HL7

Connection sheet

Sheet # Connection name Rev # Version

19 HL7: Transmission of results(from Histology/Cytology module)

0 V02.01

This interface specification is confidential and is strictly reserved for communication with a Hospital Information System. An End User Agreement containing the text on the final page of the present document must be agreed by the Customer (End User). This interface specification is for the exclusive use of sites covered by an End User Agreement. Use of this interface specification implies full acceptance of the terms and conditions of the End User Agreement included hereafter.

Table of contents

Technical pre-requisites....................................................................................3

References..........................................................................................................3Program identification..........................................................................................3

Presentation.......................................................................................................4Principle of the connection..................................................................................4Communication diagram.....................................................................................4

Communication layers: TCP/IP socket............................................................5Transmission diagram.........................................................................................5Data block structure............................................................................................6Information exchange description.......................................................................8

Installation procedure........................................................................................9

Implementation of the connection....................................................................9Labconf parameters............................................................................................9TDNTServer auto number...................................................................................9Device dictionary.................................................................................................9Specialty codes dictionary.................................................................................12Histology/Cytology module parameters.............................................................12Activation of the connection service..................................................................13

Relevant HL7 messages, segment types and fields.....................................14Structure of messages......................................................................................14

Segments description......................................................................................15MSH – Message header segment.....................................................................15MSH 1 and MSH - 2 Field Separator / Encoding Characters...........................15MSH - 3 Sending Application............................................................................15MSH - 5 Receiving Application..........................................................................15MSH - 7 Date Time of message........................................................................15MSH - 9 Message Type.....................................................................................15MSH – 10 Message Control ID..........................................................................15MSH – 11 Processing ID...................................................................................16MSH – 12 Version ID.........................................................................................16PID – Patient identifying segment.....................................................................16PID-5 Patient Name..........................................................................................17PID - 6 Mother’s Maiden Name.........................................................................17PID - 7 Patient birthdate....................................................................................17PID - 8 Patient sex............................................................................................18* Not used in case of transmission of Histology/Cytology results......................18

CNXR019 / 0 V02.01 Page 1/28Confidential. This specification requires an end user agreement

Connection sheet

PID - 10 Patient race.........................................................................................18PID - 11 Patient address...................................................................................18PID - 13 Patient phone numbers (Home)..........................................................18PID - 17 Patient religion....................................................................................19PV1 – Patient visit information..........................................................................19PV1 - 2 Patient class.........................................................................................20PV1 - 3 Assigned Patient Location....................................................................20PV1 - 7 Attending doctor...................................................................................20PV1 - 8 Referring doctor....................................................................................20PV1 - 10 Hospital Service.................................................................................20PV1 - 16 VIP Indicator.......................................................................................20PV1 - 17 Admitting doctor.................................................................................20PV1 - 19 Visit number.......................................................................................20PV1 - 20 Financial class....................................................................................20PV1 - 44 Admit date/time..................................................................................20PV1 - 45 Discharge date/time...........................................................................20ORC – Common order segment........................................................................21ORC - 1 Order Control......................................................................................21ORC - 2 Placer Order Number..........................................................................21ORC - 3 Filler Order Number............................................................................21ORC - 5 Order Status........................................................................................21ORC - 7 Quantity/Timing...................................................................................21ORC - 12 Ordering Provider..............................................................................22ORC - 13 Enterer’s Location.............................................................................22ORC - 15 Order Effective Date/Time.................................................................22OBR – Observation request segment................................................................22OBR - 2 Placer Order Number..........................................................................23OBR - 3 Filler Order Number.............................................................................23OBR - 4 Universal Service Identifier..................................................................23OBR - 10 Collector identifier..............................................................................23OBR - 11 Specimen Action Code......................................................................23OBR - 14 Specimen Received Date / Time.......................................................23OBR - 16 Ordering Provider..............................................................................23OBR - 25 Result Status +..................................................................................23OBR - 24 Diagnostic Serv Sect ID.....................................................................23OBR - 27 Quantity/Timing.................................................................................23OBR - 32 Principal Result Interpreter +.............................................................24OBX – Observation / result................................................................................24OBX - 2 Value Type..........................................................................................24OBX - 3 Observation Identifier..........................................................................24OBX – 4 Observation Sub-ID............................................................................24OBX – 5 Observation Value..............................................................................24OBX – 6 Units...................................................................................................24OBX – 6 Reference range.................................................................................24OBX – 8 Abnormal flags....................................................................................25OBX – 11 Observation Result Status................................................................25

Example of ORU message...............................................................................25

Troubleshooting...............................................................................................26Error management............................................................................................26


Connection sheet

History of document modifications

Related Version/ Revision

Short description of the modification

V02.01 / 0 Creation of the connection sheet.

Technical pre-requisites

The connection must be installed on a computer connected to the network 24 hours a day/7 days a week (computer on which the connection service is installed).

The computer must be installed with at least Windows 2000 or XP and must be conform to the recommendations specified in the Description of system components document, available on our web site (www.technidata-web.com).

To know the minimal Product configurations required to run this connection (Management database, Production database, Data model), refer to the Technical guide, Connection sheets, External system connection topic.

References

Reference number of HL7 standard (High Level Protocol): High Level protocol HL7 2.4Chapter 4 Order Entry

Date of this standard : November 2000

Reference number of HL7 standard(Low Level Protocol)

Low Level protocol HL7 2.3Appendix C Lower Layer Protocols

Date of this standard : June 1998

Program identification

Protocol DLL: TDCnxProtoHISADT.dll (HL7 Low Layer Protocol (Socket))

Format DLL: TDCnxFormHL7.dll (HL7 Format Patients / Orders / Results)

Transport DLL: TDCnxTransTCPIPSocket.dll (TCP-IP socket transport)

Application DLL: TDCnxAppResult.dll (Orders/Results transmission)


http://www.technidata-wed.com/

Connection sheet

Presentation

Principle of the connection

The purpose of this connection is to send patient results to a Host (Correspondent defined with Regular electronic interchange in the Location dictionary) as soon as the request is validated and printed.

Communication diagram

Not available

Required conditions to create a connection task:- the request must be "Validated and Printed" (VR status on the Histology/Cytology module)- the concerned Correspondent(s) must be defined in the Location dictionary with the Regular

electronic interchange parameter set to the device code of the connection.

1) When the above conditions are satisfied, a connection task is automatically created in the Task Manager window and a notification is sent to the Communication engine.

2) The Communication engine queries the Task Manager if there is any task to perform.

3) The Communication engine processes the task. The task processing consists in formatting messages and transmitting them to the correspondent of the request through the HL7 socket transfer mode.


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Communication layers: TCP/IP socket

TCP/IP socket low-level protocol is the transport layer used for exchanging data between devices located on the same network. The purpose of this chapter is to describe the exchange between a Host Information System and the Communication engine when TCP/IP socket is implemented as low-level protocol.

Transmission diagram

After the connection between the client and the server connection task, data are sent to the server by the client.

Host Information system (Client) Connection (Server)

Connection phase between the client and the server: Socket creation, establishment of the connection etc …(cf : Information exchange description)

<SB>tvv<CR>ddddcccccxxx<EB><CR> ¾¾¾>

Data block sent by the client with an HL7 embedded message. After control of the correct data transfer (physical integrity), the HL7 message is parsed and managed. Depending on the result of these processes, an HL7 ACK message is sent with the error code in case of problem.

Data block sent by the server with a HL7 ACK message embedded

<¾¾¾ <SB>tvv<CR>ddddcccccxxx<EB><CR>

"dddd" contains the different HL7 messages composing the logical acknowledgement (MSH, MSA and ERR segments).

It is up to the client system to close the connection upon reception of the Acknowledgement

Connection phase between the client and the server: Socket creation, establishment of the connection etc …(cf : Information exchange description)

<SB>tvv<CR>ddddcccccxxx<EB><CR> ¾¾¾> Data block sent by the client with an HL7 message embedded. On the physical integrity control, a wrong block format has been detected. A special data block is sent (NAK block).

Data block sent by the server with a physical NAK message embedded into it (character 'C')

<¾¾¾ <SB>Nvv<CR>C000EBxxx<EB><CR>Negative physical acknowledgement sent by the connection if something is wrong on the physical transmission (wrong checksum, wrong count of characters)

It is up to the client to send the data block back or to discard it and to execute its own error handling routine

<SB>tvv<CR>ddddcccccxxx<EB><CR> ¾¾¾> Data block sent by the client with an HL7 message embedded into it. After control of the correct data transfer (physical integrity), the HL7 message is parsed and managed. Depending on the result of these processes, an HL7 ACK message is sent with the error code in case of problem or without error code if all is correct.

Data block sent by the server with a HL7 ACK message embedded into it

<¾¾¾ <SB>tvv<CR>ddddcccccxxx<EB><CR>

"dddd" contains the different HL7 messages composing the logical acknowledgement (MSH, MSA and ERR segments).

It is up to the client to close the connection upon reception of the Acknowledgement


Connection sheet

Data block structure

Depending on the TCP-IP Lower Layer Protocol parameter in the Device Dictionary, 2 Data Block structures are possible: the Hybrid and the Minimal.

Hybrid HL7 Low Layer Protocol

There are two types of blocks: data blocks and NAK blocks.HL7 messages are transmitted in single data block.NAK blocks are used to signal physical transmission errors (NAK is used at low level protocol, instead of Nack used at high level protocol).

Both block types have the same format:<SB>tvv<CR>ddddcccccxxx<EB><CR>

Blocks consist of the following fields:

<SB> = Start Block character (1 byte).Configurable on site specific basis. Unless there is a conflict, the value should be ASCII <VT>, i.e. <0x0B>. This should not be confused with the SOH or STX ASCII characters.This character must equal to the one configured as "Start of block character" in the Device dictionary.

t = Block Type (1 byte)."D" = Data block"N" = NAK block

vv = Protocol ID (2 bytes).Characters "23 " for this version.

<CR> = Carriage Return (1 byte).The ASCII carriage return character, i.e. <0x0D>.

dddd = Data (variable number of bytes).In a data block, it corresponds to the data content of the block. The data can contain any displayable ASCII characters and the carriage return character, <CR>. Carriage returns that are not part of the HL7 message may be inserted as described in "Carriage Return Stuffing."

In a NAK block, this field contains a 1-byte reason code as follows:'C' - character count wrong in previous data block received'X' - checksum wrong in previous data block received'B' - data too long for input buffer in previous block received'G' - Error not covered elsewhere.

ccccc = Block Size (5 bytes).Character count of all characters so far in the data block up to and including the data last character. For this protocol version, it corresponds to 5 + the size of the "dddd" field. Note: HL7 message ends with a <CR> character. This character is considered as part of the data.


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xxx = Checksum (3 bytes).Exclusive-OR checksum of all characters in the block up to and including the data last character. The checksum is expressed as a decimal number in three ASCII digits. If the value of this field is 999, the checksum should not be computed.Processing will proceed as if it were correct. This feature is used for applications where the messages will be translated from one character set to another during transmission.The "Checksum type" parameter in the device dictionary must be set to "Checksum for HL7 low layer protocol".

<EB> = End Block character (1 byte).Configurable according to the site. Unless there is a conflict, the value should be ASCII <FS>, i.e. <0x1C>. This should not be confused with the ETX or EOT ASCII characters.This character must equal the one defined as "End of block character" parameter in the Device dictionary.

<CR> = Carriage Return (1 byte).The ASCII carriage return character, i.e., <0x0D>.

2. Minimal HL7 Low Layer Protocol

HL7 messages are enclosed by special characters to form a block. The format is as follows:

<SB>dddd<EB><CR>

<SB> = Start Block character (1 byte)ASCII <VT>, i.e. <0x0B>. This should not be confused with the ASCII characters SOH or STX.

This character must equal the one configured as "Start of block character" in the Device dictionary.

dddd = Data (variable number of bytes)

This is the HL7 data content of the block. The data can contain any displayable ASCII characters and the carriage return character, <CR>.

<EB> = End Block character (1 byte)ASCII <FS>, i.e., <0x1C>. This should not be confused with the ASCII characters ETX or EOT.

<CR> = Carriage Return (1 byte)The ASCII carriage return character, i.e. <0x0D>.

This character must equal the one configured as "End of block character" in the Device dictionary.


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Information exchange description

Data exchange between the Host Information System and the Communication engine corresponds to data blocks being transmitted through a socket.

In order to perform the data exchange, a socket (connection) must be established first. One system has to be the server, the other one must be the client. The client will ask the server permission to connect to a specific port. The server on its side must be listening to this port.

The sequence order in which operations must be performed is:1. The server must be created and must be listening to a specific port. 2. The client will ask the server permission to connect to this port. If granted, a socket is established between the

client and the server. Data can be sent back and forth via the previously established socket.

In our case, the Communication engine will act as the client and the Host system as the server.

Pre-requisites and sequence of operations

In order that the TCP/IP socket low-level protocol can work properly, several parameters must be set:1. The machine on which the server will be created, must be declared as the recipient's network address (it can

be the network name or the dotted address).2. The port the server will be listening to is declared as the listening port.3. The transmission mode is set to Client transmission mode.4. Then you can start your server (Host) and Communication engine5. After being allowed to access to the server, the client can send its data blocks through the socket and it can read

answers back. 6. When it is stopped, the client disconnects.

Incidents generated on the socket management

* If any exception occurs while reading from the socket, the next error is generated:Couldn't receive data through socket!


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Installation procedure

The Communication engine must be installed with a Client instance.

When the connection selection screen is displayed:

1. Select HL7: Transmission of results by left-clicking on the related line.2. Choose This feature will be installed on local hard drive option.

Implementation of the connection

To implement this connection, a number of parameter settings must be performed at different levels, as listed hereafter:- Labconf parameters- TDNTServer auto number- Device dictionary- Specialties codes dictionary- Histology/Cytology module parameters- Activation of the service specified in the Device dictionary

Labconf parameters

You must verify some "Labconf" parameters on the Management database (General parameters) before starting the implementation. These parameters are:- Patient number length- Alternate patient number length- Hospitalization number length

TDNTServer auto number

You have to define an auto number used for the Message control ID parameter (MSH)

It is necessary to define a counter with option:- Minimum value : 1- Maximum value : 9999999999- Initialization periodicity : Automatic

Device dictionary

This connection must be defined as a device and consequently it must be defined in the Device dictionary.

Create a new device.From the TD Control panel, select System Setup , then General dictionaries then Device. In the menu bar, click on the ++ sign.

The following definition of the connection in the Device dictionary is given as an example.The parameters appearing in bold are mandatory.

Name Value commentCode HL7_HOST (this is an example)


Connection sheet

Device type ConnectionService TDCnx_InstanceName_Computername Name of the computer where is

installed the service NameAbbreviated textFull textProtocol HL7 Low Layer Protocol (Socket)Format HL7 Format Patients/Orders/ResultsTransport TCP-IP socket transportApplication Orders/Results transmissionProperties …

The Protocol, Format, Transport and Application parameters give the user-friendly names of the different DLLs used for the connection. These DLLs are automatically installed by the setup program.

Once you reach this step, you must click the OK button to update the Properties. The Properties parameters are used to define the parameters related to a type of flow. Several types of flow

must be defined:1. All (displayed by default).2. Patient demographics sending 3. Result sending

1. Type of flow: All

Device properties HL7_HOST

Type of flow All

Name Value Comment GeneralInterval before job purging (days) If this parameter is not defined

here, the same parameter defined in the Site configuration window is applied.

Message control IDNumber of retries 3*Spy file maximal size 1024Spy file path C:\TECHNIDATA\spy.txtSpy file trace level Maximum / regular / minimum To modify on site.Spy traces enabled Yes/No Once the installation is finished

and you checked it runs well, set it to No.

FormatHL7 Version 2.4 HL7 version (could be modified

if needed in “2.3” or “2.5” values)Message recipient code HOSTMessage sender code TDRUnicode messaging NoTransportChecksum type Checksum applied on the socket

frame. None as default value.

Must be set to HL7 Low Layer Protocol

End of block character Last character of the socket (<1C> in the definition of the socket frame).

Do not modify.

Listening port Input port.Default value: 8000.

To modify on site.

Outgoing port Output portDefault value: 8001.

To modify on site.

Protocol version 23 Protocol version filled into socket frame, to be modified


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only if neededRecipient network address IP address or logical name of the

receiverValue: localhost

To modify on site.

Sender network address IP address or logical name of the sender.Value: localhost

To modify on site.

Start of block character First character of the socket (<0B> in the definition of the socket frame).

Do not modify.

TCP-IP layer protocol Hybrid/Minimal To modify on site.Transmission mode Defines the mode used by the

socket connection (client/server, Mono/Multi client).Default value: Unknown transmission mode.

Must be set to Client transmission mode

File locationChameleon file path Name of the directory where is

stored the "hl7.vmd" Chameleon file.

To modify on site.

Processed folder C:\TECHNIDATA… Name of the directory where trace files of sent data are stored if spy trace is set to “Maximum”.

* If the patient record is locked (protected) when the connection tries to write information in the database or when a NAK is received, the connection tries several times to access the database. The number of attempts is set in the parameter Number of retries in the database. The connection waits 2 seconds between each attempt.If the number of attempts has been reached, an error handling routine is executed. A message is logged as an error in the event viewer.

2. Type of flow: Patient demography sending

Device properties

Type of flow: Patient demography sending

Name Value Comment General

The General section defines how is managed the patient data sent in the HL7 message:

Name Value CommentStream active Default value: No. Must be set to Yes.Alternate patient’s number lengthHospitalization number lengthPatients number lengthPrefix of beneficiary number on the Host

Prefix applied to the beneficiary identification, e.g. BEN.

Prefix of hospitalization number on the Host

Prefix applied to the hospitalization identification, e.g. HOS.

Prefix of patient number on the Host

Prefix applied to the patient identification, e.g. PAT.

The use of a prefix is optional. A prefix can be applied to the patient identification (Beneficiary, Hospitalization or Patient number) sent in the HL7 message in order to specify the sending Host. These parameters must be empty if the patient identification sent in the HL7 messages must not be modified.


Connection sheet

Name Value CommentMappingDoctors Code of the coding system used to

map doctor codes. (1).Create/select the code of a coding system.

Locations Code of the coding system used to map location codes. (1).

Create/select the code of a coding system.

Titles Code of the coding system used to map title codes. (1).

Create/select the code of a coding system.

Patient class Code of the Patient class provided by the HIS in the ORU message and automatically recovered. (2)

Select "Autocreate" to have the patient class field automatically fed by the communication process.(3)

Financial class Code of the Financial class provided by the HIS in the ORU message and automatically recovered. (2)

Select "Autocreate" to have the financial class field automatically fed by the communication process.(3)

Hospital Service Code of the Hospital Service provided by the HIS in the ORU message and automatically recovered. (2)

Select "Autocreate" to have the hospital service class field automatically fed by the communication process.(3)

(1) Mapping is used to create correspondences between the Management database and Host systems code values (local codes and alternate codes).

(2) Up to now, no coding system is available and there is no user interface for those dictionaries. Only automatic creation is available.

(3) The elements of the dictionaries are not updated when the latter are modified. Only the creation of new items are taken into account.

3. Type of flow: Result sending

No properties must be set but this flow must be set to "enabled" (Stream active: Yes).

Specialty codes dictionary

Define a name for the “combined test” in the Tests for connection section. This name is used in the OBX as the test code (e.g.: HISTO).

Histology/Cytology module parameters

Make sure that Edit validated report is checked.


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Activation of the connection service

Use the Windows Service manager to start the TDConnection service.The connection service appears under the name TDCnx_InstanceName.

Addressing Connection serviceThere is a possible dynamic allocation of communication port address when Connection service is started (search for an available address on the concerned computer). It uses the first port available, starting at 8000.You can modify the way it works:- A list of excluded ports, by computer can be used. It must be setup in the registry as in the following example:

You can also specify the port to be used by the service:In regedit, go to HKLM\SYSTEM\CurrentControlSet\Services\<Service name>-<instance name>Then modify the value of Image path, adding the port number at the end of the line.Example: c:\technidata\TDRClient-Appli1\servcnx.exe TDCnx1 8011


Connection sheet

Relevant HL7 messages, segment types and fields

The transmitted file (one file by patient) is composed of the following segments:

� Segment MSH : identifies the communication (Sender / Receiver).

� Segment PID: identifies the patient.

� Segment PV1: identifies the patient visit.

� Segment ORC: identifies the order control.

� Segment OBR: contains data related to the test request such as: Access number, Prescriber code…

� Segment OBX: contains data related to results.

The message can contain NTE segments. The NTE segment can be placed at any level of the hierarchy, it is comment data related to the previous segment.

Structure of messages

Structure of ORU message:

ORU^R01 Observational Results (Unsolicited)MSH Message Header{ [ PID Patient Identification [{NTE}] Notes and Comments [PV1 Patient Visit ] { [ORC] Order common OBR Observations Report ID {[NTE]} Notes and comments { [OBX] Observation/Result {[NTE]} Notes and comments } } }

ACK^R01 AcknowledgmentMSH Message headerMSA Message acknowledgment

Each HL7 file contains only one MSH segment.


Connection sheet

Segments description

MSH – Message header segment

SEQ LEN DT FIELD NAME On Communication Engine

1 1 ST Field Separator Used to process HL7 message2 4 ST Encoding Characters Used to process HL7 message3 180 HD Sending Application Message sender identification4 180 HD Sending Facility Not Used5 180 HD Receiving Application Message recipient identification6 180 HD Receiving Facility Not Used7 26 TS Date/Time Of Message Current date time8 40 ST Security Not Used9 13 CM Message Type ORU^R01

10 20 ST Message Control ID TDNT Server counter11 3 PT Processing ID P12 60 VID Version ID HL7 version13 15 NM Sequence Number Not Used14 180 ST Continuation Pointer Not Used15 2 ID Accept Acknowledgment Type Not Used16 2 ID Application Acknowledgment Type Not Used17 3 ID Country Code Not Used18 16 ID Character Set Not Used19 250 CE Principal Language Of Message Not Used20 20 ID Alternate Character Set Handling

SchemeNot Used

21 10 ID Conformance Statement ID Not Used

Example: MSH|^~\&|TD||HOST||200305081258||ORUÔ01|TD0000000001|P|2.3

MSH 1 and MSH - 2 Field Separator / Encoding Characters

Defines the message delimiters.The first five-character set following the H character |^~\& defines which field separators are used. The following ones are used:

| = Field delimiter.^ = Sub-field delimiter.~= Repeat sub-field delimiter.\ = ESCAPE sequence &= Sub-field component delimiter.

MSH - 3 Sending Application

Corresponds to the parameter Message sender identification. By default the value is TDR.

MSH - 5 Receiving Application

Corresponds to the parameter Message recipient identification. By default the value is HOST.

MSH - 7 Date Time of message

The current date and time when the message is processed.

MSH - 9 Message Type

The value is ORU^R01.

MSH – 10 Message Control ID

Value of the counter corresponding to the parameter: Message control ID.


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The value is formatted on 10 digits with the prefix TD. For example: TD0000000001.

For this parameter, it is necessary to define a counter on TDNTServer (Tools/Autonumbers) with the following options :- Minimum value : 1- Maximum value : 9999999999- Initialization periodicity : Automatic

MSH – 11 Processing ID

P corresponds to a production message.

MSH – 12 Version ID

This field contains the value of HL7 version parameter.The protocol version supported by this connection is HL7 V2.3.

PID – Patient identifying segment


1 4 SI Set ID - PID Not Used 2 20 CX Patient ID Not Used3 250 CX Patient Identifier List Patient Number

orAlternate Patient Number

4 20 CX Alternate Patient ID - PID Not Used5 250 XPN Patient Name Patient name

NameFirst Name

6 250 XPN Mother’s Maiden Name Maiden Name7 26 TS Date/Time of Birth Patient birth date8 1 IS Sex Patient sex9 250 XPN Patient Alias Not Used10 250 CE Race Patient race11 250 XAD Patient Address Address 1st line

Address 2nd lineCityState ProvincePostal codeCountry

12 4 IS Country Code Not Used13 250 XTN Phone Number - Home Telephone number

Telephone number 2FaxEmail address

14 250 XTN Phone Number - Business Not Used15 250 CE Primary Language Not Used16 250 CE Marital Status Not Used17 250 CE Religion Religion18 250 CX Patient Account Number Not Used19 16 ST SSN Number - Patient Not Used20 25 DLN Driver's License Number - Patient Not Used21 250 CX Mother's Identifier Not Used22 250 CE Ethnic Group Not Used23 250 ST Birth Place Not Used24 1 ID Multiple Birth Indicator Not Used25 2 NM Birth Order Not Used26 250 CE Citizenship Not Used27 250 CE Veterans Military Status Not Used


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28 250 CE Nationality Not Used29 26 TS Patient Death Date and Time Not Used30 1 ID Patient Death Indicator Not Used

In the following items, the bold data are managed by the connection.

PID-3 Patient Identifier List

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

This field contains all patient identifications. It is repeatable and each element contains one identification.Each identification is identified by a user-defined type code:

Example 1245789632^^^^PATNUMBER~000BENNUM1^^^ÂLTNUMBERPATNUMBER, ALTNUMBER identify each identification type.1245789632, 000BENNUM1 are the identification ID for each identification.

Only two patient identifications are available: the Patient number or the Alternate number.

On Chameleon, there is an association between the Host user-defined patient identification codes and the two patient identifications. This association can be changed by the FSE during the connection installation using python scripting in the chameleon PatientID table.

PID-5 Patient Name

Components: <family name (FN)> ^ <given name (ST)> ^ <second and further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) > ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ <name assembly order (ID)>

Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>

This field contains all patient names. It is repeatable and each element contains one name.Each name is identified by a type code:

Example NAME^FIRST NAME^^^^^L~OTHER NAME^^^^^^TL or T identify each name type.NAME, FIRSTNAME and OTHER NAME are the string for each name.

Different levels of names are available: Patient Name, First name...

On Chameleon, there is an association between the Host patient name type codes and the two patient names.This association can be changed by the Field Service Engineer during the connection installation using python scripting in the chameleon Names table :

PID - 6 Mother’s Maiden Name

This field is managed as the Maiden name by the connection.

PID - 7 Patient birthdate

This field is managed as the patient birthdate by the connection.


Connection sheet

PID - 8 Patient sex

This field is managed as the patient sex by the connection.

Value Description

F Female

M Male

O Other*

U Unknown

A Ambiguous*

N Not applicable*

* Not used in case of transmission of Histology/Cytology results.

PID - 10 Patient race

This field is managed as the patient ethnic origin by the connection.

PID - 11 Patient address

Components: <street address (ST)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> ^ <address representation code (ID)> ^ <address validity range (DR)>

The Patient address is managed on the Management database and the Address type = L (Legal address).

Data Field usedAddress 1st line <street address (ST)>Address 2nt line <other designation (ST)>City <city (ST)>State Province <state or province (ST)>Postal code <zip or postal code (ST)>Country <country (ID)>

PID - 13 Patient phone numbers (Home)

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <e-mail address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

This field contains all patient phones. This field is repeatable and each element contains one telephone number.Each telephone number is identified by a phone type code : Telephon 1, Telephon 2, Fax and Email address.

In Chameleon, there is an association between the Host phone type codes and the phones on the Management database. This association can be changed by the FSE during the connection installation using python scripting in the chameleon Telephone table.

Data Telecommunication equipment type (ID)Telephone PH (Telephone)Telephone 2 CP (Cellular phone)Fax FX (Fax)Email address Internet (Internet address)

In the case of a transmission of Histology/Cytology result, Telephone 2 and Email address is empty.


Connection sheet

PID - 17 Patient religion

This field is managed as the patient religion code by the connectionIn the case of a transmission of Histology/Cytology result, Patient religion is not used.

PV1 – Patient visit information

SEQ LEN DT ELEMENT NAME On Communication Engine

1 4 SI Set ID - PV1 Not Used2 1 IS Patient Class Patient class code (*)3 80 PL Assigned Patient Location Location (*)4 2 IS Admission Type Not Used5 250 CX Preadmit Number Not Used6 80 PL Prior Patient Location Not Used7 250 XCN Attending Doctor Attending doctor code (*)8 250 XCN Referring Doctor Reference doctor code (*)9 250 XCN Consulting Doctor Not Used

10 3 IS Hospital Service Hospital service code (*)11 80 PL Temporary Location Not Used12 2 IS Preadmit Test Indicator Not Used13 2 IS Re-admission Indicator Not Used14 6 IS Admit Source Not Used15 2 IS Ambulatory Status Not Used16 2 IS VIP Indicator VIP or Confidential indicator (*)17 250 XCN Admitting Doctor Admitting doctor code (*)18 2 IS Patient Type Not Used19 250 CX Visit Number Stay Number20 50 FC Financial Class Financial class code and effective

date (*)21 2 IS Charge Price Indicator Not Used22 2 IS Courtesy Code Not Used23 2 IS Credit Rating Not Used24 2 IS Contract Code Not Used25 8 DT Contract Effective Date Not Used26 12 NM Contract Amount Not Used27 3 NM Contract Period Not Used28 2 IS Interest Code Not Used29 1 IS Transfer to Bad Debt Code Not Used30 8 DT Transfer to Bad Debt Date Not Used31 10 IS Bad Debt Agency Code Not Used32 12 NM Bad Debt Transfer Amount Not Used33 12 NM Bad Debt Recovery Amount Not Used34 1 IS Delete Account Indicator Not Used35 8 DT Delete Account Date Not Used36 3 IS Discharge Disposition Not Used37 25 CM Discharged to Location Not Used38 250 CE Diet Type Not Used39 2 IS Servicing Facility Not Used40 1 IS Bed Status Not Used41 2 IS Account Status Not Used42 80 PL Pending Location Not Used43 80 PL Prior Temporary Location Not Used44 26 TS Admit Date/Time Admission Date Time45 26 TS Discharge Date/Time Discharge Date Time46 12 NM Current Patient Balance Not Used47 12 NM Total Charges Not Used48 12 NM Total Adjustments Not Used


Connection sheet


49 12 NM Total Payments Not Used50 250 CX Alternate Visit ID Not Used51 1 IS Visit Indicator Not Used52 250 XCN Other Healthcare Provider Not Used

(*) Information available only with HL7 ADT connection (Communication Engine).

PV1 - 2 Patient class

This field is managed as the Stay patient class by the connection.

PV1 - 3 Assigned Patient Location

This field is managed as the Stay location by the connection.

PV1 - 7 Attending doctor

This field is managed as the Stay attending doctor by the connection.

PV1 - 8 Referring doctor

This field is managed as the Stay referring doctor and Patient reference doctor by the connection.

PV1 - 10 Hospital Service

This field is managed as the Stay hospital service (Medical discipline) by the connection.

PV1 - 16 VIP Indicator

This field is managed as the Patient VIP by the connection.It is possible to manage it as confidential indicator, this modification can be changed by the FSE during the connection installation using mapping of chameleon on the Patient table.

In Chameleon, there is an association between the different value of the Management database Patient VIP (Yes or No) and HL7 code. This association can be changed by the FSE during the connection installation using python scripting in the chameleon Patient table.

Data (VIP) PV1-16 VIP Indicator1 (yes) Yes0,null (no) No

PV1 - 17 Admitting doctor

This field is managed as the Stay admitting doctor by the connection

PV1 - 19 Visit number

This field is managed as the Stay number by the connection.

PV1 - 20 Financial class

This field is managed as the Financial class and effective date by the connection.Components: <financial class (IS)> ^ <effective date (TS)>

PV1 - 44 Admit date/time

This field is managed as the Admit Date / Time of the stay by the connection.

PV1 - 45 Discharge date/time

This field is managed as the Discharge Date / Time of the stay by the connection.


Connection sheet

ORC – Common order segment


1 2 ID Order Control Order control2 22 EI Placer Order Number Host order number3 22 EI Filler Order Number Full Access Number4 22 EI Placer Group Number Not Used5 2 ID Order Status Status6 1 ID Response Flag Not Used7 200 TQ Quantity/Timing Priority8 200 CM Parent Not Used9 26 TS Date/Time of Transaction Date/Time of Transaction10 250 XCN Entered By Not Used11 250 XCN Verified By Not Used12 250 XCN Ordering Provider Prescriber Code13 80 PL Enterer’s Location Location Code 14 250 XTN Call Back Phone Number Not used15 26 TS Order Effective Date/Time Collection date and time16 250 CE Order Control Code

ReasonNot Used

17 250 CE Entering Organization Not Used18 250 CE Entering Device Not Used19 250 XCN Action By Not Used20 250 CE Advanced Beneficiary

Notice CodeNot Used

21 250 XON Ordering Facility Name Not Used22 250 XAD Ordering Facility Address Not Used23 250 XTN Ordering Facility Phone

NumberNot Used

24 250 XAD Ordering Provider Address Not Used

ORC - 1 Order Control

This field contains NW for a new reporting request.

ORC - 2 Placer Order Number

This field contains the "External Order Number" (Host order number).Not used for Histology/Cytology result transmission.

ORC - 3 Filler Order Number

This field contains the "Full Access Number".In the case of a Histology/Cytology transmission, this field contains the requests full access number.

ORC - 5 Order Status

In the case of a Histology/Cytology transmission, this field contains for each transmission ‘CM’ : Order is completed.

ORC - 7 Quantity/Timing

This field contains the priority of the request.

Data HL7 Priority codeImmediate S (Stat With highest priority)Urgent A (Asap)Routine R (Routine)

Only R and A are used by Histology/Cytology result transmission.


Connection sheet

Components: <quantity (CQ)> ^ <interval (CM)> ^ <duration (ST)> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ST)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ST)> ^ <order sequencing (CM)> ^ <occurrence duration (CE)> ^ <total occurrences (NM)>

ORC - 12 Ordering Provider

The first subfield contains the doctor code of the Prescriber (Dr1 in Production database). This field should be identical to the OBR 16 field.

ORC - 13 Enterer’s Location

The first subfield contains the location code of the requesting Location (CR in Production database).

ORC - 15 Order Effective Date/Time

This field contains the collection date and time of the request.

OBR – Observation request segment


1 4 SI Set ID - OBR Not Used2 22 EI Placer Order Number Host order number3 22 EI Filler Order Number Full Access Number4 250 CE Universal Service Identifier Test Code and Test Abbreviated text5 2 ID Priority - OBR Not Used6 26 TS Requested Date/Time Not Used7 26 TS Observation Date/Time # Not Used8 26 TS Observation End Date/Time # Not Used9 20 CQ Collection Volume Not Used10 250 XCN Collector Identifier Collector code11 1 ID Specimen Action Code Action code12 250 CE Danger Code Not Used13 300 ST Relevant Clinical Information Not Used14 26 TS Specimen Received Date/Time Specimen received date15 300 CM Specimen Source Not Used16 250 XCN Ordering Provider Prescriber code17 250 XTN Order Callback Phone Number Not Used18 60 ST Placer Field 1 Not Used19 60 ST Placer Field 2 Not Used20 60 ST Filler Field 1 + Not Used21 60 ST Filler Field 2 + Not Used22 26 TS Results Rpt/Status Chng -

Date/Time +Not Used

23 40 CM Charge to Practice + Not Used24 10 ID Diagnostic Serv Sect ID Specialty code25 1 ID Result Status + Status26 400 CM Parent Result + Not Used27 200 TQ Quantity/Timing Collection data and time / Priority28 250 XCN Result Copies To Not Used29 200 CM Parent Not Used30 20 ID Transportation Mode Not Used31 250 CE Reason for Study Not Used32 200 CM Principal Result Interpreter + Person who validate33 200 CM Assistant Result Interpreter + Not Used34 200 CM Technician + Not Used35 200 CM Transcriptionist + Not Used36 26 TS Scheduled Date/Time + Not Used37 4 NM Number of Sample Containers Not Used38 250 CE Transport Logistics of Collected Not Used


Connection sheet


Sample 39 250 CE Collector’s Comment Not Used40 250 CE Transport Arrangement

ResponsibilityNot Used

41 30 ID Transport Arranged Not Used42 1 ID Escort Required Not Used43 250 CE Planned Patient Transport

CommentNot Used

44 250 CE Procedure Code Not Used45 250 CE Procedure Code Modifier Not Used

OBR - 2 Placer Order Number

Same as ORC-2 field. External order number is duplicated in this field.Not used for Histology/Cytology result transmission.

OBR - 3 Filler Order Number

Same as ORC-3 field. Full Access Number is duplicated in this field.

OBR - 4 Universal Service Identifier

The first subfield contains the mnemonic code and the second subfield contains the abbreviated text of the test.

In the case of a transmission of:Histology/Cytology results- The mnemonic test code corresponds to the specialty dictionary parameter Combined test in Test for connection rubric. If complementary report is used, the test code is suffixed by ‘_1’ and for next ‘_2’ …- The second field is empty.

OBR - 10 Collector identifier

The first subfield contains collector code.

OBR - 11 Specimen Action Code

TDR only manages the A (Added test), R (Revised Order) action codes.

OBR - 14 Specimen Received Date / Time

Date of the specimen reception in the laboratory.

OBR - 16 Ordering Provider

The first subfield contains doctor code of the Prescriber (Dr1 in Production database).

OBR - 25 Result Status +

In the case of a Histology/Cytology result transmission, only F status is processed.

OBR - 24 Diagnostic Serv Sect ID

In the case of a Histology/Cytology result transmission, this field contains the specialty code.

OBR - 27 Quantity/Timing

The 4th subfield contains the collection date.The 6th subfield contains the priority.

Data on Mgt database HL7 Priority codeImmediate S (Stat With highest priority)Urgent A (Asap)Routine R (Routine)

Only R and A are used by Histology/Cytology result transmission.


Connection sheet

OBR - 32 Principal Result Interpreter +

Contains validation initials in subfield 1.

Components: <name (CN)<ID number>> …> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <patient location type (IS)> ^ <building (IS)> ^ <floor (IS)>

OBX – Observation / result


1 4 SI Set ID – OBX Not Used2 2 ID Value Type Result type 3 250 CE Observation Identifier Test code and abbreviated text4 20 ST Observation Sub-ID Used in case of long result5 65536 * Observation Value Result Value6 250 CE Units Units7 60 ST Reference Range Range8 5 IS Abnormal Flags Abnormal Flags9 5 NM Probability Not Used10 2 ID Nature of Abnormal Test Not Used11 1 ID Observation Result Status Status12 26 TS Date Last Observation Normal Value Not Used13 20 ST User Defined Access Checks Not Used14 26 TS Date/Time of the Observation Not Used15 250 CE Producer's ID Not Used16 250 XC

NResponsible Observer Not Used

17 250 CE Observation Method Not Used18 22 EI Equipment Instance Identifier Not Used19 26 TS Date/Time of the Analysis Not Used

OBX - 2 Value Type

In the case of a Histology/Cytology result transmission, the result is a free text, then the value type is TX.

OBX - 3 Observation Identifier

The first subfield contains the mnemonic code and the second subfield contains the abbreviated text of test.

In the case of a Histology/Cytology result transmission:- The mnemonic test code corresponds to the specialty dictionary parameter: Combined test in Test for connection rubric.- The second field is empty.

OBX – 4 Observation Sub-ID

The result value is limited by HL7 to 65535 char. If the text result is too long, an other OBX segment is generated to complete the result. The first segment OBX have OBX-4 =1 the second have OBX-4 =2…

OBX – 5 Observation Value

In the case of a Histology/Cytology result transmission, this field contains the report (text format).

OBX – 6 Units

Not used for Histology/Cytology result transmission.

OBX – 6 Reference range

Not used for Histology/Cytology result transmission.


Connection sheet

OBX – 8 Abnormal flags

In Histology/Cytology result transmission:- N Normal- A Abnormal

The definition of the value normal and abnormal corresponds to the definition of Cytology setup for Cyto pattern values for parameters.

OBX – 11 Observation Result Status

For a Histology/Cytology result, this field contains F (final result).

Example of ORU message

MSH|^~\&|TDR||HOST||20041228142641||ORU^R01|TD0000000312|P|2.3|PID|1||0000000002^^^^PATNUMBER~6546545454654654^^^ÂLTNUMBER||SMITH^Bob^^^M|^|19460306000000|F|||12, rue des plantes vertesâppart. C^VAULNAVEYS LE BAS^Dauphiné^38600^France||0476215699^^PH~0488447755^^FX|||||PV1||||||||||||||||No|||000003213213212|||||||||||||||||||||||||20040427000000|NTE|||Patient comment|ORC|NW||HG04000055||CM||^^^20041228000000^^R|||||CLAF|CORGNT||20041228000000|NTE|||Request comment|OBR|1||HG04000055|HISTO||||||DOE^John DOE|A|||20041228000000||CLAF||||||||HGNT|F||^^^20041228000000^^R|||||GNT|OBX|1|TX|HISTO|1|Result text||||||F|


Connection sheet

Troubleshooting

Error management

For each ORU^R01message the connection is waiting for an ACK message (ACK^R01):

In the acknowledge message the following information is processed:

MSH Segment : - MSH-10 Message control ID.

MSA Segment: - MSA-1 Acknowledgement code : positive or negative acknowledgement- MSA-3 Text message: error text.

ERR Segment (in case of negative acknowledgment ) : - ERR-1 Error code and location:

Details of ERR-1:Components: <segment ID (ST)> ^ <sequence (NM)> ^ <field position (NM)> ^ <code identifying error (CE)>

Positive acknowledgmentAn ACK (Accept acknowledgement) is received: MSA-1 Acknowledgement code = AA.

=> The connection job is set to COMPLETED.

Negative acknowledgment An ACK (Accept acknowledgement) is received: MSA-1 Acknowledgement is different from code= AA. The ERR segment gives an error code allowing to identify the error.

2 different treatments are possible:- Retry n: n retries occurs according the Number of retries parameter in the Device dictionary.- Rejected: no retry.

The error codes are processed as follows:- Retry n : 206;207;100;101;102;103;204;205- Rejected : 200;201;202;203

Message error status codes

Error Condition Code

Error Condition Text Description/Comment

Errors

100 Segment sequence error The message segments were not in the proper order, or required segments are missing.

101 Required field missing A required field is missing from a segment

102 Data type error The field contained data of the wrong data type, e.g. an NM field contained "FOO".


Histo/ HOSTORU^R01

ACK^R01

Connection sheet

Error Condition Code

Error Condition Text Description/Comment

103 Table value not found A field of data type ID or IS was compared against the corresponding table, and no match was found.

Rejection

200 Unsupported message type The Message Type is not supported.

201 Unsupported event code The Event Code is not supported.

202 Unsupported processing id The Processing ID is not supported.

203 Unsupported version id The Version ID is not supported.

204 Unknown key identifier The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.

205 Duplicate key identifier The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).

206 Application record locked The transaction could not be performed at the application storage level, e.g. database locked.

207 Application internal error A catchall for internal errors not explicitly covered by other codes.

After n retries the connection job is set to the ERROR status. An error message is logged, whose structure is:

Negative acknowledgment (MSA code : ‘XX’, ERR code : ‘YYY’ ) : error text in the MSA-3 field plus ERR segment (« segment ID (ST) - sequence (NM) ^ field position (NM) - code identifying error (CE)).

XX: MSA-1 Acknowledgment code YY: ERR-1 code sub field « code identifying error (CE) »

Example:

FSE CONTEXT DATA : Negative acknowledgment (MSA code : ‘AR’, ERR code : ‘207’ ) : A catchall for internal errors not explicitly covered by other codes, Application internal error, PID – 1 – 5 – 207.

No acknowledgment The process waits for a few seconds. If no acknowledgement is received, retries occur according the Number of retries parameter defined in the Device dictionary. After n retries if no answer is received, the device status is set to “Warning” and the connection task remains in READY status.


END USER AGREEMENT FOR CONNECTION

The interface specification described in the attached Connection Sheet # CNXR019 HL7: Transmission of Results is confidential and is strictly reserved for communication with a Hospital Information System. An End User Agreement containing the text hereunder must be agreed by the Customer (End User). The interface specification "Connection Sheet # CNXR019" is for the exclusive use of sites covered by an End User Agreement. Use of the interface specification "Connection Sheet # CNXR019" implies full acceptance of the terms and conditions of the End User Agreement hereunder.

END USER AGREEMENT FOR CONNECTION SHEET # CNXR019

PLEASE READ THIS AGREEMENT CAREFULLY.THE USE OF THE INTERFACE SPECIFICATION SHALL IMPLY ACCEPTANCE OF THIS

AGREEMENT.IF YOU DO NOT AGREE, YOU MUST NOT USE THE INTERFACE SPECIFICATION.

OWNERSHIP

TECHNIDATA shall retain all titles and intellectual property rights of the attached interface specification. The interface specification is protected under international laws related to intellectual property rights.

The Customer agrees that it does not have any title or ownership on the attached interface specification.

USE

The Customer may use the Interface Specification, provided that the product license has been properly acquired.

The Customer shall only use the Interface Specification for his own needs.

The Customer shall only use the Interface Specification for the purpose of communication between the Technidata information system and other information systems/equipment. Consequently, Customer is not authorized, in any way, to use the Interface Specification for any other type of communication or for any other purpose.

The Customer shall not use any portion of the said Interface Specification for the purpose of interfacing or creating new software programs to be made available to any third party, either free of charge or for pecuniary benefit.

The Customer shall not disclose, communicate or use for the benefit of any third party any portion of the said Interface Specification

The Customer must be aware that the Interface Specification is likely to evolve. The Customer therefore agrees that any software that relies on this Interface Specification may require to be updated to maintain existing functionality.

Upon termination of this Agreement, the Customer shall return all materials which contain information related to the Interface Specification, including written notes, photographs, memoranda or notes taken.

CNXR019 / 0 V02.01 Page 28/28

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