Admission‐Discharge‐Transfer Notifications Implementation ... · ADT events; the HL7 ADT message type is used to send or receive patient demographic and/or healthcare encounter

For information visit www.mihin.org or contact http://mihin.org/requesthelp/ Copyright 2016 Michigan Health Information Network Shared Services

MichiganHealthInformationNetwork

Admission‐Discharge‐TransferNotificationsImplementationGuideforHL7Messages

Version8

July6,2016


DocumentHistory

Date VersionSection(s)Revised Description Modifier

07/05/13 0.1 All Draftversion0.1 07/12/13 0.2 All Draftversion0.2 07/29/13 0.3 All Draftversion0.3 09/13/13 0.4 All Draftversion0.4 10/05/13 0.5 All Draftversion0.5 10/16/13 0.6 All Draftversion0.6 02/18/14 1.0 All Version1.0 04/10/14 2.0 All Version2.0 06/12/14 2.01 All ChangedDOCandSS#

descriptions

06/17/14 2.1 All ChangedIN1REtoR 06/25/14 2.2 All AddedUseCaseReminder 07/24/15 2.3 All Addedonboardingsection 11/06/15 3 All Addedmappingtables,

conformancerequirements

03/22/16 4 All Review,editcontent D.Livesay04/18/16 5 All Editofthedocument S.Southard05/20/16 6 Section1.2 AddedMessageContent S.Southard06/30/16 7 All Newtemplate,definitionsadded S.Southard07/06/16 8 All Formattingwork S.Southard


TableofContents

AcronymsandAbbreviationsGuide.................................................................................................................1

Definitions...................................................................................................................................................................2

1Introduction............................................................................................................................................................6 1.1PurposeofUseCase.....................................................................................................................................6 1.2MessageContent...........................................................................................................................................7 1.3DataFlowandActors..................................................................................................................................7

2Onboarding..............................................................................................................................................................9 2.1Prerequisites...................................................................................................................................................9 2.1.1UniversalLegalPrerequisites.........................................................................................................9 2.1.2ADTReceiverUseCasePrerequisites.........................................................................................9 2.1.3ADTNotificationDiagram.............................................................................................................10

2.2SendingADTNotifications.....................................................................................................................10 2.2.1ADTSenderOnboardingProcess...............................................................................................11

2.3ReceivingADTNotifications.................................................................................................................12 2.3.1ADTReceiverOnboardingProcess............................................................................................12 2.3.2MiHINAppendedZ‐Segments......................................................................................................13

3Specifications.......................................................................................................................................................14 3.1SendingOrganizationRequirements................................................................................................14 3.1.1SegmentRequirementsforSendingOrganization.............................................................14 3.1.2SegmentUsageRequirementsforSendingOrganization................................................14 3.1.3FieldandSubfieldRequirementsforSendingOrganization..........................................15 3.1.4MappingTables..................................................................................................................................15 3.1.5ConformanceReporting.................................................................................................................16

3.2ReceivingOrganizationRequirements.............................................................................................17 3.2.1SegmentRequirementsforReceivingOrganization..........................................................17 3.2.2SegmentUsageRequirementsforReceivingOrganization............................................17 3.2.3FieldandSubfieldRequirementsforReceivingOrganization.......................................17 3.2.4AcknowledgmentMessageRequirementsforReceivingOrganization.....................18

4StaticDefinition–MessageLevel...............................................................................................................19 4.1ADT(PatientAdministration)Message–TriggerEventsA01,A04,A05,A08,A13,A14,A28,A31.....................................................................................................................................................19 4.2ADT(PatientAdministration)Message–TriggerEventsA02,A21,A22,A23,A25,A26,A27,A29,A32,A33................................................................................................................................20 4.3ADT(PatientAdministration)Message–TriggerEventA03................................................21 4.4ADT(PatientAdministration)Message–TriggerEventsA06,A07....................................22 4.5ADT(PatientAdministration)Message–TriggerEventsA09,A10,A11,A15...............23 4.6ADT(PatientAdministration)Message–TriggerEventA12................................................23 4.7ADT(PatientAdministration)Message–TriggerEventA17................................................24 4.8ADT(PatientAdministration)Message–TriggerEventA20................................................24


4.9ADT(PatientAdministration)Message–TriggerEventsA24,A37....................................25 4.10ACK(Acknowledgment)Message....................................................................................................25

5StaticDefinition–SegmentLevel...............................................................................................................26 5.1MSH(MessageHeader)Segment........................................................................................................26 5.2SFT(Software)Segment.........................................................................................................................27 5.3EVN(EventType)Segment...................................................................................................................27 5.4PID(PatientIdentification)Segment................................................................................................28 5.5PD1(AdditionalDemographics)Segment......................................................................................29 5.6PV1(PatientVisit)Segment..................................................................................................................30 5.7OBX(Observation/Result)Segment...............................................................................................32 5.8DG1(DiagnosisInformation)Segment............................................................................................33 5.9PR1(Procedures)Segment...................................................................................................................34 5.10IN1(Insurance)Segment....................................................................................................................35 5.11NPU(Non‐PatientUpdate)Segment..............................................................................................37 5.12MSA(MessageAcknowledgment)Segment................................................................................37 5.13ERR(Error)Segment............................................................................................................................37

6StaticDefinition–FieldLevel.......................................................................................................................39 6.1MSH(MessageHeader)SegmentFields..........................................................................................39 6.2SFT(Software)SegmentFields...........................................................................................................42 6.3EVN(EventType)SegmentFields.....................................................................................................43 6.5PD1(AdditionalDemographics)SegmentFields........................................................................49 6.6PV1(PatientVisit)SegmentFields....................................................................................................50 6.7OBX(Observation/Result)SegmentFields..................................................................................54 6.8DG1(DiagnosisInformation)SegmentFields...............................................................................55 6.9PR1(Procedures)SegmentFields......................................................................................................56 6.10IN1(Insurance)SegmentFields.......................................................................................................59 6.11NPU(Non‐PatientUpdate)SegmentFields.................................................................................61 6.12MSA(MessageAcknowledgment)SegmentFields...................................................................62 6.13ERR(Error)SegmentFields...............................................................................................................62

7HL7VocabularyTables...................................................................................................................................65 Table0001:Sex..................................................................................................................................................65 Table0003:EventType.................................................................................................................................65 Table0004:PatientClass..............................................................................................................................66 Table0005:Race...............................................................................................................................................66 Table0007:AdmissionType.......................................................................................................................66 Table0008:AcknowledgmentCode.........................................................................................................67 Table0010:PhysicianID...............................................................................................................................67 Table0018:PatientType...............................................................................................................................67 Table0023:AdmitSource.............................................................................................................................67 Table0051:DiagnosisCode.........................................................................................................................68 Table0052:DiagnosisType.........................................................................................................................68 Table0053:DiagnosisCodingMethod....................................................................................................68 Table0069:HospitalService.......................................................................................................................68 Table0072:InsurancePlanID....................................................................................................................68


Table0076:MessageType............................................................................................................................68 Table0085:ObservationResultStatusCodesInterpretation.......................................................69 Table0088:ProcedureCode........................................................................................................................69 Table0089:ProcedureCodingMethod...................................................................................................69 Table0104:VersionID...................................................................................................................................70 Table0112:DischargeDisposition...........................................................................................................70 Table0113:DischargedtoLocation.........................................................................................................71 Table0116:BedStatus...................................................................................................................................71 Table0125:ValueType..................................................................................................................................71 Table0136:Yes/NoIndicator.....................................................................................................................71 Table0189:EthnicGroup..............................................................................................................................71 Table0302:PointofCare..............................................................................................................................71 Table0303:Room.............................................................................................................................................72 Table0304:Bed.................................................................................................................................................72 Table0305:PersonLocationType............................................................................................................72 Table0306:LocationStatus.........................................................................................................................72 Table0307:Building.......................................................................................................................................72 Table0308:Floor..............................................................................................................................................72 Table0357:MessageErrorStatusCodes...............................................................................................72 Table0361:Application.................................................................................................................................73 Table0362:Facility..........................................................................................................................................73 Table0516:ErrorSeverity...........................................................................................................................73

8Troubleshooting.................................................................................................................................................74 8.1ProductionSupport..................................................................................................................................74

9LegalAdvisoryLanguage...............................................................................................................................75


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AcronymsandAbbreviationsGuide

API ApplicationProgrammingInterface

CCD ContinuityofCareDocument

CDA ClinicalDocumentArchitecture

CEHRT CertifiedElectronicHealthRecordTechnology

CHAMPS CommunityHealthAutomatedMedicaidProcessingSystem

CMS CentersforMedicare&MedicaidServices

DQA DataQualityAssurance

DSM DirectSecureMessaging

EHR ElectronicHealthRecord

EHR‐MIPP ElectronicHealthRecordMedicaidIncentivePaymentProgram

HL7 HealthLevelSevenHPD HealthProvider

DirectoryISO International

OrganizationforStandardization

MDHHS MichiganDepartmentofHealthandHumanServices

MIDIGATE MedicalInformationDirectGateway

MiHIN MichiganHealthInformationNetworkSharedServices

MU MeaningfulUse

PO ParticipatingOrganization

RAS RegistrationandAttestationSystem

REST RepresentationalStateTransfer

SOM StateofMichiganVPN VirtualPrivate

NetworkXML ExtendedMark‐Up

Language

For information visit www.mihin.org or contact http://mihin.org/requesthelp/

Copyright 2016 Michigan Health Information Network Shared Services - Page 2 -

DefinitionsActiveCareRelationship.(a)Forhealthproviders,apatientwhohasbeenseenbya

providerwithinthepast24months,orisconsideredpartofthehealthprovider’sactivepatientpopulationtheyareresponsibleformanaging,unlessnoticeofterminationofthattreatmentrelationshiphasbeenprovidedtoHIN;(b)forpayers,aneligiblememberofahealthplan;(c)anactiverelationshipbetweenapatientandcaremanagerorotherpersonororganizationforthepurposeoftreatment,paymentoroperations;or(d)arelationshipwithahealthproviderassertedbyaconsumerandapprovedbysuchhealthprovider.

Admission,Discharge,Transfer(ADT).Aneventthatoccurswhenapatientisadmittedto,dischargedfromortransferredfromonecaresettingtoanothercaresettingortothepatient’shome.Forexample,anADTeventoccurswhenapatientisdischargedfromahospitalandsenthome.AnADTeventalsooccurswhenapatientarrivesincaresettingsuchasahealthclinicorhospital.

ADTMessage.AtypeofHL7messagegeneratedbyhealthcaresystemsbaseduponADTevents;theHL7ADTmessagetypeisusedtosendorreceivepatientdemographicand/orhealthcareencounterinformation,generatedfromsourcesystem(s).TheHL7ADTmessagescontainpatientdemographic,visit,insuranceanddiagnosisinformation.

ADTNotification.AnelectronicnotificationthatagivenpatienthasundergoneanADTevent.

ApplicableLawsandStandards.InadditiontothedefinitionsetforthintheDataSharingAgreement,thefederalConfidentialityofAlcoholandDrugAbusePatientRecordsstatute,section543ofthePublicHealthServiceAct,42U.S.C.290dd‐2,anditsimplementingregulation,42CFRPart2;theMichiganMentalHealthCode,atMCLA§§333.1748and333.1748a;andtheMichiganPublicHealthCode,atMCL§333.5131,5114a.

Caregiver.Anindividualsuchasahealthprofessionalorsocialworkerwhoassistsintheidentification,preventionortreatmentofanillnessordisability.

DataSharingAgreement.AnydatasharingorganizationagreementsignedbybothHINandparticipatingorganization

ElectronicMedicalRecordorElectronicHealthRecord.Adigitalversionofapatient'spapermedicalchart.

EndPoint.AninstanceofanelectronicaddressorESI.

Exhibit.Ausecaseexhibitorapilotactivityexhibit.

HealthLevel7(HL7).AninterfacestandardandspecificationsforclinicalandadministrativehealthcaredatadevelopedbytheAmericanNationalStandardsInstitute.HL7providesamethodfordisparatesystemstosendandreceiveclinical



andadministrativeinformationinanormalizedformatwithacknowledgementofreceipt

HealthInformation.Anyinformation,includinggeneticinformation,whetheroralorrecordedinanyformormedium,that(a)iscreatedorreceivedbyahealthprofessional,healthplan,publichealthauthority,employer,lifeinsurer,schooloruniversity,orhealthcareclearinghouse;and(b)relatestothepast,present,orfuturephysicalormentalhealthorconditionofanindividual;theprovisionofhealthcaretoanindividual;orthepast,present,orfuturepaymentfortheprovisionofhealthcaretoanindividual.

HealthInformationNetwork(HIN).Anorganizationorgroupoforganizationsresponsibleforcoordinatingtheexchangeofprotectedhealthinformation(PHI)inaregion,state,ornationally.

HealthPlan.Anindividualorgroupplanthatprovides,orpaysthecostofmedicalcare(asdefinedinsection2791(a)(2)ofthePublicHealthServiceAct,42U.S.C.300gg‐91(a)(2)).HealthPlanfurtherincludesthoseentitiesdefinedasahealthplanunderHIPAA,45CFR160.103.

HealthProfessionalorHealthProvider.(a)Anyindividuallicensed,registered,orcertifiedunderFederalorStatelawsorregulationstoprovidehealthcareservices;(b)anypersonholdinganon‐clinicalpositionwithinorassociatedwithanorganizationthatprovideshealthcareorhealthcarerelatedservices;and(c)peoplewhocontributetothegathering,recording,processing,analysisorsendingandreceivingofHealthInformation.

HealthProviderDirectory.ThestatewidesharedserviceestablishedbyHINthatcontainscontactinformationonhealthprofessionals,facility/hospital,otherhealthcareorganizations,electronicaddresses,endpoints,andelectronicserviceinformation,asaresourceforauthorizeduserstoobtaincontactinformationandsecurelyexchangehealthinformation.

HINInfrastructureService.Certainservicesthataresharedbynumeroususecases.HINInfrastructureServicesinclude,butarenotlimitedto,ACRS,HPD,StatewideConsumerDirectory(SCD),andtheMedicalInformationDIrectGATEway(MIDIGATE®).

HINServices.TheHINinfrastructureservicesandadditionalservicesandfunctionalityprovidedbyHINallowingtheparticipatingorganizationtosend,receive,find,oruseinformationtoorfromHINasfurthersetforthinanexhibit.

InformationSource.AnyorganizationthatprovidesinformationthatisaddedtoaHINInfrastructureService.

MeaningfulUse.UsingcertifiedEHRtechnologytoimprovequality,safetyandefficiencyofhealthcare,andtoreducehealthdisparities.

Message.AmechanismforexchangingmessagecontentbetweentheparticipatingorganizationtoHINservices,includingfindingandreceiving.



MessageContent.Informationwhichissent,received,foundorusedbyaParticipatingOrganizationtoorfromHINServices,including,butnotlimitedto,PHI,commonkeys,de‐identifieddata,metadata,DigitalCredentials,anddataschema.MessageContentincludestheMessageContentHeader.

MessageHeader.TheMSHsegmentpresentineveryHL7messagetypethatdefinesthemessage'ssource,purpose,destination,andcertainsyntaxspecificssuchasdelimiters(separatorcharacters)andcharactersets.ItisalwaysthefirstsegmentintheHL7message,withtheonlyexceptionbeingHL7batchmessages.

MichiganHealthInformationNetworkSharedServices.TheHINfortheStateofMichigan.

Notice.Asentmessagethatisnotmessagecontentandwhichmayincludebutnotbelimitedtoanacknowledgementofreceiptorerrorresponse.

PatientData.Anydataaboutapatientoraconsumerthatiselectronicallyfiledinaparticipatingorganizationororganization’ssystemsorrepositories.Thedatamaycontainprotectedhealthinformation,personalcreditinformation,orpersonallyidentifiableinformation.

PersonRecord.AnyrecordinaHINInfrastructureServicethatprimarilyrelatestoanindividualperson.

ProviderCommunity.Ahealthcareproviderwithanactivecarerelationshipwiththeapplicablepatient.

Send/Receive/Find/Use.Meanssending,receiving,finding,orusingmessagecontent.Sendinginvolvestransportofmessagecontent.Receivinginvolvesacceptingandpossiblyconsuming/storingmessagecontent.Findingmeansqueryingtolocatemessagecontent.Usingmeansanyuseofthemessagecontentotherthansending,receivingandfinding.

SourceSystem.Acomputersystem,suchasanelectronichealthrecordsystem,attheparticipatingorganization,thatsends,receives,findsorusesmessagecontentornotices.

StatewideConsumerDirectory.AHINInfrastructureServicethathelpsorganizationsprovidetoolsgivingconsumerstheabilitytomanagehowtheirpersonalHealthInformationcanbesharedandused.TheSCDisessentiallyaSoftwareDevelopmentKitwitharobustsetofFHIRAPIsthatcanbeusedbyonlinehealthportals,mobileapps,oranyotherconsumer‐facinghealthapplicationsthatenableconsumerstotakeanactiveroleinviewingandeditingtheirpreferencesforhowtheirhealthinformationisshared.

TransactionalBasis.ThesendingofmessagecontentoranoticewithinaperiodoftimeofreceivingMessageContentornoticefromasendingorreceivingpartyasmaybefurthersetforthinaspecificexhibit.



TransitionsofCare.Themovementofapatientfromonesettingofcare(e.g.hospital,ambulatoryprimarycarepractice,ambulatoryspecialtycarepractice,long‐termcare,rehabilitationfacility)toanotherandcanincludetransferswithinahealthcareorganization.

TrustedDataSharingOrganization.AnorganizationthathassignedanyformofagreementwithHINfordatasharing.

UseCase.Aspecificscenarioorgroupofscenariosforsharingpatienthealthinformation.

UseCaseExhibit.ThelegalagreementattachedasanexhibittotheMasterUseCaseAgreementthatgovernsparticipationinanyspecificUseCase.

UseCaseImplementationGuide.ThedocumentprovidingtechnicalspecificationsrelatedtoMessageContentandtransportofMessageContentbetweenparticipatingorganizations,HIN,andotherdatasharingorganizations.UseCaseImplementationGuidesaremadeavailableviaURLsinexhibits.

UseCaseSummary.Thedocumentprovidingtheexecutivesummary,businessjustificationandvaluepropositionofausecase.UsecasesummariesareprovidedbyHINuponrequestandareavailableviawww.mihin.org.

ViewDownloadTransmit.ArequirementforMeaningfulUsewiththeobjectivetoprovidepatientswiththeabilitytoviewonline,downloadandsendtheirhealthinformationwithinfourbusinessdaysoftheinformationbeingavailabletoanEligibleProfessional.



1Introduction

1.1PurposeofUseCase

Admission,Discharge,Transfer(ADT)notificationiswidelyregardedasakeystonetoimprovingpatientcarecoordinationthroughhealthinformationexchange.ADTmessagesaresentwhenapatientisadmittedtoahospital,transferredtoanotherfacility,ordischargedfromthehospital.Alertsarethensenttoupdatephysiciansandcaremanagementteamsonapatient’sstatus,thusimprovingpost‐dischargetransitions,promptingfollow‐up,improvingcommunicationamongproviders,andsupportingpatientswithmultipleorchronicconditions.ADTnotificationsalsosupporttheidentificationofpatientswhoarefrequentorhighusersofthehealthcaresystem,whichallowsproviderstosteerthesepatientstowardclinicalandnon‐clinicalinterventionsthatmayreduceunnecessaryoverutilizationbypreventingavoidableemergencydepartmentvisitsandhospitalreadmissions.

Thisusecasesupportsawaytocommunicatethestatusofpatients’caretransitionswitheverycareteammemberinterestedinthatpatient.Whenapatientisadmittedtoahospital,transferred,ordischarged,anADTmessageiscreatedbythehospital’sElectronicHealthRecord(EHR)system.ThehospitalEHRsystemsendstheADTmessagestothehealthinformationnetwork(HIN)whichoperatestheStatewideADTNotificationService.TheHINthenfindsthepatientandtheproviderswhoareonthatpatient’scareteamusingtheActiveCareRelationshipService(ACRS).ACRScontainsinformationonwhichproviders(e.g.attending,referring,consulting,admitting,primarycarephysician,etc.)areinterestedinthatpatient’shealth.TheHINalsofindstheprovidersinthestatewideHealthProviderDirectory(HPD)toobtainthedeliverypreferenceforeachofthoseprovidersandtodeterminetheelectronicendpointand“transport”methodbywhichtheproviderswishtoreceiveADTnotifications(e.g.viaDirectSecureMessaging,viaHealthLevelSeven(HL7)overLLP,etc.)fortheirpatients.

Basedontheprovider’sdeliverypreferences,theHINnotifieseachproviderwhohasanactivecarerelationshipwithapatientuponthefollowingADTevents:

Patientisadmittedtothehospitalforinpatientoremergencytreatment Patientisdischargedfromthehospital Patientistransferredfromonecaresettingtoanother(e.g.toadifferentlocation

(unit,bed)withinthehospitalortoanotherfacilityoutsideofthehospital) Patient’sdemographicinformationisupdated(e.g.name,insurance,nextofkin,etc.)

byaparticipatingorganization.

NoteRelatedUseCaseRequirements:OrganizationsenteringintothisusecasealsoingeneralshouldsimultaneouslyenterintotheActiveCareRelationshipsUseCaseandtheHealthProviderDirectoryUseCase.ThesethreeusecasesgotogethertosupportADTnotifications.



1.2MessageContent

Forthisusecase,MessageContentreferstoamessageconformingtoHL72.5.1standardsidentifiedasanADTmessagetype.

1.3DataFlowandActors

Actor:SendingOrganization

Role:Collectspatientregistrationinformationandinformationaboutpatientmovementswithinhealthcareinstitutions.ForwardsthisinformationtoHIN.

Actor:HIN

Role:ReceivespatientregistrationandmovementinformationfromSendingOrganizations.ForwardsthisinformationtoReceivingOrganizations.

Actor:ReceivingOrganization

Role:ReceivespatientregistrationandmovementinformationforwardedbyHINfromSendingOrganizations.Usesthisinformationfortreatment,paymentandoperations.

Sending Org

Health Information Network

Receiving Org

Patient Registration / Movement

Figure1.OrganizationsTrackingPatientMovementWithADTNotificationsUseCase



ReceiveADTEvent

AckCodeAE:InvalidSyntax/Semantics

AckCodeAA:ApplicationAccept

AckCodeAR:DBNotAvailable

SendADTEvent

SendADTEvent

ReceiveADTEvent

SendACKwithAckCode

ReceiveACK

AckCodeAE:InvalidSyntax/Semantics

AckCodeAA:ApplicationAccept

AckCodeAR:DBNotAvailable

ReceiveADTEvent

SendACKwithAckCode

ProcessMessage

ReceiveACK

SendingOrg

ReceivingOrg

Figure2.DataFlowforADTNotificationsUseCase

HealthInformationNetwork



2OnboardingThefollowingguidelinesdescribethewayinwhichanorganizationmayonboardsendingorreceivingADTnotifications.

2.1Prerequisites

ParticipatingOrganizationsshouldbegintwoparallelonboardingtrackssimultaneously:

Obtain,review,andexecutelegalagreements Establishtechnicaltransportandtest

2.1.1UniversalLegalPrerequisites

Legalagreementsforfirst‐timeonboardingconsistofaDataSharingOrganizationAgreement,aMasterUseCaseAgreement,andUseCaseExhibitsforanyapplicableusecases.

www.mihin.org/about‐mihin/resources/mihin‐legal‐document‐templates/

ForadditionalusecasesonlyanewUseCaseExhibitisrequired.

Toinitiatethelegalonboardingcontact:[email protected].

2.1.2ADTReceiverUseCasePrerequisites

InordertoreceiveADTnotifications,thereareseveralusecasespackagedtogether:

StatewideADTNotifications ActiveCareRelationships HealthProviderDirectory

Seediagrambelowtodemonstratehowtheseusecasesworktogether.



2.1.3ADTNotificationDiagram

Figure3.DataflowwithmultipleusecasestosupportADTNotifications

2.2SendingADTNotifications

TransitionsofCareusecasesfocusoninpatientandemergencycaresettingssuchashospitals,independentemergencycareclinics,andskillednursingfacilitieswithpatientstransitioningoutoftheircareandtoanoutpatientsetting.TheseinpatientandemergencycareprovidingorganizationswouldbeclassifiedasADTSenders.



2.2.1ADTSenderOnboardingProcess

Figure4.ADTSenderOnboardingFlowchart

Onboardingprocessstepsinclude:

Expressinterestinonboardingusecase Kick‐offmeeting Exchangecontactinformation DistributeStatewideADTnotification“carepackage”

Executelegaldocuments DataSharingOrganizationAgreement(ifnotalreadyexecuted) MasterUseCaseAgreement(ifnotalreadyexecuted) UseCaseExhibit

Exchangerequireddocuments Transportdocument Completedmappingtables

Establishtransportmethod/connectivity(e.g.,viaHIE,VPN,orDirect) ProvidesampleADTmessagesandtest Completevalidationprocess Golive Two‐weekDataQualityAssurance(DQA)period

Enablefeedforrecipient(s)



2.3ReceivingADTNotifications

TransitionsofCareUseCasesfocusoninpatientandemergencycaresettingswithpatientstransitioningoutoftheircareandtoanoutpatientsettingsuchasaprimarycareprovider.TheseoutpatientcareprovidingorganizationswouldbeclassifiedasADTReceivers.

2.3.1ADTReceiverOnboardingProcess

Figure5.MiHINADTReceiverOnboardingFlowchart

ADTReceiverOnboardingSteps:

ExpressinterestinonboardingUseCase Kick‐offmeeting Exchangecontactinformation DistributeStatewideADT“carepackage”

Executelegaldocuments DataSharingOrganizationAgreement(ifnotalreadyexecuted) MasterUseCaseAgreement(ifnotalreadyexecuted) UseCaseExhibit

Exchangerequireddocuments Transportdocument Subscriptionchecklist

SendACRS™file(s)securely ValidateACRSfile(s) Establishtransportmethod/connectivity(e.g.,viaHIE,VPN,orDirect)



Golive Validateproductionmessages

2.3.2MiHINAppendedZ‐Segments

2.3.2.1NPIZ‐SegmentForeveryprovidermatchintheActiveCareRelationshipServiceagainstanADT,thecorrespondingproviderNPIwillbeappendedtothereceiver’sADT.

Format:ZNP|ACRSNPI|1234567890

2.3.2.2CommonKeyZ‐SegmentIfanADTisidentifiedasapatientwithaCommonKeythenthepatient’skeywillbeappendedtothereceiver’sADT.

Format:ZCK|CKS|9182398128

2.3.2.3MemberIDZ‐SegmentWhenapatientismatchedwithareceiver’sACRSfile,theUniquePatientIDfromthefilewillbeappendedtothereceiver’sADT.

Format:ZPD|PATIENTID|12345678



3SpecificationsThefollowingguidelinesdescribethewayinwhichsegmentandfieldrequirementsapplytoconformantmessages.

3.1SendingOrganizationRequirements

ADTsendersmustadheretoHINconformancestandardstoparticipateinthisusecase.Allrequiredsegmentslistedinthisspecmustbepopulated,andincludeddatamustadheretoreferenceddatatables.

3.1.1SegmentRequirementsforSendingOrganization

EachHL7messagesenttoHINshallconformtothestaticdefinitiongiveninthesubsectionofSection4,“StaticDefinition–MessageLevel,”correspondingtothetriggereventofthemessage.

3.1.2SegmentUsageRequirementsforSendingOrganization

ConformantAdmission‐Discharge‐Transfer(ADT)sendersshalladheretothefollowingusagerequirements.

SegmentswithusagecodeRshallalwaysbesent SegmentswithusagecodeCshallbesentconditionally,baseduponfulfillmentof

theconditioncontainedinthe“Comments”column SegmentswithusagecodeREshallbesentifinformationcorrespondingtothe

segmentdefinitionexistsonthesendingsystem SegmentswithusagecodeCEshallbesentconditionally,baseduponfulfillmentof

theconditioncontainedinthe“Comments”column,ifinformationcorrespondingtothesegmentdefinitionexistsonthesendingsystem

SegmentswithusagecodeX,orwhosesegmentIDdoesnotappearinthestaticdefinitioncorrespondingtothetriggereventofthemessage,willbeignored

3.1.2.1SegmentCardinalityRequirementsforSendingOrganizationConformantsendingorganizationsshalladheretothefollowingcardinalityrequirementsformessagesegments:

Nofeweroccurrencesofeachsegmentshallbesentthanthenumberindicatedbytheminimumcardinalityofthesegmentinthemessage‐levelstaticdefinitioncorrespondingtothetriggereventofthemessage.

Occurrencesofeachsegmentexceedingthenumberindicatedbythemaximumcardinalityofthesegmentinthemessage‐levelstaticdefinitioncorrespondingtothetriggereventofthemessagewillbeignored.



3.1.3FieldandSubfieldRequirementsforSendingOrganization

EachsegmentofeachHL7messagesenttoHINshallconformtothestaticdefinitiongiveninthesubsectionofSection5,“StaticDefinition–SegmentLevel,”correspondingtothetriggereventofthemessage.

3.1.3.1FieldandSubfieldUsageRequirementsforSendingOrganizationConformantsendingorganizationsshalladheretothefollowingusagerequirementsformessagefields,components,andsubcomponents.

FieldsandsubfieldswithusagecodeRshallalwaysbesent FieldsandsubfieldswithusagecodeCshallbesentconditionally,basedupon

fulfillmentoftheconditioncontainedinthe“Comments”column FieldsandsubfieldswithusagecodeREshallbesentiftheinformation

correspondingtothefieldorsubfielddefinitionexistsonthesendingsystem FieldsandsubfieldswithusagecodeCEshallbesentconditionally,basedupon

fulfillmentoftheconditioncontainedinthe“Comments”column,ifinformationcorrespondingtothefieldorsubfielddefinitionexistsonthesendingsystem

FieldsandsubfieldswithusagecodeX,orwhosefieldorsubfieldsequencenumberdoesnotappearinthestaticdefinitionofthefieldorsubfield,willbeignored

3.1.3.2FieldandSubfieldCardinalityRequirementsforSendingOrganizationConformantsendingorganizationsshalladheretothefollowingcardinalityrequirementsformessagefields,components,andsubcomponents.

Nofeweroccurrencesofeachfieldorsubfieldshallbesentthanthenumberindicatedbytheminimumcardinalityofthefieldinthestaticdefinitionofthesegmentinwhichthefieldorsubfieldoccurs.

Occurrencesofeachfieldorsubfieldabovethenumberindicatedbythemaximumcardinalityofthefieldorsubfieldinthestaticdefinitionofthesegmentinwhichthefieldorsubfieldoccurswillbeignored.

3.1.4MappingTables

MiHINrequiresasetofmappingtablestodocumentdatadefinitionsforspecificfields.Changesinmappingsmustbeupdatedtomaintainconformance.

3.1.4.1MappingTableFormatMiHINprovidesatemplatemappingtabletobecompletedbythesender.Fieldsthatmustbemappedinclude,butarenotlimitedto,thefollowing:

MSH‐4SendingFacility PID‐8Gender PID‐10Race PID‐22Ethnicity PID‐30DeathIndicator



DG1‐6DiagnosisType PV1‐2PatientClass PV1‐4AdmissionType PV1‐14AdmitSource PV1‐18PatientType PV1‐10HospitalService PV1‐36DischargeDisposition IN1‐17Insured’sRelationshiptoPatient IN1‐3InsuranceCompanyID IN1‐4InsuranceCompanyName

3.1.5ConformanceReporting

ADTsenderswillbemeasuredonthreetiersofconformance:

Completeroutingdata Completemapping Adherencetocodingstandards

3.1.5.1CompleteRoutingDataDatanecessaryfortheroutingofmessagestotherightdestinationbyfieldmustbepopulatedconsistentlywiththefollowing:

MSH‐4.1SendingFacility PID‐5.1PatientLastName PID‐5.2PatientFirstName PID‐7PatientDataofBirth PID‐8PatientGender PID‐11.5PatientZip‐Code PID‐19PatientSocialSecurityNumber IN1‐3InsuranceCompanyID IN1‐4InsuranceCompanyName IN1‐36PolicyNumber

CompleteroutingdatameasuresthepercentofADTsinwhicheachfieldwasfilled.OnlyADTtypeswithrelevantsegmentincludedintheADTspecificationareincludedinthispercentage.

3.1.5.2CompleteMappingCompletemappingtospecifiedvaluesetsbyfieldaremeasuredagainstprovidedmappingtables.

3.1.5.3AdherencetoCodingStandardsThepercentofADTswithdatainfieldsinwhichthedatametdesignatedcodingstandardsforrelevantmessagetypes.



MSH‐4.1UseofSendingFacilityObjectIdentifier(OID) MSH‐4.1UseofSendingHealthSystemOID DG1‐3.1DiagnosisCodeID DG1‐3.2DiagnosisCodeText(description) DG1‐3.3DiagnosisCodeNameofCodingSystem(mustuseICD‐9,ICD‐10,or

SNOMED)

3.2ReceivingOrganizationRequirements

3.2.1SegmentRequirementsforReceivingOrganization

EachHL7messagesentbyMiHINwillconformtothestaticdefinitiongiveninthesubsectionofSection4,“StaticDefinition–MessageLevel,”correspondingtothetriggereventofthemessage.

3.2.2SegmentUsageRequirementsforReceivingOrganization

Conformantreceivingorganizationsshalladheretothefollowingusagerequirementsformessagesegments.

SegmentswithusagecodeRorCshallalwaysbeacceptedandstored. SegmentswithusagecodeREorCEshallalwaysbeacceptedandstoredifreceived.

FailuretoreceiveasegmentwithusagecodeREorCEshallnotbetreatedasanerrorbythereceivingsystem.

SegmentswithusagecodeX,orwhosesegmentIDdoesnotappearinthestaticdefinitioncorrespondingtothetriggereventofthemessage,maybeignoredifreceived.

3.2.2.1SegmentCardinalityRequirementsforReceivingOrganizationConformantreceivingorganizationsshalladheretothefollowingcardinalityrequirementsformessagesegments.

Nofeweroccurrencesofeachsegmentshouldbeexpectedthanthenumberindicatedbytheminimumcardinalityofthesegmentinthemessage‐levelstaticdefinitioncorrespondingtothetriggereventofthemessage.

Nomoreoccurrencesofeachsegmentshouldbeexpectedthanthenumberindicatedbythemaximumcardinalityofthesegmentinthemessage‐levelstaticdefinitioncorrespondingtothetriggereventofthemessage.Occurrencesinexcessofthemaximummaybeignoredifreceived.

3.2.3FieldandSubfieldRequirementsforReceivingOrganization

EachsegmentofeachHL7messagesentbyMiHINwillconformtothestaticdefinitiongiveninthesubsectionofSection5,“StaticDefinition–SegmentLevel,”correspondingtothetriggereventofthemessage.



3.2.3.1FieldandSubfieldUsageRequirementsforReceivingOrganizationConformantreceivingorganizationsshalladheretothefollowingusagerequirementsformessagefieldsandsubfields.

FieldsandsubfieldswithusagecodeRandCshallalwaysbeacceptedandstored. FieldsandsubfieldswithusagecodeREandCEshallalwaysbeacceptedandstored

ifreceived.FailuretoreceiveafieldorsubfieldwithusagecodeREshallnotbetreatedasanerrorbythereceivingsystem.

FieldsandsubfieldswithusagecodeX,orwhosefieldorsubfieldsequencenumberdoesnotappearinthestaticdefinitionofthefieldorsubfield,maybeignoredifreceived.

3.2.3.2FieldCardinalityRequirementsforSendingOrganizationConformantreceivingorganizationsshalladheretothefollowingcardinalityrequirementsformessagefields.1

Nofeweroccurrencesofeachfieldshouldbeexpectedthanthenumberindicatedbytheminimumcardinalityofthefieldinthestaticdefinitionofthesegmentinwhichthefieldoccurs.

Nomoreoccurrencesofeachfieldwillbesentthanthenumberindicatedbythemaximumcardinalityofthefieldinthestaticdefinitionofthesegmentinwhichthefieldoccurs.Occurrencesinexcessofthemaximummaybeignoredifreceived.

3.2.4AcknowledgmentMessageRequirementsforReceivingOrganization

Foreachmessagereceived,areceivingorganizationshallreturnanHL7acknowledgmentmessageformattedaccordingtotherequirementsinSections4,5,and6below.AnERRsegmentshallbereturnedforeachusageandcardinalityerrorrecordedasaresultofapplyingtherulesinSection3.2,“ReceivingOrganizationRequirements.”

1Cardinalityrequirementsforsubfields–componentsandsubcomponents–arecoveredbythefieldusagerequirementsintheprevioussection;bytheHL7Version2encodingrules,subfieldsmaynothavecardinalitygreaterthan1.



4StaticDefinition–MessageLevelEachHL7messagesenttotheHINshallconformtothestaticdefinitiongiveninthesubsectionbelowcorrespondingtothetriggereventofthemessage.

4.1ADT(PatientAdministration)Message–TriggerEventsA01,A04,A05,A08,A13,A14,A28,A31

ThedefinitionsinthetablebelowshallbeconformedtobyalloftheHL7sourcemessagessendingthefollowingADTtriggerevents:

A01(admit/visitnotification) A04(registerapatient) A05(pre‐admitapatient) A08(updatepatientinformation) A13(canceldischarge/endvisit) A14(pendingadmit) A28(addpersoninformation) A31(updatepersoninformation)

Segment Description Usage Cardinality HL7Chapter CommentsMSH Messageheader R 1..1 2 [{SFT}] Softwaresegment RE 0..99 2 Implemented

beginninginHL7V2.5EVN Eventtype R 1..1 3 PID Patient

identificationR 1..1 3

[PD1] Additionaldemographics

RE 0..1 3

[{NK1}] Nextofkin/associatedparties

X 0..0 3

PV1 Patientvisit R 1..1 3 [PV2] Patientvisit‐

additionalinfo.X 0..0 3

[{DB1}] Disabilityinformation

X 0..0 3

[{OBX}] Observation/result

RE 0..2 7 Patientheightandweight

[{AL1}] Allergyinformation

X 0..0 3

[{DG1}] Diagnosisinformation

RE 0..99 6

[DRG] Diagnosisrelatedgroup

X 0..0 6

[{PR1 Procedures RE 0..99 6 [{ROL}] Role X 0..0 12 }]



Segment Description Usage Cardinality HL7Chapter Comments[{GT1}] Guarantor X 0..0 6 [ {IN1 Insurance R 0..99 6 [IN2] Insurance


[{IN3}] Insuranceadd'linfo‐cert.

X 0..0 6

} ] [ACC] Accident

informationX 0..0 6

[UB1] Universalbillinformation

X 0..0 6

[UB2] Universalbill92information

X 0..0 6

4.2ADT(PatientAdministration)Message–TriggerEventsA02,A21,A22,A23,A25,A26,A27,A29,A32,A33

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingthefollowingADTtriggerevents:

A02(transferapatient) A21(patientgoesona“leaveofabsence”) A22(patientreturnsfroma“leaveofabsence”) A23(deleteapatientrecord) A25(cancelpendingdischarge) A26(cancelpendingtransfer) A27(cancelpendingadmit) A29(deletepersoninformation) A32(cancelpatientarriving–tracking) A33(cancelpatientdeparting–tracking)





RE 0..1 3




X 0..0 3



Segment Description Usage Cardinality HL7Chapter Comments[{OBX}] Observation/

resultRE 0..2 7 Patientheightand

weight

4.3ADT(PatientAdministration)Message–TriggerEventA03

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventA03(discharge/endvisit).

Segment Description Usage Cardinality HL7Chapter CommentsMSH Messageheader R 1..1 2 [{SFT}] Softwaresegment RE 0..99 2 Implementedbeginningin

HL7V2.5EVN Eventtype R 1..1 3 PID Patient



RE 0..1 3




X 0..0 3


RE 0..99 6


X 0..0 6

[{PR1 Procedures RE 0..99 6 [{ROL}] Role X 0..0 12 }] [{OBX}] Observation/

resultRE 0..2 7 Patientheightandweight

[ {IN1 Insurance R 0..99 6 [IN2] Insurance



X 0..0 6

} ]



4.4ADT(PatientAdministration)Message–TriggerEventsA06,A07

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventsA06(changeanoutpatienttoaninpatient)andA07(changeaninpatienttoanoutpatient).





RE 0..1 3

[MRG] MergeInformation

RE 0..1 3

[{NK1}] Nextofkin/associatedparties

X 0..0 3




X 0..0 3



[{AL1}] Allergyinformation

X 0..0 3


RE 0..99 6


X 0..0 6

[{PR1 Procedures RE 0..99 6 [{ROL}] Role X 0..0 12 }] [{GT1}] Guarantor X 0..0 6 [ {IN1 Insurance R 0..99 6 [IN2] Insurance



X 0..0 6

} ] [ACC] Accident

informationX 0..0 6

[UB1] Universalbillinformation

X 0..0 6



Segment Description Usage Cardinality HL7Chapter Comments[UB2] Universalbill92

informationX 0..0 6

4.5ADT(PatientAdministration)Message–TriggerEventsA09,A10,A11,A15

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingthefollowingADTtriggerevents:

A09(patientdeparting–tracking) A10(patientarriving–tracking) A11(canceladmit/visitnotification) A15(pendingtransfer)





RE 0..1 3




X 0..0 3

[{OBX}] Observation/result RE 0..2 7 Patientheightandweight


RE 0..99 6


ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventA12(canceltransfer).





RE 0..1 3





Segment Description Usage Cardinality HL7Chapter Comments[{DB1}] Disability

informationX 0..0 3

[{OBX}] Observation/result RE 0..2 7 Patientheightandweight

[DG1] Diagnosisinformation

RE 0..1 6


ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventA17(swappatients).



identificationR 1..1 3 1stpatient("swap‐

from")information[PD1] Additional

demographicsRE 0..1 3




X 0..0 3



PID Patientidentification

R 1..1 3 2ndpatient("swap‐to")information


RE 0..1 3




X 0..0 3




ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventA20(bedstatusupdate).


beginninginHL7V2.5EVN Eventtype R 1..1 3 NPU Non‐patient

updateR 1..1 3



4.9ADT(PatientAdministration)Message–TriggerEventsA24,A37

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7sourcemessagessendingADTtriggereventA24(linkpatientinformation)andA37(unlinkpatientinformation).



identificationR 1..1 3 Patient'sfirstIDtolink

(A24)orunlink(A37)(samepersonasthatofsecondpatientID)


RE 0..1 3

[PV1] Patientvisit RE 1..1 3 Linkagemaytakeplaceoutsideavisitcontext


X 0..0 3

PID Patientidentification

R 1..1 3 Patient'ssecondIDtolink(A24)orunlink(A37)(samepersonasthatoffirstpatientID)


RE 0..1 3

[PV1] Patientvisit RE 1..1 3 Linkagemaytakeplaceoutsideavisitcontext


X 0..0 3

4.10ACK(Acknowledgment)Message

ReceivingorganizationsshallsendanacknowledgmentmessagereplytoeachmessagereceivedfromMiHIN.ThedefinitionsinthetablebelowshallbeconformedtobyallHL7acknowledgmentmessages.

Segment Description Usage Cardinality HL7Chapter CommentsMSH Messageheader R 1..1 2 MSA Message

acknowledgmentR 1..1 2

[{ERR}] Error RE 0..99 2



5StaticDefinition–SegmentLevelEachsegmentofanHL7messagesenttoMiHINshallconformtothestaticdefinitiongiveninthecorrespondingsubsectionbelow.ThedefinitionsofeachfieldaregiveninSection6,“StaticDefinition–FieldLevel.”

5.1MSH(MessageHeader)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheMSH(messageheader)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.1,“MSH(MessageHeader)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 1 ST R 1..1 00001 FieldSeparator 2 4 ST R 1..1 00002 Encoding

Characters

3 180 HD R 1..1 0361 00003 SendingApplication

OIDforsendinghospital’sorhealthsystem’sapplication

4 180 HD R 1..1 0362 00004 SendingFacility OID/NPIforsendinghospitalandOIDforsendinghealthsystem

5 180 HD R 1..1 0361 00005 ReceivingApplication

OIDforMiHINToCservice

6 180 HD R 1..1 0362 00006 ReceivingFacility OIDforMiHINenterprise

7 26 TS R 1..1 00007 Date/TimeofMessage

8 40 ST X 0..0 00008 Security 9 7 CM R 1..1 0076 0003 00009 Message

Type

10 20 ST R 1..1 00010 MessageControlID

Shouldberepopulated(ratherthanpass‐through)foroutboundmessageheader

11 3 PT R 1..1 00011 ProcessingID ShouldalwaysbeP



Seq Len DT Usage Cardinality TBL# Item# ElementName Commentswheninproduction

12 60 VID R 1..1 0104 00012 VersionID 13 15 NM X 0..0 00013 SequenceNumber 14 180 ST X 0..0 00014 Continuation

Pointer

15 2 ID X 0..0 0155 00015 AcceptAcknowledgmentType

16 2 ID X 0..0 0155 00016 ApplicationAcknowledgmentType

17 2 ID X 0..0 00017 CountryCode 18 16 ID X 0..0 00692 CharacterSet 19 60 CE X 0..0 Principal

LanguageofMessage

20 20 ID X 0..0 00356 AlternateCharacterSetHandlingScheme

5.2SFT(Software)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheSFT(software)segment.SystemsusingHL7versionsprevioustoVersion2.5shallnotbeexpectedtosendtheSFTsegment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.2,“SFT(Software)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 567 XON R 1..1 01834 SoftwareVendor

Organization

2 15 ST R 1..1 01835 SoftwareCertifiedVersionorReleaseNumber

3 20 ST R 1..1 01836 SoftwareProductName

4 20 ST R 1..1 01837 SoftwareBinaryID 5 1024 TX X 0..0 01838 SoftwareProduct

Information

6 26 TS X 0..0 01839 SoftwareInstallDate

5.3EVN(EventType)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheEVN(eventtype)segment.SystemsusingHL7versionsprevioustoVersion2.4shallnotbeexpectedtosendfieldEVN‐7‐eventfacility.



Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.3,“EVN(EventType)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 3 ID X 0..0 0003 00099 EventTypeCode 2 26 TS R 1..1 00100 Recorded

Date/Time

3 26 TS X 0..0 00101 Date/TimePlannedEvent

4 3 IS X 0..0 0062 00102 EventReasonCode

5 60 XCN X 0..0 0188 00103 OperatorID 6 26 TS X 0..0 01278 EventOccurred 7 180 HD R 1..1 01534 EventFacility Implemented

beginninginHL7V2.4

5.4PID(PatientIdentification)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingthePID(patientidentification)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.4,“PID(PatientIdentification)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI X 0..0 00104 SetID‐PID 2 20 CX RE 0..1 00105 PatientID 3 20 CX R 1..99 00106 PatientIdentifier

List

4 20 CX RE 0..99 00107 AlternatePatientID‐PID

5 48 XPN R 1..99 00108 PatientName 6 48 XPN X 0..0 00109 Mother'sMaiden

Name

7 26 TS R 1..1 00110 Date/TimeofBirth

8 1 IS R 1..1 0001 00111 Sex 9 48 XPN X 0..0 00112 PatientAlias 10 80 CE RE 0..19 0005 00113 Race 11 106 XAD RE 0..19 00114 PatientAddress 12 4 IS X 0..0 0289 00115 CountyCode 13 40 XTN RE 0..9 00116 PhoneNumber‐

Home

14 40 XTN RE 0..9 00117 PhoneNumber‐Business

15 60 CE X 0..0 0296 00118 PrimaryLanguage 16 80 CE X 0..0 0002 00119 MaritalStatus 17 80 CE X 0..0 0006 00120 Religion 18 20 CX X 0..0 00121 PatientAccount

Number



Seq Len DT Usage Cardinality TBL# Item# ElementName Comments19 4 ST R 1..1 00122 SSNNumber‐

PatientLastfourdigitsonlyarerequiredtoincreasethestrengthofpatientmatch

20 25 DLN RE 0..1 00123 Driver'sLicenseNumber‐Patient

21 20 CX C 0..1 00124 Mother'sIdentifier

Populatediftheageofthepatientislessthan1month

22 80 CE RE 0..19 0189 00125 EthnicGroup 23 60 ST X 0..0 00126 BirthPlace 24 1 ID RE 0..1 0136 00127 MultipleBirth

Indicator

25 2 NM C 0..1 00128 BirthOrder PopulatedifandonlyifPID‐24isY

26 80 CE X 0..0 0171 00129 Citizenship 27 60 CE X 0..0 0172 00130 VeteransMilitary

Status

28 80 CE X 0..0 0212 00739 Nationality 29 26 TS RE 0..1 00740 PatientDeath

DateandTime

30 1 ID RE 0..1 0136 00741 PatientDeathIndicator

5.5PD1(AdditionalDemographics)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingthePD1(additionaldemographics)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.5,“PD1(AdditionalDemographics)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 2 IS X 0..0 0223 00755 Living

Dependency

2 2 IS X 0..0 0220 00742 LivingArrangement

3 90 XON X 0..0 00756 PatientPrimaryFacility

4 90 XCN RE 0..19 00757 PatientPrimaryCareProviderName&IDNo.

5 2 IS X 0..0 0231 00745 StudentIndicator 6 2 IS X 0..0 0295 00753 Handicap 7 2 IS X 0..0 0315 00759 LivingWill 8 2 IS X 0..0 0316 00760 OrganDonor 9 1 ID X 0..0 0136 00761 SeparateBill 10 20 CX X 0..0 00762 DuplicatePatient



Seq Len DT Usage Cardinality TBL# Item# ElementName Comments11 80 CE X 0..0 0215 00743 PublicityCode 12 1 ID X 0..0 0136 00744 Protection

Indicator

5.6PV1(PatientVisit)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingthePV1(patientvisit)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.6,“PV1(PatientVisit)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI X 0..0 00131 SetID‐PV1 2 1 IS R 1..1 0004 00132 PatientClass 3 80 PL RE 0..1 00133 AssignedPatient

Location

4 2 IS RE 0..1 0007 00134 AdmissionType 5 20 CX X 0..0 00135 PreadmitNumber 6 80 PL X 0..0 00136 PriorPatient

Location

7 60 XCN RE 0..19 0010 00137 AttendingDoctor 8 60 XCN RE 0..19 0010 00138 ReferringDoctor 9 60 XCN RE 0..19 0010 00139 ConsultingDoctor Deprecatedin

V2.3.1infavorofROL

10 3 IS RE 0..1 0069 00140 HospitalService 11 80 PL X 0..0 00141 Temporary

Location

12 2 IS X 0..0 0087 00142 PreadmitTestIndicator

13 2 IS RE 0..1 0092 00143 Re‐admissionIndicator

14 3 IS RE 0..1 0023 00144 AdmitSource 15 2 IS X 0..0 0009 00145 Ambulatory

Status

16 2 IS X 0..0 0099 00146 VIPIndicator 17 60 XCN RE 0..19 0010 00147 AdmittingDoctor 18 2 IS RE 0..1 0018 00148 PatientType 19 20 CX X 0..0 00149 VisitNumber 20 50 FC X 0..0 0064 00150 FinancialClass 21 2 IS X 0..0 0032 00151 ChargePrice

Indicator

22 2 IS X 0..0 0045 00152 CourtesyCode 23 2 IS X 0..0 0046 00153 CreditRating 24 2 IS X 0..0 0044 00154 ContractCode 25 8 DT X 0..0 00155 ContractEffective

Date

26 12 NM X 0..0 00156 ContractAmount 27 3 NM X 0..0 00157 ContractPeriod 28 2 IS X 0..0 0073 00158 InterestCode



Seq Len DT Usage Cardinality TBL# Item# ElementName Comments29 1 IS X 0..0 0110 00159 TransfertoBad

DebtCode

30 8 DT X 0..0 00160 TransfertoBadDebtDate

31 10 IS X 0..0 0021 00161 BadDebtAgencyCode

32 12 NM X 0..0 00162 BadDebtTransferAmount

33 12 NM X 0..0 00163 BadDebtRecoveryAmount

34 1 IS X 0..0 0111 00164 DeleteAccountIndicator

35 8 DT X 0..0 00165 DeleteAccountDate

36 3 IS RE 0..1 0112 00166 DischargeDisposition

37 25 CM RE 0..1 0113 00167 DischargedtoLocation

38 80 CE X 0..0 0114 00168 DietType 39 2 IS X 0..0 0115 00169 ServicingFacility 40 1 IS X 0..0 0116 00170 BedStatus 41 2 IS X 0..0 0117 00171 AccountStatus 42 80 PL X 0..0 00172 PendingLocation 43 80 PL X 0..0 00173 PriorTemporary

Location

44 26 TS RE 0..1 00174 AdmitDate/Time 45 26 TS RE 0..1 00175 Discharge

Date/Time

46 12 NM X 0..0 00176 CurrentPatientBalance

47 12 NM X 0..0 00177 TotalCharges 48 12 NM X 0..0 00178 TotalAdjustments 49 12 NM X 0..0 00179 TotalPayments 50 20 CX X 0..0 0203 00180 AlternateVisitID 51 1 IS X 0..0 0326 01226 VisitIndicator 52 60 XCN X 0..0 0010 01274 OtherHealthcare

Provider



5.7OBX(Observation/Result)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheOBX(observation/result)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.7,“OBX(Observation/Result)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI RE 0..1 00569 SetID‐OBX 2 3 ID R 1..1 0125 00570 ValueType AlwaysNMfor

patientheightandweight

3 80 CE R 1..1 00571 ObservationIdentifier

AlwaysaLOINCcodeforpatientheightandweight.LOINCcodingisstronglyrecommendedforotherobservations.

4 20 ST X 0..0 00572 ObservationSub‐ID

5 65536 RE 0..1 00573 ObservationValue

MustbesentunlessOBX‐11=X

6 60 CE R 1..1 00574 Units 7 60 ST X 0..0 00575 References

Range

8 5 ID X 0..0 0078 00576 AbnormalFlags 9 5 NM X 0..0 00577 Probability 10 2 ID X 0..0 0080 00578 Natureof

AbnormalTest

11 1 ID R 1..1 0085 00579 ObservationResultStatus

12 26 TS X 0..0 00580 DateLastObsNormalValues

13 20 ST X 0..0 00581 UserDefinedAccessChecks

14 26 TS R 1..1 00582 Date/TimeoftheObservation

15 60 CE X 0..0 00583 Producer'sID 16 80 XCN X 0..0 00584 Responsible

Observer

17 60 CE X 0..0 00936 ObservationMethod



5.8DG1(DiagnosisInformation)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheDG1(diagnosisinformation)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.8,“DG1(DiagnosisInformation)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI X 0..0 00375 SetID‐DG1 2 2 ID C 0..1 0053 00376 Diagnosis

CodingMethodDeprecatedinV2.3.1infavorofDG1‐3.3/DG1‐3.6.Tobepopulatedonlywhenthosecomponentsarenotused.

3 60 CE R 1..1 0051 00377 DiagnosisCode‐DG1

4 40 ST R 1..1 00378 DiagnosisDescription

5 26 TS R 1..1 00379 DiagnosisDate/Time

6 2 IS R 1..1 0052 00380 DiagnosisType 7 60 CE X 0..0 0118 00381 Major

DiagnosticCategory

8 60 CE X 0..0 0055 00382 DiagnosisRelatedGroup

9 1 ID X 0..0 0136 00383 DRGApprovalIndicator

10 2 IS X 0..0 0056 00384 DRGGrouperReviewCode

11 60 CE X 0..0 0083 00385 OutlierType 12 3 NM X 0..0 00386 OutlierDays 13 12 CP X 0..0 00387 OutlierCost 14 4 ST X 0..0 00388 Grouper

VersionAndType

15 2 ID X 0..0 0359 00389 DiagnosisPriority

16 60 XCN X 0..0 00390 DiagnosingClinician

17 3 IS X 0..0 0228 00766 DiagnosisClassification

18 1 ID X 0..0 0136 00767 ConfidentialIndicator

19 26 TS X 0..0 00768 AttestationDate/Time



5.9PR1(Procedures)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingthePR1(procedures)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.9,“PR1(Procedures)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI X 0..0 00391 SetID‐PR1 2 2 IS C 1..1 0089 00392 Procedure

CodingMethodDeprecatedinV2.3.1infavorofPR1‐3.3/PR1‐3.6.Tobepopulatedonlywhenthosecomponentsarenotused.

3 80 CE R 1..1 0088 00393 ProcedureCode 4 40 ST C 1..1 00394 Procedure

DescriptionDeprecatedinV2.3.1infavorofPR1‐3.2/PR1‐3.5.Tobepopulatedonlywhenthosecomponentsarenotused.

5 26 TS R 1..1 00395 ProcedureDate/Time

6 2 IS X 0..0 0230 00396 ProcedureFunctionalType

7 4 NM X 0..0 00397 ProcedureMinutes

8 120 XCN RE 1..19 0010 00398 Anesthesiologist DeprecatedinV2.3.1infavorofROL

9 2 IS X 0..0 0019 00399 AnesthesiaCode 10 4 NM X 0..0 00400 Anesthesia

Minutes

11 120 XCN RE 1..19 0010 00401 Surgeon DeprecatedinV2.3.1infavorofROL

12 230 XCN X 0..0 0010 00402 ProcedurePractitioner

13 60 CE X 0..0 0059 00403 ConsentCode 14 2 NM X 0..0 00404 Procedure

Priority

15 80 CE X 0..0 0051 00772 AssociatedDiagnosisCode

16 80 CE X 0..0 0340 01316 ProcedureCodeModifier



5.10IN1(Insurance)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheIN1(insurance)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.10,“IN1(Insurance)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 4 SI R 1..1 00426 SetID‐IN1 2 60 CE R 1..1 0073 00368 InsurancePlanID 3 59 CX R 1..9 00428 Insurance

CompanyID

4 130 XON R 1..9 00429 InsuranceCompanyName

5 106 XAD X 0..0 00430 InsuranceCompanyAddress

6 48 XPN X 0..0 00431 InsuranceCoContactPerson

7 40 XTN X 0..0 00432 InsuranceCoPhoneNumber

8 12 ST X 0..0 00433 GroupNumber 9 130 XON X 0..0 00434 GroupName 10 12 CX X 0..0 00435 Insured'sGroup

EmpID

11 130 XON X 0..0 00436 Insured'sGroupEmpName

12 8 DT X 0..0 00437 PlanEffectiveDate

13 8 DT X 0..0 00438 PlanExpirationDate

14 55 CM X 0..0 00439 AuthorizationInformation

15 3 IS X 0..0 0086 00440 PlanType 16 48 XPN X 0..0 00441 NameOfInsured 17 80 CE X 0..0 0063 00442 Insured's

RelationshipToPatient

18 26 TS X 0..0 00443 Insured'sDateOfBirth

19 106 XAD X 0..0 00444 Insured'sAddress 20 2 IS X 0..0 0135 00445 AssignmentOf

Benefits

21 2 IS X 0..0 0173 00446 CoordinationOfBenefits

22 2 ST X 0..0 00447 CoordOfBen.Priority

23 1 ID X 0..0 0136 00448 NoticeOfAdmissionFlag

24 8 DT X 0..0 00449 NoticeOfAdmissionDate



Seq Len DT Usage Cardinality TBL# Item# ElementName Comments25 1 ID X 0..0 0136 00450 ReportOf

EligibilityFlag

26 8 DT X 0..0 00451 ReportOfEligibilityDate

27 2 IS X 0..0 0093 00452 ReleaseInformationCode

28 15 ST X 0..0 00453 Pre‐AdmitCert(PAC)

29 26 TS X 0..0 00454 VerificationDate/Time

30 60 XCN X 0..0 00455 VerificationBy 31 2 IS X 0..0 0098 00456 TypeOf

AgreementCode

32 2 IS X 0..0 0022 00457 BillingStatus 33 4 NM X 0..0 00458 LifetimeReserve

Days

34 4 NM X 0..0 00459 DelayBeforeL.R.Day

35 8 IS X 0..0 0042 00460 CompanyPlanCode

36 15 ST RE 0..1 00461 PolicyNumber 37 12 CP X 0..0 00462 PolicyDeductible 38 12 CP X 0..0 00463 PolicyLimit‐

Amount

39 4 NM X 0..0 00464 PolicyLimit‐Days

40 12 CP X 0..0 00465 RoomRate‐Semi‐Private

41 12 CP X 0..0 00466 RoomRate‐Private

42 60 CE X 0..0 0066 00467 Insured'sEmploymentStatus

43 1 IS X 0..0 0001 00468 Insured'sSex 44 106 XAD X 0..0 00469 Insured's

Employer'sAddress

45 2 ST X 0..0 00470 VerificationStatus 46 8 IS X 0..0 0072 00471 PriorInsurance

PlanID

47 3 IS X 0..0 0309 01227 CoverageType 48 2 IS X 0..0 0295 00753 Handicap 49 12 CX X 0..0 01230 Insured'sID

Number



5.11NPU(Non‐PatientUpdate)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheNPU(non‐patientupdate)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.11,“NPU(Non‐PatientUpdate)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 80 PL R 1..1 00209 BedLocation 2 1 IS RE 0..1 0116 00170 BedStatus

5.12MSA(MessageAcknowledgment)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheMSA(messageacknowledgment)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.12,“MSA(MessageAcknowledgment)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 2 ID R 1..1 0008 00018 Acknowledgment

Code

2 20 ST R 1..1 00010 MessageControlID

3 80 ST X 0..0 00020 TextMessage 4 15 NM X 0..0 00021 Expected

SequenceNumber

5 1 ID X 0..0 0102 00022 DelayedAcknowledgmentType

6 100 CE X 0..0 00023 ErrorCondition

5.13ERR(Error)Segment

ThedefinitionsinthetablebelowshallbeconformedtobyallHL7messagessendingtheERR(error)segment.

Definitionsofallfields,includingcomponents,subcomponents,andvocabulariesofeachfield,aregiveninSection6.13,“ERR(Error)SegmentFields.”

Seq Len DT Usage Cardinality TBL# Item# ElementName Comments1 493 ELD C 0..99 00024 ErrorCodeand

LocationDeprecatedbyHL7V2.5infavorofERR‐2throughERR‐12.IfHL7versionispriortoV2.5,mustbepresent.

2 18 ERL CE 0.99 01812 ErrorLocation IfHL7versionis2.5orlater,must



Seq Len DT Usage Cardinality TBL# Item# ElementName CommentsbepresentiferrorcodeinERR‐3relatestoamessagelocation.

3 705 CWE C 0..1 0357 01813 HL7ErrorCode IfHL7versionis2.5orlater,mustbepresent.

4 2 ID C 0..1 0516 01814 Severity IfHL7versionis2.5orlater,mustbepresent.

5 705 CWE X 0..0 0533 01815 ApplicationErrorCode

6 80 ST X 0..0 01816 ApplicationErrorParameter

7 2048 TX X 0..0 01817 DiagnosticInformation

8 250 TX X 0..0 01818 UserMessage 9 20 IS X 0..0 0517 01819 InformPerson

Indicator

10 705 CWE X 0..0 0518 01820 OverrideType 11 705 CWE X 0..0 0519 01821 Override

ReasonCode

12 652 XTN X 0..0 01822 HelpDeskContactPoint



6StaticDefinition–FieldLevel

6.1MSH(MessageHeader)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheMSH(messageheader)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheMSHsegmentisprovidedinSection5.1,“MSH(MessageHeader)Segment.”

MSH‐1 FieldSeparator

Thisfield,whosedatatypeisST(string),containsthetop‐leveldelimiterforHL7elementswithinsegments.HL7Version2.xprocessingrulesrequirethatthefieldseparatorbeasingleuniqueprintablecharacter,andthatthefieldseparatornotbeduplicatedbyanyoftheencodingcharactersinMSH‐2(seebelow).

MSH‐2 EncodingCharacters

Thisfield,whosedatatypeisST(string),containsthecomponentseparator(secondaryelementdelimiter),repetitionseparator,escapecharacter,andsubcomponentseparator(tertiaryelementdelimiter).HL7Version2.xprocessingrulesrequirethateachofthefourencodingcharactersbeasingleuniqueprintablecharacter,andthatnoneoftheencodingcharactersduplicatethefieldseparator.

MSH‐3 SendingApplication

Thisfieldcontainstheidentifieroftheapplicationthatgeneratedthecurrentmessageinstance.ThedatatypeofMSH‐3‐sendingapplicationisHD,whosecomponentsaredefinedasfollows:

Cmp DT Usage TBL# ElementName Comments1 IS R 0361 NamespaceID Astringcontainingthenameand/orother

distinguishinginformationabouttheapplicationinstance.

2 ST RE UniversalID MiHINexpectsthesendertousearegisteredforthiscomponent.TheOIDusedinthiscomponentshouldrepresenttheapplicationinstance(e.g.,theinstallationandversionofaparticularvendor’sADTorclinicaldepartmentalsystem)thatisgeneratingthemessage.

3 ID CE 0301 UniversalIDType IfComponent2isdefined,thiscomponentshallcontainISO.



MSH‐4 SendingFacility

Thisfieldcontainstheidentifiersofthefacilityandsystemthatgeneratedthecurrentmessageinstance.ThedatatypeofMSH‐4‐sendingfacilityisHD,whosecomponentsaredefinedasfollows:

Cmp DT Usage TBL# ElementName Comments1 IS R 0362 NamespaceID MiHINexpectsthesendertousea

registeredOIDforthiscomponent.TheOIDusedinthiscomponentshouldrepresentthehospitalthatissendingthemessage.Forexample,ifapatientisseenatLansingCentralHospitalanditispartoftheLansingHospitalSystemwhichhasaunifiedEHR,theLansingCentralHospitalOIDwouldgohere.

2 ST RE UniversalID MiHINexpectsthesendertousearegisteredOIDforthiscomponent.TheOIDusedinthiscomponentshouldrepresentthesystemcontainingthehospitalthatissendingthemessage.Forexample,ifapatientisseenatLansingCentralHospitalanditispartoftheLansingHospitalSystemwhichhasaunifiedEHR,theLansingHospitalSystemOIDwouldgohere.

3 ID CE 0301 UniversalIDType IfeitherComponent1orComponent2isdefined,thiscomponentshallcontainISO.

MSH‐5 ReceivingApplication

Thisfieldcontainstheidentifieroftheapplicationtowhichthecurrentmessageinstanceisdirected.ThedatatypeofMSH‐5‐receivingapplicationisHD,whosecomponentsaredefinedasfollows:


distinguishinginformationabouttheapplicationinstance.WhensendingtoMiHIN,usetheliteralstringTransitionsofCareNotification.

2 ST RE UniversalID MiHINexpectsthesendertousearegisteredOIDforthiscomponent.WhensendingproductionmessagestoMiHIN,usetheOIDvalue2.16.840.1.113883.3.1481.1.2.2.WhensendingtestmessagestoMiHIN,usetheOIDvalue2.16.840.1.113883.3.1481.2.2.2.WhensendingdevelopmentmessagestoMiHIN,usetheOIDvalue2.16.840.1.113883.3.1481.3.2.2.




MSH‐6 ReceivingFacility

Thisfieldcontainstheidentifierofthefacilitytowhichthecurrentmessageinstanceisdirected.ThedatatypeofMSH‐6‐receivingfacilityisHD,whosecomponentsaredefinedasfollows:


distinguishinginformationaboutthereceivingfacility.WhensendingtoMiHIN,usetheliteralstring“MichiganHealthInformationNetwork.”

2 ST RE UniversalID MiHINexpectsthesendertousearegisteredOIDforthiscomponent.WhensendingtoMiHIN,usethevalue2.16.840.1.113883.3.1481.


MSH‐7 Date/TimeofMessage

Thisfield,whosedatatypeisTS,containsthedateandtimewhenthesendingsystembuiltthemessage.

MSH‐9 MessageType

Thisfield,whosedatatypeisCM,containsthemessagetypeandtriggereventofthemessage.Itscomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ID R 0076 MessageType AlwaysADT2 ID R 0003 TriggerEvent Thethree‐charactertriggereventcodeforthe

currentmessageinstance3 ID X 0301 MessageStructure

MSH‐10 MessageControlID

Thisfield,whosedatatypeisST,containsauniqueidentifierforthemessage.

MSH‐11 ProcessingID

ThisfieldisofdatatypePT.Itscomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ID R 0103 ProcessingID MustcontainPforallproductionmessages.

MaycontainDfordebuggingmessagesorTfortrainingmessages.

2 ST RE 0207 UniversalID Mustbeempty,signifyingcurrent(real‐time)processing.



MSH‐12 VersionID

ThisfieldisofdatatypeVID.Itscomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ID R 0104 VersionID TheHL7versionbywhoserulesthecurrent

messageinstancewasgenerated.2 CE X Internationalization

Code

3 CE X InternalVersionID

6.2SFT(Software)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheSFT(software)segment.SystemsusingHL7versionsprevioustoVersion2.5shallnotbeexpectedtosendtheSFTsegment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheSFTsegmentisprovidedinSection5.2,“SFT(Software)Segment.”

SFT‐1SoftwareVendorOrganization

Thisfield,whosedatatypeisXON,containsnameandotheridentifyinginformationforthevendorofthesoftwarethatcreatedthecurrentmessageinstance.Itscomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R OrganizationName Nameofthevendorofthesoftwarethat

createdthecurrentmessageinstance.2 IS X 0204 OrganizationName

TypeCode

3 NM X IDNumber 4 NM X CheckDigit 5 ID X 0061 CodeIdentifying

theCheckDigitSchemeEmployed

6 HD X 0363 AssigningAuthority 7 IS X 0203 IdentifierType

Code

8 HD X AssigningFacilityID

9 ID X NameRepresentationCode

SFT‐2SoftwareCertifiedVersionorReleaseNumber

Thisfield,whosedatatypeisST,containsthelatestversionorreleasenumberofthesoftwarethatcreatedthecurrentmessageinstance.



SFT‐3SoftwareProductName

Thisfield,whosedatatypeisST,containsthenameofthesoftwarethatcreatedthecurrentmessageinstance.

SFT‐4SoftwareBinaryID

Thisfield,whosedatatypeisST,containsauniquechecksumorotheridentifierthatdistinguishestheversionofthesoftwarethatcreatedthecurrentmessageinstancefromsimilarversionsofthesamesoftwareandfromotherproductsofthesamevendor.

6.3EVN(EventType)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheEVN(eventtype)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheEVNsegmentisprovidedinSection5.3,“EVN(EventType)Segment.”

EVN‐2RecordedDate/Time

Thisfield,whosedatatypeisTS,containsthedateandtimewhentheeventthattriggeredthecreationofthecurrentmessageinstancewasrecordedinthecreatingsystem.

EVN‐7EventFacility

Thisfieldidentifiestheactualfacilitywheretheeventoccurred,asdistinctfromthefacilityidentifiedinMSH‐4‐sendingfacility.

ThedatatypeofEVN‐7‐eventfacilityisHD,whosecomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R ID Thefull,uniqueidentifiervalueforthe

patient.2 ST X CheckDigit 3 ID X 0061 CodeIdentifying


4 HD RE 0063 AssigningAuthority Thesystem,organization,agencyordepartmentthatcreatedthispatientidentifier.

5 IS RE 0203 IdentifierTypeCode

Whatkindofidentifierthisis:local,facility,stateornational,SocialSecurity,Medicare,etc.

6 HD RE AssigningFacility Theplaceorlocationwheretheidentifierwasfirstassignedtothepatient.



PID‐3 PatientIdentifierList

Thisfield,whichallowsforupto99occurrences,containsatleasttheidentifierforthepatientattheinstitutionorfacilityatwhichtheeventoccurred.ItisrecommendedthatanyotheridentifiersforthepatientbesentinadditionaloccurrencesofPID‐3‐patientidentifierlistratherthaninfieldsPID‐2‐patientID,PID‐4‐alternatepatientID‐PID,orPID‐19‐SSNnumber‐patient,allofwhichweredeprecatedasofHL7Version2.3.1.

ThedatatypeofPID‐3‐patientidentifierlistisCX,whosecomponentsareasfollows.


patient.2 ST X CheckDigit Restatementofthecheckdigitportion,ifany,

oftheIDnumberincomponent1.3 ID X 0061 CodeIdentifying




Whatkindofidentifierthisis:local,facility,stateornational,Medicare,etc.


PID‐4AlternatePatientID–PID

ThehistoricalintentofthisfieldistocontainoneormoreidentifiersforthepatientotherthantheprincipalpatientidentifiercarriedinPID‐3.ItisrecommendedthatidentifiersforthepatientbesentinoccurrencesofPID‐3‐patientidentifierlistratherthaninfieldsPID‐2‐patientID,PID‐4‐alternatepatientID‐PID,orPID‐19‐SSNnumber‐patient,allofwhichweredeprecatedasofHL7Version2.3.1.

ThedatatypeofPID‐4‐alternatepatientID‐PIDisCX,whosecomponentsareasfollows.


patient.2 ST X CheckDigit 3 ID X 0061 CodeIdentifying




Whatkindofidentifierthisis:local,facility,stateornational,SocialSecurity,Medicare,etc.




PID‐5 PatientName

Thisfieldcontainsallofthenamesbywhichthepatientisknowninthesystemthatgeneratedthecurrentmessageinstance.EachnameissentinaseparaterepetitionofPID‐5‐patientname.

Ifknown,thepatient’slegalnameistobesentinthefirstrepetitionofPID‐5‐patientname.Ifthepatient’slegalnameisnotknown,thefirstrepetitionofPID‐5‐patientnameistobeleftempty.

ThedatatypeofPID‐5‐patientnameisXPN,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R Familyname&last

nameprefixLastnameofthepatient.Ifthelastnamecontainsaprefixsuchasdeorvonthatisexcludedfromalphabetizationinthelocaleofthesendingsystem,thelastnameprefixisrestatedinthesecondsubcomponentofthiscomponent.

2 ST R GivenName Firstnameofthepatient.3 ST RE MiddleInitialor

NameMultiplemiddleinitialsornamesareseparatedbyspaces.

4 ST RE Suffix E.g.,JRorIII.5 ST RE Prefix E.g.,DR.6 IS RE 0360 Degree 7 ID RE 0200 NameTypeCode 8 ID X 4000 Name

RepresentationCode

PID‐7Date/TimeofBirth

Thisfield,whosedatatypeisTS,containsthedateandtimeofthepatient’sbirthaspreciselyasisrecordedonthesystemfromwhichthecurrentmessageinstancewassent.MinimumrequiredprecisionisYYYYMMDDorYYYYMMDDMMSS.

PID‐8 Sex

Thisfieldcontainstheadministrativesexofthepatient.ItsvalueistakenfromHL7Table0001,Sex.

PID‐10 Race

Thisfieldcontainsacodeandtextspecifyingthepatient’srace.ThedatatypeofthisfieldisCE,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodeforthepatient’srace,

preferablyfromtheCDCracecodeset.2 ST RE Text Thehuman‐readabletermforthepatient’s

race,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.



Cmp DT Usage TBL# ElementName Comments3 ST RE NameofCoding

SystemName(usuallyabbreviated)ofthecodesetfromwhichthecodeinComponent1andthetextinComponent2aretaken.

4 ST X AlternateIdentifier 5 ST X AlternateText

PID‐11 PatientAddress

Thisfieldcontainsthelocationofthepatient’sresidenceormaildeliverylocation.ThedatatypeofthisfieldisXAD,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE StreetAddress Ifthestreetaddressportionofthepatient’s

addressisoneline,itissentinthiscomponent.Ifthestreetaddressportionofthepatient’saddressistwolines,thefirstlineissentinthiscomponent.

2 ST RE OtherDesignation Ifthestreetaddressportionofthepatient’saddressisoneline,thiscomponentisempty.Ifthestreetaddressportionofthepatient’saddressistwolines,thesecondlineissentinthiscomponent.

3 ST RE City 4 ST RE StateorProvince 5 ST RE ZIPorPostalCode 6 ID RE Country Ifsent,thisshallbeacodefromtheISO3166

tableofthree‐charactercountrydesignators.7 ID RE 0190 AddressType 8 ST RE OtherGeographic

Designation

9 IS RE 0289 County/ParishCode

10 IS RE 0288 CensusTract 11 ID RE 4000 Address

RepresentationCode

PID‐13 PhoneNumber–Home

Thisfieldcontainsthetelephonenumberofthepatient’sresidence.ThedatatypeofthisfieldisXTN,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R [NNN][(999)]999‐

999[X99999][B99999][Canytext]

Thebodyofthetelephonenumbercanbesentinthiscomponent.Preferredusageistobreakoutthecomponentsofthetelephonenumberincomponents5‐9.

2 ID RE 0201 Telecommunicationsusecode

3 ID RE 0202 Telecommunicationsequipmenttype

4 ST RE EmailAddress



Cmp DT Usage TBL# ElementName Comments5 NM RE CountryCode 6 NM RE Area/CityCode 7 NM RE PhoneNumber 8 NM RE Extension 9 ST RE AnyText

PID‐14 PhoneNumber–Business

Thisfieldcontainsthetelephonenumberofthepatient’sworkplace.ThedatatypeofthisfieldisXTN,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R [NNN][(999)]999‐

999[X99999][B99999][Canytext]

Thebodyofthetelephonenumbercanbesentinthiscomponent.Preferredusageistobreakoutthecomponentsofthetelephonenumberincomponents5‐9.

2 ID RE 0201 Telecommunicationsusecode

3 ID RE 0202 Telecommunicationsequipmenttype

4 ST RE EmailAddress 5 NM RE CountryCode 6 NM RE Area/CityCode 7 NM RE PhoneNumber 8 NM RE Extension 9 ST RE AnyText

PID‐19 SSNNumber‐Patient

Thisfieldcontainsthelastfourdigitsofthepatient’sSocialSecurityNumber.Datainthisfieldareusedtoimprovethequalityofmatchingbetweenrecordscontainingsimilarpatientidentificationcriteria.ThiscanbethelastfouroftheSS#orinfullninedigitformatXXX‐XX‐XXXX.

PID‐20 Driver’sLicenseNumber–Patient

Thisfieldcontainsthepatient’sdriver’slicensenumberifavailable.ThedatatypeofthisfieldisDLN,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE LicenseNumber 2 IS RE 0333 IssuingState,

Province,CountryIfacountrycodeissent,thisshallbeacodefromtheISO3166tableofthree‐charactercountrydesignators.

3 DT RE ExpirationDate

PID‐21 Mother’sIdentifier

Thisfieldcontainsidentifiersforthepatient’smother.Itmustbepopulatediftheageofthepatientis1monthorless.

ThedatatypeofPID‐21‐mother’sidentifierisCX,whosecomponentsareasfollows.




patient.2 ST X CheckDigit Restatementofthecheckdigitportion,ifany,

oftheIDnumberincomponent1.3 ID X 0061 CodeIdentifyingthe

CheckDigitSchemeEmployed


5 IS RE 0203 IdentifierTypeCode Whatkindofidentifierthisis:local,facility,stateornational,Medicare,etc.


PID‐22 EthnicGroup

Thisfieldcontainsacodeandtextspecifyingthepatient’smembership,orlackthereof,inaparticularethnicgroup.ThedatatypeofthisfieldisCE,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodespecifyingthepatient’s

membership,orlackthereof,inanethnicgroup,preferablyfromtheCDCracecodeset.

2 ST RE Text Thehuman‐readabletermforthepatient’sethnicgroup,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.

3 ST RE NameofCodingSystem

Name(usuallyabbreviated)ofthecodesetfromwhichthecodeinComponent1andthetextinComponent2aretaken.

4 ST X AlternateIdentifier 5 ST X AlternateText 6 ST X NameofAlternate

CodingSystem

PID‐24 MultipleBirthIndicator

Ifitisknownwhetherthepatient(generallyaneonate)isoneofanumberofmultipleconcurrentbirths(e.g.,twinsortriplets),thisfield,whosedatatypeisID,containsavaluefromHL7Table0136,Yes/NoIndicator:YifthepatientispartofamultiplebirthorNifthepatientisnotpartofamultiplebirth.

PID‐25 BirthOrder

IfthevalueofPID‐24‐multiplebirthindicatorisY,thisfield,whosedatatypeisNM,containsanintegerindicatingtheorderofthispatientinthemultiplebirth:1ifthefirstborn,2ifthesecondborn,etc.



PID‐29 PatientDeathDateandTime

Ifthepatientisdeceased,thisfield,whosedatatypeisTS,containsthedateandtimeofthepatient’sdeathaspreciselyasisrecordedonthesystemfromwhichthecurrentmessageinstancewassent.

PID‐30 PatientDeathIndicator

Thisfield,whosedatatypeisID,indicateswhetherthepatientisdeceased.ItsvalueistakenfromHL7‐definedTable0136,Yes/noindicator.

6.5PD1(AdditionalDemographics)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingthePD1(additionaldemographics)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsinthePD1segmentisprovidedinSection5.5,“PD1(AdditionalDemographics)Segment.”

PD1‐4PatientPrimaryCareProviderName&IDNo.

Ifthepatient’sprimarycareproviderisknown,identifyinginformationforthatproviderissentinthisfield.

ThedatatypeofthisfieldisXCN,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE IDNumber Thefull,uniqueidentifiervalueforthe

provider.UseofNPIisrecommended.2 ST R Familyname&last

nameprefixLastnameoftheprovider.Ifthelastnamecontainsaprefixsuchasdeorvonthatisexcludedfromalphabetizationinthelocaleofthesendingsystem,thelastnameprefixisrestatedinthesecondsubcomponentofthiscomponent.

3 ST RE GivenName Firstnameoftheprovider.4 ST RE MiddleInitialor


5 ST RE Suffix E.g,JRorIII.6 ST RE Prefix E.g.DR.7 IS RE 0360 Degree 8 IS RE 0297 SourceTable 9 HD RE 0363 AssigningAuthority Thecreatoroftheauthoritativeidentification

recordfromwhichthisprovider’sIDnumberandnamedataarederived.

10 ID RE 0200 NameTypeCode 11 ST RE IdentifierCheck

DigitRestatementofthecheckdigitportion,ifany,oftheIDnumberincomponent1.



6.6PV1(PatientVisit)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingthePV1(patientvisit)segment.

Asummarytableofusages,cardinalities,andelementnamesofallfieldsinthePV1segmentisprovidedinSection5.6,“PV1(PatientVisit)Segment.”

PV1‐2PatientClass

Thisfielddesignatesthetypeofvisit,suchasinpatient(I)oroutpatient(O)forwhichthepatientisregistered.

ThedatatypeoffieldPV1‐2‐patientclassisIS.Itcontainsavaluefromuser‐definedTable0004,PatientClass.

PV1‐3AssignedPatientLocation

Foraninpatient,thisfielddesignatesthepatient’slocationinthemedicalcenter.ThedatatypeofthisfieldisPL,whichisdefinedasfollows.






5 ST RE Suffix E.g.JRorIII.6 ST RE Prefix E.g.DR.7 IS RE 0360 Degree 8 IS R 0297 SourceTable Alwaysvalued0010todesignateuser‐

definedTable0010,PhysicianID,asthesourceofvaluesforthisfield.

9 HD RE 0363 AssigningAuthority Thecreatoroftheauthoritativeidentificationrecordfromwhichthisprovider’sIDnumberandnamedataarederived.



PV1‐8ReferringDoctor

Thisfieldcontainsinformationforasinglereferringphysician.Repetitionsofthisfieldmaycontainidentifyinginformationforthesamephysicianindifferentmasterfilesor



sourcesystems.However,thisfieldisnottobeusedtosendinformationformultiplereferringphysicians.












PV1‐9ConsultingDoctor

Thisfieldcontainsinformationforoneormoreconsultingphysicians.Repetitionsofthisfieldmaycontainidentifyinginformationforthesameordifferentphysiciansindifferentmasterfilesorsourcesystems.







5 ST RE Suffix E.g.JRorIII.6 ST RE Prefix E.g.DR.7 IS RE 0360 Degree



Cmp DT Usage TBL# ElementName Comments8 IS R 0297 SourceTable Alwaysvalued0010todesignateuser‐





PV1‐10 HospitalService

Thisfield,whosedatatypeisIS,containsacodeforthetreatmentortypeofsurgerythatwasassignedtothepatientwiththemostrecentpatientmovement.Whenpresent,itispopulatedwithavaluefromuser‐definedTable0069,HospitalService.

PV1‐14 AdmitSource

Thisfield,whosedatatypeisIS,containsacodeindicatingfromwherethepatientintakeoccurred.Whenpresent,itispopulatedwithavaluefromuser‐definedTable0023,AdmitSource.

PV1‐17 AdmittingDoctor

Thisfieldcontainsinformationforasingleadmittingphysician.Repetitionsofthisfieldmaycontainidentifyinginformationforthesamephysicianindifferentmasterfilesorsourcesystems.However,thisfieldisnottobeusedtosendinformationformultipleadmittingphysicians.



provider.UseofNPIisrecommended.2 ST R FamilyNameand

LastNamePrefixLastnameoftheprovider.Ifthelastnamecontainsaprefixsuchasdeorvonthatisexcludedfromalphabetizationinthelocaleofthesendingsystem,thelastnameprefixisrestatedinthesecondsubcomponentofthiscomponent.







Cmp DT Usage TBL# ElementName Comments9 HD RE 0363 AssigningAuthority Thecreatoroftheauthoritativeidentification

recordfromwhichthisprovider’sIDnumberandnamedataarederived.



PV1‐18 PatientType

Thisfield,whosedatatypeisIS,containsasite‐specificcodespecifyingthepatienttype.Whenpresent,itispopulatedwithavaluefromuser‐definedTable0018,PatientType.

PV1‐36 DischargeDisposition

Thisfield,whosedatatypeisIS,containsasite‐specificcodeindicatingthestatusand/orlocation(e.g.,home,expired)applicabletothepatientatthetimeofdischarge.Whenpresent,itispopulatedwithavaluefromuser‐definedTable0112,DischargeDisposition.

PV1‐37 DischargedtoLocation

Thisfield,whenpopulated,containstheidentifierofthefacilitytowhichthepatientwasdischarged.

ThedatatypeoffieldPV1‐37‐dischargedtolocationisCM.Itscomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 IS RE 0113 DischargeLocation 2 TS RE EffectiveDate

PV1‐44 AdmitDate/Time

Whenpresent,thisfield,whosedatatypeisTS,containsthedateandtimewhenthepatientwasadmitted(ifthepatientisaninpatient)orwhenthecurrentencounterbegan(ifthepatientisanoutpatient).

PV1‐45 DischargeDate/Time

Whenpresent,thisfield,whosedatatypeisTS,containsthedateandtimewhenthepatientwasdischarged(ifthepatientwasaninpatientandhasbeendischarged)orwhenthecurrentencounterended(ifthepatientwasanoutpatientandthecurrentencounteriscomplete).



6.7OBX(Observation/Result)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheOBX(observation/result)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheOBXsegmentisprovidedinSection5.7,“OBX(Observation/Result)Segment.”

OBX‐2ValueType

Thisfield,whosedatatypeisID,containsthedatatypeoftheinformationcarriedinfieldOBX‐5‐observationvalue.

Whenpresent,fieldOBX‐2‐valuetypeispopulatedwithavaluefromHL7Table0125,ValueType.ThisfieldshallbepopulatedinalloccurrencesoftheOBXsegmentexceptthoseinwhichfieldOBX‐11‐ObservationResultStatusisvaluedX,indicatingthatnovaluewasobtainedfortheobservation.

OBX‐3ObservationIdentifier

ThisfieldcontainsacodethatclassifiestheinformationcarriedinfieldOBX‐5‐observationvalue.ThedatatypeoffieldOBX‐3‐observationidentifierisCE,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodespecifyingthekindof

information,preferablyfromtheLOINCcodeset.Forheightandweight,thismustbeaLOINCcode(eitherforreportedormeasured).

2 ST RE Text Thehuman‐readabletermforthekindofinformation,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.




CodingSystem

OBX‐5ObservationValue

ThisfieldcontainstheactualvaluewhosedatatypeisgiveninfieldOBX‐2‐valuetypeandwhoseclassificationisgiveninfieldOBX‐3‐observationidentifier.ItsformattingfollowstherulesoftheHL7standardforthedatatypecarriedinOBX‐2andtheHL7versioncarriedinfieldMSH‐12‐versionID.



OBX‐6Units

ThisfieldcontainstheunitsofmeasurefortheobservationcarriedinfieldOBX‐5‐observationvalue.ThedatatypeoffieldOBX‐6‐unitsisCE,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodespecifyingtheunitsof

measure,preferablyfromISOStandard2955‐1983.

2 ST RE Text Thehuman‐readabletermfortheunitsofmeasure,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.




CodingSystem

OBX‐11 ObservationResultStatus

Thisfield,whosedatatypeisID,indicatestheprocessingorreleasestageoftheobservation.ItispopulatedwithavaluefromHL7Table0085,ObservationResultStatusCodesInterpretation.

OBX‐14 Date/TimeoftheObservation

Thisfield,whosedatatypeisTS,indicatesthedateandtimewhentheobservationoccurred,aspreciselyasavailablefromthesystemthatsentthecurrentmessageinstance.

6.8DG1(DiagnosisInformation)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheDG1(diagnosisinformation)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheDG1segmentisprovidedinSection5.8,“DG1(DiagnosisInformation)Segment.”

DG1‐2DiagnosisCodingMethod

ThisfieldindicatesthecodingsystemfromwhichthecodeinfieldDG1‐3‐diagnosiscode‐DG1wasobtained.

FieldDG1‐2‐diagnosiscodingmethod,whosedatatypeisID,hasbeendeprecatedbyHL7infavorofthethirdcomponent(NameofCodingSystem)ofDG1‐3.Ifpresent,DG1‐2ispopulatedwithavaluefromHL7Table0053,DiagnosisCodingMethod.



DG1‐3DiagnosisCode–DG1

Thisfieldcontainsthesymbolicterm,suchasanICD‐9code,assignedtothisdiagnosis.

ThedatatypeofDG1‐3‐diagnosiscodeisCE,whosecomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodespecifyingthediagnosis.2 ST RE Text Thehuman‐readabletermforthediagnosis,

whichmustcorrespondtothevalueinComponent1(Identifier)ifany.UsethiscomponentinpreferencetofieldDG1‐4‐diagnosisdescription,whichhasbeendeprecatedbyHL7.


Name(usuallyabbreviated)ofthecodesetfromwhichthecodeinComponent1andthetextinComponent2aretaken.UsethiscomponentinpreferencetofieldDG1‐2‐diagnosiscodingmethod,whichhasbeendeprecatedbyHL7.


CodingSystem

DG1‐4DiagnosisDescription

Thisfieldcontainsthehuman‐readabletermforthediagnosis.

FieldDG1‐4‐diagnosisdescription,whosedatatypeisST,hasbeendeprecatedbyHL7infavorofthesecondcomponent(Text)ofDG1‐3.

DG1‐5DiagnosisDate/Time

Thisfield,whosedatatypeisTS,indicatesthedateandtimewhenthediagnosiswasdetermined,aspreciselyasavailablefromthesystemthatsentthecurrentmessageinstance.

DG1‐6DiagnosisType

Thisfield,whosedatatypeisIS,containsacodeindicatingthestageofthediagnosis,suchasadmitting(A),working(W)orfinal(F).Whenpresent,itispopulatedfromuser‐definedTable0052,DiagnosisType.

6.9PR1(Procedures)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingthePR1(procedures)segment.

Asummarytableofusages,cardinalities,andelementnamesofallfieldsinthePR1segmentisprovidedinSection5.9,“PR1(Procedures)Segment.”



PR1‐2ProcedureCodingMethod

ThisfieldindicatesthecodingsystemfromwhichthecodeinfieldPR1‐3‐procedurecodewasobtained.

FieldPR1‐2‐procedurecodingmethod,whosedatatypeisID,hasbeendeprecatedbyHL7infavorofthethirdcomponent(NameofCodingSystem)ofPR1‐3.Ifpresent,PR1‐2ispopulatedwithavaluefromHL7Table0089,ProcedureCoding.

PR1‐3ProcedureCode

Thisfieldcontainsthesymbolicterm,suchasaCPTcode,assignedtothisprocedure.

ThedatatypeofPR1‐3‐procedurecodeisCE,whosecomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thestandardcodespecifyingtheprocedure.

Populatedwithavaluefromuser‐definedTable0088,ProcedureCode.

2 ST RE Text Thehuman‐readabletermfortheprocedure,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.UsethiscomponentinpreferencetofieldPR1‐4‐proceduredescription,whichhasbeendeprecatedbyHL7.


Name(usuallyabbreviated)ofthecodesetfromwhichthecodeinComponent1andthetextinComponent2aretaken.UsethiscomponentinpreferencetofieldPR1‐2‐procedurecodingmethod,whichhasbeendeprecatedbyHL7.


CodingSystem

PR1‐4ProcedureDescription

Thisfieldcontainsthehuman‐readabletermfortheprocedure.

FieldPR1‐4‐proceduredescription,whosedatatypeisST,hasbeendeprecatedbyHL7infavorofthesecondcomponent(Text)ofPR1‐3.

PR1‐5ProcedureDate/Time

Thisfield,whosedatatypeisTS,indicatesthedateandtimewhentheprocedurewasperformed,aspreciselyasavailablefromthesystemthatsentthecurrentmessageinstance.

PR1‐8Anesthesiologist

Thisfieldcontainsinformationforasingleanesthesiologistassociatedwiththeprocedure.Repetitionsofthisfieldmaycontainidentifyinginformationforthesame



anesthesiologistindifferentmasterfilesorsourcesystems.However,thisfieldisnottobeusedtosendinformationformultipleanesthesiologists.

FieldPR1‐8‐anesthesiologisthasbeendeprecatedbyHL7infavoroftheROLsegment.



provider.2 ST R Familyname&last

nameprefixIfthelastnamecontainsaprefixsuchasdeorvonthatisexcludedfromalphabetizationinthelocaleofthesendingsystem,thelastnameprefixisrestatedinthesecondsubcomponentofthiscomponent.

3 ST RE GivenName 4 ST RE MiddleInitialor


5 ST RE Suffix e.g.,JRorIII.6 ST RE Prefix e.g.,DR.7 IS RE 0360 Degree 8 IS R 0297 SourceTable Alwaysvalued0010todesignateuser‐





PR1‐11 Surgeon

Thisfieldcontainsinformationforasinglesurgeonassociatedwiththeprocedure.Repetitionsofthisfieldmaycontainidentifyinginformationforthesamesurgeonindifferentmasterfilesorsourcesystems.However,thisfieldisnottobeusedtosendinformationformultiplesurgeons.

FieldPR1‐8‐surgeonhasbeendeprecatedbyHL7infavoroftheROLsegment.



provider.2 ST R Familyname&last

nameprefixIfthelastnamecontainsaprefixsuchasdeorvonthatisexcludedfromalphabetizationinthelocaleofthesendingsystem,thelastnameprefixisrestatedinthesecondsubcomponentofthiscomponent.

3 ST RE GivenName 4 ST RE MiddleInitialor




Cmp DT Usage TBL# ElementName Comments5 ST RE Suffix e.g.,JRorIII.6 ST RE Prefix e.g.,DR.7 IS RE 0360 Degree 8 IS R 0297 SourceTable Alwaysvalued0010todesignateuser‐





6.10IN1(Insurance)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheIN1(insurance)segment.

Asummarytableofusages,cardinalitiesandelementnamesofallfieldsintheIN1segmentisprovidedinSection5.10,“IN1(Insurance)Segment.”

IN1‐1 SetID–IN1

ThisistheordinalnumberofthisoccurrenceoftheAL1segmentwithinthecurrentmessageinstance.Thefirstoccurrenceislabeled1,thesecond2,andsoon.

Ifthepatientispayingoutofpocketratherthanusinginsurance,then,inthefirstoccurrenceoftheIN1segment,thetermSELF‐PAYmustappearinthesecondcomponentofIN1‐2‐InsurancePlanID.Thisisnecessarytosuppressthesendingofmessageinformationtoinsurancecarriers.

IN1‐2 InsurancePlanID

Thisfieldcontainsauniqueidentifierfortheinsuranceplan.

ThedatatypeofthisfieldisCE,whosecomponentsareasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST RE Identifier Thesymbolicidentifieroftheinsuranceplan.2 ST RE Text Thehuman‐readablenameoftheinsurance

plan,whichmustcorrespondtothevalueinComponent1(Identifier)ifany.Ifthepatientispayingoutofpocketratherthanusinginsurance,then,inthefirstoccurrenceoftheIN1segment,thetermSELF‐PAYmustappearinthiscomponent.Thisisnecessarytosuppressthesendingofmessageinformationtoinsurancecarriers.

3 ST X NameofCodingSystem

4 ST X AlternateIdentifier



Cmp DT Usage TBL# ElementName Comments5 ST X AlternateText 6 ST X NameofAlternate

CodingSystem

IN1‐3 InsuranceCompanyID

Thisfieldcontainsauniqueidentifierfortheinsurancecompany.MiHINwillworkwiththeADTsendingorganizationstomapcontentsofIN1‐3‐insurancecompanyIDtoinsurancecompaniesacrossthestateforaccuratedelivery.

ThedatatypeofthisfieldisCX,whosecomponentsareasfollows.


insurancecompany.2 ST X CheckDigit Restatementofthecheckdigitportion,ifany,

oftheIDnumberincomponent1.3 ID X 0061 CodeIdentifyingthe


4 HD RE 0063 AssigningAuthority Thesystem,organization,agency,ordepartmentthatcreatedthisinsurancecompanyidentifier.

5 IS RE 0203 IdentifierTypeCode Indicatesthatthisisaninsurancecompanyidentifierand,ifapplicable,morepreciselyindicateswhatkindofinsurancecompanyidentifierthisis:local,facility,stateornational,Medicare,etc.


IN1‐4 InsuranceCompanyName

Thisfield,whosedatatypeisXON,containsnameandotheridentifyinginformationfortheinsurancecompany.MiHINwillworkwiththeADTsendingorganizationstomapcontentsofIN1‐4‐insurancecompanynametoinsurancecompaniesacrossthestateforaccuratedelivery.

Itscomponentsaredefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R OrganizationName Nameoftheinsurancecompany.2 IS X 0204 OrganizationName

TypeCode

3 NM X IDNumber 4 NM X CheckDigit 5 ID X 0061 CodeIdentifyingthe


6 HD X 0363 AssigningAuthority 7 IS X 0203 IdentifierTypeCode 8 HD X AssigningFacilityID



Cmp DT Usage TBL# ElementName Comments9 ID X Name

RepresentationCode

IN1‐36 PolicyNumber

Thisfield,whosedatatypeisST,containstheindividualpolicynumberoftheinsuredtouniquelyidentifythispatient’splan.Forspecialtypesofinsurancenumbers,therearealsospecialfieldsintheIN2segmentforMedicaid,Medicare,CHAMPUS(i.e.,IN2‐8‐Medicaidcasenumber,IN2‐6‐Medicarehealthinsurancecardnumber,andIN2‐10‐MilitaryIDnumber).HoweverHL7recommendsthatIN1‐36‐policynumberbefilledevenwhenthepatient’sinsurancenumberisalsopassedinoneoftheseotherfields.

6.11NPU(Non‐PatientUpdate)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheNPU(non‐patientupdate)segment.

Asummarytableofusages,cardinalities,andelementnamesofallfieldsintheNPUsegmentisprovidedinSection5.11,“NPU(Non‐PatientUpdate)Segment.”

NPU‐1BedLocation

Thisfielddesignatesthelocationofthebedinthemedicalcenter.ThedatatypeofthisfieldisPL,whichisdefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 IS RE 0302 PointofCare Entriesinuser‐definedTable0302are

definedatthemedicalcenter.NosuggestedvaluesareprovidedbyHL7.

2 IS RE 0303 Room Entriesinuser‐definedTable0303aredefinedatthemedicalcenter.NosuggestedvaluesareprovidedbyHL7.

3 IS RE 0304 Bed Entriesinuser‐definedTable0304aredefinedatthemedicalcenter.NosuggestedvaluesareprovidedbyHL7.

4 HD RE Facility 5 IS RE 0306 LocationStatus 6 IS RE 0305 PersonLocation

Type

7 IS RE 0307 Building Entriesinuser‐definedTable0307aredefinedatthemedicalcenter.NosuggestedvaluesareprovidedbyHL7.

8 IS RE 0308 Floor Entriesinuser‐definedTable0308aredefinedatthemedicalcenter.NosuggestedvaluesareprovidedbyHL7.

9 ST RE LocationDescription



NPU‐2 BedStatus

Thisfield,whosedatatypeisIS,indicatestheoccupancystatusofthebed.Itispopulatedwithavaluefromuser‐definedTable0116,BedStatus.

6.12MSA(MessageAcknowledgment)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheMSA(messageacknowledgment)segment.

Asummarytableofusages,cardinalities,andelementnamesofallfieldsintheMSAsegmentisprovidedinSection5.12,“MSA(MessageAcknowledgment)Segment.”

MSA‐1AcknowledgmentCode

Thisfield,whosedatatypeisID,indicateswhetherthereceiverwasabletopersistandprocessthemessagesuccessfully.ItispopulatedwithavaluefromHL7‐definedTable0008,AcknowledgmentCode.

MSA‐2MessageControlID

Thisfield,whosedatatypeisST,containsthevalueofMSH‐10‐messagecontrolIDinthemessagereceivedfromtheoriginatingsystem.Itallowsanassociationtobemaintainedbetweenthisacknowledgmentresponseandthemessageitisacknowledging.

6.13ERR(Error)SegmentFields

ThedetailedfielddefinitionsbelowshallbeconformedtobyallHL7messagessendingtheERR(error)segment.

Asummarytableofusages,cardinalities,andelementnamesofallfieldsintheERRsegmentisprovidedinSection5.13,“ERR(Error)Segment.”

ERR‐1ErrorCodeandLocation

Eachoccurrenceofthisfielddesignatesatwhatsegment,field,repetitionand/orcomponentintheoriginatingmessageanerroroccurred,andthenatureoftheerror.

FieldERR‐1‐errorcodeandlocationwasdeprecatedinHL7Version2.5infavoroffieldsERR‐2throughERR‐12,whichallowerrorstobespecifiedwithgreaterprecisionanddetail.However,ERR‐1mustbepresentiftheHL7versionasspecifiedinMSH‐12‐versionIDispriorto2.5.

ThedatatypeofthisfieldisELD,whichisdefinedasfollows.



Cmp DT Usage TBL# ElementName Comments1 ST RE SegmentID Presentifandonlyiftheerrorcorresponded

toanelementoftheoriginatingmessage.2 NM CE SegmentSequence Ifandonlyifcomponent1issent,this

componentindicatestowhatoccurrenceofthesegmenttheerrorcorresponded.ItshouldcontainthevalueoftheSetIDfield(ifpresent,generallyfield1)ofthesegment.

3 NM CE FieldPosition Ifandonlyifcomponent1issent,thiscomponentindicatestowhatfield(ifany)theerrorcorresponded.

4 CE R 0357 CodeIdentifyingError

Thiscomponentissentasthreesubcomponents,separatedbythesubcomponentseparator.ThefirstcomponentistheappropriatecodefromTable0357,MessageErrorConditionCodes;thesecondcomponentisthecorrespondingdescriptionfromTable0357;thethirdcomponentisthestringliteralHL70357.

ERR‐2ErrorLocation

Thisfieldindicatesthelocation(s)inthereceivedmessageatwhichtheindicatederroroccurred.Forerrorsoccurringatoneormorespecificlocations,fieldERR‐2‐errorlocationmustbepresentiftheHL7versionasspecifiedinfieldMSH‐12‐versionIDis2.5orlater.

ThedatatypeofthisfieldisERL,whichisdefinedasfollows.

Cmp DT Usage TBL# ElementName Comments1 ST R SegmentID 2 NM R SegmentSequence Thiscomponentindicatestowhatoccurrence

ofthesegmenttheerrorcorresponded.ItshouldcontainthevalueoftheSetIDfield,ifpresent.IftheerrorcorrespondstoasegmentthatcontainsnoSetIDfieldandoccursonlyonce,thiscomponentshouldcontain1.

3 NM CE FieldPosition Thiscomponentindicatestowhatfield(ifany)theerrorcorresponded.

4 NM CE FieldRepetition Ifcomponent3ispopulatedandtheelementatthefieldpositionindicatedbycomponent3containsmultipleoccurrences,thiscomponentcontainsanintegercorrespondingtotheordinaloccurrenceinwhichtheerroroccurred.

5 NM CE ComponentNumber Ifcomponent3ispopulatedandtheelementatthefieldpositionindicatedbycomponent3containsmultiplecomponents,thiscomponentcontainsanintegercorrespondingtotheordinalpositionofthecomponentinwhichtheerroroccurred.

6 NM CE Sub‐ComponentNumber

Ifcomponent5ispopulatedandtheelementatthecomponentpositionindicatedby



Cmp DT Usage TBL# ElementName Commentscomponent5containsmultiplesubcomponents,thiscomponentcontainsanintegercorrespondingtotheordinalpositionofthesubcomponentinwhichtheerroroccurred.

ERR‐3HL7ErrorCode

Thisfield,whosedatatypeisCNE,containsacodespecifyingthenatureoftheerror.ItmustbepresentiftheHL7versionindicatedinfieldMSH‐12‐versionIDis2.5orlater.

ThevalueinthisfieldistakenfromHL7Table0357,MessageErrorConditionCodes.

ERR‐4Severity

Thisfield,whosedatatypeisID,containsacodespecifyingwhethertheerrorisinformational,warningorfatal.ItmustbepresentiftheHL7versionindicatedinfieldMSH‐12‐versionIDis2.5orlater.

ThevalueinthisfieldistakenfromHL7Table0516,ErrorSeverity.



7HL7VocabularyTablesThefollowingtablesaredefinedforuseinfields,components,andsubcomponentsofdatatypesID,ISandCEwhosevaluesarederivedfromHL7‐definedtablesoruser‐definedtablespublishedbyHL7.Eachtablebelowdescribesthevaluesourceforthetableandthedataelementstowhichthetableapplies,andlistsvaluesthatshallberecognizedbyconformantsendingandreceivingapplications.ValuesderivedfromtablesnotlistedinthissectionshallbeusedaccordingtotherulespublishedintheHL7standardforsuchtablesandthedatatypesoftheelementsinwhichtheyaresentandreceived.

Table0001:Sex

FieldPID‐8‐sexshallcontainoneofthefollowingvalues.

Value Description CommentM Male F Female O Other U Unknown

Table0003:EventType

ThistableprovidesHL7‐definedvaluestobesentincomponent2offieldMSH‐9‐messagetype.

Value Description CommentA01 ADT/ACK–Admit/visitnotification A02 ADT/ACK–Transferapatient A03 ADT/ACK–Discharge/endvisit A04 ADT/ACK–Registerapatient A05 ADT/ACK–Pre‐admitapatient A06 ADT/ACK–Changeanoutpatienttoaninpatient A07 ADT/ACK–Changeaninpatienttoanoutpatient A08 ADT/ACK–Updatepatientinformation A09 ADT/ACK–Patientdeparting–tracking A10 ADT/ACK–Patientarriving–tracking A11 ADT/ACK–Canceladmit/visitnotification A12 ADT/ACK–Canceltransfer A13 ADT/ACK–Canceldischarge/endvisit A14 ADT/ACK–Pendingadmit A15 ADT/ACK–Pendingtransfer A17 ADT/ACK–Swappatients A20 ADT/ACK–Bedstatusupdate A21 ADT/ACK–Patientgoesona“leaveofabsence” A22 ADT/ACK–Patientreturnsfroma“leaveofabsence” A23 ADT/ACK–Deleteapatientrecord A24 ADT/ACK–Linkpatientinformation A25 ADT/ACK–Cancelpendingdischarge



Value Description CommentA26 ADT/ACK–Cancelpendingtransfer A27 ADT/ACK–Cancelpendingadmit A29 ADT/ACK–Deletepersoninformation A32 ADT/ACK–Cancelpatientarriving–tracking A33 ADT/ACK–Cancelpatientdeparting–tracking A37 ADT/ACK–Unlinkpatientinformation

Table0004:PatientClass

ThistableprovidesHL7‐suggestedvaluestobesentinfieldPV1‐2‐patientclass.

Value Description CommentE Emergency I Inpatient O Outpatient P Preadmit R Recurringpatient B Obstetrics

Table0005:Race

ThistableprovidesCDC‐definedvaluestobesentinfieldPID‐10‐race.

Value Description Comment1002‐5 AmericanIndianorAlaskaNative 2028‐9 Asian 2054‐5 BlackorAfricanAmerican 2076‐8 NativeHawaiianorOtherPacificIslander 2131‐1 OtherRace 2106‐3 White

Table0007:AdmissionType

ThistableprovidesHL7‐suggestedvaluestobesentinfieldPV1‐4‐admissiontype.

Value Description CommentA Accident E Emergency L LaborandDelivery R Routine



Table0008:AcknowledgmentCode

ThistableprovidesHL7‐definedvaluestobesentinfieldMSA‐1‐acknowledgmentcode.

Value Description CommentAA ApplicationAccept Noerror.AE ApplicationError Anerrorhavingtodowiththecontentofasegment,field,component

orsubcomponentofthemessage(exceptforthosefieldslistedunderARbelow).

AR ApplicationReject AnerrorhavingtodowiththecontentoffieldMSH‐9‐messagetype,MSH‐11‐processingID,orMSH‐12‐versionID;oranerrorunrelatedtothemessagecontent,suchasasystem,programorqueuefailure.

Table0010:PhysicianID

Valuestobesentinthefollowingfieldsshallbedefinedbythesendingsite:

PD1‐4‐patientprimarycareprovidername&IDno. PV1‐7‐attendingdoctor PV1‐8‐referringdoctor PV1‐9‐consultingdoctor PV1‐17‐admittingdoctor PR1‐8‐anesthesiologist PR1‐11‐surgeon

Table0018:PatientType

ValuestobesentinfieldPV1‐18‐patienttypeshallbedefinedbythesendingsite.

Table0023:AdmitSource

ThistableprovidesHL7‐suggestedvaluestobesentinfieldPV1‐14‐admitsource.

Value Description Comment1 Physicianreferral 2 Clinicreferral 3 HMOreferral 4 Transferfromahospital 5 Transferfromaskillednursingfacility 6 Transferfromanotherhealthcarefacility 7 Emergencyroom 8 Court/lawenforcement 9 Informationnotavailable



Table0051:DiagnosisCode

NeitherHL7norMiHINdefinevaluesfromTable0051tobesentinfieldDG1‐3‐diagnosiscode–DG1.ItisrecommendedthattheapplicableSNOMED‐CT,ICD‐9,orICD‐10codebesentincomponentDG1‐3.1andthecorrespondingdescriptionincomponentDG1‐3.2.

If,andonlyif,aSNOMED‐CTcodeissentincomponentDG1‐3.1,thevalueSNMshouldbesentincomponentDG1‐3.3.

If,andonlyif,anICD‐9codeissentincomponentDG1‐3.1,thevalueI9shouldbesentincomponentDG1‐3.3.

If,andonlyif,anICD‐10codeissentincomponentDG1‐3.1,thevalueI10shouldbesentincomponentDG1‐3.3.

Table0052:DiagnosisType

ThistableprovidesHL7‐suggestedvaluestobesentinfieldDG1‐6‐diagnosistype.

Value Description CommentA Admitting W Working F Final

Table0053:DiagnosisCodingMethod

ValuestobesentinfieldDG1‐2‐diagnosiscodingmethodshallbedefinedbythesendingsite.

Table0069:HospitalService

ValuestobesentinfieldPV1‐10‐hospitalserviceshallbedefinedbythesendingsite.

Table0072:InsurancePlanID

ValuestobesentinfieldIN1‐1‐insuranceplanIDshallbedefinedbythesendingsite.

Table0076:MessageType

ThistableprovidesHL7‐definedvaluestobesentincomponent1offieldMSH‐9‐messagetype.

Value Description CommentACK Generalacknowledgmentmessage ADT ADTmessage



Table0085:ObservationResultStatusCodesInterpretation

ThistableprovidesHL7‐definedvaluestobesentinfieldOBX‐11‐observationresultstatus.

Value Description CommentC Recordcomingoverisacorrectionandthus

replacesafinalresult

D DeletestheOBXrecord F Finalresults;Canonlybechangedwitha

correctedresult.

I Specimeninlab;resultspending N Notasked;usedtoaffirmativelydocument

thattheobservationidentifiedintheOBXwasnotsoughtwhentheuniversalserviceIDinOBR‐4impliesthatitwouldbesought.

O Orderdetaildescriptiononly(noresult) P Preliminaryresults R Resultsentered–notverified S Partialresults X Resultscannotbeobtainedforthis

observation

U Resultsstatuschangetofinalwithoutresendingresultsalreadysentas“preliminary”.e.g.,radiologychangesstatusfrompreliminarytofinal

W Postoriginalaswrong,e.g.,sentandreceivedforwrongpatient

Table0088:ProcedureCode

NeitherHL7norMiHINdefinevaluesfromTable0088tobesentinfieldPR1‐3‐procedurecode.ItisrecommendedthattheapplicableCPTcodebesentincomponentPR1‐3.1andthecorrespondingdescriptionincomponentPR1‐3.2.If,andonlyif,aCPTcodeissentincomponentPR1‐3.1,thevalueC4shouldbesentincomponentPR1‐3.3.

Table0089:ProcedureCodingMethod

ValuestobesentinfieldPR1‐2‐procedurecodingmethodshallbedefinedbythesendingsite.



Table0104:VersionID

ThistableprovidesHL7‐definedvaluestobesentinfieldMSH‐12‐versionID.

Value Description Comment(ReleaseDate)2.0 Release2.0 September19882.0D Demo2.0 October19882.1 Release2.1 March19902.2 Release2.2 December19942.3 Release2.3 March19972.3.1 Release2.3.1 May19992.4 Release2.4 November20002.5 Release2.5 May20032.5.1 Release2.5.1 January20072.6 Release2.6 July20072.7 Release2.7 November20102.7.1 Release2.7.1 TBD

Table0112:DischargeDisposition

ThistableprovidesHL7‐suggestedvaluestobesentinfieldPV1‐36‐dischargedisposition.

Value Description Comment01 Dischargedtohomeorselfcare(routinedischarge) 02 Discharged/transferredtoanothershortterm

generalhospitalforinpatientcare

03 Discharged/transferredtoskillednursingfacility(SNF)

04 Discharged/transferredtoanintermediatecarefacility(ICF)

05 Discharged/transferredtoanothertypeofinstitutionforinpatientcareorreferredforoutpatientservicestoanotherinstitution

06 Discharged/transferredtohomeundercareoforganizedhomehealthserviceorganization

07 Leftagainstmedicaladviceordiscontinuedcare 08 Discharged/transferredtohomeundercareofHome

IVprovider

09 Admittedasaninpatienttothishospital 20 Expired 30 Stillpatientorexpectedtoreturnforoutpatient

services

40 Expiredathome 41 Expiredinamedicalfacility;e.g.,hospital,SNF,ICF,

orfree‐standinghospice

42 Expired–placeunknown



Table0113:DischargedtoLocation

ValuestobesentinfieldPR1‐37‐dischargetolocationshallbedefinedbythesendingsite.

Table0116:BedStatus

ThistableprovidesHL7‐suggestedvaluestobesentinfieldNPU‐2‐bedstatus.

Value Description CommentC Closed H Housekeeping O Occupied U Unoccupied K Contaminated I Isolated

Table0125:ValueType

ThistableprovidesHL7‐definedvaluestobesentinfieldOBX‐2‐valuetype.

Value Description CommentNM Numeric ST StringData

Table0136:Yes/NoIndicator

ThistableprovidesHL7‐definedvaluestobesentinfieldPID‐30‐patientdeathindicator.

Value Description CommentY Yes N No

Table0189:EthnicGroup

ThistableprovidesCDC‐definedvaluestobesentinfieldPID‐22‐ethnicgroup.

Value Description Comment2135‐2 HispanicorLatino 2186‐5 NotHispanicorLatino

Table0302:PointofCare

ThevaluesfromTable0302tobesentincomponent1offieldsofdatatypePLshallbedefinedandmaintainedbythesendingsite.



Table0303:Room


Table0304:Bed


Table0305:PersonLocationType


Table0306:LocationStatus

ThevaluesfromTable0306tobesentincomponent5offieldsofdatatypePLareexpectedtobedefinedandmaintainedbythesendingsite.Alternatively,valuesfromTable0116,BedStatus,maybeused.

Table0307:Building


Table0308:Floor


Table0357:MessageErrorStatusCodes

ThistableprovidesHL7‐definedvaluestobesentincomponent4offieldERR‐1‐errorcodeandlocation.

Value Description Comment100 Segmentsequenceerror Themessagesegmentswerenotintheproperorder,orrequired

segmentsaremissing.101 Requiredfieldmissing Arequiredfieldismissingfromasegment.Usedalsoformissing

requiredcomponentsandsubcomponents.102 Datatypeerror Thefieldcontaineddataofthewrongdatatype,suchasan

alphabeticvalueinafieldoftypeNM.103 Tablevaluenotfound ThevalueofafieldofdatatypeIDorISwascomparedagainst

thecorrespondingtable,andnomatchwasfound.200 Unsupportedmessagetype Thevalueofcomponent1offieldMSH‐9‐messagetypeisnot

supported.



Value Description Comment201 Unsupportedeventcode Thevalueofcomponent2offieldMSH‐9‐messagetypeisnot

supported.202 UnsupportedprocessingID ThevalueoffieldMSH‐11‐processingIDisnotsupported.203 UnsupportedversionID ThevalueoffieldMSH‐12‐versionIDisnotsupported.204 Unknownkeyidentifier TheIDofthepatientwasnotfound.Usedforupdateanddelete

transactions.205 Duplicatekeyidentifier TheIDofthepatientalreadyexists.Usedforcreatetransactions.206 Applicationrecordlocked Thetransactioncouldnotbeperformedattheapplication

storagelevelbecauseofalockonthedatabasefileortable.207 Applicationinternalerror Anapplicationerrornotexplicitlycoveredbyothercodes.

Table0361:Application

ThistableprovidesMiHIN‐definedvaluestobesentincomponent1offieldsMSH‐3‐sendingapplicationandMSH‐5‐receivingapplication.

Value CommentApplicationSpecificOID TobeusedinMSH3TransitionsofCare TobeusedinMSH5byallorganizationssendingtoMiHINNotifications OthervalueswillbedefinedformessagessentbyMiHIN

Table0362:Facility

Thistableprovidesvaluestobesentincomponent1offieldsMSH‐4‐sendingfacilityandMSH‐6‐receivingfacility.

Value CommentMichiganHealthInformationNetwork

TobeusedinMSH‐6byallorganizationssendingtoMiHIN

FacilitySpecificOID TobeusedinMSH‐4byallorganizationssendingtoMiHIN

Table0516:ErrorSeverity

ThistableprovidesHL7‐definedvaluestobesentinfieldERR‐4‐severity.

Value Description CommentE Error TransactionwasunsuccessfulI Information Transactionwassuccessfulbutincludesadditionalinformation,

suchasamessagetobesentand/orreceivedbythepatientorprovider

W Warning Transactionwassuccessful,butunexpectedissuesorsideeffects(e.g.,anunexpectedindeterminatestatethatrequiresadditionalactionbythemessagegenerator)mayexist



8Troubleshooting

8.1ProductionSupport

SeverityLevels1 2 3 4

Description

CriticalImpact/SystemDown:Businesscriticalsoftwareisdownorcriticalinterfacehasfailed.Theissueisimpactingallproductionsystems,causingallparticipatingorganizations’orotherorganizations’abilitytofunctiontobeunusable.

SignificantBusinessImpact:Softwarecomponentseverelyrestricted.Entireorganizationisunabletocontinuebusinessfunctions,causingallcommunicationsandtransferofmessagestobehalted.

PartialFailureorDowntime:Programisuseableandlesssignificantfeaturesunavailable.Theserviceisonline,thoughmaynotworkingasintendedormaynotcurrentlyworkingasintendedormaynotcurrentlybeaccessible,thoughothersystemsarecurrentlyavailable.

MinimalBusiness:Anon‐criticalsoftwarecomponentismalfunctioning,causingminimalimpact,oratestsystemisdown.

Example

AllmessagestoandfromMiHINareunabletobesentandreceived,letalonetracked

MiHINcannotcommunication(sendorreceive)messagesbetweensingleormultipleparticipatingorganizations,butcanstillsuccessfullycommunicatewithotherorganizations.

Messagesarelostintransit,messagescanbereceivedbutnottransmitted.

Additionalfeaturerequested.

PrimaryInitiationMethod

Phone:(517)336‐1430

Phone:(517)336‐1430

Webformathttp://mihin.org/requesthelp


SecondaryInitiationMethod



[email protected]

[email protected]

TertiaryInitiationMethod

[email protected]

[email protected]

N/A N/A

InitialResponse Within2hours Within2hours 1businessday 1businessday

ResolutionGoal 24hours 24hours 3businessdays 7businessdays

Alistofcommonquestionsregardingthisusecasecanbefoundat:

http://mihin.org/about‐mihin/faqs/

Ifyouareexperiencingdifficultiesorhavequestions,pleasecontacttheMiHINHelpDesk:

www.mihin.org/requesthelp Phone:(517)336‐1430 Monday–Friday8:00AM–5:00PM(Eastern)



9LegalAdvisoryLanguageTheDataSharingAgreement(DSA)establishesthelegalframeworkunderwhichparticipatingorganizationscanexchangemessagesthroughtheHINPlatform,andsetsforththefollowingapprovedreasonsforwhichmessagesmaybeexchanged:

a. ByhealthcareprovidersforTreatment,Paymentand/orHealthCareOperationsconsistentwiththerequirementssetforthinHIPAA

b. PublichealthactivitiesandreportingaspermittedbyHIPAAandotherApplicableLawsandStandards

c. Tofacilitatetheimplementationof“MeaningfulUse”criteriaasspecifiedintheAmericanRecoveryandReinvestmentActof2009andaspermittedbyHIPAA

d. UsesanddisclosurespursuanttoanAuthorizationprovidedbytheindividualwhoisthesubjectoftheMessageorsuchindividual’spersonalrepresentativeinaccordancewithHIPAA

e. ByDataSharingOrganizationsforanyandallpurposes,includingbutnotlimitedtopilotprogramsandtesting,providedthatsuchpurposesareconsistentwithApplicableLawsandStandards

f. Foranyadditionalpurposesasspecifiedinanyusecase,providedthatsuchpurposesareconsistentwithApplicableLawsandStandards

UndertheDSA,“ApplicableLawsandStandards”meansallapplicablefederal,state,andlocallaws,statutes,acts,ordinances,rules,codes,standards,regulationsandjudicialoradministrativedecisionspromulgatedbyanygovernmentalorself‐regulatoryagency,includingtheStateofMichigan,theMichiganHealthInformationTechnologyCommission,ortheMichiganHealthandHospitalAssociation,asanyoftheforegoingmaybeamended,modified,codified,reenacted,promulgatedorpublished,inwholeorinpart,andineffectfromtimetotime.“ApplicableLawsandStandards”includesbutisnotlimitedtoHIPAA;thefederalConfidentialityofAlcoholandDrugAbusePatientRecordsstatute,section543ofthePublicHealthServiceAct,42U.S.C.290dd‐2,anditsimplementingregulation,42CFRPart2;theMichiganMentalHealthCode,atMCLA§§333.1748and333.1748a;andtheMichiganPublicHealthCode,atMCL§333.5131,5114a.

Itiseachparticipatingorganization’sobligationandresponsibilitytoensurethatitisawareofApplicableLawsandStandardsastheypertaintothecontentofeachmessagesent,andthatitsdeliveryofeachmessagecomplieswiththeApplicableLawsandStandards.Thismeans,forexample,thatifausecaseisdirectedtotheexchangeofphysicalhealthinformationthatmaybeexchangedwithoutpatientauthorizationunderHIPAA,theparticipatingorganizationmustnotdeliveranymessagecontaininghealthinformationforwhichanexpresspatientauthorizationorconsentisrequired(e.g.,mentalorbehavioralhealthinformation).

Disclaimer:TheinformationcontainedinthisimplementationguidewascurrentasofthedateofthelatestrevisionintheDocumentHistoryinthisguide.However,Medicare



andMedicaidpoliciesaresubjecttochangeanddosofrequently.HL7versionsandformattingarealsosubjecttoupdates.Therefore,linkstoanysourcedocumentshavebeenprovidedwithinthisguideforreference.HINappliesitsbesteffortstokeepallinformationinthisguideup‐to‐date.ItisultimatelytheresponsibilityoftheparticipatingorganizationandsendingfacilitiestobeknowledgeableofchangesoutsideofHIN’scontrol.

Admission‐Discharge‐Transfer Notifications Implementation ... · ADT events; the HL7 ADT message type is used to send or receive patient demographic and/or healthcare encounter

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