The Demo site for our new HL7 Version 2+ (plus) Standard
visit the hl7 website

Draft Website - For Review Purposes Only

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

Query Type:

Query

Query Name:

Q23 Get Corresponding Identifiers

Query Trigger:

QBP^Q23^QBP_Q21

Query Mode:

Response Trigger:

RSP^K23^RSP_K23

Query Characteristics

Purpose:

Returns list of identifiers from the specified domains, given an identifier from a given domain.


QBP^Q23^QBP_Q21: Query By Parameter
HL7 MessageStructure Table - QBP_Q21
Segment Cardinality Must Implement Status
QBP_Q21

Original Mode Acknowledgement Choreography for QBP^Q23^QBP_Q21

Send Application Ack: RSP^K23^RSP_K23

Enhanced Mode Acknowledgement Choreography for QBP^Q23^QBP_Q21

When the MSH-15 value of a QBP^Q23^QBP_Q21 message is AL or ER or SU, an ACK^Q23^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q23^QBP_Q21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q23^QBP_Q21 message is AL or ER or SU, a RSP^K23^RSP_K23 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q23^QBP_Q21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q23^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K23^RSP_K23
NE (none)

RSP^K23^RSP_K23: Segment Pattern Response
HL7 MessageStructure Table - RSP_K23
Segment Cardinality Must Implement Status
RSP_K23
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..1
PID 1..1 Yes
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K23^RSP_K23

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K23^RSP_K23

When the MSH-15 value of a RSP^K23^RSP_K23 message is AL or ER or SU, an ACK^K23^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K23^RSP_K23 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^K23^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

Element Name

1

PersonIdentifier

S

Y

20

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 Q23/K23 query/response pair of messages. First is the query:

MSH|^~VALUEamp;|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600||QBP^Q23^QBP_Q21|1|D|2.5

QPD|Q23^Get Corresponding IDs^HL7nnnn|111069|112234^^^GOOD HEALTH HOSPITAL|^^^WEST CLINIC~^^^SOUTH LAB|

RCP||I|

This query is asking for identifiers from WEST CLINIC and SOUTH LAB for the person identified with the identifier 112234 from the assigning authority GOOD HEALTH HOSPITAL. Here is a sample response:

MSH|^~VALUEamp;|HOSPMPI|HOSP|CLINREG|WESTCLIN|199912121135-0600||RSP^K23^RSP_K23|1|D|2.5|

MSA|AA|8699|

QAK|111069|OK|Q23^Get Corresponding IDs^HL7nnnn|1|

QPD|Q23^Get Corresponding IDs^HL7nnn|111069|112234^^^GOOD HEALTH HOSPITAL|^^^WEST CLINIC~^^^SOUTH LAB|

PID|||56321A^^^WEST CLINIC~66532^^^SOUTH LAB||EVERYMAN^ADAM||19630423|M||C|N2378 South Street^^Madison^WI^53711|

Note: that the identifiers returned do not include the GOOD HEALTH HOSPITAL identifier, as it was not specified in the list of WhatDomainsReturned.

QBP/RSP - Allocate Identifiers (QBP) and Response (RSP) (Events Q24 and K24)

This query/response is designed for interaction between a client system and an MPI (Master Person Index). The query consists of domains in which identifiers should be allocated. The response is new identifiers in those domains.

This event is not meant to cause the creation of a new person record, or to bind identifiers to a particular person record. The events A28 - Add person information and A24 - Link patient information should be used for that purpose. This event is meant to simply reserve the use of identifiers.

Query Statement ID:

Q24

Query Type:

Query

Query Name:

Allocate Identifiers

Query Trigger:

QBP^Q24^QBP_Q21

Query Mode:

Response Trigger:

RSP^K24^RSP_K23

Query Characteristics

Purpose:

Request that an MPI allocate an identifier for a given domain.


QBP^Q24^QBP_Q21: Query By Parameter
HL7 MessageStructure Table - QBP_Q21
Segment Cardinality Must Implement Status
QBP_Q21

Original Mode Acknowledgement Choreography for QBP^Q24^QBP_Q21

Send Application Ack: RSP^K24^RSP_K23

Enhanced Mode Acknowledgement Choreography for QBP^Q24^QBP_Q21

When the MSH-15 value of a QBP^Q24^QBP_Q21 message is AL or ER or SU, an ACK^Q24^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q24^QBP_Q21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q24^QBP_Q21 message is AL or ER or SU, a RSP^K24^RSP_K23 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q24^QBP_Q21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q24^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K24^RSP_K23
NE (none)

RSP^K24^RSP_K23: Segment Pattern Response
HL7 MessageStructure Table - RSP_K23
Segment Cardinality Must Implement Status
RSP_K23
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..1
PID 1..1 Yes
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K24^RSP_K23

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K24^RSP_K23

When the MSH-15 value of a RSP^K24^RSP_K23 message is AL or ER or SU, an ACK^K24^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K24^RSP_K23 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^K24^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

Element Name

1

DomainToAllocateIn

CX

R

Y

PID-3

Patient Identifier


Input Parameter

Comp. Name

DT

Description

DomainToAllocateIn ()

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 specifies in which domains to allocate identifiers.

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

Only the following components should be valued.

DomainToAllocateIn

Assigning Authority

PID.3.4 must be valued.

DomainToAllocateIn

Identifier type code


Following is an example of a Q24/K24 query/response pair of messages. First is the query:

MSH|^~VALUEamp;|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600||QBP^Q24^QBP_Q21|1|D|2.5

QPD|Q24^Allocate Identifiers^HL7nnnn|111069|^^^WEST CLINIC~^^^SOUTH LAB|

RCP||I|

This query is asking for identifiers from WEST CLINIC and SOUTH LAB to be reserved and returned. Here is a sample response:

MSH|^~VALUEamp;|HOSPMPI|HOSP|CLINREG|WESTCLIN|199912121135-0600||RSP^K24^RSP_K23|1|D|2.5|

MSA|AA|8699|

QAK|111069|OK|Q24^Allocate Identifiers^HL7nnnn|1|

QPD|A56^Allocate Identifiers^HL7nnn|111069|^^^WEST CLINIC~^^^SOUTH LAB|

PID|||624335A^^^WEST CLINIC~564325^^^SOUTH LAB|

Note: The PID segment returned does not include any person demographics as the identifiers are not yet "attached" to any person record. Presumably the querying system would eventually send back to the MPI an A28 Add person information to create a person record for the identifiers or an A24 Link patient information to link the identifiers to an existing person record.

ADT/ACK - Update Adverse Reaction Information (Event A60)

This trigger event is used when person/patient allergy information has changed. It is used in conjunction with a new allergy segment, the IAM - Patient Allergy Information Segment-Unique Identifier, which supports Action code/unique identifier mode update for repeating segments as defined in 2.10.4, "Protocol for interpreting repeating segments or segment groups in an update Message."

ADT^A60^ADT_A60: ADT Message
HL7 MessageStructure Table - ADT_A60
Segment Cardinality Must Implement Status
ADT_A60
MSH 1..1 Yes
ARV 0..*
SFT 0..*
UAC 0..1
EVN 1..1 Yes
PID 1..1 Yes
ARV 0..* B
VISIT_GROUP 0..1
PV1 1..1 Yes
PV2 0..1
ARV 0..* B
ADVERSE_REACTION_GROUP 0..*
IAM 1..1 Yes
NTE 0..*
IAR 0..*

Original Mode Acknowledgement Choreography for ADT^A60^ADT_A60

Send Application Ack: ADT^A60^ADT_A60

Enhanced Mode Acknowledgement Choreography for ADT^A60^ADT_A60

When the MSH-15 value of an ADT^A60^ADT_A60 message is AL or ER or SU, an ACK^A60^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A60^ADT_A60 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A60^ADT_A60 message is AL or ER or SU, an ACK^A60^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A60^ADT_A60 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A60^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A60^ACK
NE (none)

ACK^A60^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^A60^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A60^ACK

When the MSH-15 value of an ACK^A60^ACK message is AL or ER or SU, an ACK^A60^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A60^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^A60^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Change Consulting Doctor (Event A61)

An A61 event is used as a result of a change in the consulting physician(s) 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. If the Patient Administration system allows demographics to change at the same time (for example an address change), two messages (an A61 followed by an A08) should be sent.

The new consulting doctor(s) of the patient should appear in the PV1-9 - Consulting Doctor and may appear in a role segment per new consulting physician.

If a consulting doctor stops being consulting doctor for this patient-visit, the end date/time can be sent in the PRT-12 - End Date/Time.

For example, an A61 event can be used to notify the billing system that doctors' fees for being a consulting doctor, should be billed to the new doctor(s) starting from the timestamp in the message.

It is recommended that field EVN-6 - Event Occurred contains the date/time the event actually occurred to the 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 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 - Participation Begin Date/Time and the PRT-12 - Participation End Date/Time in the PRT segment, with the applicable PRT-4 - PArticipation. Refer to Chapter 7 for the definition of the PRT segment.

ADT^A61^ADT_A61: ADT Message
HL7 MessageStructure Table - ADT_A61
Segment Cardinality Must Implement Status
ADT_A61
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
ROL 0..* B
PRT 0..*
PV2 0..1

Original Mode Acknowledgement Choreography for ADT^A61^ADT_A61

Send Application Ack: ADT^A61^ADT_A61

Enhanced Mode Acknowledgement Choreography for ADT^A61^ADT_A61

When the MSH-15 value of an ADT^A61^ADT_A61 message is AL or ER or SU, an ACK^A61^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A61^ADT_A61 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A61^ADT_A61 message is AL or ER or SU, an ACK^A61^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A61^ADT_A61 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A61^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A61^ACK
NE (none)

ACK^A61^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^A61^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A61^ACK

When the MSH-15 value of an ACK^A61^ACK message is AL or ER or SU, an ACK^A61^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A61^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^A61^ACK
NE (none)
MSH-16 NE (none)

ADT/ACK - Cancel Change Consulting Doctor (Event A62)

The A62 event is sent when an A61 (change consulting doctor) event is cancelled, either because of erroneous entry of the A61 event or because of a decision not to change the consulting physician(s) after all. PV1-9 - Consulting Doctor must show the patient's doctor prior to the change being cancelled.

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 is used.

ADT^A62^ADT_A61: ADT Message
HL7 MessageStructure Table - ADT_A61
Segment Cardinality Must Implement Status
ADT_A61
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
ROL 0..* B
PRT 0..*
PV2 0..1

Original Mode Acknowledgement Choreography for ADT^A62^ADT_A61

Send Application Ack: ADT^A62^ADT_A61

Enhanced Mode Acknowledgement Choreography for ADT^A62^ADT_A61

When the MSH-15 value of an ADT^A62^ADT_A61 message is AL or ER or SU, an ACK^A62^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ADT^A62^ADT_A61 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of an ADT^A62^ADT_A61 message is AL or ER or SU, an ACK^A62^ACK message SHALL be sent as an application ack.

When the MSH-16 value of an ADT^A62^ADT_A61 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^A62^ACK
NE (none)
MSH-16 AL, ER, SU application ack: ACK^A62^ACK
NE (none)

ACK^A62^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^A62^ACK

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for ACK^A62^ACK

When the MSH-15 value of an ACK^A62^ACK message is AL or ER or SU, an ACK^A62^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of an ACK^A62^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^A62^ACK
NE (none)
MSH-16 NE (none)

QBP/RSP - Find Candidates including Visit Information (QBP) and Response (RSP) (Events Q32 and K32 )

This query/response is designed for interaction between a client system and an MPI (Master Person Index). The query consists of a set of demographic and/or visit attribute values 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 and by a PV1 segment containing information about the current visit, can also have an optional QRI - Query Response Instance segment containing information about the quality of the match.

Query Statement ID:

Q32

Query Type:

Query

Query Name:

Q32 Find Candidates with Visit Information

Query Trigger:

QBP^Q32^QBP_Q21

Query Mode:

Response Trigger:

RSP^K32^RSP_K25

Query Characteristics

Purpose:

Returns list of candidates matching demographic and/or visit data specified by the input parameters.


QBP^Q32^QBP_Q21: Query By Parameter
HL7 MessageStructure Table - QBP_Q21
Segment Cardinality Must Implement Status
QBP_Q21

Original Mode Acknowledgement Choreography for QBP^Q32^QBP_Q21

Send Application Ack: RSP^K32^RSP_K32

Enhanced Mode Acknowledgement Choreography for QBP^Q32^QBP_Q21

When the MSH-15 value of a QBP^Q32^QBP_Q21 message is AL or ER or SU, an ACK^Q32^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a QBP^Q32^QBP_Q21 message is NE, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a QBP^Q32^QBP_Q21 message is AL or ER or SU, a RSP^K32^RSP_K32 message SHALL be sent as an application ack.

When the MSH-16 value of a QBP^Q32^QBP_Q21 message is NE, an application ack SHALL NOT be sent.

Field Value Send Response
MSH-15 AL, ER, SU immediate ack: ACK^Q32^ACK
NE (none)
MSH-16 AL, ER, SU application ack: RSP^K32^RSP_K32
NE (none)

RSP^K32^RSP_K32: Segment Pattern Response
HL7 MessageStructure Table - RSP_K32
Segment Cardinality Must Implement Status
RSP_K32
MSH 1..1 Yes
SFT 0..*
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..*
PV1 1..1 Yes
PV2 0..1
QRI 0..1
DSC 0..1

Original Mode Acknowledgement Choreography for RSP^K32^RSP_K32

Send An Acknowlegment is never sent in original mode.

Enhanced Mode Acknowledgement Choreography for RSP^K32^RSP_K32

When the MSH-15 value of a RSP^K32^RSP_K32 message is AL or ER or SU, an ACK^K32^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a RSP^K32^RSP_K32 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^K32^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

Demographics / Visit Fields

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

Demographics/VisitFields

QIP

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

Components may be any fields in the PID, PD1, PV1 and/or PV2. If subcomponents of fields need to be specified, each subcomponent should be listed separately.

Example: ...|@PID.5.1^SMITH~@PV1.3.2^389~...

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: ...|^^^METRO 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 Q25/K25 query/response pair of messages. First is the query:

MSH|^&~\|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600||QBP^Q25^QBP_Q21|8702|D|2.6

QPD|Q25^Find Candidates Including Visit Information^HL70471|111069|@PID.5.1^SMITH~@PV1.3.2^389 |80|MATCHWARE|1.2||^^^METRO HOSPITAL

RCP||I|20^RD

This query is asking for a list of persons matching the name SMITH who are recorded as being in Room 389. Candidates with a match level above 80 using the algorithm Matchware version 1.2 should be returned. The returned records should include identifiers for assigning authority METRO HOSPITAL. The RCP segment specifies that the number of matches should be limited to 20. Here is a sample response:

MSH|^&~\|HOSPMPI|HOSP|CLINREG|WESTCLIN|200412121135-0600||RSP^K25^RSP_K25|H352357509|D|2.6

MSA|AA|8702

QAK|111069|OK|Q25^Find Candidates Including Visit Information^HL70471|1

QPD|Q25^Find Candidates Including Visit Information^HL70471|111069|@PID.5.1^SMITH~ @PID.5.2^JOHN~@PID.8^M|80|MATCHWARE|1.2||^^^METRO HOSPITAL

PID|||66785^^^METRO HOSPITAL||Smith^John||19630423|M||C|N2378 South Street^^Madison^WI^53711

PV1||I|W^389^1^METRO HOSPITAL^^^^3||||12345^MORGAN^REX^J^^^MD^0010^METRO HOSPITAL^L||67890^GRAINGER^LUCY^X^^^MD^0010^METRO HOSPITAL^L|MED|||||A0||13579^POTTER^SHERMAN^T^^^MD^0010^METRO HOSPITAL^L

QRI|95||MATCHWARE 1.2

One candidate was returned. Notice the 1 at the end of the QAK segment signifying the number of matches. The group of segments includes a PID, PV1, and QRI segment; the QRI segment gives a confidence factor for the candidate.

MESSAGE SEGMENTS

EVN - Event Type Segment

The EVN segment is used to communicate necessary trigger event information to receiving applications. Valid event types for all chapters are contained in HL7 Table 0003 - Event Type.

HL7 Attribute Table - EVN - Event Type Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
EVN
1 00099 Event Type Code SHALL NOT W [0..0]
2 00100 Recorded Date/Time SHALL [1..1] DTM
3 00101 Date/Time Planned Event [0..1] DTM
4 00102 Event Reason Code [0..1] CWE
5 00103 Operator ID [0..*] XCN
6 01278 Event Occurred [0..1] DTM
7 01534 Event Facility [0..1] HD

EVN-1: Event Type Code

Attention: The EVN-1 field was retained for backward compatibilty only as of v2.5 and the detail was withdrawn and removed from the standard as of v2.7.

EVN-2: Recorded Date/Time (DTM) 00100

Definition: Most systems will default to the system date/time when the transaction was entered, but they should also permit an override.

EVN-3: Date/Time Planned Event (DTM) 00101

Definition: This field contains the date/time that the event is planned. We recommend that PV2-8 - Expected Admit Date/Time, PV2-9 - Expected Discharge Date/Time or PV2-47 - Expected LOA Return date/time be used whenever possible.

EVN-4: Event Reason Code (CWE) 00102

Definition: This field contains the reason for this event. Refer to User-defined Table 0062 - Event Reason in Chapter 2C, Code Tables, for suggested values.

EVN-5: Operator ID (XCN) 00103

Definition: This field identifies the individual responsible for triggering the event. Refer to User-defined Table 0188 - Operator ID in Chapter 2C, Code Tables, for suggested values.

EVN-6: Event Occurred (DTM) 01278

Definition: This field contains the date/time that the event actually occurred. For example, on a transfer (A02 transfer a patient), this field would contain the date/time the patient was actually transferred. On a cancellation event, this field should contain the date/time that the event being cancelled occurred.

EVN-7: Event Facility (HD) 01534

Definition: This field identifies the actual facility where the event occurred as differentiated from the sending facility (MSH-4). It would be the facility at which the Operator (EVN-5) has entered the event.

Use Case: System A is where the patient is originally registered. This registration message is sent to an MPI, System B. The MPI needs to broadcast the event of this update and would become the sending facility. This new field would allow for retention of knowledge of the originating facility where the event occurred. The MPI could be the assigning authority for the ID number as well which means that it is performing the function of assigning authority for the facility originating the event.

PID - Patient Identification Segment

The PID segment is used by all applications as the primary means of communicating patient identification information. This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently.

It should be noted that from V2.4 onwards the demographics of animals can also be sent in the PID segment (see PID-35 to PID-38).

The assigning authority, the fourth component of the patient identifiers, is a HD data type that is uniquely associated with the assigning authority that originally assigned the number. A given institution, or group of intercommunicating institutions, should establish a list of assigning authorities that may be potential assignors of patient identification (and other important identification) numbers. The list will be one of the institution's master dictionary lists. Since third parties (other than the assignors of patient identification numbers) may send or receive HL7 messages containing patient identification numbers, the assigning authority in the patient identification numbers may not be the same as the sending and receiving systems identified in the MSH. The assigning authority must be unique across applications at a given site. This field is required in HL7 implementations that have more than a single Patient Administration application assigning such numbers. The assigning authority and identifier type codes are strongly recommended for all CX data types.

With HL7 V2.3, the nomenclature for the fourth component of the patient identifiers was changed from "assigning facility ID" to "assigning authority". While the identifier may be unique to a given healthcare facility (for example, a medical record assigned by facility A in Hospital XYZ), the identifier might also be assigned at a system level (for example a corporate person index or enterprise number spanning multiple facilities) or by a government entity, for example a nationally assigned unique individual identifier. While a facility is usually an assigning authority, not all assigning authorities are facilities. Therefore, the fourth component is referred to as an assigning authority, but retains backward compatibility using the construct of the HD data type (see the note in chapter 2). Additionally, CX data types support the use of assigning facility (HD) as the sixth component.

HL7 Attribute Table - PID - Patient Identification Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
PID
1 00104 Set ID - PID [0..1] [1..4] SI
2 00105 Patient ID SHALL NOT W [0..0]
3 00106 Patient Identifier List SHALL [1..*] CX
4 00107 Alternate Patient ID - PID SHALL NOT W [0..0]
5 00108 Patient Name SHALL [1..*] XPN
6 00109 Mother's Maiden Name [0..*] XPN
7 00110 Date/Time of Birth [0..1] DTM
8 00111 Administrative Sex [0..1] CWE
9 00112 Patient Alias SHALL NOT W [0..0]
10 00113 Race [0..*] CWE
11 00114 Patient Address [0..*] XAD
12 00115 County Code SHALL NOT W [0..0]
13 00116 Phone Number - Home SHALL NOT W [0..0] XTN
14 00117 Phone Number - Business SHALL NOT W [0..0] XTN
15 00118 Primary Language [0..1] CWE
16 00119 Marital Status [0..1] CWE
17 00120 Religion [0..1] CWE
18 00121 Patient Account Number [0..1] CX
19 00122 SSN Number - Patient SHALL NOT W [0..0]
20 00123 Driver's License Number - Patient SHALL NOT W [0..0]
21 00124 Mother's Identifier [0..*] CX
22 00125 Ethnic Group [0..*] CWE
23 00126 Birth Place # [0..1] 250 ST
24 00127 Multiple Birth Indicator [0..1] [1..1] ID
25 00128 Birth Order = [0..1] 2 NM
26 00129 Citizenship [0..*] CWE
27 00130 Veterans Military Status [0..1] CWE
28 00739 Nationality SHALL NOT W [0..0] CWE
29 00740 Patient Death Date and Time [0..1] DTM
30 00741 Patient Death Indicator [0..1] [1..1] ID
31 01535 Identity Unknown Indicator [0..1] [1..1] ID
32 01536 Identity Reliability Code [0..*] CWE
33 01537 Last Update Date/Time [0..1] DTM
34 01538 Last Update Facility [0..1] HD
35 01539 Taxonomic Classification Code [0..1] CWE
36 01540 Breed Code B [0..1] CWE
37 01541 Strain = [0..1] 80 ST
38 01542 Production Class Code [0..2] CWE
39 01840 Tribal Citizenship [0..*] CWE
40 02289 Patient Telecommunication Information [0..*] XTN

PID-1: Set ID - PID (SI) 00104

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

PID-2: Patient ID

Attention: The PID-2 field was retained for backward compatibility only as of v2.3.1 and was withdrawn and removed from this message structure as of v2.7. It is recommended to use PID-3 - Patient Identifier List for all patient identifiers.

PID-3: Patient Identifier List (CX) 00106

(Definition from PID.3 in Ch. 3)

Definition: This field contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient (e.g., medical record number, billing number, birth registry, national unique individual identifier, etc.). In Canada, the Canadian Provincial Healthcare Number should be sent in this field. The arbitrary term of "internal ID" has been removed from the name of this field for clarity.

(Definition from SCD.33 in Ch. 17)

Definition: The unique identifier associating the patient with the supplies being sterilized.

PID-4: Alternate Patient ID - PID

Attention: The PID-4 field was retained for backward compatibility only as of v2.3.1 and was withdrawn and removed from this message structure as of v2.7. It is recommended to use PID-3 - Patient Identifier List for all patient identifiers.

PID-5: Patient Name (XPN) 00108

Definition: This field contains one or more of the names of the patient. The XPN.7 Name Type Code, and not the order, conveys how the name should be interpreted. As of v2.7, Name Type Code is Required. Refer to HL7 Table 0200 - Name Type in Chaper 2C, Code Tables, for valid values. Specification of meaning based on sequence is deprecated.

In addition to allowing repetition of this field for transmitting multiple names with different Name Type Codes, repetition also allows for representing the same name in different character sets based on the value in XPN.8 Name Representation Code.

Multiple given names and/or initials are separated by spaces.

For animals, if a Name Type of "R" is used, use "Name Context" to identify the authority with which the animal's name is registered.

PID-6: Mother's Maiden Name (XPN) 00109

(Definition from PID.6 in Ch. 3)

Definition: This field contains the family name under which the mother was born (i.e., before marriage). It is used to distinguish between patients with the same last name.

(Definition from NK1.26 in Ch. 3)

Definition: This field indicates the maiden name of the next of kin/associated party's mother.

(Definition from GT1.42 in Ch. 6)

Definition: This field indicates the guarantor's mother's maiden name.

(Definition from IN2.40 in Ch. 6)

Definition: This field indicates the insured's mother's maiden name.

PID-7: Date/Time of Birth (DTM) 00110

(Definition from PID.7 in Ch. 3)

Definition: This field contains the patient's date and time of birth.

(Definition from NK1.16 in Ch. 3)

Definition: This field contains the next of kin/associated party's birth date and time.

(Definition from STF.6 in Ch. 15)

Definition: This field contains a staff member's date and time of birth.

PID-8: Administrative Sex (CWE) 00111

(Definition from PID.8 in Ch. 3)

Definition: This field contains the patient's sex. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.15 in Ch. 3)

Definition: This field contains the next of kin/associated party's sex. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.5 in Ch. 15)

Definition: This field contains the staff person's sex. Refer to User-defined Table 0001 – Administrative Sex for suggested values.

PID-9: Patient Alias

Attention: The PID-9 field was retained for backward compatibility only as of v2.4 and was withdrawn and removed from this message structure as of v2.7. it is recommended to use PID-5 - Patient Name for all patient names.

PID-10: Race (CWE) 00113

(Definition from PID.10 in Ch. 3)

Definition: This field refers to the patient's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from NK1.35 in Ch. 3)

Definition: This field identifies the race of the next of kin/associated party. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from IN2.71 in Ch. 6)

Definition: Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from STF.27 in Ch. 15)

Definition: This field refers to the person's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

PID-11: Patient Address (XAD) 00114

Definition: This field contains the address of the patient. Multiple addresses for the same person may be sent. As of v2.7 the "primary mailing address" constraint as the first sequence has been removed...

PID-12: County Code

Attention: The PID-12 field was retained for backward compatibility only as of v2.3 and was withdrawn and removed from this message structure as of v2.7. The county can now be supported in the county/parish code component of the XAD data type (PID-11 - Patient Address).

PID-13: Phone Number - Home

Attention: The PID13 field has been retained for backward compatibility as of v 2.7 and withdrawn as of v 2.9. The reader is referrred to section 3.4.2.40, PID-40 – Patient Telecommunication Information instead, which replaces PID-13 – Phone Number - Home with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type).

This field contains the patient's personal phone numbers. All personal phone numbers for the patient are sent in the following sequence. The first sequence is considered the primary number (for backward compatibility). If the primary number is not sent, then a repeat delimiter is sent in the first sequence. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type in Chapter 2C, Code Tables, for valid values.

PID-14: Phone Number - Business

Attention: The PID-14 field has been retained for backward compatibility only as of v2.7 and withdrawn as of v 2.9.. The reader is referred to section 3.4.2.40, PID-40 – Patient Telecommunication Information instead, which replaces PID-14 – Phone Number - Business with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type).

This field contains the patient's business telephone numbers. All business numbers for the patient are sent in the following sequence. The first sequence is considered the patient's primary business phone number (for backward compatibility). If the primary business phone number is not sent, then a repeat delimiter must be sent in the first sequence. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type in Chapter 2C, Code Tables, for valid values.

PID-15: Primary Language (CWE) 00118

(Definition from PID.15 in Ch. 3)

Definition: This field contains the patient's primary language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language within Chapter 2C, Code Tables.

(Definition from NK1.20 in Ch. 3)

Definition: This field identifies the next of kin/associated party's primary speaking language. HL7 recommends using ISO 639 as the suggested values in User-defined Table 0296 - Language in Chapter 2C, Code Tables.

(Definition from GT1.36 in Ch. 6)

Definition: This field identifies the guarantor's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.

(Definition from IN2.34 in Ch. 6)

Definition: This field identifies the insured's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.

PID-16: Marital Status (CWE) 00119

(Definition from PID.16 in Ch. 3)

Definition: This field contains the patient's marital (civil) status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.14 in Ch. 3)

Definition: This field contains the next of kin/associated party's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.43 in Ch. 6)

Definition: This field contains the insured's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.17 in Ch. 15)

Definition: This field contains the staff member's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values. Same values as those for PID-16 Marital Status.

PID-17: Religion (CWE) 00120

(Definition from PID.17 in Ch. 3)

Definition: This field contains the patient's religion. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.25 in Ch. 3)

Definition: This field indicates the type of religion practiced by the next of kin/associated party. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.41 in Ch. 6)

Definition: This field indicates the type of religion practiced by the guarantor. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.39 in Ch. 6)

Definition: This field indicates the type of religion practiced by the insured. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.40 in Ch. 15)

Definition: This field contains the staff member's religion. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

PID-18: Patient Account Number (CX) 00121

Definition: This field contains the patient account number assigned by accounting to which all charges, payments, etc., are recorded. It is used to identify the patient's account. Refer to HL7 Table 0061 - Check Digit Scheme in Chapter 2C, Code Tables, for valid values.

PID-19: SSN Number - Patient

Attention: The PID-19 field was retained for backward compatibility only as of v 2.3.1 and was withdrawn and removed from this message structure as of v 2.7. It is recommended to use PID-3 - Patient Identifier List for all patient identifiers.

PID-20: Driver's License Number - Patient

Attention: The PID-20 field was retained for backward compatibility only as of v 2.5 and was withdrawn and removed from this message structure as of v 2.7. It is recommended to use PID-3 - Patient Identifier List for all patient identifiers.

PID-21: Mother's Identifier (CX) 00124

Definition: This field is used, for example, as a link field for newborns. Typically a patient ID or account number may be used. This field can contain multiple identifiers for the same mother. Refer to HL7 Table 0061 - Check Digit Scheme in Chapter 2C, Code Tables, for valid values.

PID-22: Ethnic Group (CWE) 00125

(Definition from PID.22 in Ch. 3)

Definition: This field further defines the patient's ancestry. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from NK1.28 in Ch. 3)

Definition: This field contains the next of kin/associated party's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from GT1.44 in Ch. 6)

Definition: This field contains the guarantor's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from IN2.42 in Ch. 6)

Definition: This field indicates the insured's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from STF.28 in Ch. 15)

  • Definition: This field further defines the person's ancestry. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second couplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the United States, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

PID-23: Birth Place (ST) 00126

Definition: This field indicates the location of the patient's birth, for example "St. Francis Community Hospital of Lower South Side". The actual address is reported in PID-11 with an identifier of "N".

PID-24: Multiple Birth Indicator (ID) 00127

Definition: This field indicates whether the patient was part of a multiple birth. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient was part of a multiple birth

  • N    the patient was a single birth

PID-25: Birth Order (NM) 00128

Definition: When a patient was part of a multiple birth, a value (number) indicating the patient's birth order is entered in this field.

PID-26: Citizenship (CWE) 00129

(Definition from PID.26 in Ch. 3)

This field contains the information related to a person's country citizenship. For country citizenship HL7 recommends using ISO table 3166. For a local definition, User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables, should be used.

This field repeats since persons can be citizens of more than one country. The Name of Coding System component(s) of the CWE datatype should be used to identify the table from which citizenship membership is drawn.

In the Netherlands, this field is used for "Nationaliteit".

(Definition from NK1.19 in Ch. 3)

Definition: This field contains the code to identify the next of kin/associated party's citizenship. HL7 recommends using ISO 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.

(Definition from GT1.35 in Ch. 6)

Definition: This field contains the code to identify the guarantor's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.

(Definition from IN2.33 in Ch. 6)

Definition: This field contains the code that identifies the insured's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship defined in Chapter 2C, Code Tables.

(Definition from STF.30 in Ch. 15)

Definition: This field contains the staff person's current country of citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship (in Chapter 2C, Code Tables).

PID-27: Veterans Military Status (CWE) 00130

Definition: This field contains the military status assigned to a veteran. Refer to User-defined Table 0172 - Veterans Military Status in Chapter 2C, Code Tables, for suggested values.

PID-28: Nationality

(Definition from PID.28 in Ch. 3)

Attention: The PID-28 field was retained for backward compatibility only as of v 2.4 and was withdrawn and removed from this message structure as of v 2.7. It is recommended to refer to PID-10 - Race, PID-22 - Ethnic group and PID-26 - Citizenship.

(Definition from NK1.27 in Ch. 3)

Definition: This field identifies the nation or national group to which the next of kin/associated party belongs. This information may be different than the person's citizenship in countries in which multiple nationalities are recognized (e.g., Spain: Basque, Catalan, etc.). Refer to User-defined Table 0212 - Nationality in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.43 in Ch. 6)

Definition: This field contains a code that identifies the nation or national grouping to which the person belongs. This may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.

(Definition from IN2.41 in Ch. 6)

Definition: This field contains a code that identifies the nation or national grouping to which the insured person belongs. This information may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.

PID-29: Patient Death Date and Time (DTM) 00740

Definition: This field contains the date and time at which the patient death occurred.

PID-30: Patient Death Indicator (ID) 00741

Definition: This field indicates whether the patient is deceased. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient is deceased

  • N    the patient is not deceased

PID-31: Identity Unknown Indicator (ID) 01535

Definition: This field indicates whether or not the patient's/person's identity is known. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient's/person's identity is unknown

  • N    the patient's/person's identity is known

PID-32: Identity Reliability Code (CWE) 01536

Definition: This field contains a coded value used to communicate information regarding the reliability of patient/person identifying data transmitted via a transaction. Values could indicate that certain fields on a PID segment for a given patient/person are known to be false (e.g., use of default or system-generated values for Date of Birth or Social Security Number). Refer to User-defined Table 0445 - Identity Reliability Code in Chapter 2C, Code Tables, for suggested values.

PID-33: Last Update Date/Time (DTM) 01537

Definition: This field contains the last update date and time for the patient's/person's identifying and demographic data, as defined in the PID segment. Receiving systems will use this field to determine how to apply the transaction to their systems. If the receiving system (such as an enterprise master patient index) already has a record for the person with a later last update date/time, then the EMPI could decide not to apply the patient's/person's demographic and identifying data from this transaction.

PID-34: Last Update Facility (HD) 01538

Definition: This field identifies the facility of the last update to a patient's/person's identifying and demographic data, as defined in the PID segment. Receiving systems or users will use this field to determine how to apply the transaction to their systems. If the receiving system (such as a hospital's patient management system) already has a record for the patient/person, then it may decide to only update its data if the source is a "trusted" source. A hospital might consider other hospitals trusted sources, but not "trust" updates from non-acute care facilities. For example:

...|GOOD HEALTH Hospital|...

PID-35: Taxonomic Classification Code (CWE) 01539

(Definition from PID.35 in Ch. 3)

Definition: A code representing the taxonomic classification (e.g. species and/or breed) of an organism. This may include the common or scientific name in the description component, based on the coding system(s) used. SNOMED-CT is the recommended coding system. If this field is not valued, a human is assumed. If the specificity of the coding system is insufficient to represent the organism to the degree desired, the most detailed coded value available may be used in this field and additional information sent in the text field, PID-37 – Strain.

For example:

...|L-80700^Canine, NOS^SNM3|...

...|L-80100^Bovine^SNM3|...

...|L-80A00^Feline^SNM3|...

(Definition from OM1.50 in Ch. 8)

Definition: The species of living organism. This may include the common or scientific name, based on the coding system(s) used. SNOMED is the recommended coding system. If this field is not valued, a human is assumed. Refer to User-defined Table 0446 - Species Code in Chapter 2C, Code Tables, for suggested values.

For example:

...|L-80700^Canine, NOS^SNM3|...

...|L-80100^Bovine^SNM3|...

...|L-80A00^Feline^SNM3|....

This field is a list of species or other taxonomic classification(s) to which the indicated specimen type may appropriately be applied for the indicated observation or test. If this field is omitted the default meaning is that the test or observation is applicable to humans. In a veterinary context if the test is applicable to any species, an appropriate code such as "Kingdom Animalia (organism)" should be used to avoid confusion with the meaning of human only.

(Definition from OM4.18 in Ch. 8)

Definition: The species of living organism. This may include the common or scientific name, based on the coding system(s) used. SNOMED is the recommended coding system. If this field is not valued, a human is assumed. Refer to User-defined Table 0446 - Species Code for suggested values. Refer to Table 0661 - Taxonomic Classification Code in Chapter 2C for valid values.

For example:

...|L-80700^Canine, NOS^SNM3|...

...|L-80100^Bovine^SNM3|...

...|L-80A00^Feline^SNM3|....

This field is a list of species or other taxonomic classification(s) to which the indicated specimen type may appropriately be applied for the indicated observation or test. If this field is omitted the default meaning is that the test or observation is applicable to humans. In a veterinary context, if the test is applicable to any species, an appropriate code such as "Kingdom Animalia (organism)" should be used to avoid confusion with the meaning of human only.

PID-36: Breed Code (CWE) 01540

Definition: From v 2.8 onward, this field has been retained for backward compatibility only. The specific breed of animal. This field, unlike Species and Strain is specific to animals and cannot be generally used for all living organisms. SNOMED is the recommended coding system. Refer to User-defined Table 0447 - Breed Code in Chapter 2C, Code Tables, for suggested values.

Conditionality Rule: This field must be valued if PID-37 - Strain is valued.

For example, (showing primary and alternative coding systems, using locally defined "American Kennel Club" nomenclature):

...|L-80733^ Staffordshire bull terrier^SNM3^^American Staffordshire Terrier^99AKC|...

...|L-80900^Weimaraner^SNM3|...

...|L-80439^Peruvian Paso Horse^SNM3|...

PID-37: Strain (ST) 01541

Definition: This field contains the specific strain of animal. It can also be expanded to include strain of any living organism and is not restricted to animals.

Example:

...|DeKalb|...

...|Balb/c|...

...|DXL|...

PID-38: Production Class Code (CWE) 01542

Definition: This field contains the code and/or text indicating the primary use for which the living subject was bred or grown. Refer to User-defined Table 0429 - Production Class Code in Chapter 2C, Code Tables, for suggested values. For example:

...|DA^Dairy^L|...

...|MT^Meat^L|...

...|RA^Racing^L|...

PID-39: Tribal Citizenship (CWE) 01840

This field contains the information related to a person's tribal citizenship. For tribal citizenship, in the United States, HL7 recommends using the Bureau of Indian Affairs (BIA) Tribal Identity List. For a local definition, User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables should be used.

This field repeats since persons can have tribal membership(s) and can be members of more than one tribe. The Name of Coding System component(s) of the CWE datatype should be used to identify the table from which tribal membership is drawn.

PID-40: Patient Telecommunication Information (XTN) 02289

Definition: This field contains the patient's personal telecommunication contact information. This field replaces PID-13 – Phone Number - Home and PID-14 – Phone Number – Business with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type). Jointly, these components will describe the nature of the telecommunication data contained in this field and removes the sequenced-based assumptions in PID-13 and PID-14.

PV1 - Patient Visit Segment

The PV1 segment is used by Registration/Patient Administration applications to communicate information on an account or visit-specific basis. The default is to send account level data. To use this segment for visit level data PV1-51 - Visit Indicator must be valued to "V". The value of PV-51 affects the level of data being sent on the PV1, PV2, and any other segments that are part of the associated PV1 hierarchy (e.g., ROL, DG1, or OBX).

The facility ID, the optional fourth component of each patient location field, is a HD data type that is uniquely associated with the healthcare facility containing the location. A given institution, or group of intercommunicating institutions, should establish a list of facilities that may be potential assignors of patient locations. The list will be one of the institution's master dictionary lists. Since third parties other than the assignors of patient locations may send or receive HL7 messages containing patient locations, the facility ID in the patient location may not be the same as that implied by the sending and receiving systems identified in the MSH. The facility ID must be unique across facilities at a given site. This field is required for HL7 implementations that have more than a single healthcare facility with bed locations, since the same <point of care> ^ <room> ^ <bed> combination may exist at more than one facility.

HL7 Attribute Table - PV1 - Patient Visit Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
PV1
1 00131 Set ID - PV1 [0..1] [1..4] SI
2 00132 Patient Class SHALL [1..1] CWE
3 00133 Assigned Patient Location [0..1] PL
4 00134 Admission Type [0..1] CWE
5 00135 Preadmit Number [0..1] CX
6 00136 Prior Patient Location [0..1] PL
7 00137 Attending Doctor [0..*] XCN
8 00138 Referring Doctor [0..*] XCN
9 00139 Consulting Doctor B [0..*] XCN
10 00140 Hospital Service [0..1] CWE
11 00141 Temporary Location [0..1] PL
12 00142 Preadmit Test Indicator [0..1] CWE
13 00143 Re-admission Indicator [0..1] CWE
14 00144 Admit Source [0..1] CWE
15 00145 Ambulatory Status [0..*] CWE
16 00146 VIP Indicator [0..1] CWE
17 00147 Admitting Doctor [0..*] XCN
18 00148 Patient Type [0..1] CWE
19 00149 Visit Number [0..1] CX
20 00150 Financial Class [0..*] FC
21 00151 Charge Price Indicator [0..1] CWE
22 00152 Courtesy Code [0..1] CWE
23 00153 Credit Rating [0..1] CWE
24 00154 Contract Code [0..*] CWE
25 00155 Contract Effective Date [0..*] DT
26 00156 Contract Amount = [0..*] 12 NM
27 00157 Contract Period = [0..*] 3 NM
28 00158 Interest Code [0..1] CWE
29 00159 Transfer to Bad Debt Code [0..1] CWE
30 00160 Transfer to Bad Debt Date [0..1] DT
31 00161 Bad Debt Agency Code [0..1] CWE
32 00162 Bad Debt Transfer Amount = [0..1] 12 NM
33 00163 Bad Debt Recovery Amount = [0..1] 12 NM
34 00164 Delete Account Indicator [0..1] CWE
35 00165 Delete Account Date [0..1] DT
36 00166 Discharge Disposition [0..1] CWE
37 00167 Discharged to Location [0..1] DLD
38 00168 Diet Type [0..1] CWE
39 00169 Servicing Facility [0..1] CWE
40 00170 Bed Status SHALL NOT W [0..0] CWE
41 00171 Account Status [0..1] CWE
42 00172 Pending Location [0..1] PL
43 00173 Prior Temporary Location [0..1] PL
44 00174 Admit Date/Time [0..1] DTM
45 00175 Discharge Date/Time [0..1] DTM
46 00176 Current Patient Balance = [0..1] 12 NM
47 00177 Total Charges = [0..1] 12 NM
48 00178 Total Adjustments = [0..1] 12 NM
49 00179 Total Payments = [0..1] 12 NM
50 00180 Alternate Visit ID [0..*] CX
51 01226 Visit Indicator [0..1] CWE
52 01274 Other Healthcare Provider SHALL NOT W [0..0]
53 02290 Service Episode Description # [0..1] 50 ST
54 02291 Service Episode Identifier [0..1] CX

PV1-1: Set ID - PV1 (SI) 00131

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

PV1-2: Patient Class (CWE) 00132

Definition: This field is used by systems to categorize patients by site. It does not have a consistent industry-wide definition. It is subject to site-specific variations. Refer to User-defined Table 0004 - Patient Class in Chapter 2C, Code Tables, for suggested values.

"Commercial Account" is used by reference labs for specimen processing when the service is billed back to a third party. A registration is processed for the specimen to facilitate the subsequent billing. The identity of the patient may be known or unknown. In either case, for billing and statistical purposes, the patient class is considered a commercial account due to the third party billing responsibility.

"Not Applicable" is used only in cases where the PV1 segment itself is not applicable but is retained in the message definitions for backwards compatibility (for example when a managed care system sends A28, A29, or A31 messages to indicate the enrolment of a patient in the system and there is no scheduled "visit" or "encounter" and hence the entire PV1 segment is not applicable).

PV1-3: Assigned Patient Location (PL) 00133

(Definition from PV1.3 in Ch. 3)

Definition: This field contains the patient's initial assigned location or the location to which the patient is being moved. The first component may be the nursing station for inpatient locations, or clinic or department, for locations other than inpatient. For canceling a transaction or discharging a patient, the current location (after the cancellation event or before the discharge event) should be in this field. If a value exists in the fifth component (location status), it supersedes the value in PV1-40 - Bed Status.

(Definition from FT1.16 in Ch. 6)

Definition: This field contains the current patient location. This can be the location of the patient when the charge item was ordered or when the charged service was rendered. For the current assigned patient location, use PV1-3 - Assigned Patient Location.

PV1-4: Admission Type (CWE) 00134

Definition: This field indicates the circumstances under which the patient was or will be admitted. Refer to User-defined Table 0007 - Admission Type in Chapter 2C, Code Tables, for suggested values. In the US, entities required to be compliant with the US Healthcare Information Technology Standards Panel (HITSP) are required to use the Official Universal Billing (UB) 04 2008 numeric codes found on form locator 14. Refer to External Table UB04FL14 for valid values.

For example:

Non-US |E^Emergency^HL70007|

US: |1^Emergency^UB04FL14^^^^2008, v 2.0|

To report that information is not available:

Non-US: |NI^No Information^HL70597|

US: |9^Information not available^ UB04FL14^^^^2008, v 2.0|

PV1-5: Preadmit Number (CX) 00135

Definition: This field uniquely identifies the patient's pre-admit account. Some systems will continue to use the pre-admit number as the billing number after the patient has been admitted. For backward compatibility, a ST data type can be sent; however, HL7 recommends use of the CX data type, like the account number, for new implementations. The assigning authority and identifier type codes are strongly recommended for all CX data types.

PV1-6: Prior Patient Location (PL) 00136

Definition: This field contains the prior patient location if the patient is being transferred. The old location is null if the patient is new. If a value exists in the fifth component (location status), it supersedes the value in PV1-40 - Bed Status.

PV1-7: Attending Doctor (XCN) 00137

(Definition from PV1.7 in Ch. 3)

Definition: This field contains the attending physician information. Multiple names and identifiers for the same physician may be sent. The field sequences are not used to indicate multiple attending doctors. As of v2.7, if XCN.1 ID Number is populated, then the XCN.13 Identifier Type Code and the XCN.9 Assigning Authority or XCN.22 Assigning Jurisdiction or XCN.23 Assigning Agency or Department are required. If XCN.2 Family Name is populated, then the XCN.10 Name Type Code is required. No assumptions can be safely made based on position or sequence. Specification of meaning based on sequence is deprecated. Depending on local agreements, either ID or the name may be absent in this field. Refer to User-defined Table 0010 - Physician ID in Chapter 2C, Code Tables, for suggested values.

(Definition from SCD.34 in Ch. 17)

Definition: The unique identifier associating the physician with the supplies being sterilized, used for the procedure and patient identified in this message. Refer to User-defined Table 0010 - Physician ID in Chapter 2C, Code Tables, for suggested values.

PV1-8: Referring Doctor (XCN) 00138

Definition: This field contains the referring physician information. Multiple names and identifiers for the same physician may be sent. The field sequences are not used to indicate multiple referring doctors. As of v 2.7 if XCN.1 ID Number is populated, then the XCN.13 Identifier Type Code and the XCN.9 Assigning Authority or XCN.22 Assigning Jurisdiction or XCN.23 Assigning Agency or Department are required. If XCN.2 Family Name is populated, then the XCN.10 Name Type Code is required. No assumptions can be safely made based on position or sequence. Specification of meaning based on sequence is deprecated. Depending on local agreements, either the ID or the name may be absent from this field. Refer to User-defined Table 0010 - Physician ID in Chapter 2C, Code Tables, for suggested values.

PV1-9: Consulting Doctor (XCN) 00139

From V2.4 onward, this field has been retained for backward compatibility only. It is recommended to use the PRT - Participation segment for consulting physicians instead.

PV1-10: Hospital Service (CWE) 00140

Definition: This field contains the treatment or type of surgery that the patient is scheduled to receive. It is a required field with trigger events A01 (admit/visit notification), A02 (transfer a patient), A14 (pending admit), A15 (pending transfer). Refer to User-defined Table 0069 - Hospital Service in Chapter 2C, Code Tables, for suggested values.

PV1-11: Temporary Location (PL) 00141

Definition: This field contains a location other than the assigned location required for a temporary period of time (e.g., OR, operating theatre, etc.). If a value exists in the fifth component (location status), it supersedes the value in PV1-40 - Bed Status.

PV1-12: Preadmit Test Indicator (CWE) 00142

Definition: This field indicates whether the patient must have pre-admission testing done in order to be admitted. Refer to User-defined Table 0087 - Pre-Admit Test Indicator in Chapter 2C, Code Tables, for suggested values.

PV1-13: Re-admission Indicator (CWE) 00143

Definition: This field indicates that a patient is being re-admitted to the healthcare facility and gives the circumstances. We suggest using "R" for readmission or else null. Refer to User-defined Table 0092 - Re-Admission Indicator in Chapter 2C, Code Tables, for suggested values.

PV1-14: Admit Source (CWE) 00144

Definition: This field indicates from where the patient was admitted. Refer to User-defined Table 0023 - Admit Source in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Official Uniform Billing (UB) 04 2008 numeric codes found on form locator 15. Refer to External Table UB04FL15 Source of Origin for valid values. The UB has redefined the Admission Source as the Point of Origin for Admission or Visit. The new UB definition is the code indicating the Point of Origin for this Admission or Visit

For Example:

US: |1^Physician Referral^UB04FL15^^^^2008, v 2.0|

To report that information is not available:

US: |9^Information not available^ UB04FL15^^^^2008, v 2.0|

PV1-15: Ambulatory Status (CWE) 00145

(Definition from PV1.15 in Ch. 3)

Definition: This field indicates any permanent or transient handicapped conditions. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested entries.

(Definition from NK1.18 in Ch. 3)

Definition: This field identifies the transient rate of mobility for the next of kin/associated party. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables for suggested values.

(Definition from GT1.34 in Ch. 6)

Definition: Identifies the transient state of mobility for the guarantor. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.32 in Ch. 6)

Definition: This field identifies the insured's state of mobility. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.

PV1-16: VIP Indicator (CWE) 00146

(Definition from PV1.16 in Ch. 3)

Definition: This field identifies the type of VIP. Refer to User-defined Table 0099 - VIP Indicator in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.39 in Ch. 3)

Definition: This field identifies the type of VIP for the next-of-kin. Refer to User-defined Table 0099 – VIP Indicator in Chapter 2C, Code Tables.

(Definition from GT1.57 in Ch. 6)

Definition: This field identifies the type of VIP for the guarantor. Refer to User-defined Table 0099 – VIP Indicator in Chapter 2C, Code Tables, for suggested values.

PV1-17: Admitting Doctor (XCN) 00147

Definition: This field contains the admitting physician information. Multiple names and identifiers for the same physician may be sent. The field sequences are not used to indicate multiple admitting doctors. As of v2.7 if XCN.1 ID Number is populated, then the XCN.13 Identifier Type Code and the XCN.9 Assigning Authority or XCN.22 Assigning Jurisdiction or XCN.23 Assigning Agency or Department are required. If XCN.2 Family Name is populated, then the XCN.10 Name Type Code is required. No assumptions can be safely made based on position or sequence. Specification of meaning based on sequence is deprecated. By local agreement, the name or ID may be absent in this field. Refer to User-defined Table 0010 - Physician ID in Chapter 2C, Code Tables, for suggested values.

PV1-18: Patient Type (CWE) 00148

(Definition from PV1.18 in Ch. 3)

Definition: This field contains site-specific values that identify the patient type. Refer to User-defined Table 0018 - Patient Type in Chapter 2C, Code Tables, for suggested values.

(Definition from FT1.18 in Ch. 6)

Definition: This field contains the type code assigned to the patient for this episode of care (visit or stay). Refer to User-defined Table 0018 - Patient Type in Chapter 2C, Code Tables, for suggested values. This is for use when the patient type for billing purposes is different than the visit patient type in PV1-18 - Patient Type.

PV1-19: Visit Number (CX) 00149

Definition: For backward compatibility, a NM data type may be sent, but HL7 recommends that new implementations use the CX data type. This field contains the unique number assigned to each patient visit. The assigning authority and identifier type code are strongly recommended for all CX data types.

PV1-20: Financial Class (FC) 00150

Definition: This field contains the financial class(es) assigned to the patient for the purpose of identifying sources of reimbursement. Refer to User-defined Table 0064 - Financial Class in Chapter 2C, Code Tables, for suggested values.

PV1-21: Charge Price Indicator (CWE) 00151

Definition: This field contains the code used to determine which price schedule is to be used for room and bed charges. Refer to User-defined Table 0032 - Charge/Price Indicator in Chapter 2C, Code Tables, for suggested values.

PV1-22: Courtesy Code (CWE) 00152

Definition: This field indicates whether the patient will be extended certain special courtesies. Refer to User-defined Table 0045 - Courtesy Code in Chapter 2C, Code Tables, for suggested values.

PV1-23: Credit Rating (CWE) 00153

Definition: This field contains the user-defined code to determine past credit experience. Refer to User-defined Table 0046 - Credit Rating in Chapter 2C, Code Tables, for suggested values.

PV1-24: Contract Code (CWE) 00154

Definition: This field identifies the type of contract entered into by the healthcare facility and the guarantor for the purpose of settling outstanding account balances. Refer to User-defined Table 0044 - Contract Code in Chapter 2C, Code Tables, for suggested values.

PV1-25: Contract Effective Date (DT) 00155

Definition: This field contains the date that the contract is to start or started.

PV1-26: Contract Amount (NM) 00156

Definition: This field contains the amount to be paid by the guarantor each period according to the contract.

PV1-27: Contract Period (NM) 00157

Definition: This field specifies the duration of the contract for user-defined periods.

PV1-28: Interest Code (CWE) 00158

Definition: This field indicates the amount of interest that will be charged the guarantor on any outstanding amounts. Refer to User-defined Table 0073 - Interest Rate Code in Chapter 2C, Code Tables, for suggested values.

PV1-29: Transfer to Bad Debt Code (CWE) 00159

Definition: This field indicates that the account was transferred to bad debts and gives the reason. Refer to User-defined Table 0110 - Transfer to Bad Debt Code in Chapter 2C, Code Tables, for suggested values.

PV1-30: Transfer to Bad Debt Date (DT) 00160

Definition: This field contains the date that the account was transferred to a bad debt status.

PV1-31: Bad Debt Agency Code (CWE) 00161

Definition: This field can be used as a ST type for backward compatibility. This field uniquely identifies the bad debt agency to which the account was transferred. This code is site defined. One possible implementation would be to edit against a table such as User-defined Table 0021 - Bad Debt Agency Code; in chapter 2C, however, this is not required.

PV1-32: Bad Debt Transfer Amount (NM) 00162

Definition: This field contains the amount that was transferred to a bad debt status.

PV1-33: Bad Debt Recovery Amount (NM) 00163

Definition: This field contains the amount recovered from the guarantor on the account.

PV1-34: Delete Account Indicator (CWE) 00164

Definition: This field indicates that the account was deleted from the file and gives the reason. Refer to User-defined Table 0111 - Delete Account Code in Chapter 2C, Code Tables, for suggested values.

PV1-35: Delete Account Date (DT) 00165

Definition: This field contains the date that the account was deleted from the file.

PV1-36: Discharge Disposition (CWE) 00166

Definition: This field contains the disposition of the patient at time of discharge (i.e., discharged to home, expired, etc.). Refer to User-defined Table 0112 - Discharge Disposition in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Official Uniform Billing (UB) 04 2008 numeric codes found on form locator 17. Refer to External Table UB04FL17 Patient Discharge Status for valid values.

Examples:

US: |01^ Discharged to home or self care (routine discharge)^UB04FL17^^^^2008, v 2.0|

Usage Note: NUBC does not supply a null value for this field.

PV1-37: Discharged to Location (DLD) 00167

Definition: This field indicates the healthcare facility to which the patient was discharged and the date. Refer to User-defined Table 0113 - Discharged to Location in Chapter 2C, Code Tables, for suggested values.

PV1-38: Diet Type (CWE) 00168

Definition: This field indicates a special diet type for a patient. Refer to User-defined Table 0114 - Diet Type in Chapter 2C, Code Tables, for suggested values.

PV1-39: Servicing Facility (CWE) 00169

Definition: This field is used in a multiple facility environment, e.g., multiple campuses or buildings, to indicate the healthcare facility with which this visit is associated. Refer to User-defined Table 0115 - Servicing Facility in Chapter 2C, Code Tables, for suggested values.

An optional sixth component, the facility ID, may be valued in each individual location field in PV1, instead of placing it here.

PV1-40: Bed Status

(Definition from PV1.40 in Ch. 3)

Definition: The PV1-40 field was retained for backward compatibility only as of v 2.3, and the field withdrawn as of v 2.7. The information is now held in the fifth component of the PL datatype in PV1-3.

(Definition from NPU.2 in Ch. 3)

Definition: This field contains the bed status. Refer to User-defined Table 0116 - Bed Status in Chapter 2C, Code Tables, for suggested values.

PV1-41: Account Status (CWE) 00171

Definition: This field contains the account status. Refer to User-defined Table 0117 - Account Status in Chapter 2C, Code Tables, for suggested values.

PV1-42: Pending Location (PL) 00172

Definition: This field indicates the point of care, room, bed, healthcare facility ID, and bed status to which the patient may be moved. The first component may be the nursing station for inpatient locations, or the clinic, department, or home for locations other than inpatient. If a value exists in the fifth component (location status), it supersedes the value in PV1-40 - Bed Status.

PV1-43: Prior Temporary Location (PL) 00173

Definition: This field is used to reflect the patient's temporary location (such as the operating room/theatre or x-ray) prior to a transfer from a temporary location to an actual location, or from a temporary location to another temporary location. The first component may be the nursing station for inpatient locations, or the clinic, department, or home for locations other than inpatient.

PV1-44: Admit Date/Time (DTM) 00174

Definition: This field contains the admit date/time. It is to be used if the event date/time is different than the admit date and time, i.e., a retroactive update. This field is also used to reflect the date/time of an outpatient/emergency patient registration.

PV1-45: Discharge Date/Time (DTM) 00175

Definition: This field contains the discharge date/time. It is to be used if the event date/time is different than the discharge date and time, that is, a retroactive update. This field is also used to reflect the date/time of an outpatient/emergency patient discharge.

PV1-46: Current Patient Balance (NM) 00176

Definition: This field contains the visit balance due.

PV1-47: Total Charges (NM) 00177

Definition: This field contains the total visit charges.

PV1-48: Total Adjustments (NM) 00178

Definition: This field contains the total adjustments for visit.

PV1-49: Total Payments (NM) 00179

Definition: This field contains the total payments for visit.

PV1-50: Alternate Visit ID (CX) 00180

Definition: This field contains the alternative, temporary, or pending optional visit ID number to be used if needed. Multiple alternate identifiers may be sent. Refer to HL7 Table 0061 - Check Digit Scheme in Chapter 2C, Code Tables, for valid values. Refer to HL7 Table 0203 - Identifier Type in Chapter 2C, Code Tables, for valid values. The assigning authority and identifier type codes are strongly recommended for all CX data types.

PV1-51: Visit Indicator (CWE) 01226

Definition: This field specifies the level on which data are being sent. It is the indicator used to send data at two levels, visit and account. HL7 recommends sending an 'A' or no value when the data in the message are at the account level, or 'V' to indicate that the data sent in the message are at the visit level. Refer to User-defined Table 0326 - Visit Indicator in Chapter 2C, Code Tables, for suggested values.

The value of this element affects the context of data sent in PV1, PV2 and any associated hierarchical segments (e.g., DB1, AL1, DG1, etc.).

PV1-52: Other Healthcare Provider

Definition: The PV1-52 field was retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is advised to use the PRT segment to communicate providers not specified elsewhere. Refer to Chapter 7 for the definition of the PRT segment.

PV1-53: Service Episode Description (ST) 02290

Definition: This field contains a brief user-defined description of a Service Episode in or for which the visit occurs. A Service Episode is the context in which the treatment or management of an arbitrary subset of a Patient’s medical conditions occurs. The definition of the start time, stop time, and included events of a Service Episode is entirely arbitrary; it may include a single outpatient visit or a hospitalization, or extend over significant period of time, e.g., the duration of a pregnancy, or an oncology treatment regimen, or a cardiac episode from infarction through rehabilitation. A Service Episode may involve one or more Healthcare Organizations.

PV1-54: Service Episode Identifier (CX) 02291

Definition: This field contains the identifier of a Service Episode in or for which the visit occurs.

PV2 - Patient Visit - Additional Information Segment

The PV2 segment is a continuation of information contained on the PV1 segment.

HL7 Attribute Table - PV2 - Patient Visit - Additional Information Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
PV2
1

00181 Prior Pending Location MAY
True:
False:
C
[1..1]
[0..1]
PL
2 00182 Accommodation Code [0..1] CWE
3 00183 Admit Reason [0..1] CWE
4 00184 Transfer Reason [0..1] CWE
5 00185 Patient Valuables = [0..*] 25 ST
6 00186 Patient Valuables Location = [0..1] 25 ST
7 00187 Visit User Code [0..*] CWE
8 00188 Expected Admit Date/Time [0..1] DTM
9 00189 Expected Discharge Date/Time [0..1] DTM
10 00711 Estimated Length of Inpatient Stay = [0..1] 3 NM
11 00712 Actual Length of Inpatient Stay = [0..1] 3 NM
12 00713 Visit Description # [0..1] 50 ST
13 00714 Referral Source Code [0..*] XCN
14 00715 Previous Service Date [0..1] DT
15 00716 Employment Illness Related Indicator [0..1] [1..1] ID
16 00717 Purge Status Code [0..1] CWE
17 00718 Purge Status Date [0..1] DT
18 00719 Special Program Code [0..1] CWE
19 00720 Retention Indicator [0..1] [1..1] ID
20 00721 Expected Number of Insurance Plans = [0..1] 1 NM
21 00722 Visit Publicity Code [0..1] CWE
22 00723 Visit Protection Indicator B [0..1] [1..1] ID
23 00724 Clinic Organization Name [0..*] XON
24 00725 Patient Status Code [0..1] CWE
25 00726 Visit Priority Code [0..1] CWE
26 00727 Previous Treatment Date [0..1] DT
27 00728 Expected Discharge Disposition [0..1] CWE
28 00729 Signature on File Date [0..1] DT
29 00730 First Similar Illness Date [0..1] DT
30 00731 Patient Charge Adjustment Code [0..1] CWE
31 00732 Recurring Service Code [0..1] CWE
32 00733 Billing Media Code [0..1] [1..1] ID
33 00734 Expected Surgery Date and Time [0..1] DTM
34 00735 Military Partnership Code [0..1] [1..1] ID
35 00736 Military Non-Availability Code [0..1] [1..1] ID
36 00737 Newborn Baby Indicator [0..1] [1..1] ID
37 00738 Baby Detained Indicator [0..1] [1..1] ID
38 01543 Mode of Arrival Code [0..1] CWE
39 01544 Recreational Drug Use Code [0..*] CWE
40 01545 Admission Level of Care Code [0..1] CWE
41 01546 Precaution Code [0..*] CWE
42 01547 Patient Condition Code [0..1] CWE
43 00759 Living Will Code [0..1] CWE
44 00760 Organ Donor Code [0..1] CWE
45

01548 Advance Directive Code MAY
True:
False:
C
[1..1]
[0..1]
CWE
46 01549 Patient Status Effective Date [0..1] DT
47

01550 Expected LOA Return Date/Time MAY
True:
False:
C
[1..1]
[0..1]
DTM
48 01841 Expected Pre-admission Testing Date/Time [0..1] DTM
49 01842 Notify Clergy Code [0..*] CWE
50 02141 Advance Directive Last Verified Date [0..1] DT

PV2-1: Prior Pending Location (PL) 00181

Definition: This field is required for cancel pending transfer (A26) messages. In all other events it is optional.

PV2-2: Accommodation Code (CWE) 00182

Definition: This field indicates the specific patient accommodations for this visit. Refer to User-defined Table 0129 - Accommodation Code in Chapter 2C, Code Tables, for suggested values.

PV2-3: Admit Reason (CWE) 00183

Definition: This field contains the short description of the reason for patient admission.

PV2-4: Transfer Reason (CWE) 00184

Definition: This field contains the short description of the reason for a patient location change.

PV2-5: Patient Valuables (ST) 00185

Definition: This field contains the short description of patient valuables checked in during admission.

PV2-6: Patient Valuables Location (ST) 00186

Definition: This field indicates the location of the patient's valuables.

PV2-7: Visit User Code (CWE) 00187

Definition: This field further categorizes a patient's visit with respect to an individual institution's needs, and is expected to be site-specific. Refer to User-defined Table 0130 - Visit User Code in Chapter 2C, Code Tables, for suggested values.

PV2-8: Expected Admit Date/Time (DTM) 00188

Definition: This field contains the date and time that the patient is expected to be admitted. This field is also used to reflect the date/time of an outpatient/emergency patient registration.

PV2-9: Expected Discharge Date/Time (DTM) 00189

Definition: This field contains the date and time that the patient is expected to be discharged. This is a non-event related date used by ancillaries to determine more accurately the projected workloads. This field is also used to reflect the anticipated discharge date/time of an outpatient/emergency patient, or an inpatient.

PV2-10: Estimated Length of Inpatient Stay (NM) 00711

Definition: This field specifies the estimated days of inpatient stays.

PV2-11: Actual Length of Inpatient Stay (NM) 00712

Definition: This field contains the actual days of inpatient stays. The actual length of the inpatient stay may not be calculated from the admission and discharge dates because of possible leaves of absence.

PV2-12: Visit Description (ST) 00713

Definition: This field contains a brief user-defined description of the visit.

PV2-13: Referral Source Code (XCN) 00714

Definition: This field contains the name and the identification numbers of the person or organization that made the referral. This person/organization is not the same as the referring doctor. For example, Adam Everyman referred me to the Clinic (or to Dr. Everywoman at the Clinic).

PV2-14: Previous Service Date (DT) 00715

Definition: This field contains the date of previous service for the same recurring condition. This may be a required field for billing certain illnesses (e.g., accident related) to a third party.

PV2-15: Employment Illness Related Indicator (ID) 00716

Definition: This field specifies whether a patient's illness was job-related. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient's illness was job-related

  • N    the patient's illness was not job-related

PV2-16: Purge Status Code (CWE) 00717

Definition: This field contains the purge status code for the account. It is used by the application program to determine purge processing. Refer to User-defined Table 0213 - Purge Status Code in Chapter 2C, Code Tables, for suggested values.

PV2-17: Purge Status Date (DT) 00718

Definition: This field contains the date on which the data will be purged from the system.

PV2-18: Special Program Code (CWE) 00719

Definition: This field designates the specific health insurance program for a visit required for healthcare reimbursement. Refer to User-defined Table 0214 - Special Program Codes in Chapter 2C, Code Tables, for suggested values.

PV2-19: Retention Indicator (ID) 00720

Definition: This field allows the user to control the financial and demographic purge processes at the visit. It is used to preserve demographic and financial data on specific, high priority visits. Refer to HL7 Table 0136 - Yes/No Indicator for valid values.

  • Y    retain data

  • N    normal purge processing

PV2-20: Expected Number of Insurance Plans (NM) 00721

Definition: This field contains the number of insurance plans that may provide coverage for this visit.

PV2-21: Visit Publicity Code (CWE) 00722

Definition: This field contains a user-defined code indicating what level of publicity is allowed for a specific visit. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values. Refer to PD1-11 - Publicity Code for the patient level publicity code.

PV2-22: Visit Protection Indicator (ID) 00723

Definition: From v 2.6 onward, this field has been retained for backwards compatibility only. Use the ARV segment instead. This field identifies the person's protection that determines, in turn, whether access to information about this person should be kept from users who do not have adequate authority for a specific visit. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    protect access to patient information

  • N    normal access

Refer to PD1-12 - Protection Indicator for the patient level protection indicator.

PV2-23: Clinic Organization Name (XON) 00724

Definition: This field contains the organization name or sub-unit and identifier that is associated with the (visit) episode of care. For example, the Allergy or Oncology Clinic within the healthcare facility might be named.

PV2-24: Patient Status Code (CWE) 00725

Definition: This field indicates the status of the episode of care. Refer to User-defined Table 0216 - Patient Status in Chapter 2C, Code Tables, for suggested values.

PV2-25: Visit Priority Code (CWE) 00726

Definition: This field contains the priority of the visit. Refer to User-defined Table 0217 - Visit Priority Code in Chapter 2C, Code Tables, for suggested values.

PV2-26: Previous Treatment Date (DT) 00727

Definition: This field contains the date that the patient last had treatment for any condition prior to this visit. In the case of a prior hospital visit, it is likely to be the previous discharge date.

PV2-27: Expected Discharge Disposition (CWE) 00728

Definition: This field describes what the patient's disposition is expected to be at the end of the visit. Refer to User-defined Table 0112 - Discharge Disposition in Chapter 2C, Code Tables, for suggested values.

PV2-28: Signature on File Date (DT) 00729

Definition: This field contains the date on which a signature was obtained for insurance billing purposes.

PV2-29: First Similar Illness Date (DT) 00730

Definition: This field is used to determine if the patient has a pre-existing condition.

PV2-30: Patient Charge Adjustment Code (CWE) 00731

Definition: This field contains a user-defined code that indicates which adjustments should be made to this patient's charges. Refer to User-defined Table 0218 - Patient Charge Adjustment in in chapter 2C, for suggested values. This field is the same as GT1-26 - Guarantor Charge Adjustment Code.

PV2-31: Recurring Service Code (CWE) 00732

Definition: This field indicates whether the treatment is continuous. Refer to User-defined Table 0219 - Recurring Service in Chapter 2C, Code Tables, for suggested values.

PV2-32: Billing Media Code (ID) 00733

Definition: This field indicates if the account is to be rejected from tape billing. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    reject account from tape billing

  • N    normal processing

PV2-33: Expected Surgery Date and Time (DTM) 00734

Definition: This field contains the date and time on which the surgery is expected to occur.

PV2-34: Military Partnership Code (ID) 00735

Definition: This field indicates that a military healthcare facility has contracted with a non-military healthcare facility for the use of its services. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    contract(s) exist

  • N    no contract(s) exist

PV2-35: Military Non-Availability Code (ID) 00736

Definition: This field indicates whether a patient has permission to use a non-military healthcare facility for treatment. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient has permission to use a non-military healthcare facility

  • N    the patient does not have permissions to use a non-military healthcare facility

PV2-36: Newborn Baby Indicator (ID) 00737

Definition: This field indicates whether the patient is a baby. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the patient is a baby

  • N    the patient is not a baby

PV2-37: Baby Detained Indicator (ID) 00738

Definition: This field indicates if the baby is detained after the mother's discharge. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    the baby was detained

  • N    normal discharge of mother and baby

PV2-38: Mode of Arrival Code (CWE) 01543

Definition: Identifies how the patient was brought to the healthcare facility. Refer to User-defined Table 0430 - Mode of Arrival Code in Chapter 2C, Code Tables, for suggested values.

PV2-39: Recreational Drug Use Code (CWE) 01544

Definition: This field indicates what recreational drugs the patient uses. It is used for the purpose of room assignment. Refer to User-defined Table 0431 - Recreational Drug Use Code in Chapter 2C, Code Tables, for suggested values.

PV2-40: Admission Level of Care Code (CWE) 01545

Definition: This field indicates the acuity level assigned to the patient at the time of admission. Refer to User-defined Table 0432 - Admission Level of Care Code in Chapter 2C, Code Tables, for suggested values.

PV2-41: Precaution Code (CWE) 01546

Definition: This field indicates non-clinical precautions that need to be taken with the patient. Refer to User-defined Table 0433 - Precaution Code in Chapter 2C, Code Tables, for suggested values.

PV2-42: Patient Condition Code (CWE) 01547

Definition: This field indicates the patient's current medical condition for the purpose of communicating to non-medical outside parties, e.g., family, employer, religious minister, media, etc. Refer to User-defined Table 0434 - Patient Condition Code in Chapter 2C, Code Tables, for suggested values.

PV2-43: Living Will Code (CWE) 00759

(Definition from PV2.43 in Ch. 3)

Definition: This field indicates whether or not the patient has a living will and, if so, whether a copy of the living will is on file at the healthcare facility. If the patient does not have a living will, the value of this field indicates whether the patient was provided information on living wills. Refer to User-defined Table 0315 - Living Will Code in Chapter 2C, Code Tables, for suggested values. See also PD1-7 - Living Will.

(Definition from PD1.7 in Ch. 3)

Definition: This field indicates whether or not the patient has a living will and, if so, whether a copy of the living will is on file at the healthcare facility. If the patient does not have a living will, the value of this field indicates whether the patient was provided information on living wills. Refer to User-defined Table 0315 - Living Will Code in Chapter 2C, Code Tables, for suggested values. See also PV2-43 - Living Will Code.

PV2-44: Organ Donor Code (CWE) 00760

(Definition from PV2.44 in Ch. 3)

Definition: This field indicates whether the patient wants to donate his/her organs and whether an organ donor card or similar documentation is on file with the healthcare organization. Refer to User-defined Table 0316 - Organ Donor Code in Chapter 2C, Code Tables, for suggested values. See also PD1-8 - Organ Donor.

(Definition from PD1.8 in Ch. 3)

Definition: This field indicates whether the patient wants to donate his/her organs and whether an organ donor card or similar documentation is on file with the healthcare organization. Refer to User-defined Table 0316 - Organ Donor Code in Chapter 2C, Code Tables, for suggested values. See also PV2-44 - Organ donor Code.

PV2-45: Advance Directive Code (CWE) 01548

(Definition from PV2.45 in Ch. 3)

Definition: This field indicates the patient's instructions to the healthcare facility. Refer to User-defined Table 0435 - Advance Directive Code in Chapter 2C, Code Tables, for suggested values. See also PD1-15 - Advance Directive Code. This field is required if PV2-50 - Advance Directive Last Verified Date is valued.

Note: for details about specific consent refer to the Consent (CON) segment in chapter 9.

(Definition from PD1.15 in Ch. 3)

Definition: This field indicates the patient's instructions to the healthcare facility. Refer to User-defined Table 0435 - Advance Directive Code in Chapter 2C, Code Tables, for suggested values. See also PV2-45 - Advance Directive Code. When PD1-22 - Advanced Directive Last Verified Date is valued, this field is required.

PV2-46: Patient Status Effective Date (DT) 01549

Definition: This field indicates the effective date for PV2-24 - Patient Status.

PV2-47: Expected LOA Return Date/Time (DTM) 01550

Definition: This field is conditionally required for A21 - Patient goes on LOA. It may be populated in A22 - Patient returns from LOA as well as in the A53 - Cancel LOA for a patient and the A54 - Cancel patient returns from LOA triggers. This field contains the date/time that the patient is expected to return from LOA.

PV2-48: Expected Pre-admission Testing Date/Time (DTM) 01841

Definition: This field contains the date/time that the patient is expected for pre-admission testing.

PV2-49: Notify Clergy Code (CWE) 01842

Definition: This field allows the user to indicate whether the clergy should be notified. Refer to User-defined Table 0534 - Notify Clergy Code in Chapter 2C, Code Tables, for suggested values.

PV2-50: Advance Directive Last Verified Date (DT) 02141

(Definition from PV2.50 in Ch. 3)

Definition: This field indicates the date that all the advance directives held in PV2-45 - Advance Directive Code were last verified. When this field is valued, the field PV2-45 - Advance Directive Code is required.

(Definition from PD1.22 in Ch. 3)

Definition: This field indicates the date that all the advance directives held in PD1-15 - Advance Directive Code were last validated. When this field is valued, the field PD1-15 - Advance Directive Code is required.

NK1 - Next Of Kin / Associated Parties Segment

The NK1 segment contains information about the patient's other related parties. Any associated parties may be identified. Utilizing NK1-1 - set ID, multiple NK1 segments can be sent to patient accounts.

If a person or organization fulfills multiple contact roles, for example, a person is an emergency contact and a next of kin, it is recommended to send a NK1 segment for each contact role (field 7).

HL7 Attribute Table - NK1 - Next of Kin / Associated Parties Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
NK1
1 00190 Set ID - NK1 SHALL [1..1] [1..4] SI
2 00191 Name [0..*] XPN
3 00192 Relationship [0..1] CWE
4 00193 Address [0..*] XAD
5 00194 Phone Number SHALL NOT W [0..0] XTN
6 00195 Business Phone Number SHALL NOT W [0..0] XTN
7 00196 Contact Role [0..1] CWE
8 00197 Start Date [0..1] DT
9 00198 End Date [0..1] DT
10 00199 Next of Kin / Associated Parties Job Title # [0..1] 60 ST
11 00200 Next of Kin / Associated Parties Job Code/Class [0..1] JCC
12 00201 Next of Kin / Associated Parties Employee Number [0..1] CX
13 00202 Organization Name - NK1 [0..*] XON
14 00119 Marital Status [0..1] CWE
15 00111 Administrative Sex [0..1] CWE
16 00110 Date/Time of Birth [0..1] DTM
17 00755 Living Dependency [0..*] CWE
18 00145 Ambulatory Status [0..*] CWE
19 00129 Citizenship [0..*] CWE
20 00118 Primary Language [0..1] CWE
21 00742 Living Arrangement [0..1] CWE
22 00743 Publicity Code [0..1] CWE
23 00744 Protection Indicator [0..1] [1..1] ID
24 00745 Student Indicator [0..1] CWE
25 00120 Religion [0..1] CWE
26 00109 Mother's Maiden Name [0..*] XPN
27 00739 Nationality [0..1] CWE
28 00125 Ethnic Group [0..*] CWE
29 00747 Contact Reason [0..*] CWE
30 00748 Contact Person's Name [0..*] XPN
31 00749 Contact Person's Telephone Number SHALL NOT W [0..0] XTN
32 00750 Contact Person's Address [0..*] XAD
33 00751 Next of Kin/Associated Party's Identifiers [0..*] CX
34 00752 Job Status [0..1] CWE
35 00113 Race [0..*] CWE
36 00753 Handicap [0..1] CWE
37 00754 Contact Person Social Security Number # [0..1] 16 ST
38 01905 Next of Kin Birth Place # [0..1] 250 ST
39 00146 VIP Indicator [0..1] CWE
40 02292 Next of Kin Telecommunication Information [0..1] XTN
41 02293 Contact Person's Telecommunication Information [0..1] XTN

NK1-1: Set ID - NK1 (SI) 00190

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

NK1-2: Name (XPN) 00191

Definition: This field contains one or more of the names of the next of kin or associated party. The XPN.7 Name Type Code, and not the order, conveys how the name should be interpreted. As of v 2.7 Name Type Code is required. Refer to HL7 Table 0200 - Name Type in Chapter 2C, Code Tables, for valid values. Specification of meaning based on sequence is deprecated.

In addition to allowing repetition of this field for transmitting multiple names with different Name Type Codes, repetition also allows for representing the same name in different character sets based on the value in XPN.8 Name Representation Code.

NK1-3: Relationship (CWE) 00192

Definition: This field contains the actual personal relationship that the next of kin/associated party has to the patient. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values.

NK1-4: Address (XAD) 00193

Definition: This field contains the address of the next of kin/associated party. Multiple addresses are allowed for the same person. As of v2.7 the "primary mailing address" constraint as the first sequence has been removed. Primary Mailing Address is not an entry in either XAD.7 – Address Type or in XAD.18 – Address Usage.

NK1-5: Phone Number

Attention: The NK1-5 field was retained for backward compatibility as of v2.7 and withdrawn as of v 2.9. The reader is referred to section 3.4.5.40 NK1-40 instead. This field contains the telephone number of the next of kin/associated party. Multiple phone numbers are allowed for the same person. The primary telephone number must be sent in the first sequence. If the primary telephone number is not sent, then the repeat delimiter must be sent in the first sequence. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type in Chapter 2C, Code Tables, for valid values.

NK1-6: Business Phone Number

Attention: The NK1-5 field was retained for backward compatibility as of v2.7 and withdrawn as of v 2.9. The reader is referred to section 3.4.5.40 NK1-40 instead. Multiple phone numbers are allowed for the same person. The primary business telephone number must be sent in the first sequence. If the primary business telephone number is not sent, then the repeat delimiter must be sent in the first sequence. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type in Chapter 2C, Code Tables, for valid values.

NK1-7: Contact Role (CWE) 00196

(Definition from NK1.7 in Ch. 3)

Definition: This field indicates the specific relationship role. Refer to User-defined Table 0131 - Contact Role in Chapter 2C, Code Tables, for suggested values. This field specifies the role that the next of kin/associated parties plays with regard to the patient.

(Definition from CTD.1 in Ch. 11)

Definition: This field contains the contact role that defines the relationship of the person described in this segment to the patient being referred. When a referral is inter-enterprise in nature, there are some important relationships that must be identified. For example, it may be necessary to identify the contact representative at the clinic that sent the referral. User-defined Table 0131 - Contact Role (in Chapter 3, "Patient Administration")is used as the HL7 identifier for the user-defined table of values for this field.

NK1-8: Start Date (DT) 00197

Definition: This field contains the start date of the contact role.

NK1-9: End Date (DT) 00198

Definition: This field contains the end date of the contact role.

NK1-10: Next of Kin / Associated Parties Job Title (ST) 00199

Definition: This field contains the title of the next of kin/associated parties at their place of employment. However, if the contact role is the patient's employer, this field contains the job title of the patient at their place of employment.

NK1-11: Next of Kin / Associated Parties Job Code/Class (JCC) 00200

Definition: This field contains the employer's job code and the employee classification used for the next of kin/associated parties at their place of employment. However, if the contact role is the patient's employer, this field contains the job code/class of the patient at their place of employment.

Note: The JCC data element appears in other segments as ITEM# 00786 (GT1-50, IN2-47, STF-19). It is assigned a different ITEM# in the NK1 segment because the element name and usage is variable. For example the job code/class can be for the patient's employer, or for an associated party's employment information.


NK1-12: Next of Kin / Associated Parties Employee Number (CX) 00201

Definition: For backward compatibility, the ST data type can be sent; however, HL7 recommends that the CX data type be used for new implementations. This field contains the number that the employer assigns to the employee that is acting as next of kin/associated parties. However, if the contact role is the patient's employer, this field contains the employee number of the patient at their place of employment. The assigning authority and identifier type codes are strongly recommended for all CX data types.

NK1-13: Organization Name - NK1 (XON) 00202

Definition: This field contains the name of the organization that serves as a next of kin/associated party or as the next of kin of the patient. This field may also be used to communicate the name of the organization at which the associated party works. Multiple names for the same organization may be sent. If multiple names are sent, the legal name must be sent in the first sequence. If the legal name is not sent, then a repeat delimiter must be sent in the first sequence.

NK1-14: Marital Status (CWE) 00119

(Definition from PID.16 in Ch. 3)

Definition: This field contains the patient's marital (civil) status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.14 in Ch. 3)

Definition: This field contains the next of kin/associated party's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.43 in Ch. 6)

Definition: This field contains the insured's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.17 in Ch. 15)

Definition: This field contains the staff member's marital status. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values. Same values as those for PID-16 Marital Status.

NK1-15: Administrative Sex (CWE) 00111

(Definition from PID.8 in Ch. 3)

Definition: This field contains the patient's sex. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.15 in Ch. 3)

Definition: This field contains the next of kin/associated party's sex. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.5 in Ch. 15)

Definition: This field contains the staff person's sex. Refer to User-defined Table 0001 – Administrative Sex for suggested values.

NK1-16: Date/Time of Birth (DTM) 00110

(Definition from PID.7 in Ch. 3)

Definition: This field contains the patient's date and time of birth.

(Definition from NK1.16 in Ch. 3)

Definition: This field contains the next of kin/associated party's birth date and time.

(Definition from STF.6 in Ch. 15)

Definition: This field contains a staff member's date and time of birth.

NK1-17: Living Dependency (CWE) 00755

(Definition from NK1.17 in Ch. 3)

Definition: This field identifies specific living conditions (e.g., spouse dependent on patient, walk-up) that are relevant to an evaluation of the patient's healthcare needs. This information can be used for discharge planning. Examples might include Spouse Dependent, Medical Supervision Required, Small Children Dependent. This field repeats because, for example, "spouse dependent" and "medical supervision required" can apply at the same time. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.1 in Ch. 3)

Definition: This field identifies specific living conditions (e.g., spouse dependent on patient, walk-up) that are relevant to an evaluation of the patient's healthcare needs. This information can be used for discharge planning. This field repeats because, for example, "spouse dependent" and "medical supervision required" can apply at the same time. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.33 in Ch. 6)

Definition: Identifies the specific living conditions of the guarantor. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.31 in Ch. 6)

Definition: This field identifies the specific living conditions for the insured. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

NK1-18: Ambulatory Status (CWE) 00145

(Definition from PV1.15 in Ch. 3)

Definition: This field indicates any permanent or transient handicapped conditions. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested entries.

(Definition from NK1.18 in Ch. 3)

Definition: This field identifies the transient rate of mobility for the next of kin/associated party. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables for suggested values.

(Definition from GT1.34 in Ch. 6)

Definition: Identifies the transient state of mobility for the guarantor. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.32 in Ch. 6)

Definition: This field identifies the insured's state of mobility. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.

NK1-19: Citizenship (CWE) 00129

(Definition from PID.26 in Ch. 3)

This field contains the information related to a person's country citizenship. For country citizenship HL7 recommends using ISO table 3166. For a local definition, User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables, should be used.

This field repeats since persons can be citizens of more than one country. The Name of Coding System component(s) of the CWE datatype should be used to identify the table from which citizenship membership is drawn.

In the Netherlands, this field is used for "Nationaliteit".

(Definition from NK1.19 in Ch. 3)

Definition: This field contains the code to identify the next of kin/associated party's citizenship. HL7 recommends using ISO 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.

(Definition from GT1.35 in Ch. 6)

Definition: This field contains the code to identify the guarantor's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.

(Definition from IN2.33 in Ch. 6)

Definition: This field contains the code that identifies the insured's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship defined in Chapter 2C, Code Tables.

(Definition from STF.30 in Ch. 15)

Definition: This field contains the staff person's current country of citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship (in Chapter 2C, Code Tables).

NK1-20: Primary Language (CWE) 00118

(Definition from PID.15 in Ch. 3)

Definition: This field contains the patient's primary language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language within Chapter 2C, Code Tables.

(Definition from NK1.20 in Ch. 3)

Definition: This field identifies the next of kin/associated party's primary speaking language. HL7 recommends using ISO 639 as the suggested values in User-defined Table 0296 - Language in Chapter 2C, Code Tables.

(Definition from GT1.36 in Ch. 6)

Definition: This field identifies the guarantor's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.

(Definition from IN2.34 in Ch. 6)

Definition: This field identifies the insured's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.

NK1-21: Living Arrangement (CWE) 00742

(Definition from NK1.21 in Ch. 3)

Definition: This field identifies the situation that the associated party lives in at his/her residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.2 in Ch. 3)

Definition: This field identifies the situation in which the patient lives at his residential address. Examples might include Alone, Family, Relatives, Institution, etc. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.37 in Ch. 6)

Definition: This field identifies the situation in which the person lives at his residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.35 in Ch. 6)

Definition: This field indicates the situation in which the insured person lives at his primary residence. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

NK1-22: Publicity Code (CWE) 00743

(Definition from NK1.22 in Ch. 3)

Definition: This field indicates what level of publicity is allowed (e.g., No Publicity, Family Only) for the next of kin/associated party. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.11 in Ch. 3)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for the patient. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values. Refer to PV2-21 - Visit Publicity Code for visit level code.

(Definition from GT1.38 in Ch. 6)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for a guarantor. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.36 in Ch. 6)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for the insured. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

NK1-23: Protection Indicator (ID) 00744

(Definition from NK1.23 in Ch. 3)

Definition: This field identifies that next of kin/associated party's protection that determines, in turn, whether access to information about this person should be kept from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    protect access to next-of-kin information

  • N    normal access

(Definition from PD1.12 in Ch. 3)

Definition: From V2.6 onward, this field has been retained for backward compatibility only. Use the ARV segment instead. This field identifies the patient's protection that determines, in turn, whether access to information about this person should be kept from users who do not have adequate authority for the patient. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    protect access to information

  • N    normal access

Refer to PV2-22 - Visit Protection Indicator for visit level code.

(Definition from GT1.39 in Ch. 6)

Definition: This field identifies the guarantor's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator for valid values.

  • Y    restrict access

  • N    do not restrict access

(Definition from IN2.37 in Ch. 6)

Definition: This field identifies the insured's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    Restrict access

  • N    Do not restrict access

NK1-24: Student Indicator (CWE) 00745

(Definition from NK1.24 in Ch. 3)

Definition: This field identifies whether the next of kin/associated party is currently a student or not, and whether the next of kin/associated party is a full- or a part-time student. This field does not indicate the degree (high school, college) of the student or the field of study. Refer to User-defined Table 0231 - Student Status in chapter 2C, for suggested values.

(Definition from PD1.5 in Ch. 3)

Definition: This field indicates if the patient is currently a student or not, and whether the patient is a full-time or a part-time student. This field does not indicate the student's degree level (high school, college, elementary) or the student's field of study (accounting, engineering, etc.). Refer to User-defined Table 0231 - Student Status in chapter 2C, for suggested values.

(Definition from GT1.40 in Ch. 6)

Definition: This field indicates whether the guarantor is currently a student, and whether the guarantor is a full-time or part-time student. This field does not indicate the degree level (high school, college) of the student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231- Student Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.38 in Ch. 6)

Definition: This field identifies whether the insured is currently a student or not, and whether the insured is a full-time or a part-time student. This field does not indicate the degree level (high school, college) of student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231 - Student Status in Chapter 2C, Code Tables, for suggested values.

NK1-25: Religion (CWE) 00120

(Definition from PID.17 in Ch. 3)

Definition: This field contains the patient's religion. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.25 in Ch. 3)

Definition: This field indicates the type of religion practiced by the next of kin/associated party. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.41 in Ch. 6)

Definition: This field indicates the type of religion practiced by the guarantor. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.39 in Ch. 6)

Definition: This field indicates the type of religion practiced by the insured. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

(Definition from STF.40 in Ch. 15)

Definition: This field contains the staff member's religion. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

NK1-26: Mother's Maiden Name (XPN) 00109

(Definition from PID.6 in Ch. 3)

Definition: This field contains the family name under which the mother was born (i.e., before marriage). It is used to distinguish between patients with the same last name.

(Definition from NK1.26 in Ch. 3)

Definition: This field indicates the maiden name of the next of kin/associated party's mother.

(Definition from GT1.42 in Ch. 6)

Definition: This field indicates the guarantor's mother's maiden name.

(Definition from IN2.40 in Ch. 6)

Definition: This field indicates the insured's mother's maiden name.

NK1-27: Nationality (CWE) 00739

(Definition from PID.28 in Ch. 3)

Attention: The PID-28 field was retained for backward compatibility only as of v 2.4 and was withdrawn and removed from this message structure as of v 2.7. It is recommended to refer to PID-10 - Race, PID-22 - Ethnic group and PID-26 - Citizenship.

(Definition from NK1.27 in Ch. 3)

Definition: This field identifies the nation or national group to which the next of kin/associated party belongs. This information may be different than the person's citizenship in countries in which multiple nationalities are recognized (e.g., Spain: Basque, Catalan, etc.). Refer to User-defined Table 0212 - Nationality in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.43 in Ch. 6)

Definition: This field contains a code that identifies the nation or national grouping to which the person belongs. This may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.

(Definition from IN2.41 in Ch. 6)

Definition: This field contains a code that identifies the nation or national grouping to which the insured person belongs. This information may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.

NK1-28: Ethnic Group (CWE) 00125

(Definition from PID.22 in Ch. 3)

Definition: This field further defines the patient's ancestry. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from NK1.28 in Ch. 3)

Definition: This field contains the next of kin/associated party's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from GT1.44 in Ch. 6)

Definition: This field contains the guarantor's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from IN2.42 in Ch. 6)

Definition: This field indicates the insured's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

(Definition from STF.28 in Ch. 15)

  • Definition: This field further defines the person's ancestry. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second couplet of the CWE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the United States, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

NK1-29: Contact Reason (CWE) 00747

(Definition from NK1.29 in Ch. 3)

Definition: This field identifies how the contact should be used (e.g., contact employer if patient is unable to work). Refer to User-defined Table 0222 - Contact Reason in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.47 in Ch. 6)

Definition: This field contains a user-defined code that identifies the reason for contacting the guarantor, for example, to phone the guarantor if payments are late. Refer to User-defined Table 0222 - Contact reason in Chapter 2C, Code Tables, for suggested values.

NK1-30: Contact Person's Name (XPN) 00748

(Definition from NK1.30 in Ch. 3)

Definition: This field contains one or more of the names of the person to contact, depending on the value of the relationship defined in NK1-3 - Relationship. This field is typically needed when the NK1 is an organization. The XPN.7 Name Type Code, and not the order, conveys how the name should be interpreted. As of v2.7, Name Type Code is required. Refer to HL7 Table 0200 - Name Type in Chapter 2C, Code Tables, for valid values. Specification of meaning based on sequence is deprecated.

In addition to allowing repetition of this field for transmitting multiple names with different Name Type Codes, repetition also allows for representing the same name in different character sets based on the value in XPN.8 Name Representation Code.

(Definition from GT1.45 in Ch. 6)

Definition: This field contains the name of the person who should be contacted regarding the guarantor bills, etc. This may be someone other than the guarantor. (E.g., Contact guarantor's wife regarding all bills - guarantor lives out of country.)

This is a repeating field that allows for multiple names for the same person. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

NK1-31: Contact Person's Telephone Number

(Definition from NK1.31 in Ch. 3)

Attention: The NK1-31 field was retained for backward compatibility as of v2.7 and withdrawn as of v 2.9 The reader is referred to section 3.3.5.41 NK-41 Contact Person’s Telecommunication Information instead. This field contains the telephone numbers of the contact person depending on the value of the relationship defined in NK1-3 - Relationship. This field is typically needed when the NK1 is an organization. The primary telephone number must be sent in the first sequence. If the primary telephone number is not sent, then a repeat delimiter must be sent in the first sequence. Refer to HL7 Table 0201 - Telecommunication Use Code and HL7 Table 0202 - Telecommunication Equipment Type in Chapter 2C, Code Tables, for valid values.

(Definition from GT1.46 in Ch. 6)

Definition: This field contains the telephone number of the guarantor (person) to contact regarding guarantor bills, etc. Multiple phone numbers for that person may be sent in this sequence. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

NK1-32: Contact Person's Address (XAD) 00750

Definition: This field contains the addresses of the contact person depending on the value of the relationship defined in NK1-3 - Relationship. This field is typically used when the NK1 is an organization. As of v2.7, the "primary mailing address" constraint as the first sequence has been removed. Primary Mailing Address is not an entry in either XAD.7 – Address Type or in XAD.18 – Address Usage.

NK1-33: Next of Kin/Associated Party's Identifiers (CX) 00751

Definition: This field contains the identifiers for the next of kin/associated party, for example, Social Security Number, driver's license, etc. The assigning authority and identifier type code are strongly recommended for all CX data types.

NK1-34: Job Status (CWE) 00752

(Definition from NK1.34 in Ch. 3)

Definition: This field identifies the next of kin/associated party's job status. Refer to User-defined Table 0311 - Job Status in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.53 in Ch. 6)

Definition: This field contains a code that identifies the guarantor's current job status. Refer to User-defined Table 0311 - Job Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.48 in Ch. 6)

Definition: This field indicates a code that identifies the insured's current job status. Refer to User-defined Table 0311 - Job Status in Chapter 2C, Code Tables, for suggested values.

NK1-35: Race (CWE) 00113

(Definition from PID.10 in Ch. 3)

Definition: This field refers to the patient's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from NK1.35 in Ch. 3)

Definition: This field identifies the race of the next of kin/associated party. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from IN2.71 in Ch. 6)

Definition: Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

(Definition from STF.27 in Ch. 15)

Definition: This field refers to the person's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CWE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

NK1-36: Handicap (CWE) 00753

(Definition from NK1.36 in Ch. 3)

Definition: This field contains the code that describes an associated party's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.6 in Ch. 3)

Definition: This field indicates the nature of the patient's permanent handicapped condition (e.g., deaf, blind). A handicapped condition is defined as a physical or mental disability that is permanent. Transient handicapped conditions should be sent in the ambulatory status. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.52 in Ch. 6)

Definition: This field contains a code to describe the guarantor's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from IN1.48 in Ch. 6)

Definition: This field contains a code to describe the insured's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

NK1-37: Contact Person Social Security Number (ST) 00754

Definition: In the US, this field contains the contact person's social security number. This number may also be a RR retirement number. For the Social Security number of the associated party, see NK1-33 - Next of Kin/Associated Party's identifiers.

NK1-38: Next of Kin Birth Place (ST) 01905

Definition: This field indicates the location of the next-of-kin's birth; for example, "St. Francis Community Hospital of Lower South Side." The actual address is reported in NK1-4 - Address with an identifier of "N".

NK1-39: VIP Indicator (CWE) 00146

(Definition from PV1.16 in Ch. 3)

Definition: This field identifies the type of VIP. Refer to User-defined Table 0099 - VIP Indicator in Chapter 2C, Code Tables, for suggested values.

(Definition from NK1.39 in Ch. 3)

Definition: This field identifies the type of VIP for the next-of-kin. Refer to User-defined Table 0099 – VIP Indicator in Chapter 2C, Code Tables.

(Definition from GT1.57 in Ch. 6)

Definition: This field identifies the type of VIP for the guarantor. Refer to User-defined Table 0099 – VIP Indicator in Chapter 2C, Code Tables, for suggested values.

NK1-40: Next of Kin Telecommunication Information (XTN) 02292

Definition: This field contains the next of kin’s telecommunication contact information. This field replaces NK1-5 – Phone Number and NK1-6 – Business Phone Number with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type). Jointly, these components will describe the nature of the telecommunication data contained in this field.

NK1-41: Contact Person's Telecommunication Information (XTN) 02293

Definition: This field contains the contact person’s telecommunication contact information. This field replaces NK1-31 – Contact Person’s Telephone Number with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type). Jointly, these components will describe the nature of the telecommunication data contained in this field.

AL1 - Patient Allergy Information Segment

The AL1 segment contains patient allergy information of various types. Most of this information will be derived from user-defined tables. Each AL1 segment describes a single patient allergy.

HL7 Attribute Table - AL1 - Patient Allergy Information Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
AL1
1 00203 Set ID - AL1 SHALL [1..1] [1..4] SI
2 00204 Allergen Type Code [0..1] CWE
3 00205 Allergen Code/Mnemonic/Description [0..1] CWE
4 00206 Allergy Severity Code [0..1] CWE
5 00207 Allergy Reaction Code = [0..*] 15 ST
6 00208 Identification Date SHALL NOT W [0..0]

AL1-1: Set ID - AL1 (SI) 00203

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

AL1-2: Allergen Type Code (CWE) 00204

(Definition from AL1.2 in Ch. 3)

Definition: This field indicates a general allergy category (drug, food, pollen, etc.). Refer to User-defined Table 0127 - Allergen Type in Chapter 2C, Code Tables, for suggested values.

(Definition from IAM.2 in Ch. 3)

Definition: This field indicates a general allergy category (drug, food, pollen, etc.). Refer to User-defined Table 0127 - Allergen Type in Chapter 2C, Code Tables, for suggested values.

AL1-3: Allergen Code/Mnemonic/Description (CWE) 00205

(Definition from AL1.3 in Ch. 3)

Definition: This field uniquely identifies a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

(Definition from IAM.3 in Ch. 3)

Definition: This field uniquely identifies a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

If a system maintains allergen codes as its unique identifier for a particular allergy, and two systems have agreed to process the IAM using update mode, then this field can be used as the unique identifier instead of IAM-8 - Allergy Unique Identifier. This does not preclude using allergen codes for unique identifiers for snapshot processing.

AL1-4: Allergy Severity Code (CWE) 00206

(Definition from AL1.4 in Ch. 3)

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy Severity in Chapter 2C, Code Tables, for valid values.

(Definition from IAM.4 in Ch. 3)

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy Severity Code in Chapter 2C, Code Tables, for suggested values.

AL1-5: Allergy Reaction Code (ST) 00207

(Definition from AL1.5 in Ch. 3)

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

(Definition from IAM.5 in Ch. 3)

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

AL1-6: Identification Date

Definition: The Al-6 field was retained for backward compatibility only as of v 2.4 and has been withdrawn as of v 2.7. The reader is referred to the IAM-11 – Onset Date or IAM-13 – Inset Date fields for dates when the allergy was identified..

IAM - Patient Adverse Reaction Information Segment

The IAM segment contains person/patient adverse reaction information of various types. Most of this information will be derived from user-defined tables. Each IAM segment describes a single person/patient adverse reaction. This segment is used in lieu of the AL1 - Patient Allergy Information Segment to support action code/unique identifier mode update definition of repeating segments as defined in 2.10.4.2 in chapter 2, section 2.4.10, "Protocol for interpreting repeating segments or segment groups in an update Message." The AL1 segment is used to support Snapshot mode update definition as defined in 2.10.4.1.

HL7 Attribute Table - IAM - Patient Adverse Reaction Information Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
IAM
1 01612 Set ID - IAM SHALL [1..1] [1..4] SI
2 00204 Allergen Type Code [0..1] CWE
3 00205 Allergen Code/Mnemonic/Description SHALL [1..1] CWE
4 00206 Allergy Severity Code [0..1] CWE
5 00207 Allergy Reaction Code = [0..*] 15 ST
6 01551 Allergy Action Code SHALL [1..1] CNE
7

01552 Allergy Unique Identifier MAY
True:
False:
C
[1..1]
[0..1]
EI
8 01553 Action Reason = [0..1] 60 ST
9 01554 Sensitivity to Causative Agent Code [0..1] CWE
10 01555 Allergen Group Code/Mnemonic/Description [0..1] CWE
11 01556 Onset Date [0..1] DT
12 01557 Onset Date Text = [0..1] 60 ST
13 01558 Reported Date/Time [0..1] DTM
14 01559 Reported By [0..1] XPN
15 01560 Relationship to Patient Code [0..1] CWE
16 01561 Alert Device Code [0..1] CWE
17 01562 Allergy Clinical Status Code [0..1] CWE
18 01563 Statused by Person [0..1] XCN
19 01564 Statused by Organization [0..1] XON
20 01565 Statused at Date/Time [0..1] DTM
21 02294 Inactivated by Person [0..1] XCN
22 02295 Inactivated Date/Time [0..1] DTM
23 02296 Initially Recorded by Person [0..1] XCN
24 02297 Initially Recorded Date/Time [0..1] DTM
25 02298 Modified by Person [0..1] XCN
26 02299 Modified Date/Time [0..1] DTM
27 02300 Clinician-Identified Allergen Code [0..1] CWE
28 03293 Initially Recorded by Organization [0..1] XON
29 03294 Modified by Organization [0..1] XON
30 03295 Inactivated by Organization [0..1] XON

IAM-1: Set ID - IAM (SI) 01612

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

IAM-2: Allergen Type Code (CWE) 00204

(Definition from AL1.2 in Ch. 3)

Definition: This field indicates a general allergy category (drug, food, pollen, etc.). Refer to User-defined Table 0127 - Allergen Type in Chapter 2C, Code Tables, for suggested values.

(Definition from IAM.2 in Ch. 3)

Definition: This field indicates a general allergy category (drug, food, pollen, etc.). Refer to User-defined Table 0127 - Allergen Type in Chapter 2C, Code Tables, for suggested values.

IAM-3: Allergen Code/Mnemonic/Description (CWE) 00205

(Definition from AL1.3 in Ch. 3)

Definition: This field uniquely identifies a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

(Definition from IAM.3 in Ch. 3)

Definition: This field uniquely identifies a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

If a system maintains allergen codes as its unique identifier for a particular allergy, and two systems have agreed to process the IAM using update mode, then this field can be used as the unique identifier instead of IAM-8 - Allergy Unique Identifier. This does not preclude using allergen codes for unique identifiers for snapshot processing.

IAM-4: Allergy Severity Code (CWE) 00206

(Definition from AL1.4 in Ch. 3)

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy Severity in Chapter 2C, Code Tables, for valid values.

(Definition from IAM.4 in Ch. 3)

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy Severity Code in Chapter 2C, Code Tables, for suggested values.

IAM-5: Allergy Reaction Code (ST) 00207

(Definition from AL1.5 in Ch. 3)

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

(Definition from IAM.5 in Ch. 3)

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

IAM-6: Allergy Action Code (CNE) 01551

Definition: This field contains a code defining the status of the record. It allows allergy messages to be sent to delete or update previously sent allergy messages. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for suggested values.

IAM-7: Allergy Unique Identifier (EI) 01552

Definition: This field contains a value that uniquely identifies a single allergy for a person.

This field is conditionally required. The surrogate field to use is IAM-3 - Allergen Code/Mnemonic/Description if that field can uniquely identify the allergy on the receiving system.

IAM-8: Action Reason (ST) 01553

Definition: This field contains the reason for the action indicated in the IAM-6 - Allergy Action Code field.

IAM-9: Sensitivity to Causative Agent Code (CWE) 01554

Definition: This field contains the reason why the patient should not be exposed to a substance. Refer to User-defined Table 0436 - Sensitivity to Causative Agent Code in Chapter 2C, Code Tables, for suggested values.

IAM-10: Allergen Group Code/Mnemonic/Description (CWE) 01555

Definition: This field contains the code, mnemonic, or description used to uniquely identify an allergen group when both a detailed allergy (IAM-3 - Allergen Code/Mnemonic/Description) and group level (IAM-10 - Allergen Group Code/Mnemonic/Description) need to be communicated. In cases where systems want to communicate both a specific drug allergy and the group of drugs to which the specific drug belongs (i.e., Bactrim and Sulfa drugs; Ceclor and Penicillins/Cephalosporins) then the specific drug allergy is sent in IAM-3 - Allergen Code/Mnemonic/Description and the group level is sent in IAM-10 - Allergen Group Code/Mnemonic/Description. However, if only a group level is being communicated, then it can be sent in IAM-3 as the primary identifier of the allergy.

IAM-11: Onset Date (DT) 01556

Definition: This field contains the actual date of the first reaction.

IAM-12: Onset Date Text (ST) 01557

Definition: This field contains a text description of the time period of the first reaction when an exact date is not known (e.g., adolescence, childhood, spring 1990).

IAM-13: Reported Date/Time (DTM) 01558

Definition: This field contains the date/time the allergy was reported to a caregiver.

IAM-14: Reported By (XPN) 01559

Definition: This field contains the name of the person reporting the allergy to a caregiver at the time reported in IAM-14 - Reported Date/Time.

IAM-15: Relationship to Patient Code (CWE) 01560

Definition: This field contains the personal relationship that the person reporting the allergy has to the patient. It uses the same table as that used by NK1-3. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values. Examples include: brother, sister, mother, father, friend, spouse, etc.

IAM-16: Alert Device Code (CWE) 01561

Definition: This field describes any type of allergy alert device the patient may be carrying or wearing. Refer to User-defined Table 0437 - Alert Device in Chapter 2C, Code Tables, for suggested values.

IAM-17: Allergy Clinical Status Code (CWE) 01562

Definition: This field indicates the verification status for the allergy. Refer to User-defined Table 0438 - Allergy Clinical Status in Chapter 2C, Code Tables, for suggested values.

IAM-18: Statused by Person (XCN) 01563

Definition: This field identifies the provider who assigned the clinical status to the allergy (e.g., ...| S12345^EVERYMAN^ADAM^J^III^DR^MD|...).

IAM-19: Statused by Organization (XON) 01564

Definition: This field contains the name of the organization providing the update to the allergy (e.g., Good Health Hospital).

IAM-20: Statused at Date/Time (DTM) 01565

Definition: The date and time that this allergy was last statused by the IAM-18 - Statused by Person in the IAM-19 - Statused by Organization.

IAM-21: Inactivated by Person (XCN) 02294

Definition: This field identifies the user that inactivated the record entry about the patient’s allergy

(e.g. ...| S12345^Smith^John^J^III^DR^MD|...).

IAM-22: Inactivated Date/Time (DTM) 02295

Definition: The date and time that this allergy was inactivated by the IAM-21 Inactivated by Person.

IAM-23: Initially Recorded by Person (XCN) 02296

Definition: This field identifies the user that created the entry in the record stating the allergy (e.g. ...| S12345^Smith^John^J^III^DR^MD|...).

IAM-24: Initially Recorded Date/Time (DTM) 02297

Definition: The date and time that this allergy entry was created by the IAM-23 Created by Person.

IAM-25: Modified by Person (XCN) 02298

Definition: This field identifies the user that modified the allergy (e.g. ...|S12345^Smith^John^J^III^DR^MD|...).

IAM-26: Modified Date/Time (DTM) 02299

Definition: The date and time that this allergy was modified by the IAM-25 Modified by Person.

IAM-27: Clinician-Identified Allergen Code (CWE) 02300

Definition: This field identifies the clinician entered description associated to a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

IAM-28: Initially Recorded by Organization (XON) 03293

Definition: This field contains the name of the organization that initially recorded the allergy (e.g., a General Hospital).

IAM-29: Modified by Organization (XON) 03294

Definition: This field contains the name of the organization that modified the allergy (e.g., a General Hospital).

IAM-30: Inactivated by Organization (XON) 03295

Definition: This field contains the name of the organization that inactivated the allergy (e.g., a General Hospital).

IAR - Allergy Reaction Segment

The IAR segment is used to transmit a single reaction and information associated with this single reaction occurrence for a particular patient allergy (IAM – patient adverse reaction).

HL7 Attribute Table - IAR - Allergy Reaction Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
IAR
1 03296 Allergy Reaction Code SHALL [1..1] CWE
2 03297 Allergy Severity Code SHALL [1..1] CWE
3 03298 Sensitivity to Causative Agent Code [0..1] CWE
4 03299 Management = [0..1] 250 ST

IAR-1: Allergy Reaction Code (CWE) 03296

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

IAR-2: Allergy Severity Code (CWE) 03297

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy severity code in Chapter 2C, Code Tables, for suggested values.

IAR-3: Sensitivity to Causative Agent Code (CWE) 03298

Definition: This field contains the reason why the patient should not be exposed to a substance. Refer to User-defined Table 0436 - Sensitivity to causative Agent code in Chapter 2C, Code Tables, for suggested values.

IAR-4: Management (ST) 03299

Definition: This field contains a textual description of the actions that were performed in response to the reaction.

NPU - Bed Status Update Segment

The NPU segment allows the updating of census (bed status) data without sending patient-specific data. An example might include changing the status of a bed from "housekeeping" to "unoccupied."

HL7 Attribute Table - NPU - Bed Status Update Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
NPU
1 00209 Bed Location SHALL [1..1] PL
2 00170 Bed Status [0..1] CWE

NPU-1: Bed Location (PL) 00209

Definition: This field contains the bed location that is a valid bed location.

NPU-2: Bed Status (CWE) 00170

(Definition from PV1.40 in Ch. 3)

Definition: The PV1-40 field was retained for backward compatibility only as of v 2.3, and the field withdrawn as of v 2.7. The information is now held in the fifth component of the PL datatype in PV1-3.

(Definition from NPU.2 in Ch. 3)

Definition: This field contains the bed status. Refer to User-defined Table 0116 - Bed Status in Chapter 2C, Code Tables, for suggested values.

MRG - Merge Patient Information Segment

The MRG segment provides receiving applications with information necessary to initiate the merging of patient data as well as groups of records. It is intended that this segment be used throughout the Standard to allow the merging of registration, accounting, and clinical records within specific applications.

The assigning authority, the fourth component of the patient identifiers, is an HD data type that is uniquely associated with the assigning authority that originally assigned the number. A given institution, or group of intercommunicating institutions, should establish a list of assigning authorities that may be potential assignors of patient identification (and other important identification) numbers. The list will be one of the institution's master dictionary lists. Since third parties (other than the assignors of patient identification numbers) may send or receive HL7 messages containing patient identification numbers, the assigning authority in the patient identification numbers may not be the same as those of the sending and receiving systems identified in the MSH. The assigning authority must be unique across applications at a given site. This field is required in HL7 implementations that have more than a single Patient Administration application assigning such numbers.

HL7 Attribute Table - MRG - Merge Patient Information Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
MRG
1 00211 Prior Patient Identifier List SHALL [1..*] CX
2 00212 Prior Alternate Patient ID SHALL NOT W [0..0]
3 00213 Prior Patient Account Number [0..1] CX
4 00214 Prior Patient ID SHALL NOT W [0..0]
5 01279 Prior Visit Number [0..1] CX
6 01280 Prior Alternate Visit ID [0..*] CX
7 01281 Prior Patient Name [0..*] XPN

MRG-1: Prior Patient Identifier List (CX) 00211

Definition: This field contains the prior patient identifier list. This field contains a list of potential "old" numbers to match. Only one old number can be merged with one new number in a transaction. Refer to HL7 Table 0061 - Check Digit Scheme for valid values. The assigning authority and identifier type code are strongly recommended for all CX data types.

MRG-2: Prior Alternate Patient ID

Definition: The MRG-2 field was retained for backward compatibility only as of v 2.3.1 and withdrawn as of v 2.7. The reader is referred to section ‎3.4.10.1, MRG-1 Prior Patient Identifier List (CX) 00211, instead.

MRG-3: Prior Patient Account Number (CX) 00213

Definition: This field contains the prior patient account number. Refer to HL7 Table 0061 - Check Digit Scheme for valid values. The assigning authority and identifier type code are strongly recommended for all CX data types.

MRG-4: Prior Patient ID

Definition: The MRG-4 field was retained for backward compatibility only as of v 2.3.1 and withdrawn as of v 2.7. The reader is referred to section ‎3.4.10.1, MRG-1 Prior Patient Identifier List (CX) 00211, instead.

MRG-5: Prior Visit Number (CX) 01279

Definition: This field contains the prior visit number. Refer to HL7 Table 0061 - Check Digit Scheme for valid values. The assigning authority and identifier type code are strongly recommended for all CX data types.

MRG-6: Prior Alternate Visit ID (CX) 01280

Definition: This field contains the prior alternate visit number. Multiple alternate identifiers may be sent. Refer to HL7 Table 0061 - Check Digit Scheme in Chapter 2C, Code Tables, for valid values. The assigning authority and identifier type code are strongly recommended for all CX data types.

MRG-7: Prior Patient Name (XPN) 01281

Definition: This field contains the prior name of the patient. This field is not used to change a patient name. Refer to HL7 Table 0200 - Name Type in Chapter 2C, Code Tables, for valid values.

PD1 - Patient Additional Demographic Segment

The patient additional demographic segment contains demographic information that is likely to change about the patient.

HL7 Attribute Table - PD1 - Patient Additional Demographic Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
PD1
1 00755 Living Dependency [0..*] CWE
2 00742 Living Arrangement [0..1] CWE
3 00756 Patient Primary Facility [0..*] XON
4 00757 Patient Primary Care Provider Name & ID No. SHALL NOT W [0..0]
5 00745 Student Indicator [0..1] CWE
6 00753 Handicap [0..1] CWE
7 00759 Living Will Code [0..1] CWE
8 00760 Organ Donor Code [0..1] CWE
9 00761 Separate Bill [0..1] [1..1] ID
10 00762 Duplicate Patient [0..*] CX
11 00743 Publicity Code [0..1] CWE
12 00744 Protection Indicator B [0..1] [1..1] ID
13 01566 Protection Indicator Effective Date B [0..1] DT
14 01567 Place of Worship [0..*] XON
15

01548 Advance Directive Code MAY
True:
False:
C
[1..1]
[0..1]
CWE
16 01569 Immunization Registry Status [0..1] CWE
17 01570 Immunization Registry Status Effective Date [0..1] DT
18 01571 Publicity Code Effective Date [0..1] DT
19 01572 Military Branch [0..1] CWE
20 00486 Military Rank/Grade [0..1] CWE
21 01573 Military Status [0..1] CWE
22 02141 Advance Directive Last Verified Date [0..1] DT
23 03511 Retirement Date [0..1] DT

PD1-1: Living Dependency (CWE) 00755

(Definition from NK1.17 in Ch. 3)

Definition: This field identifies specific living conditions (e.g., spouse dependent on patient, walk-up) that are relevant to an evaluation of the patient's healthcare needs. This information can be used for discharge planning. Examples might include Spouse Dependent, Medical Supervision Required, Small Children Dependent. This field repeats because, for example, "spouse dependent" and "medical supervision required" can apply at the same time. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.1 in Ch. 3)

Definition: This field identifies specific living conditions (e.g., spouse dependent on patient, walk-up) that are relevant to an evaluation of the patient's healthcare needs. This information can be used for discharge planning. This field repeats because, for example, "spouse dependent" and "medical supervision required" can apply at the same time. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.33 in Ch. 6)

Definition: Identifies the specific living conditions of the guarantor. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.31 in Ch. 6)

Definition: This field identifies the specific living conditions for the insured. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

PD1-2: Living Arrangement (CWE) 00742

(Definition from NK1.21 in Ch. 3)

Definition: This field identifies the situation that the associated party lives in at his/her residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.2 in Ch. 3)

Definition: This field identifies the situation in which the patient lives at his residential address. Examples might include Alone, Family, Relatives, Institution, etc. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.37 in Ch. 6)

Definition: This field identifies the situation in which the person lives at his residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.35 in Ch. 6)

Definition: This field indicates the situation in which the insured person lives at his primary residence. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

PD1-3: Patient Primary Facility (XON) 00756

Definition: This field contains the name and identifier that specifies the "primary care" healthcare facility selected by the patient at the time of enrolment in an HMO Insurance Plan. Multiple names and identifiers are allowed for the same facility. The legal name of the healthcare facility must be sent in the first sequence. If the legal name of the facility is not sent, then the repeat delimiter must be sent in the first sequence. Refer to User-defined Table 0204 - Organizational Name Type in Chapter 2C, Code Tables, for suggested values.

PD1-4: Patient Primary Care Provider Name & ID No.

Definition: The PD1-4 field was retained for backward compatibility only as of v 2.4 and withdrawn as of v 2.7. The reader is advised that the PRT segment is now used to convey more complete information about the primary care provider.

PD1-5: Student Indicator (CWE) 00745

(Definition from NK1.24 in Ch. 3)

Definition: This field identifies whether the next of kin/associated party is currently a student or not, and whether the next of kin/associated party is a full- or a part-time student. This field does not indicate the degree (high school, college) of the student or the field of study. Refer to User-defined Table 0231 - Student Status in chapter 2C, for suggested values.

(Definition from PD1.5 in Ch. 3)

Definition: This field indicates if the patient is currently a student or not, and whether the patient is a full-time or a part-time student. This field does not indicate the student's degree level (high school, college, elementary) or the student's field of study (accounting, engineering, etc.). Refer to User-defined Table 0231 - Student Status in chapter 2C, for suggested values.

(Definition from GT1.40 in Ch. 6)

Definition: This field indicates whether the guarantor is currently a student, and whether the guarantor is a full-time or part-time student. This field does not indicate the degree level (high school, college) of the student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231- Student Status in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.38 in Ch. 6)

Definition: This field identifies whether the insured is currently a student or not, and whether the insured is a full-time or a part-time student. This field does not indicate the degree level (high school, college) of student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231 - Student Status in Chapter 2C, Code Tables, for suggested values.

PD1-6: Handicap (CWE) 00753

(Definition from NK1.36 in Ch. 3)

Definition: This field contains the code that describes an associated party's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.6 in Ch. 3)

Definition: This field indicates the nature of the patient's permanent handicapped condition (e.g., deaf, blind). A handicapped condition is defined as a physical or mental disability that is permanent. Transient handicapped conditions should be sent in the ambulatory status. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from GT1.52 in Ch. 6)

Definition: This field contains a code to describe the guarantor's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

(Definition from IN1.48 in Ch. 6)

Definition: This field contains a code to describe the insured's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

PD1-7: Living Will Code (CWE) 00759

(Definition from PV2.43 in Ch. 3)

Definition: This field indicates whether or not the patient has a living will and, if so, whether a copy of the living will is on file at the healthcare facility. If the patient does not have a living will, the value of this field indicates whether the patient was provided information on living wills. Refer to User-defined Table 0315 - Living Will Code in Chapter 2C, Code Tables, for suggested values. See also PD1-7 - Living Will.

(Definition from PD1.7 in Ch. 3)

Definition: This field indicates whether or not the patient has a living will and, if so, whether a copy of the living will is on file at the healthcare facility. If the patient does not have a living will, the value of this field indicates whether the patient was provided information on living wills. Refer to User-defined Table 0315 - Living Will Code in Chapter 2C, Code Tables, for suggested values. See also PV2-43 - Living Will Code.

PD1-8: Organ Donor Code (CWE) 00760

(Definition from PV2.44 in Ch. 3)

Definition: This field indicates whether the patient wants to donate his/her organs and whether an organ donor card or similar documentation is on file with the healthcare organization. Refer to User-defined Table 0316 - Organ Donor Code in Chapter 2C, Code Tables, for suggested values. See also PD1-8 - Organ Donor.

(Definition from PD1.8 in Ch. 3)

Definition: This field indicates whether the patient wants to donate his/her organs and whether an organ donor card or similar documentation is on file with the healthcare organization. Refer to User-defined Table 0316 - Organ Donor Code in Chapter 2C, Code Tables, for suggested values. See also PV2-44 - Organ donor Code.

PD1-9: Separate Bill (ID) 00761

Definition: This field specifies that charges for this patient are to be billed separately from other patient bills with the same guarantor. (This bill is now a patient bill rather than a guarantor bill.) Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    Bill separately

  • N    normal processing

PD1-10: Duplicate Patient (CX) 00762

Definition: This field indicates that a patient is the same as, or a duplicate of, another patient found on the sending system. The intent is to be informational only and no action is required by the receiver. Include the patient identifier if the sender knows an identifier for the patient. The assigning authority and identifier type code are strongly recommended for all CX data types.

PD1-11: Publicity Code (CWE) 00743

(Definition from NK1.22 in Ch. 3)

Definition: This field indicates what level of publicity is allowed (e.g., No Publicity, Family Only) for the next of kin/associated party. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

(Definition from PD1.11 in Ch. 3)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for the patient. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values. Refer to PV2-21 - Visit Publicity Code for visit level code.

(Definition from GT1.38 in Ch. 6)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for a guarantor. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.36 in Ch. 6)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for the insured. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

PD1-12: Protection Indicator (ID) 00744

(Definition from NK1.23 in Ch. 3)

Definition: This field identifies that next of kin/associated party's protection that determines, in turn, whether access to information about this person should be kept from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    protect access to next-of-kin information

  • N    normal access

(Definition from PD1.12 in Ch. 3)

Definition: From V2.6 onward, this field has been retained for backward compatibility only. Use the ARV segment instead. This field identifies the patient's protection that determines, in turn, whether access to information about this person should be kept from users who do not have adequate authority for the patient. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    protect access to information

  • N    normal access

Refer to PV2-22 - Visit Protection Indicator for visit level code.

(Definition from GT1.39 in Ch. 6)

Definition: This field identifies the guarantor's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator for valid values.

  • Y    restrict access

  • N    do not restrict access

(Definition from IN2.37 in Ch. 6)

Definition: This field identifies the insured's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    Restrict access

  • N    Do not restrict access

PD1-13: Protection Indicator Effective Date (DT) 01566

Definition: From v 2.6 onward, this field has been retained for backward compatibility only. Use the ARV segment instead. This field indicates the effective date for PD1-12 - Protection Indicator.

PD1-14: Place of Worship (XON) 01567

Definition: The patient's place of worship. For example, the patient attends the First Baptist Church of Atlanta.

PD1-15: Advance Directive Code (CWE) 01548

(Definition from PV2.45 in Ch. 3)

Definition: This field indicates the patient's instructions to the healthcare facility. Refer to User-defined Table 0435 - Advance Directive Code in Chapter 2C, Code Tables, for suggested values. See also PD1-15 - Advance Directive Code. This field is required if PV2-50 - Advance Directive Last Verified Date is valued.

Note: for details about specific consent refer to the Consent (CON) segment in chapter 9.

(Definition from PD1.15 in Ch. 3)

Definition: This field indicates the patient's instructions to the healthcare facility. Refer to User-defined Table 0435 - Advance Directive Code in Chapter 2C, Code Tables, for suggested values. See also PV2-45 - Advance Directive Code. When PD1-22 - Advanced Directive Last Verified Date is valued, this field is required.

PD1-16: Immunization Registry Status (CWE) 01569

Definition: This field identifies the immunization registry status of the patient. Refer to User-defined Table 0441 - Immunization Registry Status in Chapter 2C, Code Tables, for suggested values.

PD1-17: Immunization Registry Status Effective Date (DT) 01570

Definition: This field indicates the effective date for the immunization registry status reported in PD1-16 - Immunization Registry Status.

PD1-18: Publicity Code Effective Date (DT) 01571

Definition: This is the effective date for PD1-11 - Publicity Code.

PD1-19: Military Branch (CWE) 01572

Definition: This field is defined by CMS or other regulatory agencies. Refer to User-defined Table 0140 - Military Service in Chapter 2C, Code Tables, for suggested values.

PD1-20: Military Rank/Grade (CWE) 00486

(Definition from PD1.20 in Ch. 3)

Definition: This user-defined field identifies the military rank/grade of the patient. Refer to User-defined Table 0141 - Military Rank/Grade in Chapter 2C, Code Tables, for suggested values.

(Definition from IN2.15 in Ch. 6)

Definition: This user-defined field identifies the military rank/grade of the insured. Refer to User-defined Table 0141 - Military Rank/Grade in Chapter 2C, Code Tables, for suggested values.

PD1-21: Military Status (CWE) 01573

Definition: This field is defined by CMS or other regulatory agencies. Refer to User-defined Table 0142 - Military Status in Chapter 2C, Code Tables, for suggested values.

PD1-22: Advance Directive Last Verified Date (DT) 02141

(Definition from PV2.50 in Ch. 3)

Definition: This field indicates the date that all the advance directives held in PV2-45 - Advance Directive Code were last verified. When this field is valued, the field PV2-45 - Advance Directive Code is required.

(Definition from PD1.22 in Ch. 3)

Definition: This field indicates the date that all the advance directives held in PD1-15 - Advance Directive Code were last validated. When this field is valued, the field PD1-15 - Advance Directive Code is required.

PD1-23: Retirement Date (DT) 03511

Definition: This field asserts a self-identified date that an individual considers themselves to have ‘retired’.

DB1 - Disability Segment

The disability segment contains information related to the disability of a person. This segment was created instead of adding disability attributes to each segment that contains a person (to which disability may apply). This is an optional segment that can be used to send disability information about a person already defined by the Patient Administration Chapter. The disabled person code and identifier allow for the association of the disability information to the person.

HL7 Attribute Table - DB1 - Disability Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
DB1
1 01283 Set ID - DB1 SHALL [1..1] [1..4] SI
2 01284 Disabled Person Code [0..1] CWE
3 01285 Disabled Person Identifier [0..*] CX
4 01286 Disability Indicator [0..1] [1..1] ID
5 01287 Disability Start Date [0..1] DT
6 01288 Disability End Date [0..1] DT
7 01289 Disability Return to Work Date [0..1] DT
8 01290 Disability Unable to Work Date [0..1] DT

DB1-1: Set ID - DB1 (SI) 01283

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

DB1-2: Disabled Person Code (CWE) 01284

Definition: The value of this field indicates to which person the disability information relates in the message. For example, if the value is PT, the disability information relates to the patient. Refer to User-defined Table 0334 - Disabled Person Code in Chapter 2C, Code Tables, for suggested values.

DB1-3: Disabled Person Identifier (CX) 01285

Definition: This is the identifier (or identifiers) for the person whose disability information is sent on the segment. The assigning authority and identifier type code are strongly recommended for all CX data types.

DB1-4: Disability Indicator (ID) 01286

Definition: This field indicates if the person's visit is a disability visit. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    a disability visit

  • N    not a disability visit

DB1-5: Disability Start Date (DT) 01287

Definition: This field specifies the date the person became disabled.

DB1-6: Disability End Date (DT) 01288

Definition: This field specifies the ending date of the person's disability.

DB1-7: Disability Return to Work Date (DT) 01289

Definition: This field indicates the authorized date on which the patient can return to work for a specified disability case.

DB1-8: Disability Unable to Work Date (DT) 01290

Definition: This field specifies the first date in the date span that the patient is unable to work due to disability.

PDA - Patient Death And Autopsy Segment

This segment carries information on a patient's death and possible autopsy.

HL7 Attribute Table - PDA - Patient Death and Autopsy Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
PDA
1 01574 Death Cause Code [0..*] CWE
2 01575 Death Location [0..1] PL
3 01576 Death Certified Indicator [0..1] [1..1] ID
4 01577 Death Certificate Signed Date/Time [0..1] DTM
5 01578 Death Certified By [0..1] XCN
6 01579 Autopsy Indicator [0..1] [1..1] ID
7 01580 Autopsy Start and End Date/Time [0..1] DR
8 01581 Autopsy Performed By [0..1] XCN
9 01582 Coroner Indicator [0..1] [1..1] ID

PDA-1: Death Cause Code (CWE) 01574

Definition: This field is valued with the reason of the death.

PDA-2: Death Location (PL) 01575

Definition: This field is valued with the place the death occurred.

PDA-3: Death Certified Indicator (ID) 01576

Definition: This field indicates whether a death was officially certified or not. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    death has been certified

  • N    death has not been certified

PDA-4: Death Certificate Signed Date/Time (DTM) 01577

Definition: This field is valued with the date and time the death certificate was signed.

PDA-5: Death Certified By (XCN) 01578

Definition: This field is valued with the person who signed the death certificate.

PDA-6: Autopsy Indicator (ID) 01579

Definition: This field indicates whether an autopsy was performed. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    an autopsy was performed

  • N    an autopsy was not performed

PDA-7: Autopsy Start and End Date/Time (DR) 01580

Definition: If an autopsy is performed, this field is valued with the date and time the autopsy was begun and completed

PDA-8: Autopsy Performed By (XCN) 01581

Definition: This field is valued with the authority who performed the autopsy.

PDA-9: Coroner Indicator (ID) 01582

Definition: This flag indicates whether the case/death has been assigned to the coroner/medical examiner for investigative purposed. Refer to HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables, for valid values.

  • Y    Has been assigned to the coroner.

  • N    Has not been assigned to the coroner.

ARV - Access Restrictions Segment

The ARV segment is used to communicate the requested/required type of access restrictions from system to system, at both the person/patient and the encounter/visit level.

The Access Restrictions segment (ARV) sent after the MSH acts as a manifest and declares the privacy and security classification (i.e the confidentiality level), the sensitivity (i.e. access restriction reason) and provides handling instructions (e.g. what the data can be used for, what must be done to protect it and what may not be done with the data). The segment is optional and can repeat.

Examples:

A person/patient may have the right to object to any or all of his/her information to be disclosed. In addition, the patient may request that protected information not be disclosed to family members or friends who may be involved in their care or for notification purposes.

A realm or organization may have certain privacy policies.

A patient may have the right to opt out of being included on facility directories.

In an international context, a physician may be culturally obligated to protect the patient's privacy.

Any "opt-in" or "opt-out" restrictions are communicated in ARV-3 - Access Restriction Value. This segment replaces PD1-12 and PV2-22, which have been deprecated in V2.6. The ARV segment is optional and as of 2.9 is sent immediately following the MSH segment to allow declaration of access restrictions for specific data elements (ARV-9 – Access Restriction Message Location), that are different from the overall security level declared in the Message Header Segment. The ARV segment can repeat, so that different security attributes across message elements can be declared.

Usage Notes:

The individual system security may want to utilize the Access Restriction Value along with the Access Restriction Reason and with the Confidentiality Code from Code defined in the Security Classification Tag (ARV-7)in order to implement the appropriate type of protection for the identified data. Each system has the flexibility to incorporate/map the access values into their security system appropriately; the actual implementation for access to protected data is determined by the individual system. The Access Restriction Values supported by an enterprise/system would be defined and determined by that organization.

It is expected that these access restriction values would be utilized in combination with other system security information (e.g., patient locations, user department, caregiver-patient relationships, other access restriction parameters) to determine user access.

System implementers should carefully control access to the restriction codes and values, as they themselves hold sensitive information.

HL7 Attribute Table - ARV - Access Restrictions segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
ARV
1 02143 Set ID [0..1] [1..4] SI
2 02144 Access Restriction Action Code SHALL [1..1] CNE
3 02145 Access Restriction Value SHALL [1..1] CWE
4 02146 Access Restriction Reason [0..*] CWE
5 02147 Special Access Restriction Instructions = [0..*] 250 ST
6 02148 Access Restriction Date Range [0..1] DR
7 03512 Security Classification Tag SHALL [1..1] CWE
8 03513 Security Handling Instructions [0..*] CWE
9 03514 Access Restriction Message Location [0..*] ERL
10 02470 Access Restriction Instance Identifier MAY
True:
False:
C
[1..1]
[0..1]
EI

ARV-1: Set ID (SI) 02143

Definition: This field contains the number that identifies this segment. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

ARV-2: Access Restriction Action Code (CNE) 02144

Definition: This field contains a code defining the action to be taken for this segment. It allows access restriction information to be sent to delete or update previously sent access restrictions. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

ARV-3: Access Restriction Value (CWE) 02145

Definition: This field specifies the information to which access to sensitive information is restricted by applicable jurisdictional, organizational, patient privacy policy or law. This field is used to identify overarching context, for example specific policy defined data elements or message groups when applicable to ALL groups in the message. For example, under a specific minor’s right to consent for healthcare law coded in ARV-3, all of the minor’s demographic data coded in ARV-4 is sensitive, which may be conveyed in several segments (PID, PD1, PD2)). To a specific element, access may be restricted at the field level by employing the specific HL7 field location in ARV-9. For example, when only some of the demographic data is considered sensitive under a particular minor’s consent coded in ARV-3. Refer to User-defined Table 0717 – Access Restriction Value in Chapter 2C, Code Tables, for suggested values.

The intent of this table is to declare the applicable patient consent directive, organizational policy or jurisdicitonal law.

As examples in the US this could be HIPAA Authorizations for Disclosure, HIPAA Notice of Privacy Practice or 42 CFR Part 2.

ARV-4: Access Restriction Reason (CWE) 02146

Definition: This field is used to convey the reason for the restricted access. Repeat of the Access Restriction Reason is allowed to accommodate communication of multiple reasons for an access restriction. Refer to User-defined Table 0719 – Access Restriction Reason Code in Chapter 2C, Code Tables, for suggested values.

ARV-5: Special Access Restriction Instructions (ST) 02147

Definition: Used to convey specific instructions about the protection of the patient's information which must be rendered to end users in accordance with patient consent directive, organizational policy, or jurisdictional law. For example, in US law 42 CFR Part 2, disclosed information made with patient consent must include a renderable “Prohibition on re-disclosure” warning (§ 2.32) In addition, organizational policy may require that some or all of the ARV field privacy tag values be rendered to end users, e.g., marking a consult note with “Restricted Confidentiality” or with sensitivity tags such as “VIP” or “EMP” for employee of the organization.

This field may also be used to specify instructions about the release of information to family and friends (e.g., "Do not release information to patient's brother, Adam Everyman"). These instructions may be in conjunction with other fields (as elected by the system).

ARV-6: Access Restriction Date Range (DR) 02148

Definition: This element defines the date from which an access restriction commences until the date it is specifically rescinded.

ARV-7: Security Classification Tag (CWE) 03512

Definition: This field defines the security classification (as defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995) of an IT resource, in this case the message, which may be used to make access control decisions. Use of this field supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) for a given message.

Refer to Externally-defined HL7 Table 0952 – HL7 Confidentiality Classification. Use of this table is recommended. The codes in this table are comprehensive non-overlapping hierarchical codes: Very Restricted > Restricted > Normal > Moderate > Low > Unrestricted. Restrictions to a comprehensive, non-overlapping set of codes is required for purposes of access control system algorithms such as Bell–LaPadula Mode, which is used to adjudicate access requests against privacy policies. See Chapter 2C, Code Tables, for suggested values.

ARV-8: Security Handling Instructions (CWE) 03513

Definition: This field is repeatable and conveys instructions to users and receivers for secure distribution, transmission, and storage; dictates obligations or mandated actions; specifies any action prohibited by refrain policy such as dissemination controls; and stipulates the permissible purpose of use of an IT resource. It is used where MSH-27 or MSH-28, which may be the compliation of all Security Handling Instructions across all labels, are used, but differ from the appliable ones for the data identified in this ARV segment.

Refer to Externally-defined Table 0953 – Security Label Handling Instructions in Chapter 2C, Code Tables, for suggested values. – Use of this table is recommended.

ARV-9: Access Restriction Message Location (ERL) 03514

Definition: This field is optional and repeating and identifies the location in a message related to the identified access restricted data. If multiple repetitions are present, the listed access restrictions apply to all listed places.

Note: Realm, business and policy rules will determine to what level the restrictions need to be supported. For example in a lab result exchange setting identifying elements more granular than the result at the segment level (i.e.OBX) is not expected, while in other settings more granular settings may apply.

ARV-10: Access Restriction Instance Identifier (EI) 02470

Definition: This field carries the unique identifier for this access restriction and is conditionally required when ARV-2 is NOT valued ‘S’ to support the use of action code for tracking changes when using dynamic mode. This instance identifier is persistent between messages. Implementation guides may restrict what mode to use, which will affect the effective optionality of this field.

OH1 - Person Employment Status Segment

The OH1 segment is a clinical statement about the subject’s state of being employed at the point in time the statement is recorded. Awareness of the subject’s Employment Status can assist in understanding the subject’s resources, access to benefits, and demands at home and work. If the subject is working (regardless of pay), information about their current job is communicated in OH2 Past or Present Job Segment. Information about volunteer work and past jobs can be collected in the Past or Present Job Segment regardless of current employment status, i.e., even if the subject is not employed at the time.

The intent is for the segment to be allowed to repeat within a message definition to allow a history of employment status for the patient.

This segment relates only to the patient and is not intended to relate to the Next of Kin.

Examples:

A person/patient may be currently employed following a period of choosing to not be in the labor force. This would be represented by a repeating OH1 segment.

HL7 Attribute Table - OH1 - Person Employment Status segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
OH1
1 03516 Set ID SHALL [1..1] SI
2 00816 Action Code [0..1] [2..2] ID
3 03518 Employment Status SHALL [1..1] CWE
4 03519 Employment Status Start Date [0..1] DT
5 03520 Employment Status End Date [0..1] DT
6 03521 Entered Date SHALL [1..1] DT
7 02432 Employment Status Unique Identifier [0..1] EI

OH1-1: Set ID (SI) 03516

Definition: This field contains the number that identifies the OH1 segment instances in message structures where the OH1 segment repeats. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

OH1-2: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

OH1-3: Employment Status (CWE) 03518

Definition: This field contains a code defining the employment status of a person during the ssociated time. Refer to HL7 Table 0957 – Employment Status (ODH) in Chapter 2C, Code Tables, for suggested values.

OH1-4: Employment Status Start Date (DT) 03519

Definition: This field asserts when the employment status began.

OH1-5: Employment Status End Date (DT) 03520

Definition: This field asserts when the employment status ended. If employment status is current, Employment Status End Date should be empty.

Note: The Employment Status End Date SHALL not be greater than the time the observation is made (OH1-6 Entered Date).

OH1-6: Entered Date (DT) 03521

Definition: This field records the date that the information was entered into the patient record.

OH1-7: Employment Status Unique Identifier (EI) 02432

Definition: This field contains a value that uniquely identifies a single employment status for a person.

OH2 - Past Or Present Job Segment

The OH2 segment is used to communicate the information about a job or jobs which the subject currently holds or has held in the past. It includes related observations about the occupation (type of work), the type of business (industry) in which that occupation is performed, supervisory level (including military pay grade), and the employer's name and location. It should also include observations about the job's compensation and sector employment type (e.g., paid work, self-employed, volunteer) and work schedule, and may also contain observations for job duties and occupational exposures. The type of work a person performs (occupation) and their industry (type of business in which they work) are critical data elements for patient care, population health, and public health, with the current information being the most important. In the health care encounter, current occupation and industry are important because they provide information regarding the exposures a person may have to substances/environments/hazards that may cause illness/injury or may impact the treatment plan. The combination of occupation and industry serves as a key indicator of the person’s work environment. The segment is designed to ensure that these data remain associated with one-another in perpetuity, even if multiple jobs are included.

This segment may relate either to the patient or to the Next of Kin.

The intent is for the segment to be allowed to repeat within a message definition to enable a job history for the person.

Examples:

A person/patient may currently hold a job as carpenter, and previously held a job as a painter. This would be represented by repeating OH2 segments.

HL7 Attribute Table - OH2 - Past or Present Job segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
OH2
1 03522 Set ID SHALL [1..1] SI
2 00816 Action Code [0..1] [2..2] ID
3 03524 Entered Date [0..1] DT
4 03525 Occupation SHALL [1..1] CWE
5 03526 Industry SHALL [1..1] CWE
6 03527 Work Classification [0..1] CWE
7 02494 Job Start Date [0..1] [8..*] DT
8 02495 Job End Date [0..1] [8..*] DT
9 03528 Work Schedule [0..1] CWE
10 03529 Average Hours worked per Day [0..1] NM
11 03530 Average Days Worked per Week [0..1] NM
12 03531 Employer Organization [0..1] [48..*] XON
13 03546 Employer Address [0..*] [106..*] XAD
14 03532 Supervisory Level [0..1] CWE
15 03533 Job Duties [0..*] [250..*] ST
16 03534 Occupational Hazards [0..*] [250..*] FT
17 02433 Job Unique Identifier [0..1] EI
18 02471 Current Job Indicator [0..1] CWE

OH2-1: Set ID (SI) 03522

Definition: This field contains the number that identifies the OH2 segment instances in message structures where the OH2 segment repeats. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. If the subject of the OH2 segment changes (e.g. Patient vs Next of Kin) the Set ID sequence will be reset.

OH2-2: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

OH2-3: Entered Date (DT) 03524

(Definition from OH2.3 in Ch. 3)

Definition: This field records the date that the information was entered into the patient record.

(Definition from OH4.5 in Ch. 3)

Definition: This field records the date that the information was entered into the patient record.

OH2-4: Occupation (CWE) 03525

Definition: This field contains a code defining the occupation in which an individual is engaged in for the job recorded in this segment, regardless of duration. Refer to HL7 Table 0958 – Occupation Code in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Occupation CDC Census 2010 codes published at https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7186

OH2-5: Industry (CWE) 03526

Definition: This field contains a code defining the industry in which an individual is engaged for the job recorded in this segment, regardless of duration. Refer to HL7 Table 0955 – Industry Code in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Industry CDC Census 2010 codes published at https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7187

OH2-6: Work Classification (CWE) 03527

Definition: This field contains a code defining the work classification associated with the job of a person recorded in this segment. Refer to HL7 Table 0959 – Work Classification Code in Chapter 2C, Code Tables, for suggested values.

OH2-7: Job Start Date (DT) 02494

Definition: This field asserts when the job began.

OH2-8: Job End Date (DT) 02495

Definition: This field asserts when the job ended. If the job is current, Job End Date shall be empty.

Note: The Employment Status End Date SHALL not be greater than the date noted in OH2-3 Entered Date.

OH2-9: Work Schedule (CWE) 03528

Definition: This field contains a code defining the work schedule associated with the job of a person recorded in this segment. Describes an individual's typical arrangement of working hours for a job. For example, work schedule may capture that an individual typically works a regular day shift, evening shift, or night shift. It can also specify if an individual has another type of schedule such as a rotating shift, split shift, etc. In healthcare settings, knowledge of a patient's typical work schedule may assist in diagnosis of healthcare issues related to irregular work hours or sleep patterns. It may also assist in determining appropriate treatment and prevention plans that will coordinate with the patient's work schedule. Refer to HL7 Table 0954 – Work Schedule Code in Chapter 2C, Code Tables, for suggested values.

OH2-10: Average Hours worked per Day (NM) 03529

Definition: This field asserts the average hours worked per day for the job of a person recorded in this segment.

OH2-11: Average Days Worked per Week (NM) 03530

Definition: This field asserts the average days worked per week for the job of a person recorded in this segment.

OH2-12: Employer Organization (XON) 03531

Definition: This field asserts the name and or identifier of the employer organization for the job of a person recorded in this segment.

OH2-13: Employer Address (XAD) 03546

Definition: This field asserts the address of the employer organization for the job of a person recorded in this segment. This field shall be populated with the address of the employer rather than the site that the employee works.

The field may repeat.

OH2-14: Supervisory Level (CWE) 03532

Definition: This field contains a code defining the supervisory level associated with the job of a person recorded in this segment. Supervisory Level reflects the amount of supervisory or management responsibilities for an individual’s job. For example, in the US, in the military, this is the person’s pay grade, which serves as a proxy for supervisory level and can be interpreted across branches. Refer to HL7 Table 0956 – Supervisory Level Code in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Job Supervisory Level or Pay Grade (ODH)codes published at https://phinvads.cdc.gov/vads/ViewCodeSystem.action?oid=2.16.840.1.114222.4.11.7613

OH2-15: Job Duties (ST) 03533

Definition: This field lists the regular actions performed at work. For example, a person may have the occupation of “construction laborer” and his specific job duties are to carry construction supplies. Specific job information is important in the healthcare setting because it provides information regarding hazards to which a person may have been exposed, which is pertinent to treatment and prevention. This field may repeat to list multiple job duties, or the job duties may be compiled as a single narrative.

OH2-16: Occupational Hazards (FT) 03534

Definition: This field lists the hazard(s) associated with a person’s job. Job hazards are a source of potential harm to an individual’s physical or mental health. Hazards may be biological, physical, psychological, chemical, or radiological in nature. An occupational hazard is one that is specific to the work or work environment of an individual. This field may repeat to list multiple occupational hazards, or the occupational hazards may be compiled as a single narrative.

OH2-17: Job Unique Identifier (EI) 02433

Definition: This field contains a value the uniquely identifies a single job for a person.

OH2-18: Current Job Indicator (CWE) 02471

Definition: This field defines a flag indicating if this is the person’s current job (at the time the record was last updated) using 'Yes', when current and 'No' when not. Refer to HL7 Table 0136 – Yes/no Indicator in Chapter 2C, Code Tables, for valid values.

OH3 - Usual Work Segment

The OH3 segment contains information about the occupation which the subject has held for the longest duration through his or her working history, at the point in time the statement is recorded. Longest-held occupations can be associated with conditions that develop slowly over time or even after the person is no longer performing that type of work, e.g., some respiratory conditions and cancers. It optionally includes a total duration observation, because a person can be in and out of a given occupation over time. In addition, knowing when the person began working in this occupation can provide information about potential exposures and allows the clinician to assess whether sufficient time has elapsed for a chronic condition to appear, i.e. the latency period. This guides appropriate use of screening tests to detect early disease. This segment may be related to either patient or to the Next of Kin.

Examples:

A person/patient may have worked as a waiter for 3 years, and worked as a nurse for 20 years. The Usual Work would reflect an occupation of nurse as the longest held occupation.

The intent is for the segment to be allowed to repeat within a message definition to enable communication of Usual Work for multiple family members, but not the patient. For instance, the Usual Work segment may be repeated in multiple Next of Kin groups in order to allow for inclusion of mother, father, or other related persons, but not more than one usual job is permitted for one person.

HL7 Attribute Table - OH3 - Usual Work segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
OH3
1 03535 Set ID SHALL [1..1] SI
2 00816 Action Code [0..1] [2..2] ID
3 03537 Occupation SHALL [1..1] CWE
4 03538 Industry SHALL [1..1] CWE
5 03539 Usual Occupation Duration (years) [0..1] NM
6 03540 Start year [0..1] DT
7 03542 Entered Date [0..1] DT
8 02446 Work Unique Identifier [0..1] EI

OH3-1: Set ID (SI) 03535

Definition: This field contains the sequence number used to identify the OH3 segment instances in message structures where the OH3 segment repeats. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. If the subject of the OH3 segment changes (e.g. Patient vs Next of Kin) the Set ID sequence will be reset.

OH3-2: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

OH3-3: Occupation (CWE) 03537

Definition: This field contains a code defining the occupation a person has held for the longest time during his or her life, regardless of the occupation currently held and regardless of whether or not it has been continuous time. Refer to HL7 Table 0958 – Occupation Code in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Occupation CDC Census 2010 codes published at https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7186

OH3-4: Industry (CWE) 03538

Definition: This field contains a code defining the industry a person has worked in for the longest time while in the usual occupation. Refer to HL7 Table 0955 – Industry Code in Chapter 2C, Code Tables, for suggested values. In the US, this field should use the Industry CDC Census 2010 codes published at https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7187

OH3-5: Usual Occupation Duration (years) (NM) 03539

Definition: This field asserts the number of years that the person has been working in the usual occupation. Decimals shall be used to indicate a duration shorter than 1 year.

OH3-6: Start year (DT) 03540

Definition: This field identifies the year that the person began work in their usual occupation.

OH3-7: Entered Date (DT) 03542

Definition: This field records the date that the information was entered into the patient record.

OH3-8: Work Unique Identifier (EI) 02446

Definition: This field contains a value the uniquely identifies a single work for a person.

OH4 - Combat Zone Work Segment

The OH4 segment contains the date range an individual has worked in what is considered a combat or hazardous duty zone; both civilian and military.

The intent is for the segment to be allowed to repeat within a message definition to enable a combat zone history for the patient.

Examples:

A person/ may have worked in a combat zone for 2 years, followed by 3 years where there was no combat zone work, returning to combat zone work for another 2 years. This would be reflected as two Combat work segments documenting the date ranges for the 2 periods when the combat zone work occurred.

HL7 Attribute Table - OH4 - Combat Zone Work segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
OH4
1 03543 Set ID SHALL [1..1] SI
2 00816 Action Code [0..1] [2..2] ID
3 03544 Combat Zone Start Date SHALL [1..1] DT
4 03545 Combat Zone End Date [0..1] DT
5 03524 Entered Date [0..1] DT
6 02449 Combat Zone Unique Identifier [0..1] EI

OH4-1: Set ID (SI) 03543

Definition: This field contains the sequence number used to identify the OH4 segment instances in message structures where the OH4 segment repeats. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

OH4-2: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

(Definition from RXV.22 in Ch. 4A)

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

OH4-3: Combat Zone Start Date (DT) 03544

Definition: This field asserts when the combat zone duty began.

OH4-4: Combat Zone End Date (DT) 03545

Definition: This field asserts when the combat zone duty ended. If combat zone duty is current, Combat Zone End Date should be empty.

OH4-5: Entered Date (DT) 03524

(Definition from OH2.3 in Ch. 3)

Definition: This field records the date that the information was entered into the patient record.

(Definition from OH4.5 in Ch. 3)

Definition: This field records the date that the information was entered into the patient record.

OH4-6: Combat Zone Unique Identifier (EI) 02449

Definition: This field contains a value the uniquely identifies a single combat zone for a person.

EXAMPLE TRANSACTIONS

Admit/visit notification - event A01 (admitted patient)-

MSH|^~VALUEamp;|ADT1|GOOD HEALTH HOSPITAL|GHH LAB, INC.|GOOD HEALTH HOSPITAL|198808181126|SECURITY|ADT^A01^ADT_A01|MSG00001|P|2.8||<cr>

EVN|A01|200708181123||<cr>

PID|1||PATID1234^5^M11^ADT1^MR^GOOD HEALTH HOSPITAL~123456789^^^USSSA^SS||EVERYMAN^ADAM^A^III||19610615|M||C|2222 HOME STREET^^GREENSBORO^NC^27401-1020|GL|(555) 555-2004|(555)555-2004||S||

PATID12345001^2^M10^ADT1^AN^A|444333333|987654^NC|<cr>

NK1|1|NUCLEAR^NELDA^W|SPO^SPOUSE||||NK^NEXT OF KIN<cr>

PV1|1|I|2000^2012^01||||004777^ATTEND^AARON^A|||SUR||||ADM|A0|<cr>

Patient Adam A. Everyman, III was admitted on July 18, 2007 at 11:23 a.m. by Doctor Aaron A. Attending (#004777) for surgery (SUR). He has been assigned to room 2012, bed 01 on nursing unit 2000.

The message was sent from system ADT1 at the Good Health Hospital site to system GHH Lab, also at the Good Health Hospital site, on the same date as the admission took place, but three minutes after the admit.

Pre-admit notification - event A05 (nonadmitted patient)

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|GHH LAB||200701061000||ADT^A05^ADT_A05|000001|P|2.8||||<cr>

EVN|A05|200701061000|200701101400|01||200701061000<cr>

PID|1|| PATID1234^^^GOOD HEALTH HOSPITAL^MR^GOOD HEALTH HOSPITAL~123456789^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||(555) 555-2004|(555)555-2004||S|C|99999^^^GOOD HEALTH HOSPITAL^AN|444-33-3333||<cr>

NK1|1|NUCLEAR^NELDA^W|SPO^SPOUSE|6666 HOME STREET ^^ISHPEMING^MI^49849^""^|555-555-5001|555-555-5001555-555-5001|EC^EMERGENCY CONTACT<cr>

NK1|2|MUM^MARTHA^M|MOTHER|4444 HOME STREET ^^ISHPEMING^MI^49849^""^|555-555-2006|555-555-2006~555-555-2006|EC^EMERGENCY CONTACT<cr>

NK1|3<cr>

NK1|4|||6666 WORKER LOOP^^ISHPEMING^MI^49849|555-555-3003|EM^EMPLOYER|19940605||PROGRAMMER|||WORK IS FUN, INC.<cr>

PV1||O|||||0148^ATTEND^AARON^A|0148^SENDER^SAM||AMB|||||||0148^ATTEND^AARON^A|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL||||||<cr>

PV2||||||||200301101400||||||||||||||||||||||||||200301101400<cr>

OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F<cr>

OBX||ST|1010.1^HEIGHT||190|cm|||||F<cr>

DG1|1|19||BIOPSY||00<cr>

GT1|1||EVERYMAN^ADAM^A^""^""^""^""^||2222 HOME STREET ^ISHPEMING^MI^49849^""^|(555) 555-2004|555 555-2004||||SE^SELF|444-33 3333||||    |2222 HOME STREET^^ISHPEMING^MI^49849^""|555-555-2004 |||||||||||||||||||||||||||||||||AUTO CLINIC<cr>

IN1|1|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M1^49849^^||555-555-3015|90||||||50 OK<cr>

IN1|2|""|""<cr>

Patient Adam A. Everyman was pre-admitted on January 6th, 2007 for ambulatory surgery, which is scheduled for January 10, 2007 at 1400. As part of the pre-admission process, he specified two emergency contacts as well as employer, insurance, and guarantor information. He also was measured and weighed.

Note: Above, the REGADT system supports the entry of four NK1 type records: first, second, and third emergency contacts and employer information. A third emergency contact was not provided for Adam A. Everyman. However, an NK1 record must be sent to support "snapshot" mode of update. The REGADT system also supports entry of two insurance plans, one guarantor, and one diagnosis.

Register a patient - event A04 (nonadmitted patient)

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|GHH LAB||200712311501||ADT^A04^ADT_A01|000001|P|2.8||||<cr>

EVN|A04|200701101500|200701101400|01||200701101410<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL^MR^GOOD HEALTH HOSPITAL^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555- 2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|371-66-9256||<cr>

NK1|1|NUCLEAR^NELDA|SPOUSE|6666 HOME STREET^^ISHPEMING^MI^49849^""^|555-555-5001|555-555-5001~555-555-5001|EC1^FIRST EMERGENCY CONTACT<cr>

NK1|2|MUM^MARTHA|MOTHER|4444 HOME STREET^^ISHPEMING^MI^49849^""^|555-555 2006|555-555-2006~555-555-2006|EC2^SECOND EMERGENCY CONTACT<cr>

NK1|3<cr>

NK1|4|||6666 WORKER LOOP^^ISHPEMING^MI^49849^""^||(900)545-1200|EM^EMPLOYER|19940605||PROGRAMMER|||WORK IS FUN, INC.<cr>

PV1||O|O/R||||0148^ATTEND^AARON^A|0148^ATTEND^AARON^A|0148^ATTEND^AARON^A|AMB|||||||0148^ATTEND^AARON^A|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||199501101410|<cr>

PV2||||||||200701101400||||||||||||||||||||||||||200301101400<cr>

OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F<cr>

OBX||ST|1010.1^HEIGHT||190|cm|||||F<cr>

DG1|1|19||BIOPSY||00|<cr>

GT1|1||EVERYMAN^ADAM^A||2222 HOME STREET^^ISHPEMING^MI^49849^""^|444-33 3333|555-555-2004||||SE^SELF|444-33 3333||||AUTO CLINIC|2222 HOME STREET^^ISHPEMING^MI^49849^""|555-555-2004|<cr>

IN1|0|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M149849^""^||555-555-3015|90||||||50 OK|<cr>

IN1|2|""|""<cr>

Patient Adam A. Everyman arrived at location O/R for surgery on January 10th, 2007 at 1410 for ambulatory surgery which was scheduled for January 10, 2007 at 1400. The visit event was recorded into the Good Health Hospital system on January 10, 2007 at 1500. It was sent to the interface engine (IFENG) at 1501.

Change an outpatient to an inpatient - event A06

MSH|^~VALUEamp;|REGADT|MCM|IFENG||200701110025||ADT^A06^ADT_A06|000001|P|2.8||||<cr>

EVN|A06|200701100250||01||200701102300<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL^MR^FAC1~11111^^^USSSA^SS|253763|MASSIE^JAMES^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|371-66-9256||<cr>

NK1|1|MASSIE^ELLEN|SPOUSE|2222 HOME STREET^^ISHPEMING^MI^49849^""^|555) 555 2004|555-555-5001~555-555-5001|EC1^FIRST EMERGENCY CONTACT<cr>

NK1|2|MASSIE^MARYLOU|MOTHER|300 ZOBERLEIN^^ISHPEMING^MI^49849^""^|555) 555 2004|555-555-5001~555-555-5001|EC2^SECOND EMERGENCY CONTACT<cr>

NK1|3<cr>

NK1|4|||6666 WORKER LOOP^^ISHPEMING^MI^49849^""^||(900)545-1200|EM^EMPLOYER|19940605||PROGRAMMER|||WORK IS FUN, INC.<cr>

PV1||I|6N^1234^A^GOOD HEALTH HOSPITAL||||0100^SENDER,SAM|0148^ATTEND^AARON^A||SUR|||||||0148^SENDER,SAM|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||199501102300|<cr>

OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F<cr>

OBX||ST|1010.1^HEIGHT||190|cm|||||F<cr>

DG1|1|19||BIOPSY||00<cr>

GT1|1||EVERYMAN^ADAM^A||2222 HOME STREET^^ISHPEMING^MI^49849^""^|444-33 3333|555-555-2004||||SE^SELF|444-33 3333||||AUTO CLINIC|2222 HOME STREET^^ISHPEMING^MI^49849^""|555-555-2004<cr>

IN1|0|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M149849^""^||555-555-3015|90||||||50 OK<cr>

IN1|2|""|""<cr>

Patient Adam A. Everyman was later converted to an inpatient on January 10th, 2007 at 2300 to recover from the operation. The change from outpatient to inpatient was recorded on the MCM system on January 11, 2007 at 0020. He was assigned to room 1234, bed A on unit 6N. When Patient Adam A. Everyman was converted to an inpatient on January 10th, 2007 at 2300, his hospital service changed to SUR. His attending doctor and admitting doctors changed to Dr Sam Sender. As a result of the conversion, his account number changed from 10199923 to 10199925

Transfer patient - event A02 (first example)

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|IFENG||200701110500||ADT^A02^ADT_A02|000001|P|2.8||||<cr>

EVN|A02|200701110520||01||200701110500<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL^MR~111111^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|444-33-3333|||||||||<cr>

PV1||I|SICU^0001^01^GOOD HEALTH HOSPITAL|||6N^1234^A^GOOD HEALTH HOSPITAL|0200^ATTEND^AARON^A|0148^ SENDER^SAM||ICU|||||||0148^SENDER^SAM|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||200701102300|<cr>

On January 11th, 2007 at 0500, Adam A. Everyman condition became worse due to a complication. As a result, he was transferred to the surgical ICU (SICU). The transfer was recorded on the Good Health Hospital system on January 11, 2007 at 0520. He was assigned to room 0001, bed 1. When Patient Adam A. Everyman was transferred to SICU, his hospital service changed to ICU and his attending doctor changed to Dr. Sam Sender.

Cancel transfer - event A12

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|IFENG||200701110600||ADT^A12^ADT_A12|000001|P|2.8||||<cr>

EVN|A02|200701110600||01||200701110500<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925|444-33-3333||

PV1||I|6N^1234^A^GOOD HEALTH HOSPITAL|||SICU^0001^1^GOOD HEALTH HOSPITAL|0100^ATTEND^AARON^A|0148^ATTEND^AARON^A||SUR|||||||0148^ATTEND^AARON^A|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||200701102300|<cr>

It was determined that Adam A. Everyman was transferred to the wrong room in the SICU. Therefore, the transfer was cancelled.

Transfer patient - event A02 (second example)

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|IFENG||200701110603||ADT^A02^ADT_A02|000001|P|2.8||||<cr>

EVN|A02|200701110603||01||200701110500<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL^MR^FAC1~1111^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|444-33-3333||

PV1||I|SICU^0001^02^GOOD HEALTH HOSPITAL|||6N^1234^A^GOOD HEALTH HOSPITAL|0100^ATTEND^AARON^A|0148^ATTEND^AARON^A||SUR|||||||0148^ATTEND^AARON^A|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||200701102300|<cr>

The transfer is then repeated, this time to the correct bed: bed 2 of room 0001 in the SICU.

Discharge patient - event A03

MSH|^~VALUEamp;|REGADT|GOOD HEALTH HOSPITAL|IFENG||200701121005||ADT^A03^ADT_A03|000001|P|2.8||||<cr>

EVN|A03|200701121005||01||200701121000<cr>

PID|||191919^^^GOOD HEALTH HOSPITAL^MR~11111^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|444-33-3333|||||||||<cr>

PV1||I|6N||||0100^ATTEND^AARON^A|0148^ATTEND^AARON^A||SUR|||||||0148^ATTEND^AARON^A|S|1400|A||||||||||||||||SNF|ISH^GREEN ACRES RETIREMENT HOME||GOOD HEALTH HOSPITAL|||||200701102300|200791121005<cr>

When Adam A. Everyman's condition became more stable, he returned to 6N for another day (transfer not shown) and then was discharged to the Green Acres Retirement Home.

Update adverse reaction info - unique identifier is provided - event A60 (where unique identifier is provided)

MSH|^~VALUEamp;|ADT|CA.SCA|IE|200701310815-0800|200702010101||ADT^A60^ADT_A60|6757498734|P|2.8|

EVN||200701310815-0800

PID|||987654321098||EVERYWOMAN^EVE^E||19530406|F

PV1||O

PV2||||||||200701310800-0800

IAM|1|DA|^Penicillin|SV^^HL70128|^rash on back|A^^HL70323|12345||AL^^HL70436|
19990127||200301311015|NUCLEAR^NEVILLE^H|^Husband||C^^HL70438|MLEE^ATTEND^AARON^A^^^MD||

Update adverse reaction info - allergen code provides unique identifier - event A60 (where the allergen code provides unique identifier)

MSH|^~VALUEamp;|ADT|CA.SCA|IE|200701310815-0800|200702010101||ADT^A60^ADT_A60|6757498734|P|2.8|

EVN||200701310815-0800

PID|||987654321098||EVERYWOMAN^EVE^E||19530406|F

PV1||O

PV2||||||||200701310800-0800

IAM|1|DA|PHM1345^Penicillin^local|SV^^HL70128|^rash on back|A^^HL70323|||AL^^HL70436| 01^Penicillins,Cephalosporins^NDDF DAC|20070127||200701311015| NUCLEAR^NEVILLE^H|^Husband||C^^HL70438|MLEE^ATTEND^AARON^A^^^MD||

IMPLEMENTATION NOTES

Swapping a patient

Some systems may handle this as a single function. Others may require a multiple process in which:

  1. patient A is assigned a temporary location

  2. patient B is assigned patient A's location

  3. patient A is assigned patient B's prior location

This three-step scenario requires three separate transfer messages instead of a single swap message. If all beds in a hospital are occupied, it may be necessary to use a dummy location.

Merging patient/person information

Definitions: Merge, move, and change identifier events

The term "identifier" is used throughout this section. An identifier is associated with a set (or sets) of data. For example, an identifier (PID-3 - Patient Identifier List) may be a medical record number which has associated with it account numbers (PID-18 - Patient Account Number). Account number (PID-18 - Patient Account Number) is a type of identifier which may have associated with it visit numbers (PV1-19 - Visit Number).

This section addresses the events that occur usually for the purposes of correcting errors in person, patient, account, or visit identifiers. The types of errors that occur typically fall into three categories:

  1. Duplicate identifier created
    The registrar fails to identify an existing person, patient, account, or visit and creates a new, "duplicate" record instead of using the existing record. A "merge" operation is used to fix this type of error.

  2. Incorrect identifier selected
    The registrar mistakenly selects the wrong person, patient, or account and creates or attaches a patient, account, or visit underneath the incorrect person, patient, or account. A "move" operation is used to fix this type of error.

  3. Incorrect identifier assigned
    The registrar accidentally types in the wrong new identifier for a person, patient, account, or visit. This type of mistake usually occurs when identifiers are manually assigned (not system generated). A "change identifier" operation is used to fix this type of error.

Hierarchy of Identifiers

This section was written from the perspective of one controlling MPI and does not adequately cover the implementation of peer MPIs or multiple enterprise identifiers. To avoid future problems implementors should carefully examine the inferences of multiple identifiers.

Enterprise level MPI systems may collaborate forming either peer-to-peer or hierarchical relationships. When this occurs, multiple enterprise level identifiers may be required in the context of a single HL7 message. An example of a peer-to-peer MPI relationship might be represented by a data sharing application between the US Department of Veterans Affairs and the US Department of Defense, where each have their own MPI. An example of a hierarchical MPI relationship might be required by the need for local, city, and state organizations to collaborate, where each have an MPI.

These events assume a hierarchy of identifiers exists between person, patient, account, and visit. The hierarchy is as follows:

Level 3 - Patient (identified by PID-3 - Patient Identifier List)

Level 2 - Account (identified by PID-18 - Patient Account Number)

Level 1 - Visit (identified by PV1-19 - Visit Number)

The visit-level identifier PV1-19 - Visit Number is the lowest level identifier and is considered subordinate to the account-level identifier PID-18 - Patient Account Number.

This means that visit identifiers are defined within the context of an account identifier, and implies that visit identifiers are unique within account identifiers. Similarly, account identifiers are subordinate to, and unique within, patient identifiers; patient identifiers are subordinate to, and unique within, person identifiers.

Conversely, the person-level identifier is the highest-level identifier and is considered superior to the patient-level identifiers, which are superior to the account-level identifier, which is superior to any visit-level identifiers.

Note that these events will also apply to environments in which one or more of these levels do not occur. For example, some environments may not have a person (or MPI) level, or they may not have a visit level, or they may have a visit level without an account level. The hierarchy concept is depicted graphically below. For example, Adam Everyman might be assigned an MPI number at the Good Health Hospital network (depicted by the circle). He may have different medical records at two hospitals within the network (depicted by the squares). Associated with each of these medical records are two accounts (depicted by the triangles). Note that the environment illustrated does not support the "visit" level, although in other implementations it might.

Merge

A merge event signals that two distinct records have been combined together into a single record with a single set of identifiers and data surviving at the level of the merge. All records at a level subordinate to the merged identifier are combined under the surviving record. For example, an A40 (merge patient - patient identifier list) event would be sent to signal that two person records (identified by MRG-1 - Prior Patient ID and by PID-3 - Patient ID) have been merged into a single record. All of the identifiers, accounts, and visits under the person record are not merged together - they are instead combined under the same person record. The following figure graphically depicts the merge event:

Note: It is not the intent of the merge definition to define the application or implementation specifics of how various systems or environments define, use or handle non-surviving information. "Non-surviving" in this document implies that a data set was existing in a fashion that was incorrect. Merging it into a new data set in itself implies that where there were two datasets, there is now only one. The means by which any system or environment conveys this new data set and the absence of the previous data set to the user is application specific. It is noted that some systems may still physically keep these "incorrect" datasets for audit trail or other purposes.


Move

A "move" involves transferring one or more datasets (identified by a subordinate identifier) from one superior identifier at the next hierarchical level to another superior identifier at the next hierarchical level, while all identifiers involved retain their original value. An exception to retaining the original identifier value may occur if any of the subordinate source identifiers already exist under the target superior identifier. In this case the identifier value may have to be renumbered in order to be uniquely identified under the target superior identifier. (Refer to section 3.5.2.2.8, "A45 - Move visit information" for an illustration of this.)

A move event signals that a patient, account, or visit has been moved from one person, patient, or account, respectively, to another. All records at a subordinate level are also moved. For example, an A43 (move patient information - patient identifier list) event would be sent to signal that a medical records administrator has moved a medical record attached to an incorrect person to a correct person. The following figure graphically depicts the move event:

Note:    The move event implies that all data related to the incorrect source ID and its subordinate IDs (specified in the MRG segment) will be moved to the correct target ID (specified in the PID or PV1 segment). Specifying each subordinate ID in repeating PID/MRG/PV1 sets is optional but not recommended.


Change identifier

A change identifier event signals that a single person, patient, account, or visit identifier has been changed. It does not reflect a merge or a move; it is simply a change of an identifier. For example, a "Change Identifier" event would be sent to signal that the registrar has changed an incorrectly assigned person identifier to a correct person identifier. The following picture graphically depicts this event:

Source and target identifiers

Merge, move, and change events reference target and source identifiers. The incorrect source identifier is specified in the MRG segment. The correct target identifier is identified in the PID or PV1 segment. For example, when you are changing a patient account number the source would be MRG-3 - Prior Patient Account Number. The target is PID-18 - Patient Account Number.

Tightly coupled relationship

When patient/person identifiers are the target in merge, move, or change events, as specified in the PID-2 - Patient ID, PID-3 - Patient Identifier List and PID-4 - Alternate Patient ID-PID, the associated source identifiers in the MRG-4 - Prior Patient ID, MRG-1 - Prior Patient Identifier List, and MRG-2 - Prior Alternate Patient ID, respectively, must be "tightly coupled." Each event that is defined as a merge, move, or change message carries the "tightly" coupled relationship at the appropriate level in one of two ways: first, by virtue of positional placement in the sequence of identifiers; or, second, by identifier type and assigning authority. The methodology used to establish the definition of "tightly coupled" relationship is determined by site negotiation. The recommended definition is by virtue of positional placement in the sequence of identifiers (pairwise). In addition, HL7 allows the use of the second definition by identifier type and assigning authority as an acceptable convention to establish a "tightly coupled" relationship. In the absence of a site negotiated definition, it is assumed that the positional placement of the identifiers is the default method.

The list of identifiers can be aligned positionally in their respective segment fields and processed by the receiving system by virtue of their order. This is sometimes referred to as an "ordered pairwise" relationship and is described further in section 3.5.2.1.7, "Ordered pairwise relationship".

Alternatively, the uniqueness of the identifiers included in the message is determined by the combination of identifier type and assigning authority. It is assumed that both sending system and receiving system can inspect both of these qualifiers as a message is constructed or processed to determine the "tightly coupled" relationship between the identifiers. This can be referred to as "identifier type/assigning authority" relationship and is described further in section 3.5.2.1.8, "Identifier type/assigning authority relationship".

The pairing of identifiers between the MRG segment fields and their associated identifiers in the PID or PV1 segment are defined below:

Person

PID-2 - Patient ID

with

MRG-4 - Prior Patient ID

Patient

Pid-3 - Patient Identifier List

with

MRG-1 - Prior Patient Identifier List

and by

Explicit order of identifiers in the list

or by

<identifier type code> and <assigning authority> field components

PID-4 - Alternate Patient ID

with

MRG-2 - Prior Alternate Patient ID

Account

PID-18 - Patient Account Number

with

MRG-3 - Prior Patient Account Number

Visit

PV1-19 - Visit Number

with

MRG-5 - Prior Visit Number

PV1-50 - Alternate Visit ID

with

MRG-6 - Prior Alternate Visit ID


Ordered pairwise relationship

In a strict sense, this type of relationship is characterized by a one-to-one association based on type (e.g., medical record number to medical record number, etc.) and the corresponding order of the element, and is typically found in list or set operations. However, for purposes of practical implementation, this relationship will be defined as a simple one-for-one pairing, as exists between the PID-3 - Patient Identifier List and the MRG-1 - Prior Patient Identifier List. In other words, elements "A", "B", and "C" in the first list would directly correspond to elements "X", "Y", and "Z" in the second list. No consideration is made to the type or value of the corresponding elements; it is the explicit order of the elements which controls the association process. This scenario could be expressed as follows:

List1 = {A,B,C}

List2 = {X,Y,Z}

A : X

B : Y

C : Z


A second scenario may arise which deserves mention. As in the list example above, elements "A", "B", and "C" in the first list would "pair-up" with elements "X", "Y", "Z", "Q", "R", and "S" in the second list. Again, no consideration is made to the type or value of the corresponding elements; it is the order and presence which controls the association process. This scenario could be expressed as follows:

List1 = {A,B,C}

List2 = {X,Y,Z,Q,R,S}

A : X

B : Y

C : Z

: Q

: R

: S


In the second scenario, the last three elements "Q", "R", and "S" are not affected and their value remains as if no association had been made.

A third scenario may arise which deserves mention. As in the list example above, elements "A", "B", "C", "D", "E", and "F" in the first list would "pair-up" with elements "X", "Y", and "Z" in the second list. Again, no consideration is made to the type or value of the corresponding elements; it is the order and presence which controls the association process. This scenario could be expressed as follows:

List1 = {A,B,C,D,E,F}

List2 = {X,Y,Z}

A : X

B : Y

C : Z

D :

E :

F :


In the third scenario, the last three elements "D", "E", and "F" are not affected and their value remains the same as if no association had been made.

Identifier type / assigning authority relationship

As stated earlier, the uniqueness of the identifiers included in a message can be determined by the combination of identifier type (t) and assigning authority (a). It is assumed that both sending system and receiving system can inspect both of these qualifiers as a message is constructed or processed. This method is used to determine the "tightly coupled" relationship between the identifiers. The implementation of this relationship exists between the PID-3 - Patient Identifier List and the MRG-1 - Prior Patient Identifier List. In other words, elements "B^t2^a1", "C^t3^a1", "D^t4^a1", "A^t1^a1", "E^t5^a1", and "F^t6^a1" in the first list would be associated with elements "X^t1^a1", "Y^t2^a1", and "Z^t3^a1 in the second list. This scenario could be expressed as follows:

List1 = {B^t2^a1,C^t3^a1,D^t4^a1,A^t1^a1,E^t5^a1,F^t6^a1}

List2 = {X^t1^a1,Y^t2^a1,Z^t3^a1}

B^t2^a1 : Y^t2^a1

C^t3^a1 : Z^t3^a1

D^t4^a1 :

A^t1^a1 : X^t1^a1

E^t5^a1 :

F^t6^a1 :


In this scenario, the three elements which do not have corresponding identifier type and assigning authority "D^t4^a1", "E^t5^a1", and "F^t6^a1" are not affected and their value remains the same as if no association had been made.

A second scenario may arise which deserves mention. In the case of identifier type and assigning authority definition, the elements "A^t1^a1", "B^t2^a1", and "C^t3^a1" in the first list would be associated with elements "X^t4^a1", "Y^t2^a1", "Z^t3^a1", "Q^t1^a1", "R^t5^a1", and "S^t6^a1" in the second list. No consideration is made to the order of the identifiers; it is the identifier type and assigning authority of the corresponding elements which controls the association process. This scenario could be expressed as follows:

List1 = {A^t1^a1,B^t2^a1,C^t3^a1}

List2 = {X^t4^a1,Y^t2^a1,Z^t3^a1, Q^t1^a1,R^t5^a1,S^t6^a1}

A^t1^a1 : Q^t1^a1

B^t2^a1 : Y^t2^a1

C^t3^a1 : Z^t3^a1

: X^t4^a1

: R^t5^a1

: S^t6^a1


In the second scenario, the three elements which do not have corresponding identifier type and assigning authority "X^t4^a1", "R^t5^a1", and "S^t6^a1" are not affected and their value remains the same as if no association had been made.

Global merge and move message construct versus repeating segment message constructs

A flexible message construct is provided for merge trigger events. The message construct allows for a repeating set of PID, optional PD1, MRG, and optional PV1 segments as illustrated below:

MSH

EVN

{ PID

[PD1]

MRG

[PV1]

}

Trigger events support the concept of a global move or merge, where all the subordinate identifiers are moved or merged. For example, the use case for A41 (merge account-patient account number) (Section 3.5.2.2.3, "A41 - merge account - patient account number (global)") illustrates a merge on the patient account number (PID-18 - Patient Account Number). All subordinate identifiers (PV1-19 - Visit Number) are moved to the target PID-18 - Patient Account Number Identifier, even though they are not specified in the message.

A repeating segment message construct supports reporting of the subordinate identifiers using the repeating segments. This is illustrated in the use case for A40 (merge patient - patient identifier list) (Section 3.5.2.2.2, "A40 - merge patient - patient identifier list (repeating segment)," A41 (merge account - patient account number) (Section 3.5.2.2.4, "A41 - merge account - patient account number (repeating segment)"), and A45 (move visit information-visit number) (Section 3.5.2.2.9 "A45 - move visit information - visit number (repeating segment)"). Specifying each subordinate ID in repeating segments is optional but not recommended. This construct can be used when renumbering of identifiers is necessary as illustrated in Sections 3.5.2.2.2, "A40 - merge patient - patient identifier list (repeating segment)," 3.5.2.2.4, "A41 - merge account - patient account number (repeating segment)," and 3.5.2.2.9, "A45 - move visit information - visit number (repeating segment)," or to explicitly identify individual subordinate identifiers as illustrated in Section 3.5.2.2.9, "A45 - move visit information - visit number (repeating segment)."

Identifier renumbering

When renumbering of identifiers occurs, the repeating segment construct may be required in order to report identifier number changes. When renumbering occurs, the incorrect source identifier is specified in the MRG segment and the correct target identifier is reported in the PID or PV1 segment. Refer to the use case for A41 (merge account-patient account number) for an illustration.

Superior identifier reporting

When merging or moving subordinate numbers, the higher level, "superior" identifiers should be included in the message. For example, when merging an account where the target is PID-18 - Patient Account Number and the source is MRG-3 - Prior Patient Account Number, the higher level patient identifiers (PID-3 -Patient Identifier List and MRG-1 - Prior Patient Identifier List) and person identifiers (PID-2 - Patient ID and MRG-4 - Prior Patient ID) should also be reported in the message.

Trigger events

The intent of trigger events A40 (merge patient- patient identifier list), A41 (merge account-patient account number), A42 (merge visit-visit number), A43 (move patient information-patient identifier list), A44 (move account information-patient account number), A45 (move visit information-visit number), A47 (change patient identifier list), A49 (change patient account number), A50 (change visit number), and A51 (change alternate visit ID) is to reconcile distinct sets of existing person/patient data records that have been entered under different identification numbers, either deliberately or because of errors. Ideally, following any of these trigger events, all of the person/patient data should be accessible under whatever surviving identifiers were specified in the messages. Because of substantial differences in database architectures and system-dependent data processing requirements or limitations, the exact meaning and implementation of these events must be negotiated between systems.

A40 - merge patient - patient identifier list

A40 - Merge patient - patient identifier list

Use Case - During the admission process, the registrar does not find a record for patient EVE EVERYWOMAN in the ADT system and creates a new record with patient identifier MR2. EVE EVERYWOMAN has actually been to the healthcare facility several times in the past under her maiden name, Eve Maidenname with patient identifier MR1. The problem persists for a while. During that time, several more accounts are assigned to Eve under her newly created patient ID MR2. Finally, the problem is discovered and Medical Records merges her two charts together leaving patient identifier MR1. All the accounts (ACCT1, ACCT2) that were assigned to MR2 are combined under MR1 as a result.

Target: PID-3 - Patient Identifier List (Note: PID-18 - Patient Account Number is not valued; all accounts associated with MR2 are combined under MR1). To merge PID-18 - Patient Account Number data only, use event A41 (merge account-patient account number). To move PID-18 - Patient Account Number data use event A44 (move account information-patient account number).

Source: MRG-1 - Prior Patient Identifier List) (Note: MRG-3 - Prior Patient Account Number is not valued; all accounts associated with MR2 are combined under MR1.)

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A40^ADT_A39|00000003|P|2.8|<cr>

EVN|A40|200301051530<cr>

PID|||MR1^^^XYZ||MAIDENNAME^EVE|....<cr>

MRG|MR2^^^XYZ<cr>

Before Merge

After Merge

MR1 MR2

ACCT1 ACCT1

ACCT2 ACCT2

MR1

ACCT1

ACCT2

ACCT1

ACCT2

Implementation considerations: This scenario exists when two medical records are established for the same person.

Since there could be a discrepancy in the demographic information between the two records, reconciliation may be required. In the example above, the implementation allowed the older demographic information (in the PID) to survive. The demographics implied by the IDs in the MRG segment, did not survive. Surviving and non-surviving demographic information is application and implementation specific. An A08 (update patient information) event should be sent and/or negotiated as necessary to provide for implementation and application-specific needs.


A40 - merge patient - patient identifier list (repeating segment)

A40 - Merge patient - patient identifier list

Use Case - During the admission process, the registrar does not find a record for patient EVE EVERYWOMAN in the Patient Administration system and creates a new record with patient identifier MR2. EVE EVERYWOMAN has actually been to the healthcare facility several times in the past under her maiden name, EVE MAIDENNAME with patient identifier MR1. The problem persists for a while. During that time, several more accounts are assigned to EVE under her newly created patient ID MR2. Finally, the problem is discovered and Medical Records merges her two charts together leaving patient identifier MR1. All the accounts (ACCT1, ACCT2) that were assigned to MR2 are combined under MR1 as a result. Since the account numbers are not unique, they are also renumbered.

Target: PID-3 - Patient Identifier List and PID-18 - Patient Account Number

Source: MRG-1 - Prior Patient Identifier List and MRG-3 - Prior Patient Account Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A40^ADT_A39|00000003|P|2.8|<cr>

EVN|A40|200301051530<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE|||||||||||||ACCT3<cr>

MRG|MR2^^^XYZ||ACCT1<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE|||||||||||||ACCT4<cr>

MRG|MR2^^^XYZ||ACCT2<cr>

Before Merge

After Merge

MR1 MR2

ACCT1 ACCT1*

ACCT2 ACCT2*

MR1

ACCT1

ACCT2

ACCT3*

ACCT4*

*accounts renumbered

Implementation considerations: This scenario exists when two medical records are established for the same person.

If the account numbers are not unique (as implied by the After Merge example above) and renumbering of the accounts is required, you must use repeating segments as illustrated in the Example Transaction. Refer to Section 3.5.2.1.9, "Global merge and move message construct versus repeating segment message constructs," for additional information regarding message construct.

Since there could be a discrepancy in the demographic information between the two records, reconciliation may be required. In the example above, the implementation allowed the older demographic information (in the PID) to survive. The demographics implied by the IDs in the MRG segment, did not survive. Surviving and non-surviving demographic information is application and implementation specific. An A08 (update patient information) event should be sent and/or negotiated as necessary to provide for implementation and application specific needs.


A41 - merge account - patient account number (global)

This event illustrates the concept of a global merge as defined in Section 3.5.2.1.9, "Global merge and move message construct versus repeating segment message constructs."

A41 - Merge account information - patient account number

Use Case - Eve Everywoman (patient identifier MR1) is a recurring outpatient at the Physical Therapy clinic at hospital XYZ with account number ACCT1. She has visited the clinic several times. When she arrives for therapy, a new registrar does not realize she already has an account and opens a new one with account number ACCT2. When the mistake is discovered, the two accounts are merged together, combining all visits under account ACCT1.

Target: PID-18 - Patient Account Number

Source: MRG-3 - Prior Patient Account Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A41^ADT_A39|00000005|P|2.8|<cr>

EVN|A41|200301051530<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE||19501010|M|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR1^^^XYZ||ACCT2<cr>

Before Merge

After Merge

MR1

ACCT1

96124

96126

ACCT2

96128

96130

MR1

ACCT1

96124

96126

96128

96130

Implementation considerations: This scenario exists when two accounts are established for the same patient.

The PV1 segment is not valued since this event is really a merge at the PID-18 - Patient Account Number level. All identifiers below the PID-18 - Patient Account Number are combined under the surviving Patient Account Number.

Since there could be a discrepancy in the demographic information between the two records, reconciliation may be required. Surviving and non-surviving demographic information is application and implementation specific. An A08 (update patient information) event should be sent and/or negotiated as necessary to provide for implementation and application-specific needs.


A41 - merge account - patient account number (repeating segment)

This event illustrates the concept of a repeating segment merge as defined in 3.5.2.2.1.

A41 - Merge account - patient account number

Use Case - Eve Everywoman (patient identifier MR1) is a recurring outpatient at the Physical Therapy clinic at hospital XYZ with account number ACCT1. She has visited the clinic several times. When she arrives for therapy, a new registrar does not realize she already has an account and opens a new one with account number ACCT2. When the mistake is discovered, the two accounts are merged together, combining all visits under account ACCT1.

Target: PID-18 - Patient Account Number and PV1-19 - Visit Number

Source: MRG-3 - Prior Patient Account Number and MRG-5 - Prior Visit Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A41^ADT_A39|00000005|P|2.8|<cr>

EVN|A41|200301051530<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE||19501010|F|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR1^^^XYZ||ACCT2||VISIT1<cr>

PV1|1|I|||||||||||||||||VISIT3<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE||19501010|F|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR1^^^XYZ||ACCT2||VISIT2

PV1|1|I|||||||||||||||||VISIT4<cr>

Before Merge

After Merge

MR1

ACCT1

VISIT1

VISIT2

ACCT2

VISIT1*

VISIT2*

*Visits erroneously assigned

MR1

ACCT1

VISIT1

VISIT2

VISIT3**

VISIT4**

**Visits combined and renumbered as a result of merging the account

Implementation considerations: This scenario exists when two accounts and associated visits are established for the same patient.

Repeating PID/MRG/PV1 segments report each Account Number and Visit Number affected. This construct is required since the visits are renumbered in this example.

Since there could be a discrepancy in the demographic information between the two records, reconciliation may be required. Surviving and non-surviving demographic information is application and implementation specific. An A08 (update patient information) event should be sent and/or negotiated as necessary to provide for implementation and application-specific needs.


A42 - Merge visit - visit number

A42 - Merge visit - visit number

Use Case - A42 (merge visit -visit number) - Eve Everywoman (patient identifier MR1) is a recurring outpatient at the Physical Therapy clinic at hospital XYZ with account number ACCT1. She has visited the clinic several times. When she arrives for therapy, two different registrars create a new visit numbers. The mistake is not discovered immediately and clinical data is recorded under both visit numbers. When the mistake is discovered, the two visits are merged together, leaving visit VISIT1.

Target: PV1-19 - Visit Number

Source: MRG-5 - Prior Visit Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A42^ADT_A39|00000005|P|2.8|<cr>

EVN|A42|200301051530<cr>

PID|||MR1^^^XYZ||EVERYEWOMAN^EVE||19501010|F|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR1^^^XYZ||ACCT1||VISIT2<cr>

PV1|1|I|||||||||||||||||VISIT1

Before Merge

After Merge

MR1

ACCT1

VISIT1

VISIT2

MR1

ACCT1

VISIT1

Implementation considerations: This scenario exists when two visits are established in error for the same patient and episode of care.


A43 - move patient information - patient identifier list

A43 - Move patient information - patient identifier list

Use Case - information from ABC HMO is loaded to a repository system each month. Eve Everywoman is entered in January and assigned Enterprise Number 1 (E1). Eve has visited Hospital XYZ and is assigned medical record number MR1. Evi Everywoman (a different person) is also a member of ABC HMO loaded to the repository and assigned Enterprise Number E2. Evi has visited Hospital XYZ and is assigned medical record number MR1. Evi visits Clinic DEF where she is assigned medical record number MR2 which is erroneously associated with Eve's Enterprise Number (E1). When the error is discovered MR2 is moved from Enterprise Number E1 to E2.

Target: PID-2 - Patient ID

Source: MRG-4 - Prior Patient ID

Example transaction:

MSH|^~VALUEamp;|REPOSITORY|ENT|RSP1P8|MCM|200301051530|SEC|ADT^A43^ADT_A43|0000009|P|2.8|<cr>

EVN|A43|200301051530<cr>

PID|1|E2|MR2^^^ABCHMO|||EVERYWOMAN^EVI|....<cr>

MRG|MR2^^^ABCHMO|||E1<cr>

Before Move

After Move

E1 E2

MR1 MR1

MR2

E1 E2

MR1 MR1

MR2

Implementation considerations: PID-3 - Patient Identifier List and MRG-1 - Prior Patient Identifier List are the same value since the PID-3 value does not change in this scenario.

The example above would be expressed as follows. In the following example, the assigning authority ENT1 represents an Enterprise and the PE identifier type code represents the Person's Enterprise number. The MR1 identifier is omitted from the message because it is not moved.

MSH|^~VALUEamp;|REPOSITORY|ENT|RSP1P8|MCM|200301051530|SEC|ADT^A43^ADT_A43|0000009|P|2.8|<cr>

EVN|A43|200301051530<cr>

PID|1||E2^^^ENT1^PE~MR2^^^ABCHMO^MR|||EVERYWOMAN^EVI|....<cr>

MRG|E1^^^ENT1^PE~MR2^^^ABCHMO^MR|. . .<cr>


A44 - move account information - patient account number

A44 - Move account information - patient account number

Use Case - During the admission process, the admitting clerk uses the Medical Record Number of Adam Everyman III (MR1) instead of Adam Everyman, Jr. (MR2). The Patient Administration system assigns the new admission account number ACCT2. When the mistake is discovered, account ACCT2 is moved to the correct Medical Record, MR2. The account number is not changed.

Target: PID-3 - Patient Identifier List and PID-18 - Patient Account Number (Note: PID-18 - Patient Account Number and MRG-3 - Prior Patient Account Number will be the same since the account number does not change in this scenario).

Source: MRG-1 - Prior Patient Identifier List and MRG-3 - Prior Patient Account Number (NOTE: MRG-3 - Prior Patient Account Number must be valued to indicate which account to move)

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A44^ADT_A43|00000007|P|2.8|<cr>

EVN|A44|200301051530<cr>

PID|||MR2^^^XYZ||Everyman^Adam^A^JR||19501010|M|||123 EAST STREET^^NY^NY^10021||(212)111-3333|||S||ACCT2<cr>

MRG|MR1^^^XYZ||ACCT2<cr>

Before Move

After Move

MR1 MR2

ACCT1 ACCT1

ACCT2

MR1 MR2

ACCT1 ACCT1

ACCT2

Implementation considerations: This scenario exists when two medical records legitimately exist for two different people and an account is incorrectly associated with the wrong medical record number.


A45 - move visit information - visit number (repeating segment)



A45 - Move visit information - visit number

Use Case - Eve Everywoman (patient identifier MR1) is a recurring outpatient at the Physical Therapy and Speech Therapy clinics at hospital XYZ. She is assigned a different account for each clinic; her account number for Physical Therapy is ACCT1 and her account number for Speech Therapy is X1. However, on two different occasions, the Speech Therapy registrar accidentally assigned her visits (96102 and 96104) to the Physical Therapy account. The problem is later discovered and the corresponding visits are moved to the correct account.

Target: PID-18 - Patient Account Number and PV1-19 - Visit Number.

Source: MRG-3 - Prior Patient Account Number and MRG-5 - Prior Visit Number.

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A45^ADT_A45|00000005|P|2.8|<cr>

EVN|A45|200301051530<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE||19501010|M|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||X1<cr>

MRG|MR1^^^XYZ||ACCT1||96102<cr>

PV1||O|PT||||||||||||||||96102<cr>

MRG|MR1^^^XYZ||ACCT1||96104<cr>

PV1||O|PT||||||||||||||||96104<cr>

Before Move

After Move

MR1

ACCT1

96100

96102*

96104*

X1

96101

96103

96105

*Visits erroneously assigned

MR1

ACCT1

96100

X1

96101

96102

96103

96104

96105

In the above transaction/implementation, the application that generated the message assigns unique visit numbers.

Implementation Considerations: In this scenario the repeating MRG/PV1 construct is used to indicate which visits are moved, as illustrated in the Example Transaction. MRG-5 - Prior Visit Number and PV1-19 - Visit Number are the same values because the visit numbers do not change. Refer to section 3.5.2.1.9, "Global merge and move message construct versus repeating segment message constructs," for additional information regarding message construct.


A45 - move visit information - visit number (repeating segment)



A45 - Move visit information - visit number

Use Case -Eve Everywoman (patient identifier MR1) is a recurring outpatient at the Physical Therapy and Speech Therapy clinics at hospital XYZ. She is assigned a different account for each clinic; her account number for Physical Therapy is ACCT1 and her account number for Speech Therapy is X1. However, on two different occasions, the Speech Therapy registrar accidentally assigned her visits (VISIT2 and VISIT3) to the Physical Therapy account. The problem is later discovered and the corresponding visits are moved to the correct account.

Target: PID-18 - Patient Account Number and PV1-19 - Visit Number.

Source: MRG-3 - Prior Patient Account Number and MRG-5 - Prior Visit Number.

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A45^ADT_A45|00000005|P|2.8|<cr>

EVN|A45|200301051530<cr>

PID|||MR1^^^XYZ||EVERYWOMAN^EVE||19501010|M|||123 NORTH STREET^^NY^NY^10021||(212)111-3333|||S||X1<cr>

MRG|MR1^^^XYZ||ACCT1||VISIT2<cr>

PV1||O|PT||||||||||||||||VISIT4<cr>

MRG|MR1^^^XYZ||ACCT1||VISIT3<cr>

PV1||O|PT||||||||||||||||VISIT5<cr>

Before Move

After Move

MR1

ACCT1

VISIT1

VISIT2*

VISIT3*

X1

VISIT1

VISIT2

VISIT3

*Visits erroneously assigned

MR1

ACCT1

VISIT1

X1

VISIT1

VISIT2

VISIT3

VISIT4**

VISIT5**

**visits moved and renumbered

In the above transaction/implementation, the application that generated the message allows non-unique visit numbers.

Implementation Considerations: If Visit Numbers are not unique (as implied by the After Move example above) and renumbering of the visits is required, you must use a repeating MRG/PV1 construct as illustrated in the Example Transaction. Refer to 3.5.2.2.1, "A40 - merge patient - patient identifier list," for additional information regarding message construct.


A47 - change patient identifier list

A47 - Change patient identifier list

Use Case - The Medical Records Department of XYZ hospital uses a system of manual medical record number assignment. During the admission process, the registrar accidentally assigned the wrong Medical Record Number (MR2 instead of MR1) to ADAM EVERYMAN. Since the correct Medical Record has not yet been assigned to any patient, no merge takes place. The Patient Identifier List is simply changed.

Target: PID-3 - Patient Identifier List

Source: MRG-1 - Prior Patient Identifier List

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A47|00000002|P|2.8|<cr>

EVN|A47|200301051530<cr>

PID|||MR1^^^XYZ||EVERYMAN^ADAM||19501010|M|||987 SOUTH STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR2^^^XYZ||ACCT1<cr>

Before Change

After Change

MR2

ACCT1

MR1

ACCT1

Implementation considerations: None.


A49 - change patient account number

A49 - Change patient account number

Use Case - Patients are automatically assigned an account number by hospital XYZ's Patient Administration system at admission. However, when the Patient Administration system is down, the admitting clerk manually assigns account numbers from a pool of downtime account numbers. ADAM EVERYMAN (patient ID MR1) was manually assigned downtime account number ACCT1. When the Patient Administration system came back up, the admitting clerk accidentally entered the wrong account number, X1, into the system. When the problem was later discovered, the account number was changed from X1 to ACCT1.

Target: PID-18 - Patient Account Number

Source: MRG-3 - Prior Patient Account Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A49^ADT_A30|00000006|P|2.8|<cr>

EVN|A49|200301051530<cr>

PID|||MR1^^^XYZ||EVERYMAN^ADAM||19501010|M|||123 SOUTH STREET^^NY^NY^10021||(212)111-2222|||S|CAT|ACCT1<cr>

MRG|MR1^^^XYZ||X1<cr>

Before Change

After Change

MR1

X1

MR1

ACCT1

Implementation Considerations: None.


A50 - change visit number

A50 - Change visit number

Use Case - Patients are automatically assigned a visit number by hospital XYZ's Patient Administration system at check-in. However, when the Patient Administration system is down, the admitting clerk manually assigns visit numbers from a pool of downtime numbers. ADAM EVERYMAN (patient ID MR1) was manually assigned downtime visit number VISIT1. When the Patient Administration system came back up, the admitting clerk accidentally entered the wrong visit number, VISIT2, into the system. When the problem was later discovered, the visit number was changed from VISIT2 to VISIT1.

Target: PV1-19 - Visit Number

Source: MRG-5 - Prior Visit Number

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A50^ADT_A50|00000006|P|2.8|<cr>

EVN|A50|200301051530<cr>

PID|||MR1^^^XYZ||EVERYMAN^ADAM||19501010|M|||123 SOUTH STREET^^NY^NY^10021||(212)111-2222|||S|CAT|ACCT1<cr>

MRG|MR1^^^XYZ||ACCT1||VISIT2<cr>

PV1|1|O||3|||99^BROWN^JERRY|||ONC||||1||VIP|99^BROWN^JERRY|O/P|VISIT1...<cr>

Before Change

After Change

MR1

ACCT1

VISIT2

MR1

ACCT1

VISIT1

Implementation considerations: None.


A51 - change alternate visit ID

A51 - Change alternate visit ID

Use Case - Patients are automatically assigned an alternate visit number by hospital XYZ's Patient Administration system at check-in. However, when the Patient Administration system is down, the admitting clerk manually assigns alternate visit numbers from a pool of downtime numbers. ADAM EVERYMAN was manually assigned downtime alternate visit number AV1. When the Patient Administration system came back up, the admitting clerk accidentally entered the wrong alternate visit number, AV2, into the system. When the problem was later discovered, the alternate visit number was changed from AV2 to AV1.

Target: PV1-50 - Alternate Visit ID

Source: MRG-6 - Prior Alternate Visit ID

Example Transaction:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SECURITY|ADT^A51^ADT_A50|00000006|P|2.8|<cr>

EVN|A51|200301051530<cr>

PID|||MR1^^^XYZ||EVERYMAN^ADAM||19501010|M|||123 SOUTH STREET^^NY^NY^10021||(212)111-2222|||S|CAT|ACCT1<cr>

MRG|MR1^^^XYZ||ACCT1|||AV2<cr>

PV1|1|O||3|||99^BROWN^JERRY|||ONC||||1||VIP|99^BROWN^JERRY|O/P|V1|SP|||||||||||||||||||A|||||19990902081010||||||AV1<cr>

Before Change

After Change

MR1

ACCT1

VISIT1

AV2

MR1

ACCT1

VISIT1

AV1

Implementation Considerations: None.


Example using multiple messages

A47 - Change patient identifier list and A49 - Change patient account number

Use Case - Patients are automatically assigned Medical Records Numbers and account numbers by hospital XYZ's Patient Administration system at admission. However, when the Patient Administration system is down, the admitting clerk manually assigns account numbers and Medical Records numbers from a pool of downtime numbers. ADAM EVERYMAN was manually assigned downtime Medical Record Number MR1 and downtime account number A1. When the Patient Administration system came back up, the admitting clerk accidentally enters the wrong Medical Record Number (MR2) and account number (X1) into the system. The error occurred because she was reading from the paperwork for a different downtime admit not yet entered into the Patient Administration system. The problem is quickly discovered, and the medical record number and account number was fixed accordingly. Since the other downtime admit had not yet been entered into the Patient Administration system, no merge was required.

Target: PID-3 - Patient Identifier List (Message 1) and PID-18 - Patient Account Number (Message 2)

Source: MRG-1 - Prior Patient Identifier List (Message 1) and MRG-3 - Prior Patient Account Number (Message 2)

Example Transaction - Message 1:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A47^ADT_A30|00000006|P|2.8|<cr>

EVN|A47|200301051530<cr>

PID|||MR1^^^XYZ^MR||EVERYMAN^ADAM||19501010|M|||123 SOUTH STREET^^NY^NY^10021||(212)111-2222|||S|CAT|X1<cr>

MRG|MR2^^^XYZ^MR|<cr>

Example Transaction - Message 2:

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A49^ADT_A30|00000006|P|2.5<cr>

EVN|A49|200301051530<cr>

PID|||MR1^^^XYZ^MR||EVERYMAN^ADAM||19501010|M|||123 SOUTH STREET^^NY^NY^10021||(212)111-2222|||S|CAT|ACCT1<cr>

MRG|MR1^^^XYZ^MR||X1<cr>

Before Change

After Change

MR2

X1

MR1

ACCT1

Implementation considerations: Message 1 (A47) changes the patient identifier list. Message 2 (A49) changes the account number.


Example using multiple messages

A44 - Move account information - patient account number and A49 - Change patient account number

Use Case - During the admitting process, the admitting clerk uses the Medical Record Number of Adam Everyman, III (MR1) instead of Adam Everyman, Jr. (MR2). The Patient Administration system assigns the new admission account number A1. When the mistake is discovered, the account is moved to the correct Medical Record, MR2. The Patient Administration system generates a new account number as a result: number X1.

Target: PID-3 - Patient Identifier List (Message 1) and PID-18 - Patient Account Number (Message 2)

Source: MRG-1 - Prior Patient Identifier List (Message 1) and MRG-3 - Prior Patient Account Number (Message 2)

Example Transaction (Message 1):

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A44^ADT_A43|00000007|P|2.8|<cr>

EVN|A44|200301051530<cr>

PID|||MR2^^^XYZ^MR||EVERYMAN^ADAM^A^JR||19501010|M|||123 EAST STREET^^NY^NY^10021||(212)111-3333|||S||ACCT1<cr>

MRG|MR1^^^XYZ^MR||ACCT1<cr>

Example Transaction (Message 2):

MSH|^~VALUEamp;|REGADT|MCM|RSP1P8|MCM|200301051530|SEC|ADT^A49^ADT_A30|00000007|P|2.5<cr>

EVN|A49|200301051530<cr>

PID|||MR2^^^XYZ^MR||EVERYMAN^ADAM^A^JR||19501010|M|||123 EAST STREET^^NY^NY^10021||(212)111-3333|||S||X1<cr>

MRG|MR2^^^XYZ^MR||ACCT1<cr>

Before Change

After Change

MR1 MR2

ACCT1

MR1 MR2

X1

Implementation Considerations: Message 1, A44 (move account information-patient account number), moves the account from MR1 to MR2. Message 2, A49 (change patient account number), changes the account number.


Patient record links

Linking two or more patients does not require the actual merging of patient information as discussed in Section 3.5.2, "Merging patient/person information;" following a link trigger event, sets of affected patient data records should remain distinct. However, because of differences in database architectures, there may be system-dependent limitations or restrictions regarding the linking of one or more patients that must be negotiated.

There are multiple approaches for implementing Master Patient Indexes. It is useful for the purpose of MPI mediation to support two types of linkage. Explicit linkage requires a message declaring a link has been made between multiple identifiers. Implicit linkage is performed when a receiving system infers the linkage from the presence of multiple identifiers present in PID-3 - Patient Identifier List.

In an MPI setting, the A24 -link patient information message is preferred for transmitting an explicit link of identifiers whether they are in the same or different assigning authorities. The A37 unlink patient information message is preferred for transmitting the explicit unlinking of identifiers.

Implicit linkage of identifiers, sometimes called passive linking, has been implemented using various messages. An acknowledged method is inclusion of multiple identifiers in PID-3 - Patient Identifier List, which the receiving system implicitly links. An MPI or application that makes such an implicit linkage can generate an A24 - link patient information message to explicitly notify another system of this action.

MPI Integration - an introduction

The purpose of this section is to provide some insight into how HL7 committees have approached the area of MPI integration, as well as to provide concrete examples of how the integration could be done using messages in Version 2.4 and later.

(hidden text)

Definitions - what is an MPI?

There can be quite a bit of confusion as to what defines an MPI. Early definitions called it a Master Patient Index, implying only patient data would be managed. Later the definition was expanded to mean persons in general, including patients, guarantors, subscribers, and even providers; essentially any entity that could be considered a "person." Thus the current acronym MPI generally is inferred to mean Master Person Index.

An MPI is generally used to manage person identification and cross-reference across disparate systems. Healthcare organizations may have several systems handling various different data processing needs, from laboratory to billing, each with its own database of persons and person identifier numbering schemes. Each of these can be called an ID Domain. An MPI can function as a Correlation Manager between these domains, providing a cross-reference of a person's identifiers across each of the domains. Typically an MPI will also have one universal or enterprise identifier that uniquely identifies the person in the MPI itself. The domain for this identifier may or may not be the domain for clients of the MPI.

MPI functionality also typically includes methods to provide an identifier for a person, given a set of traits or demographics for that person. An example of the use of this is for a client system to query the MPI for a person given a set of demographics. The MPI uses matching algorithms to find possible matching persons, and returns to the client system the identifiers for those persons.

This section currently deals only with MPI functionality related to persons in the context of Version 2.4 and later. It is assuming integration using Version 2.4 and later ADT messages, and the functionality surrounding finding and identifying a person.

HL7 and CORBAmed PIDS

There has been an effort to harmonize the modeling work that has been done in the CORBAMed Patient Identification Service (PIDS) with the HL7 message set, with an eye toward HL7 Version 3.0. You may see evidence of CORBAMed modeling in this implementation, but that should not be taken as evidence that full harmonization has taken place. There is much work left to do in this area.

MPI QUERY for person lookup and identification

Several QBP/RSP queries have been developed to aid in the integration of systems with an MPI. They consist of several Qxx/Kxx trigger/response pairs and one Q24/K24 trigger/response pair. The following table lists their functions:

MPI QBP/RSP Queries

Query

Name

MPI Use

Q21/K21

Get Person Demographics

Given a person identifier, return the PID and optionally the PD1 segments for the matching person.

Q22/K22

Find Candidates

Given some demographics, optionally a match threshold and algorithm, find and return a list of matching persons.

Q23/K23

Get Corresponding Identifiers

Given a person's identifier and a list of identifier domains, return the person's identifiers in those domains.

Q24/K24

Allocate Identifiers

Given a list of identifier domains, return new identifiers for those domains. Should not link to a person, just reserve and return identifiers.


The following sections show several scenarios involving looking up a person on a "client" system, and how it can be integrated to an MPI. The basic flow is for a user to enter person information on the client system, and the client system using services of the MPI to match the user's input to a person that exists somewhere on the two systems.

The scenarios are differentiated on two variables:

ID Creator - Which system assigns new person identifiers for the client system. This can either be the MPI or the client system.

Person Existence - On which system the person record currently exists - the client system, the MPI, or both.

Client system assigns identifier, person exists on MPI only

In this scenario, a client system (e.g., a registration system) will query an MPI for a person that does not currently exist on the client system. The MPI returns a list of one or more possible matching candidates, and one is chosen by the user on the client system. The client system assigns the person an identifier and an update is sent to the MPI to notify it of the new assigned identifier.

Figure 3-1 - Client system assigns identifier, person exists on MPI only

The messages are defined as follows:

Q22/K22 Find Candidates - This signals the MPI to search its database for a list of persons that match the demographic criteria sent in the query, using whatever algorithms it has at its disposal, or using the algorithm optionally specified in the query. The response includes a list of "candidates" that matched the criteria in the query, one PID segment for each candidate. The query can also specify the identifier domains to return in PID-3 - Patient Identifier List, so that the client system identifier and the MPI enterprise identifier could be returned for each match.

Q21/K21 Get Person Demographics - Once a candidate is chosen from the list, another query may be done to retrieve the full set of demographics for that person.

A24 or A01/A04/A05 - This transaction is to update the MPI with the new identifier the client system has created for the person. It is acceptable for systems to simply send an A01 Admit/visit notification, A04 Register a patient or A05 Pre-admit a patient as may have been done traditionally, with the new client system identifier and the existing MPI enterprise identifier in PID-3. However an A24 Link patient information may be sent instead, with one PID segment containing the MPI enterprise identifier for the person, and the second PID segment containing the new registration system identifier.

Client system assigns identifier, person exists on both systems

In this scenario, a client system (e.g., a registration system) will query an MPI for a person, and the person record exists on both systems. The MPI returns a list of possible matching candidates, and one is chosen by the user on the client system. The client system simply asks the MPI for an updated set of demographics and does not assign an identifier since the person already exists with an identifier on the client system.

Prior to querying the MPI, the client system may query its own database to reduce network transactions. However, the full searching capabilities of the MPI may be preferred to the client system in order to prevent the selection of the wrong person.

Figure 3-2 - Client system assigns identifier, person exists on both systems

The message flow is identical to the message flow in the 3.5.4.5 example, with the exception that the final update to the MPI is not needed in order to give the MPI a new identifier for the person. The MPI should already have the client system identifier from previous transactions.

An ADT event may be sent later by the client system simply to update the MPI with any demographic changes that occur.

Client system assigns identifier, person exists on neither system

In this scenario, a client system (e.g., a registration system) will query an MPI for a person, and the person does not exist on either system. The MPI returns a list of possible matching candidates, or possibly an empty list. The user does not choose one, and a new person record is created.

Figure 3-3 - Client system assigns identifier, does not exist on either system

The message flow again begins with a Q22/K22 Find Candidates query. The response may or may not contain a list of candidates.

If the client system assigns a person identifier when the record is created, an A28 Add person information could be sent to the MPI to notify it of the record creation. If the client system does not create an identifier until the registration is completed, the A01, A04 or A05 events could serve the purpose of notifying the MPI of an added person and identifier. The fact that the person will have an identifier unknown to the MPI, and no enterprise identifier, will allow the MPI to infer that a person record is being added.

When the person record is added to the MPI with the new identifier, an enterprise identifier is assigned, and ancillary systems may be notified of the new person record creation.

MPI assigns identifier, person exists on MPI

In the next set of three scenarios, it is assumed that a third party (ID Manager) creates identifiers for the client system, and for these examples the MPI fulfills this role. The QBP/RSP queries support this service.

Figure 3-4 - Example of two healthcare organizations merging

Figure 3-4 shows a case where identifiers may need to be assigned by a third party. In the example, East Health Organization had one identifier domain (XXXX numbers) for both the hospital registration system and the outpatient clinic registration numbers. Coordination was done through the use of pre-printed charts for new patients, which prevented the two systems from using the same XXXX number for two patients.

Later West Health Organization is bought and merged with East. West has been using its own identifier domain (YYYY numbers). An MPI is also implemented to keep a cross-reference between the two systems, and assigns its own enterprise identifier (EEEE number) to each patient.

Because the organization is attempting to go paperless, East decides to forgo its pre-printed charts, but still keep the XXXX numbers. Since the pre-printed charts are no longer there to keep numbers from being re-used between the hospital and clinic, a third party is needed to assign the XXXX numbers.

A patient arrives at East Hospital that had never been there, but had been to West previously. To register the patient, the hospital system submits a Find Candidates Q22/K22 query to get from the MPI a list of possible matching patients. The user finds the patient since she had been to West previously. Since the patient is new to East, she must be given a new East identifier (XXXX number). An Allocate Identifiers A56/K24 query is sent from the East Hospital to the MPI and the MPI generates an XXXX number and returns it. Later when the registration is finished, an A24 Link Person Information message is sent to notify the MPI that the allocated identifier has been assigned to a patient

In the following first scenario, the person record exists on the MPI, however it does not exist on the client system. The message flow assumes that the MPI is assigning identifiers for the client system that are not the enterprise identifiers. If this were not the case, the Allocate Identifiers A56/K24 query would not be needed.

Figure 3-5 - MPI assigns identifier, person exists on MPI

The message flow is similar to previous examples, with the exception of the Q24/K24 Allocate Identifiers query and the final A24 Link Patient Information message:

Q24/K24 Allocate Identifiers - This query is for the client system to ask the MPI for an identifier in the client system's domain. It is not to assign the identifier to a particular person record, but rather just to reserve an identifier for later use.

A24 Link patient information - This message is to notify the MPI that the previously allocated identifier has been assigned to a person. The A24 should include one PID segment with the new identifier and one PID segment with the MPI enterprise identifier.

MPI assigns identifier, person exists on both systems

is scenario is identical to the scenario in 3.5.4.2 Client system assigns identifier, person exists on both systems.

RegistrationSystemMatching criteriaenteredFind Candidates Q22DetermineCandidate ListChoose matchResponse K22 - List of matchesGet Person Demographics Q21RetrievedemographicsResponse K21Open patientrecordand continue withregistrationMPIRegistrationSystemMatching criteriaenteredFind Candidates Q22DetermineCandidate ListChoose matchResponse K22 - List of matchesGet Person Demographics Q21RetrievedemographicsResponse K21Open patientrecordand continue withregistrationMPI

Figure 3- 6 - MPI assigns identifier, person exists on both systems

MPI assigns identifier, person exists on neither system

In this scenario, the person does not exist on either system. The message flow is similar to 3.5.4.7, "MPI assigns identifier, person exists on MPI"; however, there is no need for the Q21/K21Get person Demographics query as a double-check for the user since the person does not exist on the MPI. Also, after the person is registered and the identifier assigned, an A28 Add Person Information is sent to the MPI to have it add the person to its database and assign an enterprise identifier.

Figure 3-7 - MPI assigns identifier, person exists on neither system

Usage notes: Non-human PID patient identification

The species attribute is required for non-human patients. The breed and strain attributes are conditional. Thus if the strain attribute is populated, the species attribute must be populated, but the breed attribute is optional. The production class attribute is optional, but if populated the species attribute must also be populated. The name of the animal populates the PID-5 attribute, component 2. The last name of the owner may populate component 1 of PID-5. Owner information is transmitted in the NK1 segment.

Example 1: Mrs. EVERYWOMAN brings her 9 year old, female, spayed miniature poodle, Fluffy, into the Allstate University, Veterinary Medical Teaching Hospital to have skin growths removed. The poodle resides with Mrs. EVERYWOMAN in her apartment at 2222 Home Street, Apt 123, in Ann Arbor, MI 11111, Washtenaw County;

MSH|^~VALUEamp;||ALLSTATE UNIV VMTH|||200702171830||ADT^A04<cr>

PID|1||A83245^^^VMTH^MR^UCD||EVERYWOMAN^Fluffy^^^^^^D||19901001|S|||2222 Home St^Apt 123^Ann Arbor^MI^11111^USA^^^Washtenaw||||||||||||MI||||||||||||L-80700^Canine, NOS^SNM3|L-80832^Miniature Poodle, NOS^SNM3<cr>

NK1|1|EVERYWOMAN^EVE^M^^Mrs.^^L|O|2222 Home St^Apt 123^Ann Arbor^MI ^11111^USA^^^Washtenaw|(530) 555-4325^^^emeverywoman123@AOL.COM||CP|<cr>

PV1|1|O||R|||0045^BARKER^BART^^Dr.^DVM||||||||||||||||||||||||||||||||||||199902161015<cr>

OBX|1|NM|21611-9^Age^LN||9|yr<cr>

OBX|2|NM|3141-9^Body Weight^LN||16|lb<cr>

Example 2: Over the Hill Horses owns the Morgan horse mare named Breeze that is referred by Dr. Equine of Foothill Veterinary Clinic for colic (acute abdominal pain) to the Allstate University, Veterinary Medical Teaching Hospital. The manager of the farm and contact person is Randall "Buck" Shins, who works at the farm headquarters in Ypsilanti, MI, 11111:

MSH|^~VALUEamp;||Foothill Veterinary Clinic||Allstate Univ VMTH|200702171830||ADT^A04<cr>

PID|1||N324256^^^^^Foothill Vet Clinic||^Breeze^^^^^^D|||F|||^^^MI^^^^^Lassen||||||||||||||||||19981123|Y|||||L-80400^Horse^SNM3|L-80431^Morgan horse^SNM3||BR<cr>

NK1|1||||||O|||||Over the Hill Horses|||||||||||||||||~Shins^Buck^^^Mr.^^N|(530) 555-9843^^^Buckshins@OvertheHill.com|2222 Farm Rd ^Suite A^Ypsilanti^MI^11111^^^^Lassen<cr>

PV1|1|E||R|||^Equine^^^Dr.^DVM||||||||||||||||||||||||||||||||||||199903102013<cr>

REFERENCED ORGANIZATIONS AND DOCUMENTS

  • HCFA, Health Care Financing Administration, U.S. Dept. of Health and Human Services, USA

  • CMS, Centers for Medicare/Medicaid Services

  • ERISA: Employment Retirement Income Security Act, USA

  • LOINC: Lab Observation Identifier Names and Codes, Regenstrief Institute, Indianapolis, IN, USA

  • CORBAMed Person Identification Service (PIDS) - Adopted Submission. 12 February 1998.