The format for the exchange of patient and order information with via Health Level 7 (HL7) messages. Patient Information transmitted via HL7 Admit Discharge Transaction (ADT) will populate the patient’s demographics and identifiers in the application. Orders transmitted via Order Request Management (ORM) will populate the application with pending orders while at the same time providing a notification to the monitor technician.
Specification
SafeNSound supports the HL7 2.3.1 standard messaging format (www.hl7.org). Data are transmitted via secure VPN using TCP/IP and MLLP protocols for message integrity.
Communication
Data transmission uses TCP/IP protocols.
Messages sent conform to the HL7 format.
After the receiving application verifies the validity of a message, an Acknowledgement (ACK) will be returned to the message source.
Message Definitions
SafeNSound accepts ADT and ORM messages. All messages must contain a Message Header (MSH), Patient Identifier (PID) and Patient Visit Information (PV1) segments. Order messages must also include Common Order (ORC) and Observation Request (OBR) segments. All other segments will be ignored.
Patient Information (ADT)
SafeNSound accepts ADT messages of type A01, A02, A03, A04, A05, A06, A08, A40, and A44.
MSH – Message Header
The message header is required for all messages and defines the message type, data source and data receiver.
| Seq. | Name | Req. (Y/N) | Notes |
| 01 | Field Seperator | Y | "|" |
| 02 | Encoding Characters | Y | "^~\&" |
| 03 | Sending Application | Y | |
| 04 | Sending Facility | Y | Required for all inbound messages. Must match what is configured in the Facility HL7 field. |
| 05 | Receiving Application | N | |
| 06 | Receiving Facility | N | |
| 07 | Message Date/Time | Y | YYYYMMDDhhmmss |
| 08 | Security | N | |
| 09 | Message Type | Y |
"ADT^A01" "ADT^A08" |
| 10 | Message Control ID | Y | |
| 11 | Processing ID | Y | "P" |
| 12 | Version ID | Y |
"2.3"
|
PID – Patient Identification
The patient identification segment contains information which details patient identity. Dithered fields are ignored.
| Seq. | Name | Req. (Y/N/O) | Notes |
| 01 | Set ID | Y | '1' |
| 02 |
Patient Class |
Not used |
|
| 03 |
Patient Location |
Y | |
| 3.1 |
Nurse Unit |
Y | |
| 3.2 | Room | O | |
| 3.3 | Bed | O | |
| 04 |
Admission Type |
Not used |
|
| 05 |
Pre-admit Number |
Not used |
|
| 06 |
Prior Patient Location |
Conditional | Used only for A02 transfer messages. Same format as PV1:3 patient location. |
| 07 |
Attending Doctor |
Not used |
|
| 08 |
Referring Doctor |
Not used |
|
| 09 |
Consulting Doctor |
Not used |
|
| 10 |
Hospital Service |
Not used |
|
| 11 |
Temporary Location |
Not used |
|
| 12 |
Pre-admit Test Indicator |
Not used |
|
| 13 |
Readmission Indicator |
Not used |
|
| 14 |
Admit Source |
Not used |
|
| 15 |
Ambulatory Status |
Not used |
|
| 16 |
VIP Indicator |
Not used |
|
| 17 |
Admitting Doctor |
Not used |
|
| 18 |
Patient Type |
Not used |
|
| 19 |
Visit Number |
Not used |
|
| 20 |
Financial Class |
Not used |
|
| 21 |
Charge Price Indicator |
Not used |
PV1 – Patient Visit Information
The patient visit information segment contains registration information specific to an encounter and is used to determine a patient’s location.
|
Seq. |
Name |
Req. (Y/N/O) |
Notes |
|
01 |
Set ID |
Y |
'1' |
|
02 |
Patient Class |
|
Not used |
|
03 |
Patient Location |
Y |
|
|
3.1 |
Nurse Unit |
Y |
|
|
3.2 |
Room |
O |
|
|
3.3 |
Bed |
O |
|
|
04 |
Admission Type |
|
Not used |
|
05 |
Pre-admit Number |
|
Not used |
|
06 |
Prior Patient Location |
Conditional |
Used only for A02 transfer messages. Same format as PV1:3 patient location. |
|
07 |
Attending Doctor |
Not used |
|
|
08 |
Referring Doctor |
Not used |
|
|
09 |
Consulting Doctor |
Not used |
|
|
10 |
Hospital Service |
Not used |
|
|
11 |
Temporary Location |
Not used |
|
|
12 |
Pre-admit Test Indicator |
Not used |
|
|
13 |
Readmission Indicator |
Not used |
|
|
14 |
Admit Source |
Not used |
|
|
15 |
Ambulatory Status |
Not used |
|
|
16 |
VIP Indicator |
Not used |
|
|
17 |
Admitting Doctor |
Not used |
|
|
18 |
Patient Type |
Not used |
|
|
19 |
Visit Number |
Not used |
|
|
20 |
Financial Class |
Not used |
|
|
21 |
Charge Price Indicator |
Not used |
| Seq. | Name | Req. (Y/N/O) | Notes |
| 1 | Set ID | N | EMPI number, if available. (See PID:4) |
| 2 | Patient ID (external) | Y | Medical Record Number or Patient Identifier. |
| 3 | Patient ID (internal) | Y | Unique encounter identifier. required for integration with multiple facilities when EMPI # is not available in PID:2. Populates TeleCom ID2 field. |
| 4 | Alternate Patient ID | Conditional | FamilyName^GivenName^MiddleName^Suffix^Prefix |
| 5 | PatientName | Y | |
| 5.1 | FamilyName | Y | |
| 5.2 | GivenName | Y | |
| 5.3 | MiddleName | N | |
| 5.4 | Suffix | N | |
| 5.5 | Prefix | N | |
| 6 | Mother's Maiden Name | YYYYMMDD | |
| 7 | Date of Birth | Y | |
| 8 | Gender | Y | |
| 9 | Patient Alias | N | |
| 10 | Race | N | Street1^Street2^City^State^ZIP |
| 11 | Patient Address | N | |
| 11.1 | Street Address 1 | N | |
| 11.2 | Street Address 2 | N | |
| 11.3 | City | N | |
| 11.4 | State | N | |
| 11.5 | ZIP | N | |
| 12 | County | N | (000)000-0000 |
| 13 | Phone (home) | N | |
| 14 | Phone (business) | N | |
| 15 | Language | N | |
| 16 | Marital Status | N | |
| 17 | Religion | N | |
| 18 | Patient Account Number | Y | Account Number or Financial Number |
| 19 | SSN | N | Social Security Number in 000000000 format |
Note: Nothing else in PV1 is used.
Example: ADT Messages
Inpatient Admit
MSH|^~\@|EPC|HOSP1|BXVW|HOSP1|201004070956||ADT^A01|ADMT|P|2.3|||
PID||4886311|234567||EXAMPLE^PATIENT^X^^||19840404|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-4444|||||23456701|444556666
PV1|1|I|4NTH^430^1||||0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|I|23456701|||||||||||||||||||||||||201004070956||
Outpatient Registration
MSH|^~\@|EPC|HOSP1|BXVW|HOSP1|201004071011||ADT^A04|86543549|P|2.3|||
PID||4886311|433567||EXAMPLE^PATIENT^Y^^||19950711|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-6677|||||43356701|333445555
PV1|1|E|ER^001^1||||0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|E|43356701|||||||||||||||||||||||||201004071011||
Transfer
MSH|^~\@|EPC|HOSP1|BXVW|HOSP1|201004071120||ADT^A02|654999845|P|2.3|||
PID||4886311|234567||EXAMPLE^PATIENT^X^^||19840404|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-4444|||||23456701|444556666
PV1|1|I|5NTH^510^1|||4NTH^430^1|0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|I|23456701|||||||||||||||||||||||||201004071120||
Update
MSH|^~\@|EPC|HOSP1|BXVW|HOSP1|201004071218||ADT^A08|351494446|P|2.3|||
PID||4886311|234567||EXAMPLE^PATIENT^X^^||19840405|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-4444|||||23456701|444556666
PV1|1|I|4NTH^430^1||||0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|I|23456701|||||||||||||||||||||||||201004071218||
Order Information (ORM)
The SafeNSound orders interface accepts ORM^O01 messages with the following required message segments: MSH, PID, PV1, ORC and OBR..
ORC – Common Order
The ORC segment contains fields common to all order messages. The ORC segment is required for the transmission of an order to a receiving system.The order control code sent in ORC:1 will contain the usage of the order message: NW – new, SC – status change, CA – Cancelled, DC- discontinued.
|
Seq. |
Name |
Req. (Y/N) |
Notes |
|
01 |
Order Control ID |
Y |
NW, SC, CA, DC |
|
02 |
Placer Order Number |
Y |
Unique Order ID |
|
03 |
Filler Order Number |
N |
Identifies the order within the sending system. |
|
04 |
Placer Group Number |
|
Not used |
|
05 |
Order Status |
Y |
O- Ordered, P- In Process, C- Complete, X- Cancelled |
|
06 |
Response Flag |
|
Not used |
|
07 |
Quantity/Timing |
|
Not used |
|
08 |
Parent |
|
Not used |
|
09 |
Date of Transaction |
|
Not used |
|
10 |
Entered By |
|
Not used |
|
11 |
Verified By |
|
Not Used |
|
12 |
Ordering Provider ID |
N |
Not used |
|
13 |
Enterer's Location |
|
Not used |
|
14 |
Call Back Phone |
|
Not used |
|
15 |
Order Effective Date |
N |
OBR – Order Detail
The Observation Request (OBR) segment contains information specific to the ordered patient monitoring observation.This segment defines the attributes and usage of the order.
| Seq. | Name | Req. (Y/N/O) | Notes |
| 1 | Set ID | Y | Always 1, SafeNSound only accepts one order per ORM |
| 2 | Placer Order Number | Y | Unique Order ID |
| 3 | Filler Order Number | N | Identifies the order within the sending system |
| 4 | Universal Service ID | Y | Universal Service ID |
| 5 | Priority | O | Not used |
| 6 | Requested Date/Time | O | Not used |
| 7 | Observation Date/Time | O | Not used |
| 8 | Observation End Date/Time | O | Not used |
| 9 | Collection Volume | O | Not used |
| 10 | Collector Identifier | O | Not used |
| 11 | Specimen Action Code | O | Not used |
| 12 | Danger Code | O | Not used |
| 13 | Relevant Clinical Info | O | Not used |
| 14 | Spec Received Date | O | Not used |
| 15 | Specimen Source | O | Not used |
| 16 | Ordering Provider | Y | Alias of ordering provider |
| 17 | Call Back Phone Number | O | Not used |
| 18 | Placer Field 1 | O | Not used |
| 19 | Placer Field 2 | O | Not used |
| 20 | Filler Field 1 | O | Not used |
| 21 | Filler Field 2 | O | Not used |
| 22 | Results Report | O | Not used |
| O | |||
| Status Change | O | ||
| O | |||
| Date/Time | O | ||
| 23 | Charge to Practice | O | Not used |
| 24 | Diagnostic Service Sector ID | O | Not used |
| 25 | Result Status | O | Not used |
| 26 | Parent Result | O | Not used |
| 27 | Quantity Timing | O | Not used |
| 28 | Result Copies To | O | Not used |
| 29 | Parent | O | Not used |
| 30 | Transportation Mode | O | Not used |
| 31 | Reason for Study | N | |
| 31.1 | Reason ID | O | |
| 31.2 | Reason Text | O | Freetext |
| 32 | Principal Result Interpreter | O | Not used |
| 33 | Assistant Result Interpreter | O | Not used |
| 34 | Technician | O | Not used |
| 35 | Transportation | O | Not used |
| 36 | Schedule Date/Time | N | Date & Time of a scheduled observation |
Example: ORM Message
Order Request
MSH|^~\&|EPC|HOSP1|BXVW|HOSP1|201004071719||ORM^O01|65499544992|P|2.3
PID||4886311|234567||EXAMPLE^PATIENT^X^^||19840405|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-4444|||||23456701|444556666
PV1|1|I|4NTH^430^1||||0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|I|23456701|||||||||||||||||||||||||201004070956||
ORC|NW|67227396^SYS_ORDERID|||Ordered||||20100407160155|65411|||||20100407160155||||65411^EXAMPLE^USER
OBR|1|67227396^SYS_ORDERID||TELEMETRY||20100407160155||||||||||20288^PROVIDER^ORDERING||||ACN65188843||20100407160155||TELEMETRY|||1^^0^20100407161411||||^MONITORING EXAMPLE PATIENT|||||20100407160000
Clinical Information (OBX)
The SafeNSound clinical information interface accepts OBX^O01 messages with the following required message segments: MSH, PID, PV1, and OBX.
|
Seq. |
Name |
Req. (Y/N/O) |
Notes |
|
01 |
Set ID |
Y |
Always 1, SafeNSound only accepts one order per OBX |
|
02 |
Placer Order Number |
N |
Unique ID |
|
03 |
Filler Order Number |
N |
Identifies the order within the sending system |
|
04 |
|
Y |
|
|
4.1 |
Universal ID |
Y |
Universal ID 'WT' or 'HT' |
|
4.2 |
Universal Name |
Y |
Universal Name ID 'WEIGHT' or 'HEIGHT' |
|
5 |
Blank |
N |
|
|
6 |
Value |
Y |
|
|
7 |
Unit of Measurement |
Y |
Weight 'kg' or 'lbs' Height 'cm' or 'in' |
Example: OBX Message
MSH|^~\@|EPC|HOSP1|BXVW|HOSP1|201004071218||ADT^A08|351494446|P|2.3|||
PID||4886311|234567||EXAMPLE^PATIENT^X^^||19840405|M||W|STREET1^STREET2^CITY^ST^73100||(505)555-4444|||||23456701|444556666
PV1|1|I|4NTH^430^1||||0123^Referring,Doctor, MD|0123^Admitting,Doctor,MD||TEL|||||||0123^Admitting, Doctor, MD^^^^^^|I|23456701|||||||||||||||||||||||||201004071218||
OBX|||WT^WEIGHT||102|pounds|
OBX|||HT^HEIGHT||32|cm|