How do HL7 interfaces work

HL7 Version 2 A brief introduction

Transcript

1 HL7 Version 2 A brief introduction

2 HL7 communication patient admission patient administration system diagnosis transmission clinical workstation system

3 HL-7 Message Message segment Field Component Sub-component MSH ^ ~ \ & KIS Aufn PDMS ADT ^ A P 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE

4 Important fields Segment ID Separator Message type Trigger event MSH ^ ~ \ & KIS Aufn PDMS ADT ^ A P 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE

5 Segment ID MSH ^ ~ \ & KIS Aufn PDMS ADT ^ AP 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE Segment ID Description MSH Message Header EVN PID PV1 OBR OBX DG1 Event Patient Information Patient Visit Observation Request Observation Result Diagnosis PR1 Procedure FT1 Financial Transaction

6 Separator MSH ^ ~ \ & KIS Aufn PDMS ADT ^ A P 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE Position Description Standard character 1 Component separator ^ 2 Repeat separator ~ 3 Escape symbol \ 4 Subcomponent separator &

7 Message Type Message-Type Description ACK ADT ORU BAR DFT Acknowledgment message (Acknowledge) Patient master data message (Admission-Discharge-Transfer) i Unsolicited transmission of findings Billing Account Record Billing (Detailed Financial Transaction)

8 Trigger Event Trigger Event A01 A02 A03 P01 P03 R01 Description Patient admission Patient transfer Patient discharge Create / change patient Send financial transaction Result

9 Meaning of the fields: Example MSH MSH ^ ~ \ & KIS Aufn PDMS ADT ^ AP 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE SEQ LEN DT OPT ELEMENT NAME 1 1 ST R Field Separator 2 4 ST R Encoding Characters HD O Sending Application HD O Sending Facility HD O Receiving Application HD O Receiving Facility 7 26 TS O Date / Time Of Message 8 40 ST O Security 9 7 CM R Message Type

10 Data type Description Format Examples ST (String) TX (Text) Text <200 characters Text <65k characters, to be read by the user Repetition characters as hard line breaks NM Numbers Can sign and (Numeric) decimal point. Contain acute fever Acute fever. ~ Then get better soon. I ID (Identifier) ​​Values ​​from HL-7 tables ADT ^ A01 CE (Coded Element) XPN (Extended Person Name) Entry from controlled vocabulary with code and text Personal name and name suffixes identifier ^ text ^ coding system ^ alt-identifier ^ alttext ^ alt-coding system Name ^ first name ^ second name ^ suffix ^ prefix ^ grade R55 ^ syncope and collapse ^ ICD10 ^ 10512 ^ syn kope ^ gmdd Johner ^ Christian ^^^ Prof. Dr. DT (Date) Date YYYY [MM [DD]]], TM (Time) Time to precision of one ten-thousandth of a second HH [MM [SS [.S [S [S]]]]] [+/- ZZZZ] TS (Timestamp) point in time to an accuracy of one ten-thousandth of a second. YYYY [MM [DD [HHMM [SS [. S [S [S [S]]]]]]] [+/- ZZZZ]: 11: TR time ranges TS ^ TS:: 02 (Date Range) ^ See also -> common elements v2.1.pdf

11 Meaning of the fields: Example EVN MSH ^ ~ \ & KIS Aufn PDMS ADT ^ AP 2.3 D EVN A PID Maier ^ Ingo PV1 2 I ACH-S-SAUE Field Description Data type Mandatory 1 Event Type Code ID N 2 Time of recording in the system TS J 3 Planned time of the event TS N 4 Reason for the event IS N 5 Clerk identification characters XCN N 6 Actual time of occurrence TS N

12 Exercise 1 MSH ^ ~ \ & GHH LAB ELAB-3 GHH OE BLDG ORU ^ R01 CNTRL-3456 P 2.4 PID BAUER ^ EVE ^ A ^^^^ L MISOL F Hauptstr. 150 ^ ^ Konstanz ^^ 78462 (7531) 12345 (7531) 12346 AC A4335 ^ OH ^ OBR ^ GHH OE ^ GHH LAB ^ GLUCOSE ^ Mabuse ^ Gerda ^^^^ Dr ^^ F ^ Brunner ^ Ulrich ^^^^ Dr OBX 1 SN ^ GLUCOSE ^ POST 12H CFST: MCNC: PT: SER / PLAS: QN ^ 182 mg / dl 70_105 HF Use the official HL7 documentation (chapter 7) and answer the following questions: What type of message is it ? Which data is primarily primarily transmitted? How is this data coded? Which of the fields in the OBX segment could have been left blank?

13 Exercise 2 Submitting Diagnoses What does a DG1 (Diagnosis) segment look like? (Section 6.5.2) In which field would you enter the diagnosis code? Which classification is suitable for coding? How would you deal with the fact that there is a house catalog in a clinic? For which message types is the DG1 segment transmitted? Give an example

14 Exercise 3 Analyzing an HL7 message with a tool Install the HL7 inspector Define the profile (Profile Manager) Open sample file Picture A02 In which ward, in which room in which bed is the patient located?

15 Generating HL7 messages Important message types Patient admission: ADT ^ A01 Diagnosis / procedure transmission: BAR ^ P01 Service transmission: DFT ^ P03 Report transmission: ORU ^ R01 Type and number of message elements is specified

16 ADT ^ A01 Message patient admission Segment Description Chapter MSH Message Header 2 [{SFT}] Software Segment 2 EVN Event Type 3 PID Patient Identification 3 [PD1] Additional Demographics 3 [{ROL}] Role 15 [{NK1}] Next of Kin / Associated Parties 3 PV1 Patient Visit 3 [PV2] Patient Visit - Additional Info. 3 [{ROL}] Role 15 [{DB1}] Disability Information 3 [{OBX}] Observation / Result 7 [{AL1}] Allergy Information 3 [{DG1}] Diagnosis Information 6 [DRG] Diagnosis i Related Group 6 [ {--- PROCEDURE begin PR1 Procedures 6 [{ROL}] Role 15}] --- PROCEDURE end [{GT1}] Guarantor 6 [{--- INSURANCE begin IN1 Insurance 6 [IN2] Insurance Additional Info. 6 [{IN3}] Insurance Additional Info - Cert. 6 [{ROL}] Role 15}] --- INSURANCE end [ACC] Accident Information 6 [UB1] Universal Bill Information 6 [UB2] Universal Bill 92 Information 6 {} Segment can be repeated [{DB1}] Disability Information 3 [] Segment is optional

17 Note ADT stands for the Message Type Admission, i Discharge, Transfer Important segments are MSH, PID, PV1 The type of message is in the MSH segment The patient identification t id tifik is in the PID segment Details about the stay are in the PV1 segment Important i ADT events are A01 inpatient admission A02 inpatient tti transfer A03 inpatient discharge A08 correction of data (update)

18 BAR ^ P01 Message diagnosis / procedure transmission MSH ^ ~ \ & KAOS system DRG module I EVN P PID Michel-Ofen ^ Achim hi PV1 2 I ACH-S-SAUE DG Segment Description Chapter MSH Message Header 2 [{SFT} ] Software Segment 2 EVN Event Type 3 PID Patient t Identification 3 [PD1] Additional Demographics 3 [{ROL}] Role 15 {--- VISIT begin [PV1] Patient Visit 3 [PV2] Patient Visit - Additional Info 3 [{ROL }] Role 15 [{DB1}] Disability Information 3 [{OBX}] Observation / Result 7 [{AL1}] Allergy Information 3 [{DG1}] Diagnosis 6 [DRG] Diagnosis Related Group 6 [{--- PROCEDURE begin PR1 Procedures 6 [{ROL}] Role 15}] --- PROCEDURE end [{GT1}] Guarantor 6 [{NK1}] Next of Kin / Associated Parties 3 [{--- INSURANCE begin IN1 Insurance 6 [IN2] Insurance - Additional info. 6 [{IN3}] Insurance - Add'l Info. - Cert. 6 [{ROL}] Role 15}] --- INSURANCE end [ACC] Accident Information 6 [UB1] Universal Bill Information 6 [UB2] Universal Bill 92 Information 6} --- VISIT end

19 Note Send diagnoses and procedures via BAR ^ P01 messages Describe diagnoses in the DG1 segment Procedures in the PR1 segment Differentiate *) for diagnoses, admission and discharge diagnoses, main and secondary diagnoses *) you can enter the diagnosis type in field DG1-6. Own abbreviation

20 OBU ^ R01 Message transfer of findings MSH ^ ~ \ & LABO-System ELYT-Module ICU-System PID Michel-Ofen ^ Achim OBR SA R OBX 1 NM NA ^ Sodium ^ L 126 1 ^ mmol / l ^ L OBX 2 NM K ^ Potassium ^ L 3.2 1 ^ mmol / l ^ L OBX 3 Segment Description Chapter MSH Message Header 2 [{SFT}] Software Segment 2 {--- PATIENT_RESULT begin [--- PATIENT begin PID Patient Identification 3 [PD1] Additional Demographics 3 [{NTE}] Notes and Comments 2 [{NK1}] Next of Kin / Associated Parties 3 [--- VISIT begin PV1 Patient Visit 3 [PV2] Patient Visit - Additional Info 3] --- VISIT end] --- PATIENT end {--- ORDER_OBSERVATION begin [ORC] Od Order common 4 OBR Observations Request 7 {[NTE]} Notes and comments 2 [{--- TIMING_QTY begin TQ1 Timing / Quantity 4 [{TQ2}] Timing / Quantity Order Sequence 4}] --- TIMING_QTY end [CTD] Contact Data 11 [{--- OBSERVATION begin OBX Observation related to OBR 7 {[NTE]} Notes and comments 2}] --- OBSERVATION end [{FT1}] Financial Transaction 6 {[CTI]} Clinical Trial Identification 7 [{--- SPECIM EN begin SPM Specimen [{OBX}] Observation related to Specimen}] --- SPECIMEN end} --- ORDER_OBSERVATION end} --- PATIENT_RESULT end [DSC] Continuation Pointer 2

21 Note Findings are sent as ORU ^ R01 messages Information on the examination in the OBR segment Finding results in OBX segments HL7 Version 2.x only defines the syntax Semantic standards such as LOINC Semantic standards such as LOINC must also be integrated

22 Exercise 3 Which segments are DFT ^ P03 messages made up of? What information do they convey? How is the following DFT1 ^ P03 message to be read? MSH ^ ~ \ & NARKO-Sys ILV-Module KAOS-System ILV- Module DFT ^ PP 2 PP 2.22 EVN P PID Michel-Oven ^ Achim PV1 1 I ACH-S-SAUE FT H ANA_0001 ^ Presence time ^ NarkoData 89 min _Notfall OP (E10) elective ACH-S-SAUE ACH-S-SAUE

23 Exercise 4 Segment Description MSH Message Header Which segments are [{SFT}] software segments for this EVN Event Type PID Patient Identification Message Type [PD1] Additional Demographics [{ROL}] Role (DFT ^ P03)? [PV1] Patient Visit [PV2] Patient Visit - Additional Info [{ROL}] Role [{DB1}] Disability Information [{--- COMMON_ORDER begin [ORC] Common Order (across all FT1s) [{--- TIMING_QUANTITY begin TQ1 Timing / Quantity [{TQ2}] Timing / Quantity Order Sequence ence}] --- TIMING_QUANTITY end [--- ORDER begin OBR Order Detail Segment [{NTE}] Notes and Comments (on Order Detail)] --- ORDER end [{--- OBSERVATION begin OBX Observations / Result [{NTE}] Notes and Comments (on Result)}] --- OBSERVATION end}] --- COMMON_ORDER end {--- FINANCIAL begin FT1 Financial Transaction

24 Summary

25 Criticism of HL7 Version 2 What HL7 Version 2 is missing Specification of the messaging (sequence and delivery of messages) Communication server Theoretical foundation for design decisions Definition of semantics What is a problem with HL7 Version 2 Communication scenarios and rules are vaguely defined Too many options (e.g. optional segments and fields) Solution approach HL7 message profiles, ht IHE New theoretical well-founded approach: HL7 version 3

26 HL7 Communication ADT1 ^ A01 Patient admission Patient administration system Diagnosis transmission BAR ^ P01 Clinical workplace system

27 Structure of the messages 0th field = segment ID Message 1st segment = message header Message type h field KompFeldKomp field field (message) segments field KompFeldKomp field KompFeldKomp field field KompFeldKomp field