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Patient Administration

Chapter Chair/Editor:

Alexander de León

Kaiser Permanente

Chapter Editor:

Riki Merrick

Vernetzt, LLC

International Liaison:

Irma Jongeneel de Haas

HL7 The Netherlands, VZVZ

Sponsoring Committee:

Patient Administration

List Server:

pafm@lists.hl7.org


PURPOSE

The Patient Administration transaction set provides for the transmission of new or updated demographic and visit information about patients. Since virtually any system attached to the network requires information about patients, the Patient Administration transaction set is one of the most commonly used.

Generally, information is entered into a Patient Administration system and passed to the nursing, ancillary and financial systems either in the form of an unsolicited update or a response to a record-oriented query.

This chapter defines the transactions that occur at the seventh level, that is, the abstract messages. The examples included in this chapter were constructed using the HL7 Encoding Rules.

Trigger Events and Message Definitions

ADT/ACK - Admit/Visit Notification (Event A01)

An A01 event is intended to be used for "Admitted" patients only. An A01 event is sent as a result of a patient undergoing the admission process which assigns the patient to a bed. It signals the beginning of a patient's stay in a healthcare facility. Normally, this information is entered in the primary Patient Administration system and broadcast to the nursing units and ancillary systems. It includes short stay and "Adam Everyman" (e.g., patient name is unknown) admissions. For example, an A01 event can be used to notify: the pharmacy system that a patient has been admitted and may be legitimately prescribed drugs; the nursing system that the patient has been admitted and needs a care plan prepared; the finance system of the start of the billing period; the dietary system that a new patient has been installed and requires dietary services; the laboratory, pathology, and radiology systems that a patient has been admitted and is entitled to receive services; the clinical repository that an admission has taken place for the EMR (electronic medical record).

When an account's start and end dates span a period greater than any particular visit, the P01 (add patient account) event should be used to transmit the opening of an account. The A01 event can notify systems of the creation of an account as well as notify them of a patient's arrival in the healthcare facility. In order to create a new account without notifying of patient's arrival, use the P01 event.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin and end date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A01^ADT_A01: ADT Message
HL7 MessageStructure Table - ADT_A01
Segment Cardinality Must Implement Status
ADT_A01
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A01^ADT_A01

Send Application Ack: ACK^A01^ACK

Enhanced Mode Acknowledgement Choreography for ADT^A01^ADT_A01

When the MSH-15 value of an ADT^A01^ADT_A01 message is AL or ER or SU, an ACK^A01^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A01^ADT_A01 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A01^ADT_A01 message is AL or ER or SU, an ACK^A01^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A01^ADT_A01 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A01^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A01^ACK
NE (none)

ACK^A01^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A01^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A01^ACK

When the MSH-15 value of an ACK^A01^ACK message is AL or ER or SU, an ACK^A01^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A01^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A01^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Transfer a Patient (Event A02)

An A02 event is issued as a result of the patient changing his or her assigned physical location.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition. If the transfer function of your Patient Administration system allows demographics to change at the same time as the transfer (for example an address change), we recommend (but do not require) sending two messages (an A02 followed by an A08). This A02 event can be used with admitted and non-admitted patients.

The new patient location should appear in PV1-3 - Assigned Patient Location while the old patient location should appear in PV1-6 - Prior Patient Location. For example, an A02 event can be used to notify: laboratory, radiology, pathology that the patient has changed location and test results should be redirected; pharmacy that drugs should be redirected for the patient; dietary that the meals should be delivered to a different location; the clinical repository that a transfer has taken place for the Electronic Medical Record.

If the patient is going to a temporary location (such as the O/R, X-RAY, LIMBO, the HALLWAY) it is recommended that the A09 (patient departing-tracking) and A10 (patient arriving-tracking) events be used instead of A02. It is recommended that A02 be used only for a real change in the census bed in the Patient Administration system.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A02^ADT_A02: ADT Message
HL7 MessageStructure Table - ADT_A02
Segment Cardinality Must Implement Status
ADT_A02
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A02^ADT_A02

Send Application Ack: ADT^A02^ADT_A02

Enhanced Mode Acknowledgement Choreography for ADT^A02^ADT_A02

When the MSH-15 value of an ADT^A02^ADT_A02 message is AL or ER or SU, an ACK^A02^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A02^ADT_A02 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A02^ADT_A02 message is AL or ER or SU, an ACK^A02^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A02^ADT_A02 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A02^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A02^ACK
NE (none)

ACK^A02^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A02^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A02^ACK

When the MSH-15 value of an ACK^A02^ACK message is AL or ER or SU, an ACK^A02^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A02^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A02^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Discharge/End Visit (Event A03)

An A03 event signals the end of a patient's stay in a healthcare facility. It signals that the patient's status has changed to "discharged" and that a discharge date has been recorded. The patient is no longer in the facility. The patient's location prior to discharge should be entered in PV1-3 - Assigned Patient Location.

An A03 event can be sent to notify: the pharmacy that the patient's stay has ended and that entitlement to drugs has changed accordingly; the nursing system that the patient has been discharged and that the care plan can be completed; the extended care or home health system that the patient has been discharged and that the new extended care or home health admission assessment can be scheduled; the finance system that the patient billing period has ended; and/or the clinical repository that discharge has taken place for the EMR.

For non-admitted patients, an A03 event signals the end of a patient's visit to a healthcare facility. It could be used to signal the end of a visit for a one-time or recurring outpatient who is not assigned to a bed. It could also be used to signal the end of a visit to the Emergency Room. PV1-45 - Discharge Date/Time can be used for the visit end date/time.

When an account's start and end dates span a period greater than any particular visit, the P06 (end account) event should be used to transmit information about the closing of an account. To indicate that a patient has expired, use an A03 event with the PID-29 - Patient Death Date and Time and PID-30 - Patient Death Indicator filled in.

The fields included when this message is sent should be the fields pertinent to communicate this event. The optional allergy, next-of-kin, insurance and guarantor fields should be sent when required to support advanced notification for pending extended care or home health admission requirements (such as scheduling of a nursing assessment in preparation for completion of the extended care plan). When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin date and end date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Particpation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A03^ADT_A03: ADT Message
HL7 MessageStructure Table - ADT_A03
Segment Cardinality Must Implement Status
ADT_A03
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A03^ADT_A03

Send Application Ack: ADT^A03^ADT_A03

Enhanced Mode Acknowledgement Choreography for ADT^A03^ADT_A03

When the MSH-15 value of an ADT^A03^ADT_A03 message is AL or ER or SU, an ACK^A03^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A03^ADT_A03 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A03^ADT_A03 message is AL or ER or SU, an ACK^A03^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A03^ADT_A03 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A03^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A03^ACK
NE (none)

ACK^A03^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A03^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A03^ACK

When the MSH-15 value of an ACK^A03^ACK message is AL or ER or SU, an ACK^A03^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A03^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A03^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Register a Patient (Event A04)

An A04 event signals that the patient has arrived or checked in as a one-time, or recurring outpatient, and is not assigned to a bed. One example might be its use to signal the beginning of a visit to the Emergency Room (= Casualty, etc.).

Note: Some systems refer to these events as outpatient registrations or emergency admissions. PV1-44 - Admit Date/Time is used for the visit start date/time.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRTsegment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A04^ADT_A01: ADT Message
HL7 MessageStructure Table - ADT_A01
Segment Cardinality Must Implement Status
ADT_A01
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A04^ADT_A01

Send Application Ack: ADT^A04^ADT_A01

Enhanced Mode Acknowledgement Choreography for ADT^A04^ADT_A01

When the MSH-15 value of an ADT^A04^ADT_A01 message is AL or ER or SU, an ACK^A04^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A04^ADT_A01 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A04^ADT_A01 message is AL or ER or SU, an ACK^A04^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A04^ADT_A01 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A04^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A04^ACK
NE (none)

ACK^A04^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A04^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A04^ACK

When the MSH-15 value of an ACK^A04^ACK message is AL or ER or SU, an ACK^A04^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A04^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A04^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Pre-Admit a Patient (Event A05)

An A05 event is sent when a patient undergoes the pre-admission process. During this process, episode-related data is collected in preparation for a patient's visit or stay in a healthcare facility. For example, a pre-admit may be performed prior to inpatient or outpatient surgery so that lab tests can be performed prior to the surgery. This event can also be used to pre-register a non-admitted patient.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Visit level providers (corresponding to the PV1 data) are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 15 for the definition of the PRT segment.

ADT^A05^ADT_A05: ADT Message
HL7 MessageStructure Table - ADT_A05
Segment Cardinality Must Implement Status
ADT_A05
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A05^ADT_A05

Send Application Ack: ADT^A05^ADT_A05

Enhanced Mode Acknowledgement Choreography for ADT^A05^ADT_A05

When the MSH-15 value of an ADT^A05^ADT_A05 message is AL or ER or SU, an ACK^A05^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A05^ADT_A05 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A05^ADT_A05 message is AL or ER or SU, an ACK^A05^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A05^ADT_A05 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A05^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A05^ACK
NE (none)

ACK^A05^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A05^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A05^ACK

When the MSH-15 value of an ACK^A05^ACK message is AL or ER or SU, an ACK^A05^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A05^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A05^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change an Outpatient to an Inpatient (Event A06)

An A06 event is sent when a patient who was present for a non-admitted visit is being admitted after an evaluation of the seriousness of the patient's condition. This event changes a patient's status from non-admitted to admitted. The new patient location should appear in PV1-3 - Assigned Patient Location, while the old patient location (if different) should appear in PV1-6 - Prior Patient Location. The new patient class should appear in PV1-2 - Patient Class.

It will be left to implementation negotiation to determine whether disparate systems merely change the patient class, or close and open a new account. The current active account number should appear in field PID-18 - Patient Account Number; the prior account number can be included optionally in MRG-3 - Prior Patient Account Number. This arrangement is not intended to be a type of merge. The MRG segment is used here only for MRG-3 - Prior Patient Account Number. PV1-19 - Visit Number may also be changed during this event.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Visit level providers (corresponding to the PV1 data) are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the PRT-11 –Begin Date/Time and the PRT-12 –End Date/Time in the PRT segment, with the applicable PRT-4 – role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A06^ADT_A06: ADT Message
HL7 MessageStructure Table - ADT_A06
Segment Cardinality Must Implement Status
ADT_A06
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
MRG 0..1
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 1..1 Yes
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A06^ADT_A06

Send Application Ack: ADT^A06^ADT_A06

Enhanced Mode Acknowledgement Choreography for ADT^A06^ADT_A06

When the MSH-15 value of an ADT^A06^ADT_A06 message is AL or ER or SU, an ACK^A06^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A06^ADT_A06 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A06^ADT_A06 message is AL or ER or SU, an ACK^A06^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A06^ADT_A06 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A06^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A06^ACK
NE (none)

ACK^A06^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A06^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A06^ACK

When the MSH-15 value of an ACK^A06^ACK message is AL or ER or SU, an ACK^A06^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A06^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A06^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change an Inpatient to an Outpatient (Event A07)

An A07 event is sent when a patient who was admitted changes his/her status to "no longer admitted" but is still being seen for this episode of care. This event changes a patient from an "admitted" to a "non-admitted" status. The new patient location should appear in PV1-3 - Assigned Patient Location, while the old patient location (if different) should appear in PV1-6 - Prior Patient Location.

It will be left to implementation negotiation to determine whether disparate systems merely change the patient class, or close and open a new account. The current active account number should appear in field PID-18 - Patient Account Number; the prior account number can be included optionally in MRG-3 - Prior Patient Account Number. This arrangement is not intended to be a type of merge. The MRG segment is used here only for MRG-3 - Prior Patient Account Number. PV1-19 - Visit Number may also be changed during this event.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin and end date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A07^ADT_A06: ADT Message
HL7 MessageStructure Table - ADT_A06
Segment Cardinality Must Implement Status
ADT_A06
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
MRG 0..1
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 1..1 Yes
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A07^ADT_A06

Send Application Ack: ADT^A07^ADT_A06

Enhanced Mode Acknowledgement Choreography for ADT^A07^ADT_A06

When the MSH-15 value of an ADT^A07^ADT_A06 message is AL or ER or SU, an ACK^A07^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A07^ADT_A06 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A07^ADT_A06 message is AL or ER or SU, an ACK^A07^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A07^ADT_A06 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A07^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A07^ACK
NE (none)

ACK^A07^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A07^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A07^ACK

When the MSH-15 value of an ACK^A07^ACK message is AL or ER or SU, an ACK^A07^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A07^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A07^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Update Patient Information (Event A08)

This trigger event is used when any patient information has changed but when no other trigger event has occurred. For example, an A08 event can be used to notify the receiving systems of a change of address or a name change. We strongly recommend that the A08 transaction be used to update fields that are not updated by any of the other trigger events. If there are specific trigger events for this update, these trigger events should be used. For example, if a patient's address and location are to be changed, then an A08 is used to change the patient address and the appropriate patient location trigger event is used to change the patient location. The A08 event can include information specific to an episode of care, but it can also be used for demographic information only.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the PRT-11 – Begin Date/Time and the –PRT-12 - End Date/Time in the PRT, with the applicable PRT-4 – role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A08^ADT_A01: ADT Message
HL7 MessageStructure Table - ADT_A01
Segment Cardinality Must Implement Status
ADT_A01
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A08^ADT_A01

Send Application Ack: ADT^A08^ADT_A01

Enhanced Mode Acknowledgement Choreography for ADT^A08^ADT_A01

When the MSH-15 value of an ADT^A08^ADT_A01 message is AL or ER or SU, an ACK^A08^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A08^ADT_A01 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A08^ADT_A01 message is AL or ER or SU, an ACK^A08^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A08^ADT_A01 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A08^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A08^ACK
NE (none)

ACK^A08^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A08^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A08^ACK

When the MSH-15 value of an ACK^A08^ACK message is AL or ER or SU, an ACK^A08^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A08^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A08^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Patient Departing - Tracking (Event A09)

The A09 and A10 - patient arriving-tracking events are used when there is a change in a patient's physical location (inpatient or outpatient) and when this is NOT a change in the official census bed location, as in the case of an outpatient setting. There are three situations that qualify as non-census location changes: (a) patient tracking, (b) the patient is in transit between locations for some time, (c) a notification of temporary location change.

Patient tracking: This can be used when the nursing application sends a "transfer" before the Patient Administration (or official census) system issues an A02 (transfer a patient) event. If the patient has left for a non-temporary location and is not in transit, then the PV1-3 - Assigned Patient Location must contain the new patient location, while PV1-6 - Prior Patient Location must contain the old patient location.

In transit: The patient's location during the time between an A09 and an A10 (patient arriving - tracking) is defined as "in transit." The A09 event is sent when a patient departs from one area of the healthcare facility for the purpose of arriving at another area, but without leaving the healthcare institution. This event is used when there is a time span during which the patient is neither at his/her old location nor at his/her new location. This process can take some time if a patient is being sent to another area in a multi-campus or multi-facility environment. The combination of an A09 and an A10 would serve the same purpose as an A02 (transfer a patient) event, except that it accounts for a gap in time required for transport between facilities. If the patient will be in transit during the time between the A09 (patient departing - tracking) event and the A10 (patient arriving - tracking) event, then PV1-42 - Pending Location is used for the new location, and PV1-11 - Temporary Location and PV1-43 - Prior Temporary Location would not be used. PV1-6 - Prior Patient Location should be used for the old location.

Temporary location: An A09 can also be used when the patient is being sent to a temporary location (such as the O/R, X-RAY, LIMBO, or HALLWAY). The patient may or may not return to the same assigned location after occupying the temporary location. If the patient is going to a temporary location (such as the O/R, X-RAY, LIMBO, or HALLWAY), then PV1-11 - Temporary Location is used to indicate the new temporary location. If the patient is moving from one temporary location to another, then PV1-43 - Prior Temporary Location may also be used. PV1-6 - Prior Patient Location and PV1-11 - Temporary Location should be used when the patient is moving from a permanent location to a temporary location.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

Attention: The DG1 segment was retained for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7.

ADT^A09^ADT_A09: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A09^ADT_A09

Send Application Ack: ADT^A09^ADT_A09

Enhanced Mode Acknowledgement Choreography for ADT^A09^ADT_A09

When the MSH-15 value of an ADT^A09^ADT_A09 message is AL or ER or SU, an ACK^A09^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A09^ADT_A09 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A09^ADT_A09 message is AL or ER or SU, an ACK^A09^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A09^ADT_A09 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A09^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A09^ACK
NE (none)

ACK^A09^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A09^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A09^ACK

When the MSH-15 value of an ACK^A09^ACK message is AL or ER or SU, an ACK^A09^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A09^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A09^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Patient Arriving - Tracking (Event A10)

The A10 event is sent when a patient arrives at a new location in the healthcare facility (inpatient or outpatient). The A09 - patient departing-tracking and A10 events are used when there is a change in a patient's physical location and when this is NOT a change in the official census bed location, as in the case of an outpatient setting. There are three varieties of these non-census location changes involving three different kinds of notification: (a) an unofficial notification of location change prior to the official notification of patient tracking, (b) the patient is in transit between locations for some time, (c) a notification of a temporary location change.

Patient tracking: If the patient is now at a non-temporary location and is not in transit, then PV1-3 - Assigned Patient Location must contain the new patient location and PV1-6 - Prior Patient Location can contain the old patient location.

In transit: This is used when there is some period of time between when the patient leaves his/her old location and when he/she arrives at the new assigned location. If the patient was in transit during the time between the A09 (patient departing-tracking) event and the A10 (patient arriving-tracking) event, then PV1-3 - Assigned Patient Location is used for the new location and PV1-6 - Prior Patient Location should be used for the old location. PV1-11 - Temporary Location and PV1-43 - Prior Temporary Location are not used.

Temporary location: An A10 event can also be used when the patient is being transferred from a temporary location (X-RAY, O/R, LIMBO, or HALLWAY) to the new assigned location. If the patient is arriving at a temporary location (such as the O/R, X-RAY, LIMBO, or HALLWAY), then PV1-11 - Temporary Location would be used to indicate the new temporary location. If the patient is moving from one temporary location to another, then PV1-43 - Prior Temporary Location may also be used. If the patient is arriving at a permanent location from a temporary location, PV1-3 - Assigned Patient Location should be used for the new location, and PV1-43 - Prior Temporary Location should be used for the old location.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

Attention: The DG1 segment was retained for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7.

ADT^A10^ADT_A09: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A10^ADT_A09

Send Application Ack: ADT^A10^ADT_A09

Enhanced Mode Acknowledgement Choreography for ADT^A10^ADT_A09

When the MSH-15 value of an ADT^A10^ADT_A09 message is AL or ER or SU, an ACK^A10^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A10^ADT_A09 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A10^ADT_A09 message is AL or ER or SU, an ACK^A10^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A10^ADT_A09 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A10^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A10^ACK
NE (none)

ACK^A10^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A10^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A10^ACK

When the MSH-15 value of an ACK^A10^ACK message is AL or ER or SU, an ACK^A10^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A10^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A10^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Admit / Visit Notification (Event A11)

For "admitted" patients, the A11 event is sent when an A01 (admit/visit notification) event is cancelled, either because of an erroneous entry of the A01 event, or because of a decision not to admit the patient after all.

For "non-admitted" patients, the A11 event is sent when an A04 (register a patient) event is cancelled, either because of an erroneous entry of the A04 event, or because of a decision not to check the patient in for the visit after all. To cancel an A05 (pre-admit a patient) event, use the A38 (cancel pre-admit), which was new for Version 2.3 of this Standard.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

Attention: The DG1 segment was retained for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7.

ADT^A11^ADT_A09: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A11^ADT_A09

Send Application Ack: ADT^A11^ADT_A09

Enhanced Mode Acknowledgement Choreography for ADT^A11^ADT_A09

When the MSH-15 value of an ADT^A11^ADT_A09 message is AL or ER or SU, an ACK^A11^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A11^ADT_A09 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A11^ADT_A09 message is AL or ER or SU, an ACK^A11^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A11^ADT_A09 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A11^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A11^ACK
NE (none)

ACK^A11^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A11^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A11^ACK

When the MSH-15 value of an ACK^A11^ACK message is AL or ER or SU, an ACK^A11^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A11^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A11^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Transfer (Event A12)

The A12 event is sent when an A02 (transfer a patient) event is cancelled, either because of erroneous entry of the A02 event or because of a decision not to transfer the patient after all. PV1-3 - Assigned Patient Location must show the location of the patient prior to the original transfer.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) even be used in addition.

Attention: The DG1 segment was retained for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7.

ADT^A12^ADT_A12: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A12^ADT_A12

Send Application Ack: ADT^A12^ADT_A12

Enhanced Mode Acknowledgement Choreography for ADT^A12^ADT_A12

When the MSH-15 value of an ADT^A12^ADT_A12 message is AL or ER or SU, an ACK^A12^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A12^ADT_A12 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A12^ADT_A12 message is AL or ER or SU, an ACK^A12^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A12^ADT_A12 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A12^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A12^ACK
NE (none)

ACK^A12^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A12^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A12^ACK

When the MSH-15 value of an ACK^A12^ACK message is AL or ER or SU, an ACK^A12^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A12^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A12^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Discharge / End Visit (Event A13)

The A13 event is sent when an A03 (discharge/end visit) event is cancelled, either because of erroneous entry of the A03 event or because of a decision not to discharge or end the visit of the patient after all. PV1-3 - Assigned Patient Location should reflect the location of the patient after the cancellation has been processed.

Note: This location may be different from the patient's location prior to the erroneous discharge. Prior Location could be used to show the location of the patient prior to the erroneous discharge.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the ROL, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A13^ADT_A01: ADT Message
HL7 MessageStructure Table - ADT_A01
Segment Cardinality Must Implement Status
ADT_A01
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1
PDA 0..1

Original Mode Acknowledgement Choreography for ADT^A13^ADT_A01

Send Application Ack: ADT^A13^ADT_A01

Enhanced Mode Acknowledgement Choreography for ADT^A13^ADT_A01

When the MSH-15 value of an ADT^A13^ADT_A01 message is AL or ER or SU, an ACK^A13^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A13^ADT_A01 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A13^ADT_A01 message is AL or ER or SU, an ACK^A13^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A13^ADT_A01 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A13^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A13^ACK
NE (none)

ACK^A13^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A13^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A13^ACK

When the MSH-15 value of an ACK^A13^ACK message is AL or ER or SU, an ACK^A13^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A13^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A13^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Pending Admit (Event A14)

An A14 event notifies other systems of a planned admission, when there is a reservation or when patient admission is to occur imminently. The A14 event is similar to a pre-admit, but without the implication that an account should be opened for the purposes of tests prior to admission. It is used when advanced notification of an admit is required in order to prepare for the patient's arrival.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the –PRT-11 - Begin Date/Time and the –PRT-12 - End Date/Time in the PRT, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A14^ADT_A05: ADT Message
HL7 MessageStructure Table - ADT_A05
Segment Cardinality Must Implement Status
ADT_A05
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A14^ADT_A05

Send Application Ack: ADT^A14^ADT_A05

Enhanced Mode Acknowledgement Choreography for ADT^A14^ADT_A05

When the MSH-15 value of an ADT^A14^ADT_A05 message is AL or ER or SU, an ACK^A14^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A14^ADT_A05 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A14^ADT_A05 message is AL or ER or SU, an ACK^A14^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A14^ADT_A05 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A14^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A14^ACK
NE (none)

ACK^A14^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A14^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A14^ACK

When the MSH-15 value of an ACK^A14^ACK message is AL or ER or SU, an ACK^A14^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A14^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A14^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Pending Transfer (Event A15)

An A15 event notifies other systems of a plan to transfer a patient to a new location when the patient has not yet left the old location. It is used when advanced notification of a transfer is required in order to prepare for the patient's location change. For example, this transaction could be sent so that staff will be on hand to move the patient or so that dietary services can route the next meal to the new location.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the PRT-11 - Begin Date/Time and the PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

Attention: The DG1 segment was retained in this message for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7.

ADT^A15^ADT_A15: ADT Message
HL7 MessageStructure Table - ADT_A15
Segment Cardinality Must Implement Status
ADT_A15
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 1..* Yes
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A15^ADT_A15

Send Application Ack: ADT^A15^ADT_A15

Enhanced Mode Acknowledgement Choreography for ADT^A15^ADT_A15

When the MSH-15 value of an ADT^A15^ADT_A15 message is AL or ER or SU, an ACK^A15^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A15^ADT_A15 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A15^ADT_A15 message is AL or ER or SU, an ACK^A15^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A15^ADT_A15 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A15^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A15^ACK
NE (none)

ACK^A15^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A15^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A15^ACK

When the MSH-15 value of an ACK^A15^ACK message is AL or ER or SU, an ACK^A15^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A15^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A15^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Pending Discharge (Event A16)

An A16 event notifies other systems of a plan to discharge a patient when the patient has not yet left the healthcare facility. It is used when advanced notification of a discharge is required in order to prepare for the patient's change in location. For example, it is used to notify the pharmacy of the possible need for discharge drugs or to notify psychotherapy of the possible need for post-discharge appointments or to notify the extended care or home health system that the patient will be discharged and that the new extended care and home health admission assessment can be scheduled.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin- and end-date of the provider, use the PRT-11 - Begin Date/Time and the PRT-12 - End Date/Time in the PRT, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A16^ADT_A16: ADT Message
HL7 MessageStructure Table - ADT_A16
Segment Cardinality Must Implement Status
ADT_A16
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1

Original Mode Acknowledgement Choreography for ADT^A16^ADT_A16

Send Application Ack: ADT^A16^ADT_A16

Enhanced Mode Acknowledgement Choreography for ADT^A16^ADT_A16

When the MSH-15 value of an ADT^A16^ADT_A16 message is AL or ER or SU, an ACK^A16^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A16^ADT_A16 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A16^ADT_A16 message is AL or ER or SU, an ACK^A16^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A16^ADT_A16 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A16^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A16^ACK
NE (none)

ACK^A16^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A16^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A16^ACK

When the MSH-15 value of an ACK^A16^ACK message is AL or ER or SU, an ACK^A16^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A16^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A16^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Swap Patients (Event A17)

The A17 is used when it is decided that two patients will exchange beds. The patient ID and visit data are repeated for the two patients changing places. See section 3.5.1, "Swapping a patient," for a discussion of issues related to implementing this trigger event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A17^ADT_A17: ADT Message
HL7 MessageStructure Table - ADT_A17
Segment Cardinality Must Implement Status
ADT_A17
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION_RESULT_1 0..*
OBX 1..1 Yes
PRT 0..*
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION_RESULT_2 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A17^ADT_A17

Send Application Ack: ADT^A17^ADT_A17

Enhanced Mode Acknowledgement Choreography for ADT^A17^ADT_A17

When the MSH-15 value of an ADT^A17^ADT_A17 message is AL or ER or SU, an ACK^A17^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A17^ADT_A17 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A17^ADT_A17 message is AL or ER or SU, an ACK^A17^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A17^ADT_A17 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A17^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A17^ACK
NE (none)

ACK^A17^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A17^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A17^ACK

When the MSH-15 value of an ACK^A17^ACK message is AL or ER or SU, an ACK^A17^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A17^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A17^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Merge Patient Information (Event A18)

The Original Mode Query was maintained for backward compatibility as of v2.3.1 and was withdrawn as of v2.7. The reader is referred to sections 3.3.40 – (event A40 - merge patient-patient identifier list), 3.3.41 (event A41 - merge account-patient account number) and 3.3.42 (event A42 - merge visit-visit number) for the current query/response message structure.

See section 3.5.2, "Merging patient/person information," for a discussion of issues related to implementing patient merge events.

QRY/ADR - Patient Query (Event A19)

The Original Mode Query was maintained for backward compatibility as of v2.4 and was withdrawn as of v2.7. The reader is referred to chapter 5, section 5.4, for the current query/response message structure.

ADT/ACK - Bed Status Update (Event A20)

Certain nursing/census applications need to be able to update the Patient Administration system's bed status. The following is the associated record layout:

ADT^A20^ADT_A20: ADT Message
HL7 MessageStructure Table - ADT_A20
Segment Cardinality Must Implement Status
ADT_A20
MSH 1..1 Yes
SFT 0..*
UAC 0..1
EVN 1..1 Yes
NPU 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A20^ADT_A20

Send Application Ack: ADT^A20^ADT_A20

Enhanced Mode Acknowledgement Choreography for ADT^A20^ADT_A20

When the MSH-15 value of an ADT^A20^ADT_A20 message is AL or ER or SU, an ACK^A20^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A20^ADT_A20 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A20^ADT_A20 message is AL or ER or SU, an ACK^A20^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A20^ADT_A20 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A20^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A20^ACK
NE (none)

ACK^A20^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A20^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A20^ACK

When the MSH-15 value of an ACK^A20^ACK message is AL or ER or SU, an ACK^A20^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A20^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A20^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Patient Goes on a Leave of Absence (Event A21)

An A21 event is sent to notify systems that an admitted patient has left the healthcare institution temporarily. It is used for systems in which a bed is still assigned to the patient, and it puts the current admitted patient activities on hold. For example, it is used to notify dietary services and laboratory systems when the patient goes home for the weekend.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

As there is no specific field for the LOA start date/time, it is recommended field EVN-6 - Event Occurred contain the date/time the patient actually left. PV2-47 - Expected LOA Return Date/Time is used to communicate the date/time the patient is expected to return from LOA.

ADT^A21^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A21^ADT_A21

Send Application Ack: ADT^A21^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A21^ADT_A21

When the MSH-15 value of an ADT^A21^ADT_A21 message is AL or ER or SU, an ACK^A21^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A21^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A21^ADT_A21 message is AL or ER or SU, an ACK^A21^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A21^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A21^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A21^ACK
NE (none)

ACK^A21^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A21^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A21^ACK

When the MSH-15 value of an ACK^A21^ACK message is AL or ER or SU, an ACK^A21^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A21^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A21^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Patient Returns From a Leave of Absence (Event A22)

An A22 event is sent to notify systems that an admitted patient has returned to the healthcare institution after a temporary "leave of absence." It is used for systems in which a bed is still assigned to the patient, and it takes their current admitted patient activities off of "hold" status. For example, it is used to notify dietary services and laboratory systems when the patient returns from a weekend trip to his/her home.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

As there is no specific field for the LOA start date/time, it is recommended that field EVN-6 - Event Occurred contain the date/time the patient actually returned from LOA. PV2-47 - Expected LOA Return Date/Time is used to communicate the date/time the patient was expected to return from LOA.

ADT^A22^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A22^ADT_A21

Send Application Ack: ADT^A22^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A22^ADT_A21

When the MSH-15 value of an ADT^A22^ADT_A21 message is AL or ER or SU, an ACK^A22^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A22^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A22^ADT_A21 message is AL or ER or SU, an ACK^A22^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A22^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A22^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A22^ACK
NE (none)

ACK^A22^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A22^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A22^ACK

When the MSH-15 value of an ACK^A22^ACK message is AL or ER or SU, an ACK^A22^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A22^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A22^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Delete a Patient Record (Event A23)

The A23 event is used to delete visit or episode-specific information from the patient record. For example, it is used to remove old data from a database that cannot hold all historical patient visit data. When an event was entered erroneously, use one of the cancel transactions. This event can be used to purge account-level data while retaining the person in the database.

ADT^A23^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A23^ADT_A21

Send Application Ack: ADT^A23^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A23^ADT_A21

When the MSH-15 value of an ADT^A23^ADT_A21 message is AL or ER or SU, an ACK^A23^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A23^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A23^ADT_A21 message is AL or ER or SU, an ACK^A23^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A23^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A23^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A23^ACK
NE (none)

ACK^A23^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A23^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A23^ACK

When the MSH-15 value of an ACK^A23^ACK message is AL or ER or SU, an ACK^A23^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A23^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A23^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Link Patient Information (Event A24)

The A24 event is used when the first PID segment needs to be linked to the second PID segment and when both patient identifiers identify the same patient. Linking two or more patients does not require the actual merging of patient information; following a link event, the affected patient data records should remain distinct. For example, this event could be used in a hospital network environment in which there are multiple campuses and in which records need to be linked. For example, hospital A, hospital B, and hospital C would each keep their own records on a patient, but an A24 link event would be sent to a corporate-wide MPI to enable the coupling of ID information with the corporate ID number. It is used for corporate data repositories, etc. This event is not meant to link mothers and babies since a field exists (PID-21 - Mother's Identifier) for that purpose. See section 3.5.3, "Patient record links," for a discussion of issues related to implementing patient link messages and MPI issues.

This event can also be used to link two patient identifiers when a patient changes from inpatient to outpatient, or vice versa. This event can also be used to link two visits of the same patient.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A24^ADT_A24: ADT Message
HL7 MessageStructure Table - ADT_A24
Segment Cardinality Must Implement Status
ADT_A24
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 0..1
DB1 0..*
PID 1..1 Yes
PD1 0..1
PV1 0..1
DB1 0..*

Original Mode Acknowledgement Choreography for ADT^A24^ADT_A24

Send Application Ack: ADT^A24^ADT_A24

Enhanced Mode Acknowledgement Choreography for ADT^A24^ADT_A24

When the MSH-15 value of an ADT^A24^ADT_A24 message is AL or ER or SU, an ACK^A24^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A24^ADT_A24 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A24^ADT_A24 message is AL or ER or SU, an ACK^A24^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A24^ADT_A24 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A24^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A24^ACK
NE (none)

ACK^A24^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A24^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A24^ACK

When the MSH-15 value of an ACK^A24^ACK message is AL or ER or SU, an ACK^A24^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A24^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A24^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Pending Discharge (Event A25)

The A25 event is sent when an A16 (pending discharge) event is cancelled, either because of erroneous entry of the A16 event or because of a decision not to discharge the patient after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A25^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A25^ADT_A21

Send Application Ack: ADT^A25^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A25^ADT_A21

When the MSH-15 value of an ADT^A25^ADT_A21 message is AL or ER or SU, an ACK^A25^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A25^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A25^ADT_A21 message is AL or ER or SU, an ACK^A25^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A25^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A25^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A25^ACK
NE (none)

ACK^A25^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A25^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A25^ACK

When the MSH-15 value of an ACK^A25^ACK message is AL or ER or SU, an ACK^A25^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A25^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A25^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Pending Transfer (Event A26)

The A26 event is sent when an A15 (pending transfer) event is cancelled, either because of erroneous entry of the A15 event or because of a decision not to transfer the patient after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A26^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A26^ADT_A21

Send Application Ack: ADT^A26^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A26^ADT_A21

When the MSH-15 value of an ADT^A26^ADT_A21 message is AL or ER or SU, an ACK^A26^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A26^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A26^ADT_A21 message is AL or ER or SU, an ACK^A26^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A26^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A26^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A26^ACK
NE (none)

ACK^A26^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A26^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A26^ACK

When the MSH-15 value of an ACK^A26^ACK message is AL or ER or SU, an ACK^A26^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A26^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A26^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Pending Admit (Event A27)

The A27 event is sent when an A14 (pending admit) event is cancelled, either because of erroneous entry of the A14 event or because of a decision not to admit the patient after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A27^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A27^ADT_A21

Send Application Ack: ADT^A27^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A27^ADT_A21

When the MSH-15 value of an ADT^A27^ADT_A21 message is AL or ER or SU, an ACK^A27^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A27^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A27^ADT_A21 message is AL or ER or SU, an ACK^A27^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A27^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A27^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A27^ACK
NE (none)

ACK^A27^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A27^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A27^ACK

When the MSH-15 value of an ACK^A27^ACK message is AL or ER or SU, an ACK^A27^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A27^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A27^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Add Person or Patient Information (Event A28)

The purpose of this and the three following messages was to allow sites with multiple systems and respective master patient databases to communicate activity related to a person regardless of whether that person is currently a patient on each system. Each system has an interest in the database activity of the others in order to maintain data integrity across an institution. Though they are defined within the ADT message set, these messages differ in that they are not patient-specific. To a certain registry, the person may be a person of interest, a potential future patient, or a potential guarantor. For example, these events can be used to maintain an MPI (master patient index), a cancer registry, members of a managed care plan, an HIV database, etc.

These events should not replace the use of the A01 (admit/visit notification), A03 (discharge/end visit), A04 (register a patient), A08 (update patient information), etc., events. They are not intended to be used for notification of real-time Patient Administration events. These events are primarily for demographic data, but optional historical non-demographic data may be sent as well.

The person whose data is being sent should be identified in the PID segment using the PID-3 - Patient Identifier List, even when the person is not a patient and may be a potential guarantor. An A28 establishes person identifiers, e.g., social security number, guarantor identifier, or other unique identifiers, and contains a person identifier in the PID-3 - Patient Identifier List. The person involved may or may not have active or inactive cases associated with them. When field names and descriptions say "patient," we must translate that to "person" for these transactions. In this manner, "person information" about a guarantor can be sent independently of the guarantor's relation to any patient.

For example, a site with separate inpatient, outpatient and medical records systems may require that each system maintain concurrent person information. Prior to an admit, the new person is added to the master database of the inpatient system, resulting in the broadcast of a message. The outpatient system receives the message and adds the person to its database with the possibility that the person may someday become a patient in its system. The medical records system receives the message and adds the person to its database with the possibility that it will track inpatient, outpatient, or clinical data for that person. The clinical repository database or MPI receives the message to keep all potential patients and guarantors in its database.

The A28 event can be used to send everything that is known about a person. For example, it can be sent to an ICU unit (in addition to the A02 (transfer a patient) event) when a patient is transferred to the ICU unit in order to backload all demographic information for the patient into the ICU system. An A28 (add person information) or A31 (update person information) can also be used for backloading MPI information for the person, or for backloading person and historical information.

In addition to adding a person to a database, the delete, update, and merge messages work in a similar manner to maintain concurrent person information. It is left up to site-specific negotiations to decide how much data must be transmitted or re-transmitted when a person becomes a patient.

To maintain backward compatibility with previous releases, the PV1 segment is required. However, a "pseudo-optional" PV1 can be achieved by valuing PV1-2 - Patient Class to N - not applicable.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin and end date of the provider, use the PRT-11 - Begin Date/Time and the PRT-12 - End Date/Time in the PRT, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A28^ADT_A05: ADT Message
HL7 MessageStructure Table - ADT_A05
Segment Cardinality Must Implement Status
ADT_A05
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A28^ADT_A05

Send Application Ack: ADT^A28^ADT_A05

Enhanced Mode Acknowledgement Choreography for ADT^A28^ADT_A05

When the MSH-15 value of an ADT^A28^ADT_A05 message is AL or ER or SU, an ACK^A28^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A28^ADT_A05 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A28^ADT_A05 message is AL or ER or SU, an ACK^A28^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A28^ADT_A05 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A28^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A28^ACK
NE (none)

ACK^A28^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A28^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A28^ACK

When the MSH-15 value of an ACK^A28^ACK message is AL or ER or SU, an ACK^A28^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A28^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A28^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Delete Person Information (Event A29)

An A29 event can be used to delete all demographic information related to a given person. This event "undoes" an A28 (add person information) event. The information from the A28 event is deleted. This event is used, for example, when adding the information was performed in error, or when another record already exists for the person, or when one wants to purge the person from the database. When this event occurs, all visit and account level data for this person is also purged.

To maintain backward compatibility with previous releases, the PV1 segment is required. However, a "pseudo-optional" PV1 can be achieved by valuing PV1-2 - Patient Class to N - not applicable.

ADT^A29^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A29^ADT_A21

Send Application Ack: ADT^A29^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A29^ADT_A21

When the MSH-15 value of an ADT^A29^ADT_A21 message is AL or ER or SU, an ACK^A29^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A29^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A29^ADT_A21 message is AL or ER or SU, an ACK^A29^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A29^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A29^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A29^ACK
NE (none)

ACK^A29^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A29^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A29^ACK

When the MSH-15 value of an ACK^A29^ACK message is AL or ER or SU, an ACK^A29^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A29^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A29^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Merge Person Information (Event A30)

Attention: The Merge Person Information event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A40 (merge patient-patient identifier list) event to be used to merge patient information for a current episode.

ADT/ACK - Update Person Information (Event A31)

An A31 event can be used to update person information on an MPI. It is similar to an A08 (update patient information) event, but an A08 (update patient information) event should be used to update patient information for a current episode. An A28 (add person information) or A31 can also be used for backloading MPI information for the person, or for backloading person and historical information.

To maintain backward compatibility with previous releases, the PV1 segment is required. However, a "pseudo-optional" PV1 can be achieved by valuing PV1-2 - Patient Class to N - not applicable.

The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.

The PRT – Participation Information Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin and end date of the provider, use the PRT-11 - Begin Date/Time and the PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A31^ADT_A05: ADT Message
HL7 MessageStructure Table - ADT_A05
Segment Cardinality Must Implement Status
ADT_A05
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
OH1 0..*
OH2 0..*
OH3 0..1
OH4 0..*
ARV 0..* B
ROL 0..* B
PRT 0..*
NEXT_OF_KIN 0..*
NK1 1..1 Yes
OH2 0..*
OH3 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
AL1 0..*
IAM 0..*
DG1 0..*
DRG 0..1
PROCEDURE 0..*
PR1 1..1 Yes
ROL 0..* B
PRT 0..*
GT1 0..*
INSURANCE 0..*
IN1 1..1 Yes
IN2 0..1
IN3 0..*
ROL 0..* B
PRT 0..*
AUTHORIZATION 0..*
AUT 1..1 Yes
PRT 0..*
REFERRAL 0..*
RF1 1..1 Yes
PRT 0..*
ACC 0..1
UB1 0..1
UB2 0..1

Original Mode Acknowledgement Choreography for ADT^A31^ADT_A05

Send Application Ack: ADT^A31^ADT_A05

Enhanced Mode Acknowledgement Choreography for ADT^A31^ADT_A05

When the MSH-15 value of an ADT^A31^ADT_A05 message is AL or ER or SU, an ACK^A31^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A31^ADT_A05 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A31^ADT_A05 message is AL or ER or SU, an ACK^A31^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A31^ADT_A05 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A31^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A31^ACK
NE (none)

ACK^A31^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A31^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A31^ACK

When the MSH-15 value of an ACK^A31^ACK message is AL or ER or SU, an ACK^A31^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A31^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A31^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Patient Arriving - Tracking (Event A32)

The A32 event is sent when an A10 (patient arriving-tracking) event is cancelled, either because of erroneous entry of the A10 event or because of a decision not to receive the patient after all.

If the patient was in a non-temporary location, then the PV1-3 - Assigned Patient Location may contain (if known) the original patient location prior to the erroneous A10 (patient arriving-tracking) event. If the patient was in a temporary location, then PV1-11 - Temporary Location may contain (if known) the original patient location prior to the erroneous A10 (patient arriving-tracking) event.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A32^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A32^ADT_A21

Send Application Ack: ADT^A32^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A32^ADT_A21

When the MSH-15 value of an ADT^A32^ADT_A21 message is AL or ER or SU, an ACK^A32^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A32^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A32^ADT_A21 message is AL or ER or SU, an ACK^A32^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A32^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A32^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A32^ACK
NE (none)

ACK^A32^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A32^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A32^ACK

When the MSH-15 value of an ACK^A32^ACK message is AL or ER or SU, an ACK^A32^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A32^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A32^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Patient Departing - Tracking (Event A33)

The A33 event is sent when an A09 (patient departing-tracking) event is cancelled, either because of erroneous entry of the A09 event or because of a decision not to send the patient after all.

If the patient was in a non-temporary location, then PV1-3 - Assigned Patient location must contain the original patient location prior to the erroneous A09 (patient departing-tracking) event. If the patient was in a temporary location, then PV1-11 - Temporary Location must contain the original patient location prior to the erroneous A09 (patient departing-tracking) event.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A33^ADT_A21: ADT Message
HL7 MessageStructure Table - ADT_A09
Segment Cardinality Must Implement Status
ADT_A09
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A33^ADT_A21

Send Application Ack: ADT^A33^ADT_A21

Enhanced Mode Acknowledgement Choreography for ADT^A33^ADT_A21

When the MSH-15 value of an ADT^A33^ADT_A21 message is AL or ER or SU, an ACK^A33^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A33^ADT_A21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A33^ADT_A21 message is AL or ER or SU, an ACK^A33^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A33^ADT_A21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A33^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A33^ACK
NE (none)

ACK^A33^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A33^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A33^ACK

When the MSH-15 value of an ACK^A33^ACK message is AL or ER or SU, an ACK^A33^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A33^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A33^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Merge Patient Information - Patient ID Only (Event A34)

Attention: The Merge Patient Information – Patient ID Only (A34) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A40 (Merge Patient-Patient Identifier List) event.

ADT/ACK - Merge Patient Information - Account Number Only (Event A35)

Attention: The Merge Patient Information – Account Number Only (A35) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A41 (Merge Patient - Patient Account Number) event.

ADT/ACK - Merge Patient Information - Patient ID & Account Number (Event A36)

Attention: The Merge Patient Information – Patient ID & Account Number (A36) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A40 (Merge Patient-Patient Identifier List) event and the A41 (merge patient - patient account number) event.     

ADT/ACK - Unlink Patient Information (Event A37)

The A37 event unlinks two patient identifiers.

ADT^A37^ADT_A15
HL7 MessageStructure Table - ADT_A15
Segment Cardinality Must Implement Status
ADT_A15
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
ARV 0..* B
ROL 0..* B
PRT 0..*
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ROL 0..* B
PRT 1..* Yes
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A37^ADT_A15

Send Application Ack: ADT^A37^ADT_A15

Enhanced Mode Acknowledgement Choreography for ADT^A37^ADT_A15

When the MSH-15 value of an ADT^A37^ADT_A15 message is AL or ER or SU, an ACK^A37^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A37^ADT_A15 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A37^ADT_A15 message is AL or ER or SU, an ACK^A37^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A37^ADT_A15 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A37^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A37^ACK
NE (none)

ACK^A37^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A37^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A37^ACK

When the MSH-15 value of an ACK^A37^ACK message is AL or ER or SU, an ACK^A37^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A37^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A37^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Pre-Admit (Event A38)

The A38 event is sent when an A05 (pre-admit a patient) event is cancelled, either because of erroneous entry of the A05 event or because of a decision not to pre-admit the patient after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A38^ADT_A38: ADT Message
HL7 MessageStructure Table - ADT_A38
Segment Cardinality Must Implement Status
ADT_A38
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1
DB1 0..*
OBSERVATION 0..*
OBX 1..1 Yes
PRT 0..*
DG1 0..*
DRG 0..1

Original Mode Acknowledgement Choreography for ADT^A38^ADT_A38

Send Application Ack: ADT^A38^ADT_A38

Enhanced Mode Acknowledgement Choreography for ADT^A38^ADT_A38

When the MSH-15 value of an ADT^A38^ADT_A38 message is AL or ER or SU, an ACK^A38^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A38^ADT_A38 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A38^ADT_A38 message is AL or ER or SU, an ACK^A38^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A38^ADT_A38 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A38^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A38^ACK
NE (none)

ACK^A38^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A38^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A38^ACK

When the MSH-15 value of an ACK^A38^ACK message is AL or ER or SU, an ACK^A38^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A38^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A38^ACK
NE (none)
MSH-16 NE (none)

st

ADT/ACK - Merge Person - Patient ID (Event A39)

Attention: The Merge Person – Patient ID (A39) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A41 (Merge Patient - Patient Account Number) event.

ADT/ACK - Merge Patient - Patient Identifier List (Event A40)

A merge has been done at the patient identifier list level. That is, two PID-3 - Patient Identifier List identifiers have been merged into one.

An A40 event is used to signal a merge of records for a patient that was incorrectly filed under two different identifiers. The "incorrect source identifier" identified in the MRG segment (MRG-1 - Prior Patient Identifier List) is to be merged with the required "correct target identifier" of the same "identifier type code" component identified in the PID segment (PID-3 - Patient Identifier List). The "incorrect source identifier" would then logically never be referenced in future transactions. It is noted that some systems may still physically keep this "incorrect identifier" for audit trail purposes or other reasons associated with database index implementation requirements.

The identifiers involved in identifying the patients may or may not have accounts, which may or may not have visits. An A40 (merge patient-patient identifier list) event is intended for merging patient records without merging other subordinate identifiers. Any other subordinate identifiers that were previously associated with the "incorrect source identifier" are now associated with the "correct target identifier." Specification of these other subordinate identifiers is not required.

This event and the message syntax do, however, allow for the specification of any other "new subordinate identifiers" (in addition to the PID-3 - Patient Identifier List identifier). For those environments that may require changes to these other subordinate identifiers because of the A40 (merge patient-patient identifier list) event, it is required that the old and new identifiers be a "tightly coupled" pair.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.2, "Merge," for a discussion of issues related to the implementation of merge messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other fields change, it is recommended that the A31 (update person information) event be used for person level updates and A08 (update patient information) event for patient level updates.

ADT^A40^ADT_A39: ADT Message
HL7 MessageStructure Table - ADT_A39
Segment Cardinality Must Implement Status
ADT_A39
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes
PV1 0..1

Original Mode Acknowledgement Choreography for ADT^A40^ADT_A39

Send Application Ack: ADT^A40^ADT_A39

Enhanced Mode Acknowledgement Choreography for ADT^A40^ADT_A39

When the MSH-15 value of an ADT^A40^ADT_A39 message is AL or ER or SU, an ACK^A40^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A40^ADT_A39 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A40^ADT_A39 message is AL or ER or SU, an ACK^A40^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A40^ADT_A39 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A40^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A40^ACK
NE (none)

ACK^A40^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A40^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A40^ACK

When the MSH-15 value of an ACK^A40^ACK message is AL or ER or SU, an ACK^A40^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A40^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A40^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Merge Account - Patient Account Number (Event A41)

A merge has been done at the account identifier level. That is, two PID-18 - Patient Account Number identifiers have been merged into one.

An A41 event is used to signal a merge of records for an account that was incorrectly filed under two different account numbers. The "incorrect source patient account number" identified in the MRG segment (MRG-3 - Prior Patient Account Number) is to be merged with the "correct target patient account number" identified in the PID segment (PID-18 - Patient Account Number). The "incorrect source patient account number" would then logically never be referenced in future transactions. It is noted that some systems may still physically keep this "incorrect identifier" for audit trail purposes or other reasons associated with database index implementation requirements.

The patient account numbers involved may or may not have visits. An A41 (merge account-patient account number) is intended for merging account records without merging other subordinate identifiers. Any other subordinate identifiers that were previously associated with the "incorrect source account number" are now associated with the required "correct target account number." Specification of these other subordinate identifiers is not required.

This event and the message syntax do, however, allow for the specification of any other "new subordinate identifiers" (in addition to the PID-18 - Patient Account Number identifier). For those environments that may require changes to these other subordinate identifiers because of this A41 (merge account-patient account number) event, it is required that the old and new identifiers be a "tightly coupled" pair.

Each superior identifier associated with this account identifier level should have the same value in both the PID and MRG segments.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.2, "Merge," for a discussion of issues related to the implementation of merge messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other fields change, it is recommended that the A08 (update patient information) event be used in addition

ADT^A41^ADT_A39: ADT Message
HL7 MessageStructure Table - ADT_A39
Segment Cardinality Must Implement Status
ADT_A39
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes
PV1 0..1

Original Mode Acknowledgement Choreography for ADT^A41^ADT_A39

Send Application Ack: ADT^A41^ADT_A39

Enhanced Mode Acknowledgement Choreography for ADT^A41^ADT_A39

When the MSH-15 value of an ADT^A41^ADT_A39 message is AL or ER or SU, an ACK^A41^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A41^ADT_A39 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A41^ADT_A39 message is AL or ER or SU, an ACK^A41^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A41^ADT_A39 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A41^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A41^ACK
NE (none)

ACK^A41^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A41^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A41^ACK

When the MSH-15 value of an ACK^A41^ACK message is AL or ER or SU, an ACK^A41^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A41^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A41^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Merge Visit - Visit Number (Event A42)

A merge has been done at the visit identifier level. That is, two PV1-19 - Visit Number identifiers have been merged into one.

An A42 event is used to signal a merge of records for a visit that was incorrectly filed under two different visit numbers. The "incorrect source visit number" identified in the MRG segment (MRG-5 - Prior Visit Number) is to be merged with the required "correct target visit number" identified in the PV1 segment (PV1-19 - Visit Number). The "incorrect source visit number" would then logically never be referenced in future transactions. It is noted that some systems may still physically keep this "incorrect identifier" for audit trail purposes or other reasons associated with database index implementation requirements.

An A42 (merge visit-visit number) event is intended for merging visit records without merging other identifiers. Any other identifiers that were previously associated with the "incorrect source visit number" are now associated with the "correct target visit number."

Each superior identifier associated with this visit identifier level should have the same value in the PID and MRG segments, or the MRG and PV1 segments, as appropriate.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.2, "Merge," for a discussion of issues related to the implementation of merge messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other fields change, it is recommended that the A08 (update patient information) event be used in addition

ADT^A42^ADT_A39: ADT Message
HL7 MessageStructure Table - ADT_A39
Segment Cardinality Must Implement Status
ADT_A39
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes
PV1 0..1

Original Mode Acknowledgement Choreography for ADT^A42^ADT_A39

Send Application Ack: ADT^A42^ADT_A39

Enhanced Mode Acknowledgement Choreography for ADT^A42^ADT_A39

When the MSH-15 value of an ADT^A42^ADT_A39 message is AL or ER or SU, an ACK^A42^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A42^ADT_A39 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A42^ADT_A39 message is AL or ER or SU, an ACK^A42^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A42^ADT_A39 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A42^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A42^ACK
NE (none)

ACK^A42^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A42^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A42^ACK

When the MSH-15 value of an ACK^A42^ACK message is AL or ER or SU, an ACK^A42^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A42^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A42^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Move Patient Information - Patient Identifier List (Event A43)

A move has been done at the patient identifier list level. Identifier to be moved in the PID-3 - Patient Identifier List and MRG-1 - Prior Patient Identifier List will have the same value. The "from" (incorrect source patient ID) and "to" (correct target patient ID) identifiers have different values. See A43 examples in section 5. The identifiers involved in identifying the patient to be moved (MRG-1 - Prior Patient Identifier List) may or may not have accounts, which may or may not have visits. In any case, all subordinate data sets associated with the identifier in MRG-1 - Prior Patient Identifier List are moved along with the identifier, from the "incorrect source patient ID" to the "correct target patient ID."

No identifiers subordinate to the identifier (account number, visit number, alternate visit ID) are valued in this message. Specification of these other subordinate identifiers is not required.

This event and the message syntax do, however, allow for the specification of a "new identifier" (PID-3 - Patient Identifier List), which may be application and/or implementation specific and therefore require site negotiation.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.3, "Move," for a discussion of issues related to the implementation of move messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message. However, all PID data associated with the "correct target identifier" (PID-3 - Patient Identifier List) are treated as updated information.

ADT^A43^ADT_A43: ADT Message
HL7 MessageStructure Table - ADT_A43
Segment Cardinality Must Implement Status
ADT_A43
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A43^ADT_A43

Send Application Ack: ADT^A43^ADT_A43

Enhanced Mode Acknowledgement Choreography for ADT^A43^ADT_A43

When the MSH-15 value of an ADT^A43^ADT_A43 message is AL or ER or SU, an ACK^A43^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A43^ADT_A43 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A43^ADT_A43 message is AL or ER or SU, an ACK^A43^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A43^ADT_A43 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A43^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A43^ACK
NE (none)

ACK^A43^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A43^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A43^ACK

When the MSH-15 value of an ACK^A43^ACK message is AL or ER or SU, an ACK^A43^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A43^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A43^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Move Account Information - Patient Account Number (Event A44)

A move has been done at the account identifier level. That is, a PID-18 - Patient Account Number associated with one PID-3 - Patient Identifier List has been moved to another patient identifier list.

An A44 event is used to signal a move of records identified by the MRG-3 - Prior Patient Account Number from the "incorrect source patient identifier list" identified in the MRG segment (MRG-1 - Prior Patient Identifier List) to the "correct target patient identifier list" identified in the PID segment (PID-3 - Patient Identifier List).

The account number involved in identifying the account to be moved (MRG-3 - Prior Patient Account Number) may or may not have visits. In any case, all subordinate data sets associated with the account number in MRG-3 - Prior Patient Account Number are moved along with the account number, from the "incorrect source" ID (MRG-1 - Prior Patient Identifier List) to the "correct target" ID (PID-3 - Patient Identifier List).

No identifiers subordinate to the account number (visit number, alternate visit ID) are valued in this message.

This event and the message syntax do, however, allow for the specification of a "new identifier" (PID-18 - Patient Account Number), which may be application and/or implementation-specific and therefore require site negotiation.

All of the identifiers superior to the account number should be valued in both the MRG segment and the PID segment. In this message, the PID-3 - Patient Identifier List is superior to the account number.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.3, "Move," for a discussion of issues related to the implementation of move messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message. However, all PID data associated with the "account number" are treated as updated information.

ADT^A44^ADT_A44: ADT Message
HL7 MessageStructure Table - ADT_A44
Segment Cardinality Must Implement Status
ADT_A44
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
ARV 0..* B
MRG 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A44^ADT_A44

Send Application Ack: ADT^A44^ADT_A44

Enhanced Mode Acknowledgement Choreography for ADT^A44^ADT_A44

When the MSH-15 value of an ADT^A44^ADT_A44 message is AL or ER or SU, an ACK^A44^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A44^ADT_A44 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A44^ADT_A44 message is AL or ER or SU, an ACK^A44^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A44^ADT_A44 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A44^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A44^ACK
NE (none)

ACK^A44^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A44^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A44^ACK

When the MSH-15 value of an ACK^A44^ACK message is AL or ER or SU, an ACK^A44^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A44^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A44^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Move Visit Information - Visit Number (Event A45)

A move has been done at the visit identifier level. That is, a PV1-19 - Visit Number or PV1-50 - Alternate Visit ID associated with one account identifier (PID-18 - Patient Account Number) has been moved to another account identifier.

An A45 event is used to signal a move of records identified by the MRG-5 - Prior Visit Number or the MRG-6 - Prior Alternate Visit ID from the "incorrect source account identifier" identified in the MRG segment (MRG-3 - Prior Patient Account Number) to the "correct target account identifier" identified in the PID segment (PID-18 - Patient Account Number).

This event and the message syntax do allow for the specification of "new identifiers" (PV1-19 - Visit Number, or PV1-50 - Alternate Visit ID), which may be application and/or implementation-specific and therefore require site negotiation.

All of the identifiers superior to the visit number or alternate visit ID should be valued in both the MRG segment and the PID segments. In this message, the account number and PID-3 - Patient Identifier List are superior to the visit number and alternate visit ID.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.3, "Move," for a discussion of issues related to the implementation of move messages. The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message. However, all PID data associated with the "correct target visit ID" are treated as updated information.

ADT^A45^ADT_A45: ADT Message
HL7 MessageStructure Table - ADT_A45
Segment Cardinality Must Implement Status
ADT_A45
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
MERGE_INFO 1..* Yes
MRG 1..1 Yes
PV1 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A45^ADT_A45

Send Application Ack: ADT^A45^ADT_A45

Enhanced Mode Acknowledgement Choreography for ADT^A45^ADT_A45

When the MSH-15 value of an ADT^A45^ADT_A45 message is AL or ER or SU, an ACK^A45^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A45^ADT_A45 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A45^ADT_A45 message is AL or ER or SU, an ACK^A45^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A45^ADT_A45 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A45^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A45^ACK
NE (none)

ACK^A45^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A45^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A45^ACK

When the MSH-15 value of an ACK^A45^ACK message is AL or ER or SU, an ACK^A45^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A45^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A45^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Patient ID (Event A46)

Attention: The Change Patient ID(A46) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A47 (Change patient Identifier List) event..

ADT/ACK - Change Patient Identifier List (Event A47)

A change has been done at the patient identifier list level. That is, a single PID-3 - patient identifier list value has been found to be incorrect and has been changed.

An A47 event is used to signal a change of an incorrectly assigned PID-3 - Patient Identifier List value. The "incorrect source identifier" value is stored in the MRG segment (MRG-1 - Prior Patient Identifier List) and is to be changed to the "correct target patient ID" value stored in the PID segment (PID-3 - Patient Identifier List).

The identifier involved in identifying the patient may or may not have accounts, which may or may not have visits. An A47 (change patient identifier list) event is intended for changing the value of the patient identifier list without affecting other subordinate identifiers. Any other subordinate identifiers that were previously associated with the "incorrect source identifier" are now associated with the "correct target identifier." Specification of these other subordinate identifiers is not required.

This event and the message syntax do, however, allow for the specification of "new subordinate identifiers" (in addition to the PID-3 - Patient Identifier List identifier). For those environments that may require changes to these other subordinate identifiers because of this A47 (change patient identifier list) event, it is required that the old and new identifiers be a "tightly coupled" pair.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.4, "Change identifier," for a discussion of issues related to the implementation of change messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A31 (update patient information) event be used in conjunction with this message.

ADT^A47^ADT_A44: ADT Message
HL7 MessageStructure Table - ADT_A44
Segment Cardinality Must Implement Status
ADT_A44
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
ARV 0..* B
MRG 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A47^ADT_A44

Send Application Ack: ADT^A47^ADT_A44

Enhanced Mode Acknowledgement Choreography for ADT^A47^ADT_A44

When the MSH-15 value of an ADT^A47^ADT_A44 message is AL or ER or SU, an ACK^A47^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A47^ADT_A44 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A47^ADT_A44 message is AL or ER or SU, an ACK^A47^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A47^ADT_A44 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A47^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A47^ACK
NE (none)

ACK^A47^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A47^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A47^ACK

When the MSH-15 value of an ACK^A47^ACK message is AL or ER or SU, an ACK^A47^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A47^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A47^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Alternate Patient ID (Event A48)

Attention: The Change Alternate Patient ID (A48) event was maintained for backward compatibility only as of v2.3.1 and withdrawn as of v2.7. From V 2.3.1 onwards, the reader is referred to the A37 (Change patient Identifier List) event.

ADT/ACK - Change Patient Account Number (Event A49)

A change has been done at the account identifier level. That is, a PID-18 - patient account number has been found to be incorrect and has been changed.

An A49 event is used to signal a change of an incorrectly assigned account number value. The "incorrect source account number" value is stored in the MRG segment (MRG-3 - Prior Patient Account Number) and is to be changed to the "correct target account number" value stored in the PID segment (PID-18 - Patient Account Number).

The patient account identifier involved in identifying the account may or may not have visits. An A49 (change patient account number) event is intended for changing the value of the account identifier without affecting other subordinate identifiers. Any other subordinate identifiers that were previously associated with the "incorrect source account number" are now associated with the "correct target account number". Specification of these other subordinate identifiers is not required.

This event and the message syntax do, however, allow for the specification of "new subordinate identifiers" (in addition to the PID-18 - Patient Account Number Identifier). For those environments that may require changes to these other subordinate identifiers because of this A49 (change patient account number) event, it is required that the old and new identifiers be a "tightly coupled" pair.

Each superior identifier associated with this account identifier level, i.e. the PID-3/MRG-1 should have the same value in both the PID and MRG segments.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.4, "Change identifier," for a discussion of issues related to the implementation of change messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message.

ADT^A49^ADT_A43: ADT Message
HL7 MessageStructure Table - ADT_A43
Segment Cardinality Must Implement Status
ADT_A43
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PATIENT 1..* Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A49^ADT_A43

Send Application Ack: ADT^A49^ADT_A43

Enhanced Mode Acknowledgement Choreography for ADT^A49^ADT_A43

When the MSH-15 value of an ADT^A49^ADT_A43 message is AL or ER or SU, an ACK^A49^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A49^ADT_A43 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A49^ADT_A43 message is AL or ER or SU, an ACK^A49^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A49^ADT_A43 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A49^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A49^ACK
NE (none)

ACK^A49^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A49^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A49^ACK

When the MSH-15 value of an ACK^A49^ACK message is AL or ER or SU, an ACK^A49^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A49^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A49^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Visit Number (Event A50)

A change has been done at the visit identifier level. That is, a PV1-19 - Visit Number has been found to be incorrect and has been changed.

An A50 event is used to signal a change of an incorrectly assigned visit number value. The "incorrect source visit number" value is stored in the MRG segment (MRG-5 - Prior Visit Number) and is to be changed to the "correct target visit number" value stored in the PV1 segment (PV1-19 - Visit Number).

Each superior identifier associated with this visit number identifier level, i.e. PID-3/MRG-1 and PID-18/MRG-3 should have the same value in both the PID and MRG segments.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.4, "Change identifier," for a discussion of issues related to the implementation of change messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message.

ADT^A50^ADT_A50: ADT Message
HL7 MessageStructure Table - ADT_A50
Segment Cardinality Must Implement Status
ADT_A50
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes
PV1 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A50^ADT_A50

Send Application Ack: ADT^A50^ADT_A50

Enhanced Mode Acknowledgement Choreography for ADT^A50^ADT_A50

When the MSH-15 value of an ADT^A50^ADT_A50 message is AL or ER or SU, an ACK^A50^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A50^ADT_A50 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A50^ADT_A50 message is AL or ER or SU, an ACK^A50^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A50^ADT_A50 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A50^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A50^ACK
NE (none)

ACK^A50^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A50^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A50^ACK

When the MSH-15 value of an ACK^A50^ACK message is AL or ER or SU, an ACK^A50^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A50^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A50^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Alternate Visit ID (Event A51)

A change has been done at the alternate visit identifier level. That is, a PV1-50 - Alternate Visit ID has been found to be incorrect and has been changed.

An A51 event is used to signal a change of an incorrectly assigned alternate visit ID value. The "incorrect source alternate visit ID" value is stored in the MRG segment (MRG-6 - Prior Alternate Visit ID) and is to be changed to the "correct target alternate visit ID" value stored in the PV1 segment (PV1-50 - Alternate Visit ID).

Each superior identifier associated with this alternate visit identifier level, i.e. PID-3/MRG-1 and PID-18/MRG-3 should have the same value in both the PID and MRG segments.

See sections 3.5.2, "Merging patient/person information," and 3.5.2.1.4, "Change identifier," for a discussion of issues related to the implementation of change messages.

The fields included when this message is sent should be the fields pertinent to communicate this event. When demographic data in other fields change, it is recommended that the A08 (update patient information) event be used in conjunction with this message.

ADT^A51^ADT_A50: ADT Message
HL7 MessageStructure Table - ADT_A50
Segment Cardinality Must Implement Status
ADT_A50
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
MRG 1..1 Yes
PV1 1..1 Yes

Original Mode Acknowledgement Choreography for ADT^A51^ADT_A50

Send Application Ack: ADT^A51^ADT_A50

Enhanced Mode Acknowledgement Choreography for ADT^A51^ADT_A50

When the MSH-15 value of an ADT^A51^ADT_A50 message is AL or ER or SU, an ACK^A51^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A51^ADT_A50 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A51^ADT_A50 message is AL or ER or SU, an ACK^A51^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A51^ADT_A50 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A51^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A51^ACK
NE (none)

ACK^A51^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A51^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A51^ACK

When the MSH-15 value of an ACK^A51^ACK message is AL or ER or SU, an ACK^A51^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A51^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A51^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK- Cancel Leave of Absence for a Patient (Event A52)

The A52 event is sent when an A21 (patient goes on "leave of absence") event is cancelled, either because of erroneous entry of the A21 event or because of a decision not to put the patient on "leave of absence" after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

As there is no specific field for the cancel LOA date/time, it is recommended field EVN-6 - Event Occurred contain the date/time the LOA was actually cancelled (but not necessarily recorded).

ADT^A52^ADT_A52: ADT Message
HL7 MessageStructure Table - ADT_A52
Segment Cardinality Must Implement Status
ADT_A52
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1

Original Mode Acknowledgement Choreography for ADT^A52^ADT_A52

Send Application Ack: ADT^A52^ADT_A52

Enhanced Mode Acknowledgement Choreography for ADT^A52^ADT_A52

When the MSH-15 value of an ADT^A52^ADT_A52 message is AL or ER or SU, an ACK^A52^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A52^ADT_A52 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A52^ADT_A52 message is AL or ER or SU, an ACK^A52^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A52^ADT_A52 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A52^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A52^ACK
NE (none)

ACK^A52^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A52^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A52^ACK

When the MSH-15 value of an ACK^A52^ACK message is AL or ER or SU, an ACK^A52^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A52^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A52^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Patient Returns from a Leave of Absence (Event A53)

The A53 event is sent when an A22 (patient returns from "leave of absence") event is cancelled, either because of erroneous entry of the A22 event or because of a decision not to return the patient from "leave of absence" after all.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

As there is no specific field for the cancel LOA date/time, it is recommended that field EVN-6 - Event Occurred contain the date/time the return from LOA was actually cancelled (but not necessarily recorded).

PV2-47 - Expected LOA Return Date/Time is used to communicate the date/time the patient is expected to return from LOA.

ADT^A53^ADT_A52: ADT Message
HL7 MessageStructure Table - ADT_A52
Segment Cardinality Must Implement Status
ADT_A52
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
PV1 1..1 Yes
PV2 0..1

Original Mode Acknowledgement Choreography for ADT^A53^ADT_A52

Send Application Ack: ADT^A53^ADT_A52

Enhanced Mode Acknowledgement Choreography for ADT^A53^ADT_A52

When the MSH-15 value of an ADT^A53^ADT_A52 message is AL or ER or SU, an ACK^A53^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A53^ADT_A52 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A53^ADT_A52 message is AL or ER or SU, an ACK^A53^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A53^ADT_A52 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A53^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A53^ACK
NE (none)

ACK^A53^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A53^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A53^ACK

When the MSH-15 value of an ACK^A53^ACK message is AL or ER or SU, an ACK^A53^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A53^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A53^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Attending Doctor (Event A54)

An A54 event is issued as a result of a change in the attending doctor responsible for the treatment of a patient.

When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

The new attending doctor of the patient should appear in the PV1-7 - Attending Doctor. For example, an A54 event can be used to notify the billing system that doctors' fees should be billed to the new doctor starting from the timestamp in the message.

The ROL - Role Segment was used in this message to communicate providers not specified elsewhere. As of v2.9, this has been deprecated in preference to the PRT segment as a more robust and flexible method of conveying participation. Hereafter, instructions for the PRT segment should apply, using the PRT segment. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments.

To communicate the begin and end date of the attending, referring, or admitting doctor, use the PRT-11 - Begin Date/Time and the PRT-12 - End Date/time in the PRT segment, with the applicable PRT-4 – Role of Participation. Refer to Chapter 7 for the definition of the PRT segment. Use "UP" in PRT-2 - Action Code.

ADT^A54^ADT_A54: ADT Message
HL7 MessageStructure Table - ADT_A54
Segment Cardinality Must Implement Status
ADT_A54
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
ROL 0..* B
PRT 0..*
PV1 1..1 Yes
PV2 0..1
ROL 0..* B
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A54^ADT_A54

Send Application Ack: ADT^A54^ADT_A54

Enhanced Mode Acknowledgement Choreography for ADT^A54^ADT_A54

When the MSH-15 value of an ADT^A54^ADT_A54 message is AL or ER or SU, an ACK^A54^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A54^ADT_A54 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A54^ADT_A54 message is AL or ER or SU, an ACK^A54^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A54^ADT_A54 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A54^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A54^ACK
NE (none)

ACK^A54^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A54^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A54^ACK

When the MSH-15 value of an ACK^A54^ACK message is AL or ER or SU, an ACK^A54^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A54^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A54^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Change Attending Doctor (Event A55)

The A55 event is sent when an A54 (change attending doctor) event is cancelled, either because of erroneous entry of the A54 event or because of a decision not to change the attending doctor after all. PV1-7 - Attending Doctor must contain the patient's doctor prior to the change of attending doctor.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.

ADT^A55^ADT_A54: ADT Message
HL7 MessageStructure Table - ADT_A54
Segment Cardinality Must Implement Status
ADT_A54
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
PD1 0..1
ROL 0..* B
PRT 0..*
PV1 1..1 Yes
PV2 0..1
ROL 0..* B
PRT 0..*

Original Mode Acknowledgement Choreography for ADT^A55^ADT_A54

Send Application Ack: ADT^A55^ADT_A54

Enhanced Mode Acknowledgement Choreography for ADT^A55^ADT_A54

When the MSH-15 value of an ADT^A55^ADT_A54 message is AL or ER or SU, an ACK^A55^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A55^ADT_A54 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A55^ADT_A54 message is AL or ER or SU, an ACK^A55^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A55^ADT_A54 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A55^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A55^ACK
NE (none)

ACK^A55^ACK: General Acknowledgment
HL7 MessageStructure Table - ACK
Segment Cardinality Must Implement Status
ACK
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..*

Original Mode Acknowledgement Choreography for ACK^A55^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A55^ACK

When the MSH-15 value of an ACK^A55^ACK message is AL or ER or SU, an ACK^A55^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A55^ACK message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A55^ACK
NE (none)
MSH-16 NE (none)

QBP/RSP - Get Person Demographics (QBP) and Response (RSP) (Events Q21 and K21)

This query/response is designed for interaction between a client system and an MPI (Master Person Index). The query consists of an identifier for a person, and the response of the demographics for that person.

Query Statement ID:

Q21

Query Type:

Query

Query Name:

Q21 Get Person Demographics

Query Trigger:

QBP^Q21^QBP_Q21

Query Mode:

Response Trigger:

RSP^K21^RSP_K21

Query Characteristics

Purpose:

Returns demographics information for a specified person


QBP^Q21^QBP_Q21: Query By Parameter
HL7 MessageStructure Table - QBP_Q21
Segment Cardinality Must Implement Status
QBP_Q21

Original Mode Acknowledgement Choreography for QBP^Q21^QBP_Q21

Send Application Ack: RSP^K21^RSP_K21

Enhanced Mode Acknowledgement Choreography for QBP^Q21^QBP_Q21

When the MSH-15 value of a QBP^Q21^QBP_Q21 message is AL or ER or SU, an ACK^Q21^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q21^QBP_Q21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q21^QBP_Q21 message is AL or ER or SU, a RSP^K21^RSP_K21 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q21^QBP_Q21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q21^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K21^RSP_K21
NE (none)

RSP^K21^RSP_K21: Segment Pattern Response
HL7 MessageStructure Table - RSP_K21
Segment Cardinality Must Implement Status
RSP_K21
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..1
QAK 1..1 Yes
QPD 1..1 Yes
QUERY_RESPONSE 0..1
PID 1..1 Yes
PD1 0..1
ARV 0..* B
NK1 0..*
QRI 1..1 Yes
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K21^RSP_K21

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K21^RSP_K21

When the MSH-15 value of a RSP^K21^RSP_K21 message is AL or ER or SU, an ACK^K21^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K21^RSP_K21 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^K21^ACK
NE (none)
MSH-16 NE (none)

Field Seq.

Field Name

Key/

Search

Sort

LEN

TYPE

Opt

Rep

Match Op

TBL

Segment Field Name

LOINC or HL7 Code/Domain

ElementName

1

PersonIdentifier

S

Y

250

CX

R

N

PID-3

Patient Identifier List

2

WhatDomainsReturned

CX

O

Y

PID-3

Patient Identifier List


Input Parameter

Comp. Name

DT

Description

PersonIdentifier ()

CX

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (IS)> ^ < assigning facility (HD)

The combination of values for PersonIdentifier.ID, and PersonIdentifier.AssigningAuthority, are intended to identify a person uniquely. The PersonIdentifier.IDTypeCode is useful for further filtering or to supply uniqueness in the event that the assigning authority may have more than one coding system.

Example: ...|112234^^^GOOD HEALTH HOSPITAL|...

Only one PID.3 may be specified, only 1 segment pattern will be returned.

PersonIdentifier.

ID

PID.3.1must be valued.

PersonIdentifier

Assigning Authority

PID.3.4 must be valued.

PersonIdentifier

Identifier type code

WhatDomainsReturned

CX

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (IS)> ^ < assigning facility (HD)

This parameter restricts the set of domains for which identifiers are returned in PID-3. If this is not specified, then identifiers for all known domains shall be returned. It does not restrict the search for the person.

Example: ...|^^^GOOD HEALTH HOSPITAL~^^^SOUTH LAB|...

Only the following components should be valued.

WhatDomainsReturned

Assigning Authority

PID.3.4 must be valued.

WhatDomainsReturned

Identifier type code


Following is an example of a Q21/K21 query/response pair of messages. First is the query:

MSH|^~VALUEamp;|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600||QBP^Q21^QBP_Q21|1|D|2.5

QPD|Q21^Get Person Demographics^HL7nnn|111069|112234^^^GOOD HEALTH HOSPITAL|^^^ GOOD HEALTH HOSPITAL~^^^SOUTH LAB|

RCP|I|

This query is asking for demographics for the person identified by the identifier 112234 from the assigning authority GOOD HEALTH HOSPITAL. With the demographics, we want identifiers returned for the person from the assigning authorities GOOD HEALTH HOSPITAL and SOUTH LAB. Here is a sample response:

MSH|^~VALUEamp;|HOSPMPI|HOSP|CLINREG|WESTCLIN|199912121135-0600||RSP^K21^RSP_K21|1|D|2.5|

MSA|AA|8699|

QAK|111069|OK|Q21^Get Person Demographics^HL7nnn|1|

QPD|Q21^Get Person Demographics^HL7nnn|111069|112234^^^GOOD HEALTH HOSPITAL|^^^ GOOD HEALTH HOSPITAL~^^^SOUTH LAB|

PID|||112234^^^GOOD HEALTH HOSPITAL~98223^^^SOUTH LAB||Everyman^Adam||19600614|M||C|2101 Webster # 106^^Oakland^CA^94612|

QRI|100|

QBP/RSP - Find Candidates (QBP) and Response (RSP) (Events Q22 and K22)

This query/response is designed for interaction between a client system and an MPI (Master Person Index). The query consists of a set of demographics for a person, and the response is the list of candidates considered by the MPI to match that set.

Each returned person, specified by a PID segment, can also have an optional QRI - Query Response Instance segment containing information about the quality of the match.

Query Statement ID:

Q22

Query Type:

Query

Query Name:

Q22 Find Candidates

Query Trigger:

QBP^Q22^QBP_Q21

Query Mode:

Response Trigger:

RSP^K22^RSP_K22

Query Characteristics

Purpose:

Returns list of candidates matching demographic data specified by the input parameters.


QBP^Q22^QBP_Q21: Query By Parameter
HL7 MessageStructure Table - QBP_Q21
Segment Cardinality Must Implement Status
QBP_Q21

Original Mode Acknowledgement Choreography for QBP^Q22^QBP_Q21

Send Application Ack: RSP^K22^RSP_K22

Enhanced Mode Acknowledgement Choreography for QBP^Q22^QBP_Q21

When the MSH-15 value of a QBP^Q22^QBP_Q21 message is AL or ER or SU, an ACK^Q22^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q22^QBP_Q21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q22^QBP_Q21 message is AL or ER or SU, a RSP^K22^RSP_K22 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q22^QBP_Q21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q22^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K22^RSP_K22
NE (none)

RSP^K22^RSP_K22: Segment Pattern Response
HL7 MessageStructure Table - RSP_K22
Segment Cardinality Must Implement Status
RSP_K22
MSH 1..1 Yes
SFT 0..*
UAC 0..1
MSA 1..1 Yes
ERR 0..1
QAK 1..1 Yes
QPD 1..1 Yes
QUERY_RESPONSE 0..*
PID 1..1 Yes
PD1 0..1
NK1 0..*
QRI 0..1
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K22^RSP_K22

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K22^RSP_K22

When the MSH-15 value of a RSP^K22^RSP_K22 message is AL or ER or SU, an ACK^K22^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K22^RSP_K22 message is NE, an immediate ack SHALL NOT be sent.

Never send an application ack in enhanced mode.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^K22^ACK
NE (none)
MSH-16 NE (none)

Field Seq.

Field Name

Key/

Search

Sort

LEN

TYPE

Opt

Rep

Match Op

TBL

Segment Field Name

LOINC or HL7 Code/Domain

ElementName

1

DemographicsFields

QIP

R

Y

2

SearchConfidenceThreshold

NM

O

N

3

AlgorithmName

ST

O

N

4

AlgorithmVersion

ST

O

N

5

AlgorithmDescription

ST

O

N

6

WhatDomainsReturned

CX

O

Y

PID-3

Patient Identifier List


Input Parameter

Comp. Name

DT

Description

DemographicsFields

QIP

Components: <segment field name (ST)> ^ <value1 (ST) & value2 (ST) & value3 (ST...>

Components may be any fields in the PID or PD1. If subcomponents of fields need to be specified, each subcomponent should be listed separately.

Example: ...|@PID.5.1^EVERYMAN~@PID.5.2^ADAM~@PID.8^M|...

SearchConfidenceThreshold

NM

Indicates the minimum match confidence for candidates to be returned for the query. The value instructs the queried system to return no records (PID segments) for persons whose "match weight" on the lookup was lower than the user-defined value.

Example: |80|

AlgorithmName

ST

Identifies the specific algorithm the queried system should use.

Example: |MATCHWARE|

AlgorithmVersion

ST

Identifies the specific algorithm version the queried system should use.

Example: |1.2|

AlgorithmDescription

ST

Description of the algorithm the queried system should use.

WhatDomainsReturned

CX

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (IS)> ^ < assigning facility (HD)

This parameter restricts the set of domains for which identifiers are returned in PID-3. If this is not specified, then identifiers for all known domains shall be returned. It does not restrict the search for persons.

Example: ...|^^^GOOD HEALTH HOSPITAL~^^^SOUTH LAB|...

Only the following components should be valued.

WhatDomainsReturned

Assigning Authority

PID.3.4 must be valued.

WhatDomainsReturned

Identifier type code


Following is an example of a Q22/K22 query/response pair of messages. First is the query:

MSH|^~VALUEamp;|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600||QBP^Q22^QBP_Q21|1|D|2.5

QPD|Q22^Find Candidates^HL7nnn|111069|@PID.5.1^EVERYMAN~@PID.5.2^ADAM~ @PID.8^M|80|MATCHWARE|1.2||^^^GOOD HEALTH HOSPITAL~^^^SOUTH LAB|

RCP|I|20^RD

This query is asking for a list of persons matching the name ADAM EVERYMAN with the gender Male. Candidates with a match level above 80 using the algorithm Matchware version 1.2 should be returned. The returned records should include identifiers for both the assigning authorities GOOD HEALTH HOSPITAL and SOUTH LAB. The RCP segment specifies that the number of matches should be limited to 20. Here is a sample response:

MSH|^~VALUEamp;|HOSPMPI|HOSP|CLINREG|WESTCLIN|200712121135-0600||RSP^K22^RSP_K22|1|D|2.5.1|

MSA|AA|8699|

QAK|111069|OK|Q22^Find Candidates^HL7nnnn|3|

QPD|Q22^Find Candidates^HL7nnn|111069|@PID.5.1^EVERYMAN~ @PID.5.2^ADAM~@PID.8^M|80|MATCHWARE|1.2||^^^GOOD HEALTH HOSPITAL~^^^SOUTH LAB|

PID|||66785^^^GOOD HEALTH HOSPITAL~99999^^^SOUTH LAB||Everyman^Adam||19630423|M||C|C^^Madison^WI^99999|

QRI|95||MATCHWARE 1.2|

PID|||87443^^^GOOD HEALTH HOSPITAL~651189^^^SOUTH LAB||Everyman^Adam||19470606|M||C|555-555-2004^^Madison^WI^99999|

QRI|90||MATCHWARE 1.2|

PID|||43266^^^GOOD HEALTH HOSPITAL~81209^^^SOUTH LAB||Everyman^Adam||19901210|M||C|4444 Home Street^^Lodi^WI^99999|

QRI|85||MATCHWARE 1.2|

Three candidates were returned. Notice the 3 at the end of the QAK segment signifying the number of matches. Each has a PID and QRI segment, and the QRI segment in each case gives a confidence factor for each of the candidates

QBP/RSP - Get Corresponding Identifiers (QBP) and Response (RSP) (Events Q23 and K23)

This query/response is designed for interaction between a client system and an MPI (Master Person Index). The query consists of an identifier for a person, and the response is a list of identifiers for that person from the domains specified.

Query Statement ID:

Q23