Draft Website - For Review Purposes Only

1 Introduction

• 1.1 PURPOSE
• 1.2 BACKGROUND
• 1.3 NEED FOR A STANDARD
• 1.4 GOALS OF THE STANDARD
• 1.5 HISTORY OF HL7 Version 1.0 to 2.9 DEVELOPMENT
• 1.6 OVERVIEW
  • 1.6.1 HL7 Encoding Rules
  • 1.6.2 Local Variations
  • 1.6.3 Evolutionary Changes to the Standards
  • 1.6.4 Applicability to File Transfers (Batch Processing)
  • 1.6.5 Relationship to Other Protocols
    • 1.6.5.1 Lower layer protocols
    • 1.6.5.2 Other application protocols
• 1.7 THE SCOPE OF HL7
  • 1.7.1 A Complete Solution
  • 1.7.2 Protection of Healthcare Information
  • 1.7.3 Department of Defense (DOD) Requirements for Systems Security and Robustness
  • 1.7.4 Enforcement of Organizational Security and Access Control Policies
  • 1.7.5 Security Classifications (Markings) and User Authentication and Identification
  • 1.7.6 Roles and Relationships
  • 1.7.7 Accountability, Audit Trails and Assigned Responsibility
  • 1.7.8 Central, Unified Hardware and Software Controls for Security and Trusted Continuous Protection
  • 1.7.9 Uniform Data Definition and Data Architecture
  • 1.7.10 Controlled Disclosure, Notification of Disclosed Information as Protected and Tracking Exceptions of Protected Health Information
  • 1.7.11 Tracking of Corrections, Amendments or Refusals to Correct or Amend Protected Health Information
  • 1.7.12 Disclosure of Disidentified Health Information
  • 1.7.13 Ensuring and Tracking Data Source Authentication and Non-alterability
  • 1.7.14 Tracking Input Validation
  • 1.7.15 The Longitudinal Health Record
  • 1.7.16 Integration of the Health Record
  • 1.7.17 Data, Clock Synchrony
  • 1.7.18 Intersystem Database Record Locking and Transaction Processing
  • 1.7.19 Operations, Process and Other “Local” Support
  • 1.7.20 Interface Engines
  • 1.7.21 Rules Engines
  • 1.7.22 Infrastructure Based Applications
  • 1.7.23 Support for Secondary Clinical Records
• 1.8 REFERENCE DOCUMENTS
  • 1.8.1 ANSI Standards
  • 1.8.2 ISO Standards
  • 1.8.3 Codes and Terminology Sources
  • 1.8.4 Other Applicable Documents
• 1.9 TECHNICAL EDITORS
• 1.10 SUGGESTIONS AND COMMENTS
• 1.11 Errata

2 Control

• 2.1 Introduction
  • 2.1.1 ANSI modal verbs
• 2.2 Conceptual Approach
  • 2.2.1 Assumptions
  • 2.2.2 Trigger events
  • 2.2.3 Acknowledgments: original mode
  • 2.2.4 Acknowledgments: enhanced mode
  • 2.2.5 Queries
• 2.3 Communications Environment
• 2.4 Message Framework
  • 2.4.1 Messages
  • 2.4.2 Segments and segment groups
  • 2.4.3 Fields
    • 2.4.3.1 Field or Component Status
    • 2.4.3.2 Position (sequence within the segment)
    • 2.4.3.3 Length
    • 2.4.3.4 Conformance Length
    • 2.4.3.5 Data type
    • 2.4.3.6 Optionality
    • 2.4.3.7 Repetition
    • 2.4.3.8 Table
    • 2.4.3.9 ID number
    • 2.4.3.10 Name
  • 2.4.4 Message delimiters
  • 2.4.5 Length
    • 2.4.5.1 Normative Length
    • 2.4.5.2 Length & Persistent Data Stores
    • 2.4.5.3 Truncation Pattern
    • 2.4.5.4 Conformance Length
    • 2.4.5.5 Type and Component/Field lengths
    • 2.4.5.6 Implications for Implementers
  • 2.4.6 Acknowledegment Choreography
• 2.5 Message construction rules
  • 2.5.1 Message Construction Pseudocode
    • 2.5.1.1 Message Construction Flow Chart
  • 2.5.2 Rules for the recipient
  • 2.5.3 Encoding rules notes
• 2.6 Use of escape sequences in fields
  • 2.6.1 Formatting codes
  • 2.6.2 Truncation Character escape
  • 2.6.3 Escape sequences supporting multiple character sets
  • 2.6.4 Highlighting
  • 2.6.5 Special character
  • 2.6.6 Hexadecimal
  • 2.6.7 Usage and Examples of Formatted Text
  • 2.6.8 Local
• 2.7 Version compatibility definition
  • 2.7.1 Adding messages or message constituents
  • 2.7.2 Changing messages or message constituents
  • 2.7.3 Deprecating messages or message constituents
  • 2.7.4 Removing messages or message constituents
  • 2.7.5 Early adoption of HL7 changes
  • 2.7.6 Technical correction rules
• 2.8 Message Processing Rules
  • 2.8.1 Message initiation
  • 2.8.2 Message response using the original processing rules
    • 2.8.2.1 Accept and validate the message in responding system
    • 2.8.2.2 Accept and validate/process the message in the receiving application
    • 2.8.2.3 Transmit the response message
    • 2.8.2.4 Original Mode flow chart
  • 2.8.3 Response using enhanced acknowledgment
    • 2.8.3.1 Accept and validate the message in responding system
    • 2.8.3.2 Transmit general acknowledgment message
    • 2.8.3.3 Transmit application acknowledgment
    • 2.8.3.4 Enhanced acknowledgment flow chart
• 2.9 Special HL7 Protocols
  • 2.9.1 Sequence number protocol
  • 2.9.2 Continuation messages and segments
    • 2.9.2.1 Segment fragmentation/continuation using the ADD segment
    • 2.9.2.2 Segment fragmentation/continuation using the DSC segment
    • 2.9.2.3 Segment fragmentation across messages
  • 2.9.3 HL7 batch protocol
    • 2.9.3.1 HL7 batch file structure
    • 2.9.3.2 Related segments and data usage
    • 2.9.3.3 Acknowledging batches
    • 2.9.3.4 Batch message as a query response
  • 2.9.4 Protocol for interpreting repeating segments or segment groups in an update Message
    • 2.9.4.1 Snapshot mode update definition
      • 2.9.4.1.1 Snapshot Mode and Repeating Segments - Example
      • 2.9.4.1.2 Snapshot Mode and Repeating Segment Groups
    • 2.9.4.2 Action code/unique identifier mode update definition
  • 2.9.5 Protocol for interpreting repeating fields in an update message
• 2.10 Local Extension
  • 2.10.1 Messages
  • 2.10.2 Trigger events
  • 2.10.3 Segment groups
  • 2.10.4 Segments
    • 2.10.4.1 Local extension rules for segments
    • 2.10.4.2 Caveats for locally extending segments
  • 2.10.5 Data types
  • 2.10.6 Tables
  • 2.10.7 Fields
  • 2.10.8 Message representation
• 2.11 Chapter Formats For Defining HL7 Messages
  • 2.11.1 HL7 abstract message syntax example
  • 2.11.2 HL7 Acknowledgment Choreography Example
• 2.12 Acknowledgment Messages
  • 2.12.1 ACK - general acknowledgment
    • 2.12.1.1 Acknowledgment Choreography
• 2.13 Message Control Segments
  • 2.13.1 ADD - addendum segment
  • 2.13.2 BHS - batch header segment
  • 2.13.3 BTS - batch trailer segment
  • 2.13.4 DSC - continuation pointer segment
  • 2.13.5 ERR - error segment
  • 2.13.6 FHS - file header segment
  • 2.13.7 FTS - file trailer segment
  • 2.13.8 MSA - message acknowledgment segment
  • 2.13.9 MSH - message header segment
  • 2.13.10 NTE - notes and comments segment
  • 2.13.11 OVR – override segment
  • 2.13.12 SFT – software segment
  • 2.13.13 SGH – segment group header segment
  • 2.13.14 SGT – segment group trailer segment
  • 2.13.15 UAC - user authentication credential segment
• 2.14 Data types
• 2.15 Miscellaneous HL7 tables used across all chapters
  • 2.15.1 Message Type Table (0076)
  • 2.15.2 Event Type Table (0003)
  • 2.15.3 Message Structure Table (0354)
  • 2.15.4 Coding System Table (0396)
  • 2.15.5 Yes/no Indicator Table (0136)
  • 2.15.6 Expanded Yes/no Indicator Table (0532)
• 2.16 Sample Control Messages
  • 2.16.1 General acknowledgment
  • 2.16.2 General acknowledgment, error return
  • 2.16.3 Message using sequence number: protocol
  • 2.16.4 Message fragmentation
  • 2.16.5 Acknowledgment message using original mode processing
  • 2.16.6 Acknowledgment message using enhanced mode processing
• 2.17 Outstanding Issues

3 Data Type

• 3.1 Data types
  • 3.1.1 AD - address
  • 3.1.2 AUI - authorization information
  • 3.1.3 CCD - charge code and date
  • 3.1.4 CCP - channel calibration parameters
  • 3.1.5 CD - channel definition
  • 3.1.6 WITHDRAWN (CE – coded entry)
  • 3.1.7 CF - coded element with formatted values
  • 3.1.8 CNE – coded with no exceptions
  • 3.1.9 CNN - composite ID number and name simplified
  • 3.1.10 CP - composite price
  • 3.1.11 CQ - composite quantity with units
  • 3.1.12 CSU - channel sensitivity and units
  • 3.1.13 CWE – coded with exceptions
  • 3.1.14 CX - extended composite ID with check digit
  • 3.1.15 DDI - daily deductible information
  • 3.1.16 DIN - date and institution name
  • 3.1.17 DLD – discharge to location and date
  • 3.1.18 DLN - driver’s license number
  • 3.1.19 DLT - delta
  • 3.1.20 DR - date/time range
  • 3.1.21 DT - date
  • 3.1.22 DTM - date/time
  • 3.1.23 DTN - day type and number
  • 3.1.24 ED - encapsulated data
  • 3.1.25 EI - entity identifier
  • 3.1.26 EIP - entity identifier pair
  • 3.1.27 WITHDRAWN (ELD – error location and description)
  • 3.1.28 ERL - Message location
  • 3.1.29 FC - financial class
  • 3.1.30 FN - family name
  • 3.1.31 FT - formatted text data
  • 3.1.32 GTS – general timing specification
  • 3.1.33 HD - hierarchic designator
  • 3.1.34 ICD - insurance certification definition
  • 3.1.35 ID - coded value for HL7 defined tables
  • 3.1.36 IS - coded value for user-defined tables
  • 3.1.37 JCC - job code/class
  • 3.1.38 WITHDRAWN (LA1 - location with address variation 1)
  • 3.1.39 WITHDRAWN (LA2 - location with address variation 2)
  • 3.1.40 MA - multiplexed array
  • 3.1.41 MO - money
  • 3.1.42 MOC - money and charge code
  • 3.1.43 MOP - money or percentage
  • 3.1.44 MSG - message type
  • 3.1.45 NA - numeric array
  • 3.1.46 NDL – name with date and location
  • 3.1.47 NM - numeric
  • 3.1.48 NR - numeric range
  • 3.1.49 OCD - occurrence code and date
  • 3.1.50 OG – observation grouper
  • 3.1.51 WITHDRAWN (OSD – order sequence definition)
  • 3.1.52 OSP - occurrence span code and date
  • 3.1.53 PIP – practitioner institutional privileges
  • 3.1.54 PL - person location
  • 3.1.55 PLN – practitioner license or other Id number
  • 3.1.56 PPN - performing person time stamp
  • 3.1.57 PRL - parent result link
  • 3.1.58 PT - processing type
  • 3.1.59 PTA - policy type and amount
  • 3.1.60 QIP - query input parameter list
  • 3.1.61 QSC - query selection criteria
  • 3.1.62 RCD - row column definition
  • 3.1.63 RFR - reference range
  • 3.1.64 RI - repeat interval
  • 3.1.65 RMC - room coverage
  • 3.1.66 RP - reference pointer
  • 3.1.67 RPT – repeat pattern
  • 3.1.68 SAD – street address
  • 3.1.69 SCV - scheduling class value pair
  • 3.1.70 SI - sequence ID
  • 3.1.71 SN - structured numeric
  • 3.1.72 SNM - string of telephone number digits
  • 3.1.73 SPD – specialty description
  • 3.1.74 WITHDRAWN (SPS – specimen source)
  • 3.1.75 SRT – sort order
  • 3.1.76 ST - string data
  • 3.1.77 TM – time
  • 3.1.78 WITHDRAWN (TQ – timing/quantity)
  • 3.1.79 WITHDRAWN (TS – timestamp)
  • 3.1.80 TX - text data
  • 3.1.81 UVC - UB value code and amount
  • 3.1.82 VH - visiting hours
  • 3.1.83 VID – version identifier
  • 3.1.84 VR - value range
  • 3.1.85 WVI - channel identifier
  • 3.1.86 WVS - waveform source
  • 3.1.87 XAD - extended address
  • 3.1.88 XCN - extended composite ID number and name for persons
  • 3.1.89 XON - extended composite name and identification number for organizations
  • 3.1.90 XPN - extended person name
  • 3.1.91 XTN - extended telecommunication number

4 Patient Administration

• 4.1 PURPOSE
• 4.2 Trigger Events and Message Definitions
  • 4.2.1 ADT/ACK - Admit/Visit Notification (Event A01)
  • 4.2.2 ADT/ACK - Transfer a Patient (Event A02)
  • 4.2.3 ADT/ACK - Discharge/End Visit (Event A03)
  • 4.2.4 ADT/ACK - Register a Patient (Event A04)
  • 4.2.5 ADT/ACK - Pre-Admit a Patient (Event A05)
  • 4.2.6 ADT/ACK - Change an Outpatient to an Inpatient (Event A06)
  • 4.2.7 ADT/ACK - Change an Inpatient to an Outpatient (Event A07)
  • 4.2.8 ADT/ACK - Update Patient Information (Event A08)
  • 4.2.9 ADT/ACK - Patient Departing - Tracking (Event A09)
  • 4.2.10 ADT/ACK - Patient Arriving - Tracking (Event A10)
  • 4.2.11 ADT/ACK - Cancel Admit / Visit Notification (Event A11)
  • 4.2.12 ADT/ACK - Cancel Transfer (Event A12)
  • 4.2.13 ADT/ACK - Cancel Discharge / End Visit (Event A13)
  • 4.2.14 ADT/ACK - Pending Admit (Event A14)
  • 4.2.15 ADT/ACK - Pending Transfer (Event A15)
  • 4.2.16 ADT/ACK - Pending Discharge (Event A16)
  • 4.2.17 ADT/ACK - Swap Patients (Event A17)
  • 4.2.18 ADT/ACK - Merge Patient Information (Event A18)
  • 4.2.19 QRY/ADR - Patient Query (Event A19)
  • 4.2.20 ADT/ACK - Bed Status Update (Event A20)
  • 4.2.21 ADT/ACK - Patient Goes on a Leave of Absence (Event A21)
  • 4.2.22 ADT/ACK - Patient Returns From a Leave of Absence (Event A22)
  • 4.2.23 ADT/ACK - Delete a Patient Record (Event A23)
  • 4.2.24 ADT/ACK - Link Patient Information (Event A24)
  • 4.2.25 ADT/ACK - Cancel Pending Discharge (Event A25)
  • 4.2.26 ADT/ACK - Cancel Pending Transfer (Event A26)
  • 4.2.27 ADT/ACK - Cancel Pending Admit (Event A27)
  • 4.2.28 ADT/ACK - Add Person or Patient Information (Event A28)
  • 4.2.29 ADT/ACK - Delete Person Information (Event A29)
  • 4.2.30 ADT/ACK - Merge Person Information (Event A30)
  • 4.2.31 ADT/ACK - Update Person Information (Event A31)
  • 4.2.32 ADT/ACK - Cancel Patient Arriving - Tracking (Event A32)
  • 4.2.33 ADT/ACK - Cancel Patient Departing - Tracking (Event A33)
  • 4.2.34 ADT/ACK - Merge Patient Information - Patient ID Only (Event A34)
  • 4.2.35 ADT/ACK - Merge Patient Information - Account Number Only (Event A35)
  • 4.2.36 ADT/ACK - Merge Patient Information - Patient ID & Account Number (Event A36)
  • 4.2.37 ADT/ACK - Unlink Patient Information (Event A37)
  • 4.2.38 ADT/ACK - Cancel Pre-Admit (Event A38)
  • 4.2.39 ADT/ACK - Merge Person - Patient ID (Event A39)
  • 4.2.40 ADT/ACK - Merge Patient - Patient Identifier List (Event A40)
  • 4.2.41 ADT/ACK - Merge Account - Patient Account Number (Event A41)
  • 4.2.42 ADT/ACK - Merge Visit - Visit Number (Event A42)
  • 4.2.43 ADT/ACK - Move Patient Information - Patient Identifier List (Event A43)
  • 4.2.44 ADT/ACK - Move Account Information - Patient Account Number (Event A44)
  • 4.2.45 ADT/ACK - Move Visit Information - Visit Number (Event A45)
  • 4.2.46 ADT/ACK - Change Patient ID (Event A46)
  • 4.2.47 ADT/ACK - Change Patient Identifier List (Event A47)
  • 4.2.48 ADT/ACK - Change Alternate Patient ID (Event A48)
  • 4.2.49 ADT/ACK - Change Patient Account Number (Event A49)
  • 4.2.50 ADT/ACK - Change Visit Number (Event A50)
  • 4.2.51 ADT/ACK - Change Alternate Visit ID (Event A51)
  • 4.2.52 ADT/ACK- Cancel Leave of Absence for a Patient (Event A52)
  • 4.2.53 ADT/ACK - Cancel Patient Returns from a Leave of Absence (Event A53)
  • 4.2.54 ADT/ACK - Change Attending Doctor (Event A54)
  • 4.2.55 ADT/ACK - Cancel Change Attending Doctor (Event A55)
  • 4.2.56 QBP/RSP - Get Person Demographics (QBP) and Response (RSP) (Events Q21 and K21)
  • 4.2.57 QBP/RSP - Find Candidates (QBP) and Response (RSP) (Events Q22 and K22)
  • 4.2.58 QBP/RSP - Get Corresponding Identifiers (QBP) and Response (RSP) (Events Q23 and K23)
  • 4.2.59 QBP/RSP - Allocate Identifiers (QBP) and Response (RSP) (Events Q24 and K24)
  • 4.2.60 ADT/ACK - Update Adverse Reaction Information (Event A60)
  • 4.2.61 ADT/ACK - Change Consulting Doctor (Event A61)
  • 4.2.62 ADT/ACK - Cancel Change Consulting Doctor (Event A62)
  • 4.2.63 QBP/RSP - Find Candidates including Visit Information (QBP) and Response (RSP) (Events Q32 and K32 )
• 4.3 MESSAGE SEGMENTS
  • 4.3.1 EVN - Event Type Segment
  • 4.3.2 PID - Patient Identification Segment
  • 4.3.3 PV1 - Patient Visit Segment
  • 4.3.4 PV2 - Patient Visit - Additional Information Segment
  • 4.3.5 NK1 - Next of Kin / Associated Parties Segment
  • 4.3.6 AL1 - Patient Allergy Information Segment
  • 4.3.7 IAM - Patient Adverse Reaction Information Segment
  • 4.3.8 IAR - Allergy Reaction Segment
  • 4.3.9 NPU - Bed Status Update Segment
  • 4.3.10 MRG - Merge Patient Information Segment
  • 4.3.11 PD1 - Patient Additional Demographic Segment
  • 4.3.12 DB1 - Disability Segment
  • 4.3.13 PDA - Patient Death and Autopsy Segment
  • 4.3.14 ARV - Access Restrictions segment
  • 4.3.15 OH1 - Person Employment Status segment
  • 4.3.16 OH2 - Past or Present Job segment
  • 4.3.17 OH3 - Usual Work segment
  • 4.3.18 OH4 - Combat Zone Work segment
• 4.4 EXAMPLE TRANSACTIONS
  • 4.4.1 Admit/visit notification - event A01 (admitted patient)-
  • 4.4.2 Pre-admit notification - event A05 (nonadmitted patient)
  • 4.4.3 Register a patient - event A04 (nonadmitted patient)
  • 4.4.4 Change an outpatient to an inpatient - event A06
  • 4.4.5 Transfer patient - event A02 (first example)
  • 4.4.6 Cancel transfer - event A12
  • 4.4.7 Transfer patient - event A02 (second example)
  • 4.4.8 Discharge patient - event A03
  • 4.4.9 Update adverse reaction info - unique identifier is provided - event A60 (where unique identifier is provided)
  • 4.4.10 Update adverse reaction info - allergen code provides unique identifier - event A60 (where the allergen code provides unique identifier)
• 4.5 IMPLEMENTATION NOTES
  • 4.5.1 Swapping a patient
  • 4.5.2 Merging patient/person information
    • 4.5.2.1 Definitions: Merge, move, and change identifier events
      • 4.5.2.1.1 Hierarchy of Identifiers
      • 4.5.2.1.2 Merge
      • 4.5.2.1.3 Move
      • 4.5.2.1.4 Change identifier
      • 4.5.2.1.5 Source and target identifiers
      • 4.5.2.1.6 Tightly coupled relationship
      • 4.5.2.1.7 Ordered pairwise relationship
      • 4.5.2.1.8 Identifier type / assigning authority relationship
      • 4.5.2.1.9 Global merge and move message construct versus repeating segment message constructs
      • 4.5.2.1.10 Identifier renumbering
      • 4.5.2.1.11 Superior identifier reporting
    • 4.5.2.2 Trigger events
      • 4.5.2.2.1 A40 - merge patient - patient identifier list
      • 4.5.2.2.2 A40 - merge patient - patient identifier list (repeating segment)
      • 4.5.2.2.3 A41 - merge account - patient account number (global)
      • 4.5.2.2.4 A41 - merge account - patient account number (repeating segment)
      • 4.5.2.2.5 A42 - Merge visit - visit number
      • 4.5.2.2.6 A43 - move patient information - patient identifier list
      • 4.5.2.2.7 A44 - move account information - patient account number
      • 4.5.2.2.8 A45 - move visit information - visit number (repeating segment)
      • 4.5.2.2.9 A45 - move visit information - visit number (repeating segment)
      • 4.5.2.2.10 A47 - change patient identifier list
      • 4.5.2.2.11 A49 - change patient account number
      • 4.5.2.2.12 A50 - change visit number
      • 4.5.2.2.13 A51 - change alternate visit ID
      • 4.5.2.2.14 Example using multiple messages
      • 4.5.2.2.15 Example using multiple messages
  • 4.5.3 Patient record links
  • 4.5.4 MPI Integration - an introduction
    • 4.5.4.1 (hidden text)
    • 4.5.4.2 Definitions - what is an MPI?
    • 4.5.4.3 HL7 and CORBAmed PIDS
    • 4.5.4.4 MPI QUERY for person lookup and identification
    • 4.5.4.5 Client system assigns identifier, person exists on MPI only
      • 4.5.4.5.1 Figure 3-1 - Client system assigns identifier, person exists on MPI only
    • 4.5.4.6 Client system assigns identifier, person exists on both systems
      • 4.5.4.6.1 Figure 3-2 - Client system assigns identifier, person exists on both systems
    • 4.5.4.7 Client system assigns identifier, person exists on neither system
      • 4.5.4.7.1 Figure 3-3 - Client system assigns identifier, does not exist on either system
    • 4.5.4.8 MPI assigns identifier, person exists on MPI
      • 4.5.4.8.1 Figure 3-4 - Example of two healthcare organizations merging
      • 4.5.4.8.2 Figure 3-5 - MPI assigns identifier, person exists on MPI
    • 4.5.4.9 MPI assigns identifier, person exists on both systems
      • 4.5.4.9.1 Figure 3- 6 - MPI assigns identifier, person exists on both systems
    • 4.5.4.10 MPI assigns identifier, person exists on neither system
      • 4.5.4.10.1 Figure 3-7 - MPI assigns identifier, person exists on neither system
  • 4.5.5 Usage notes: Non-human PID patient identification
• 4.6 REFERENCED ORGANIZATIONS AND DOCUMENTS

5 Order Entry: General, Laboratory, Dietary, Supply, Blood Transfusion

• 5.1 Purpose
  • 5.1.1 Preface (organization of this chapter)
  • 5.1.2 Glossary
    • 5.1.2.1 Filler:
    • 5.1.2.2 Observation segment:
    • 5.1.2.3 Order:
    • 5.1.2.4 Order detail segment:
    • 5.1.2.5 Placer:
    • 5.1.2.6 Placer order group:
    • 5.1.2.7 Order Number:
• 5.2 Quantity/Timing (TQ) Data Type Definition
• 5.3 General Trigger Events & Message Definitions
  • 5.3.1 ORM – general order message
  • 5.3.2 ORR – general order response message response to any ORM
  • 5.3.3 OSQ/OSR- query response for order
  • 5.3.4 OMG – general clinical order message (event O19)
  • 5.3.5 ORG – general clinical order acknowledgement message (event O20)
  • 5.3.6 OML – laboratory order message (event O21)
  • 5.3.7 ORL – general laboratory order response message to any OML
    • 5.3.7.1 Patient Segments Required
    • 5.3.7.2 Patient Segments Optional
  • 5.3.8 OML – Laboratory order for multiple orders related to a single specimen (event O33)
  • 5.3.9 ORL – Laboratory order response message to a multiple order related to single specimen OML (Event O34 and O54)
    • 5.3.9.1 Patient Segments Required
    • 5.3.9.2 Patient Segments Optional
  • 5.3.10 OML – Laboratory order for multiple orders related to a single container of a specimen (event O35)
  • 5.3.11 ORL – Laboratory order response message to a single container of a specimen OML(Event O36 and O55)
    • 5.3.11.1 Patient Segments Required
    • 5.3.11.2 Patient Segments Optional
  • 5.3.12 OML – Specimen shipment centric laboratory order (event O39)
  • 5.3.13 ORL – Specimen shipment centric laboratory order response message to specimen shipment OML(Event O40 and O56)
    • 5.3.13.1 Patient Segments Required
    • 5.3.13.2 Patient Segments Optional
  • 5.3.14 OMI – Imaging Order Message (Event O23)
  • 5.3.15 ORI – Imaging Order Response Message to Any OMI (Event O24)
  • 5.3.16 OPL – Population/Location-Based Laboratory Order Message (Event O37)
  • 5.3.17 OPR – Population/Location-Based Laboratory Order Acknowledgment Message (Event O38)
  • 5.3.18 OSU - Order Status Update (Event O51)
  • 5.3.19 OSU – Order Status Update Acknowledgement (Event O52)
  • 5.3.20 OMQ – General Order Message with Document Payload (Event O57)
  • 5.3.21 ORX – General Order Message with Document Payload Acknowledgement Message (Event O58)
  • 5.3.22 OML – Laboratory Result Interpretation Request Message (Event O59)
• 5.4 General Segments
  • 5.4.1 ORC – Common Order Segment
  • 5.4.2 BLG – Billing Segment
  • 5.4.3 OBR – Observation Request Segment
  • 5.4.4 TQ1 – Timing/Quantity Segment
  • 5.4.5 TQ2 – Timing/Quantity Relationship Segment
  • 5.4.6 IPC – Imaging Procedure Control Segment
• 5.5 General Message Examples
  • 5.5.1 An order replaced by three orders
  • 5.5.2 Ordering non-medical services
    • 5.5.2.1 Examples
• 5.6 Diet Trigger Events & Message Definitions
  • 5.6.1 OMD - Dietary Order (Event O03)
  • 5.6.2 ORD - dietary order acknowledgment (Event O04)
• 5.7 Diet Segments
  • 5.7.1 ODS - dietary orders, supplements, and preferences segment
  • 5.7.2 ODT - diet tray instructions segment
• 5.8 Diet Message Examples
  • 5.8.1 Typical progression of orders for a surgery patient
  • 5.8.2 Complex order
  • 5.8.3 Tube feeding
  • 5.8.4 Patient preference
• 5.9 Supply Trigger Events & Messages
  • 5.9.1 OMS - stock requisition order message (event O05)
  • 5.9.2 ORS - stock requisition order acknowledgment message (event O06)
  • 5.9.3 OMN - non-stock requisition order message (event O07)
  • 5.9.4 ORN - non-stock requisition order acknowledgment message (event O08)
• 5.10 Supply Segments
  • 5.10.1 RQD - Requisition Detail Segment
  • 5.10.2 RQ1 - Requisition Detail-1 Segment
• 5.11 Supply Message Examples
  • 5.11.1 Patient order
  • 5.11.2 Replenish Supply Closet
• 5.12 Transfusion Service (Blood Bank) Trigger Events & Messages
  • 5.12.1 Usage notes for transfusion service messages
  • 5.12.2 OMB – Blood Product Order Message (Event O27)
    • 5.12.2.1 OMB use notes
  • 5.12.3 ORB – Blood Product Order Acknowledgment (Event O28)
  • 5.12.4 BPS – Blood Product Dispense Status Message (Event O29)
  • 5.12.5 BRP – Blood Product Dispense Status Acknowledgment (Event O30)
  • 5.12.6 BTS – Blood Product Transfusion/Disposition Message (Event O31)
  • 5.12.7 BRT – Blood Product Transfusion/Disposition Acknowledgment (Event O32)
• 5.13 Transfusion Service (Blood Bank) Segments
  • 5.13.1 BPO – Blood Product Order Segment
  • 5.13.2 BPX – Blood Product Dispense Status Segment
  • 5.13.3 BTX – Blood Product Transfusion/Disposition Segment
• 5.14 Transfusion Service (Blood Bank) Transaction Flow Diagram
• 5.15 Donation Service (Blood Bank) Trigger Events and Messages
  • 5.15.1 Usage Notes for Donation Service (Blood Bank)
  • 5.15.2 Activity Diagram
  • 5.15.3 Actors
    • 5.15.3.1 Ordering Provider
    • 5.15.3.2 Registration System
    • 5.15.3.3 Donor book of record System
    • 5.15.3.4 Mini-physical System
    • 5.15.3.5 Questionnaire System
    • 5.15.3.6 Donation System
    • 5.15.3.7 Device Interfaces
    • 5.15.3.8 Provider Master
    • 5.15.3.9 Shipping System
  • 5.15.4 DBC - Create Donor Record Message (Event O41 )
  • 5.15.5 DBU - Update Donor Record Message (Event O42)
  • 5.15.6 QBP - Get Donor Record Candidates (Event Q33)
  • 5.15.7 RSP - Get Donor Record Candidates Response (Event K33)
  • 5.15.8 QBP - Get Donor Record (Event Q34)
  • 5.15.9 RSP - Get Donor Record Response (Event K34)
  • 5.15.10 DRG - Donor Registration (Event O43)
  • 5.15.11 DER - Donor Eligibility Request (Event O44)
  • 5.15.12 DEO - Donor Eligibility Observations (Event O45)
  • 5.15.13 DEL - Donor Eligibility (Event O46)
  • 5.15.14 DRC - Donor Request to Collect (Event O47)
  • 5.15.15 DPR - Donation Procedure (Event O48)
• 5.16 Donation Service (Blood Bank) Segments
  • 5.16.1 DON – Donation Segment
  • 5.16.2 BUI – Blood Unit information Segment
• 5.17 TABLES LISTINGS
  • 5.17.1 Figure 4-8 Associations between Order Control Codes and Trigger Events
• 5.18 OUTSTANDING ISSUES

6 Order Entry: Pharmacy/Treatment, Vaccination

• 6.1 Purpose
  • 6.1.1 Preface (organization of this chapter)
• 6.2 Pharmacy/Treatment Trigger Events & Messages
  • 6.2.1 Usage notes for pharmacy/treatment messages
  • 6.2.2 IV solution groups
  • 6.2.3 OMP - Pharmacy/Treatment Order Message (Event O09)
  • 6.2.4 ORP - Pharmacy/Treatment Order Acknowledgment (Event O10)
  • 6.2.5 RDE/RRE - pharmacy/treatment encoded order message (O01/O02)
  • 6.2.6 RDE - Pharmacy/Treatment Encoded Order Message (Event O11)
  • 6.2.7 RRE - Pharmacy/Treatment Encoded Order Acknowledgment (Event O12)
  • 6.2.8 RDS - Pharmacy/Treatment Dispense Message (Event O13)
  • 6.2.9 RRD - Pharmacy/Treatment Dispense Acknowledgement Message (Event O14)
  • 6.2.10 RGV/RRG - pharmacy/treatment give message (O01/O02)
  • 6.2.11 RGV - Pharmacy/Treatment Give Message (Event O15)
  • 6.2.12 RRG - Pharmacy/Treatment Give Acknowledgment Message (Event O16)
  • 6.2.13 RAS/RRA - pharmacy/treatment administration message (O01/O02)
  • 6.2.14 RAS - Pharmacy/Treatment Administration Message (Event O17)
  • 6.2.15 RRA - Pharmacy/Treatment Administration Acknowledgment Message (Event O18)
  • 6.2.16 RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)
  • 6.2.17 RRE - Pharmacy/Treatment Refill Authorization Request Acknowledgment (Event O26)
  • 6.2.18 ROR - Pharmacy/Treatment Order Response
  • 6.2.19 RAR - Pharmacy/Treatment Administration Information
  • 6.2.20 RDR - Pharmacy/Treatment Dispense Information
  • 6.2.21 RER - Pharmacy/Treatment Encoded Order
  • 6.2.22 RGR - Pharmacy/Treatment Dose Information
  • 6.2.23 Pharmacy Query/Response Message Pair
    • 6.2.23.1 Example
  • 6.2.24 RDE - Pharmacy/Treatment Dispense Request Message (Event O49)
  • 6.2.25 RRE - Pharmacy/Treatment Encoded Order Acknowledgment (Event O50)
  • 6.2.26 RCV - Pharmacy/Treatment Dispense Message (Event O59)
• 6.3 Pharmacy/Treatment Segments
  • 6.3.1 RXO - Pharmacy/Treatment Order Segment
  • 6.3.2 RXR - Pharmacy/Treatment Route Segment
  • 6.3.3 RXC - Pharmacy/Treatment Component Order Segment
  • 6.3.4 RXE - Pharmacy/Treatment Encoded Order Segment
  • 6.3.5 RXD - Pharmacy/Treatment Dispense Segment
  • 6.3.6 RXG - Pharmacy/Treatment Give Segment
  • 6.3.7 RXA - Pharmacy/Treatment Administration Segment
  • 6.3.8 RXV - Pharmacy/Treatment Infusion Segment
  • 6.3.9 CDO – Cumulative Dosage Segment
• 6.4 Pharmacy/Treatment Message Examples
  • 6.4.1 Example of various levels of coding in an order
  • 6.4.2 RXO segment field examples
    • 6.4.2.1 RXO segment field examples
    • 6.4.2.2 RXO-1 Requested Give code example
    • 6.4.2.3 RXO-18 and RXO-19 Requested Strength and Strength Unit examples
  • 6.4.3 RXD segment field examples
    • 6.4.3.1 RXD segment field examples
    • 6.4.3.2 RXD-4 and RXD-5 Dispense amount and Actual dispense units
    • 6.4.3.3 Actual dispense amount, Actual dispense units, Actual strength, Actual strength units
    • 6.4.3.4 Valuing the Dispense Package Size Unit
  • 6.4.4 RDS with FT1 segments example
  • 6.4.5 Alternating IV order messages
  • 6.4.6 Query examples
• 6.5 Pharmacy/Treatment Transaction Flow Diagram
  • 6.5.1 OMP:
  • 6.5.2 RDE:
  • 6.5.3 RDS:
  • 6.5.4 RGV:
  • 6.5.5 RAS:
• 6.6 Vaccine Trigger Events & Message Definitions
  • 6.6.1 Vaccine administration data
  • 6.6.2 Queries for immunization records (QRF Segments)
  • 6.6.3 XQ - Query for Vaccination Record (Event V01)
  • 6.6.4 VXX - RESPONSE TO VACCINATION QUERY RETURNING MULTIPLE PID MATCHES (Event V02)
  • 6.6.5 VXR - Vaccination Record Response (Event V03)
  • 6.6.6 VXU - Unsolicited Vaccination Record Update (Event V04)
• 6.7 Vaccine Segments
  • 6.7.1 RXA - segment usage in vaccine messages
• 6.8 Vaccination Message Examples
  • 6.8.1 VXQ - query for vaccination record
  • 6.8.2 VXX - response to vaccination query with multiple PID matches
  • 6.8.3 VXR - vaccination record response
  • 6.8.4 VXU - unsolicited vaccination record update
  • 6.8.5 Query acknowledgment with no records found

7 Query

• 7.1 INTRODUCTION
  • 7.1.1 Query/response model
  • 7.1.2 Evolution of the query standard
  • 7.1.3 Query development methodology
  • 7.1.4 Response format
    • 7.1.4.1 Segment pattern response
    • 7.1.4.2 Tabular response
    • 7.1.4.3 Display response
    • 7.1.4.4 Choosing among available response formats
  • 7.1.5 Query specification formats
    • 7.1.5.1 Expressing the same data using the variants
      • 7.1.5.1.1 Expression as simple parameters
      • 7.1.5.1.2 Expression as query by example
      • 7.1.5.1.3 Expression as a complex expression
  • 7.1.6 Summary chart of query/response pairs
  • 7.1.7 Acknowledgment Choreography
• 7.2 QUERY/RESPONSE PROFILE
  • 7.2.1 Using the Query Profile
    • 7.2.1.1 Query with tabular response example
    • 7.2.1.2 Example of Query Profile with tabular response
  • 7.2.2 Formal specification of the Query Profile
    • 7.2.2.1 Steps for developing a Query Profile
    • 7.2.2.2 Query Profile introduction
    • 7.2.2.3 Query grammar
    • 7.2.2.4 Response grammar
    • 7.2.2.5 Response grammar for display response
    • 7.2.2.6 QPD input parameter specification
    • 7.2.2.7 QPD input parameter field description and commentary
    • 7.2.2.8 QBE input parameter specification
    • 7.2.2.9 QBE input parameter field description and commentary
    • 7.2.2.10 RCP input parameter field description and commentary
    • 7.2.2.11 Input specification: virtual table
    • 7.2.2.12 Virtual table field description and commentary
    • 7.2.2.13 Output specification for tabular response
  • 7.2.3 Query Profile templates
    • 7.2.3.1 Query Profile template for query with tabular response
    • 7.2.3.2 Query Profile template for query with segment pattern response
    • 7.2.3.3 Query Profile for query with display response
    • 7.2.3.4 Query Profile table summaries
• 7.3 QUERY/RESPONSE MESSAGE PAIRS
  • 7.3.1 QBP/RSP – query by parameter/segment pattern response (events vary)
  • 7.3.2 QBP/RTB – query by parameter/tabular response (events vary)
  • 7.3.3 QBP/RDY – query by parameter/display response (events vary)
  • 7.3.4 QSB – Create subscription (Event Q16)
  • 7.3.5 QVR – query for previous events (Event Q17)
  • 7.3.6 QCN/ACK – cancel query/acknowledge message (Event J01)
  • 7.3.7 QSX /ACK – cancel subscription/acknowledge message (Event J02)
• 7.4 QUERY/RESPONSE MESSAGE SEGMENTS
  • 7.4.1 DSP – display data segment
  • 7.4.2 QAK - query acknowledgment segment
  • 7.4.3 QID - query identification segment
  • 7.4.4 QPD – query parameter definition segment
  • 7.4.5 QRI – query response instance segment
  • 7.4.6 RCP – response control parameter segment
  • 7.4.7 RDF – table row definition segment
  • 7.4.8 RDT – table row data segment
• 7.5 AUXILIARY QUERY PROTOCOLS
  • 7.5.1 Immediate vs. deferred response
    • 7.5.1.1 Immediate response
    • 7.5.1.2 Deferred response example
  • 7.5.2 Query cancellation
  • 7.5.3 Interactive continuation of response messages
    • 7.5.3.1 Interactive continuation algorithm and rules
    • 7.5.3.2 Use case
    • 7.5.3.3 Example of interactive continuation protocol
    • 7.5.3.4 Message fragmentation example
  • 7.5.4 Batch message as a query response
  • 7.5.5 Query error response
• 7.6 PUBLISH AND SUBSCRIBE
  • 7.6.1 Introduction
  • 7.6.2 Details
  • 7.6.3 Examples
    • 7.6.3.1 Example of a publish and subscribe Query Profile
  • 7.6.4 Establishing a subscription
  • 7.6.5 Canceling a subscription
• 7.7 QUERY IMPLEMENTATION CONSIDERATIONS
• 7.8 QUERY/RESPONSE MESSAGE EXAMPLES
  • 7.8.1 Query by parameter (QBP) / segment pattern response (RSP)
    • 7.8.1.1 Proposed dispense history example and Query Profile
      • 7.8.1.1.1 Associated dispense history Query Profile
    • 7.8.1.2 Comprehensive pharmacy information examples and Query Profile
      • 7.8.1.2.1 Comprehensive pharmacy information Query Profile
  • 7.8.2 Query using QSC variant / segment pattern response examples
    • 7.8.2.1 Dispense information example and Query Profile
      • 7.8.2.1.1 Associated dispense information Query Profile
    • 7.8.2.2 Dispense information query showing different instantiation
    • 7.8.2.3 Lab results history example
    • 7.8.2.4 Lab results history Query Profile
    • 7.8.2.5 Lab example different instantiation
  • 7.8.3 Query by parameter (QBP) / tabular response (RTB)
    • 7.8.3.1 MPI example
      • 7.8.3.1.1 MPI Query Profile
    • 7.8.3.2 Pharmacy example:
      • 7.8.3.2.1 QBP/RTB dispense history Query Profile
  • 7.8.4 Query using QSC variant / tabular response (RTB)
    • 7.8.4.1 Pharmacy example
      • 7.8.4.1.1 QBP/RTB dispense history Query Profile using QSC variant
  • 7.8.5 Query by parameter (QBP) / display response (RDY)
    • 7.8.5.1 Dispense history display Query Profile
  • 7.8.6 Query using QSC variant (QBP) / display response (RDY)
    • 7.8.6.1 Dispense history display Query Profile using QSC variant
  • 7.8.7 Query by example (QBP) / tabular response (RTB)
    • 7.8.7.1 MPI Query Profile using QBE variant
    • 7.8.7.2 MPI Query Profile – Non query by example version
• 7.9 SUPERSEDED QUERY/RESPONSE TRIGGER EVENTS AND MESSAGE PAIRS
  • 7.9.1 Display message
    • 7.9.1.1 Display vs. record-oriented messages
    • 7.9.1.2 UDM/ACK - unsolicited display update message (event Q05)
    • 7.9.1.3 Continuation of unsolicited display update message
  • 7.9.2 Original mode queries
• 7.10 OUTSTANDING ISSUES

8 Financial Management

• 8.1 PURPOSE
• 8.2 PATIENT ACCOUNTING MESSAGE SET
• 8.3 TRIGGER EVENTS AND MESSAGE DEFINITIONS
  • 8.3.1 BAR/ACK - Add Patient Account (Event P01)
  • 8.3.2 BAR/ACK - Purge Patient Accounts (Event P02)
  • 8.3.3 DFT/ACK - Post Detail Financial Transactions (Event P03)
  • 8.3.4 QRY/DSR - Generate Bills And Accounts Receivable Statements (Event P04)
  • 8.3.5 BAR/ACK - Update Account (Event P05)
  • 8.3.6 BAR/ACK - End Account (event P06)
  • 8.3.7 BAR/ACK - Transmit Ambulatory Payment Classification (APC) Groups (Event P10)
  • 8.3.8 DFT/ACK - Post Detail Financial Transactions - Expanded (Event P11)
  • 8.3.9 BAR/ACK - Update Diagnosis/Procedure (Event P12)
• 8.4 MESSAGE SEGMENTS
  • 8.4.1 FT1 - Financial Transaction Segment
  • 8.4.2 DG1 - Diagnosis Segment
  • 8.4.3 DRG - Diagnosis Related Group Segment
  • 8.4.4 PR1 - Procedures Segment
  • 8.4.5 GT1 - Guarantor Segment
  • 8.4.6 IN1 - Insurance Segment
  • 8.4.7 IN2 - Insurance Additional Information Segment
  • 8.4.8 IN3 - Insurance Additional Information, Certification Segment
  • 8.4.9 ACC - Accident Segment
  • 8.4.10 UB1 - Uniform Billing 1 Segment
  • 8.4.11 UB2 - UB92 Data Segment
  • 8.4.12 ABS - Abstract Segment
  • 8.4.13 BLC - Blood Code Segment
  • 8.4.14 RMI - Risk Management Incident Segment
  • 8.4.15 GP1 - Grouping/Reimbursement - Visit Segment
  • 8.4.16 GP2 - Grouping/Reimbursement - Procedure Line Item Segment
• 8.5 EXAMPLE TRANSACTIONS
  • 8.5.1 Create a patient billing/accounts receivable record
  • 8.5.2 Post a charge to a patient's account
  • 8.5.3 Update patient accounts - update UB1 information
  • 8.5.4 Update patient accounts - update diagnosis and DRG information

9 Observation Reporting

• 9.1 PURPOSE
  • 9.1.1 Snapshot Mode
  • 9.1.2 Preface (organization of this chapter)
  • 9.1.3 Glossary
    • 9.1.3.1 Placer:
    • 9.1.3.2 Filler:
    • 9.1.3.3 Battery:
    • 9.1.3.4 Observation:
    • 9.1.3.5 Clinical Document Architecture (CDA):
  • 9.1.4 Narrative Reports as Batteries with Many OBX
  • 9.1.5 Suffixes for Defining Observation IDs for Common Components of Narrative Reports
• 9.2 General Trigger Events & Message Definitions
  • 9.2.1 ORU – Unsolicited Observation Message (Event R01)
  • 9.2.2 OUL – Unsolicited Laboratory Observation Message (Event R21)
  • 9.2.3 QRY/ORF - Query for Results of Observation (Events R02, R04)
  • 9.2.4 ORU – Unsolicited Point-Of-Care Observation Message without Existing Order – Place an Order (Event R30)
  • 9.2.5 ORU – Unsolicited New Point-Of-Care Observation Message – Search for an Order (Event R31)
  • 9.2.6 ORU – Unsolicited Pre-Ordered Point-Of-Care Observation (Event R32)
  • 9.2.7 ORA – Observation Report Acknowledgement (Event R33)
  • 9.2.8 OUL – Unsolicited Specimen Oriented Observation Message (Event R22 )
  • 9.2.9 OUL – Unsolicited Specimen Container Oriented Observation Message (Event R23)
  • 9.2.10 OUL – Unsolicited Order Oriented Observation Message (Event R24)
  • 9.2.11 OPU – Unsolicited Population/Location-Based Laboratory Observation Message (Event R25 )
  • 9.2.12 ORU – Unsolicited Alert Observation Message (Event R40)
  • 9.2.13 ORA – Observation Report Alert Acknowledgement (Event R41)
  • 9.2.14 ORU – Unsolicited Device Event Observation Message (Event R42)
  • 9.2.15 ORU – Unsolicited Patient-Device Association Observation Message (Event R43)
• 9.3 General Segments
  • 9.3.1 OBR – Observation Request Segment
  • 9.3.2 OBX - Observation/Result Segment
  • 9.3.3 SPM – Specimen Segment
  • 9.3.4 PRT – Participation Information Segment
• 9.4 Examples of use
  • 9.4.1 Query/response
  • 9.4.2 Unsolicited
  • 9.4.3 Laboratory
  • 9.4.4 Narrative report messages
  • 9.4.5 Reporting Cultures and Susceptibilities
    • 9.4.5.1 Culture battery/report representation
    • 9.4.5.2 Susceptibility battery/report representation
    • 9.4.5.3 Identification of the organism for a susceptibility battery
  • 9.4.6 EKG Results Reporting
  • 9.4.7 Patient-Specific Clinical Data with an Order
  • 9.4.8 Patient-connected medical device reporting
• 9.5 Clinical Trials
  • 9.5.1 Glossary
    • 9.5.1.1 Clinical trial:
    • 9.5.1.2 Phase of a clinical trial:
      • 9.5.1.2.1 Example 1
      • 9.5.1.2.2 Example 2
      • 9.5.1.2.3 Example 3
    • 9.5.1.3 Data schedule:
      • 9.5.1.3.1 Schedule for a randomized cancer prevention trial
      • 9.5.1.3.2 Schedule for a cancer chemotherapy trial
      • 9.5.1.3.3 Schedule for a randomized pain medication trial
• 9.6 Clinical Trials - Trigger Events And Message Definitions
  • 9.6.1 CRM - Clinical Study Registration Message (Events C01-C08)
  • 9.6.2 CSU - Unsolicited Study Data Message (Events C09-C12)
• 9.7 Clinical Trials – Segment Definitions
  • 9.7.1 CSR - Clinical Study Registration Segment
  • 9.7.2 CSP - Clinical Study Phase Segment
  • 9.7.3 CSS - Clinical Study Data Schedule Segment
  • 9.7.4 CTI - Clinical Trial Identification Segment
  • 9.7.5 CM0 - Clinical Study Master Segment
  • 9.7.6 CM1 - Clinical Study Phase Master Segment
  • 9.7.7 CM2 - Clinical Study Schedule Master Segment
• 9.8 Clinical Trials – Examples of use
  • 9.8.1 CRM - Message When Patient Registered on a Clinical Trial
  • 9.8.2 CRM - Message When Patient Begins a Phase of a Clinical Trial
  • 9.8.3 CSU - Message Reporting Monthly Patient Data Updates to the Sponsor
• 9.9 Product Experience
  • 9.9.1 Glossary
    • 9.9.1.1 Drug:
    • 9.9.1.2 Medical device:
    • 9.9.1.3 Product:
    • 9.9.1.4 Non-proprietary (generic) name:
    • 9.9.1.5 Trade (brand) name:
    • 9.9.1.6 Adverse event/adverse experience:
    • 9.9.1.7 Adverse drug reaction:
    • 9.9.1.8 Causation:
    • 9.9.1.9 Causal relationship:
    • 9.9.1.10 Regulatory agency:
    • 9.9.1.11 Product manufacturer:
    • 9.9.1.12 Holder of marketing authorization:
    • 9.9.1.13 Serious adverse product reaction:
    • 9.9.1.14 Expected adverse product reaction:
  • 9.9.2 References
• 9.10 Product Experience - Trigger Events And Message Definitions
  • 9.10.1 PEX - Product Experience Message (Events P07, P08)
  • 9.10.2 SUR - Summary Product Experience Report (Event P09)
• 9.11 Product Experience – Segment Definitions
  • 9.11.1 PES - Product Experience Sender Segment
  • 9.11.2 PEO - Product Experience Observation Segment
  • 9.11.3 PCR - Possible Causal Relationship Segment
  • 9.11.4 PSH - Product Summary Header Segment
  • 9.11.5 PDC - Product Detail Country Segment
  • 9.11.6 FAC - Facility Segment
• 9.12 Product Experience – Examples of use
• 9.13 Waveform
• 9.14 Waveform – Trigger Events & Message Definitions
• 9.15 SpECIMEN SHIPMENT MANIFEST
  • 9.15.1 OSM - Unsolicited Specimen Shipment Manifest Message (Event R26)
    • 9.15.1.1 Segment Notes
    • 9.15.1.2 Actors
      • 9.15.1.2.1 Specimen Shipper
      • 9.15.1.2.2 Specimen Shipment Receiver
    • 9.15.1.3 Activity Diagram
  • 9.15.2 SHP - Shipment Segment
  • 9.15.3 PAC – Shipment Package Segment
• 9.16 TABLES LISTINGS
  • 9.16.1 Common ISO Derived Units & ISO+ Extensions
  • 9.16.2 External Units of Measure Examples
• 9.17 Outstanding Issues

10 Master Files

• 10.1 PURPOSE
• 10.2 TRIGGER EVENTS
• 10.3 MESSAGES
  • 10.3.1 MFN/MFK - Master File Notification [WITHDRAWN] (Event M01)
  • 10.3.2 MFN/MFK - Master File Notification - General (Event M13)
    • 10.3.2.1 MFK use notes
  • 10.3.3 MFN/MFK - Master File Notification - Site Defined (Event M14)
    • 10.3.3.1 MFN use notes
    • 10.3.3.2 MFK use notes
  • 10.3.4 MFQ/MFR - Master Files Query [WITHDRAWN] (Event M01-M17)
• 10.4 GENERAL MASTER FILE SEGMENTS
  • 10.4.1 MFI - Master File Identification Segment
  • 10.4.2 MFE - Master File Entry Segment
  • 10.4.3 MFA - Master File Acknowledgment Segment
• 10.5 GENERIC MASTER FILE EXAMPLES
  • 10.5.1 ZL7 - ZL7 Segment (Proposed Example Only)
  • 10.5.2 MFN Message with Original Acknowledgment Mode
    • 10.5.2.1 Example message
  • 10.5.3 MFN message with enhanced Mode Application-Level Acknowledgment
    • 10.5.3.1 Example message
• 10.6 STAFF AND PRACTITIONER MASTER FILES
  • 10.6.1 MFN/MFK - Staff/Practitioner Master File Message (Event M02)
  • 10.6.2 Example: Staff and Health Practitioner Master File MFN Message
• 10.7 SERVICE/TEST/OBSERVATIONS MASTER FILES
  • 10.7.1 General Approach of Service/Test/Observation Master Files
  • 10.7.2 MFN/MFK - Master File Notification - Test/Observation [WITHDRAWN] (Event M03)
  • 10.7.3 MFN/MFK - Master File Notification - Test/Observation (Numeric) (Event M08)
  • 10.7.4 MFN/MFK - Master File Notification - Test/Observation (Categorical) (Event M09)
  • 10.7.5 MFN/MFK - Master File Notification - Test/Observation Batteries (Event M10)
  • 10.7.6 MFN/MFK - Master File Notification - Test/Calculated Observations (Event M11)
  • 10.7.7 MFN/MFK - Master File Notification - Additional Basic Observation/Service Attributes (Event M12)
  • 10.7.8 MFN/MFK – Master File Notification – Test/Observation (Payer) (Event M18)
  • 10.7.9 OM1 - General Segment (Fields That Apply to Most Observations)
  • 10.7.10 OM2 - Numeric Observation Segment
  • 10.7.11 OM3 - Categorical Service/Test/Observation Segment
  • 10.7.12 OM4 - Observations That Require Specimens Segment
  • 10.7.13 OM5 - Observation Batteries (Sets) Segment
  • 10.7.14 OM6 - Observations that are Calculated from Other Observations Segment
  • 10.7.15 OM7 - Additional Basic Attributes Segment (Fields That Apply to Most Observations/Services)
  • 10.7.16 OMC - Supporting Clinical Information Segment
  • 10.7.17 PM1 – Payer Master File Segment
  • 10.7.18 MCP – Master File Coverage Policy Segment
  • 10.7.19 DPS – Diagnosis and Procedure Code Segment
• 10.8 LOCATION MASTER FILES
  • 10.8.1 MFN/MFK - Patient Location Master File Message (event M05)
  • 10.8.2 LOC - Location Identification Segment
  • 10.8.3 LCH - Location Characteristic Segment
  • 10.8.4 LRL - Location Relationship Segment
  • 10.8.5 LDP - Location Department Segment
  • 10.8.6 LCC - Location Charge Code Segment
• 10.9 CHARGE DESCRIPTION MASTER FILES
  • 10.9.1 MFN/MFK - Charge Description Master File Message (Event M04)
  • 10.9.2 CDM - Charge Description Master Segment
  • 10.9.3 PRC - Pricing Segment
  • 10.9.4 Example: MFN Message Charge Description Master File
• 10.10 CLINICAL TRIALS MASTER FILES
  • 10.10.1 MFN/MFK - Clinical Trials Master File Message (Event M06-M07)
  • 10.10.2 CM0 - Clinical Study Master Segment
  • 10.10.3 CM1 - Clinical Study Phase Master Segment
  • 10.10.4 CM2 - Clinical Study Schedule Master Segment
• 10.11 INVENTORY ITEM MASTER FILES
  • 10.11.1 MFN/MFK - Inventory Item Master File Message (Event M15)
  • 10.11.2 MFN/MFK - Inventory Item Master File Message – Enhanced (Event M16)
• 10.12 DRG MASTER FILES
  • 10.12.1 MFN/MFK - DRG Master File Message (Event M17)
  • 10.12.2 DMI - DRG Master File Information Segment
• 10.13 Contract Master Files
  • 10.13.1 MFN/MFK - Contract Master File – (Event M19)
  • 10.13.2 CTR – Contract Master Outbound Segment
• 10.14 Examples
  • 10.14.1 Master file update examples: with original and enhanced acknowledgment protocol
• 10.15 OUTSTANDING ISSUES

11 Medical Records/Information Management (Document Management)

• 11.1 PURPOSE
  • 11.1.1 Definition of Document Management Terms and Concepts
    • 11.1.1.1 Addendum:
    • 11.1.1.2 Archived:
    • 11.1.1.3 Canceled:
    • 11.1.1.4 Composite document:
    • 11.1.1.5 Document completion table:
      • 11.1.1.5.1 Authenticated:
      • 11.1.1.5.2 Dictated:
      • 11.1.1.5.3 Documented:
      • 11.1.1.5.4 In Progress/Assigned:
      • 11.1.1.5.5 Incomplete:
      • 11.1.1.5.6 Legally Authenticated:
      • 11.1.1.5.7 Pre-Authenticated:
    • 11.1.1.6 Edited Document:
    • 11.1.1.7 New or Original Document:
    • 11.1.1.8 Obsolete:
    • 11.1.1.9 Purged:
    • 11.1.1.10 Replacement Document:
    • 11.1.1.11 Restricted:
    • 11.1.1.12 Revised document:
    • 11.1.1.13 Transcription:
  • 11.1.2 Definition of Consent Terms and Concepts
    • 11.1.2.1 Background Text:
    • 11.1.2.2 Consent Bypass Reason:
    • 11.1.2.3 Consent Decision Date/Time:
    • 11.1.2.4 Consent Disclosure Level:
    • 11.1.2.5 Consent Discussion Date/Time:
    • 11.1.2.6 Consent Effective Date/Time:
    • 11.1.2.7 Consent End Date/Time:
    • 11.1.2.8 Consent Form ID:
    • 11.1.2.9 Consent Mode:
    • 11.1.2.10 Consent Non-disclosure Reason:
    • 11.1.2.11 Consent Segment
    • 11.1.2.12 Consent Status:
    • 11.1.2.13 Consent Text:
    • 11.1.2.14 Consent Type:
    • 11.1.2.15 Informational Material Supplied Indicator:
    • 11.1.2.16 Subject Competence Indicator:
    • 11.1.2.17 Subject-imposed Limitations:
    • 11.1.2.18 Subject-specific Background Text:
    • 11.1.2.19 Subject-specific Consent Text:
    • 11.1.2.20 Translation Type:
    • 11.1.2.21 Translator Assistance Indicator:
• 11.2 DOCUMENT MANAGEMENT SECTION
• 11.3 Consent information
  • 11.3.1 Example 1:
• 11.4 ASSUMPTIONS
• 11.5 TRIGGER EVENTS AND MESSAGE DEFINITIONS
  • 11.5.1 MDM/ACK - Original Document Notification (Event T01)
  • 11.5.2 MDM/ACK - Original Document Notification and Content (Event T02)
  • 11.5.3 MDM/ACK - Document Status Change Notification (Event T03)
  • 11.5.4 MDM/ACK - Document Status Change Notification and Content (Event T04)
  • 11.5.5 MDM/ACK - Document Addendum Notification (Event T05)
  • 11.5.6 MDM/ACK - Document Addendum Notification and Content (Event T06)
  • 11.5.7 MDM/ACK - Document Edit Notification (Event T07)
  • 11.5.8 MDM/ACK - Document Edit Notification and Content (Event T08)
  • 11.5.9 MDM/ACK - Document Replacement Notification (Event T09)
  • 11.5.10 MDM/ACK - Document Replacement Notification and Content (Event T10)
  • 11.5.11 MDM/ACK - Document Cancel Notification (Event T11)
• 11.6 MESSAGE SEGMENTS
  • 11.6.1 CON – Consent Segment
  • 11.6.2 OBX - Observation Segment Usage
  • 11.6.3 TXA - Transcription Document Header Segment
• 11.7 EXAMPLE MESSAGES
  • 11.7.1 History and Physical Exam:
  • 11.7.2 Document Folder
• 11.8 QUERY
  • 11.8.1 QRY/DOC - Document Query (Event T12)
• 11.9 OUTSTANDING ISSUES

12 Scheduling

• 12.1 PURPOSE
  • 12.1.1 Schedules, Appointments, Services, and Resources
    • 12.1.1.1 Schedules
    • 12.1.1.2 Services and Resources
    • 12.1.1.3 Appointments
    • 12.1.1.4 Parent and Child Appointments
  • 12.1.2 Application Roles
    • 12.1.2.1 The Filler Application Role
    • 12.1.2.2 The Placer Application Role
    • 12.1.2.3 The Querying Application Role
    • 12.1.2.4 The Auxiliary Application Role
    • 12.1.2.5 Application Roles in a Messaging Environment
  • 12.1.3 Trigger Events, Status, Reasons, and Types
    • 12.1.3.1 Trigger Events
    • 12.1.3.2 Status
    • 12.1.3.3 Reasons
    • 12.1.3.4 Types
  • 12.1.4 Appointments, Orders, and Referrals
  • 12.1.5 Glossary
    • 12.1.5.1 Appointment
    • 12.1.5.2 Auxiliary Application
    • 12.1.5.3 Block
    • 12.1.5.4 Book
    • 12.1.5.5 Child Appointment
    • 12.1.5.6 Filler Application
    • 12.1.5.7 Parent Appointment
    • 12.1.5.8 Placer Application
    • 12.1.5.9 Querying Application
    • 12.1.5.10 Resource
    • 12.1.5.11 Schedule
    • 12.1.5.12 Service
    • 12.1.5.13 Slot
  • 12.1.6 Organization of This Chapter: Trigger Events and Message Definitions
    • 12.1.6.1 Update mode
• 12.2 PLACER APPLICATION REQUESTS AND TRIGGER EVENTS
  • 12.2.1 Request New Appointment Booking (Event S01)
  • 12.2.2 Request Appointment Rescheduling (Event S02)
  • 12.2.3 Request Appointment Modification (Event S03)
  • 12.2.4 Request Appointment Cancellation (Event S04)
  • 12.2.5 Request Appointment Discontinuation (Event S05)
  • 12.2.6 Request Appointment Deletion (Event S06)
  • 12.2.7 Request Addition of Service/Resource on Appointment (Event S07)
  • 12.2.8 Request Modification of Service/Resource on Appointment (Event S08)
  • 12.2.9 Request Cancellation of Service/Resource on Appointment (Event S09)
  • 12.2.10 Request Discontinuation of Service/Resource on Appointment (Event S10)
  • 12.2.11 Request Deletion of Service/Resource on Appointment (Event S11)
• 12.3 FILLER APPLICATION MESSAGES AND TRIGGER EVENTS UNSOLICITED
  • 12.3.1 Notification of New Appointment Booking (Event S12)
  • 12.3.2 Notification of Appointment Rescheduling (Event S13)
  • 12.3.3 Notification of Appointment Modification (Event S14)
  • 12.3.4 Notification of Appointment Cancellation (Event S15)
  • 12.3.5 Notification of Appointment Discontinuation (Event S16)
  • 12.3.6 Notification of Appointment Deletion (Event S17)
  • 12.3.7 Notification of Addition of Service/Resource on Appointment (Event S18)
  • 12.3.8 Notification of Modification of Service/Resource on Appointment (Event S19)
  • 12.3.9 Notification of Cancellation of Service/Resource on Appointment (Event S20)
  • 12.3.10 Notification of Discontinuation of Service/Resource on Appointment (Event S21)
  • 12.3.11 Notification of Deletion of Service/Resource on Appointment (Event S22)
  • 12.3.12 Notification of Blocked Schedule Time Slot(S) (Event S23)
  • 12.3.13 Notification of Opened ("un-blocked") Schedule Time Slot(s) (Event S24)
  • 12.3.14 Notification That Patient Did Not Show Up for Scheduled Appointment (Event S26)
  • 12.3.15 Broadcast Notification of Scheduled Appointments (Event S27)
• 12.4 QUERY TRANSACTIONS AND TRIGGER EVENTS
  • 12.4.1 Original Mode Queries - Display Oriented
  • 12.4.2 Original Mode Queries - Record Oriented
  • 12.4.3 SQM/SQR - Schedule Query Message and Response (Event S25)
  • 12.4.4 Enhanced Mode Queries
• 12.5 MESSAGE SEGMENTS
  • 12.5.1 ARQ - Appointment Request Segment
  • 12.5.2 SCH - Schedule Activity Information Segment
  • 12.5.3 RGS - Resource Group Segment
  • 12.5.4 AIS - Appointment Information - Service Segment
  • 12.5.5 AIG - Appointment Information - General Resource Segment
  • 12.5.6 AIL - Appointment Information - Location Resource Segment
  • 12.5.7 AIP - Appointment Information - Personnel Resource Segment
  • 12.5.8 APR - Appointment Preferences Segment
• 12.6 EXAMPLE TRANSACTIONS
  • 12.6.1 Request and Receive New Appointment - Event S01
  • 12.6.2 Unsolicited Notification of Rescheduled Appointment - Event S13
  • 12.6.3 Request and Receive New Appointment with Repeating Interval - Event S01
• 12.7 IMPLEMENTATION CONSIDERATIONS
  • 12.7.1 Logical Relationship of Resource and Service Segments
  • 12.7.2 Multiple Placer Applications
• 12.8 ISSUES

13 Patient Referral

• 13.1 PURPOSE
  • 13.1.1 Patient Referral and Responses
    • 13.1.1.1 Patient referral
    • 13.1.1.2 Responding to a patient referral
    • 13.1.1.3 Communicating Collaborative Care of a Patient
  • 13.1.2 Application Roles and Data Process
    • 13.1.2.1 Application roles
    • 13.1.2.2 The referring provider application role
    • 13.1.2.3 The referred-to provider application role
    • 13.1.2.4 The querying application role
    • 13.1.2.5 The auxiliary application role
    • 13.1.2.6 Application roles in a messaging environment
  • 13.1.3 Acknowledgment Choreography
  • 13.1.4 Glossary
    • 13.1.4.1 Benefits:
    • 13.1.4.2 Clinical information:
    • 13.1.4.3 Dependent:
    • 13.1.4.4 Eligibility/coverage:
    • 13.1.4.5 Encounter:
    • 13.1.4.6 Guarantor:
    • 13.1.4.7 Healthcare provider:
    • 13.1.4.8 Payor:
    • 13.1.4.9 Pre-authorization:
    • 13.1.4.10 Primary care provider:
    • 13.1.4.11 Referral:
    • 13.1.4.12 Referring provider:
    • 13.1.4.13 Referred-to-provider:
    • 13.1.4.14 Specialist:
    • 13.1.4.15 Subscriber:
• 13.2 PATIENT INFORMATION REQUEST MESSAGES AND TRIGGER EVENTS
  • 13.2.1 RQI/RPI - Request for Insurance Information (Event I01)
  • 13.2.2 RQI/RPL - Request/Receipt of Patient Selection Display List (Event I02)
  • 13.2.3 RQI/RPR - Request/Receipt of Patient Selection List (Event I03)
  • 13.2.4 RQP/RPI - request for patient demographic data (Event I04)
  • 13.2.5 RQC/RCI - Request for Patient Clinical Information (Event I05)
  • 13.2.6 RQC/RCL - Request/Receipt of Clinical Data Listing (Event I06)
  • 13.2.7 PIN/ACK - Unsolicited Insurance Information (Event I07)
• 13.3 PATIENT TREATMENT AUTHORIZATION REQUESTS
  • 13.3.1 RQA/RPA – Request for Treatment Authorization Information (Event I08)
  • 13.3.2 RQA/RPA - Request for Modification to an Authorization (Event I09)
  • 13.3.3 RQA/RPA - Request for Resubmission of an Authorization (Event I10)
  • 13.3.4 RQA/RPA - Request for Cancellation of an Authorization (Event I11)
• 13.4 PATIENT REFERRAL MESSAGES AND TRIGGER EVENTS
  • 13.4.1 REF/RRI - Patient Referral Message
  • 13.4.2 REF/RRI - Patient Referral (Event I12)
  • 13.4.3 REF/RRI - Modify Patient Referral (Event I13)
  • 13.4.4 REF/RRI - Cancel Patient Referral (Event I14)
  • 13.4.5 REF/RRI - Request Patient Referral Status (Event I15)
• 13.5 COLLABORATIVE CARE MESSAGES AND TRIGGER EVENTS
  • 13.5.1 CCM/ACK – Collaborative Care Message (Event I21)
  • 13.5.2 CCR/ACK – Collaborative Care Referral (Events I16-I18)
  • 13.5.3 CCR/ACK – Collaborative Care Referral (Event I16)
  • 13.5.4 CCR/ACK – Modify Collaborative Care Referral (Event I17)
  • 13.5.5 CCR/ACK – Cancel Collaborative Care Referral (Event I18)
  • 13.5.6 CCU/ACK – Asynchronous Collaborative Care Update (Event I20)
• 13.6 COLLABORATIVE CARE INFORMATION REQUEST MESSAGES AND TRIGGER EVENTS
  • 13.6.1 CCQ/CQU – Collaborative Care Query/Collaborative Care Query Update (Event I19)
  • 13.6.2 CCF/CCI – Collaborative Care Fetch / Collaborative Care Information (Event I22)
• 13.7 SEGMENTS
  • 13.7.1 RF1 - Referral Information Segment
  • 13.7.2 AUT - Authorization Information Segment
  • 13.7.3 PRD - Provider Data Segment
  • 13.7.4 CTD - Contact Data Segment
• 13.8 EXAMPLES
  • 13.8.1 RQI Message Using an I01 Event with an Immediate Response
  • 13.8.2 RQA Message Using an I08 Event with an Immediate Response
  • 13.8.3 RQA Message Using an I08 Event with a Deferred Response
  • 13.8.4 REF Message Using an I11 Event with an Immediate Response
  • 13.8.5 REF Message Using an I11 Event with a Deferred Response
  • 13.8.6 RQC Inquiry Message Using an I05 Event with an Immediate Response
• 13.9 OUTSTANDING ISSUES
  • 13.9.1 HL7 Overlapping With ASC X12N

14 Patient Care

• 14.1 INTRODUCTION AND OVERVIEW
  • 14.1.1 Glossary
    • 14.1.1.1 Goal:
    • 14.1.1.2 Problem:
    • 14.1.1.3 Role:
    • 14.1.1.4 Clinical pathway:
    • 14.1.1.5 Variance:
  • 14.1.2 Scenario Descriptions
    • 14.1.2.1 Patient pre-admission or patient admission
    • 14.1.2.2 Consultation
    • 14.1.2.3 Loading a clinical repository
    • 14.1.2.4 Communicating clinical pathways and multidisciplinary plans of care
  • 14.1.3 Trigger Events
  • 14.1.4 Use of Action Codes
    • 14.1.4.1 Examples of action code usage
  • 14.1.5 Message Construction Rules
    • 14.1.5.1 Rule 1
    • 14.1.5.2 Rule 2
    • 14.1.5.3 Rule 3
    • 14.1.5.4 Rule 4
    • 14.1.5.5 Rule 5
    • 14.1.5.6 Rule 6
  • 14.1.6 Acknowledgment Choreography
• 14.2 MESSAGE DEFINITIONS
  • 14.2.1 PGL/ACK - Patient Goal Message (Events PC6, PC7, PC8)
  • 14.2.2 PPR/ACK - Patient Problem Message (Events PC1, PC2, PC3)
  • 14.2.3 PPP/ACK - Patient Pathway Message (Problem-Oriented) (Events PCB, PCC, PCD)
  • 14.2.4 PPG/ACK - Patient Pathway Message (Goal-Oriented) (Events PCG, PCH, PCJ)
  • 14.2.5 QRY - Patient Care Problem Query (Event PC4)
  • 14.2.6 PRR - Patient Problem Response (Event PC5)
  • 14.2.7 QRY - Patient Goal Query (Event PC9)
  • 14.2.8 PPV - Patient Goal Response (Event PCA)
  • 14.2.9 QRY - Patient Pathway (Problem-Oriented) Query (Event PCE)
  • 14.2.10 PTR - Patient Pathway (Problem-Oriented) Response (Event PCF)
  • 14.2.11 QRY - Patient Pathway (Goal-Oriented) Query (Event PCK)
  • 14.2.12 PPT - Patient Pathway (Goal-Oriented) Response (Event PCL)
• 14.3 MESSAGE SEGMENTS
  • 14.3.1 GOL - Goal Detail Segment
  • 14.3.2 PRB - Problem Detail Segment
  • 14.3.3 PTH - Pathway Segment
  • 14.3.4 VAR - Variance Segment
  • 14.3.5 REL - Clinical Relationship Segment
• 14.4 EXAMPLE TRANSACTIONS
• 14.5 IMPLEMENTATION CONSIDERATIONS
• 14.6 Outstanding ISSUES

15 Clinical Laboratory Automation

• 15.1 Background and Introduction
  • 15.1.1 Background
  • 15.1.2 Introduction
  • 15.1.3 Glossary
    • 15.1.3.1 Accession Identifier (also accession number):
    • 15.1.3.2 Additive:
    • 15.1.3.3 Aliquot:
    • 15.1.3.4 Analyzer:
    • 15.1.3.5 Automated:
    • 15.1.3.6 Automated instrument:
    • 15.1.3.7 Automation system:
    • 15.1.3.8 Bar code:
    • 15.1.3.9 Bar length:
    • 15.1.3.10 Barrier:
    • 15.1.3.11 Barrier Delta:
    • 15.1.3.12 Bottom of cap:
    • 15.1.3.13 Bottom of container//Bottom of tube:
    • 15.1.3.14 Bottom of tube:
    • 15.1.3.15 Carrier:
    • 15.1.3.16 Character:
    • 15.1.3.17 Clinical laboratory automation:
    • 15.1.3.18 Clinical laboratory automation systems:
    • 15.1.3.19 Closed-container sampling//Closed-tube sampling:
    • 15.1.3.20 Closed-tube sampling:
    • 15.1.3.21 Container//Tube//Test Tube:
    • 15.1.3.22 Container Identifier
    • 15.1.3.23 Cycle time components:
    • 15.1.3.24 Decapping:
    • 15.1.3.25 Delimiter:
    • 15.1.3.26 Directions of the specimen, Transportation system, Instrument or Specimen processing and handling device interfaces:
    • 15.1.3.27 Directions of the sample, Transportation system, Instrument or Specimen processing handling device and interfaces
    • 15.1.3.28 Direct track sampling:
    • 15.1.3.29 Docking site:
    • 15.1.3.30 Flection:
    • 15.1.3.31 Interaction:
    • 15.1.3.32 Label:
    • 15.1.3.33 Laboratory automation system (LAS):
    • 15.1.3.34 Laboratory equipment control interface specification (LECIS):
    • 15.1.3.35 Laboratory information system (LIS):
    • 15.1.3.36 LECIS:
    • 15.1.3.37 Location:
    • 15.1.3.38 Open-container sampling//Open-tube sampling:
    • 15.1.3.39 Open-tube sampling:
    • 15.1.3.40 Pitch:
    • 15.1.3.41 Point of reference//Point in space, (POR):
    • 15.1.3.42 Process instruments:
    • 15.1.3.43 Quiet zone:
    • 15.1.3.44 Recap:
    • 15.1.3.45 Robotic arm:
    • 15.1.3.46 Sample//(Specimen):
    • 15.1.3.47 Sample carrier:
    • 15.1.3.48 Sample container:
    • 15.1.3.49 Sample-positioning system:
    • 15.1.3.50 Sample probe:
    • 15.1.3.51 Separator:
    • 15.1.3.52 Serum/Plasma Separator:
    • 15.1.3.53 Service envelope:
    • 15.1.3.54 Specimen:
    • 15.1.3.55 Specimen carrier//Sample carrier//Carrier:
    • 15.1.3.56 Specimen collection container//Specimen container//Sample container//Container:
    • 15.1.3.57 Specimen-positioning system//Sample-positioning system (SPS):
    • 15.1.3.58 Specimen probe//Sample probe:
    • 15.1.3.59 Stay clear zone:
    • 15.1.3.60 Symbol:
    • 15.1.3.61 Test mnemonics:
    • 15.1.3.62 Top of container//Top of tube:
    • 15.1.3.63 Top of tube:
    • 15.1.3.64 Tray:
    • 15.1.3.65 X–direction:
    • 15.1.3.66 Y–direction:
    • 15.1.3.67 Z–direction:
• 15.2 Trigger Events and Message Definitions
  • 15.2.1 ESU/ACK - Automated Equipment Status Update (Event U01)
  • 15.2.2 ESR/ACK - Automated Equipment Status Request (Event U02)
  • 15.2.3 SSU/ACK - Specimen Status Update (Event U03)
  • 15.2.4 SSR/ACK - Specimen Status Request (Event U04)
  • 15.2.5 INU/ACK – Automated Equipment Inventory Update (Event U05)
  • 15.2.6 INR/ACK – Automated Equipment Inventory Request (Event U06)
  • 15.2.7 EAC/ACK – Automated Equipment Command (Event U07)
  • 15.2.8 EAR/ACK – Automated Equipment Response (Event U08)
  • 15.2.9 EAN/ACK - Automated Equipment Notification (Event U09)
  • 15.2.10 TCU/ACK - Automated Equipment Test Code Settings Update (Event U10)
  • 15.2.11 TCR/ACK - Automated Equipment Test Code Settings Request (Event U11)
  • 15.2.12 LSU/ACK - Automated Equipment Log/Service Update (Event U12)
  • 15.2.13 LSR/ACK - Automated Equipment Log/Service Request (Event U13)
  • 15.2.14 INR/ACK – Automated Equipment Inventory Request (Event U14)
• 15.3 Message Segments
  • 15.3.1 EQU - Equipment Detail Segment
  • 15.3.2 ISD – Interaction Status Detail Segment
  • 15.3.3 SAC – Specimen Container Detail Segment
  • 15.3.4 INV – Inventory Detail Segment
  • 15.3.5 ECD - Equipment Command Segment
  • 15.3.6 ECR - Equipment Command Response Segment
  • 15.3.7 NDS - Notification Detail Segment
  • 15.3.8 CNS – Clear Notification Segment
  • 15.3.9 TCC - Test Code Configuration Segment
  • 15.3.10 TCD - Test Code Detail Segment
  • 15.3.11 SID – Substance Identifier Segment
  • 15.3.12 EQP - Equipment Log/Service Segment
  • 15.3.13 DST – Transport Destination Segment
• 15.4 Each repetion indicates the device to which the sample needs to be moved along the route.Notes regarding usage
  • 15.4.1 Other Required Original HL7 Messages
  • 15.4.2 Transfer of Laboratory Test Orders and Results
  • 15.4.3 Transfer of QC Results
  • 15.4.4 Query for Order Information – Triggers for Download of Test Orders
  • 15.4.5 Transfer of Additional Information for Automated Processing
  • 15.4.6 Working With Non-Substance Inventory Items
• 15.5 Example Messages
  • 15.5.1 Automated Equipment Status Update
  • 15.5.2 Automated Equipment Status Request
  • 15.5.3 Specimen Status Update
  • 15.5.4 Specimen Status Request
  • 15.5.5 Automated Equipment Inventory Update
  • 15.5.6 Automated Equipment Inventory Request
  • 15.5.7 Automated Equipment Command
  • 15.5.8 Automated Equipment Response
  • 15.5.9 Automated Equipment Notification
  • 15.5.10 Automated Equipment Test Code Settings Update
  • 15.5.11 Automated Equipment Test Code Settings Request
  • 15.5.12 Automated Equipment Log/Service Update
  • 15.5.13 Automated Equipment Log/Service Request
• 15.6 outstanding issues

16 Application Management

• 16.1 Introduction
• 16.2 Trigger Events and Message Definitions
  • 16.2.1 NMQ - Application Management Query Message (Event N01)
    • 16.2.1.1 Acknowledgement Choreography
  • 16.2.2 NMD - Application Management Data Message (Event N02)
• 16.3 message segments
  • 16.3.1 NCK - System Clock Segment
  • 16.3.2 NSC – Application Status Change Segment
  • 16.3.3 NST – Application Control-Level Statistics Segment
• 16.4 outstanding issues

17 Personnel Management

• 17.1 PURPOSE
  • 17.1.1 Usage of Chapter 15 vs. Chapter 8
• 17.2 TRIGGER EVENTS AND MESSAGE DESCRIPTIONS
  • 17.2.1 PMU/ACK – Add Personnel Record (Event B01)
  • 17.2.2 PMU/ACK – Update Personnel Record (Event B02)
  • 17.2.3 PMU/ACK – Delete Personnel Record (Event B03)
  • 17.2.4 PMU/ACK – Activate Practicing Person (Event B04)
  • 17.2.5 PMU/ACK – Deactivate Practicing Person (Event B05)
  • 17.2.6 PMU/ACK – Terminate Practicing Person (Event B06)
  • 17.2.7 QBP/RSP – Query Information (Event Q25/K25)
  • 17.2.8 PMU/ACK – Grant Certificate/Permission (Event B07)
  • 17.2.9 PMU/ACK – Revoke Certificate/Permission (Event B08)
• 17.3 MESSAGE SEGMENTS
  • 17.3.1 AFF - Professional Affiliation Segment
  • 17.3.2 CER - Certificate Detail Segment
  • 17.3.3 EDU - Educational Detail Segment
  • 17.3.4 LAN - Language Detail Segment
  • 17.3.5 ORG - Practitioner Organization Unit Segment
  • 17.3.6 PRA - Practitioner Detail Segment
  • 17.3.7 ROL - Role Segment
  • 17.3.8 STF - Staff Identification Segment
• 17.4 EXAMPLE TRANSACTIONS
  • 17.4.1 Add Personnel Record - Event B01
• 17.5 Outstanding Issues

18 Claims and Reimbursement

• 18.1 Purpose
  • 18.1.1 Scope
• 18.2 Trigger Events and Message Definitions
  • 18.2.1 EHC^E01 – Submit HealthCare Services Invoice (event E01)
  • 18.2.2 EHC^E02 – Cancel HealthCare Services Invoice (event E02)
  • 18.2.3 QBP^E03 – Query HealthCare Services Invoice Status (event E03)
  • 18.2.4 RSP^E03 – HealthCare Services Invoice Status Query Response (event E03)
  • 18.2.5 EHC^E04 – Re-Assess HealthCare Services Invoice Request (event E04)
  • 18.2.6 EHC^E10 – Edit/Adjudication Results (event E10)
  • 18.2.7 EHC^E12 – Request Additional Information (event E12)
  • 18.2.8 EHC^E13 – Additional Information Response (event E13)
  • 18.2.9 EHC^E15 – Payment/Remittance Advice (event E15)
  • 18.2.10 EHC^E20 – Submit Authorization Request (event E20)
  • 18.2.11 EHC^E21 – Cancel Authorization Request (event E21)
  • 18.2.12 QBP^E22 – Query Authorization Request Status (event E22)
  • 18.2.13 RSP^E22 – Authorization Request Status Query Response (event E22)
  • 18.2.14 EHC^E24 – Authorization Response (event E24)
  • 18.2.15 EHC^E30 – Submit Health Document related to Authorization Request (event E30)
  • 18.2.16 EHC^E31 – Cancel Health Document related to Authorization Request (event E31)
• 18.3 Message Segments
  • 18.3.1 RFI – Request for Information Segment
  • 18.3.2 IVC – Invoice Segment
  • 18.3.3 PYE – Payee Information Segment
  • 18.3.4 PSS – Product/Service Section Segment
  • 18.3.5 PSG – Product/Service Group Segment
  • 18.3.6 PSL – Product/Service Line Item Segment
  • 18.3.7 ADJ – Adjustment Segment
  • 18.3.8 PMT – Payment Information Segment
  • 18.3.9 IPR – Invoice Processing Results Segment
• 18.4 Outstanding Issues

19 Materials Management

• 19.1 PURPOSE
  • 19.1.1 Inventory Item Master Updates
    • 19.1.1.1 Item Master Catalog
    • 19.1.1.2 Inventory Locations
  • 19.1.2 Sterilization and Decontamination
  • 19.1.3 Application roles
• 19.2 Trigger Events
  • 19.2.1 Statuses
  • 19.2.2 Glossary
    • 19.2.2.1 Bowie-Dick Test
    • 19.2.2.2 Catalog Item
    • 19.2.2.3 Cycle - Sterilization
    • 19.2.2.4 Cycle - Steam Sterilization, Gravity Displacement Type
    • 19.2.2.5 Cycle Time
    • 19.2.2.6 Decontamination
    • 19.2.2.7 Entrainment
    • 19.2.2.8 EO
    • 19.2.2.9 Exposure Time
    • 19.2.2.10 Lot Control
    • 19.2.2.11 Nonstocked Items
    • 19.2.2.12 NonCatalog Item
    • 19.2.2.13 Par Level
    • 19.2.2.14 Sterile
    • 19.2.2.15 Sterilization
    • 19.2.2.16 Sterilizer
    • 19.2.2.17 Stocked Items
    • 19.2.2.18 TDC
    • 19.2.2.19 Washer
  • 19.2.3 Organization of This Chapter: Trigger Events and Message Definitions
    • 19.2.3.1 Update mode
• 19.3 Inventory Item Master Messages Segments
  • 19.3.1 IIM - Inventory Item Master Segment
  • 19.3.2 ITM - Material Item Segment
  • 19.3.3 STZ - Sterilization Parameter Segment
  • 19.3.4 VND – Purchasing Vendor Segment
  • 19.3.5 PKG - Packaging Segment
  • 19.3.6 PCE – Patient Charge Cost Center Exception Segment
  • 19.3.7 IVT – Material Location Segment
  • 19.3.8 ILT – Material Lot Segment
• 19.4 Placer Application Requests and Trigger Events
  • 19.4.1 SLR/ACK/SLS - Request New Sterilization Lot (Event S28)
  • 19.4.2 SLR/ACK/SLS - Request Sterilization Lot Deletion (Event S29)
  • 19.4.3 STI/ACK/STS - Request Item (Event S30)
  • 19.4.4 SDR/ACK/SDS - Request Anti-Microbial Device Data (Event S31)
  • 19.4.5 SMD/ACK/SMS - Request Anti-Microbial Device Cycle Data (Event S32)
• 19.5 Filler Application Messages and Trigger Events Unsolicited
  • 19.5.1 STC/ACK - Notification of Sterilization Configuration (Event S33)
  • 19.5.2 SLN/ACK - Notification of New Sterilization Lot (Event S34)
  • 19.5.3 SLN/ACK - Notification of Sterilization Lot Deletion (Event S35)
  • 19.5.4 SDN/ACK - Notification of Anti-Microbial Device Data (Event S36)
  • 19.5.5 SCN/ACK - Notification of Anti-Microbial Device Cycle Data (Event S37)
• 19.6 Sterilization and Decontamination Message segments
  • 19.6.1 SCP – Sterilizer Configuration Segment
  • 19.6.2 SLT – Sterilization Lot Segment
  • 19.6.3 SDD - Sterilization Device Data Segment
  • 19.6.4 SCD – Anti-Microbial Cycle Data Segment
• 19.7 Material Management Segments
  • 19.7.1 DEV – Device Segment
• 19.8 Example Transactions
  • 19.8.1 Inventory Item Master Catalog Add - Event M16
  • 19.8.2 Request New Sterilization Lot - Event S28
• 19.9 Implementation Considerations
• 19.10 OUtstanding Issues

20 XML Encoding

21 Hybrid Lower Layer Protocol

22 Minimal Lower Layer Protocol

23 HL7 Over HTTP Specification