HL7 Conformance Statement - SSTMED · VARIOstorage HL7 Conformance Statement VARIOSTORAGE ... (SIU^S12) ... the VS server act as Image Manager. It

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VARIOstorage HL7 Conformance Statement

VARIOSTORAGE

HL7 Conformance Statement

Schäf Systemtechnik GmbH

Falkenstrasse 22

D-91580 Petersaurach

Germany

Phone: +49 (0) 9872 2002

Fax: +49 (0) 9872 2823

E-Mail: [email protected]

WWW: http://www.sstmed.com

mailto:[email protected]

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TABLE OF CONTENTS

VARIOSTORAGE ....................................................................................................................................................... 1

Introduction ............................................................................................................................................................ 3

Revision History ................................................................................................................................................... 3

Audience ............................................................................................................................................................. 3

Remarks............................................................................................................................................................... 3

Definitions, Terms and Abbreviations ................................................................................................................. 4

Networking .............................................................................................................................................................. 5

HL7 protocol support .......................................................................................................................................... 5

Notations ............................................................................................................................................................. 5

Patient Update Component .................................................................................................................................... 7

Inbound Messages .............................................................................................................................................. 7

Update Patient Information (A08) ...................................................................................................................... 7

Supported segments ........................................................................................................................................... 7

Supported Fields ................................................................................................................................................. 8

Merge Patient – Internal ID (A40) ....................................................................................................................... 9

Supported segments ........................................................................................................................................... 9

Supported Fields ................................................................................................................................................. 9

Worklist Management Component ...................................................................................................................... 11

Supported segments (ORMÔ01) ..................................................................................................................... 11

Supported Fields ............................................................................................................................................... 11

Supported segments (SIU^S12) ......................................................................................................................... 14

Supported Fields ............................................................................................................................................... 14

Forwarding Component ........................................................................................................................................ 15

Supported Character Sets ..................................................................................................................................... 15

Configuration ........................................................................................................................................................ 15

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INTRODUCTION

The software package „VARIOStorage Communication Server“ is an universal solution for managing the archiving and communication of medical images with integrated workflow control. In order to offer these services VARIOStorage utilizes and supports different medical communication standards. Apart from DICOM [DICOM 2006] services, which are described in a dedicated Conformance Statement [DICOM CS] VARIOstorage uses HL7 [HL7 V2.3] services to communicate with other medical systems.

VARIOstorage supports several HL7 messages in order to provide the following capabilities:

Allow systems like HIS or RIS for updating patient information controlled by VARIOstorage

Allow for generating DICOM Worklist information from HL7 messages

Allow for forwarding all kind of HL7 messages

REVISION HISTORY

Revision 1.0 Rossel 2011-01-28 Draft for official review

AUDIENCE

This HL7 conformance statement is targeted at people who are involved in integrating the VARIOstorage

Communication Server with complementary products, e.g. hospital or radiological information systems. A

reader of this document should possess working knowledge of the HL7 standard [HL7 V2.3].

REMARKS

The HL7 standard neither requires manufacturers of HL7-compliant software or hardware vendors to

provide a conformance statement nor describes what information should be included into such a

statement. This document utilizes or modifies some notations of a DICOM conformance statement and

adds additional content if necessary.

The fact that a product X has a HL7 conformance statement which is complementary to that of

VARIOstorage does not automatically guarantee interoperability between said product X and

VARIOstorage. A comparison of two complementary conformance statements is only one step towards

determining whether two applications are interoperable; aside from this comparison other steps are

inevitable, e. g. the analysis of interoperability requirements for the communicating applications, the

creation of a test scheme to verify interoperability and the execution of this test scheme.

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DEFINITIONS, TERMS AND ABBREVIATIONS

The following list illustrates all terms and abbreviations, which are used in this document. For an extensive

definition of these terms and abbreviations, please refer to the HL7 or DICOM standard.

ADT Admission – Discharge – Transfer

DICOM Digital Imaging and Communication in Medicine

HL7 Health Level Seven

HIS Hospital Information System

IHE Integrating the Healthcare Enterprise

MWL DICOM Modality Worklist

ORM Order Request Message

ORU Unsolicited Transmission of an Observation

RIS Radiological Information System

TCP/IP Transmission Control Protocol / Internet Protocol

VS VARIOstorage

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NETWORKING

Figure 1 shows an application data flow diagram. The circles on the right side represent events from the

real world and deal with sending HL7 messages to the VS Communication Server. In the middle of the

figure different components of VS are shown which receive and process the messages from the real world

activities. After that, each component reacts in a way that is shown by the circles on the left.

All components, the HL7 messages they handle an their reactions are described thoroughly in the following

sections.

HL7 PROTOCOL SUPPORT

VS uses the HL7 protocol options as required by IHE. This includes the Minimal Lower Layer Protocol

defined in Appendix C of the HL7 implementation Support Guide [HL7 IG] and the Original

Acknowledgement Mode defined in the HL7 standard [HL7 V2.3]

NOTATIONS

The networking capabilities of the VS Communication Server are presented separately for each VS

component and for each HL7 message it supports. Every HL7 message is mainly described using tables that

list all segments and fields of the message VS is able to process. The column „OPT“ in these tables uses

some abbreviations listed in Table 1.

Abbreviation Meaning

R Required by HL7 Standard

R2 Additionally required by IHE

C Conditional, required under certain conditions

O Optional

Table 1: Abbreviations for column “OPT”

Some segments of fields are optional in the HL7 standard but marked as “conditional” or “required” in the IHE

framework. In such cases the stricter IHE requirement was selected. The corresponding condition for type “C”

segments or fields can be found in the HL7 standard or the IHE framework.

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Figure 1: Application Data Flow Diagram

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PATIENT UPDATE COMPONENT

The Patient Update Component reacts to an HL7 Patient Update (ADTÂ08) or Patient Merge (ADTÂ40)

message sent from an external system. VS processes these messages and updates all affected data (e.g.

images and database) accordingly.

In the IHE profile “Patient Information Reconciliation” [IHE RTF 6.0] the VS server act as Image Manager. It

supports the IHE transactions “Patient Update” and “Patient Merge” as Image Manager.

INBOUND MESSAGES

The following HL7 events (Table 2) are supported by the Patient Update Component:

Functional Area Event Code ADT Trigger Event

ADT A08 Update patient Information

ADT A40 Merge patient – patient identifier list

Table 2: Supported ADT Events of the Patient Update Component

UPDATE PATIENT INFORMATION (A08)

When receiving an ADTÂ08 message, VARIOstorage updates the patient demographics information

according to the message content.

SUPPORTED SEGMENTS

The following segments are processed from an incoming ADTÂ08 message:

Functional Area Segment Segment Name OPT Supported by VS Notes

ADT MSH Message Header

R Yes

ADT EVN Event Type R Not used

ADT PID Patient Identification

R Yes

ADT PV1 Patient Visit R Not Used

ADT [{OBX}] Observation results

C Not Used

ADT [{AL1}] Allergy C Not Used

Table 3: Processing segments from ADT^08

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SUPPORTED FIELDS

The following tables list the supported fields of each segment.

Supported Fields of the MSH Segment

SEQ OPT Element Name Supported by VS

1 R Field Separator Yes

2 R Encoding Yes

3 R Sending Application Yes

4 R Sending Facility Yes

5 R Receiving Application Yes

6 R Receiving Facility Yes

7 O Date/Time of Message

8 O Security

9 R Message Type Yes

10 R Message Control ID Yes

11 R Processing ID Yes

12 R Version ID Yes

13 O Sequence Number

14 O Continuation Pointer

15 O Accept Acknowledgement Type

16 O Application Acknowledgement Type

17 O Country Code

18 C Character Set

19 O Principal Language of Message

20 O Alternate Character Set Handling Scheme

Table 4: Supported fields of the MSH segment (in reference to [IHE RAD 6.0])

Supported Fields of the PID Segment


1 C Set ID – Patient ID

2 C Patient ID

3 R Patient Identifier List Used for identifying the patient. All studies of this patient will be changed

4 C Alternate Patient ID

5 R Patient Name Updated

6 C Mother’s Maiden Name

7 C Date/Time of Birth Updated

8 C Sex Updated

9 C Patient Alias

10 C Race

11 C Patient Address

12 C Country Code

13 C Phone Number – Home

14 C Phone Number – Business

15 C Primary Language

16 C Marital Language

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17 C Religion

18 C Patient Account Number

19 C SSN Number – Patient

20 C Driver’s License Number – Patient

21 C Mother’s Identifier

22 C Ethnic Group

23 C Birth Place

24 C Multiple Birth Indicator

25 C Birth Order

26 C Citizenship

27 C Veterans Military Status

28 C Nationality

29 C Patient Death Date and Time

30 C Patient Death Indicator

Table 5: Supported fields of the PID segment (in reference to [IHE RAD 6.0])

MERGE PATIENT – INTERNAL ID (A40)

When VS receives an ADTÂ40 message, it merges two patients according to the patient identifier

contained in this message.

SUPPORTED SEGMENTS

The following segments are processed from an incoming ADTÂ40 message:



R Yes



R Yes


ADT MRG Merge Information

R Yes

Table 6: Processed Segments from ADTÂ40

SUPPORTED FIELDS


Supported fields of the MSH segment: See Table 4.

Supported fields of the PID segment


1 O Set ID – Patient ID

2 O Patient ID

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3 R Patient Identifier List Updated

4 O Alternate Patient ID

5 R Patient Name Updated

6 C Mother’s Maiden Name

7 O Date/Time of Birth Updated

8 O Sex Updated

9 O Patient Alias

10 O Race

11 O Patient Address

12 O Country Code

13 O Phone Number – Home

14 O Phone Number – Business

15 O Primary Language

16 O Marital Language

17 O Religion

18 O Patient Account Number

19 O SSN Number – Patient

20 O Driver’s License Number – Patient

21 O Mother’s Identifier

22 O Ethnic Group

23 O Birth Place

24 O Multiple Birth Indicator

25 O Birth Order

26 O Citizenship

27 O Veterans Military Status

28 O Nationality

29 O Patient Death Date and Time

30 O Patient Death Indicator

Table 7: Supported fields of the PID segment (in reference to [IHE RAD 6.0])

Supported fields of the MRG segment


1 R Prior Patient Identifier List Used for identifying the patient. All studies of this patient will be changed.

2 O Prior Alternate Patient ID

3 O Prior Patient Account Number

4 R2 Prior Patient ID

5 O Prior Visit Number

6 O Prior Alternate Visit ID

7 R2 Prior Patient Name

Table 8: Supported fields of the MRG segment (in reference to [IHE RAD 6.0])

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WORKLIST MANAGEMENT COMPONENT

VS can easily be configured to extract worklist information from HL7 messages and to prepare a DICOM

worklist from this data. The Worklist Management Component reacts to an General Order Message

(ORMÔ01) or Notification of new Appointment (SIU^S12)

SUPPORTED SEGMENTS (ORMÔ01)

The following segments are processed from an incoming ORMÔ01 message:



R Yes



R Yes

ADT PV1 Patient Visit R Yes

ADT ORC Common Order R Yes

ADT OBR Observation Request

Yes

Table 9: Processed Segments from ORMÔ01

SUPPORTED FIELDS



Supported fields of the PID segment: See Table 5.

Supported fields of the ORC segment


1 R Order Control Yes

2 O Placer Order Number

3 O Filler Order Number

4 R Placer Order Number Yes

5 O Order Status

6 O Response Flag

7 R Quantity/Timing Yes

8 O Parent

9 O Date/Time of Transaction

10 O Entered By

11 O Verified By

12 O Ordering Provider

13 O Enterer’s Location

14 O Call Back Phone Number

15 O Order Effective Date/Time

16 O Order Control Code Reason

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17 O Entering Organization

18 R Entering Device Yes

19 O Action By

Table 10: Supported fields of the ORC segment (in reference to [IHE RAD 6.0])

Supported fields of the OBR segment


1 O Set ID – Observation Request

2 O Placer Order Number

3 O Filler Order Number

4 R Universal Service ID Yes

5 O Priority

6 O Requested Date/Time

7 O Observation Date/Time

8 O Observation End Date/Time

9 O Collection Volume

10 O Collector Identifier

11 O Specimen Action Code

12 O Danger Code

13 O Relevant Clinical Info.

14 O Specimen Rcv’d. Date/Time

15 O Specimen Source

16 O Ordering Provider

17 O Order Provider

18 O Placer Field 1 Yes

19 O Placer Field 2

20 O Filler Field 1

21 O Filler Field 2

22 O Results Rpt./Status Change

23 O Charge to Practice

24 O Diagnostic Service Sect ID Yes

25 O Result Status

26 O Parent Result

27 O Quantity/Timing

28 O Result Copies To

29 O Parent Number

30 O Transportation Mode

31 O Reason for Study

32 O Principal Result Interpreter

33 O Assistant Result Interpreter

34 O Technician

35 O Transcriptionist

36 O Scheduled Date/Time

37 O Number of Sample Containers

38 O Transport Logistics of Collected Sample

39 O Collector’s Comment

40 O Transport Arrangement Responsibility

41 O Transport Arranged

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42 O Escort Required

43 O Planned Patient Transport Comment

Table 11: Supported fields of the OBR segment (in reference to [IHE RAD 6.0])

Supported fields of the PV1 segment


1 O Set ID – PV1

2 R Patient Class

3 O Assigned Patient Location Yes

4 O Admission Type

5 O Pre-Admin Number

6 O Prior Patient Location

7 O Attending Doctor

8 O Referring Doctor Yes

9 O Consulting Doctor

10 O Hospital Service

11 O Temporary Location

12 O Pre-Admit Test Indicator

13 O Re-Admission Indicator

14 O Admit Source

15 O Ambulatory Status

16 O VIP Indicators

17 O Admitting Doctor

18 O Patient Type

19 O Visit Number

20 O Financial Class

21 O Charge Price Indicator

22 O Courtesy Code

23 O Credit Rating

24 O Contract Code

25 O Contract Effective Date

26 O Contract Amount

27 O Contract Period

28 O Interest Code

29 O Transfer to Bad Debt Code

30 O Transfer to Bad Debt Date

31 O Bad Debt Agency Code

32 O Bad Debt Transfer Amount

33 O Bad Debt Recovery Amount

34 O Delete Account Indicator

35 O Delete Account Date

36 O Discharge Disposition

37 O Discharged to Location

38 O Diet Type

39 O Servicing Facility

40 O Bed Status

41 O Account Status

42 O Pending Location

43 O Prior Temporary Location

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44 O Admit Date/Time

45 O Discharge Date/TIme

46 O Current Patient Balance

47 O Total Charges

48 O Total Adjustments

49 O Total Payments

50 O Alternate Visit ID

51 O Visit Indicator

52 O Other Health Care Provider

Table 12: Supported fields of the PV1 segment (in reference to [IHE RAD 6.0])

SUPPORTED SEGMENTS (SIU^S12)

The following segments are processed from an incoming SIU^S12 message:



R Yes



R Yes


ADT SCH Schedule Activity Information

R Yes

Table 13: Processed Segments from ORMÔ01

SUPPORTED FIELDS



Supported fields of the PID segment: See Table 5.

Supported fields of the SCH segment


1 R Placer Appointment ID

2 C Filler Appointment ID Yes

3 C Occurrence Number

4 O Placer Group Number

5 O Schedule ID

6 R Event Reason Yes

7 O Appointment Reason

8 O Appointment Type

9 O Appointment Duration

10 O Appointment Duration Units

11 R Appointment Timing Quantity Yes

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12 O Placer Contact Person

13 O Placer Contact Phone Number

14 O Placer Contact Address

15 O Placer Contact Location

16 R Filler Contact Person

17 O Filler Contact Phone Number

18 O Filler Contact Address

19 O Filler Contact Location

20 R Entered By Person

21 O Entered By Phone Number

22 O Entered By Location

23 O Parent Placer Appointment ID

24 O Parent Filler Appointment ID

25 O Filler Status Code

Table 14: Supported fields of the SCH segment (in reference to [IHE RAD 6.0])

FORWARDING COMPONENT

VS offers a general HL7 Forwarding Component. It can be configured to forward every HL7 message it

receives to a configurable list of systems. The sequence of messages is retained by the Forwarding

Component and the messages are not altered in any way.

SUPPORTED CHARACTER SETS

VS supports the ISO 8859 character set

CONFIGURATION

VS can be configured using the control panel of VS. Details can be found in the user manuals of the VS

communication Server.

HL7 Conformance Statement - SSTMED · VARIOstorage HL7 Conformance Statement VARIOSTORAGE ... (SIU^S12) ... the VS server act as Image Manager. It

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