HL7 Interface Specification · Specification TABLE OF CONTENTS ... Table 2.1 summarizes supported IHE transactions and their corresponding HL7 messages. Table 2.1 – Supported IHE

HL7 Interface Specification

HL7 Interface 1.2

May 2004

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HL7 Interface 1.2 Specification

TABLE OF CONTENTS

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

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

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

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

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

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

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

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

5 HL7 MESSAGES .......................................................................................................... 10 5.1 Patient Update ......................................................................................................................................11

5.1.1 ADTÂ08 — update patient information ......................................................................................11 5.1.2 ADTÂ40 — merge patient - patient identifier list ........................................................................13

5.2 Procedure Scheduled ..........................................................................................................................16 5.2.1 ORMÔ01 — general order message .........................................................................................16

5.3 Procedure Update ................................................................................................................................20 5.3.1 ORM Ô01 — general order message ........................................................................................20

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1 Introduction

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

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

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

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

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

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2 Implementation

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

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

Table 2.1 – Supported IHE Transactions

IHE Transactions HL7 Messages Procedure Scheduled ORMÔ01 (general order message) Patient Update ADTÂ08 (update patient information)

ADTÂ40 (merge patient - patient identifier list) Procedure Update ORMÔ01 (general order message)

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

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3 Communication Profile

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

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

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

• Each HL7 segment is terminated by 0x0D.

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4 HL7 Implementation

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

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

Table 4.1 – Delimiter Values

Delimiter Value Segment Terminator <cr>

Field Separator | Component Separator ^

Subcomponent Separator &

Repetition Separator ~ Escape Character \

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

1. Accepts the message.

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

Field IHE Notes MSH-3-sending application Namespace ID is the only sub component used

in HD data type. This field is required.

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

MSH-5-receiving application Namespace ID is the only sub component used in HD data type. This field is required.

MSH-6-receiving facility Namespace ID is the only sub component used in HD data type. This field is required.

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

MSH-10-message control ID Unique identifier used to relate the response to the initial message. This field is required.

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

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

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

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

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

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

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

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

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

ACK General Acknowledgement HL7 v. 2.3.1 Chapter MSH Message Header 2

MSA Message Acknowledgement 3

With the following fields value:

MSH Segment

SEQ Element Name Value 1 Field Separator | 2 Encoding Characters ^~\&

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

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

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

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

7 Date/Time Of Message Time stamp when the message is sent

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

10 Message Control ID Same value from the received message.

11 Processing ID P

12 Version ID 2.3.1

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MSA Segment

SEQ Element Name Item # 1 Acknowledgment Code Possible values: AA, AE, AR

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

3 Text Message Error description, if any

4.4.1 Rejection Messages

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

4.4.2 Error Messages

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

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5 HL7 Messages

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

In describing messages semantics, the following conventions are used:

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

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

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

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

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5.1 Patient Update 5.1.1 ADTÂ08 — update patient information

Message Grammar

ADT ADT Message HL7 v. 2.3.1 Chapter # MSH Message Header 2

EVN Event Type 3

PID Patient Identification 3 PV1 Patient Visit 3

[ {OBX} ] Observation/Result 7

[ {AL1} ] Allergy Information 3

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ADTÂ08 Message Semantics

Segment SEQ OPT IHE/ Archive

RP/# HL7 Data Type

HL7 Element Name

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

EVN 2 R/O TS Recorded Date/Time

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

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

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

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

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

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

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

18 R/O CX Patient Account Number

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

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

PID

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

3 O/O PL Assigned Patient Location

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

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

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

PV1

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

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3 R/O CE Observation Identifier 3.2 = “Body Weight” or “Body Height”

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

OBX

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

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

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

5.1.2 ADTÂ40 — merge patient - patient identifier list

Message Grammar


EVN Event Type 3

PID Patient Identification 3 MRG Merge Information 3

[ PV1 ] Patient Visit 3

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ADTÂ40 Message Semantics


RP/# HL7 Data Type

HL7 Element Name


EVN 2 R/O TS Recorded Date/Time




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

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



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


PID


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


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

PV1


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RP/# HL7 Data Type

HL7 Element Name


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

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

MRG

4 O/R CX Prior Patient ID (External) (0010, 0020) Patient ID = 3.1 (0010, 0021) Issuer if Patient ID = 3.4

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5.2 Procedure Scheduled 5.2.1 ORMÔ01 — general order message

Message Grammar


PID Patient Identification 3

PV1 Patient Visit 3 {

ORC Common Order 4

OBR Order Detail 4 }

ORMÔ01 Message Semantics


RP/# HL7 Data Type

HL7 Element Name




PID


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RP/# HL7 Data Type

HL7 Element Name


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

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








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

PV1


ORC 1 R/R ID Order Control = NW

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RP/# HL7 Data Type

HL7 Element Name


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

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

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

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

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

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

OBR

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

SCH 11 R/O TQ Appointment Timing Quantity

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

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RP/# HL7 Data Type

HL7 Element Name


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

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5.3 Procedure Update 5.3.1 ORM Ô01 — general order message

Message Grammar


PID Patient Identification 3

PV1 Patient Visit 3 {

ORC Common Order 4

OBR Order Detail 4 }

ORMÔ01 Message Semantics


RP/# HL7 Data Type

HL7 Element Name




PID


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RP/# HL7 Data Type

HL7 Element Name


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

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








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

PV1


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

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RP/# HL7 Data Type

HL7 Element Name


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

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

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

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

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

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

OBR

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

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

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