IntelliVue Information Center HL7 Parameter Data Interface Programmer s Guide

Transcription

1 IntelliVue Information Center HL7 Parameter Data Interface Programmer s Guide Part Number Printed in the U.S.A. January 2009 Edition 1

2 About this Manual Proprietary Information This document contains proprietary information, which is protected by copyright. All Rights Reserved. Reproduction, adaptation, or translation without prior written permission is prohibited, except as allowed under the copyright laws. Philips Healthcare 3000 Minuteman Road Andover, MA Warranty The information contained in this document is subject to change without notice. Philips Healthcare makes no warranty of any kind with regard to this material, including, but not limited to, the implied warranties or merchantability and fitness for Philips Healthcare shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing, performance, or use of this material. Copyright Copyright 2009 Koninklijke Philips Electronics N.V. All Rights Reserved Acknowledgements Microsoft and Windows are trademarks of Microsoft Corporation in the USA and other countries. Printing History New editions of this document incorporate all material updated since the previous edition. Update packages may be issued between editions and contain replacement and additional pages to be merged by a revision date at the bottom of the page. Pages that are rearranged due to changes on a previous page are not considered revised. The documentation printing date and part number indicate its current edition. The printing date changes when a new edition is printed. (Minor corrections and updates that are incorporated at reprint do not cause the date to change.) The document part number changes when extensive technical changes are incorporated. First Edition January 2009 ii

3 Table of Contents Overview Introduction Compatibility with Patient Monitors Overview of PDI operation Unsolicited Messages Interface Polling Interface Communication layers TCP/IP socket connection HL7 low-level protocol HL7 messages supported by PDI Deviations from HL7 Standard International characters Troubleshooting HL7 Parameter Data Interface HL7 Messages - Unsolicited Message Interface Introduction Message transmission intervals Periodic parameters Aperiodic parameters, settings, and configuration Time information Message syntax Supported HL7 Messages Network Management (NMD) Unsolicited Observation Reporting (ORU) Message Segments MSH Message Header NCK System Clock PID Patient Identification PV1 Patient Visit OBR Observation Request OBX Observation HL7 Messages: Polling Interface Introduction Message syntax Supported HL7 Messages QRY Message ORF Message ACK Message iii

4 Message Segments MSH Message Header MSA Message Acknowledgement QRD Query Definition QRF Query Filter PID Patient Identification PV1 Patient Visit OBR Observation Request OBX Observation Message contents Error Handling Parameter Support Parameter Identifiers Coding Systems Parameter Flow Parameter List MRx Device Parameter List Physiological Calculation Parameter Identifiers Unit Code Identifiers Parameter Data Interface vs. Clinical Data Server Introduction A-1 Parameter Label Differences A-3 HL7 Data Output Considerations A-7 iv

5 1 Overview Introduction HL7 Parameter Data Interface (PDI) is a software option available for the Information Center (IIC) system. This interface provides a gateway between a Philips CareNet (SDN) network/ IntelliVue Clinical Network and a TCP/IP hospital network. Message transmission between PDI and client systems can take place via the unsolicited messages interface or the polling interface. These two interfaces are completely independent from each other (although both can be used simultaneously) and are described in Chapter 2. When working with the unsolicited messages interface, patient data, bed labels, and vital sign parameter values are distributed to PDI client systems at a time interval that can be configured (30 seconds is the default), with averaged or the latest (current) values of periodic parameters. When working with the polling interface, specific patient data, bed labels and vital sign parameters can be requested at any time by PDI client systems. In both cases, the data format is compliant with the HL7 (Health Level 7) standard version 2.x. Compatibility with Patient Monitors IntelliVue Clinical Network Monitors HL7 output for the M2/M3/M4 bedsides and the IntelliVue Patient Monitors (MP90, MP70, and so on) are available on alerts and inops originating from these monitors, all monitors from M2/M3/M4 beds, monitoring parameters from IntelliVue Patient Monitors (including Vuelink), EEG measurement and calculation parameters, Essential Gas Module (EGM) and Anesthesia Gas Module (AGM). PDI uses codes from the Medical Device Interface Language (MDIL) nomenclature to uniquely identify parameter and alert sources. If EMFC coded parameters are required for HL7 output, there is a configuration option in the Information Center Configuration Wizard to map the MDIL codes to EMFC codes wherever possible. See Parameter List on page 4-5. Refer to the Information Center System Installation and Service Manual. MRx The number of alerts and parameters originating from MRx and available for HL7 export are listed in MRx Device Parameter List on page CareNet/SDN Monitors The CareNet/SDN monitors (CMS, V24, and so on.) connected to an Information Center system have limitations with the HL7 export interface. All SDN alerts and bed parameters displayed with the patient windows of the Information Center are supported and will be sent via HL7. Parameters from VueLink modules that do not appear at the Information Center display, settings, blood analysis parameters, physio calculation parameters are not available. These require the presence of an M2384 Clinical Data Server in the system in order to be available in HL7 output. Overview 1-1

6 Overview of PDI operation Overview of PDI operation When the Information Center system comes online, it waits for client systems to establish TCP/IP socket connections to PDI. Multiple clients can be online at the same time and may use the unsolicited messages interface and the polling interface at the same time. Data for one bed can be sent to up to 6 client destinations. The bed to client assignment is configured in the Config Wizard at the Information Center. Refer to the Information Center System Installation and Service Manual. The unsolicited messages interface and the polling interface use configured TCP/IP port numbers in order to allow external systems to choose the service they want. PDI receives and only sends current data. Data is not stored, therefore data that has been on the network at an earlier point in time cannot be retrieved and sent. Unsolicited Messages Interface After a connection through the unsolicited messages interface is established, the HL7 Parameter Data Interface performs the following functions: Once every minute, transmits the time of day (can be enabled or disabled for each individual client system in the Config Wizard at the Information Center). At a configured interval (5, 10, 30 or 60 seconds), transmits periodic parameter data, updates to aperiodic parameters, monitoring status, alert data from monitoring devices, and patient information to the clients. The HL7 Parameter Data Interface handles each connection s data independently. As long as the connection exists, PDI sends data. If the connection is broken or closed in unsolicited mode, the client must re-establish the connection. Auto-Unsolicited Polling Interface If configured in the Information Center Config Wizard, PDI automatically sends of HL7 unsolicited data without a request from the client. If the connection is broken or closed, PDI starts to reestablish the connection and continues to do so until the connection is reestablished or the system is shut down. After a connection through the polling interface is established, PDI transmits data upon request, with every query message generating exactly one response message. The response message can only contain data for beds that were assigned to the client performing the query. The maximum query response time is 20 seconds, assuming that the queries are executed one at a time. If more than one query is executed at a time, the queries will be serialized and the query response time may increase accordingly. This performance is delivered in parallel to all other services running on the Information Center. 1-2 Overview

7 Communication layers Communication layers The following diagram shows the communication layers involved in the communication between the HL7 Parameter Data Interface and a client computer: Parameter Data Interface HL7 Message Client Computer HL7 Message HL7 low-level protocol (message delimiters) TCP/IP Socket Connection Network Interface (Ethernet) HL7 low-level protocol (message delimiters) TCP/IP Socket Connection Network Interface (Ethernet) IP Network TCP/IP socket connection Each client uses a TCP/IP socket connection for PDI communication. PDI allows multiple connections, but only one connection at one time to one particular client machine as identified by IP Address. Note If a client machine not configured for any bed in the Config Wizard attempts to connect to an Unsolicited port, the connection will be shut down immediately by the Parameter Data Interface. A client that is configured for a particular set of beds will receive data for those beds and no others. The hostname or IP address of the client systems are set in the Config Wizard (as described in the Information Center System Installation and Service Guide). The port number for the unsolicited messages interface as well as the polling interface is specified by a parameter set with the Information Center configuration utility (Config Wizard). The default PDI port number for the unsolicited messages interface (UMI) is The default port number for the polling interface is The port numbers can be modified in the IIC Config Wizard. Overview 1-3

8 Communication layers HL7 low-level protocol TCP/IP is a byte-stream protocol and does not provide messaging boundaries. HL7, which is the standard for the upper-level protocol, is based on messages but does not provide a mechanism to detect message termination. To mark message boundaries, the Minimal Lower Layer Protocol is used (as described in HL7 Interface Standards Version 2.x). Messages are transmitted as follows: <VT>ddddd<FS><CR> where: <VT> is a vertical tab. ddddd is the HL7 message. Includes only ISO characters (hexadecimal values between 20 and FF, inclusive) and <CR>. Must not contain other control/non-printable characters. It is the responsibility of the external system not to send any forbidden control characters. There is no special treatment for forbidden control characters in PDI. Note Unwanted symbols must be filtered out at the receiving system. <FS> is a field separator. <CR> is a carriage return. HL7 messages supported by PDI HL7 is a standard for electronic data exchange in healthcare environments, with special emphasis on inpatient acute care facilities (hospitals). Initially defined in the United States, the HL7 standard is now used in many countries. PDI message definitions are based on HL7 version 2.x. For a detailed description of the HL7 standard, see the HL7 Interface Standards Version 2.x. Because PDI handles only a very limited set of data, only a small subset of HL7 message types, segment types, and data is required for use with PDI. Deviations from HL7 Standard For queries for current data from PDI interfaces is mostly but not completely compliant with the HL7 standard 2.x as it is published today. Deviations: When setting the Message Type configuration to PDS Compatible, the PID segment, Patient Name field contains the patient name in the format FirstName LastName (separated by a space) which is not standard. If EMFC coding or MDIL coding is chosen, the patient name format is LastName^FirstName which is standard. Polling Interface: The inclusion of a PV1 segment in the query response is not in conformance to the HL7 definition but required for PDI as it contains the identification of the bed. As there is no safe way to identify data through patient name or number, the bed identification is absolutely crucial and cannot be omitted. Polling Interface: Sending the sequence PID - PV1 - OBR - OBX multiple times for the same patient in a single query response is NOT compliant to the HL7 specification but required in order to query the parameters of multiple beds in a single query. 1-4 Overview

9 International characters Polling Interface: The use of a bed list in the Other query subject filter field of the query filter (QRF) segment is a PDI-specific definition. This definition is not contrary to HL7 as HL7 does not specify any format for this field. However, it is very likely that this definition is not compatible with other implementations of HL7. The HL7 ST data type (String Data) that is used within the HL7 data fields (for the parameter label or the unit label, for example) requires that only ASCII characters with hexadecimal values between 20 and 7E are used. PDI, in some cases, will not conform to the standard and send String Data characters within the full ISO range of hexadecimal values between 20 and FF (degree Celsius label is sent as C, for example). International characters International characters are provided in the ISO character set, which covers most European languages. This character set is compatible with the character set used in Microsoft Windows and contains equivalents for all characters that can be distributed on the network. East European and Asian characters are not supported; for these countries, PDI uses the English language. Overview 1-5

10 Troubleshooting HL7 Parameter Data Interface Troubleshooting HL7 Parameter Data Interface If problems are encountered HL7 Parameter Data Interface (PDI) on the Information Center system, there are tools and a log file that can be used to identify the source of the problem. In addition, if the Information Center detects a failure in communication with one or more HL7 clients, a System Message is displayed on the Information Center main screen that states: HL7 Client Disconnected. Refer to the troubleshooting chapter in the IntelliVue Information Center System Installation and Service Manual, located on the Information Center documentation CDROM, for details on these tools. 1-6 Overview

11 2 HL7 Messages - Unsolicited Message Interface Introduction This chapter describes two types of HL7 (version 2.x) messages, ORU and NMD, that are supported with the HL7 Patient Data Interface (PDI) unsolicited message interface. Note The HL7 standard supports many message types, but only two types of message are required to support the two types of data sent through the unsolicited message interface. The following sections describe general syntax rules for construction of the two supported HL7 messages. Specific contents of message fields and how the field contents are interpreted in the context of the CareNet network are also described. HL7 Messages - Unsolicited Message Interface 2-1

12 Message transmission intervals Message transmission intervals HL7 messages are sent at fixed intervals, depending on the type of data they include. Periodic parameters Aperiodic parameters, settings, and configuration Periodic parameters are sent every 5, 10, 30 or 60 seconds depending on the Sending Interval configuration setting. Aperiodic data arrives at the HL7 server at varying, unpredictable intervals. it is sent on change only. If new aperiodic data has arrived at the end of a sending interval, a set of ORU messages (each of which contains all aperiodic parameters, settings, and configurations from one bed) is sent. Note Some parameters (SpO 2 and ptemp) are not always periodic or aperiodic. For example, when a telemetry unit is in SpO 2 spot check mode so that measurements are initiated manually by a clinician rather than an automatic schedule, SpO 2 is delivered as aperiodic. When the telemetry unit is configured for a fixed measurement interval, SpO 2 is delivered as a periodic parameter. Time information Time information is sent in network management messages immediately upon connection startup and every 60 seconds thereafter. The time information used is configured at the IntelliVue Information Center (IIC); transmission of time information can be turned off by clearing the Send time Messages checkbox. Note These are configuration parameters that are set in IIC Config Wizard. Refer to the IntelliVue Information Center Installation and Service Guide for detailed information. 2-2 HL7 Messages - Unsolicited Message Interface

13 Message syntax Message syntax An overview of PDI message elements and syntax follows. Note For a complete and detailed description of HL7 message syntax, see the HL7 standard provided by the HL7 standardization committee. Each HL7 message consists of a variable number of segments that are delimited by the <CR> character. Each segment consists of a three-letter identifier and a variable number of fields, which in turn can contain varying numbers of subfields, components, and subcomponents. Fields, subfields, components, and subcomponents are delimited by special characters specified in the first segment of each message, the MSH segment. For example: MSH ^~\& ORU^R01 HP P 2.x 8859/1<CR> where: The first five characters after MSH define the special characters used for delimiting fields, components, and subcomponents. Although you can use any non-alpha character, the HL7 standard recommends using the following: Special Character Meaning field separator ^ & component separator subcomponent separator ~ repetition separator \ Escape character The first field in the MSH segment contains the delimiters. More fields follow, many of which are empty because they are optional and not used by PDI. Field 9 contains the message type. Field 10 contains a unique alpha string as a message identifier. Field 11 defines the Processing ID (set to P for Production, but can be set in Config Wizard to D or T for use with VistA). Field 12 defines the version of the HL7 standard in which the message is encoded (2.x). HL7 Messages - Unsolicited Message Interface 2-3

14 Message syntax For each type of message, a sequence of segments that follow the MSH segment must be adhered to. These sequences are described in detail in the following sections, using a common syntax to describe optional and repetitive fields: [ ] Enclosed segments are optional. { }Enclosed segments or sequences of segments can be repeated zero or more times. Supported HL7 Messages When using the unsolicited message interface, PDI sends only two types of message: Network Management (NMD) - The current date and time setting of the system. Time information about the time of day is obtained from the IIC system. For example: MSH ^~\& NMD HP P 2.x 8859/1<CR> NCK <CR> The message is sent once on connection startup and once every full minute thereafter. Unsolicited Observation Reporting (ORU) - Patient data and vital sign parameters. Contains this information: patient information distributed on the network (patient name and number) bed data (network ID, bed ID, bed label) all parameters and device settings available on the network MSH ^~\& ORU^R01 HP P 2.x 8859/1<CR> PID MRN5733 Smith^John M<CR> PV1 I ^^Doc1&5&1<CR> OBR <CR> OBX NM bb8^SpO2^MDIL ^%^MDIL F<CR> OBX NM ^Resp^MDIL ae0^rpm^MDIL F<CR> OBX NM ^HR^MDIL aa0^bpm^MDIL F<CR> OBX NM a15^ABPs^MDIL f20^mmHg^MDIL F<CR> OBX NM a16^ABPd^MDIL f20^mmHg^MDIL F<CR> OBX NM a17^ABPm^MDIL f20^mmHg^MDIL F<CR> The unsolicited message interface sends only NMD and ORU messages to external systems. Also, it does not react to any messages sent to it. Any messages or data that are sent to the Unsolicited Message Interface are ignored. HL7 Acknowledgments The HL7 specification states that the receiving system must acknowledge each message by returning an acknowledgment message back to the sending system. Note The returning of acknowledgments does not enhance the reliability of TCP/IP connections because TCP/IP provides error-free transmission. HL7PDI treats acknowledgements as optional. Although a receiving system may send acknowledgments, PDI disregards them because they are not required. PDI does not resend messages that have not been acknowledged. 2-4 HL7 Messages - Unsolicited Message Interface

15 Message syntax Network Management (NMD) The network management (NMD) message distributes the current date and time setting of the PDI system. Time information is obtained from the IIC system. Syntax: MSH NCK [NTE] message header system clock note/comment The NCK segment specifies the time used by the PDI in ISO format (year month day hour minute second). The NTE segment is not used. Unsolicited Observation Reporting (ORU) The unsolicited observation reporting (ORU) message contains patient data and vital sign parameters, including: patim data (network ID, bed ID, bed label) all vital sign parameters currently available on the network One set of messages for each bed is sent at the configured time interval: MSH { PID PV1 { } } OBR {OBX} Message Header Patient Identification Patient Visit Observations Request Result where: PID segment contains patient name and identification number of the patient as entered at the Information Center. PV1 segment contains bed label, clinical unit name, network ID, and the bed ID. Network ID and bed ID are configured values that have to be set for each bed in the IIC Config Wizard. OBR segment and OBX segment contain observations (may also contain alert information if alert messages are sent). The OBX segment contains the time stamp for aperiodic parameters. HL7 Messages - Unsolicited Message Interface 2-5

16 Message Segments Message Segments The tables in this section provide the following information about components of each message segment: field length data type usage requirements The tables list all fields that are required in message segments. (The tables do not include HL7 message fields that are not used by PDI.) Note Only fields that have special usages or intents are described in this document. All other fields are as described in HL7 Interface Standards Version 2.x. MSH Message Header Every message begins with the MSH segment. MSH segment components follow: Sequence Length Data Req Used Field Name Notes 1 1 ST Yes Yes Field Separator 2 4 ST Yes Yes Encoding Characters HD No Yes Sending Application VistA config specifies MDHL-IN (Not Used, otherwise) HD No Yes Sending Facility VistA config permits use of IIC Institution Id set in Config Wizard HD No Yes Receiving Application VistA config specifies MDHL-OUT (Not Used, otherwise) HD No Yes Receiving Facility VistA config specifies VistA (Not Used, otherwise) 7 26 TS No No Date/Time of Message 8 40 ST No No Security 9 7 CM Yes Yes Message Type 2-6 HL7 Messages - Unsolicited Message Interface

17 Message Segments Sequence Length Data Req Used Field Name Notes ST Yes Yes Message Control ID 11 3 P, D, T Yes Yes Processing ID Set in IIC Config Wizard VID Yes Yes Version ID VistA specifies 2.4 (2.3 otherwise) NM No No Sequence Number ST No No Continuation Pointer 15 2 ID No No Accept acknowledgment type 16 2 ID No No Application acknowledgment type 17 2 ID No No Country code ID No Yes Character Set CE No No Principle Language of Message ID No No Alternate Character Set Handling Scheme MSH fields PDI uses the following fields in the MSH segment: Sequence Field Name Description 1 Field Separator Contains the separator between segment ID and the first real field. Defines the characters to be used as separators for the rest of the message. 2 Encoding Characters Contains the component separator, repetition separator, escape character and subcomponent separator. 9 Message Type Either NMD for network time messages or ORU for parameter reporting messages. 10 Message Control ID Unique alpha ID that identifies each Control ID message sent. 11 Processing ID Always set to P (for Production). HL7 Messages - Unsolicited Message Interface 2-7

18 Message Segments Sequence Field Name Description For example: 12 Version ID Version of the HL7 protocol transmitted. Always set to 2.3 but the output is usable with systems expecting versions 2.3 to 2.5. See Deviations from HL7 Standard, page Character Set Always 8859/1 MSH ^~\& NMD HP P 2.x 8859/1<CR> NCK System Clock PDI sends the NCK segment in NMD messages to identify the current network time. The time is sent in ISO format (year month day hour minute second). Sequence Length Data Req Used Field Name 1 26 TS Yes Yes System Date/Time For example: NCK <CR> PID Patient Identification The PID segment is sent in ORU messages to identify patients. Sequence Length Data Req Used Field Name 1 4 SI No No Set ID 2 20 CX No No Patient ID 3 20 CX Yes Yes Patient Identifier List 4 20 CX No No Alternate Patient ID 5 48 XPN Yes Yes Patient Name 6 48 XPN No No Mother s Maiden Name 7 26 TS No Yes Date/Time Birth 8 1 IS No Yes Sex 2-8 HL7 Messages - Unsolicited Message Interface

19 Message Segments PID fields PDI uses the following fields in the PID segment: Sequence Field Name Description 3 Patient Identifier List Contains the patient ID as entered at the Information Center (IIC) Can contain any printable character; if no data is entered at the IIC the field contains NULL value ( ). Config Wizard may also specify Visit Number and Alternate ID as additional Patient Identifiers. For example, 12345^^^^MR^23456^^^^VN^34567^^^^U -where MR is MRN, VN is Visit Number, and U is Alternate ID 5 Patient Name Contains the patient name as entered at the Information Center. Format depends on the configured Message Type. Refer to the IIC Installation and Service Guide. Config Wizard may optionally include Middle Name. For example, Lastname^FirstName^MiddleName 7 Date/Time Birth Contains the date of birth as entered at the Information Center. The format is YYYYMMDD. If no data is entered at the IIC, the field contains NULL value ( ). This field is not used if configured Message Type is PDS Compatible. 8 Sex Contains the sex of the patient as entered at the IIC The format is: Male: M Female: F Unknown: U This field is not used if configured Message Type is PDS Compatible. Note With PDS (Patient Data Server) and the Clinical Data Server (CDS), the patient name was not sent in accordance with the HL7 standard. If the Message Type configuration is not set to PDS Compatible, the HL7 Patient Data Interface uses the field components Family Name and Given Name for the HL7 output which is in accordance to the HL7 standard. For example: PDS Compatible: PID Robert Miller<CR> Other configurations (EMFC Coding/MDIL Coding): PID 33MR865 Baylor^James "" U<CR> PID MRNXR Johnson^Robert M<CR> HL7 Messages - Unsolicited Message Interface 2-9

20 Message Segments PV1 Patient Visit The PV1 segment is sent in ADT and ORU messages to identify the bed. Sequence Length Data Req Used Field Name 1 4 SI No No Set ID 2 1 IS Yes Yes Patient Class 3 80 PL No Yes Assigned Patient Location PV1 fields PDI uses the following fields in the PV1 segment: Sequence Field Name Description 2 Patient Class Always set to I (for Inpatient) 3 Assigned Patient Location Format: <point of care>^<room>^<bed> <point of care> = ClinicalUnit Name 1 PDI uses its own format for the bed component and divides it into the following sub-components: <bed label>&<bed id>&<network id> where: <bed label> = bed label as configured on the Information Center <bed id> = artificial branch number <network id> = artificial CareNet number 1 not used if the Message type is configured as PDS Compatible For example: PV1 I ICU^^Bed14&14&1<CR> The parameters network id and bed id refer to the SDN/Carenet network number and the branch number where a monitor is connected. The following pairs describe the same thing: network id carenet number bed id branch number The terms 'network id' and 'bed id' are generic in HL7PDI because there are no branch numbers for IntelliVue Clinical Network monitors. Manual configuration of these artificial branch numbers and Carenet numbers for connected monitors are created in Config Wizard HL7 Messages - Unsolicited Message Interface

21 Message Segments OBR Observation Request The OBR segment is sent in ORU messages to report parameter data. There is one OBR for each time stamp (except for the aperiodic data which has its own) in the message. Sequence Length DT Req Used Field Name 1 4 SI No No Set ID 2 22 EI No No Placer s Order # 3 22 EI No No Filler s Order # CE Yes No Universal Service Identifier 5 2 ID No No Priority 6 26 TS No No Requested Date/time 7 26 TS No Yes Observation Date/Time For example: OBR <CR> OBX Observation The OBX segment is sent in ORU messages to report parameter data, settings, and device configuration. It is also used for reporting alert states if the interface has been configured for sending alert messages of the monitor. The format of certain HL7 output fields depends on the message type setting configured in the Information Center Configuration Wizard (refer to the Information Center System Installation and Service Manual.) There is one OBX segment for each value. OBX for periodic data is sent at 5, 10, 30 or 60 sec interval. An OBX for aperiodic data is sent only upon change. OBX for settings is sent only when connection is first established and when settings change. (The disappearance of a setting or a change in the validity of a parameter is treated as a change.) OBX for alerts is sent only when the monitor currently is in alert state and the Information Center is configured to send alerts. Several alerts can be present at the same time. In this case, all alerts which are present at a certain time stamp specified in the OBR segment are sent with the following OBX segments. As soon as an alert is not displayed at the monitor anymore (either because it has been acknowledged or no longer exists), the alert disappears in the corresponding OBX segment. The beginning and the end of an alert can be determined by its appearance in an OBX segment. HL7 Messages - Unsolicited Message Interface 2-11

22 Message Segments Sequence Length DT Req Used Field Name 1 4 SI No No Set ID 2 3 ID Yes Yes Value Type 3 80 CE Yes Yes Observation Identifier 4 20 ST No Yes Observation Sub-ID 5 65K * 1 Yes Yes Observation Results 6 60 CE No Yes Units 7 60 ST No No Reference Range 8 5 ID No No Abnormal Flags 9 5 NM No No Probability 10 2 ID No No Nature of Abnormal Test 11 1 ID Yes Yes Observation Result Status TS No No Date last Observed Normal Values ST No Yes User Defined Access Checks TS No Yes Date/Time of Observation CE No No Producer s ID XCN No No Responsible Observer CE No No Observation Method 1 OBX sequence 2 (Value Type) contains the data type for this field HL7 Messages - Unsolicited Message Interface

23 Message Segments OBX fields PDI uses the following fields in the OBX segment: Table 2-1 OBX fields Sequence Field Name Description 2 Value Type NM () for values, ST (string) for string data, TX for textual values 3 Observation Identifier This field contains a unique identifier for the observation. The format depends on the Message Type configuration setting. See Observation identifier field and Coding Systems, page 4-2 for more information. 4 Observation Sub-ID Number between 0 and 67 that identifies the device that provides the data In case of a MDIL-alert observation, field contains a sequence number. Alert observations of a certain alert type will use a sequence number that starts with 1 and will increase by 1 with each alert observation of the same alert type. 5 Observation Result Contains the result value or string In case of an alert observation, field contains the alert message. 6 Units Contains unit information The format depends on the Message Type configuration setting. 11 Observation Result Status 13 User Defined Access Checks 14 Date/Time of Observation Always set to F for Final This field is not used if the Message Type is set to PDS Compatible. Indicates type of parameter May have the values PERIODIC, APERIODIC, SETTING, and CONFIGURATION An empty field indicates a value of PERIODIC. See Parameter types for more details. Date and time of the measurement of the parameter in ISO format (YYYYMMDDHHMMSS) Only present with APERIODIC parameters 17 Observation Method Method used to make the observation Normally empty -- The observation is made automatically by the instrument, but for manually entered parameter values this field will contain the value, MANUAL. Observation identifier field This field contains a unique identifier for the observation. The used format is: <identifier> ^ <text> ^ <name of coding system> Types of observations supported by PDI are parameter observations or alert observations. The Coding system depends on the configured Message Type (page 4-2). HL7 Messages - Unsolicited Message Interface 2-13

24 Message Segments Observation Sub-Id (Device Identifier) Table 2-2 shows special device IDs; the device name sent depends on the IIC HL7 Configuration Message Type setting. Table 2-2 PDS Compatible EMFC Coding/MDIL Coding/VistA Compatible Data Source Device ID Device Name Device Name Monitor 0 SDN Broadcast Monitoring Data VueLink From monitor From monitor Hemodynamic Calculation Oxygenation Calculation Ventilation Calculation 65 Hemo Calc Source Hemo Calculation 66 Oxy Calc Source Oxy Calculation 67 Vent Calc Source Vent Calculation 1 Four VueLink modules (max.) can be connected to a monitor. Each connected VueLink module is assigned a number from 1 to 4 by the monitor; this number is used as the sub-id in HL7 output. Note EMFC Coding and EMFC with PDS Compatible codes are provided for backward compatibility only and may not be supported in future releases of the Information Center. MDIL Coding is recommended because more parameters can be mapped (Table 4-1). Parameter labels may be different from original Philips CareNet labels. Parameter types If the User Defined Access Checks field is empty or contains, PERIODIC, the parameter is a periodic parameter sent at the intervals specified in the configuration. A value of APERIODIC indicates an aperiodic parameter that is sent only when a new measurement is made. An aperiodic parameter usually contains a time stamp. A value of SETTING indicates a setting at the monitor or at a device connected via VueLink. Settings are sent when a new connection to the Unsolicited Message Interface is established and when a change occurs. Settings remain valid until they are explicitly changed or explicitly disappear. The disappearance of a setting is indicated by the NULL value ("") in the parameter value field. Settings contain no time stamp. If the value is CONFIGURATION, the value type is ST (string) and provides a description of the device from which the parameter comes. Configuration values are sent only at connection startup or when a new device appears (is attached via VueLink). When a device disappears, a NULL value ( ) is sent for the device HL7 Messages - Unsolicited Message Interface

25 Message Segments Special parameters Two EMFC parameters do not originate from a device, but are generated by the Patient Data Interface to provide additional information: smode (EMFC 32920/MDIL 0402-f85f) - String value setting that provides information about the operating mode of the attached patient monitor. Values are: MONITORING - Monitoring mode (provided data for this bed is real) DEMO - Demonstration mode (provided data for this bed is generated artificially by the monitor for demonstrations or training) CONFIGURATION - Configuration mode (not available if configured for PDS Compatible) SERVICING - Service mode (not available if configured for PDS Compatible) Model (EMFC 33040/MDIL 0002-f887) String-valued configuration parameter that provides information about the device generating the data (device name shown in Table 2-2). When a device disappears, this parameter is sent again with the same device ID and a NULL ( ) value. The following table shows the possible monitoring mode strings depending on the Message Type configuration option. Monitoring mode PDS compatible EMFC coding / MDIL coding Demo mode DEMO DEMO Monitoring mode MONITORING MONITORING Configuration mode DEMO CONFIGURING Servicing mode DEMO SERVICING OBX fields message type summary The following table summarizes all OBX fields that are dependent on the Message Type configuration option. PDS Compatible EMFC Coding MDIL Coding Parameter Results: OBX Segment, Observation ID field EMFC-Code ^ Label ^ SDN EMFC-Code ^ Label ^ SDN MDIL-Code ^ Label ^ MDIL Parameter Results: OBX Segment, Units field UnitLabel MDIL-Code ^ UnitLabel ^ MDIL MDIL-Code ^ UnitLabel ^ MDIL Alert results: OBX Segment, Observation ID Code ^ AlertLabel ^ SDN- ALARM Code ^ AlertLabel ^ MDIL- ALARM Code ^ AlertLabel ^ MDIL- ALARM HL7 Messages - Unsolicited Message Interface 2-15

26 Message Segments PDS Compatible EMFC Coding MDIL Coding OBX segment, Assigned Patient location field, Point of Care component OBX segment, Observation result status field empty ClinicalUnitName 1 ClinicalUnitName empty F (final result) F (final result) 1 set on the IntelliVue Information Center Examples Single periodic parameters (MDIL coded): OBX NM ^HR^MDIL aa0^bpm^MDIL F<CR> OBX NM 0002-e014^Tblood^MDIL a0^ C^MDIL F<CR> OBX NM c^TV^MDIL ^l^MDIL F<CR> Single periodic parameters (SDN coded): OBX NM 92^RR^SDN 0 30<CR> OBX NM 44^PULSE^SDN 0 80<CR> OBX NM 1204^inAGT^SDN % 0.0^25.0<CR> OBX NM 1200^etAGT^SDN %<CR> Triple periodic parameters (MDIL coded): OBX NM a49^UVPs^MDIL f20^mmHg^MDIL F<CR> OBX NM a4a^UVPd^MDIL f20^mmHg^MDIL F<CR> OBX NM a4b^UVPm^MDIL f20^mmHg^MDIL F<CR> Triple periodic parameters (SDN coded): OBX NM 65^ABP S^SDN 0 119<CR> OBX NM 66^ABP D^SDN 0 1<CR> OBX NM 67^ABP M^SDN 0 40<CR> OBX NM 1105^UVP S^SDN mmhg 100.0^180.0<CR> OBX NM 1106^UVP D^SDN mmhg 20.0^95.0<CR> OBX NM 1107^UVP M^SDN mmhg 100.0^170.0<CR> Single aperiodic parameters (SDN coded): OBX NM 124^C.O.^SDN F APERIODIC <CR> OBX NM 460^Weight^SDN kg ^110.0 F APERIODIC <CR> OBX NM 1412^UrpH^SDN F APERIODIC <CR> Single aperiodic parameters (MDIL coded): OBX NM ac^Patm^MDIL f72^mbar^MDIL F APERIODIC <CR> OBX NM 0002-f093^Weight^MDIL c3^kg^MDIL F APERIODIC <CR> Triple aperiodic parameters (MDIL coded): OBX NM a15^ABPs^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a16^ABPd^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a17^ABPm^MDIL f20^mmHg^MDIL F APERIODIC <CR> 2-16 HL7 Messages - Unsolicited Message Interface

27 Message Segments Monitoring mode setting: OBX ST 0402-f8f5^sMode^MDIL 0 DEMO F SETTING<CR> OBX ST 0402-f8f5^sMode^MDIL 0 MONITORING F SETTING<CR> OBX ST 0402-f8f5^sMode^MDIL 0 SERVICING F SETTING<CR> OBX ST 0402-f8f5^sMode^MDIL 0 CONFIGURING F SETTING<CR> Note Monitoring mode settings are only sent for device 0 (the patient monitor itself). Connected device attached via VueLink: OBX ST 0002-f887^Model^MDIL 4 RMA SL F CONFIGURATION<CR> Disconnected device attached via VueLink: OBX ST 0002-f887^Model^MDIL 4 """" F CONFIGURATION<CR> Alerts (MDIL coded): OBX TX 6^Soft Inop^MDIL-ALERT 1 ARRHYTHMIA OFF F<CR> OBX TX 6^Soft Inop^MDIL-ALERT 2 CCO NO CALIBRATION F<CR> OBX TX 2^Yellow Alarm^MDIL-ALERT 1 **CVPm 9 > 4 F<CR> OBX TX 2^Yellow Alarm^MDIL-ALERT 2 **ABPs 120 > 90 F<CR> OBX TX 1^Red Alarm^MDIL-ALERT 1 ***BRADY 60 < 80 F<CR> OBX TX 2^Yellow Alarm^MDIL-ALERT 3 **RR 15 < 30 F<CR> Alerts (SDN coded): OBX TX 1^Red^SDN-ALARM 0 *** HF > 120<CR> OBX TX 2^Yellow^SDN-ALARM 0 ** Sp02 < 95<CR> OBX TX 3^Green^SDN-ALARM 0 Leads Off<CR> Calculations OBX NM b24^PVR^MDIL ^DS/ cm5^mdil F APERIODIC <CR> OBX NM b28^SVR^MDIL ^DS/ cm5^mdil F APERIODIC <CR> OBX NM 0002-f048^SI^MDIL ^ml/ m2^mdil F APERIODIC <CR> OBX NM 0002-f093^Weight^MDIL e0^lb^MDIL F APERIODIC <CR> OBX NM 0002-f094^Height^MDIL ^in^MDIL F APERIODIC <CR> OBX NM ^HR^MDIL aa0^bpm^MDIL F APERIODIC <CR> OBX NM a15^ABPs^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a16^ABPd^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a17^ABPm^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM b84^SV^MDIL ^ml^MDIL F APERIODIC <CR> HL7 Messages - Unsolicited Message Interface 2-17

28 Message Segments OBX NM a1d^PAPs^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a1e^PAPd^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a1f^PAPm^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM b90^LCW^MDIL ^kgm^MDIL F APERIODIC <CR> OBX NM a24^PAWP^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM ^SVRI^MDIL ^DSm2/ cm5^mdil F APERIODIC <CR> OBX NM b94^RCW^MDIL ^kgm^MDIL F APERIODIC <CR> OBX NM 0002-f067^PVRI^MDIL ^DSm2/ cm5^mdil F APERIODIC <CR> OBX NM ^LVSWI^MDIL ^g-m/ m2^mdil F APERIODIC <CR> OBX NM b04^C.O.^MDIL c00^l/ min^mdil F APERIODIC <CR> OBX NM 0002-f068^LCWI^MDIL ^kg-m/ m2^mdil F APERIODIC <CR> OBX NM 0002-f069^RCWI^MDIL ^kg-m/ m2^mdil F APERIODIC <CR> OBX NM ^RVSWI^MDIL ^g-m/ m2^mdil F APERIODIC <CR> OBX NM b9c^LVSW^MDIL ^gm^MDIL F APERIODIC <CR> OBX NM c^C.I.^MDIL b20^l/min/ m2^mdil F APERIODIC <CR> OBX NM 0002-f071^BSA^MDIL 65 2.x c0^m2^MDIL F APERIODIC <CR> OBX NM ba4^RVSW^MDIL ^gm^MDIL F APERIODIC <CR> OBX NM a47^CVPm^MDIL f20^mmHg^MDIL F APERIODIC <CR> 2-18 HL7 Messages - Unsolicited Message Interface

29 3 HL7 Messages: Polling Interface Introduction This chapter describes the three types (QRY, ORF, and ACK) of HL7 (version 2.x) messages for use with PDI polling interface. The polling interface is limited to processing these message types in the pattern shown below. Messages are processed one by one with every query message generating exactly one response message. Periodic parameters are always sent with their current value. Averaged values are not accessible via the polling interface. The following picture illustrates how the polling interface operates: PDI polling interface Query message QRY External system Query response ORF or neg. acknowledgement ACK Note The HL7 standard supports many message types, but only three types of messages are required to support the data sent through the polling interface. The message definitions for the messages used are less restrictive compared to the original HL7 message definition. This allows the PDI to work even with systems that have a simplified HL7 interface. Compatibility with HL7 is not reduced through this approach. The following sections describe the general syntactical rules for the construction of the HL7 messages supported. They also describe specific contents of message fields and how these field contents are interpreted in the context of the CareNet network. Message syntax The Message syntax is the same as in the Unsolicited Message Interface and is described in Message syntax on page 2-3. Supported HL7 Messages The polling interface serves external systems according to a query-response pattern. It processes only three types of messages: Query Messages (QRY) Query results of an observation. Observation Reporting Messages (ORF) Query response Used to report CareNet data as a reply to a query Acknowledgement Message (ACK) This message type is only used if the message received from the external system is incorrect or not supported; it cannot be processed. (The ORF message represents the reply to the corresponding query.) HL7 Messages: Polling Interface 3-1

30 Introduction QRY Message The query message (QRY) is used to request current parameter data. It triggers the event R02 (query for results of an observation). QRY messages have the following structure: MSH QRD [QRF] where: Message Header Query definition Query filter The MSH segment contains an acknowledgement code and the corresponding message control ID along with an error string in case of an error. The QRD segment specifies the data and time of the query, the format code, the priority and some query filter information. Most important is the Who Subject, where data for specific patient information can be requested. See QRD Query Definition on page 3-9 The QRF segment specifies the current data from the requested beds. Examples This message requests data from the patient James Miller who has a medical record number of MRN999: MSH ^~\& QRY^R02 HP P 2.x.1 QRD R I Q MRN999^Miller^James RES QRF MON ORF Message The query response message (ORF) is used to report parameter data as a reply to a query. ORF messages have the following structure: MSH MSA QRD [QRF] { PID PV1 } } where: Message Header Message Acknowledgement Query definition (from QRY message) Query filter (from QRY message) Patient Identification Patient Visit {OBR Observations Report ID {OBX} Result } The MSA segment contains an acknowledgement code and the corresponding message control ID along with an error string in case of an error. The QRD segment repeats the corresponding query definition. The QRF segment repeats the corresponding query filter definition. The PID segment contains the patient ID and name. The PV1 segment specifies the bed to be accessed along with the patient class if the query refers to current data from the CareNet. The OBR segment contains the timestamp (in ISO format) of the OBX parameters that follow. the QBX segment contains the result for the timestamp specified in the preceding OBR segment. 3-2 HL7 Messages: Polling Interface

31 Introduction Note The inclusion of a PV1 segment in an ORF message does not conform to the HL7 definition. The inclusion of the PV1 is required as it contains the identification of the bed. As there is no safe way to identify data through patient name or number, the bed identification is absolutely crucial and cannot be omitted. MDIL Coding Example MSH ^~\& ORF^R04 HP P 2.x 8859/1<CR> MSA AA HP <CR> QRD R I Q RES<CR> QRF MON Bed1~Bed2~*1-12<CR> PID Smith^Robert M<CR> PV1 I ^^Bed2&0&0<CR> OBR <CR> OBX ST 0002-f887^Model^MDIL 0 Monitoring Data F CONFIGURATION<CR> OBX ST 0002-d006^EctSta^MDIL 0 "" F<CR> OBX ST 0002-d007^RhySta^MDIL 0 SV Rhythm F<CR> OBX NM bb8^SpO2^MDIL ^%^MDIL F<CR> OBX NM ^ST-I^MDIL ^mm^MDIL F<CR> OBX NM ^ST-II^MDIL ^mm^MDIL F<CR> OBX NM ^HR^MDIL aa0^bpm^MDIL F<CR> OBX NM a15^ABPs^MDIL f20^mmHg^MDIL F<CR> OBX NM a16^ABPd^MDIL f20^mmHg^MDIL F<CR> OBX NM a17^ABPm^MDIL f20^mmHg^MDIL F<CR> OBX NM ^PVC^MDIL aa0^bpm^MDIL F<CR> OBX NM a05^NBPs^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a06^NBPd^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX NM a07^NBPm^MDIL f20^mmHg^MDIL F APERIODIC <CR> OBX ST 0402-f8f5^sMode^MDIL 0 DEMO F SETTING<CR> OBX ST 0002-f887^Model^MDIL 4 VueLink 1 F CONFIGURATION<CR> OBX NM ^awRR^MDIL ae0^rpm^MDIL F<CR> OBX NM 0002-e014^Tblood^MDIL a0^ C^MDIL F<CR> OBX NM c^TV^MDIL ^l^MDIL F<CR> OBX NM b0^etCO2^MDIL ^%^MDIL F<CR> OBX NM c^etAGT^MDIL ^%^MDIL F<CR> OBX NM ^inAGT^MDIL ^%^MDIL F<CR> OBX NM ba^imCO2^MDIL ^%^MDIL F<CR> OBX NM ^PIP^MDIL f40^cmH2O^MDIL F<CR> OBX NM a8^PEEP^MDIL f40^cmH2O^MDIL F<CR> OBX NM 0002-f093^Weight^MDIL c3^kg^MDIL F APERIODIC <CR> OBX NM ^sAWRR^MDIL ae0^rpm^MDIL F SETTING<CR> OBX NM c^sTV^MDIL ^l^MDIL F SETTING<CR> <FS> <CR> HL7 Messages: Polling Interface 3-3