Installation and Specifications Manual Part Number : *************ENG Version / Revision : A
Disclaimer Information in this manual is subject to change without notice and does not represent a commitment on the part of nspire Health. The software described in this document is furnished under a license agreement. The software may be used or copied only in accordance with the terms of the agreement. It is against the law to copy the software on any medium except as specifically allowed in the license or nondisclosure agreement. No part of this manual may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, for any purpose without the express written permission of nspire Health. The software is provided "as is" without warranty of any kind, either expressed or implied including but not limited to the implied warranties of merchantability or fitness for a particular purpose. Some states do not allow the exclusion of implied warranties, so the above exclusion may not apply to you. This warranty gives you specific legal rights and you may also have other rights which vary from state to state. nspire Health does not warrant that the functions contained in the system will meet your requirements or that the operation of the system will be uninterrupted or error free. In no event will nspire Health be liable to you for any damages, including any lost profits, lost savings or other incidental or consequential damages arising out of the use or inability to use such system even if nspire Health or an authorised nspire Health dealer or distributor has been advised of the possibility of such damages, or for any claim by any other party. In the event you should have any claim, whether based on the license agreement, express or implied warranty or otherwise, you agree to accept refund of your money in full satisfaction of your claim. Some states do not allow the limitation or exclusion or liability for incidental or consequential damages so the above limitation or exclusion may not apply to you. www.nspirehealth.com Manufactured for Authorized Representative nspire Health Inc 1830 lefthand Circle, Longmont, Colorado, 80501, USA nspire Health Ltd Unit 10, Hartforde Court John Tate Road Hertford, SG13 7NW U.K. nspire Health GmbH, Schlimpfhofer Strasse 14 D-97723 Oberthulba Germany Tel: 1.800.574.7374 Email: sales@nspirehealth.com Tel: (+44) (0) 1992.526.300 Email: info@nspirehealth.com Tel: (+49) 097.36.8181.17 (+49) 097.36.8181.27 Email: zan@nspirehealth.com All brand and product names mentioned in this document are trademarks and/or registered trademarks of their respective holders.
Thank you for purchasing the ZAN HL7 interface. The product complies to the newest state of technical development. In order to improve the lifetime of this product, only materials of extremely high quality are used. All materials are environmentally safe and can be recycled. The manual provides instructions for installing and operating ZAN HL7 interface. The instructions in this manual assume the user is familiar with the intended use and application of pulmonary-laboratory systems. Your nspire Health-Team nspire Health GmbH Schlimpfhofer Str.14 97723 Oberthulba/Germany Tel. +49 9736 8181-0 Fax +49 9736 8181-20 info@nspirehealth.com www.nspirehealth.com
Content Table of Contents 1 SPECIFICATION AND DESCIPTION... 2 1.1 ABOUT THIS CHAPTER... 2 1.2 SYSTEM REQUIREMENTS... 2 1.3 PRODUCT OVERVIEW... 2 1.4 MESSAGING... 3 1.4.1 Definition... 3 1.4.2 Messages Overview... 4 1.4.3 Messages supported by ZAN... 4 1.5 NETWORKING... 8 1.6 SYSTEM ARCHITECTURE... 8 1.6.1 Overall Architecture... 8 1.6.2 Interface HIS ZanHL7 Service... 9 1.7 WORKFLOW... 10 1.7.1 Patient Information... 10 1.7.2 Observation Request Messages (ORM)... 10 1.7.3 Measurement and Observation Results... 11 1.8 MESSAGE AND SEGMENT DESCRIPTIONS... 11 1.8.1 Message Descriptions... 11 1.8.2 Segment Descriptions... 13 1.9 APPENDIX... 17 2 ZANHL7 SERVICE... 18 2.1 INSTALLATION... 18 2.2 CONFIGURATION OF THE ZAN WORKSTATIONS... 21 2.2.1 HIS Interface... 22 2.2.2 Waiting Room... 22 2.2.3 Options... 22 2.3 TECHNICAL DESCRIPTION OF THE CONFIGURATION... 23 2.3.1 Directory structure (ZanHL7 Service)... 23 2.3.2 ZanHL7.cfg (ZanHL7 Service)... 25 2.3.3 wingpi.cfg (ZAN Workstations)... 27 3 HL7 TCPIP... 29 3.1 INSTALLATION... 29 3.2 CONFIGURATION... 32 3.2.1 Architecture (HL7TCPIP)... 32 3.2.2 hl7tcpip.cfg (HL7TCPIP)... 32 1-33 Part No ************ENG.A
1 Specification and Desciption 1.1 About this chapter This chapter describes specification and use of the ZAN HL7 software. Specification and Desciption For a description of installation and configuration, cf. document HL7Install.doc. This product is fully integrated with the Microsoft Windows 2000/XP operating systems. This manual does not attempt to be a comprehensive guide for the operating system features. Please refer to your Microsoft Windows documentation for details on these features. 1.2 System Requirements The computer requirements for running the ZAN HL7 Server software are the follow: Intel Pentium III based PC. Microsoft Windows 2000 or higher 1.3 Product Overview ZAN HL7 is a set of components that enables ZAN applications to exchange medical information with hospital information systems (HIS). Overall Architecture WS HIS ZAN HL7 Service ZAN Database ZAN Waiting Room WS WS WS The ZAN HL7 Server is implemented as a Windows Service. This Service can run on one of the Hospital Servers. Normally it is installed on the same PC as the ZAN database and the ZAN waiting room. The HL7 Service communicates between the Hospital Information System (HIS) on the one end, and the PFT laboratory WS (Work-Stations) and all other WS which work with the ZAN software on the other end. 2-33 Part No ************ENG.A
Specification and Desciption 1.4 Messaging 1.4.1 Definition A message is the atomic unit of data transferred between systems. It is comprised of a group of segments in a defined sequence. Each message has a message type that defines its purpose. For example the ADT Message type is used to transmit portions of a patient s Patient Administration (ADT) data from one system to another. A three-character code contained within each message identifies its type. 1 Message Segment : : Segment A segment is a logical grouping of data fields. Segments of a message may be required or optional. They may occur only once in a message or they may be allowed to repeat. Each segment is given a name. For example, the ADT message may contain the following segments: Message Header (MSH), Event Type (EVN), Patient ID (PID), and Patient Visit (PV1). Each segment is identified by a unique three-character code known as the Segment ID. 1 Segment ID Field 1 : : Field N A field is a string of characters. It consists of one or more components. Field Component 1 : : Component N 1 Health Level Seven, Version 2.3.1, Chapter 2 3-33 Part No ************ENG.A
Specification and Desciption Example of a HL7 message ORU message (Observation Result Unsolicited) MSH ^~\& ZAN PCS 200201131203 ORU^R01 P 2.4 PID SmiBil16041933 Smith^Bill OBR ECG 200201131202 20020113 OBX ST Befund Here is the interpretation.^second statement line. R 1.4.2 Messages Overview HL7 messages can be classified according to their direction. Incoming messages: HIS ZAN Outgoing messages: ZAN HIS Bidirectional messages: ZAN HIS ZAN Incoming messages are used to send information from the HIS to the client. This information can be: Patient information (patient identification, visit information) Observation request Recognized incoming message types are: ADT, ORM All messages of other types are ignored. Outgoing messages are used to send information from the client to the HIS. This information can be: Observation results (plain text) Medical document (pdf) Outgoing message types are: ORU, MDM Bi-directional messages are used for queries from the client to the HIS. If the HIS supports queries, clients can query the HIS for full patient information given the patient ID number. Bi-directional message types are: QRY/ADR 1.4.3 Messages supported by ZAN 1.4.3.1 ADT (Admission, Discharge, Transfer) 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 recordoriented query. 2 2 Health Level Seven, Version 2.3.1, Chapter 3.1 4-33 Part No ************ENG.A
Specification and Desciption ADT messages are sent from the HIS to the clients as trigger events. From all possible ADT trigger events, ZAN uses only a subset. All other ADT events are ignored. ZAN uses those ADT trigger events that contain information needed to update its database. ADT trigger events processed by ZanHL7: ADT^A01 admit/visit notification 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. ADT^A02 Transfer a patient An A02 event is issued as a result of the patient changing his or her assigned physical location. ADT^A03 Discharge/end visit 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. When ZAN receives an ADT^A03 message for a patient who was not undergoing any measurements in ZAN systems, this patient is removed from the ZAN database. ADT^A04 Register a patient 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. ADT^A08 Update patient information 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. ADT^A18 Merge patient information The A18 event is used to merge current and previous patient identification numbers. This procedure is required, for example, when a previous patient is registered under a new patient identification number because of an error, or because there was insufficient time to determine the actual patient identification number. The merge event occurs when a decision is made to combine the information under either the new or the old identifier(s). 1.4.3.2 ORM^O01 (general order message) The function of this message is to initiate the transmission of information about an order. This includes placing new orders, cancellation of existing orders, changes in existing orders. The trigger event for this message is any change to an order. Such changes include submission of new orders, cancellations, updates. ZanHL7 uses ORM messages to get information about: - Observation Requests (e.g. CPX, Bodyplethysmography etc.) - Patient information (patient identification, visit information) 5-33 Part No ************ENG.A
Specification and Desciption Every ORM message will be processed, the patient information will be read and the patient stored in the ZAN waiting room. The patients from the waiting room are available on every workstation on which the ZAN GPI 3.00 software is installed. 1.4.3.3 ORU^R01 (Observational Results Unsolicited) A common use of these transaction sets will be to transmit observations and results of diagnostic studies from the producing system to the ordering system (e.g., HIS order entry, physician s office system). These transaction sets carry information that is reported as text, numeric or categorical values. These messages do not carry the images themselves. The unsolicited mode is used to transmit the values of new observations. It is the mode used by producing services to return the values of observations requested by an ordering system. 3 ZanHL7 uses ORU messages to transmit observation results in alpha-numeric format. Observation results can be observation results as individual numeric values observation results as tabular data observation remarks (annotations, interpretation etc.) 1.4.3.4 MDM^T02 (Medical Document Management) The main purpose of the medical record is to produce an accurate, legal, and legible document that serves as a comprehensive account of healthcare services provided to a patient. The MDM message is similar to the ORU message in that both message types are used to send observation results to the HIS. Whereas ORU messages contain the results data in alpha-numeric format included in the message, MDM messages contain a link to a comprehensive document such as a Word document, an HTML-webfile, an image file, a PDF document, etc. The MDM message type requires 2 additional components: Report-Server PDF converter o Report-Server This is the ZAN Report Server. This component creates HTML files (observation reports) from print jobs. o PDF converter This component converts HTML files (produced by the Report-Server) to PDF files. For every measurement type (Spirometry, Bodyplethysmography, CO-Diffusion, CPX etc.) one or more print templates can be defined. A configuration file defines, what measurement type to assign to what print template(s). Workflow: New measurement completed on any workstation. 3 Health Level Seven, Version 2.3.1, Chapter 7.1 6-33 Part No ************ENG.A
Specification and Desciption Store patient file in ZAN database. This simultaneously triggers a data export to the HIS through HL7. Creation of ZAN report (HTML file) by Report-Server. Conversion of ZAN report to PDF file. Creation of MDM message with link to PDF file by ZanHL7 Service. Send message and PDF file to HIS. 1.4.3.5 QRY^Q01 / ADR^A19 The following trigger event is served by QRY (a query from another system) and ADR (a response from an Patient Administration system.) An application determines a need for Patient Administration data about a patient and sends a query to the Patient Administration system. The Who Filter in the QRD identifies the patient ID number upon which the query is defined. The HIS responds with an ADR message containing patient administration data. Workflow: Any workstation queries for patient administration data given the patient ID number. ZanHL7 Service converts this request to an HL7 message and sends it to the HIS. If patient administration data is found in HIS for the requested patient ID number, the HIS sends an ADR message to ZanHL7 Service. ZanHL7 Service sends the data back to the workstation that requested the data. The workstation displays the data (and updates the ZAN database if necessary). If patient administration data is not found in HIS for the requested patient ID number, the HIS sends a failure notification to ZanHL7 Service. ZanHL7 Service transfers this failure notification back to the workstation that requested the data. Technical information: ADR^A19 must contain the message-control-id of the QRY^Q01 message. a) Either ADR^A19 and QRY^Q01 have the same message-control-id (MSH-10) OR b) ADR^A19 has a MSA segment with the message-control-id of the QRQ^Q01 message in the MSA- 2 field. Examples a) b) MSH ^~\& MICQRY SAP 20040422141105 QRY^Q01 59647003604 P 2.2 QRD 200404221411 R I 59647003604 1^RD 120441MA106 DEM MSH ^~\& SAP MICQRY 20040422141125 ADR^A19 59647003604 P 2.2 QRD 200404221411 R I 59647003604 1^RD 120441MA106 DEM MSH ^~\& SAP MICQRY 20040422141125 ADR^A19 59647003608 P 2.2 MSA AA 59647003604 P QRD 200404221411 R I 59647003604 1^RD 120441MA106 DEM 7-33 Part No ************ENG.A
Specification and Desciption 1.5 Networking The network communication between HIS and ZanHL7 Service can be based on the TCP/IP protocol. file-based using a shared directory. Required components: a. ZanHL7 Service (base component) + HL7TCPIP Service (additional component). b. ZanHL7 Service (base component) only. Recommendation: Wherever possible, the file-based version is the preferred solution. 1.6 System Architecture 1.6.1 Overall Architecture HIS ZAN HL7 Service ZAN Database WS WS ZAN Waiting Room WS WS 8-33 Part No ************ENG.A
Specification and Desciption The ZAN HL7 Server is implemented as a Windows Service. This Service can run on one of the Hospital Servers. Normally it is installed on the same PC as the ZAN database and the ZAN waiting room. The HL7 Service communicates between the Hospital Information System (HIS) on the one end, and the PFT laboratory WS (Work-Stations) and all other WS running ZAN software on the other end. 1.6.2 Interface HIS ZanHL7 Service The interface between HIS and the ZanHL7 Service can be a. TCP/IP based or b. file-based. For the TCP/IP based version, an additional component is necessary (HL7TCPIP Service). This bi-directional service converts HL7 message files to network messages and vice versa. Some HIS don't support file-based message transfer. In this case you need the HL7TCPIP message converter. We recommend to use the file-based interface wherever possible. 1.6.2.1 TCPIP Based HIS TCP/IP HL7TCP/IP Service File Interface ZanHL7 Service 1.6.2.2 File Based File Interface HIS ZANHL7 Service 9-33 Part No ************ENG.A
Specification and Desciption ZANHL7 Service 1. Incoming HL7 messages (HIS ZAN) ZanHL7Service.exe accepts HL7 messages from the HIS through the HIS\Out directory. ZanHL7Service.exe interprets the HL7 message and performs an action depending on the message type. Typically this action is a database action (new or update recordset), or a message sent to ZAN applications (e.g. new waiting room file). 2. Outgoing HL7 messages (ZAN HIS) ZanHL7Service.exe accepts messages from ZAN applications through the GPI\Out directory (e.g. query for patient information given the patient ID number). ZanHL7Service.exe interprets the message, converts it to an HL7 message and writes it to the HIS\In directory. In the TCP/IP based version, HL7TCPIP opens this message and sends it to the HIS. In the file-based version, the HIS opens this message file, performs the appropriate action, and deletes the file. 1.7 Workflow The exact workflow depends upon the capabilities of the hospital information system and the needs and definitions in a special medical environment. Usually measurements begin with the selection of a patient or the selection of an observation request for a patient. This can be done in different ways (cf. below). In very rare cases, patient information must be entered manually, e.g. in cases of emergency, unexpected measurements, or network failure, where patient information is not yet available through the HIS. After the measurements are completed, usually some kind of results report is sent back to the HIS. This can also be configured in different ways. 1.7.1 Patient Information Patient information can be sent from the HIS to ZAN applications in 3 different ways. 1.7.2 Observation Request Messages (ORM) Observation requests are created in the HIS and sent to ZAN applications as HL7 ORM messages. These observation requests show up in ZAN applications in the waiting room. Observation request messages contain full patient information. This is the preferred way of receiving patient information. 1.7.2.1 Patient Administration Messages (ADT) ADT messages are sent from the HIS to ZAN applications whenever patient information changes. This results in an update or new entry inside the ZAN database. The disadvantage of this procedure is that ADT messages fill up the database very quickly with lots of patient information, many of these patients never being tested in ZAN. The other disadvantage is that there is no list of patients that need to be tested (observation requests). 10-33 Part No ************ENG.A
Specification and Desciption 1.7.2.2 Patient Query (QRY) When the patient ID number is known and the HIS supports queries, patient information can also be received through a patient query. The user enters the patient ID in a ZAN workstation, sends the query to the HIS, and the HIS responds with the full patient information. This method can be combined with both ORM or ADT. 1.7.3 Measurement and Observation Results Once the patient information is available, the measurements can be performed in the ZAN system in the usual way (cf. manuals of ZAN applications). After some or all measurements are completed, the user stores the patient file (including all his/her measurements) to the archive (cf. manual of ZAN wingpi). At this moment, the observation results will be created and sent to the HIS. 1.8 Message and Segment Descriptions 1.8.1 Message Descriptions 1.8.1.1 Incoming messages The following section describes required and option segments for incoming HL7 messages. Required segments are put in plain text. Ex: MSH Optional segments are put in brackets. Ex: [PV1] ADT ADT^A01 ADT^A02 ADT^A03 ADT^A04 ADT^A08 ADT^A18 ADT^A19 ADR^A19 MSH, PID, PV1 MSH, PID, PV1 MSH, PID MSH, PID, [PV1] MSH, PID, PV1 MSH, PID, MRG MSH, [MSA], PID, [PV1], [STF] MSH, [MSA], PID, [PV1], [STF] 11-33 Part No ************ENG.A
Specification and Desciption ORM^O01 MSH, PID, PV1 1.8.1.2 Outgoing messages The following section describes the segments in ZAN generated HL7 messages. ORU MDM QRY MSH, PID, PV1, ORC, (OBR, OBX) n MSH, EVN, PID, PV1, TXA MSH, QRD 12-33 Part No ************ENG.A
Specification and Desciption 1.8.2 Segment Descriptions For outgoing messages, the remarks column contains the content of the field, filled in by the ZAN HL7 application. This is indicated by the word (outgoing). MSH SEQ LEN OPT ELEMENT NAME REMARKS 1 1 R Field Separator 2 4 R Encoding Characters ^~\& 3 15 O Sending Application ZAN (outgoing) 4 20 O Sending Facility ZAN (outgoing) 5 30 O Receiving Application configurable (outgoing) 6 30 O Receiving Facility 7 26 O Date/Time Of Message 8 40 O Security 9 7 R Message Type 10 20 R Message Control ID a random number (outgoing) 11 3 R Processing ID P (outgoing) 12 8 R Version ID 2.4 (outgoing) 13 15 O Sequence Number 14 180 O Continuation Pointer 15 2 O Accept Acknowledgment Type 16 2 O Application Acknowledgment Type 17 2 O Country Code EVN SEQ LEN OPT ELEMENT NAME REMARKS 1 3 B Event Type Code 2 26 R Recorded Date/Time PID SEQ LEN OPT ELEMENT NAME REMARKS 1 4 O Set ID - PID 3 20 R Patient Identifier List 5-1 20 R Patient Last Name 5-2 20 O Patient First Name 7 26 R Date/Time of Birth 8 1 R Sex male: M, m female: F, f, W, w 11 106 O Patient Address 13 40 O Phone Number - Home 16 80 O Marital Status 23 60 O Birth Place 24 1 O Multiple Birth Indicator 13-33 Part No ************ENG.A
Specification and Desciption PV1 SEQ LEN OPT ELEMENT NAME REMARKS 1 4 O Set ID - PV1 3 80 O Assigned Patient Location 6 80 O Prior Patient Location 12 1 O Preadmit Test Indicator 19 20 R Visit Number 39 12 O Servicing Facility 44 26 O Admit Date/Time TXA SEQ LEN OPT ELEMENT NAME REMARKS 1 4 R Set ID- TXA Message Control ID (outgoing) 2 30 R Document Type CN (outgoing) 4 26 O Activity Date/Time 12 30 R Unique Document Number Document Number^ZAN (outgoing) 16 30 O Unique Document File Name Document File Name (outgoing) ORC SEQ LEN OPT ELEMENT NAME REMARKS 1 2 O Order Control 2 75 R Placer Order Number 3 75 O Filler Order Number 9 26 O Date/Time of Transaction 10 80 O Entered By 12 80 O Ordering Provider 13 80 O Enterer s Location 15 26 O Order Effective Date/Time 14-33 Part No ************ENG.A
Specification and Desciption OBR SEQ LEN OPT ELEMENT NAME REMARKS 1 4 O Set ID - OBR 2 75 C Placer Order Number 3 75 C Filler Order Number + 4 200 R Universal Service ID 5 2 B Priority 6 26 B Requested Date/time 7 26 C Observation Date/Time # 8 26 O Observation End Date/Time # 9 20 O Collection Volume * 10 60 O Collector Identifier * 11 1 O Specimen Action Code * 12 60 O Danger Code 13 300 O Relevant Clinical Info. 14 26 C Specimen Received Date/Time * 15 300 O Specimen Source * 16 120 O Ordering Provider 17 40 O Order Callback Phone Number 18 60 O Placer Field 1 19 60 O Placer Field 2 20 60 O Filler Field 1 + 21 60 O Filler Field 2 + 22 26 C Results Rpt/Status Chng - Date/Time + 23 40 O Charge to Practice + 24 10 O Diagnostic Serv Sect ID 25 1 C Result Status + 26 200 O Parent Result + 27 200 O Quantity/Timing 28 150 O Result Copies To 29 150 O Parent 30 20 O Transportation Mode 31 300 O Reason for Study 32 200 O Principal Result Interpreter + 33 200 O Assistant Result Interpreter + 34 200 O Technician + 35 200 O Transcriptionist + 36 26 O Scheduled Date/Time + 37 4 O Number of Sample Containers * 38 60 O Transport Logistics of Collected Sample * 39 200 O Collector s Comment * 40 60 O Transport Arrangement Responsibility 41 30 O Transport Arranged 42 1 O Escort Required 43 200 O Planned Patient Transport Comment 44 60 O Ordering Facility Name 45 106 O Ordering Facility Address 46 48 O Ordering Facility Phone Number 47 106 O Ordering Provider Address 15-33 Part No ************ENG.A
Specification and Desciption OBX SEQ LEN OPT ELEMENT NAME REMARKS 1 10 O Set ID - OBX 2 3 C Value Type 3 590 R Observation Identifier 4 20 C Observation Sub-ID 5 65536 C Observation Value 6 60 O Units 7 60 O References Range 8 5 O Abnormal Flags 9 5 O Probability 10 2 O Nature of Abnormal Test 11 1 R Observ Result Status 12 26 O Date Last Obs Normal Values 13 20 O User Defined Access Checks 14 26 O Date/Time of the Observation 15 60 O Producer's ID 16 80 O Responsible Observer 17 60 O Observation Method QRD SEQ LEN OPT ELEMENT NAME REMARKS 1 26 R Query Date/Time 2 1 R Query Format Code R (outgoing) 3 1 R Query Priority I (outgoing) 4 10 R Query ID Message Control ID (outgoing) 7 10 R Quantity Limited Request 1^RD (outgoing) 8 60 R Who Subject Filter Patient ID Number (outgoing) 9 60 R What Subject Filter DEM (outgoing) MRG SEQ LEN OPT ELEMENT NAME REMARKS 1 20 R Prior Patient Identifier List Prior Patient ID 2 20 O Prior Alternate Patient ID 3 20 O Prior Patient Account Number 4 20 O Prior Patient ID 5 20 O Prior Visit Number 6 20 O Prior Alternate Visit ID 7 48 O Prior Patient Name MSA SEQ LEN OPT ELEMENT NAME REMARKS 1 2 R Acknowledgment Code 2 20 O Message Control ID 3 80 R Text Message 4 15 O Expected Sequence Number 5 1 O Delayed Acknowledgment Type 6 100 O Error Condition 16-33 Part No ************ENG.A
Specification and Desciption STF SEQ LEN OPT ELEMENT NAME REMARKS 1 60 R Primary Key Value - STF 2 60 O Staff ID Code 3 48 O Staff Name 4 2 O Staff Type 5 1 O Sex 10 40 O Phone 11 106 O Office/Home Address 1.9 Appendix What are visit numbers? A patient being "admitted" is undergoing the admission process which assigns the patient to a bed. This is the beginning of a patient s stay in a healthcare facility. The span from the account s start until its end is called a visit. A hierarchy of identifiers exists between person, patient, account, and visit. The hierarchy is as follows: Level 4 - Person (identified by PID-2-patient ID) 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 PID-2-patient ID 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. 4 4 Health Level Seven, Version 2.3.1, Chapter 3.5.2.1.1 17-33 Part No ************ENG.A
Installation 2 ZanHL7 Service 2.1 Installation 1. Go to the server where you want to install the HL7 Service, and run the application ZANHL7Install.exe 2. Accept the default installation path, unless you have a reason to install in a different folder. 3. Configure the HL7 base component. 18-33 Part No ************ENG.A
Installation 3.1. ZAN Patient ID-Nr The ZAN Patient ID-Nr can be created in different ways: - automatically using last name, first name and birthday to create a 12 sign ID-Nr. - automatically counting 1,2,3, - manually In a HIS environment, every patient has 2 ID numbers: the ZAN Id-Nr and the HIS Id-Nr. These ID numbers can be the same or they can be different. Available options: - Use HIS Id-Nr If you select this option, ZAN Id-Nr. and HIS Id-Nr will be the same. This is only possible when the HIS Id-Nr. has 12 signs or less. - Create ZAN Id-Nr If you select this option, ZAN will create its own Id-Nr using the method wingpi.cfg. Both Id numbers are visible in the patient pane of wingpi. The preferred option is: Use HIS Id-Nr wherever possible. 3.2. Directories - Interface to HIS This is the directory that ZanHL7 shares with the Hospital Information System. Both applications need read/write access to this directory. If you also use ZANHL7TCPIP, ZanHL7 shares this directory with ZANHL7TCPIP. - Interface to GPI This is the directory that ZanHL7 shares with the ZAN workstations. ZanHL7 and all ZAN workstations need read/write access to this directory. - Database This is the ZAN database directory. ZanHL7 and all ZAN workstations share this database. The database directory must be configured when using the ADT option. - Waiting Room This is the ZAN waiting room directory. ZanHL7 and all ZAN workstations share the waiting room. The waiting room directory must be configured when using the ORM option. 3.3. Messages Here you can enable or disable the available message types of the ZanHL7 Service. Some message types have a details button. - ADT details Check or uncheck the used ADT trigger events. - MDM details ZAN Report-Server: Enter or browse for the ZAN Report-Server application. Medical Documents Path: Enter or browse for the folder the ZanHL7 shares with the HIS for export of medical documents. 4. Autorun Normally the ZanHL7 Service should start up with the PC. This can be achieved in 2 ways: 19-33 Part No ************ENG.A
Installation 4.1. Run ZanHL7 as a Windows Service - To install ZanHL7Service.exe as a Windows Service, you can use the file "ZanHL7 Service Install.bat" in the ZANHL7 folder. When you run this file, ZanHL7Service.exe will be installed as a Windows Service. - After installing ZanHL7Service.exe as a Windows Service, open the services administration window and edit the properties of ZAN HL7 Service: Change the start type to "automatic". 20-33 Part No ************ENG.A
Installation In the logon tab you can select the account under which the service will run. Be sure that this account has read/write access privileges for the ZANHL7\HIS folder and subfolders! 4.2. Run ZanHL7 as a Windows Application If for any reason you don't want to run ZanHL7 as a Windows Service, you can also run it as a windows application. In this case create a shortcut to "ZANHL7\ZanHL7Service.exe debug" in your startup folder. Be sure that this account has read/write access privileges for the ZANHL7\HIS folder and subfolders! The disadvantage of running ZanHL7 as a Windows application is that the application will only run when this user is logged on. 2.2 Configuration of the ZAN Workstations Go to every workstation with ZAN software and activate HL7. To do this, open wingpi and click on the Setup button. In the ZAN Settings program, open menu System-HL7: 21-33 Part No ************ENG.A
Installation Configure HL7 in this dialog: 2.2.1 HIS Interface This is the interface directory that all workstations share with the ZanHL7 service. It should be located on the PC where ZanHL7 service is running. All workstations and the ZanHL7 service need read/write access privileges for this folder and subfolders! 2.2.2 Waiting Room The waiting room must be enabled when ORM messages are used. This directory is shared from all workstations and the ZanHL7 service. It should be located on the PC where ZanHL7 service is running. All workstations and the ZanHL7 service need read/write access privileges for this folder! 2.2.3 Options 2.2.3.1 Show HIS Patient-ID and Visit Number Patient ID number in HIS and ZAN can differ (cf. 1.1 Installation chapter 3.1: ZAN Patient ID-Nr). Also some HIS support HL7 visit numbers, others don't. When this option is enabled, HIS Patient Ids and Visit Numbers will be visible in the patient pane in wingpi. 22-33 Part No ************ENG.A
Installation 2.2.3.2 Query for patients through HIS Check this option if you want to use queries. The HIS must support queries and the QRY message type must be enabled in the ZanHL7 service. With Queries you can search for patient information in the HIS given the patient Id number. This is described in the ZanHL7 guide chapter 4.3.5. 2.2.3.3 Enable ORU messages Check this option if you want to export observation results (ORU) to the HIS. The ORU message type must be enabled in the ZanHL7 service (cf. 1.1 Installation chapter 3.3: Messages). 2.2.3.4 Enable MDM messages Check this option if you want to export medical documents (MDM) to the HIS. The MDM message type must be enabled in the ZanHL7 service (cf. 1.1 Installation chapter 3.3: Messages). 2.3 Technical Description of the Configuration 2.3.1 Directory structure (ZanHL7 Service) This installation program ZanHL7Install.exe will create this directory structure on the server: 23-33 Part No ************ENG.A
Installation The folder ZANHL7 is the main folder. Content: - ZanHL7Service.exe - ZanHL7.dll, ZanHL7BDE.dll (Extensions to ZanHL7Service.exe) - ZanHL7.cfg (Configuration file) The folder GPI is the file interface to the ZAN workstations. The ZanHL7 Service and all workstations need read/write access to this folder and subfolders. - GPI-In is used for messages from ZanHL7 to the workstations. - GPI-Out is used for messages from workstations to ZanHL7. The folder HIS is the file interface to a) the Hospital Information System OR b) the ZanHL7TCPIP service, if installed. The ZanHL7 Service and the HIS (or ZanHL7TCPIP) need read/write access to this folder and subfolders. - HIS-In is used for HL7 messages from ZanHL7 to the HIS (or ZanHL7TCPIP). - HIS-Out is used for HL7 messages from HIS (or ZanHL7TCPIP) to ZanHL7. - HIS-Delayed stores messages that cannot be handled immediately (e.g. because the patient is opened on a workstation) temporarily. - HIS-Unhandled saves all HL7 messages that could not be handled by ZanHL7 for any reason. All unhandled messages have an entry with detailed description in the log file ZANHL7\ZanHL7.log. 24-33 Part No ************ENG.A
2.3.2 ZanHL7.cfg (ZanHL7 Service) Installation Normally you need not edit the ZanHL7.cfg configuration file. Most entries can be edited through the configuration tool config.exe (cf. 1.1 Installation chapter 3: cf. 1.1 Installation chapter 3.1: ZAN Patient ID-Nr). The following is a technical description for extended needs. [system] Server= Defines special HIS (e.g. Siemens-Medico, SAP, ). Unless you have a special HIS, use UNDEF. [ZID] Configuration of Patient ID numbers ZID= In a HIS environment, every patient has 2 ID numbers: the ZAN Id-Nr and the HIS Id-Nr. These ID numbers can be the same or they can be different. Available options: ZID=LID ZAN Id-Nr. will be copied from the HIS Id-Nr. This is only possible when the HIS Id-Nr. has 12 signs or less! ZID=AUTO The ZAN Id-Nr will be created automatically using last name, first name and birthday to create a 12 sign ID-Nr. FillZero=YES NO If ZID=AUTO and FillZero=YES, the ZAN Id-Nr will be padded with zeros to the left. ZeroCount=0 12 If ZID=AUTO and FillZero=YES, the ZAN Id-Nr will be padded with ZeroCount zeros to the left. UpperCase=YES NO Makes ZAN Id-Nrs upper case. [HIS] Configuration of the interface to HIS Dir_In= Used for HL7 messages from ZanHL7 to the HIS (or ZanHL7TCPIP). Dir_Out= 25-33 Part No ************ENG.A
Installation Used for HL7 messages from HIS (or ZanHL7TCPIP) to ZanHL7. Dir_Unhandled= All HL7 messages that could not be handled by ZanHL7 for any reason are saved to this folder. Dir_Delayed= All messages that cannot be handled immediately (e.g. because the patient is opened on a workstation) are temporarily stored in this folder. Messages= Enabled message types in ZanHL7 service. [ADT] Configuration of ADT messages Messages=A01,A04,A08,A18,A19 If [HIS] Messages contains the ADT message type, [ADT] Messages defines the ADT trigger events. [MDM] Configuration of MDM messages ReportConfig= Special Report.cfg that defines report templates. ReportPath= Directory in which the ZAN Report-Server is located. ReportServer= File name of the ZAN Report-Server. MedDocPath= Directory for Medical Documents. ZanHL7 service and HIS both need read/write access to this directory. MedDocFileNameType= Naming convention of the PDF file. 0=increasing number, 1=LID_YYYYMMDD_HHMM (patient id + date) 2= increasing number_ztmname (ztmname from ZanHL7Report.cfg [Names]) ORC=YES NO 26-33 Part No ************ENG.A
Installation Defines whether a ORC segment should be added (exports Placer Order Number). [GPI] Configuration of the interface to workstations ZanHL7 and all ZAN workstations need read/write access to these directories. Dir_In= Used for messages from ZanHL7 to the workstations. Dir_Out= Used for messages from workstations to ZanHL7. Archiv=C:\ZAN\GPI200\Archiv The ZAN database directory. Wartezimmer=C:\ZAN\GPI200\WARTEN The ZAN waiting room directory. 2.3.3 wingpi.cfg (ZAN Workstations) Normally you need not edit the wingpi.cfg configuration file. Most entries can be edited through ZAN Settings program (cf. 1.2). The following is a technical description for extended needs. [HL7] Enable=YES NO Enable/Disable HL7 in wingpi. InPath=C:\ZANHL7\GPI\In Used for messages from ZanHL7 service to ZAN workstations. OutPath=C:\ZANHL7\GPI\Out Used for messages from ZAN workstation to ZanHL7 service. ShowLIDCN=YES Visibility of HIS Patient Ids and Visit Numbers in the patient pane in wingpi (cf. 1.2.3.1). Query=YES NO Support for patient queries (cf. 1.2.3.2) QueryEx=YES NO Support for extended patient queries: update patient information in wingpi from HIS query result. 27-33 Part No ************ENG.A
Installation QueryFillZero=YES NO Pad patient ID numbers with ZeroCount zeros to the left in the query definition that will be sent to the HIS. ORU=YES NO Enable/Disable ORU messages in wingpi. MDM=YES NO Enable/Disable MDM messages in wingpi. [idnr] Section for patient ID number definitions autoid=on OFF Defines creation of ZAN ID numbers: automatic or manual entry. Should be OFF when using HL7. FillZero=YES NO Pad ZAN ID numbers with zeros to the left. ZeroCount=12 If FillZero=YES, the ZAN Id-Nr will be padded with ZeroCount zeros to the left. SearchCaseSensitive=YES NO Patient query from ID-Nr in HIS case sensitive/insensitive. 28-33 Part No ************ENG.A
Installation 3 HL7 TCPIP 3.1 Installation 1. Assure that you have already installed the HL7 Service (cf. Chapter 1: ZanHL7 Service). 2. Go to the server where you have installed the HL7 Service, and run the application HL7TCPIPInstall.exe 3. Accept the default installation path, unless you have a reason to install in a different folder. 4. Configure the HL7 TCP/IP interface 29-33 Part No ************ENG.A
Installation 4.1. ZAN HL7 Service - HIS directory This is the directory that ZANHL7TCPIP shares with ZanHL7 Service for message exchange. 4.2. Components ZANHL7TCPIP consists of 2 components: - Query (QRY) - Listener (ADT, ORM) Each component has its own TCP/IP connection. Each TCP/IP connection needs configuration: Client-/Server-mode, Port (Socket), IP-Address. 5. Autorun Normally the HL7 TCPIP Service should start up with the PC. This can be achieved in 2 ways: 5.1. Run HL7 TCPIP as a Windows Service - To install HL7TCPIPService.exe as a Windows Service, you can use the file "HL7TCPIP Service Install.bat" in the ZANHL7 folder. When you run this file, HL7TCPIPService.exe will be installed as a Windows Service. - After installing HL7TCPIPService.exe as a Windows Service, open the services administration window and edit the properties of ZAN HL7 TCPIP Service: 30-33 Part No ************ENG.A
Installation Change the start type to "automatic". In the logon tab you can select the account under which the service will run. Be sure that this account has read/write access privileges for the ZANHL7\HIS folder and subfolders! 31-33 Part No ************ENG.A
Installation 5.2. Run HL7 TCPIP as a Windows Application If for any reason you don't want to run HL7 TCPIP as a Windows Service, you can run the windows application instead. In this case create a shortcut to ZANHL7\ HL7TCPIP.exe in your startup folder. HL7TCPIP.exe is a pure Windows application that creates an icon in the taskbar. Be sure that this account has read/write access privileges for the ZANHL7\HIS folder and subfolders! The disadvantage of running HL7 TCPIP as a Windows application is that the application will only run when this user is logged on. 3.2 Configuration 3.2.1 Architecture (HL7TCPIP) TCPIP Service ZANHL7 Service HIS OutPath InPath 3.2.2 hl7tcpip.cfg (HL7TCPIP) Normally you need not edit the hl7tcpip.cfg configuration file. Most entries can be edited through the configuration tool hl7tcpipconfig.exe. The following is a technical description for extended needs. [System] TempPath=c:\ZANHL7\temp Directory for temporary files. InPath=c:\ZANHL7\HIS\Out Directory for incoming HL7 messages from HIS to ZanHL7. OutPath=c:\ZANHL7\HIS\In Directory for outgoing HL7 messages from ZanHL7 to HIS. [HL7] StartCharacters=11 LLM delimiters start HL7 message 32-33 Part No ************ENG.A
Installation EndCharacters=28,13 LLM delimiters end HL7 message [Query] Handler for QRY messages (with ADT or ADR responses) [Listener] Handler for unsolicited messages (e.g. ADT) [Query] and [Listener] Mode=0 1 0 = TCPIP Client 1 = TCPIP Server PermanentConnection=YES NO Defines whether connection is opened permanently or only when needed. ReadTimeout=5000 Timeout for message reading (ms). -1 = no timeout (infinite) Port=3000 Socket number IPAdress=127.0.0.1 IP address 33-33 Part No ************ENG.A