Connecticut Department of Public Health Electronic Laboratory Reporting HL7 v2.5.1 Message Validation Tool User Guide

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Connecticut Department of Public Health Electronic Laboratory eporting HL7 v2.5.1 Message Validation Tool User Guide November 30, 2015 Version 1.0

EL HL7 v2.5.1 Message Validation Tool User Guide Table of Contents Introduction... 3 Purpose... 3 Scope... 4 Objectives... 4 The CT Profile EL Validation Tool... 5 1. Access the tool... 5 2. Tool areas (tabs and links)... 7 3. Navigating the Validation Tool... 8 a. Documentation... 8 b. Validation Panel... 9 c. Validation eport... 10 d. Profile Viewer... 10 e. Vocabulary... 12 4. Using the CT Profile Tool to Validate a Test EL 2.5.1 Message... 12 5. Example messages with CT specific errors... 17 Appendix A Quick Guide... 18 Appendix B. Differences between the CT EL Local Guide and the National EL Guide. 9... 21 Appendix C. esults of testing CT specific example messages in the CT specific NIST validation tool.... 24 1

evision History Issue Date Summary of Changes 1.0 Nov. 30, 2015 Initial release by CT EL team. 2

Introduction Welcome to the Connecticut Department of Public Health (CTDPH) Electronic Laboratory eporting (EL) HL7 2.5.1 Message Validation Tool User Guide. The CTDPH EL message validation tool is a modification of the National Institute of Standards and Technology (NIST) allpurpose HL7 v2.x Message Validation Tool 1 that provides validation services to messages given an XML conformance message profile. Working with NIST, the CTDPH EL team has developed a Connecticut (CT) specific profile for use by laboratories wishing to test de-identified HL7 2.5.1 EL messages as part of EL on-boarding with CTDPH. This modified tool is based on the NIST EL context-free testing tool and tests for message structure and most vocabulary. The CT EL team thanks NIST for working with us to develop this locally defined tool and would like to acknowledge in particular the efforts of obert Snelick, Caroline osin, and Harold Affo, as well as others. The EL Validation Tool was created by NIST to validate EL messages created by Electronic Health ecords (EH) technology and can be used for certifying 2014 Edition Meaningful Use EH technology using context-based testing. The context-based testing tool will assess all conformance requirements of the national EL guide (see reference below) and is used for certifying 2014 Edition Meaningful Use EH technology. Purpose The purpose of this Guide is to provide you with a thorough understanding on how to test your HL7 v 2.5.1 EL message using the CT specific profile (CT Profile) NIST validation tool and how to interpret validation results. The CT Profile has been constructed to reflect additional constraints for HL7 2.5.1 EL messaging to meet CTDPH laboratory reporting requirements as defined by state regulation in the Connecticut Public Health Code Sections 19a-2a and 19a-36-A2 2. These additional requirements are captured in the CTDPH EL Local Implementation Guide for HL7 v2.5.1: OU^01 (CT Local Guide). This local guide will be posted on the CTDPH website 3 by searching for Electronic Laboratory eporting. It is also posted on the NIST website for the CTspecific EL validation tool under the Validation-Documentation tab. Laboratories wishing to engage in HL7 2.5.1 EL are urged to review this local guide and the national EL guide HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory eporting to Public Health, elease 1 1 The National Institute of Standards and Technology, U.S. Department of Commerce. http://hl7v2-cfvalidator.nist.gov/cf-validator/#/about 2 The Connecticut Public Health Code can be browsed at: http://www.ct.gov/dph/cwp/view.asp?a=3118&q=397982 3 www.ct.gov/dph 3

(US ealm). Both guides are available from CTDPH by contacting dph.elr@ct.gov, and will be posted on the CTDPH website. The CT Profile EL validation tool is available to laboratories, laboratory information system vendors, and third party integrators to test HL7 2.5.1 messages for parsing, message format and certain content review against the CT Local Guide. Scope The scope of the tool is to validate HL7 v2.5.1 messages in a context-free environment (i.e., there is no associated specific test case or test data considered in the validation) based on the CT Profile. The tool validates message structure and vocabulary content. equirements are encapsulated in an HL7 v2 conformance message profile (XML) that can be viewed using the Profile Viewer utility provided by the tool. The vocabulary (i.e., value set collection) requirements are encapsulated in the value set library file (XML) and can be viewed by the Vocabulary Viewer. These will be explained later in this Guide. The workflow for EL testing is shown in Figure 1. Objectives Upon completion of this manual, you will be able to: Access the CT Profile UL. Navigate the NIST HL7 v2.x Message Validation Tool window home. Understand and navigate the Validation window tabs: o Documentation locate relevant documentation for message testing; use example messages; view value sets; view release notes and known issues. o Validation Panel upload and run a test message validation; understand the Message Tree, and interpret the Message Validation esult. o View and interpret the Validation eport. o Use the Profile Viewer. o Use the Vocabulary tab. Use the primary Documentation tab. We will direct you towards those areas of most value for assessing your de-identified HL7 2.5.1 EL message. Once you are familiar with the tool, please reference the tool Quick Guide in Appendix A. Please note that this guide is best viewed or printed in color. 4

Figure 1. EL Testing Workflow. From "Electronic Laboratory esults (EL) Validation Tool Tutorial and Guide by obert Snelick, Caroline osin, NIST, December 8, 2012 see the Documentation tab at http://hl7v2-elr-testing.nist.gov/mu-elr/ The CT Profile EL Validation Tool 1. Access the tool Go to NIST Message Validation or copy and paste the UL into any browser (IE, Firefox, or Chrome) http://hl7v2-cf-validator.nist.gov/cf-validator/#/home. You should see the following (Figure 2). This page shows the list of supported implementation guides and profiles, tabs and icons that will direct you to different areas linked to this page, and illustrations of the various areas of interest in the validation tool. These areas are described in the next item. The side arrows next to the Supported Implementation Guide and Profiles table will show you the HIPAA statement (Figure 3) and a cartoon of the NIST Context-free Validation Process (Figure 4). 5

Figure 2. Home page of the NIST context-free Validation Tool. List of supported profiles Links to Tool areas (same as tabs above) Click on Go Some Tool Functions Figure 2. Home page of the NIST context free Validation Tool. 6

In compliance with HIPAA equirements, parties using the NIST HL7 V2 Validation Tools via this NIST Web site shall not use real data about living, identifiable individuals. Parties shall adhere to all Federal egulations including, but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Due to patient confidentiality issues (e.g., HIPPA requirements regarding PHI), this software should not be used via the NIST Web site for validation of messages containing real patient information. With proper precautions in place to maintain patient confidentiality, if an organization downloads the Validation Tool and uses it locally the Tool can validate messages with real patient information. Figure 3. HIPAA Patient Confidentiality Notice. Figure 4. Cartoon of the NIST Context-free Validation Process. 2. Tool areas (tabs and links) The Validation Tool has the following areas: Home this is the start page of the Validation Tool UL Validation this has the artifact documents and is where the message validation will be performed and results obtained. Documentation this is where the tool file can be downloaded. 7

About describes the NIST message validation tool and has the NIST disclaimer and a HIPPA Patient Confidentiality Notice. Note: please do not submit tests that contain real data about living, identifiable individuals. Contact Us the NIST contacts for general administration and results and technical operation of the tool. 3. Navigating the Validation Tool In this section, we will review how to use and navigate the Validation tool. The Validation window is where you will be able to test your message and get results of the testing. It also has additional information and documentation. The Validation window has the following tabs: Documentation Validation Panel Validation eport Profile Viewer Vocabulary Each will be described in the following sections. a. Documentation This window has several areas that contain documentation that may be of use as you construct and test your EL message. It is the default window that appears when you click on the upper Validation tab or click on Go under the green check icon in the Home window (see Figure 2 above). Overview: This is a description of the NIST CT Profile for EL for the State of Connecticut as well as a list of artifacts and a summary of the NIST support of the conformance profiles defined in the implementation guide. User Documentation: This is where documents from CTDPH relating to the EL OU_01 message are available. Profile Documentation: This is where you can download the xml file that describes the conformances, including those specific to CT, for the EL OU_01 message. Example Messages: this is a list of example messages that illustrate various errors of importance to CT EL, included a correct test message. Value Sets: Here is where you can download some value sets for the OU_01 message. elease Notes: these are the release notes for the CT Profile. Known Issues: here is where any known issues will be listed. 8

b. Validation Panel When you select the Validation Panel tab, you will see the window shown in Figure 5, until an integration profile is chosen (red circles). Figure 5. Validation Panel initial view (no profile chosen). To choose an integration profile click on the down arrow and select Electronic Lab eporting (EL 1) State of Connecticut. You will now see items appear in the window as in Figure 6, i.e., the Message Tree, Message Content and Message Validation esult areas (large red arrows). Note: the conformance profile default is OU_01 just leave this selection in place. Figure 6. Validation Panel window post-integration profile selection. 9

c. Validation eport The validation report will be populated once a message is tested. This will be described further below. d. Profile Viewer The Profile Viewer shows the EL OU_01 message in detail based on message segments along with the accompanying conformance statement. There are two types of conformance statements shown. Those labeled EL-### reflect datatype or usage variations from the base HL7 version 2.x standard that are in the national EL guide. Those labeled CT-EL-### reflect further changes specific for CT EL. In addition, CT EL has some further usage constraints based on CTDPH reporting regulations. These differences are shown in Appendix B, and are also explained in the CT EL Local Guide. The Profile Viewer will be of use for laboratories in constructing a conformant HL7 2.5.1 EL message for CT EL. More details on using the Profile Viewer follow. Navigating the Profile Viewer 1. Usage views you can view the profile for only equired (), equired but Empty (E) or Conditional (C) usages by selecting the button,e,c (only). Or you can view the profile for all usages,e,c,o,x (All). When buttons are selected they appear as white letters on a blue background. 2. You can choose Concise View (narrower columns) or Expanded View (wider columns). Both views show Element Name, Usage, Cardinality, Datatype, Length, Value Set, Predicate, and Conformance Statement. Column headers are used as described in the HL7 v2 standard. 3. Message profile definitions the Profile Viewer show the static message profile for the HL7 2.5.1 OU^01 message. The message composition is 4 : a. Groups contain segments or groups. Groups are designated by G. b. Segments are designated by S and contain fields. c. Fields F contain components C. d. Components contain sub-components, designated by S. The reader is referred to HL7 Messaging Standard Version 2.5.1, An Application Protocol for Electronic Data Exchange in Healthcare Environments 5 for further information. 4 Obtained from: http://hl7standards.com/blog/2006/10/05/what-are-the-components-of-an-hl7- message/comment-page-1/ 5 The HL7 Version 2.5.1 Standard Copyright 2007 by Health Level Seven, Inc. www.hl7.org 10

4. Message Segments The next area of the Profile Viewer allows you to view either the entire message profile or individual segments of the message profile. This will be especially useful for laboratories as they design and implement their HL7 2.5.1 messages for CT EL. Selection of a segment will open the view which will list the group, segment or field levels. Clicking on the left arrows will expand those into additional areas as described in item 3 above. For example, CT EL requires that PID-11 Patient Address contain, at a minimum, the following elements: street or mailing address, city, state, zip code (at least first five digits). This can be seen in the Profile Viewer by clicking on PID and then clicking the left arrow next to PID. 11: Patient Address (Figures 7 and 8). ed circles in Figure 7 indicate what segment was selected (PID) and where the left arrow for PID-11 is. ed circles in Figure 8 are where the CT Profile has conformance different from the national EL profile (CT is ; national profile is E for these data elements). Figure 7. Selection of PID in the Profile Viewer (red circles). 11

Figure 8. PID 11 expanded view. ed circles are differences from the national EL profile. e. Vocabulary The final tab of the Validation window is Vocabulary. This contains two areas: Vocabulary Collections and Value Set Information. Selecting one of the Vocabulary Collections (ICD, External, CDC, or HL7) will cause information about that collection to appear in the Value Set Information area. Also shown will be Value Set Attributes and Value (Code) information. The Vocabulary tab will allow you to either search the lists presented or reference standard vocabulary helpful to constructing and contenting your EL message. Many of the value sets shown are from the HL7 Messaging Standard Version 2.5.1 Appendix A (Data Definition Tables) 6 or from the Centers for Disease Control and Prevention (CDC) PHIN Vocabulary Access and Distribution System (PHIN VADS) 7. PHIN VADS is a web-based enterprise vocabulary system for accessing, searching, and distributing vocabularies used in public health and clinical care practice 8. 4. Using the CT Profile Tool to Validate a Test EL 2.5.1 Message The following are step by step instructions on how to run a validation on your test EL 2.5.1 message. NOTE: please only use de-identified messages for testing! a. Select Validation Panel Tab Under the Validation window, select the Validation Panel tab. Check to be sure you have selected the CT Profile for OU_01. 6 The HL7 Version 2.5.1 Standard Copyright 2007 by Health Level Seven, Inc. www.hl7.org 7 http://phinvads.cdc.gov 8 http://www.cdc.gov/phin/tools/phinvads/index.html 12

b. Input a test EL 2.5.1 message Under the Message Content area, input a test de-identified EL 2.5.1 message by: 1) Click on the folder icon to the right of the message content area, and select your file. It should appear in the Message Content window. O 2) Cut and paste your test message into the Message Content window. Open your message in a text editor; copy the message; click in the Message Content window so cursor appears; paste the message. 3) Once the message is uploaded or pasted into the Message Content window, validation will automatically run. If it doesn t, click on the refresh button. 4) The results of the validation will appear in the Message Validation area. A green check mark will appear next to Message Validation esult. The number of Errors, Warnings, Alerts, Affirmatives and Ignores will be listed. esults of inputting a test message are shown in Figure 9. 1. Upload or paste test message into Message Content box. 2. Validation runs immediately showing the Message Tree and Message Validation esults. Figure 9. esults of inputting a test EL message. 13

c. Content of the Message Validation esults The Message Validation esults show the following: 1) Errors are conformance violations, i.e., the standard was not implemented as it should have been in the message. For example, missing data elements. These are important as they may prevent data exchange or data incorporation from the message. NOTE: These are the results that CT EL expects laboratories to pay attention to and correct if required by CTDPH. 2) Warnings are an indication that the detected issue should be looked at, but is not an error. Note: NIST has not defined any warnings at this point. 3) Alerts are indications that the validation was not performed for one reason or another. For example, some value sets are only defined locally, so are not available to perform a validation against. So a user is alerted to that fact. For example, the tool does not support validation of PHVS_County_FIPS_6-4. See the list of excluded tables from the validation context for details. 4) Affirmatives are reported assertions that are found to be true (as opposed to errors where an assertion was made and was false). Assertions can include: version, message type (MSH.9), message structure at the segment level is correct, message contains no datatype error, contains no data (value of an element) error, and, no cardinality error. Not all affirmatives are given. 5) Ignores are detections that the user decides to ignore, e.g., length. These are technically assertions made that are false, but are currently not considered important. Errors, warnings, and alerts are included in the Validation eport. d. Use the Message Tree to view errors The Message Tree provides a complete breakdown of the input test message by segment, field and component. The content of the component is also shown. The Message Tree is helpful for viewing and locating the errors noted in the Validation esult. When you select a data element in the message tree, that element is highlighted in yellow in the message pasted into the message content box. e. View and print the Validation eport The Validation eport can be viewed by clicking on the Validation eport tab. Figure 10 shows an excerpt of a Validation eport. The following describes each section as numbered in Figure 10. 1. Save as allows you to save the Validation eport in pdf, word, and xml or html format. 2. Title and date/time report generated. 14

3. Testing tool information. 4. Test Case o Title is the conformance profile used (OU_01). o Description indicates the context used for validation (context-free for CT EL testing). 5. Profile o Name of the profile (Electronic Laboratory esults Connecticut). o Organization who built this conformance profile (NIST). o Type is the conformance type NIST used to build the validation (OU^01^OU_01). o Profile Version is the NIST version (3.0.1). o Profile date is the version date (if provided). o HL7 Version is the version for the conformance profile used (2.5.1). 6. Message header encoding. 7. Message Content the input test message. 8. Summary table with count of errors, warnings, ignored and alerts. 9. Validation Errors this is the list of output related to errors, warnings, and alerts, in that order. Errors include: the type of error (e.g., message structure); the description of the conformance that was not met to cause the error; the location of the error; and, the assertion declaration (if any). o Location will include the following additional information: Line this is the line in the message content. Column this is the space location starting from the left side of the line with the segment name. Path this is the message location as described in the message tree. Segment the segment where the error occurred. Field the HL7 data element name. Component the field component where the error occurred. Subcomponent the subcomponent where the error occurred. Warnings will be listed once NIST has implemented any detection for them. Alerts include: type, description, and location if applicable. If location is present, the same additional information as for errors will be show. Some examples of possible errors and how to identify and correct them are given in the next section. 15

2 1 3 4 5 6 7 8 9 Figure 10. Sections of the Validation eport. 16

5. Example messages with CT specific errors The following examples include some errors that are specific to CT EL requirements for usage that is constrained more than national usage as described in Appendix B. Both an excerpt from validation report and the validation panel are shown. The list of CT example messages is: CT_base_deidentified_HL7msg.txt this is a basic HL7 2.5.1 EL message that meets CT specifications for required data elements. This message will show no errors on testing. CT1_MSH5_missingOID.txt -- missing the OID required in MSH-5 CT2_MSH6_missingOID.txt missing the OID required in MSH-6 CT3_MSH6_wrongOID.txt -- use of the wrong OID in MSH-6 These are both CT defined OIDs. CT4_PID11_missingstreet.txt CT5_PID11_missingtown.txt CT EL requires that Patient street address, city/town, state and zip code be populated. CT6_OC12_missingprovname.txt CT7_OC14_missingprovphone.txt CT8_OC24_missingprovaddr.txt CT EL requires that the Ordering Provider first and last names and street address, city/town, state, zip code and a contact number be populated. esults from validating these example messages in the CT NIST tool are shown in Appendix C. 17

Appendix A Quick Guide The following is a quick guide for use of the CT specific NIST EL validation tool. Step 1. Navigate to the NIST context free testing tool site Step 2. Select the Integration Profile: Electronic Lab eporting (EL 1) State of Connecticut Step 3. Open Validation Panel page. 18

Step 4. Paste your de-identified message into the message content box O click on the folder icon and upload your file. The message validation should run, if not, click on the button. The message tree and message validation result areas should populate. Step 5. Check your errors Click on the message tree location of the data element in error to highlight it. 19

Step 6. Open and download, if needed, the message validation report for that test. Step 7. Make corrections to your test message as needed, and re-test. Contact the CT EL team with any questions. Once you have a test message that passes validation, you are ready for CTDPH validation. 20

Appendix B. Differences between the CT EL Local Guide and the National EL Guide. 9 Segment-Sequence National EL Usage CT EL Usage Comments/Constraints Message Header (MSH) Segment MSH-5 eceiving Application MSH-6 eceiving Facility MSH-15 Accept Acknowledgment Type MSH-16 Accept Application Type MSH-21 Message Profile Identifier C(/E) C(/E) Patient Identification (PID) Segment PID-11 Patient Address E I I CTDPH requires using the following literal values. Testing/Staging: CT^2.16.840.1.113883.3.5609.4.1.1.3.2.2^ISO Production: CT^2.16.840.1.113883.3.5609.4.1.1.3.2.1^ISO These OIDs are specific for EL HL7 2.5.1 elease 1. CTDPH requires using the following literal value which is the same for testing and production: CTA-DPH^2.16.840.1.113883.3.5609.4.1^ISO This OID is specific for EL HL7 2.5.1 elease 1. CTDPH is not processing this data element at this time. CTDPH will inform the sending facility by email of any errors found in the message. CTDPH is not processing this data element at this time. CTDPH will inform the sending facility by email of any errors found in the message. MSH-21 (Message Profile Identifier) is specific for the version of HL7 2.5.1 implementation. CT is using EL HL7 2.5.1 elease 1 and CTDPH recommends populating this data element with: PHLabeport- NoAck^^2.16.840.1.113883.3.5609.9.2.1^ISO CTDPH requires the following address information as a minimum: street or mailing address, city, state, zip code (at least first five digits). Note: use of the 169 CT town names is preferred, but not required. PID-35 Species Code E I CTDPH is not processing this data element at this time. Next of Kin (NK 1) Segment NK1-4 Address E E If information available, please follow requirements for PID-11 above. Next of kin may be required for certain diseases reports, e.g., blood lead findings in children. 21

Segment-Sequence National EL Usage CT EL Usage Comments/Constraints Common Order (OC) Segment OC-2 Placer Order Number C(/E) CTDPH will allow either an OID or a CLIA ID for the Universal ID and the appropriate designation for Universal ID Type (CLIA or ISO). These are CT specific EL conformances CT-EL-003 (Universal ID) and CT-EL-004 (Universal ID Type). OC-3 Filler Order Number CTDPH will allow either an OID or a CLIA ID for the Universal ID and the appropriate designation for Universal ID Type (CLIA or ISO). These are CT specific EL conformances CT-EL-003 (Universal ID) and CT-EL-004 (Universal ID Type). OC-4 Placer Group Number E I CTDPH is not processing this data element at this time, but laboratories should be able to populate this. If element is populated, please follow the CT-EL-003 and 004 constraints as described above. OC-12 Ordering Provider C(/X) Populated with the same values as OB-16. CTDPH requires at least the first and last names of the ordering provider in OB-16. OC-14 Order Callback Phone Number C(/X) Populated with the same values as OB-17. CTDPH requires a contact number for the ordering provider in OB-17. OC-24 Ordering Provider Address E CTDPH requires that an address for the ordering provider be sent. The address must follow the minimum elements as for PID-11. Observation equest (OB) Segment OB-2 Placer Order Number CTDPH will allow either an OID or a CLIA ID for the Universal ID and the appropriate designation for Universal ID Type (CLIA or ISO). These are CT specific EL conformances CT-EL-003 (Universal ID) and CT-EL-004 (Universal ID Type). OB-3 Filler Order Number CTDPH will allow either an OID or a CLIA ID for the Universal ID and the appropriate designation for Universal ID Type (CLIA or ISO). These are CT specific EL conformances CT-EL-003 (Universal ID) and CT-EL-004 (Universal ID Type). 22

Segment-Sequence OB-16 Ordering Provider OB-17 Order Callback Phone Number OB-32 Principal esult Interpreter National EL Usage E E Observation/esult (OBX) Segment CT EL Usage Comments/Constraints CTDPH requires at least the first and last names of the ordering provider be provided. OC-12 is populated with the same values. CTDPH requires that a contact number for the ordering provider be sent in OB-17. OC-14 is populated with the same values. E I CTDPH is not processing this data element at this time. OBX-2 Value Type C(/X) CTDPH requires that OBX-2 Value Type be populated. The OBX-5 (Observation Value), -6 (Units) and -7 (eferences anges) must be consistent with the OBX-2 Value Type. Specimen (SPM) Segment SPM-2 Specimen ID SPM-6 Specimen Additives SPM-12 Specimen Collection Amount SPM-21 Specimen eject eason E E E I I I CTDPH will allow either an OID or a CLIA ID for the Universal ID and the appropriate designation for Universal ID Type (CLIA or ISO). These are CT specific EL conformances CT-EL-003 (Universal ID) and CT-EL-004 (Universal ID Type). CTDPH is not processing this data element at this time. Laboratories should be able to demonstrate they can populate this data element. CTDPH is not processing this data element at this time. Laboratories should be able to demonstrate they can populate this data element. CTDPH is not processing this data element at this time. Laboratories should be able to demonstrate they can populate this data element. 9 Excerpted from the Connecticut Department of Public Health Electronic Laboratory eporting Local Implementation Guide HL7 Version 2.5.1:OU^01. 23

Appendix C. esults of testing CT specific example messages in the CT specific NIST validation tool. Example 1 Missing MSH-5 OID CT EL requires a specific OID for the eceiving Application (CTDPH). If that OID is missing you get the following error on the Validation eport. There are two errors one for the missing OID, and one to tell you which OID is expected. Example 1. Missing MSH-5 OID Validation eport excerpt. Example 1. Missing MSH-5 OID validation panel view. 24

Example 2 Missing MSH-6 OID CT EL requires a specific OID for eceiving Facility. If that OID is missing, you see a similar report as for a missing MSH-5 OID. Example 2 - Missing MSH-6 OID Validation eport excerpt. Example 2 - Missing MSH-6 OID Validation Panel view. 25

Example 3 Incorrect MSH-6 OID If the OID for MSH-6 is incorrect, will see the following error: Example 3 - Incorrect MSH-6 OID Validation eport excerpt. Example 3 - Incorrect MSH-6 validation panel view. 26

Example 4 Missing Patient Street Address CTDPH requires that patient address be populated in the HL7 2.5.1 message for the following data elements: street address, city, state, zip code. In the following examples, you can see where the Validation report lists the field (Patient Address) and the component (Street Address) for the missing data elements. Example 4 - Missing Patient Street Address Validation eport excerpt. Example 4 - Missing patient street address validation panel view. Example 5 Missing Patient Town. Similar to street address, CTDPH requires that a town/city be populated. Example 5 - Missing Patient town Validation eport excerpt. 27

Example 5 - Missing Patient Town validation panel view. Example 6 Missing Ordering Provider Name. CTDPH requires that the name of the provider ordering the test be provided. Ordering Provider Name is valued in OB-16. In addition, HL7 2.5.1 EL conformance requires that OC-12 be populated with the same value. The errors below illustrate both issues. Example 6 - Missing Ordering Provider Name Validation eport excerpt. 28

Example 6 - Missing Ordering Provider Name validation panel view. Note that not only is the data element listed as missing (red arrows), but the conformance for OC-12 to be the same as OB-16 (top line). Example 7 Missing Ordering Provider phone. CTDPH requires that a phone number for the ordering provider be included in OC-14, and the conformance requires this is the same as OB-17. Example 7 - Ordering Provider Phone number missing Validation eport excerpt. 29

Example 7 - Missing Ordering Provider phone validation panel view. Example 8 Missing Ordering Provider address. If Ordering Provider address is missing the required elements street address, city, state or zip code, the tool will generate errors similar to those seen for PID-11 (Patient Address). Example 8 - Missing Ordering Provider address Validation eport excerpt. Example 8 - Missing Ordering Provider address validation panel view. 30