Integration Guide for Data Originators of Immunizations. Version 1.2

Transcription

1 Integration Guide for Data riginators of Immunizations Version 1.2 December 28, 2010

2 evision History Date Version Description Author September 15, DAFT Created first draft using standard template Jane Terrien ctober 15, Initial elease D Callaghan December 18, Clarified EM to Immunization egistry for adding immunizations December 28, enamed document for clarity and consistency; minor edits D Callaghan D Callaghan Page 2

3 Table of Contents 1 ABUT THIS GUIDE Purpose Audience Scope elated Documentation VEVIEW Service Description Patient Identifiers etrieve Immunizations History Service Add Immunization/Vaccination Service SEVICE EQUIEMENTS Connectivity Message Versions HL7 Events Supported Segments Supported Acknowledgements Processing Instructions Technology Assumptions TANSACTIN EQUIEMENTS Query for a Patient s Vaccination ecord (VXQ^V01) esponse to Vaccination Query, eturns Multiple PID Matches (VXX^V02) esponse to Vaccination Query, eturns the Immunization ecord (VX^V03) Vaccination ecord Update (VXU^V04) No Data Found (QCK) Page 3

4 5 E HANDLING THE EQUIEMENTS...46 APPENDIX A: PTLET DISPLAY F IMMUNIZATIN DATA...47 APPENDIX B: VALIDATIN TABLES...47 APPENDIX C: IMMUNIZATIN QUEY MESSAGE (VXQ^V01)...49 APPENDIX D: MULTIPLE PID MATCHES (VXX^V02)...50 APPENDIX E: IMMUNIZATIN ESPNSE MESSAGE (VX^V03)...50 APPENDIX F: UPDATE IMMUNIZATIN MESSAGE (VXU^V04)...52 APPENDIX G: N DATA FUND MESSAGE (QCK^)...53 Page 4

5 1 ABUT THIS GUIDE 1.1 Purpose The purpose of this document is to describe the technical details of the service for the retrieval of immunizations from a data originator system and for updating a patient s immunization record maintained by a data originator. 1.2 Audience This document is intended for application developers and implementers of standards-based, interoperable healthcare information systems. Implementers will require access to the VXQ, VX, VXX, and VXU HL7 v specifications referenced in this document. 1.3 Scope The scope of the Immunization service is a request-reply transaction set between the client (i.e. portal or other consuming system) and the participating data originator. In addition, the Immunization service also enables an unsolicited update to a patient s immunization records Included Topics etrieval of a patient s immunization records Updating a patient s immunization record at the registry Excluded Topics Although the XML versions of the HL7 versions 2.3, 2.4 and 2.5 exist and are used by some registries, to meet CDC certification requirements, per the CDC guide identified above, only the standard version of HL7 transactions is supported within the Covisint Immunization Service. Page 5

6 1.4 elated Documentation Covisint Documents: PMS Vendor Integration Guide AppCloud TM Service Provider Immunization Transaction Specification HL7 Mappings an excel spreadsheet with each Immunization HL7 message that can be used by data originators for additional mapping analysis Connect perations - Messaging Industry Documentation: Implementation Guide for Immunization Data Transactions using Version of the Health Level Seven (HL7) Standard Protocol, Version 2.2 (CDC-IG) published by Centers for Disease Control and Prevention, National Center for Immunization and espiratory Diseases (CDC/NIP) Page 6

7 2 VEVIEW 2.1 Service Description Covisint s immunization service has been implemented in strict compliance with the guidelines, recommendations, and requirements of the CDC IG for immunizations. The immunization service provides immunization data real-time from a data originator at the patient s point of care either via the Covisint portal or within the patient s electronic medical record (EM). The data originator is typically a state Immunization egistry. A user can access this service from a community or physician office portal, or directly from the user s native EM system using web services. There are two basic scenarios that are handled by the service: 1. retrieving a patient s immunization history for review, and 2. submitting vaccination information to the registry in order to update the patient s data. 2.2 Patient Identifiers Patient identity is critical for successful immunization retrieval. There are two different models that can be used for patient identification based on whether the environment is a health exchange community with a Master Patient Index (MPI), or a provider office without benefit of an MPI. In the community integration model, the patient identity will be constructed from demographics retrieved from the community MPI. While demographics may be contributed to the MPI from multiple sources, the service will select the best known demographics (usually the most recent available) for the patient. The provider office integration model requires that the provider s PMS is integrated with Covisint using our standard PMS Integration solution. (efer to the PMS Vendor Integration Guide for more details.) The patient identity will be constructed from the demographics and patient ID provided to Covisint on the PMS integration feed. Both methods require the Immunization egistry to match the demographics sent on the request with a known patient in the registry. The method used by the registry to perform that that matching is beyond the scope of this document. Page 7

8 2.3 etrieve Immunizations History Service The retrieve service provides a user with the ability to securely request and view a patient s immunizations history in real-time. The service uses patient demographics or identifiers from a community MPI or provider s office patient list and standard HL7 transactions to request and receive immunization history and information about recommended vaccinations for the patient for an immunization data originator. efer to Appendix A for a summary view of patient s immunization history. Figure 1 - etrieve Immunizations Page 8

9 2.4 Add Immunization/Vaccination Service When adding an immunization the user will directly enter the patient s immunization data into the portal and the service will create an HL7 transaction to send an update to the immunization registry. Adding immunization data via a provider s EM is not addressed in this document. Contact your Covisint representative for information on establishing connectivity to transmit immunization records from your system directly to an immunization registry. Figure 2 - Add Immunizations Page 9

10 3 SEVICE EQUIEMENTS 3.1 Connectivity Historical Immunization etrieval Messages (eal-time, synchronous) HTTP(s) Update Immunization Data Messages FTP(s) Mailbox HTTP(s) Mailbox LLP over TCP/IP For more connectivity details please refer to the Connect perations Messaging document. 3.2 Message Versions HL7 V HL7 Events VXQ^V01- Query for a Patient s Vaccination ecord VXX^V02- esponse to Vaccination Query, eturns Multiple PID Matches VX^V03- esponse to Vaccination Query, eturns the Vaccination ecord VXU^V04- Vaccination ecord Update QCK^ - No Data Found 3.4 Supported Segments MSH Message Header MSA Message Acknowledgement PID - Patient Identification Segment NK1 - Next of Kin/Associated Parties QD Query Definition QF Query Filter XA - Pharmacy / Treatment Administration X Pharmacy/ Treatment oute 3.5 Supported Acknowledgements Ack_General 3.6 Processing Instructions The data exchanged between Covisint and the immunization registry occurs as the result of two activities: (1) A query from Covisint for a patient's vaccination record that is held by the immunization registry (VXQ); A response to a query containing multiple patient "matches" to the query, but not returning vaccination records (VXX); A response to a query from the Immunization Data originator containing the vaccination record (VX); and A response indicating that no data was found (QCK) (2) An unsolicited update from Covisint to the immunization registry with a vaccination record (VXU). Page 10

11 3.7 Technology Assumptions The use of standard tables for validating fields (efer to Appendix B) is required in order to display similar data. Page 11

12 4 TANSACTIN EQUIEMENTS 4.1 Query for a Patient s Vaccination ecord (VXQ^V01) When a health care provider needs to obtain a complete patient vaccination record from the immunization registry, the specific patient is selected or passed to the Immunization Service using a Query for Immunization ecord VXQ message. The following are the attributes and requirements for the immunization query: covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 1 Segment MSH Message Header N 2 MSH MSH MSH MSH MSH MSH MSH MSH MSH / MSH MSH MSH MSH Field Separator ST " " Encoding Characters ST "^~\&" Sending Application HD Sender ID per trading partner agreement Sending Facility HD eceiving Application HD eceiving ID per trading partner agreement eceiving Facility HD Date/Time f Message TS System Date Time. Format YYYYMMDDHHMMSS Security ST Message Type MSG "VXQ^V01" Message Control ID ST Unique Control Number Processing ID PT "P" Version ID VID "2.3.1" Sequence Number NM Page 12

13 covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table 15 MSH MSH MSH MSH MSH MSH MSH Segment QD Query Definition N QD QD QD QD QD QD QD QD QD QD QD QD QD.8.3 External r/o/c/b ep# Description Item Section Data Continuation Pointer ST Accept Acknowledgment Type ID "NE" Application Acknowledgment ID "AL" Type Country Code ID Y Character Set ID Principal Language f Message CE Alternate Character Set Handling Scheme ID Query Date/Time TS System Date Time. Format YYYYMMDDHHMMSS Query Format Code ID "" Query Priority ID "I" Query ID ST Unique Control Number Deferred esponse Type ID Deferred esponse Date/Time TS Quantity Limited equest CQ Quantity Maximum count of records to be returned Units "D" Y Who Subject Filter XCN ID number patient identifier Family name patient s last name Given name patient s first name Page 13

14 covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table 36 QD QD QD QD QD QD QD QD QD External r/o/c/b ep# Description Item Section Data Middle name patient s middle name Suffix patient s name suffix Prefix patient s name prefix Y What Subject Filter CE_0048 Identifier "VXI" Text "VACCINE INFMATIN" Coding System "HL70048" Y What Department Data Code CE "SIIS" Y What Data Code Value Qual V Query esults Level ID 45 QD Sement QF Query Filter N 47 QF.1 20 Y egistry ID ST Varies by trading partner 48 QF.2 26 When Data Start Date/Time TS 49 QF.3 26 When Data End Date/Time TS 50 QF.4 60 Y What User Qualifier ST QF QF QF QF Y ther QY Subject Filter ST This field can contains following values as repeats. Patient's SSN, Patient's DB, Patient's Birth State, Mother's current name, Mother's maiden name. Format: Patient's SSN~Patient's DB~Patient's Birth State~Mother's current name~mother's maiden name. Y Which Date/Time Qualifier ID Y Which Date/Time Status Qualifier ID Y Date/Time Selection Qualifier ID Page 14

15 covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table 55 QF.9 60 External r/o/c/b ep# Description Item Section Data When Quantity/Timing Qualifier TQ NTES:The Immunization Service may pass but does not use the following the optional segments (PD1, PV1, PV2, IN1, IN2, IN3, C, BX, and NTE). Page 15

16 4.2 esponse to Vaccination Query, eturns Multiple PID Matches (VXX^V02) If the query results in multiple "matches; i.e., more than one patient record matches the identifiers in the query so that there is no unique identification, the response to the query is a VXX Vaccination esponse. The Covisint portal will display a message to the user indicating the patient could not be uniquely identified. The immunization service will pass the message to a web service client as received, and it is the client s responsibility to determine the appropriate action to take. The following are the attributes and requirements for the immunization query response with multiple patient matches: covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b 1 Segment MSH Message Header ep# Description Item Section Data 2 MSH.1 1 Field Separator ST " " 3 MSH.2 4 Encoding Characters ST "^~\&" 4 MSH Sending Application HD Sender ID per trading partner agreement 5 MSH Sending Facility HD 6 MSH eceiving Application HD eceiving ID per trading partner agreement 7 MSH eceiving Facility HD 8 MSH.7 26 Date/Time f Message TS System Date Time. Format YYYYMMDDHHMMSS 9 MSH.8 40 Security ST 10 MSH / 0003 Message Type MSG "VXX^V02" 11 MSH Message Control ID ST Unique Control Number 12 MSH.11 3 Processing ID PT "P" 13 MSH Version ID VID "2.3.1" Page 16

17 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 14 MSH Sequence Number NM 15 MSH Continuation Pointer ST 16 MSH Accept Acknowledgment Type ID 17 MSH Application Acknowledgment Type ID 18 MSH.17 2 Country Code ID 19 MSH Y Character Set ID 20 MSH Principal Language f Message CE 21 MSH Alternate Character Set Handling Scheme ID 22 Segment MSA - Message Acknowledgment 23 MSA Acknowledgement Code ID 24 MSA.2 20 Message Control ID ST 25 MSA.3 80 Text Message ST 26 MSA.4 15 Expected Sequence Number NM 27 MSA B Delayed Acknowledgment Type ID 28 MSA Error Condition CE 29 Segment QD Query Definition N riginal Values from the VXQ Immunization Query 30 QD.1 26 Query Date/Time TS System Date Time. Format YYYYMMDDHHMMSS 31 QD Query Format Code ID "" 32 QD Query Priority ID "I" Page 17

18 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 33 QD.4 10 Query ID ST Unique Control Number 34 QD Deferred esponse Type ID 35 QD.6 26 Deferred esponse Date/Time TS 36 QD Quantity Limited equest CQ 37 QD.7.1 Quantity Maximum count of records to be returned 38 QD.7.2 Units "D" 39 QD.8 60 Y Who Subject Filter XCN 40 QD.8.1 ID number patient identifier 41 QD.8.2 Family name patient s last name 42 QD.8.3 Given name patient s first name 43 QD.8.4 Middle name patient s middle name 44 QD.8.5 Suffix patient s name suffix 45 QD.8.6 Prefix patient s name prefix 46 QD Y What Subject Filter CE_ QD.9.1 Identifier "VXI" 48 QD.9.2 Text "VACCINE INFMATIN" 49 QD.9.3 Coding System "HL70048" 50 QD Y What Department Data Code CE "SIIS" 51 QD Y What Data Code Value Qual V 52 QD Query esults Level ID 53 Sement QF Query Filter N riginal Values from the VXQ Immunization Query Page 18

19 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 54 QF.1 20 Y egistry ID ST Varies by trading partner 55 QF.2 26 When Data Start Date/Time TS 56 QF.3 26 When Data End Date/Time TS 57 QF.4 60 Y What User Qualifier ST 58 QF.5 60 Y ther QY Subject Filter ST This field can contains following values as repeats. Patient's SSN, Patient's DB, Patient's Birth State, Mother's current name, Mother's maiden name. Format: Patient's SSN~Patient's DB~Patient's Birth State~Mother's current name~mother's maiden name. 59 QF Y Which Date/Time Qualifier ID 60 QF Y Which Date/Time Status Qualifier ID 61 QF Y Date/Time Selection Qualifier ID 62 QF.9 60 When Quantity/Timing Qualifier TQ 63 QF.9 60 When Quantity/Timing Qualifier TQ 64 Segment PID Patient Identification 65 PID.1 4 Set ID - PID SI Numbered from 1 to nnn for each patient PID segment returned if more than 1 is included 66 PID.2 20 B Patient ID CX 67 PID.3 20 Y Patient Identifier List CX epeats (delimited by ~ ) and contains the State s egistry ID for the Patient (value^^^^s^), local record IDs (code L), MNs (code M), SSN (code SS), etc.) 68 PID.4 20 B Y Alternate Patient ID - PID CX 69 PID.5 48 Y Patient Name XPN Patient s Name (last, first, middle, suffix, type, etc., delimited by ^ ). Types include L-Legal, M-Maiden, etc. Page 19

20 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 70 PID.6 48 Y Mother s Maiden Name XPN Mother s Name (last, first, middle, suffix, type, etc., delimited by ^ ). Types include L-Legal, M-Maiden, etc. 71 PID.7 26 Date/Time f Birth TS Date of Birth YYYYMMDD remainder not used 72 PID Sex IS Sex (M/F) 73 PID.9 48 Y Patient Alias XPN 74 PID Y ace CE_ PID Y Patient Address XAD 76 PID B County Code IS 77 PID Y Phone Number - Home XTN 78 PID Y Phone Number - Business XTN 79 PID Primary Language CE_ PID Marital Status CE_ PID eligion CE_ PID Patient Account Number CX 83 PID B SSN Number - Patient ST 84 PID Driver's License Number - Patient DLN 85 PID Y Mother's Identifier CX 86 PID Y Ethnic Group CE_ PID Birth Place ST Location/Name of Birthing Facility 88 PID Multiple Birth Indicator ID Y/N 89 PID.25 2 Birth rder NM If PID.25= Y, numbered from 1 to nn for 1 st, 2 nd, 3 rd born, etc. 90 PID Y Citizenship CE_ PID Veterans Military Status CE_0172 Page 20

21 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 92 PID Nationality CE_ PID Patient Death Date and Time TS If PID.30= Y. YYYYMMDDHHMMSS remainder not used 94 PID Patient Death Indicator ID Y/N 95 Segment NK1 Next of Kin / Associated Parties 96 NK1.1 4 Set ID - NK SI epeats, Numbered from 1 to nnn for each NK1 segment returned if more than 1 is included 97 NK Y Name XPN epeats (delimited by ~ ) 98 NK1.2.1 Last Name Mother s Maiden Last Name 99 NK1.2.2 First Name Mother s First Name 100 NK1.2.3 Middle Name Mother s Middle Name or MI 101 NK1.2.4 Suffix Suffix 102 NK1.2.5 Prefix Prefix 103 NK1.2.6 Degree Degree 104 NK Name Type Code M for Maiden Name 105 NK elationship CE_ NK1.3.1 Identifier ST MTH or FTH for mother or father 107 NK1.3.2 Text ST MTHE or FATHE 108 NK Name of Code ST 109 NK Y Address XAD 110 NK Y Phone Number XTN Page 21

22 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 111 NK Y Business Phone Number XTN 112 NK Contact ole CE_ NK1.8 8 Start Date DT YYYYMMDD remainder not used 114 NK1.9 8 End Date DT YYYYMMDD remainder not used 115 NK Next of Kin / Associated Parties Job Title ST 116 NK /328 Next of Kin / Associated Parties Job JCC Code/Class 117 NK Next of Kin / Associated Parties Employee CX Number 118 NK Y rganization Name - NK XN epeats (delimited by ~ ) 119 NK Marital Status CE_ NK Sex IS 121 NK Date/Time f Birth TS YYYYMMDDHHMMSS remainder not used 122 NK Y Living Dependency IS 123 NK Y Ambulatory Status IS 124 NK Y Citizenship CE_ NK Primary Language CE_ NK Living Arrangement IS 127 NK Publicity Code CE_ NK Protection Indicator ID 129 NK Student Indicator IS 130 NK eligion CE_ NK Y Mother s Maiden Name XPN 132 NK Nationality CE_0212 Page 22

23 covisint Standard HL7 v2.3.1 VXX esponse to Vaccination Query eturning Multiple PID Matches Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data 133 NK Y Ethnic Group CE_ NK Y Contact eason CE_ NK Y Contact Person s Name XPN 136 NK Y Contact Person s Telephone Number XTN 137 NK Y Contact Person s Address XAD 138 NK Y Next of Kin/Associated Party s Identifiers CX 139 NK Job Status IS 140 NK Y ace CE_ NK Handicap IS 142 NK Contact Person Social Security Number ST Note: The Immunization Service may pass but does not use the following the optional segments (PD1, PV1, PV2, IN1, IN2, IN3, C, BX, and NTE). Page 23

24 4.3 esponse to Vaccination Query, eturns the Immunization ecord (VX^V03) When there is only one "match" to the query, the response to the query a VX Vaccination esponse. The following are the attributes and requirements for the immunization query response with a single patient s immunization history: covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data Segment MSH 1 Message Header 2 MSH.1 1 Field Separator ST " " 3 MSH.2 4 Encoding Characters ST "^~\&" 4 MSH Sending Application HD Sender ID per trading partner agreement 5 MSH Sending Facility HD 6 MSH eceiving Application HD eceiving ID per trading partner agreement 7 MSH eceiving Facility HD 8 MSH.7 26 Date/Time f Message TS System Date Time. Format YYYYMMDDHHMMSS 9 MSH.8 40 Security ST 10 MSH / 0003 Message Type MSG "VX^V03" 11 MSH Message Control ID ST Unique Control Number 12 MSH.11 3 Processing ID PT "P" 13 MSH Version ID VID "2.3.1" 14 MSH Sequence Number NM 15 MSH Continuation Pointer ST 16 MSH Accept Acknowledgment Type ID 17 MSH Application Acknowledgment Type ID 18 MSH.17 2 Country Code ID 19 MSH Y Character Set ID 20 MSH Principal Language f Message CE 21 MSH Alternate Character Set Handling Scheme ID Page 24

25 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields ef Seq Length Table 22 Segment MSA - Message Acknowledgment External r/o/c/b ep# Description Item Section Data 23 MSA Acknowledgement Code ID 24 MSA.2 20 Message Control ID ST 25 MSA.3 80 Text Message ST 26 MSA.4 15 Expected Sequence Number NM 27 MSA B Delayed Acknowledgment Type ID 28 MSA Error Condition CE 29 Segment QD Query Definition N riginal Values from the VXQ Immunization Query 30 QD.1 26 Query Date/Time TS System Date Time. Format YYYYMMDDHHMMSS 31 QD Query Format Code ID "" 32 QD Query Priority ID "I" QD.4 10 Query ID ST Unique Control Number QD Deferred esponse Type ID 35 QD.6 26 Deferred esponse Date/Time TS 36 QD Quantity Limited equest CQ 37 QD.7.1 Quantity Maximum count of records to be returned 38 QD.7.2 Units "D" 39 QD.8 60 Y Who Subject Filter XCN 40 QD.8.1 ID number patient identifier 41 QD.8.2 Family name patient s last name 42 QD.8.3 Given name patient s first name 43 QD.8.4 Middle name patient s middle name 44 QD.8.5 Suffix patient s name suffix 45 QD.8.6 Prefix patient s name prefix Page 25

26 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 46 QD Y What Subject Filter CE_ QD.9.1 Identifier "VXI" 48 QD.9.2 Text "VACCINE INFMATIN" 49 QD.9.3 Coding System "HL70048" 50 QD Y What Department Data Code CE "SIIS" 51 QD Y What Data Code Value Qual V 52 QD Query esults Level ID 53 Sement QF Query Filter N riginal Values from the VXQ Immunization Query 54 QF.1 20 Y egistry ID ST Varies by trading partner 55 QF.2 26 When Data Start Date/Time TS 56 QF.3 26 When Data End Date/Time TS 57 QF.4 60 Y What User Qualifier ST 58 QF.5 60 Y ther QY Subject Filter ST This field can contains following values as repeats. Patient's SSN, Patient's DB, Patient's Birth State, Mother's current name, Mother's maiden name. Format: Patient's SSN~Patient's DB~Patient's Birth State~Mother's current name~mother's maiden name. 59 QF Y Which Date/Time Qualifier ID 60 QF Y Which Date/Time Status Qualifier ID 61 QF Y Date/Time Selection Qualifier ID 62 QF.9 60 When Quantity/Timing Qualifier TQ 63 QF.9 60 When Quantity/Timing Qualifier TQ 64 Segment PID Patient Identification 65 PID.1 4 Set ID - PID SI "1" 66 PID.2 20 B Patient ID CX Page 26

27 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields ef Seq Length Table PID.3 External r/o/c/b ep# Description Item Section Data Patient Identifier List CX epeats (delimited by ~ ) and contains the State s egistry ID for the Patient (value^^^^s^), local record IDs (code L), MNs (code M), SSN (code SS), etc.) 20 Y PID.4 20 B Y Alternate Patient ID - PID CX PID Y 70 PID.6 48 Y Patient Name XPN Patient s Name (last, first, middle, suffix, type, etc., delimited by ^ ). Types include L-Legal, M-Maiden, etc. Mother s Maiden Name XPN Mother s Name (last, first, middle, suffix, type, etc., delimited by ^ ). Types include L-Legal, M-Maiden, etc. 71 PID.7 26 Date/Time f Birth TS Date of Birth YYYYMMDD remainder not used 72 PID Sex IS Sex (M/F) 73 PID.9 48 Y Patient Alias XPN 74 PID Y ace CE_ PID Y Patient Address XAD 76 PID B County Code IS 77 PID Y Phone Number - Home XTN 78 PID Y Phone Number - Business XTN 79 PID Primary Language CE_ PID Marital Status CE_ PID eligion CE_ PID Patient Account Number CX 83 PID B SSN Number - Patient ST 84 PID Driver's License Number - Patient DLN 85 PID Y Mother's Identifier CX 86 PID Y Ethnic Group CE_ PID Birth Place ST Location/Name of Birthing Facility 88 PID Multiple Birth Indicator ID Y/N PID.25 Birth rder NM If PID.25= Y, numbered from 1 to nn for 1 st, 2 nd, 3 rd 2 born, etc PID Y Citizenship CE_ PID Veterans Military Status CE_ PID Nationality CE_0212 Page 27

28 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data PID.29 Patient Death Date and Time TS If PID.30= Y. YYYYMMDDHHMMSS remainder not 26 used PID Patient Death Indicator ID Y/N Segment PD1 Patient Additional Demographic NT USED Segment NK1 Next of Kin / Associated Parties NT USED 156 Segment PV1 Patient Visit NT USED Segment PV2 Patient Visit-Additional Information NT USED Segment IN1 Insurance NT USED Page 28

29 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External r/o/c/b ep# Description Item Section Data ef Seq Length Table Segment IN2 Insurance Additional Information NT USED Segment IN3 Insurance Additional Information,Certification NT USED 396 Segment C Common rder NT USED Segment XA Pharmacy / Treatment Administration The XA segment carries pharmacy administration data. It is a repeating segment in the VX and VXU messages and can record unlimited numbers of vaccinations. Data elements in Bold are used by the Immunization Service XA.1 4 Give Sub-ID Counter NM 0 XA.2 4 Administration Sub-ID Counter NM Numbered from 1 to nnn for each vaccine 423 administered. 424 XA.3 26 Date/Time Start of Administration TS YYYYMMDD remainder not used 425 XA.4 26 Date/Time End of Administration TS YYYYMMDD Page 29

30 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 426 XA Administered Code CE_0292 Delimited by ^ & HL7 Table In the event that the data originator can report recommendations but has no history of administered vaccines, a dummy XA segment must be sent in the VX. The dummy XA should contain a coded vaccine of 998 and a vaccine description of No vaccine administered. XA.5.1 Identifier ST If XA.5.3 contains "CVX", then this code is used as a lookup into table HL70292 to get the vaccine 427 description 428 XA.5.2 Text ST If XA.5.3 does not contain "CVX", then this text is used as the vaccine description for display. XA.5.3 Name of Code Sys. ST CVX is the only code system supported by the immunization service. If other code systems are specified then the text description in XA.5.2 will be used instead XA.5.4 Alt. Ident. ST 431 XA.5.5 Alt. Text ST 432 XA.5.6 Name of Alt. Code Sys. ST 433 XA.6 20 Administered Amount NM Amount of Vaccine administered 434 XA.7 60 C Administered Units CE Administered Units 435 XA.7.1 Identifier ST Administered Units, e.g. ML 436 XA.8 60 Administered Dosage Form CE XA Y Administration Notes CE If XA-9.3 = NIP001, then the code in XA-9.1 will be used as a lookup in the NIP001 table. therwise, Display the text from XA XA Y Administering Provider XCN 439 XA.10.1 ID Number ST Provider s ID 440 XA.10.2 Last Name ST Provider s Last Name Page 30

31 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External r/o/c/b ep# Description Item Section Data ef Seq Length Table 441 XA.10.4 First Name ST Provider s First Name 442 XA.10.5 Middle Name/MI ST Provider s Middle Name/MI 443 XA.10.6 Suffix ST Provider s Suffix 444 XA.10.7 Prefix ST Provider s Prefix (e.g. D ) 445 AX.10.8 Degree ST Provider s Degree (e.g. D ) 446 XA C Administered-at Location LA2 447 XA C Administered Per (Time Unit) ST 448 XA Administered Strength NM 449 XA Administered Strength Units CE 450 XA Y Substance Lot Number ST Lot No of the vaccine administered 451 XA Y Substance Expiration Date TS YYYYMM or YYYYMMDD 452 XA Y Substance Manufacturer Name CE_ XA.17.1 Identifier ST Code (e.g.. AB ) 454 XA.17.2 Text ST Text (Mfg Name) (i.e. Abbott Labs ) 455 XA.17.3 Name of Code ST MVX 456 XA Y Substance efusal eason CE If XA-18.3 = NIP002, then the code in XA-18.1 will be used as a lookup in the NIP002 table. therwise Display the text from XA XA Y Indication CE 458 XA Completion Status ID 459 XA Action Code-XA ID 460 XA System Entry Date/Time TS YYYYMMDDHHMMSS timestamp Segment X Pharmacy / Treatment oute NT USED 461 Page 31

32 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields ef Seq Length Table Segment BX bservation / esult External r/o/c/b ep# Description Item Section Data BX.1 4 Set ID - BX SI 475 BX Value Type ID 476 BX.3 80 bservation Identifier CE If , then BX-5 should = next recommended vaccine. If & , then BX-5 should = next dose number If & , then BX-5 should = due date If & , then BX-5 should = earliest date 477 BX.4 20 bservation Sub-ID ST Any other value is ignored. Page 32

33 covisint Standard HL7 v2.3.1 VX Vaccination ecord esponse Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 478 BX C Y bservation Value varies May be next recommended vaccine, next dose number, due date, or earliest date, according to value in BX-3. All other values are ignored. For next recommended vaccine: If BX-5.3 = CVX then value in BX-5.1 is used as a lookup in HL7 Table 0292 to retreive the display name. therwise text from XA-5.2 is used. 479 BX.6 60 X Units CE 480 BX.7 60 X eferences ange ST 481 BX X Y/5 Abnormal Flags ID 482 BX.9 5 X Y/5 Probability NM 483 BX X Nature of Abnormal Test ID 484 BX bservation esult Status ID 485 BX X Date Last bs Normal Values TS 486 BX X User Defined Access Checks ST 487 BX Date/Time of the bservation TS 488 BX Producer's ID CE 489 BX X Y esponsible bserver XCN 490 BX X Y bservation Method CE Segment NTE Notes & Comments NT IMPLEMENTED 491 Note: The Immunization Service may pass but does not use the following the optional segments (PD1, PV1, PV2, IN1, IN2, IN3, C, and NTE). Page 33

34 4.4 Vaccination ecord Update (VXU^V04) When a health care provider participating in the Exchange needs to update the patient's vaccination record in the Immunization egistry, the specific patient is selected or passed to the Immunization Service along with triggering the V04 event from the Exchange to the Immunization egistry to update the patient s immunization record. The following are the attributes and requirements for the unsolicited immunization update: covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data Segment MSH 1 Message Header 2 MSH.1 1 Field Separator ST " " 3 MSH.2 4 Encoding Characters ST "^~\&" 4 MSH Sending Application HD Sender ID per trading partner agreement 5 MSH Sending Facility HD 6 MSH eceiving Application HD eceiving ID per trading partner agreement 7 MSH eceiving Facility HD 8 MSH.7 26 Date/Time f Message TS System Date Time. Format YYYYMMDDHHMMSS 9 MSH.8 40 Security ST 10 MSH / 0003 Message Type MSG "VXU^V04" 11 MSH Message Control ID ST Unique Control Number 12 MSH.11 3 Processing ID PT "P" 13 MSH Version ID VID "2.3.1" 14 MSH Sequence Number NM 15 MSH Continuation Pointer ST 16 MSH Accept Acknowledgment Type ID 17 MSH Application Acknowledgment Type ID Page 34

35 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 18 MSH.17 2 Country Code ID 19 MSH Y Character Set ID 20 MSH Principal Language f Message CE 21 MSH Alternate Character Set Handling Scheme ID 22 Segment PID Patient Identification 23 PID.1 4 Set ID - PID SI "1" 24 PID.2 20 B Patient ID CX PID.3 Patient Identifier List CX Contains the Data originator's ID for the Patient from 20 Y the MPI, (value^^^^s^) or a local record IDs (code 25 L) 26 PID.4 20 B Y Alternate Patient ID - PID CX 27 PID.5 48 Y Patient Name XPN Patient s Name PID-5.1 Last name PID-5.2 First name PID-5.3 Middle name PID-5.4 Suffix PID-5.5 Prefix PID-5.7 L, indicating legal name 28 PID.6 48 Y Mother s Maiden Name XPN Mother s Maiden Name PID-6.1 Last Name PID-6.2 First Name PID.6.7 M, indicating maiden name 29 PID.7 26 Date/Time f Birth TS Date of Birth YYYYMMDD remainder not used 30 PID Sex IS Sex (M/F) 31 PID.9 48 Y Patient Alias XPN PID-9.1 Last name Page 35

36 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data PID-9.2 First name PID-9.3 Middle name PID-9.4 Suffix PID-9.5 Prefix 32 PID Y ace CE_ PID Y Patient Address XAD PID-11.1 Address Line 1 PID-11.2 Address Line 2 PID-11.3 City PID-11.4 State PID-11.5 Zip Code 34 PID B County Code IS 35 PID Y Phone Number - Home XTN This field may repeat. Full Phone number Phone number formatted exactly as: (999) X99999 Area code and extension are optional PID-12.1 PID-12.6 Area code PID-12.7 Phone Number PID-12.8 Extension 36 PID Y Phone Number - Business XTN 37 PID Primary Language CE_ PID Marital Status CE_ PID eligion CE_ PID Patient Account Number CX 41 PID B SSN Number - Patient ST 42 PID Driver's License Number - Patient DLN 43 PID Y Mother's Identifier CX 44 PID Y Ethnic Group CE_ PID Birth Place ST Page 36

37 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 46 PID Multiple Birth Indicator ID 47 PID.25 2 Birth rder NM 48 PID Y Citizenship CE_ PID Veterans Military Status CE_ PID Nationality CE_ PID Patient Death Date and Time TS 52 PID Patient Death Indicator ID Segment PD1 Patient Additional Demographic Segment NK1 Next of Kin / Associated Parties NT USED 97 NK NK Y Set ID - NK SI epeats, Numbered from 1 to nnn for each NK1 segment returned if more than 1 is included Name XPN First occurrence is mother's legal name; second occurrence is mother's maiden name. 99 NK1.2.1 Last Name Mother s Last Name 100 NK1.2.2 First Name Mother s First Name 105 NK Name Type Code "L" or Legal name, M for Maiden Name 106 NK elationship CE_ NK1.3.1 Identifier ST MTH 108 NK1.3.2 Text ST MTHE 109 NK Name of Code ST HL NK Y Address XAD Page 37

38 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 111 NK Y Phone Number XTN 112 NK Y Business Phone Number XTN 113 NK Contact ole CE_ NK1.8 8 Start Date DT 115 NK1.9 8 End Date DT 116 NK Next of Kin / Associated Parties Job Title ST NK1.11 Next of Kin / Associated Parties Job JCC / Code/Class 118 NK1.12 Next of Kin / Associated Parties Employee CX 20 Number 119 NK Y rganization Name - NK XN 120 NK Marital Status CE_ NK Sex IS 122 NK Date/Time f Birth TS 123 NK Y Living Dependency IS 124 NK Y Ambulatory Status IS 125 NK Y Citizenship CE_ NK Primary Language CE_ NK Living Arrangement IS 128 NK Publicity Code CE_ NK Protection Indicator ID 130 NK Student Indicator IS 131 NK eligion CE_ NK Y Mother s Maiden Name XPN 133 NK Nationality CE_ NK Y Ethnic Group CE_ NK Y Contact eason CE_ NK Y Contact Person s Name XPN 137 NK Y Contact Person s Telephone Number XTN Page 38

39 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 138 NK Y Contact Person s Address XAD 139 NK Y Next of Kin/Associated Party s Identifiers CX 140 NK Job Status IS 141 NK Y ace CE_ NK Handicap IS 143 NK Contact Person Social Security Number ST Segment PV1 Patient Visit Segment PV2 Patient Visit-Additional Information NT USED NT USED 272 Segment IN1 Insurance 322 Segment IN2 Insurance Additional Information NT USED NT USED Segment IN3 Insurance Additional Information,Certification NT USED 395 Page 39

40 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data Segment C Common rder Segment XA Pharmacy / Treatment Administration NT USED The XA segment carries pharmacy administration data. It is a repeating segment in the VX and VXU messages and can record unlimited numbers of vaccinations. Data elements in Bold are used by the Immunization Service 447 XA.1 4 Give Sub-ID Counter NM XA.2 4 Administration Sub-ID Counter NM 999, indicating dose information is not provided 0 if the vaccine was offered but refused 449 XA.3 26 Date/Time Start of Administration TS YYYYMMDD remainder not used 450 XA.4 26 Date/Time End of Administration TS Same as XA XA Administered Code CE_ XA.5.1 Identifier ST CVX code for the selected vaccine 453 XA.5.2 Text ST Text Description for the selected vaccine 454 XA.5.3 Name of Code Sys. ST CVX, for the code set used 458 XA.6 20 Administered Amount NM 999, indicating Administered amount is not provided 459 XA.7 60 C Administered Units CE 460 XA.7.1 Identifier ST 461 XA.8 60 Administered Dosage Form CE 462 XA Y Administration Notes CE 00 if new, 01 if historical 463 XA Y Administering Provider XCN 465 XA.10.2 Last Name ST Provider s Last Name XA.10.3 First Name Provider s First Name 466 XA.10.4 Middle Name ST Provider s Middle Name Page 40

41 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 468 XA.10.6 Prefix ST Provider s Prefix 471 XA C Administered-at Location LA2 XA.11.4 Facility name Facility name 472 XA C Administered Per (Time Unit) ST 473 XA Administered Strength NM 474 XA Administered Strength Units CE 475 XA Y Substance Lot Number ST Lot No of the vaccine administered 476 XA Y Substance Expiration Date TS YYYYMM or YYYYMMDD 477 XA Y Substance Manufacturer Name CE_ XA.17.1 Identifier ST Code, from the MVX code set 479 XA.17.2 Text ST Text description for the code 480 XA.17.3 Name of Code ST MVX, to identify the code table used. XA Y Substance efusal eason CE efusal reason; this field records the reason the patient refused the medical substance. Any entry in the field indicates that the patient did not take the substance. The vaccine that was offered should be recorded in XA-5, with the number 0 recorded for the 481 dose number in XA XA Y Indication CE 483 XA Completion Status ID 484 XA Action Code-XA ID 485 XA System Entry Date/Time TS YYYYMMDDHHMMSS timestamp 486 Segment X Pharmacy / Treatment oute The X Pharmacy/Treatment oute Segment contains the alternative combination of route, site, administration device, and administration method that are prescribed. For immunization registries, the actual route and site used should be recorded. Data elements in Bold are used by the Immunization Service. 487 X oute CE_0162 Page 41

42 covisint Standard HL7 v2.3.1 VXU Unsolicited Vaccination ecord Update Segments/Fields External ef Seq Length Table r/o/c/b ep# Description Item Section Data 488 X.1.1 Identifier ST Code, from HL7 table X.1.2 Text ST Text description for the code 490 X Name of Coding ST HL70162, to identify the code table used. 491 X Site CE_ X.2.1 Identifier ST Code, from HL7 table X.2.2 Text ST Text description for the code 494 X Name of Coding ST HL70163, to identify the code table used. 495 X Administration Device CE_ X Administration Method CE_ X.5 60 outing Instruction CE 498 Segment BX NT USED bservation / esult 516 Segment NTE Notes & Comments NT USED Note: Multiple immunizations or vaccines for an individual patient may be transmitted through the use of multiple XA and associated X segments within a VXU. Page 42

43 4.5 No Data Found (QCK) The QCK message is a valid response to a Immunization Query indicating no match to the patient was found. covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table External r/o/c/b ep# Description Item Section Data Segment MSH 1 Message Header N 2 MSH.1 1 Field Separator ST " " 3 MSH.2 4 Encoding Characters ST "^~\&" 4 MSH Sending Application HD Sender ID per trading partner agreement 5 MSH Sending Facility HD 6 MSH eceiving Application HD eceiving ID per trading partner agreement 7 MSH eceiving Facility HD 8 MSH.7 26 Date/Time f Message TS System Date Time. Format YYYYMMDDHHMMSS 9 MSH.8 40 Security ST 10 MSH / Message Type MSG "QCK^" MSH Message Control ID ST Unique control number 12 MSH.11 3 Processing ID PT "P" 13 MSH Version ID VID "2.3.1" 14 MSH Sequence Number NM 15 MSH Continuation Pointer ST 16 MSH Accept Acknowledgment Type ID 17 MSH Application Acknowledgment Type ID 18 MSH.17 2 Country Code ID 19 MSH Y Character Set ID 20 MSH Principal Language f Message CE MSH Alternate Character Set Handling ID 21 Scheme Page 43

44 covisint Standard HL7 v2.3.1 VXQ Query for Vaccination ecord Segments/Fields ef Seq Length Table Segment MSA - Message Acknowledgment External r/o/c/b ep# Description Item Section Data MSA Acknowledgement Code ID 24 MSA.2 20 Message Control ID ST 25 MSA.3 80 Text Message ST 26 MSA.4 15 Expected Sequence Number NM 27 MSA B Delayed Acknowledgment Type ID 28 MSA Error Condition CE Segment E Error E Y Error Code and location CM Segment QAK - Query Acknowledgement QAK.1 32 Query Tag ST 24 QAK Query esponse Status ID Page 44

45 5 E HANDLING This error handling section describes the types of errors and outcomes that are part of the Covisint architecture from a technology view point. This discussion outlines the area and most common type of error and is not necessarily all inclusive of every error that may be encountered during processing. This section is not intended to address error reporting, resolution or any other service from an operations perspective since each client and/or data originator establishes these processes or SLAs as part of their contractual agreement with Covisint. Errors between Covisint and a data originator using the interface described in this Implementation Guide may fall into these areas: Data originator fails to respond: If a Data originator fails to respond to the synchronous request for immunizations data within the configured time limit, then an exception will be returned by Covisint to the client indicating the Data originator failed to respond. It is the responsibility of the client to interpret the exception and provide the end user with an appropriate informational message. The amount of time that the request will wait for a response is determined by Covisint, to ensure a consistent user experience. Transport level exception returned by Data originator If a Data originator returns a transport level error, (e.g. HTTPs 500) then an exception will be returned by Covisint to the client. It is the responsibility of the client to interpret the exception and provide the end user with an appropriate informational message. Application level exception returned by Data originator If a Data originator returns an application level error (e.g. ACK transaction containing error inforamation), then the error will be returned by Covisint to the client. It is the responsibility of the client to interpret the application error and provide the end user with an appropriate informational message. Non-compliant response returned by Data originator If the Data originator returns a response that does not comply with the expected standard interface defined in this Implementation Guide, then the response will be rejected. It will not be returned to the client. The client will instead receive a general exception error from Covisint. Covisint may optionally return an ACK asynchronously to the Data originator, according to the agreement between Covisint and the Data originator. In all cases, the Service Level Agreement (SLA) between Covisint and the Data originator will determine any operational processes for responding to errors. esponses may range from no action taken, to immediate escalation for resolution. Contact your Covisint representative for information on the available options. Page 45

46 6 THE EQUIEMENTS Accuracy & Completeness When processing transaction from a Data originator, Covisint does not inspect and/or translate any incoming data. Content is displayed as provided and should comply with specifications contained in this document. If there are issues with data displayed, display formats and/or associated codes, it is the responsibility of the Data originator to address these content issues. If a Data originator should need custom mapping, this functionality is available but is not considered part of the standard implementation activities Audit Covisint only audits that transactions happened within the Covisint environment; it does not log the content of those transactions. If a data source has other business requirements to log and audit the content of transactional flow, the data source must provide that capability. Data etention Data that is obtained for the Portal or obtained as part of the Hosted Web Service is not stored within the Covisint environment. Page 46

47 Appendix A: Portlet display of Immunization Data Sample portlet, illustrating how immunization data received from a data source may be displayed. The exact appearance of the portlet and its content may vary by specific installation. Appendix B: Validation Tables NIP-defined Table NIP001 - Immunization information source (use in XA-9) Value Description 00 New immunization record 01 Historical information - source unspecified 02 Historical information - from other provider 03 Historical information - from parent s written record 04 Historical information - from parent s recall 05 Historical information - from other registry 06 Historical information - from birth certificate 07 Historical information - from school record 08 Historical information - from public agency NIP-defined Table NIP002 - Substance refusal reason (use in XA-18) Value Description 00 Parental decision 01 eligious exemption 02 ther (use text component of the field with description) 03 Patient decision HL7-defined Table oute of administration [only selected values listed] (use in X-1) Value Description ID Intradermal IM Intramuscular IN Intranasal IV Intravenous P ral TH ther/miscellaneous SC Subcutaneous Page 47