OTObase HL7 Integration

Transcription

1 OTObase HL7 Integration Reference Manual Doc. No EN/01 Part No EN

2 Copyright notice The manufacturer authorizes GN Otometrics A/S to publish manuals approved and released by the manufacturer. [XXXX], 2018 GN Otometrics A/S. All rights reserved. Otometrics, the Otometrics Icon, ARICAL, MADSEN, ICS and HORTMANN are registered trademarks of GN Otometrics A/S in the.s.a. and/or other countries. Version release date (181380) Technical support Please contact your supplier. 2 Otometrics - OTObase

3 Table of Contents 1 Overview 5 2 OTObase EMR connector for HL7 interface 6 3 Supported HL7 messages types ORM (Observation/Order Request Order Message) Placing a new Order request Message Header (MSH) segment Patient Identification (PID) segment Patient Visit (PV1) segment Common Order (ORC) segment Observation Request (OBR) segment Example of ORM Message for a new order request ADT^A01 (Patient Admit Message) Message Header (MSH) segment Patient Identification (PID) segment Patient Visit 1 (PV1) segment Example of ADT^A01 message ADT^A03 (Patient Discharge Message) ADT^A04 (Patient Registration Message) ADT^A08 (Patient Information pdate Message) ACK (Acknowledgment) message & ADT Message Header (MSH) segment Message Acknowledgment (MSA) segment Example of Acknowledgment (ACK) message in case of success Example of Acknowledgment (ACK) message in case of failure QRY_A19 (Patient Query Request message) Message Header (MSH) segment Query Definition (QRD) segment Example of QRY_A19 message ADR_A19 (Patient Query Response message) Message Header (MSH) segment Message Acknowledgment (MSA) segment Query Definition (QRD) segment Patient Identification (PID) segment Patient Visit (PV1) segment Example of ADR_A19 message when patient found Example of ADR_A19 message when patient not found OR (Observation Result nsolicited message) Message Header (MSH) segment Common Order (ORC) segment Observation Request (OBR) segment Observation Result (OBX) segment Example of OR message ACK (Acknowledgment message for OR) Message Header (MSH) segment Message Acknowledgment (MSA) segment Example of OR Acknowledgment (ACK) message in case of success Example of OR Acknowledgment (ACK) message in case of failure 33 Otometrics - OTObase 3

4 4 Communication protocol 34 5 Opening an existing order 35 4 Otometrics - OTObase

5 1 Overview 1 Overview The HL7 (Health Level Seven) standard was developed by a community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. HL7 refers to the highest level of the international Standards Organization s (ISO) communication model for Open System Interconnection (OSI). The application level addresses the data definition to be exchanged, the interchange timing, and the communication of certain errors to the application. The seventh level supports such functions as security checks, participant identification, availability checks, exchange mechanism negotiations and, most importantly, it supports the standard for exchange of data among healthcare applications. Otometrics - OTObase 5

6 2 OTObase EMR connector for HL7 interface 2 OTObase EMR connector for HL7 interface The OTObase EMR connector for HL7 interface provides a standard messaging format for transferring information from system to system. The OTObase EMR Connector provides a work flow to interchange the electronic data of patients such as demographic data and audiology measurement reports. The following response paradigms relate to the communication between an EMR System and the OTObase HL7 interface. The EMR system sends ORM (Observation/Order Request Message) messages to OTObase. OTObase replies with an ACK (Acknowledgment) message and then OTObase sends an OR (Observation Result nsolicited) message containing the finished transcriptions back to the EMR system. The EMR system should send an ACK message to OTObase in reply to the OR message. OTObase sends a QRY (Patient Query) message to the EMR System. The EMR System should send an ADR (Patient Query Response) message back to OTObase. 6 Otometrics - OTObase

7 3 Supported HL7 messages types The following HL7 message types are supported by the OTObase EMR Connector for HL7 Interface: ORM (Observation/Order Request Order Message) 7 ADT^A01 (Patient Admit Message) 16 ADT^A03 (Patient Discharge Message) 17 ADT^A04 (Patient Registration Message) 17 ADT^A08 (Patient Information pdate Message) 18 ACK (Acknowledgment) message & ADT 18 QRY_A19 (Patient Query Request message) 21 ADR_A19 (Patient Query Response message) 23 OR (Observation Result nsolicited message) 26 ACK (Acknowledgment message for OR) 31 The tables in the following sections of the manual describe the elements in each of the message types. The table rows are color coded to indicate whether the element is Required (R), Optional (O) or nused (), as follows: Row type se identifier Description 1 O Optional 2 R Required 3 nused 3.1 ORM (Observation/Order Request Order Message) The function of this message is to initiate the transmission of information about an order/observation. This includes placing a new observation request and registering a patient in OTObase Placing a new Order request The HL7 Order message (ORM) should contain the following information in order to place a new observation/order request in OTObase Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & Otometrics - OTObase 7

8 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss 8 Security Message Type 1. Message Type 2. Trigger Event R ORMO01 or ADT^A01 or ADT^A03 or ADT^A04 or ADT^A08 ORM/ADT O01/A01/A03/A04/A08 Note: Message type & trigger event will be different depending upon the type of message. 10 Message Control Identifier R ORM Processing ID O P = Production T= Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number A non-null value in this field implies that the sequence number protocol is in use. This numeric field is incremented by one for each subsequent value. 14 Continuation Pointer This field is used to define continuations in application-specific ways. 15 Accept Acknowledgment Type AL = Always NE = Never ER = Erroneous conditions S = Successful completion 8 Otometrics - OTObase

9 16 Application Acknowledgment Type AL = Always NE = Never ER = Erroneous conditions S = Successful completion 17 Country Code ISO 3166 provides a list of country codes. 18 Character Set Alternate character sets not used. 19 Principle Language of Message ISO 639 provides a list of codes Patient Identification (PID) segment 1 Set ID R 2 Patient ID External ID O 3 Patient ID Internal ID R Alternate Patient ID 5 Patient Name 1. Last Name 2. First Name 3. Middle Name 4. Suffix 5. Prefix R Mr. Fischer Martin 6 Mother s Maiden Name 7 Date and Time of Birth R YYYYMMDDhhmmss Sex R M 9 Patient Alias 1. Last Name 2. First Name 3. Middle Name 4. Suffix 5. Prefix 10 Race Otometrics - OTObase 9

10 11 Patient Address 1. Street Or Mailing Address 2. Other destination 3. City 4. State 5. Postal Code 6. Country R 123 West St. Denver CO SA. 12 County Code O 13 Phone Number Home R Phone Number Business R Primary Language O 16 Marital Status O 17 Religion O 18 Patient Account Number O 19 Social Security Number O 20 Driver s License Number 21 Mother s Identifier 22 Ethnic Group 23 Birth Place 24 Multiple Birth Indicator 25 Birth Order 26 Citizenship 27 Veteran s Military Status 28 Nationality 29 Patient Death and Time 30 Patient Death Indicator Patient Visit (PV1) segment This is an optional segment. An ORM or ADT message may or may not contain this segment. 10 Otometrics - OTObase

11 If this segment is included in the incoming message, then OTObase will use this segment to get the visit location detail. Based on that, the patient location filter will be populated. OTObase provides the patient visit location filter in the pending work list. This location filter can be used to get the list of patients that are expected to visit the specific facility/location. 1 Set ID O 2 Patient Class O 3 Assigned Patient Location Point of Care Room Bed Facility R 4 Admission type 5 Pre admit Number 6 Prior Patient Location 7 Attending Doctor 1. Last Name 2. First Name 3. Middle Initial 8 Referring Doctor 4. Last Name 5. First Name 6. Middle Initial 9 Consulting Doctor 7. Last Name 8. First Name 9. Middle Initial O O O 10 Hospital Service 11 Temporary Location 12 Pre-admit Test Indicator 13 Re-admission Indicator 14 Admit Source Otometrics - OTObase 11

12 15 Ambulatory Status 16 VIP Indicator 17 Admitting Doctor 18 Patient Type 19 Visit Number R Financial Class 21 Charge Price Indicator 22 Courtesy Code 23 Credit Rating 24 Contract Code 25 Contract Effective Date 26 Contract Amount 27 Contract Period 28 Interest Code 29 Transfer to Bad Debt Code 30 Transfer to Bad Debt Date 31 Bad Debt Agency Code 32 Bad Debt Transfer Amount 33 Bad Debt Recovery Amount 34 Delete Account Indicator 35 Delete Account Date 36 Discharge Disposition 37 Discharged to Location 38 Diet Type 39 Servicing Facility 40 Bed Status 12 Otometrics - OTObase

13 41 Account Status 42 Pending Location 43 Prior Temporary Location 44 Admit Date and Time 45 Discharge Date and Time 46 Current Patient Balance 47 Total Charges 48 Total Adjustments 49 Total Payments 50 Alternative Visit ID 51 Visit Indicator 52 Other Healthcare Provider Common Order (ORC) segment Pos ition Element se Example 1 Order Control O NW 2 Placer Order Number O Filler Order Number 4 Placer Group Number 5 Order Status 6 Response Flag 7 Quantity/Timing 8 Parent 9 Date and Time of Transaction 10 Entered By 11 Verified By Otometrics - OTObase 13

14 Pos ition Element se Example 12 Ordering Provider 13 Enterer s Location 14 Callback Phone Number 15 Order Effective Date and Time 16 Order Control Code Reason 17 Entering Organization 18 Entering Device 19 Action By Observation Request (OBR) segment 1 Set ID R 1 2 Placer Order Number R Filler Order Number O niversal Service Identifier O 5 Priority 6 Requested Date and Time 7 Observation Date and Time 8 Observation End Date and Time 9 Collection Volume 10 Collector Identifier 11 Specimen Action Code 12 Danger Code 13 Relevant Clinical Information 14 Specimen Received Date and Time 14 Otometrics - OTObase

15 15 Specimen Source 16 Ordering Provider 17 Order Callback Phone Number 18 Placer Field 1 19 Placer Field 2 20 Filler Field 1 21 Filler Field 2 22 Results Report/Status Change Date and Time 23 Charge to Practice 24 Diagnostic Service Section ID 25 Result Status 26 Parent Result 27 Quantity / Timing 28 Result Copies to 29 Parent 30 Transportation Mode 31 Reason for Study 32 Principal Result Interpreter 33 Assistant Result Interpreter 34 Technician 35 Transcriptionist 36 Scheduled Date and Time 37 Number of Sample Containers 38 Transport Logistics of Collected Samples 39 Collector s Comment Otometrics - OTObase 15

16 40 Transport Arrangement Responsibility 41 Transport Arranged 42 Escort Required 43 Planned Patient Transport Comment Example of ORM Message for a new order request The following is an example of an ORM message : MSH ^~\& EMR EMR OTObase OTObase ORM^O01 ORM P 2.7 PID Fischer^Martin^^^Mr M 123 West St. ^^Denver^CO^80020^SA PV1 O OP^PAREG^ 2342^Jones^Bob OP ORC NW OBR ^rinalysis^L ADT^A01 (Patient Admit Message) An Admit Patient Message (A01 event) is used for admitted patients only. These messages are sent when the patient begins the stay at the healthcare facility. Normally, this information is entered in the hospital information system and then sent to nursing units and ancillary systems, to notify the patients' arrival at the healthcare facility. When OTObase receives this message, it extracts the patient demographic information. If the patient does not exist, OTObase creates the patient. If the patient exists, OTObase updates the existing patient. After that OTObase adds the patient appointment in the work list Message Header (MSH) segment See Message Header (MSH) segment Patient Identification (PID) segment See Patient Identification (PID) segment Patient Visit 1 (PV1) segment See Patient Visit (PV1) segment Example of ADT^A01 message The following is an example of an ADT^A01 message: 16 Otometrics - OTObase

17 MSH ^~\& ADT1 MCM LABADT MCM SECRITY ADT^A01 MSG P 2.6 EVN A PID PATID1234^5^M11^^AN JONES^WILLIAM^A^III M DELAWARE AVENE^^EVERETT^MA^02149 GL (919) (000) ~(000) S PATID ^2^M10^^ACSN ^NC PV1 1 I 2000^2012^01^SRO ^LEBAER^SIDNEY^J. SR - ADM A0 Note OTObase will ignore the unsupported segments included in the ADT message, if there are any. 3.3 ADT^A03 (Patient Discharge Message) A "Patient Discharge" or "end visit" message (A03 event) should be sent when an in-patient s stay at the healthcare facility has ended, or an out-patient visit has ended. OTObase deletes the patient entry from the Pending Worklist (appointment), when this message is received. There are two possible scenarios for when the system automatically deletes a patient entry from the work list: When the user does the sign-off, an OR message will be sent to the connected EMR system and the patient entry will be deleted from the pending worklist. When OTObase receives an ADT^A03 message, the patient entry will be deleted from the Pending Worklist without sending any message to the connected EMR system. If OTObase does not contain any pending work item (appointment) for this patient, an ADT^A03 message will be ignored. An ADT^A03 message should have MSH, PID, and PV1 segments like the ADT^A01 message. See the segment definition details above in the ADT^A01 message section, Message Header (MSH) segment 16 MSH ^~\& ADT1 MCM LABADT MCM SECRITY ADT^A03 MSG P 2.6 EVN A PID PATID1234^5^M11^^AN JONES^WILLIAM^A^III M DELAWARE AVENE^^EVERETT^MA^02149 GL (919) (000) ~(000) S PATID ^2^M10^^ACSN ^NC PV1 1 I 2000^2012^01^SRO ^LEBAER^SIDNEY^J. SR - ADM A0 3.4 ADT^A04 (Patient Registration Message) A "Patient Registration" message (A04 event) signals that the patient has arrived or has checked in as an out-patient, or as a recurring or emergency room patient. This message is like ADT^A01 (Patient Admit) message and OTObase handles this message exactly like the ADT^A01 message. An ADT^A04 message should have MSH, PID, NK1, and PV1 segments like the ADT^A01 message. See the segment definition details in the ADT^A01 message section, Message Header (MSH) segment 16 Otometrics - OTObase 17

18 MSH ^~\& ADT1 MCM LABADT MCM SECRITY ADT^A03 MSG P 2.6 EVN A PID PATID1234^5^M11^^AN JONES^WILLIAM^A^III M DELAWARE AVENE^^EVERETT^MA^02149 GL (919) (000) ~(000) S PATID ^2^M10^^ACSN ^NC PV1 1 I 2000^2012^01^SRO ^LEBAER^SIDNEY^J. SR - ADM A0 3.5 ADT^A08 (Patient Information pdate Message) The "Patient Information pdate Message" (A08 event) is used when any patient information has changed but no other ADT event has occurred. OTObase updates the patient details if the patient already exists, or creates a new patient with updated details. In this case patient information will be updated but any appointments will not be scheduled (i.e. the patient entry will not be added to the OTObase Pending Worklist). An ADT^A08 message structure is like an ADT^A01 message. See the message, and segment details above in ADT^A01 (Patient Admit Message) 16. MSH ^~\& ADT1 MCM LABADT MCM SECRITY ADT^A08 MSG P 2.6 EVN A PID PATID1234^5^M11^^AN JONES^WILLIAM^A^III M DELAWARE AVENE^^EVERETT^MA^02149 GL (919) (000) ~(000) S PATID ^2^M10^^ACSN ^NC PV1 1 I 2000^2012^01^SRO ^LEBAER^SIDNEY^J. SR - ADM A0 Note It is assumed that the EMR system sends a supported ADT message to OTObase only for relevant patients. Nonaudiological patient visits are completely irrelevant for OTObase. It is recommended that the EMR system should send only audiological patient ADT messages to OTObase. 3.6 ACK (Acknowledgment) message & ADT OTObase sends acknowledgment (ACK) messages for all incoming ORM & ADT messages. The structure of the ACK is as follows: 18 Otometrics - OTObase

19 3.6.1 Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss 8 Security 9 Message Type R ACK Message Control Identifier R ORM Processing ID O P = Production T= Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number 14 Continuation Pointer 15 Accept Acknowledgment Type 16 Application Acknowledgment Type 17 Country Code Otometrics - OTObase 19

20 18 Character Set 19 Principle Language of Message Message Acknowledgment (MSA) segment 1 Acknowledgment Code R AA = Success AE = Error AR = Reject 2 Message Control ID R ORM Text Message O Success, Or Failure 4 Expected Sequence Number 5 Delayed Acknowledgment Type 6 Error Condition O Example of Acknowledgment (ACK) message in case of success OTObase sends an ACK message to acknowledge receipt of an ORM & ADT message. If the received message is accepted by OTObase, then OTObase sends a Success Acknowledgment message to the EMR system. The following is an example of a Success Acknowledgment (ACK) message: MSH ^~\& OTObase OTObase EMR EMR ACK ORM P 2.7 MSA AA ORM Success Example of Acknowledgment (ACK) message in case of failure If the received message is not accepted by OTObase, then OTObase sends a Failure Acknowledgment message to the EMR system. The following is an example of a Failure Acknowledgment (ACK) message: MSH ^~\& OTObase OTObase EMR EMR ACK ORM P 2.7 MSA AE ORM Failure 20 Otometrics - OTObase

21 3.7 QRY_A19 (Patient Query Request message) The function of this message is to send a query for patient information to the EMR system. This message will contain the patient number for unique identification Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss 8 Security Message Type 1. Message Type 2. Trigger Event R QRY^A19 QRY A19 10 Message Control Identifier R QRY Processing ID O P = Production T = Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number Otometrics - OTObase 21

22 14 Continuation Pointer. 15 Accept Acknowledgment Type 16 Application Acknowledgment Type 17 Country Code 18 Character Set 19 Principal Language of Message Query Definition (QRD) segment 1 Query Date Time R YYYYMMDDhhmmss Query Format Code R R (record oriented response) 3 Query Priority R I (Immediate) 4 Query ID 5 Deferred Response Type 6 Deferred Response Date Time Quantity 7 Quantity 8 Who Subject Filter 1. Patient ID Number 2. Family Name 3. Given Name R What Subject Filter 10 What Department Data Code 11 What Data Code Value 12 Query Result Level Example of QRY_A19 message The following is an example of a patient query request message (for Patient Number: 10204) : 22 Otometrics - OTObase

23 MSH ^~\& OTObase OTObase EMR EMR QRY^A19 QRY P 2.7 QRD R I This message queries for the demographics information for a patient based upon the Patient ID/Number (medical record number). The Patient ID Number is specified in the QRD-8 element: Who Subject Filter. 3.8 ADR_A19 (Patient Query Response message) This message is sent by the EMR system in response to the Patient Query Request (QRY_A19) message sent by OTObase. This message contains the patient demographic information for a particular patient based upon the Patient ID Number (medical record number) Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss 8 Security Message Type 1. Message Type 2. Trigger Type R ADR^A19 ADR A19 10 Message Control Identifier R QRY Otometrics - OTObase 23

24 11 Processing ID O P = Production T= Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number 14 Continuation Pointer 15 Accept Acknowledgment Type 16 Application Acknowledgment Type 17 Country Code 18 Character Set 19 Principal Language of Message Message Acknowledgment (MSA) segment See Message Acknowledgment (MSA) segment Query Definition (QRD) segment 1 Query Date Time R YYYYMMDDhhmmss Query Format Code R R (record oriented response) 3 Query Priority R I (Immediate) 4 Query ID 5 Deferred Response Type 6 Deferred Response Date Time Quantity 7 Quantity 24 Otometrics - OTObase

25 8 Who Subject Filter 1. Patient ID Number 2. Family Name 3. Given Name R What Subject Filter 10 What Department Data Code 11 What Data Code Value 12 Query Result Level Patient Identification (PID) segment See Patient Identification (PID) segment Patient Visit (PV1) segment See Patient Visit (PV1) segment Example of ADR_A19 message when patient found The following is an example of a patient query response message (for Patient Number: 10204) : MSH ^~\& AWS1 ZISSERVER OTObase OTObase ADR^A19 QRY P 2.7 MSA AA QRY QRD R I PID Fischer^Martin^^^Mr M 123 West St. ^^Denver ^CO ^80020 ^SA PV1 I A5TA^5014^ 0019^Jonge^^MWC^^de^Jhr.Dr. O The above message contains patient demographic and visit information Example of ADR_A19 message when patient not found The following is an example of a patient query response message (for Patient Number: 10204) if patient information is not found: MSH ^~\& AWS1 ZISSERVER OTObase OTObase ADR^A19 QRY P 2.7 MSA AE QRY Patient Not found. Otometrics - OTObase 25

26 3.9 OR (Observation Result nsolicited message) OTObase returns finished transcriptions (a PDF report containing the test data or xml data based on the configuration) to the EMR system using an Observation Result nsolicited (OR) message that is triggered by OTObase when the patient is Signed Off (either manually or automatically). The HL7 message will contain the following information: Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss Security 9 Message Type 1. Message Type 2. Trigger Event R OR^R01 OR R01 10 Message Control Identifier R OR Processing ID O P = Production T= Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number 14 Continuation Pointer 26 Otometrics - OTObase

27 15 Accept Acknowledgment Type 16 Application Acknowledgment Type 17 Country Code 18 Character Set 19 Principal Language of Message Common Order (ORC) segment 1 Order Control O NW 2 Placer Order Number O Filler Order Number O Placer Group Number 5 Order Status 6 Response Flag 7 Quantity/Timing 8 Parent 9 Date and Time of Transaction 10 Entered By 11 Verified By 12 Ordering Provider 13 Enterer s Location 14 Callback Phone Number 15 Order Effective Date and Time 16 Order Control Code Reason Otometrics - OTObase 27

28 17 Entering Organization 18 Entering Device 19 Action By Observation Request (OBR) segment 1 Set ID O 1 2 Placer Order Number R Filler Order Number R niversal Service Identifier 5 Priority 6 Requested Date and Time O 7 Observation Date and Time 8 Observation End Date and Time 9 Collection Volume 10 Collector Identifier 11 Specimen Action Code 12 Danger Code 13 Relevant Clinical Information 14 Specimen Received Date and Time 15 Specimen Source 16 Ordering Provider 17 Order Callback Phone Number 18 Placer Field 1 19 Placer Field 2 28 Otometrics - OTObase

29 20 Filler Field 1 21 Filler Field 2 22 Results Report/Status Change Date and Time 23 Charge to Practice 24 Diagnostic Service Section ID 25 Result Status 26 Parent Result 27 Quantity / Timing 28 Result Copies to 29 Parent 30 Transportation Mode 31 Reason for Study 32 Principal Result Interpreter 33 Assistant Result Interpreter 34 Technician 35 Transcriptionist 36 Scheduled Date and Time 37 Number of Sample Containers 38 Transport Logistics of Collected Samples 39 Collector s Comment 40 Transport Arrangement Responsibility 41 Transport Arranged 42 Escort Required 43 Planned Patient Transport Comment Otometrics - OTObase 29

30 3.9.4 Observation Result (OBX) segment 1 Set ID R 2 Value Type R AD Address DT Date ED Encapsulated Data RP Reference Pointer FT Formatted Text (Display) ST String Data. 3 Observation Identifier O TX Text Data (Display) 4 4 Observation Sub-ID R PDF Report Raw data 5 Observation Value 6 nits 7 References Range 8 Abnormal Flags 9 Probability 10 Nature of Abnormal Test 11 Observation Result Status (eg. Acrobat^text^pdf^Base64^JV BE Ri0xLjQK Jcfsj6IKNSAwIG9 iago8pc9mz W5ndGggNiAwIFIvRmlsdG) PDF file path XML string (OTOsuite.gnd file format) 12 Date of Last Observation Normal Values 13 ser-defined Access Checks 14 Date and Time of the Observation 15 Producer s ID 16 Responsible Observer 17 Observation Method 30 Otometrics - OTObase

31 Note The ORC and OBR segments of OR message have a Placer Order number filed. This value is supposed to be supplied by the EMR system. OTObase gets this value when it receives the ORM message (in the order processing workflow). So, when OTObase will send the OR message in response to ORM message, it will include the Placer order number in the message. However, the Placer order number field is not available in the ADT message, which means that when OTObase will send the OR message in response to the ADT message, then the value of this field will remain blank Example of OR message The following is an example of an OR message containing embedded PDF report data: The following is an example of an OR message containing the path to the PDF report file: MSH ^~\& OTObase OTObase EMR EMR OR^R01 OR P 2.7 PID PATID1234^5^M11^^AN JONES^WILLIAM^A^III M DELAWARE AVENE^^EVERETT^MA^02149 GL (919) (000) ~(000) S PATID ^2^M10^^ACSN ^NC PV1 1 I 2000^2012^01^SRO ^LEBAER^SIDNEY^J. SR - ADM A0 OBR OBX 1 RP 18 1 C:\E\Reports\E\ pdf 3.10 ACK (Acknowledgment message for OR) The EMR System should send an acknowledgment for all OR messages received from OTObase. The structure of the ACK message is as follows: Otometrics - OTObase 31

32 Message Header (MSH) segment 1 Field Separator R Pipe symbol - 2 Encoding Characters 1. Component 2. Repeat 3. Escape 4. Sub component R ^~\& ^ ~ \ & 3 Sending Application Name R OTObase (ser defined during configuration) 4 Sending Facility Name R OTObase (ser defined during configuration) 5 Receiving Application R EMR System (ser defined during configuration) 6 Receiving Facility R EMR System (ser defined during configuration) 7 Date and Time of Message R YYYYMMDDhhmmss 8 Security 9 Message Type R ACK Message Control Identifier R OR Processing ID O P = Production T = Training D= Debugging 12 HL7 Version R 2.4,2.5,2.6, Sequence Number 14 Continuation Pointer. 15 Accept Acknowledgment Type 16 Application Acknowledgment Type 17 Country Code 18 Character Set 19 Principal Language of Message 32 Otometrics - OTObase

33 Message Acknowledgment (MSA) segment 1 Acknowledgment Code R AA = Success AE = Error AR = Reject 2 Message Control ID R OR Text Message O Success, Or Failure 4 Expected Sequence Number 5 Delayed Acknowledgment Type 6 Error Condition O Example of OR Acknowledgment (ACK) message in case of success OTObase sends an ACK message to acknowledge receipt of an OR. If the received OR message is accepted by OTObase, then OTObase sends a Success Acknowledgment message to the EMR system. The following is an example of a Success Acknowledgment (ACK) message: MSH ^~\& EMR EMR OTObase OTObase ACK OR P 2.7 MSA AA OR Success Example of OR Acknowledgment (ACK) message in case of failure If the received OR message is not accepted by OTObase, then OTObase sends a Failure Acknowledgment message to the EMR system. The following is an example of a Failure Acknowledgment (ACK) message: MSH ^~\& EMR EMR OTObase OTObase ACK OR P 2.7 MSA AE OR Failure Otometrics - OTObase 33

34 4 Communication protocol 4 Communication protocol The OTObase EMR Connector for HL7 interface uses the TCP/IP protocol for communication and information exchange. TCP/IP Protocol implies that the data just starts coming in a stream and there is no set size. Some messages are quite concise with a couple of segments, other HL7 standard messages are extremely long with multiple observation segments that each contain an entire patient report. Therefore, in order to identify where one HL7 message starts and ends, the Minimal Lower Layer Protocol (MLLP) is used to wrap the HL7 message. The HL7 message is wrapped with a header and footer to ensure that you know where a message starts, where a message stops, and where the next message starts. These headers and footers are non-printable characters that would not typically be in the content of HL7 messages. Description The header is a vertical tab character. The footer is a field separator character, immediately followed by a carriage return. Character <VT>(Hex 0x0b) <FS> (Hex 0x1c) <CR> (Hex 0x0d) The message being transported via TCP/IP will look like this: <VT> HL7 message <FS> <CR> 34 Otometrics - OTObase

35 5 Opening an existing order 5 Opening an existing order It is possible to open OTObase and an existing order in OTObase from the EMR system. This can be done by invoking the OTObase executable with command line parameters. The following command can be used to invoke OTObase from the EMR system and open the measurement linked with a specific order. Syntax:- OTObase MODE=HL7 ORDERID=<Order_Id> The above command will: Open OTObase in HL7 mode. Automatically select the patient linked with Order ID 26. Automatically open the latest measurement linked with the order ID 26. MODE OTObase mode to run. The value would be HL7 as we are opening OTObase in HL7 mode to open the measurement linked with the specific order. ORDERID OTObase sends a unique identification number (see Observation Request (OBR) segment 28) to the EMR system in OR messages. This identification number is referred to as Order ID in OTObase. Otometrics - OTObase 35