Generic EHR HL7 Interface Specification Abraxas v. 4

Transcription

1 Generic EHR HL7 Interface Specification Abraxas v. 4 Merge Healthcare 900 Walnut Ridge Drive Hartland, WI USA MERGE

2 2012 Merge Healthcare. The information contained herein is confidential and is the sole property of Merge Healthcare. None of the information may be reproduced, copied, and/or re-distributed electronically, manually, or otherwise to any person without advance written permission from Merge Healthcare, except as may be expressly authorized by contracts or other agreements between Merge Healthcare and its customer. Merge Healthcare and AMICAS are registered trademarks and VERICIS, RadSuite, Abraxas, and iconnect are also trademarks of Merge Healthcare. Other trademarks or service marks referred to herein are the property of their respective owners. Doc # Revision Date Description EHPM /26/12 Converted source.

3 Table of Contents HL7 Implementation Outbound Order (ORM) Message Header Segment Patient Identification Segment Insurance Segment Guarantor Segment Diagnosis Segment Common Order Segment Order Detail Observation Order Sample Inbound Result (ORU) Message Header Segment Patient Identification Segment Common Order Segment Observation Request Segment Notes and Comments Segment Observation Note and Comments Segment Result Sample of 13

4 HL7 Implementation Outbound Order (ORM) This message includes submission of placing new orders only. This excludes any cancellation of existing orders, discontinuation, holding, etc. Segment Description Condition MSH Message Header PID Patient Identification IN1 Insurance GT1 Guarantor DG1 Diagnosis ORC Common Order OBR Order Detail OBX Observation Message Header Segment The order MSH defines the source, destination in addition of some specifics of the order trigger. 1 Field Separator 1 (ASCII 124) 2 Encoding Characters 4 ^~\& 3 Sending Application 50 Merge EHR/PM Application 4 Sending Facility 50 Merge EHR/PM Facility 5 Receiving Application 100 Vendor Application 6 Receiving Facility 100 Vendor Facility 7 Date/Time of Message 14 yyyymmddhhmmss 9 Message Type 7 ORM^O01 10 Message Control ID Processing ID 1 P 12 Version ID of 13

5 Patient Identification Segment The PID segment identifies demographic information. 1 Set ID Patient ID 12 Merge EHR/PM Patient MRN 3 Patient Identifier List 50 Merge EHR/PM Patient ExtID 4 Alternative patient ID 10 Merge EHR/PM Patient PID 5 Patient Name 162 Merge EHR/PM Patient First, last, middle 7 Date of Birth 8 yyyymmdd 8 Administrative Sex 1 F,M,U 11 Patient Address 250 Merge EHR/PM Patient Address City, state zip 13 Phone Number - Home 10 Merge EHR/PM Patient Home Phone 14 Phone Number - Work 10 Merge EHR/PM Patient Work Phone 16 Marital Status 1 Merge EHR/PM Patient Marital Status 18 Account Number 50 Merge EHR/PM Patient Account Number 19 SSN 12 Merge EHR/PM Patient Social Security Number 3 of 13

6 Insurance Segment If the billing for the patient is set for Third Party Billing then IN1 is generated based on existence of primary and secondary insurance(s). 1 Set ID 1 1 for Primary, 2 for secondary 2 Insurance Plan ID 104 Merge EHR/PM GenInsurPlanType Code & Text 3 Insurance Company ID 50 Merge EHR/PM PayerID of EDIPayerInfo 4 Insurance Company Name 75 Merge EHR/PM Carrier Name 5 Insurance Company Address 215 Merge EHR/PM Carrier Address 15 Plan Type 1 Medicare Part B=D, Commercial Insurance Co=F, Champus=H, ChampVA=V, Medicaid=C, default=z 16 Name Of Insured 24 Merge EHR/PM Subscriber first, last, initial 17 Insured's Relationship to Patient 1 Self=0,spouse=1,child=2,defaul t=3 32 Type of Agreement Code 1 Y,N 36 Policy Number 50 Merge EHR/PM Subscriber Policy Number 4 of 13

7 Guarantor Segment The GT1 segment contains guarantor data for patient and insurance billing. 1 Set ID Guarantor Name 250 Merge EHR/PM guarantor first, last 5 Guarantor Address 250 Merge EHR/PM guarantor address 6 Guarantor Phone Home 10 Merge EHR/PM guarantor home phone 9 Guarantor Sex 1 U 11 Guarantor Relationship 1 1,S,C,O 12 Guarantor SSN 12 Merge EHR/PM guarantor Social Security Number Diagnosis Segment The DG1 segment is used to send patient's multiple ICD9 diagnoses codes. 1 Set ID 1 1,2,3, 2 Diagnosis Coding Method 2 I9 3 Diagnosis Code DG1 3 ICD9 code Common Order Segment The Common Order segment (ORC) is used to send fields that are common to all orders. 1 Order Control 2 NW 2 Placer Order Number 40 Merge EHR/PM IDHL7Msg+` -` + PID 3 Filler Order Number 40 Merge EHR/PM IDHL7Msg+ `-` + PID 9 Date/Time of Transaction 14 yyyymmddhhmmss 12 Ordering Provider 260 NPI and/or UPIN Number,First, Last, Middle Initial 5 of 13

8 Order Detail The Order Detail Segment (OBR) contains information specific to an order. 1 Set ID 1 1,2,3, 2 Placer Order Number 40 Merge EHR/PM IDHL7Msg+ `-` + PID 3 Filler Order Number 40 Merge EHR/PM IDHL7Msg+ `-` + PID 4 Universal Service Identifier 255 Merge EHR/PM TestInfo Code, Name w/ Coding system L 7 Observation Date/Time 14 If Merge EHR/PM Collection time empty then Now yyyymmddhhmmss 11 Specimen Action Code 1 N 13 Relevant Clinical information 300 Merge EHR/PM order notes plus order comments 15 Specimen Source 100 Merge EHR/PM order specimen source 16 Ordering Provider 260 First, Last, Middle Initial NPI and/or UPIN Number 25 Result Status 1 F 27 Quantity/Timing 1 Priority S,A,R,P,T Observation The OBX segment is used to transmit a single observation. 1 Set ID 1 1,2,3, 2 Value Type 2 ST 3 Observation Identifier 356 Merge EHR/PM External question and code 5 Observation Value 7000 Merge EHR/PM answer 11 Obs. Result Status 1 F 6 of 13

9 Order Sample MSH ^~\& ABRAXAS TEST CLIENT CLIENTSite ORM^O P 2.4 PID TESTPATIENT^SIOBHAN F 123 SOME ROAD ROAD^^SOUTHAMPTON^NJ^ SINGLE ^^^T IN1 1 ZZ^OTHER 1733 CIGNA HEALTHCARE PO BOX ^^CHATTAGNOOGA^TN^37422 Z TESTPATIENT^SIOBHAN 0 N GT1 1 TESTPATIENT^SIOBHAN 123 DIRT ROAD^^SOUTHAMPTON^NJ^ U DG1 1 I9 V72.31 DG1 2 I9 V72.84 ORC NW ^Testman^Testor^^^^^N~654321^Testman^Testor^^^^^U OBR ^THINPREP RFX HPV^L N ^THIS ORDER SHOULD BE PERFORMED ON 6/17/ ^Testman^Testor^^^^^N~654321^Testman^Testor^^^^^U F ^^^^^R OBX 1 ST srg^have surgery YES F OBX 2 ST hos^hospitalized YES F 7 of 13

10 Inbound Result (ORU) Merge EHR/PM Generic HL7 Interface processes both solicited and unsolicited results. However, in both cases a unique patient must be matched. In addition, to avoid cross facility message processing, Sending Facility (MSH.4) must also match with Merge EHR/PM EdiInfo record setup. Segment Description Condition MSH Message Header Required PID Patient Identification Required ORC Common Order Required OBR Observation Request Required NTE Notes and Comments OBX Observation NTE Notes and Comments Message Header Segment The result MSH defines the source, destination in addition of some specifics of the order trigger. 1 Field Separator 1 (ASCII 124) Required 2 Encoding Characters 4 ^~\& Required 3 Sending Application 50 Vendor Application 4 Sending Facility 50 Vendor Facility Required 5 Receiving Application 100 Merge EHR/PM Application 6 Receiving Facility 100 Merge EHR/PM Facility 7 Date/Time of Message 24 yyyymmddhhmmss Required 9 Message Type 7 ORU^R01 Required 10 Message Control ID 50 Required 11 Processing ID 1 12 Version ID 3 2.0, 2.0D, 2.1, 2.2, 2.3, 2.3.1, 2.4, 2.5, Required Sending Vendor Facility Matching Sending Vendor Facility (MSH.4) must be present and be matched with Merge EHR/PM EdiInfo record. Message Control ID Message Control ID (MSH.10) must be unique. 8 of 13

11 Patient Identification Segment The PID segment is used for patient matching. Patients must be matched uniquely for the results to be imported. No new patient is created if not matched. 1 Set ID 1 1 Required 2 Patient ID 12 Merge EHR/PM Patient MRN 3 Patient Identifier List 50 Merge EHR/PM Patient MRN 5 Patient Name 162 Merge EHR/PM Patient First, last Required 7 Date of Birth 8 yyyymmdd Required Patient Matching If Merge EHR/PM Patient MRN is present on PID.2 or PID.3.1 then MRN, First Name, Last Name, and Date of Birth must match to a single patient. Otherwise First Name, Last Name, and Date of Birth must match to a single patient. If patient is not matched, then user has ability to manually link the message to a patient's record. Common Order Segment The ORC segment is common to all. 1 Order Control 2 Required 2 Placer Order Number 40 Merge EHR/PM Requisition Number 3 Filler Order Number 40 Merge EHR/PM ExtLabOrderNo 12 Ordering Provider 260 First, Last Initial NPI and/or UPIN Number Ordering Provider Matching If NPI or UPIN number is present, it is used for matching. If not present or unmatched, then provider's Last Name and First Name are used for searching. If multiple active providers found, then the first retrieved provider is used. 9 of 13

12 Observation Request Segment The Order Detail Segment (OBR) contains information specific to an observation request. 1 Set ID 1 1,2,3, Required 2 Placer Order Number 40 Merge EHR/PM Requisition Number 3 Filler Order Number 40 Merge EHR/PM Perform LabInfo 4 Universal Service Identifier 255 Merge EHR/PM OrderID and Description 7 Observation Date/Time 14 If Merge EHR/PM Collection date/time 14 Specimen Received Date/ Time 14 Merge EHR/PM Test date/time 16 Ordering Provider 260 First, Last Initial NPI and/or UPIN Number 20 Filler Field Performing Laboratory ID^ Name^ Address '^' delimited. 22 Result Status Change Date/Time 14 Merge EHR/PM result Date/ time 25 Result Status 1 X for cancellation Solicited Result Both Placer Order Number OBR.2 that contains requisition number and Universal Service Identifier OBR.4.1 must be present to link the result to a specific order. Ordering Provider A blank or unmatched Ordering Provider field (ORC.12)causes OBR.16 matched provider to be used. OBR Cancellation Result Status OBR.25 of value X causes that particular Observation Request and its following results to be skipped. Performing Lab In order to show Performing Lab information on the Merge EHR/PM Lab Result Report, OBR.20 must contain a ^ delimited string in the form of Lab ID^Name^Address. 10 of 13

13 Notes and Comments Segment The NTE segment after each OBR is parsed and saved. 1 Set ID 4 3 Comment 1024 Merge EHR/PM test comment Observation The OBX segment contains observation information. 1 Set ID 4 2 Value Type 3 3 Observation Identifier 100 Merge EHR/PM ObsCode & ObsName 4 Observation Sub-ID 50 Merge EHR/PM ObsSubID 5 Observation Value 80 Merge EHR/PM ObsValue 6 Observation Units 20 Merge EHR/PM ObsUnit 7 References Range 100 Merge EHR/PM NormalRange 8 Abnormal Flags 5 9 Probability 5 Merge EHR/PM Probability 11 Observation result Status 1 X for Cancellation 14 Date/Time of the Observation 14 Merge EHR/PM ObsDate 15 Producer's ID 50 Merge EHR/PM Performing LabID. 16 Responsible Observer 50 Merge EHR/PM Observer Observation Value Observation Value must be less than 80 characters. OBX Cancellation Observation Result Status OBX.11 of value of X causes that particular result to be skipped. Date/Time of Observation If OBX.14 not present then OBR.7 Observation Date/Time is used. 11 of 13

14 Producer s ID Performing Lab ID (OBX.15) must match with the lab identifier value of Filler Field 1 (OBR.20) performing lab information. Note and Comments Segment The NTE segment after each OBX is parsed and saved. 1 Set ID 4 3 Comment Merge EHR/PM result comment Result Sample MSH ^~\& CLIENT CLIENTSite ABRAXAS TEST ORU^R P 2.4 PID TESTPATIENT^VERONICA^^ F 40 SOME BLVDARD^^SOMERS POINT^NJ^ ORC RE ^Testman^Testor^^^^^N OBR ^COMPREHENSIVE METABOLIC PANEL W/ egfr^quest^80053^^cpt A ^Testman^Testor^^^^^N ABX^Abraxas Lab^114 Pacifica^^Irvine^CA^92618^^DOCTOR WHO, MD, FCAP F 1^^^^^R^^^ OBX 1 NM ^GLUCOSE 105 mg/dl H F ABX^Abraxas Lab NTE 1 L NTE 2 L Fasting 24 Hours NTE 3 L OBX 2 NM ^UREA NITROGEN (BUN) 28 mg/dl 7-25 H F ABX^Abraxas Lab OBX 3 NM ^CREATININE 0.5 mg/dl L F ABX^Abraxas Lab OBX 4 ST ^eGFR NON-AFR. AMERICAN >60 ml/min/1.73m2 > OR = 60 N F ABX^Abraxas Lab OBX 5 ST ^eGFR AFRICAN AMERICAN >60 ml/min/1.73m2 > OR = 60 N F ABX^Abraxas Lab ORC RE ^Testman^Testor^^^^^N OBR ^CBC (INCLUDES DIFF/ PLT)^QUEST^85025^^CPT A ^Testman^Testor^^^^^N ABX^Abraxas Lab^114 Pacifica^^Irvine^CA^92618^^DOCTOR WHO, MD, FCAP F 1^^^^^R^^^ OBX 1 NM ^WHITE BLOOD CELL COUNT 4.2 Thousand/uL N F ABX^Abraxas Lab of 13

15 OBX 2 NM ^RED BLOOD CELL COUNT 4.85 Million/uL N F ABX^Abraxas Lab NTE 1 L NTE 2 L Test Performed at: NTE 3 L Abraxas Lab NTE 4 L 13 of 13