Transcript TRN-000-13 HL7 Overview - Thomas Jefferson University

HL7 Overview
Learning Objectives
• Define “HL7”
• Understand the basic structure of HL7 messages
• Understand typical usage of HL7 messages
• Understand common message content and workflow
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Table of Contents
• Terminology
• Introduction
• Overview
• Summary
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Terminology
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Terminology
• Message Types are messages that reference a group of related actions
(example: ADT)
• Trigger Events are specific actions that are associated with the
generation of a message (example: ADT_A01)
• Segments are logical groups of data elements or “fields” (example: PID)
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Introduction
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Introduction
• Health care organizations often operate numerous information systems
and integrate them via data transfer interfaces
• HL7 (Health Level 7) is the name of the organization and the
predominant messaging standard for exchanging key sets of
administrative and clinical data in the healthcare enterprise
• The cross-departmental usage of HL7 leads to the use of some generic
labels
• Example: Diagnostic Service Section ID (~AE Title) and Universal
Service ID (Procedure Code)
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Introduction
• Departmental system databases typically store a combination of
redundant and unique data
• The most common redundant data are patient IDs and demographics
• Health care organizations usually assign primary responsibility for
correctly identifying patients to a single department that manages the
data in a single system
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Introduction
• The department(s) with primary responsibility for patient ID usually
use(s) a system commonly referred to as a Healthcare Information
System (HIS)
• Typical HIS functions are registration/admitting, and billing
• Order entry, claims, clinical viewing, decision support, and other
functions may or may not be supported by the HIS
• The HIS is regarded as the master system
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Overview
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HL7 Overview
• What is HL7?
– “Health Level Seven develops specifications, the most widely used being a
messaging standard that enables disparate healthcare applications to
exchange keys sets of clinical and administrative data.”1
• What is a “Message?”
– A message is a basic communication unit containing information that models a
real world event
• How does one read a Message?
– A message is structured like an organizational chart
Message
Segment
Fields
Fields
1 – About Health Level Seven
Source: http://www.hl7.ie/about_us.asp
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Segment
Component
Segment
Fields
Segment
Common HL7 Message
Types, Segments, and
Fields based on HL7
Standards http://www.hl7.org
Fields
Component
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HL7 Message Structure
Message
has
User
User
Segments
contains
User
User
Fields
comprised of
User
User
Components
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Message Types
• ADT is an (A)dmit, (D)ischarge, and (T)ransfer message that is
“triggered” by a patient admission, discharge, or transfer
• ORM is an (Or)der (M)essage which includes new orders, order status
changes, and order cancels
• ORU is a Report/Result Message
• Example:
<11>MSH|^~\&|IMAGING|PSJMC|TDSresults|PSJMC|20030926000401||
ORM^O01|783744|P|2.3<13>
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Message Segments
<11>MSH|^~\&|IMAGING|PSJMD|TDS|PSJMD|20 •
030926133719||ORM^O01|785465|P|2.3<13>
PID||01000083270000160771229|555-55555^^^PSJ||ESCARDA^NARVARO||19000606|
M|||1234 SOMEWHERE AVE^^^CA^90001•
0000||213-456-7890|312-9876543||||60771229|55555555<13>
PV1||I|4S^S460|||||FEB^SINATRA^FRANK^E^^^M
D^8888||||||||||IP||||||||||||||||||||||||||200102240414< •
13>
ORC|SN||100A01011800||IP|N|1^^^200102241201^^S||20030
9261015|^INTERFACE^HIS||FEB^SINATRA^F •
RANK^E^^^MD^8888<13>
OBR|||100A-01011800|9025^CT PELVIS
72193^MWA||| 200102241201||||||-•
..|||FEB^SINATRA^FRANK^E^^^MD^8888||589
44||||
200102240414||CT|||1^^^200102240414^^S|ST
1^TAPAIN^STEVEN^^^^MD^0275~SLP^POLIS
•
H^JOSEPH^L^^^MD^9828<13>
NTE|1||CT UROGRAM ,PT GOING TO OR 1230
TODAY<13>
<28><13>
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PID is a Patient Identifier
Segment
PV1 is a Patient Visit Segment
ORC is the top level Order
Information Segment
OBR is the Order Detail Segment
NTE is the Notes and Comments
Segment
OBX is the Report/Result
Segment in an ORU Message
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Typical Message Content and Functions
• HL7 specifies requirements for SEQs/components but this does not
confer an obligation to process this data
• Conversely, a target application may require data that is not HL7
required
• HL7 sometimes requires codified data
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Typical Message Work Flow
• ADT-establish patient, visit, update demographics, update visit
• Example: ADT_A04, A06, A08, A03
• ORM-order with account (PID-18) vs. visit (PV1-19), order response,
result
• Example: ORM_O01, ORR_O02, ORU_R01
• ORU by definition is unsolicited-does not have to be in response to an
order
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“Data Flow”
*Table represents typical HL7 data flow – actual message types vary by organization
Process
HL7 Message Type
Exam Status
Patient admitted
ADT01
N/A
Patient demographic change
ADT08
N/A
Patient merge
ADT18 or 34
N/A
Radiology procedure ordered/scheduled
ORMNW
S(cheduled)
Ordered procedure modified
ORMXO
S(cheduled)
Image acquisition at modality begins
N/A
I(n progress)
Procedure completed by technologist
ORMSC
C(omplete)
Report dictated by radiologist
ORMSC
D(ictated)
Preliminary report transcribed
ORU
P(reliminary)
Final report signed
ORU
F(inal)
Radiology procedure canceled
ORMCA
X(canceled)
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HL7 Message Fields
Common Fields
Order and Report Fields
•
•
•
•
•
•
•
•
•
• ORC-02 or OBR-02 Order
Number
• ORC-03 or OBR-03 Accession
No.
• ORC-12 Ordering MD
• OBR-04 Exam Code and Exam
Description
• OBR-07 Order Date and Time
• OBR-24 Resource Name
• OBR-25 Order/Exam Status
• OBX-05 Result Text
PID-02 MPI number
PID-03 MRN
PID-05 Patient name
PID-07 DOB
PID-08 Sex
PID-18 Patient Account No.
PID-19 SSN
PV1-07 Attending MD
PV1-17 Admitting MD
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Summary
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Summary
• HL7 is a messaging protocol
• Message types, trigger events, and segments are identified with 3
character labels; fields are identified by position (SEQ) in segments.
• Data placement, basic structure, message types, and event definitions
should be consistent in HL7 messaging
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Summary
• Due to variations in healthcare business requirements and supported
functionality of different information systems there are many variations
in HL7 conformance
• Variation in HL7 data content is present at the message, segment and
field level
• Variation is also present in workflow
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For assistance, please call customer support at
1-877-328-2808 or 1-877-328-2809
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