Touchstone Systems Limited
FUNCTIONAL AND TECHNICAL SPECIFICATION FOR
HL7 V2.3.1 ADT (ADMISSION, DISCHARGE AND TRANSFER) MESSAGES
PREPARED FOR
Internal Specification
DATE
1ST OCTOBER 2005
CONTACT DETAILS
For further information please contact: Martin Baker Touchstone Systems Ltd Nyumbani House 15 Belmont Heights Hatch Warren Basingstoke Hampshire RG22 4RW
Telephone: +44 0845 434 8949
SPEC VERSION : V1.1
Touchstone Systems Limited – HL7 2.3.1 ADT specification
1.
Document Information
Prepared by:
Martin Baker
For:
Internal Specification
Attention: 1st October 2005
Date Submitted:
2.
Document Revision Date
Version
Description
Author
12/09/2005
1.0
Initial Draft of development specification
Martin Baker
01/10/05
1.1
Updated to correct one field usage in PID (19)
Martin Baker
3.
Specification Signoff for Development
Name: ______________ Title: ________________
Date: ______________ Signed: ______________ Touchstone systems Ltd
Name: ______________ Title: ________________
Date: ______________ Signed: ______________
Name: ______________ Title: ________________
Date: ______________ Signed: ______________
Specification Version : V1.1 Page 2 of 14
Touchstone Systems Limited – HL7 2.3.1 ADT specification
4.
Table of Contents
1.
Document Information .................................................................................................... 2
2.
Document Revision ............................................................................................................ 2
3.
Specification Signoff for Development ...................................................................... 2
4.
Table of Contents ............................................................................................................... 3
5.
Introduction ......................................................................................................................... 4
HL7 Messages ...................................................................................................................................... 4 6.
Message Types .................................................................................................................... 5
Patient Demographic Registration and Update, etc. ................................................................... 5 ADT Message Structure.............................................................................................................. 5 Acknowledgement Message Structure.......................................................................................... 12 7.
Socket Applications ......................................................................................................... 13
8.
About Touchstone Systems .......................................................................................... 14
Page 3 of 14
Touchstone Systems Limited – HL7 2.3.1 ADT specification
5.
Introduction This document provides an overview to the exchange of patient information will be via HL7 ADT (Admission, Discharge and Transfer) messages to update patient details on the remote system from the central Trust PAS system. This message flow will use the HL7 Functional Specification version 2.3.1. The mode of communication will be through TCP/IP sockets - one for outgoing messages and another for incoming messages - between the hospital’s interface manager and local HL7 clinical applications. All messages received at both ends will be acknowledged accordingly using the appropriate acknowledgement message type.
HL7 Messages It is beyond the scope of this document to provide a proper description of the HL7 functional specifications. Refer to the original HL7 Support Guide in \\wwant\software\Project Documentation\HL7 Support Guide. The following is an extract from the HL7 support guide: HL7 UK will use the HL7-defined Minimal Lower Layer Protocol (MLLP) as the basis for the specification of the lower-level communications requirements in a pure network environment. Generally, this will encompass physical network connectivity and transportation (for example, using Token Ring, Ethernet, and FDDI as appropriate) utilizing the TCP/IP or LU 6.2 protocols for communications management over these networks. From the perspective of the application, the selection of one protocol or another will be transparent. Message envelopes for the MLLP have the following format: <SB>dddd<EB><CR> Where: <SB> = Start block character (ASCII <VT> that is, x0B) dddd = data, the HL7 message <EB> = end block character (ASCII <FS> that is, x1C) <CR> = Carriage return (ASCII x0D)
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Touchstone Systems Limited – HL7 2.3.1 ADT specification
6.
Message Types Patient Demographic Registration and Update, etc. The following ADT event types are supported: •
A01 admit/visit notification – a local patient PAS record update.
•
A04 register a patient – a local patient PAS record insert.
•
A08 & A31 update patient info – a local patient PAS record update.
•
A18 & A34 merge patient information – merge a local patient PAS record to new record, and remove previous one.
•
A28 add patient information – a local patient PAS record insert/update.
ADT Message Structure MSH [
Message Header Segment EVN
Event type segment
PID
Patient Identification segment
[PD1] Patient Additional Demographic segment [PV1] Patient Visit segment ]
MSH - Message Header Segment Field
Name
Componen t
Notes
001
Field Separator
“|”
002
Encoding Characters
“^~\&”
003
Sending Application
004
Sending Facility
005
Receiving Application
006
Receiving Facility
007
Date/Time of Message
008
Security
009
Message Type
“ADT^A04”, “ADT^A02”
010
Message Control ID
HIS unique message ID
011
Processing ID
“P”roduction, “T”esting
012
Version ID
“2.3”
013
Sequence Number
014
Continuation
“myapp HL7” YYYYMMDDhhmmss
Page 5 of 14
Touchstone Systems Limited – HL7 2.3.1 ADT specification
015
Accept ACK type
“AL”
EVN - Event Type Segment Field 0099 0100
Name Event Type Code Recorded Date/Time
Component
Notes “ADT/ACK” YYYYMMDDhhmmss (System Date/Time of transmission)
Page 6 of 14
Touchstone Systems Limited – HL7 2.3.1 ADT specification
PID – Patient Identification Segment Field
Name
0104
Set ID
0105
Patient ID (external)
0106
Patient ID (internal)
0107
Alternate Patient ID
0108
Patient Name
Component
Notes
Hospital Patient ID Family Name
Surname
Given Name
Forenames
Middle Name Suffix Prefix
Title (e.g. Mr, Mrs etc)
0109
Mother’s Maiden Name
0110
Date of Birth
YYYYMMDD
0111
Sex
“M”, “F”, “U”
0112
Alias
0113
Race
0114
Patient Address
Street Other City State/Province Postal Code
0115
Country Code
0116
Phone number – home
0117
Phone number – work
0118
Primary Language
0119
Marital Status
0120
Religion
0121
Patient Account Number
0122
SSN Number – patient
0123
Driver’s License Number – patient
0124
Mother’s Identifier
0125
Ethnic Group
0126
Birth Place
0127
Multiple Birth Indicator
0128
Birth Order
0129
Citizenship
0130
Veterans Military Status
0739
Nationality
0740
Patient Death Date
YYYYMMDD (if applicable)
0741
Patient Death Indicator
Y for yes else blank Page 7 of 14
Touchstone Systems Limited â&#x20AC;&#x201C; HL7 2.3.1 ADT specification
PD1 â&#x20AC;&#x201C; Patient Additional Demographic Segment 075 5
Living Dependency
074 2
Living Arrangement
075 6
Patient Primary Facility
Organisation Name Name Code ID No.
075 7
Patient Primary Provider
074 5
Student Indicator
075 3
Handicap
075 9
Living Will
076 0
Organ Donor
076 1
Patient Separate Bill Indicator
076 2
Duplicate Patient
074 3
Publicity Indicator
074 4
Protection Indicator
ID No. Family Name
Page 8 of 14
Touchstone Systems Limited â&#x20AC;&#x201C; HL7 2.3.1 ADT specification
PV1 - Patient Visit Segment Field
Name
0131
Set ID
0132
Patient Class
0133
Assigned Patient Location
0134
Admission Type
0135
Pre-admit Number
0136
Prior Patient Location
0137
Attending Doctor
0138
Referring Doctor
0139
Consulting Doctor
0140
Hospital Service
0141
Temporary Location
0142
Pre-admit Test
0143
Readmission Indicator
0144
Admit Source
0145
Ambulatory Status
0146
VIP Flag
0147
Admitting Doctor
0148
Patient Type
0149
Visit Number
0150
Financial Class
0151
Charge Price Indicator
0152
Courtesy Code
0153
Credit Rating
0154
Contract Code
0155
Contract Effective Date
0156
Contract Amount
0157
Contract Period
0158
Interest Code
0159
Transfer to Bad Debt Code
0160
Transfer to Bad Debt Date
0161
Bad Debt Agency Code
0162
Bad Debt Transfer Amount
0163
Bad Debt Recovery Amount
Componen t
Notes
HIS Ward Code of patient being admitted or transferred to.
HIS Ward Code of patient being transferred from.
HIS Consultant Code.
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Touchstone Systems Limited â&#x20AC;&#x201C; HL7 2.3.1 ADT specification
0164
Delete Account Indicator
0165
Delete Account Date
0166
Discharge Disposition
0167
Discharged to Location
0168
Diet Type
0169
Servicing Facility
0170
Bed Status
0171
Account Status
0172
Pending Location
0173
Prior Temporary Location
0174
Admit Date/Time
YYYYMMDD (Admission Date or Date of Transfer)
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Touchstone Systems Limited – HL7 2.3.1 ADT specification
Example: MSH|^~\&|MEDWAY|MEDWAY|MYapp1|Myapp2|200309121053||ADT^A08|1063360560218 C000.1.|P|2.3|||AL|NE EVN|A08|200309121053|||10432 PID|||000022270^^^^U|000022270^^^M^D~6125261719^^^M^N~03A0088494^^^^X ~03W0087215^^^^X~UV01-1064^^^^X~U00-11766^^^^X~C01-2297^^^^X~A0117865^^^^X~M98-4077^^^^X|CREWS^WILLIAM^^^MR||19300309|M|||8 The Canney^Chiseldon^SWINDON^^SN4 0PQ||741426 EX DIRET|||2|||6125261719||||||||||00000000 PD1|||WROUGHTON HEALTH CENTRE^^?|G9610468^CROSSLEY PV1||
MSH|^~\&|HNAM|CAPIOUK|JDE|JDE|20030821153359||ADT^A04|Q590076T590056X77||2. 3 EVN|A04|20030822172800|||1 PID|1|151^^^CD:678893^CD:1079^""|151^^^CD:678893^CD:10^""||ZZTEST^selfpayGT ^^^^^CD:766||20030820000000|CD:363||""|1^test^chester^""^ch11ab^CD:312726^CD :756^^cheshire||01234567890^CD:170||""|CD:309239|""|166^^^CD:678894^CD:1077^" "||||""|||0|""|""|""||"" PD1|""|""||589824^Waller^Dave^Cerner|""||""|""
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Touchstone Systems Limited – HL7 2.3.1 ADT specification
Acknowledgement Message Structure MSH
Message Header Segment
MSA
Message Acknowledgement Segment
MSH – Message Header Segment Field
Component
Notes
001
Name Field Separator
002
Encoding Characters
“^~\&”
003
Sending Application
“myapp HL7”
004
Sending Facility
005
Receiving Application
006
Receiving Facility
007
Date/Time of Message
008
Security
009
Message Type
“MSA”
010
Message Control ID
WinPath unique message ID
011
Processing ID
“P”roduction, “T”esting
012
Version ID
“2.3”
013
Sequence Number
014
Continuation
015
Accept ACK type
“|”
YYYYMMDDhhmms s
MSA - Message Acknowledgement Segment Field
Name
Component
Notes
0018
Acknowledgement Code
See Note below
0010
Message Control ID
The original Message Control ID from HIS
0020
Text Message
Free text.
Note 6 Acknowledgement Codes supported: “AA” Accept “AE” Error
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Touchstone Systems Limited – HL7 2.3.1 ADT specification
Example: MSH|^~\&|myapp HL7|| ||20010508150310||MSA|567890|P|2.3||| MSA|AA|123456|Accepted for processing MSH|^~\&|myapp HL7|| ||20010508150310||MSA|567890|P|2.3||| MSA|AE|123456|Error
7.
Socket Applications A message socket receiver/sender needs to be provided which will allow set-up and receiving of HL7 messages via an HL7 socket listener. It will be the responsibility of the Trust or Trust Integration Engine to transmit HL7 messages to the application listener on the specified IP address and socket number. The socket application will need to receive the HL7 ADT messages and generate the required HL7 application acknowledgements as detailed:
•
Incoming messages – a socket to receive incoming HL7 messages from HIS interface manager. These messages are then stored as individual files for processing by local system to update the patient details as required.
•
Outgoing messages – a socket to send outgoing HL7 acknowledgement messages to HIS interface manager.
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Touchstone Systems Limited – HL7 2.3.1 ADT specification
8.
About Touchstone Systems
Touchstone is a UK based independent freelancing and consultancy company specialising in data migration, data warehousing, report, application and health systems. Touchstone Systems has been working within the Health environment for many years, and can provide consultancy, contractor resource or health solutions covering a wide range of Health areas. We have extensive experience within the NHS Connecting For Health (CfH, Formally named the National Program for IT (NPfIT)) program including working in a consultancy role within the program for some of the major suppliers and local service providers (LSPs). Touchstone consultants have sat on some of the national design and steering committees for the national program (MiM and Steering groups) All of our work, including supplied products and contractor/consultancy resources are fully covered by our 100% satisfaction guarantee We can provide contractors and consultants with working knowledge of the following Health areas: •
Pathology and Radiology
•
Requesting and Results Reporting
•
HISS and PAS integration
•
HL7 messaging: ADTs, Orders and Results – including the supply of plug-and-play HL7 modules which can be used in your own products
•
Clinical Coding (PMIP and SNOMED)
•
Health Document Capture (EDM, scanning, etc)
•
Pharmacy Ordering and Stock Control
•
Blood Tracking, Phlebotomy and Transfusion
•
Positive Patient Identification
•
Many other Health areas
We are member of HL7 UK, the body which manages the use of HL7 (Health Level 7) format messages for health system integration. It has used this knowledge to provide consultancy and contracting services to various trusts and organisations for health system development, system integration and quality assurance. For further information please contact: Touchstone Systems Ltd Nyumbani House 15 Belmont Heights Hatch Warren Basingstoke Hampshire RG22 4RW Telephone: +44 0845 434 8949
www.touchstone-systems.co.uk Page 14 of 14