Standard, HL7 Interface Specification Orders Outbound

Transcription

1 Standard, HL7 Interface Specification Orders Outbound MediLinks 2009 August North Juniper, Suite 100 Chandler, Arizona fax

2 Title MediServe - Standard HL7 Interface Specification Guide - Orders Outbound (MediLinks 2009) Published August MediServe. All Rights Reserved. Printed in the U.S.A. MediLinks is a registered trademark of MediServe. All other products are trademarks or registered trademarks of their respective holders, all rights reserved. Reference to these products is not intended to imply affiliation with or sponsorship of MediServe. Proprietary Notice This document is an unpublished work containing confidential and trade secret information, which is proprietary to MediServe, and is protected by laws pertaining to such materials. This document, the information in this document, and all rights thereto are the sole and exclusive property of MediServe, are intended for use by customers and employees of MediServe, and are not to be copied, used, or disclosed to anyone else, in whole or in part, without the express written permission of MediServe Corporation.

3 1Orders Outbound Topic Page About This Guide 2 Trigger Events 3 Order Events 3 Common Message Definition 3 Message Segments 4 MSH Message Header 5 EVN Event Identification 6 PID Patient Identification 6 PV1 Patient Visit 8 AL1 Allergy Information 11 ORC Common Order 11 OBR Observation Request 12 RXO - Pharmacy/Treatment Order 14 NTE Notes 15 Sample Messages 16 HL7 New Order 16 HL7 Parent Order 16 HL7 Order Canceled 16 HL7 Change Order 16 HL7 New Order with One Medication 17 HL7 New Order with Multiple Medications 17

4 MediLinks Interface Specification About This Guide Assumptions and Purpose Audience Related Publications It is assumed that you are familiar with, and have access to, the HL7 Standard. This guide is for interface engineers who are charged with assuring the successful communication of order entry data from MediLinks via HL7 interfaces. This document is to be used in conjunction with the HL7 Standard. The format and layout of this document is similar, but not identical to, the HL7 Standard. Orders Module Health Level Seven, Version 2.4. HL7 order messages are sent to a receiving application via a TCP/IP connection. The messages are constructed based on new orders, updated orders, discontinued orders, or accompanying orders. When any of these events occur, MediLinks notifies the interface by flagging the patient s order record. The interface runs a series of checks to determine which of these types of order message should be constructed. Implementing SN/NA Protocol MediLinks outbound interface supports the SN/NA protocol. The flag for this option changes the outbound messaging from requesting placer numbers to sending all new orders with a MediLinks placer number. The option applies to parent orders and order occurrences with the SN or NW order control, depending on whether the number assignment request. 2

5 Orders Outbound Trigger Events Order Events This section describes all the trigger events that are associated with this interface module and what actions generate communication to the ancillaries. This table is a list of Order default events used by the MediLinks interface orders outbound module. Event ORM^O01 ORM^O02 OMG^O19 OML^O21 Description NW or PA - New Order or Parent Order CA, DC, or OC - Cancel Order Request, Discontinue Order Request, or Order Canceled XO or XX - Modified or Change Order NA Number Assignment General Clinical Order Message. See ORM for supported Order Control Codes. Laboratory Order Message. See ORM for supported Order Control Codes. Common Message Definition These segments are used to populate the MediLinks PATORDERS or UNVERIFIEDORDERS tables: Segment Description R/O Condition MSH Message Header R PID Patient Identification R PV1 Patient Visit R [{IN1}] Insurance Information O [{IN2}] Insurance Additional Information [GT1] Guarantor O [{AL1}] Allergy Information O ORC Common Order R O 3

6 MediLinks Interface Specification Segment Description R/O Condition OBR Observation Request R [{RXO}] Pharmacy/Treatment Order C When medications are attached as an order. [NTE] Notes O Note: Segments surrounded with [ ] indicate an optional segment, and ones surrounded with { } indicate a repeating segment. Field lengths are MediLink s field lengths unless otherwise indicated. Message Segments If a field is identified as required (R) in the R/O column, the MLSI sends a value in this field and expects a value in this field when receiving messages. These are the reasons a field can be considered required: Compatibility and compliance with the HL7 standard (i.e., HL7 lists it as a required field). Ensure certain MediLinks functionality works correctly. Forward compatibility with a planned feature or functionality in MLS. Processing and error reporting (e.g., message control ID). For outbound communication - a field that the MediLinks interface will populate because MediLinks requires its entry. The conditional (C) status indicates that under certain conditions this field will be required. Fields or subfields marked with (N) are not supported by MLSI. After the last field supported by MLSI, any additional unsupported fields have been omitted. This same convention has been applied to HL7 subfields where the additional HL7-defined subfields have been omitted if not supported by MLSI. Note: Field lengths are MediLinks field lengths unless otherwise indicated. 4

7 Orders Outbound MSH Message Header Field Subfield Element Name MLS Navigation Len R/O Comments 1 Field Separator 1 R 2 Encoding Characters ^~\& 4 R 3 Sending Application <SENDING APPLICATION> 180 R For outbound, the default is MediLinks. 4 Sending facility <SENDING FACILITY> 180 R 5 Receiving Application <RECEIVING APPLICATION> 180 R 6 Receiving Facility <RECEIVING FACILITY> 10 R 7 Creation Date/Time CCYYMMDDHHMM 12 R 8 Security 40 N 9 1 Message Type see Trigger Events Table 7 R 9 2 Trigger Event see Trigger Events Table 3 R 10 Message Control ID Identifier 20 R Identifier used to relate the response (HL7 Ack) to the initial message. The value uniquely identifies a message. 11 Processing ID <D>ebug, <P>roduction, <T>raining 3 R 12 Version ID R 13 Sequence Number 15 N 14 Continuation Pointer 180 N 15 Accept ACK Type 2 O 16 Application ACK Type 2 N 17 Country Code 2 N 18 Character Set 6 N 19 Principal Language of Message 60 N 5

8 MediLinks Interface Specification Note: The sending system waits for an HL7 acknowledgement from the receiving system before assuming commitment by the receiver (and before proceeding to send the next message). The sender uses the Message Control ID (MSH10 and MSA2) for this purpose. When sending a message, the sender remembers the Message Control ID it puts in MSH10 and waits for a corresponding HL7 Acknowledgement message. When an acknowledgement is received, the sender verifies that MSA2 matches the Message Control ID that was sent. If so, the sender proceeds to the next message. If not, the sender discards the Acknowledgement message and continues to wait for an acknowledgement with the correct Message Control ID. EVN Event Identification Field Subfield Element Name MLS Field Value Len R/O Comments 1 Event Type Code O01, O02 3 R 2 Recorded Date/Time CCYYMMDDHHMM 20 R 3 Date/Time Planned Event CCYYMMDDHHMM 20 R PID Patient Identification Field Subfield Element Name MediLinks Navigation Len R/O Comments 1 Set ID - PID 1 4 N Required by HL7, but not used by MediLinks. 2 Patient ID 15 N 3 1 Patient Identifier List, ID Patient Info, MRN 50 R If multiple numbers are sent, MediLinks only accepts the first number. 3 2 Patient Identifier List, Check Digit 3 3 Patient Identifier List, Check Digit Scheme 3 4 Patient Identifier List, Assigning Authority Not displayed. For internal use as the ID domain. 199 N 10 N 10 R Unique name of the system that created this identifier. 4 Alternate Patient ID - PID Patient Info, Other ID 15 O 5 1 Patient Last Name Patient Info, Name, Last 100 R 5 2 Patient First Name Patient Info, Name, First 100 O Required by HL7, but not used by MediLinks. 5 3 Patient Middle Initial Patient Info, Name, Middle 1 O 5 4 Patient Name Suffix Patient Info, Name, Suffix 5 O 6 Mother s Maiden Name 48 N 6

9 Orders Outbound Field Subfield Element Name MediLinks Navigation Len R/O Comments 7 Date/Time of Birth Patient Info, DOB 8 O CCYYMMDD Required by HL7, but not used by MediLinks. 8 Sex Patient Info, Gender 1 O Required by HL7, but not used by MediLinks. 9 Patient Alias 48 N 10 Race 80 N 11 1 Patient Address Contact Information, Mailing Address Street Patient Address Contact Information, Mailing Address Street Patient Address Contact Information, Mailing Address, City 11 4 Patient Address Contact Information, Mailing Address, State 11 5 Patient Address Contact Information, Mailing Address, Zip 12 County Code Contact Information, Mailing Address, Country 13 Phone Number - Home Contact Information, Phone, Home 14 Phone Number - Business Contact Information, Phone, Work 15 Primary Language Contact Information, Speaks 60 O Required by HL7, but not used by MediLinks. 60 O 60 O Required by HL7, but not used by MediLinks. 2 O Required by HL7, but not used by MediLinks. 9 O Required by HL7, but not used by MediLinks. 4 N default USA 10 O [(999)] O If GT1.18 for a 'self'' segment is not present, PID14 will be used 20 O 16 Marital Status Patient Info, Marital Status 50 O 17 Religion 80 N 18 1 Patient Account Number Edit Account, Account ID 50 C For Admit messages, if not present, a temporary account is created Patient Account Number, Check Digit 18 3 Patient Account Number, Check Digit Scheme 18 4 Patient Account Number, Assigning Authority Not displayed. For internal use as the ID domain. 199 N 10 N 10 R Unique ID of the system that created the account identifier. 19 SSN Number - Patient Patient Info, Name, SSN 9 O Driver's License Number - Patient 25 N 7

10 MediLinks Interface Specification Field Subfield Element Name MediLinks Navigation Len R/O Comments 21 Mother's Identifier 20 N 22 Ethnic Group Patient Info, Racial/Ethnic Group 30 O 23 Birth Place 60 N 24 Multiple Birth Indicator 1 N 25 Birth Order 2 N 26 Citizenship 80 N 27 Veterans Military Status 60 N 28 Nationality 80 N 29 Patient Death Date and Time Patient Info, Demographics Deceased (date/time) 30 Patient Death Indicator Patient Info, Demographics Deceased 12 O A date or a date and time may be passed. 1 O PV1 Patient Visit Field Subfield Element Name MLS Field Value Len R/O Comments 1 Set ID - PV1 4 N 2 Patient Type Account, Administration Patient Type 3 1 Point of Care Edit Account, Administration, Patient Location 3 2 Room Edit Account, Administration, Patient Location 3 3 Bed Edit Account, Administration, Patient Location 3 4 Facility Edit Account, Administration, Patient Location 7 O 10 R Workarea 10 R 3 O 10 R 3 5 Location Status 10 N 4 Admission Type 2 N 5 Preadmit Number 20 N 6 Prior Patient Location 80 N 7 1 Attending Doctor ID Practitioners Dictionary Doctor Code 7 2 Attending Doctor Last Name Practitioner, Name (Last) Association = Attending 7 3 Attending Doctor First Name Practitioner, Name (First) Association = Attending 10 R 25 R 15 R 8

11 Orders Outbound Field Subfield Element Name MLS Field Value Len R/O Comments 8 1 Referring Doctor ID Practitioners Dictionary Doctor Code 8 2 Referring Doctor Last Name Practitioner, Name (Last) Association = Referring 8 3 Referring Doctor First Name Practitioner, Name (Last) Association = Referring 9 1 Consulting Doctor ID Practitioners Dictionary Doctor Code 9 2 Consulting Doctor Last Name Practitioner, Name (Last) Association = Consulting 9 3 Consulting Doctor First Name Practitioner, Name (Last) Association = Consulting 10 O 25 O 15 O 10 O 25 O 15 O 10 Hospital Service 7 N 11 Temporary Location 80 N 12 Preadmit Test Indicator 2 N 13 Readmission Indicator 2 N 14 Admit Source 3 N 15 Ambulatory Status 2 N 16 VIP Indicator 2 N 17 1 Admitting Doctor ID Practitioners dictionary Doctor Code 17 2 Admitting Doctor Last Name Practitioner, Name (Last) Association=Admitting 17 3 Admitting Doctor First Name Practitioner, Name (First) Association=Admitting 18 Patient Type Account, Administration Patient Type 10 R 25 R 15 R 7 O 19 Visit Number 15 N 20 Financial Class Account, Administration Financial Class 7 O 21 Charge Price Indicator 2 N 22 Courtesy Code 2 N 23 Credit Rating 2 N 24 Contract Code 2 N 25 Contract Effective Date 8 N 26 Contract Amount 12 N 27 Contract Period 3 N 28 Interest Code 2 N 9

12 MediLinks Interface Specification Field Subfield Element Name MLS Field Value Len R/O Comments 29 Transfer to Bad Debt Code 1 N 30 Transfer to Bad Debt Date 8 N 31 Bad Debt Agency Code 10 N 32 Bad Debt Transfer Amount 12 N 33 Bad Debt Recovery Amount 12 N 34 Delete Account Indicator 1 N 35 Delete Account Date 8 N 36 Discharge Disposition Account, Administration Discharge Disposition 37 Discharged Description Account, Administration Discharge Description 7 O 60 O 38 Diet Type 2 N 39 1 Servicing Facility 10 N 40 Bed Status 1 N 41 Account Status 2 N 42 Pending Location 80 N 43 Prior Temporary Location 80 N 44 Admit Date/Time Account, Administration Opened 45 Discharge Date/Time Account, Administration Closed 12 R 12 C Required for Discharge events. 46 Current Patient Balance 12 N 47 Total Charges 12 N 48 Total Adjustments 12 N 49 Total Payments 12 N 50 Alternate Visit ID 51 Visit Indicator 1 N 52 Other Healthcare Provider 60 N 10

13 Orders Outbound AL1 Allergy Information Field Subfield Element Name MLS Field Value Len R/O Comments 1 Set ID - AL1 N/A R Used for interface processing. If the allergy code unique identifier exists it must be sent in this field as well as 3.1. If deactivating allergies from the interface is desired. 2 Allergy Type Code Patient Info, Meds & Allergies (Type) 50 R Type = MA, (Allergies) Type = DA, (Drug Allergies) Type = FA (Food Allergies) 3 1 Allergen Code/Mnemonic R 3 2 Allergen Code Name Patient Info, Meds & Allergies (Allergen) 50 R 3 3 Allergen Coding System O 4 Allergy Severity Code Patient Info, Meds & Allergies (Severity) 5 Repeating Allergy Reaction Code Patient Info, Meds & Allergies (Reaction) 50 O 50 O Reaction (multiples shall be concatenated and comma delimited) 6 Identification Date 8 N Date of Onset ORC Common Order Field Subfield Element Name Len R/O Comments 1 Order Control 2 R NW or PA; CA, DC, or OC; XO or XX; NA, SC Used for processing rules 2 1 Placer Order Number 32 C If not provided, value in OBR2 will be used 3 1 Filler Order Number 32 R MediLinks generated alphanumeric (32 CHAR) 4 Placer Group Number 22 N 5 Order Status 2 N 6 Response Flag 1 N 7 1 Quantity/Timing Quantity 10 N Value in OBR 27 used 7 2 Quantity/Timing Interval 20 N Value in OBR 27 used 7 3 Quantity/Timing Duration 12 N Value in OBR 27 used 7 4 Quantity/Timing Start Date/Time 12 N Value in OBR 27 used 8 1 Parent Placer Number 50 N 11

14 MediLinks Interface Specification Field Subfield Element Name Len R/O Comments 8 2 Parent Filler Number 50 N 9 Date/Time of Transaction 12 N 10 1 Entered By 15 O ID 10 2 Entered By 25 O Last Name 10 3 Entered By 15 O First Name 11 Verified By 120 N 12 Ordering Provider 10 O 13 Enterer's Location 50 N 14 Call Back Phone Number 40 N 15 Order Effective Date/Time 26 N 16 Order Control Code Reason 200 N 17 Entering Organization 60 N 18 Entering Device 60 N 19 Action By 120 N OBR Observation Request Field Subfield Element Name Len R/O Comments 1 Set ID - OBR 4 O 2 Placer Order Number 32 R 3 Filler Order Number 32 R 4 Universal Service ID 20 R 5 Priority 2 N 6 Requested Date/time 12 N 7 Observation Date/Time 12 C Required for observation results trigger events. 8 Observation End Date/Time 12 N 9 Collection Volume 20 N 10 Collector Identifier 60 N 11 Specimen Action Code 1 N 12 Danger Code 60 N 13 Relevant Clinical Info. 300 N 12

15 Orders Outbound Field Subfield Element Name Len R/O Comments 14 Specimen Received Date/Time 12 C 15 Specimen Source 300 N 16 1 Ordering Provider 10 O ID 16 2 Ordering Provider 25 O Last Name 16 3 Ordering Provider 15 O First Name 17 Order Callback Phone Number 40 N 18 Placer field 1 60 N 19 Placer field 2 60 N 20 Filler Field 1 60 N 21 Filler Field 2 60 N 22 Results Rpt/Status Chng - Date/Time 23 Charge to Practice 40 N 24 Diagnostic Serv Sect ID 10 N 25 Result Status 1 N 26 Parent Result 400 N 27 1 Quantity/Timing Quantity 10 O 27 2 Quantity/Timing Interval 20 R Frequency 27 3 Quantity/Timing Duration 4 R 12 C Required for observation results trigger events Quantity/Timing Start Date/Time 12 R Start time + Duration = End time 28 Result Copies To 150 N 29 1 Parent Placer Number 32 N 29 2 Parent Filler Number 32 N 30 Transportation Mode 1 N 31 Reason for Study/Indication 255 N 32 1 Principal Result Interpreter 8 C Optional for observations results Principal Result Interpreter 25 C Optional for observations results Principal Result Interpreter 15 C Optional for observations results. 33 Assistant Result Interpreter 200 N 34 Technician 200 N 35 Transcriptionist 200 N 36 Scheduled Date/Time 26 N 13

16 MediLinks Interface Specification Field Subfield Element Name Len R/O Comments 37 Number of Sample Containers 4 N 38 Transport Logistics of Collected Sample 60 N 39 Collector's Comment 200 N 40 Transport Arrangement Responsibility 60 N 41 Transport Arranged 30 N 42 Escort Required 1 N 43 Planned Patient Transport Comment 200 N RXO - Pharmacy/Treatment Order Field Subfield Element Name MediServe Field Value Len R/O Comments 1 1 Requested Give Code - ID N 1 2 Requested Give Code - Text Order Entry, Medications / Oxygen (Description) 1 3 Requested Give Code - Coding System 50 R N 2 Requested Give Amount - Minimum 3 Requested Give Amount - Maximum Order Entry, Medications / Oxygen 15 R Range dosages are not supported and the exact amount dosage is sent in this field. This value is the first component of the dosage entry in the MLS Medication dictionary before the first space character. Dosage must be entered following this example: "50 mg" or "50 mg per Kg" or dosage<space> units. N 4 Requested Give Units Order Entry, Medications / Oxygen 20 R This value is the second component of the dosage entry in the MLS Medication dictionary after the first space character. 5 Requested Dosage Form 25 N 6 Provider's Pharmacy/Treatment Instructions 7 1 Provider's Administration Instructions 25 N 30 N 14

17 Orders Outbound Field Subfield Element Name MediServe Field Value Len R/O Comments 7 2 Provider's Administration Instructions Order Entry, Page 1 Order Code Description 30 O 8 Deliver-to Location N 9 Allow Substitutions N 10 Requested dispense code 3 N 11 Requested dispense amount 3 N 12 Requested dispense units 50 N 13 Number of refills 90 N 14 Ordering provider's DEA number 15 Pharmacist/treatment supplier's verifier ID 8 N 1 N 16 Needs human review 1 N 17 Requested give per (time unit) 8 N 18 Requested give strength N 19 Requested give strength units 1 N 20 Indication 1 N 21 Requested give rate amount 30 N 22 Requested give rate units 1 N 23 Total daily dose 90 N 24 Supplementary code 2 N NTE Notes Field Subfield Element Name MLS Field Value Len R/O Comments 1 Set ID - NTE 1 4 R 2 Source of Comment Order 8 R 3 Comment Order Comment 100 R 15

18 MediLinks Interface Specification Sample Messages HL7 New Order HL7 Parent Order HL7 Order Canceled HL7 Change Order MSH ^~\& MEDILINKS MEDISERVE VENDORORHOST A ORM^O01 T 2.4 <CR> PID LAST^IFIRST F <CR> PV1 1 51^ ^02^A1 OPT O 07 A <CR> ORC NW F895E8324CDA437BAA1682DB83B8D36E QHS &P A1 <CR> OBR 1 F895E8324CDA437BAA1682DB83B8D36E A ^BIPAP(FOR OSA) ^QHS & P^^ ^False ^ <CR> NTE A1 P THIS IS THE COMMENT FIELD <CR> MSH ^~\& HBOC E ENGINE E ORM^O D AL 42<CR> PID ^^^E TESTPATIENT M 3 UNKNOWN^^YOUNGSTOWN^OH^4450 1^US^C^MAHON MAHON ENGLISH^E M CAT ^^^E <CR> PV1 I 85^8502^A^E^^^S 2 777^TEST^PATIENT^G 609^TEST^PATIENT^A MED 2 777^TEST^PAT IENT^G^^^MD IPE ^^^E A E ITT <CR> ORC PA 36383^HBOC IP N 36383&HBOC UT00029^TESTID^TWENTYNINE 609^TE ST^PATIENT^A B3W UT00029<CR> OBR ^HBOC 19300^O2 BY NASALCANNULA^RTE N 609^TEST^PATIENT^A 1^CONT&&&1J ^O1^ ^ ^1<CR> MSH ^~\& HBOC E ENGINE E ORM^O T AL 42<CR> PID ^^^E TEST^PATIENT^^MR M N MAINST^PATIENT ADDRESS LINE2^GIRARD^OH^44420^US^C^TRUMB TRUMB (999) X2 (111) ENGLISH^E S CAT ^^^E <CR> PV1 I 54A^5407^A^E^^^S 3 375^TEST^PATIENT^J MED 1 375^TEST^PATIENT^J^^^MD IPE ^^^E A E OCC <CR> ORC OC 37999^HBOC CA N 1^ONCE&&&1J ^O1^ ^ ^ &H BOC UH01416^TEST^PATIENT^D 375^NOVAK^GLENN^J B UH01 416<CR> OBR ^HBOC 19711^ENGORDER^NSE N 375^TEST^PATIENT^J 1^ONCE&&&1J ^O1^ ^ ^ ^PARTYPHOID FEVER A<CR> NTE A1 P THIS IS THE ORDER COMMENTS<CR> MSH ^~\& MEDILINKS MEDISERVE VENDORORHOST A ORM^ O01 T 2.4 <CR> PID DOE^JOHN U <CR> PV1 1 ECU^ ^01^A ECU E 01 A <CR> ORC XX B86FDB3723C5453E C8E6AD A1 < CR> OBR 1 B86FDB3723C5453E C8E6AD8^ A ^NCPAP ^ ^ ^ ^False ^ <CR> 16

19 Orders Outbound HL7 New Order with One Medication MSH ^~\& MEDILINKS MEDISERVE VENDORORHOST A ORM^O01 T 2.4 <CR> PID LAST^IFIRST F <CR> PV1 1 51^ ^02^A1 OPT O 07 A <CR> ORC NW F895E8324CDA437BAA1682DB83B8D36E A1 <CR> OBR 1 F895E8324CDA437BAA1682DB83B8D36E NEB^Nebulizer ^Q4H^^ <CR> NTE A1 P THIS IS THE COMMENT FIELD <CR> RXO ^Albuterol 2.5 mg ^Nebulizer <CR> HL7 New Order with Multiple Medications MSH ^~\& MEDILINKS MEDISERVE VENDORORHOST A ORM^O01 T 2.4 <CR> PID LAST^IFIRST F <CR> PV1 1 51^ ^02^A1 OPT O 07 A <CR> ORC NW F895E8324CDA437BAA1682DB83B8D36E A1 <CR> OBR 1 F895E8324CDA437BAA1682DB83B8D36E MDI^Metered Dose Inhaler ^QID^^ <CR> RXO ^Albuterol 1-3 puffs ^Metered Dose Inhaler <CR> RXO ^Atrovent 2 puffs (18mcg/puff) ^Metered Dose Inhaler <CR> 17

20 MediLinks Interface Specification 18