5 R/O CE Observation Value (0010, 1030) Patient Weight (DS) = 5; if OBX:3.2 = “Body Weight” & OBX:6.2 = “kg” (0010, 2010) Patient Size (DS) = 5; If OBX:3.2 = “Body Height” & OBX:6.2 = “m”

OBX

6 R/O CE Units 6.2 =”kg” for Body Weight or “m” for Body Height

AL1 3 R/O CE Allergy Code/ Mnemonic/ Description

(0010, 2110) Contrast Allergies (LO) = 3

5.1.2 ADT^A40 — merge patient - patient identifier list

Message Grammar



EVN Event Type 3


MRG Merge Information 3

[ PV1 ] Patient Visit 3



ADT^A40 Message Semantics


RP/# HL7 Data Type

HL7 Element Name


EVN 2 R/O TS Recorded Date/Time

3 R/R Y CX Patient Identifier List (0010, 0020) Patient ID (LO) = 3.1 (0010, 0021) Issuer of Patient ID (LO) = 3.4 (0010, 1000) Other Patient ID (LO) = 3.1 repetition




7 O/O TS Date/Time of Birth (0010, 0030) Patient Birth Date (DA) = 7 (date part) (0010, 0032) Patient Birth Date (TM) = 7 (time part)

8 O/O IS Sex (0010, 0040) Patient Sex (CS) = 8






PID


(0010, 1080) Military Rank (LO) = 27

3 R/O PL Assigned Patient Location



PV1

15 O/O IS Ambulatory Status (0010, 21c0) Pregnancy Status (US) = 15, if equal to “B6”





RP/# HL7 Data Type

HL7 Element Name


1 R/R Y CX Prior Patient Identifier List (Internal)

(0010, 0020) Patient ID = 1.1 (0010, 0021) Issuer of Patient ID = 1.4

MRG

4 O/R CX Prior Patient ID (External)

(0010, 0020) Patient ID = 3.1 (0010, 0021) Issuer if Patient ID = 3.4

5.2 Procedure Scheduled 5.2.1 ORM^O01 — general order message

Message Grammar




PV1 Patient Visit 3

{

ORC Common Order 4

OBR Order Detail 4

}



ORM^O01 Message Semantics


RP/# HL7 Data Type

HL7 Element Name




6 O/O XPN Mother’s Maiden Name (0010, 1060) Mother Birth Name (PN) = 6

7 R/`R TS Date/Time of Birth (0010, 0030) Patient Birth Date (DA) = 7 (date part) (0010, 0032) Patient Birth Date (TM) = 7 (time part)

8 R/R IS Sex (0010, 0040) Patient Sex (CS) = 8



18 R/O CX Patient Account Number (0038, 0010) Admission ID (LO) = 18.1 (0038, 0011) Issuer of Admission ID (LO) = 18.4


PID

27 O/O CE Veterans Military Status (0010, 1080) Military Rank (LO) = 27

3 R/O PL Assigned Patient Location (0038, 0300) Current Patient Location (LO) = 3

PV1





Data Type


15 O/O IS Ambulatory Status (0010, 21c0) Pregnancy Status (US) = “3”, if 15 equal to “B6”


ORC 1 R/R ID Order Control = NW

4 R/O CE Universal Service ID (0032, 1064) Requested Procedure Coding Sequence (SQ): >(0008, 0100) Requested Procedure Code Value (SH) = 4.1 >(0008, 0104) Requested Procedure Code Meaning (LO)= 4.2 >(0008, 0102) Requested Procedure Coding Scheme (SH)= 4.3 (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0040, 0008) Scheduled Protocol Code Sequence >>(0008, 0100) Scheduled Procedure Code value (SH)= 4.4 >>(0008, 0104) Scheduled Procedure Code Meaning (LO) = 4.5 >>(0008, 0102) Scheduled Procedure Coding Scheme (SH)= 4.6 (0040, 0007) Scheduled Procedure Description (LO)= 4.5

OBR

15 O/O CM Specimen Source (0032, 1060) Requested Procedure Description (LO)= 4.2 + 15.5




Data Type


18 O/O ST Placer Field 1 (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0008, 0050) Accession Number (SH) = 15

19 O/O ST Placer Field 2 (0040, 1001) Requested Procedure ID (SH) = 19

20 O/O ST Filler Field 1 + (0040, 0009) Scheduled Requested Procedure ID (SH) = 20

24 O/O ID Diagnostic Serv Sect ID (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0008, 0060) Modality (CS) = 24

27 O/O TS Quantity/Timing (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0040, 0002) Scheduled Procedure Start Date (DA) = 27.4 (date part) >(0040, 0003) Scheduled Procedure Start Time (TM) = 27.4 (time part)

SCH 11 R/O TQ Appointment Timing Quantity

(0008, 0020) Appointment Start Date (DA) = 11.4 (date part) (0008, 0030) Appointment Start Time (TM) = 11.4 (time part)

ZDS 1 R/R RP Study Instance UID (0020, 000D) Study Instance UID (UI) = 1.1



5.3 Procedure Update 5.3.1 ORM ^O01 — general order message

Message Grammar




PV1 Patient Visit 3

{

ORC Common Order 4

OBR Order Detail 4

}



ORM^O01 Message Semantics


RP/# HL7 Data Type

HL7 Element Name






7 R/R TS Date/Time of Birth (0010, 0030) Patient Birth Date (DA) = 7 (date part) (0010, 0032) Patient Birth Date (TM) = 7 (time part)

8 R/R IS Sex (0010, 0040) Patient Sex (CS) = 8






PID


(0010, 1080) Military Rank (LO) = 27

3 R/O PL Assigned Patient Location



15 O/O IS Ambulatory Status (0010, 21c0) Pregnancy Status (US) = “3”, if 15 equal to “B6”

PV1





Data Type


ORC 1 R/R ID Order Control = DC, CA, XO

4 R/O CE Universal Service ID (0032, 1064) Requested Procedure Coding Sequence (SQ): >(0008, 0100) Requested Procedure Code Value (SH) = 4.1 >(0008, 0104) Requested Procedure Code Meaning (LO)= 4.2 >(0008, 0102) Requested Procedure Coding Scheme (SH)= 4.3 (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0040, 0008) Scheduled Protocol Code Sequence >>(0008, 0100) Scheduled Procedure Code value (SH)= 4.4 >>(0008, 0104) Scheduled Procedure Code Meaning (LO) = 4.5 >>(0008, 0102) Scheduled Procedure Coding Scheme (SH)= 4.6 (0040, 0007) Scheduled Procedure Description (LO)= 4.5

15 O/O CM Specimen Source (0032, 1060) Requested Procedure Description (LO)= 4.2 + 15.5

18 O/O ST Placer Field 1 (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0008, 0050) Accession Number (SH) = 15

OBR

19 O/O ST Placer Field 2 (0040, 1001) Requested Procedure ID (SH) = 19




Data Type


20 O/O ST Filler Field 1 + (0040, 0009) Scheduled Requested Procedure ID (SH) = 20

24 O/O ID Diagnostic Serv Sect ID

(0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0008, 0060) Modality (CS) = 24

27 O/O TS Quantity/Timing (0040, 0100) Scheduled Procedure Step Sequence (SQ) >(0040, 0002) Scheduled Procedure Start Date (DA) = 27.4 (date part) >(0040, 0003) Scheduled Procedure Start Time (TM) = 27.4 (time part)

ZDS 1 R/R RP Study Instance UID (0020, 000D) Study Instance UID (UI) = 1.1



6 Unsolicited Observation

The EVMS will receive Unsolicited Observation HL7 messages and convert them to DICOM Structured Reports (SR) for storage in the archive. The HL7 mappings are customizable and the SR creation strategies can handle site-specific HL7 configurations.

6.1 ORU^R01 Example Message: MSH|^~\&|IDX|SM|PACS||20050222150005||ORU^R01|7020943|P|2.3 PID|||00169853^^^CLINIC||IDE^RUSSELL^E^^^||19231229|M ORC|||2264355 OBR|||2264355|PCHEST1V^XR PORT CHEST 1 VIEW|||20050222100000||||||||||||||||||||||||WEAKNESS|09431^HOYER^ERIC^^^^ OBX|1|FT|PCHEST1V&GDT||This document is currently in Preliminary Status||||||P OBX|2|FT|PCHEST1V&GDT||ONE VIEW CHEST ||||||P OBX|3|FT|PCHEST1V&GDT|| ||||||P

NAME Associated

DICOM HL7

Standard Required Additional Notes Client HL7 Location

PID Patient ID (0010,0020) PID 3.1 yes MRN Number Issuer of Patient ID (0010,0021) PID 3.4 Other Patient ID (0010,1000) PID 4 Patient Name (0010,0010) PID 5 yes Last^First^Middle^suffix^prefix Mother's Birth Name (0010,0060) PID 6 Last^First^Middle^suffix^prefix Patient Birth Date (0010,0030) PID 7 yes YYYYMMDD Patient Birth Time (0010,0032) PID 7 hhmmss



NAME Associated

DICOM HL7

Standard Required Additional Notes Client HL7 Location

Patient Sex (0010,0040) PID 8 Patient Ethnic Group (0010,2160) PID 10 Patient Address (0010,1040) PID 11 Issuer Of Admission ID (0038,0011) PID 18.4 Admission ID (0038,0010) PID 18.1 OBR Accession Number (0080,0050) OBR 3.1 yes Requested Procedure ID (0040,1001) OBR 4.1 yes Requested Procedure Description (0008,1030) OBR 4.2 yes Requested Procedure Code Value (0008,0100) OBR 4.3 Requested Procedure Priority (0032, 000C) OBR 27.6 Content Date (0008,0023) OBR 7 yes YYYYMMDD Content Time (0008,0033) OBR 7 yes hhmmss Modality (0008,0060) OBR 24 yes Results Status (0040,A491) OBR 25 yes Partial, Complete Scheduled Procedure Start Date (0040,0002) OBR 27 yes YYYYMMDD Scheduled Procedure Start Time (0040,0003) OBR 27 yes hhmmss Reason For Study (0032,1030) OBR 31 Principal Result Interpretator (0040, A075) OBR 32 OBX Observation Value OBX 3 Observation Text OBX 5 yes Report Text


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