Issued by: PHILIPS HEALTHCARE Patient Care and Clinical Informatics Interoperability Competence Center Philips Innovation Campus 560045 Bangalore India E-mail: hl7@philips.com Internet: http://www.healthcare.philips.com/connectivity Document Number: CAI.0001237 Created in September 2012 Updated in October 2012
Interface Specification Intellispace PACS DCX 3.1 Page 1 of 23 TABLE OF CONTENTS 1. INTRODUCTION... 2 1.1. Purpose of this Document... 2 1.2. Intended Audience... 2 1.3. Scope and Exclusion... 2 1.4. Sources for this Document... 2 1.5. Related Documents... 2 1.6. Definitions... 2 1.7. Acronyms and Abbreviations... 3 2. OVERVIEW... 4 2.1. Functional Overview... 4 3. COMMUNICATION PROFILE... 6 3.1. TCP/IP Sockect Low Level Protocol... 6 3.2. Shared Network File... 6 3.3. Messaging Data Flow... 7 4. MESSAGE SPECIFICATION... 8 4.1. Message Definition... 8 4.2. Message Delimiters... 8 4.3. Supported Messsages... 9 4.3.1. Patient Related Messages... 9 4.3.2. Merge Patient Messages... 9 4.3.3. Visit Related Messages... 10 4.3.4. Order Related Messages... 10 4.3.5. Observation Related Messages... 10 4.3.6. Acknoledgement Messages... 10 4.4. Supported Messsage Grammars... 10 4.5. Supported Attributes... 11 4.5.1. MSH- Message Header Segments... 12 4.5.2. MSA- Message Acknowledgement Segment... 12 4.5.3. PID Segment-Patient Information... 13 4.5.4. PD1- Patient Demographic Segment... 13 4.5.5. MRG- Merging Segment... 13 4.5.6. ARV- Access Restirctions Segment... 14 4.5.7. PV1- Patient Visit Information... 14 4.5.8. PV2- Patient Visit- Additional Information... 14 4.5.9. AL1- Patient Allergy Information Segment... 15 4.5.10. ORC- Common Order Segment... 15 4.5.11. OBR - Observation Request Segment... 15 4.5.12. OBX Observation / Result Segment... 17 5. TO DCX R2.3 DATA VALUES MAPPING... 18 5.1. Default Values Mapping... 18 5.1.1. Patient Gender Mapping... 18 5.1.2. Ambulatory Status Mapping... 18 5.1.3. Living Dependency Mapping... 19 5.1.4. Order Control to Study Mapping... 19 5.1.5. Order Status to Study Mapping... 20 5.1.6. Coding Scheme Designator Mapping... 20 5.1.7. Priority Mapping... 20 5.1.8. Observation Result Status Mapping... 21 5.1.9. Event to Visit Status Mapping... 21 6. USER CONFIGURABLE OPTIONS... 23
Interface Specification Intellispace PACS DCX 3.1 Page 2 of 23 1. INTRODUCTION 1.1. Purpose of this Document This document provides the requirements to interoperate with the Philips IntelliBridge Enterprise CV (Futher reffered as DCX 3.1) using the Health Level Seven () standard. Objective of this document is to provide a standard set of HIS/CIS/RIS requirements to effectively support and connect to the Philips Intellispace PACS DCX 3.1. This chapter provides general information about the purpose, scope and contents of the Interface Specification. 1.2. Intended Audience The intended audience for the Interface Specification is: Hospital Information System Provider Cardiology Information System Provider Healthcare IT Consultants Qualified Medical or System administration personnel 1.3. Scope and Exclusion The use of this interface specification in conjunction with the standard is intended to facilitate communication with DCX 3.1, it is not sufficient to guarantee, by itself, the interoperation of the connection between DCX 3.1 and the 3rd party -based system. The integration of any device into a system of interconnected devices goes beyond the scope of the standard and this conformance statement when interoperability is desired. The responsibility for analyzing the applications requirements and developing a solution that integrates the DCX equipment with othervendors' systems is the user s responsibility and should not be underestimated. 1.4. Sources for this Document Health Level Seven Version 2.3 IHE Radiology Technical Framework Revision 6.0 NEMA 2007 DICOM Standards 4522 170 19701 R3.1 L1 IntelliSpace PACS DCX Administrator Guide 4522 170 19721 R3.1 L1 IntelliSpace PACS DCX Admin Guide Profile Builder 1.5. Related Documents This document is intended to complement, not replace, the following document(s): IntelliSpace PACS DCX 3.1 DICOM Conformance Statement IntelliSpace PACS DCX 3.1 IHE Integration Statement 1.6. Definitions Patient ID Pat. ID + Inst. Code Message Order Service Request Trigger Event Unsolicited Update Hospital-wide, unique identifier for a patient Enterprise-wide, unique identifier for a patient An atomic unit of data transferred between two systems. An Order is a request for a service from one application to another. Orders are associated with a particular patient and comprise a set of one or more procedures to be performed on a patient. Equivalent to an Order An event that initiates the flow of information among application systems. The transfer of information initiated by the application system relating to a Trigger Event.
Interface Specification Intellispace PACS DCX 3.1 Page 3 of 23 1.7. Acronyms and Abbreviations ACK ADT AL1 CIS DICOM EMR EPR EVN HIS IHE IS LLP MLLP MPPS MRG MRN MSA MSH MWLM OBR OBX OMG OMI ORC ORM ORU PD1 PID PV1 RIS General Acknowledgement Message Admission, Discharge and Transfer Message Patient Allergy Information segment Cardiology Information System Digital Imaging and Communication in Medicine Electronic Medical Record Electronic Patient Record Event Type Segment Hospital Information System Health Level 7 (Interface Standard) Integrating the Healthcare Enterprise Information System (Hospital Information System, Radiology Information System or other healthcare information system) Lower Layer Protocol Minimal Lower Layer Protocol (DICOM) Modality Performed Procedure Step Merge Patient information Segment Medical Record Number Message Acknowledgment Segment Message Header Segment (DICOM) Modality Worklist Management Observation Request segment Observation/Result segment General clinical order Imaging order Common Order segment Order Request message Observation Results - Unsolicited message Additional Demographics segment Patient Identification segment Patient Visit segment Radiology Information System
Interface Specification Intellispace PACS DCX 3.1 Page 4 of 23 2. OVERVIEW 2.1. Functional Overview DCX 3.1 Interface receives -based messages from other application (IS), converts data todicom and DCX 3.1 internal terms and populates received data into internal database. This data are later used in the PACS to reconcile differences that may occur between received from IS data and received from modality data. Note: Communication with only one information system is supported by current version of DCX 3.1 The DCX 3.1 does not support full range of transaction messages. Supported by default profile ADT events are: ADT^A01, ADT^A02, ADT^A03, ADT^A04, ADT^A05, ADT^A06, ADT^A07, ADT^A08, ADT^A09, ADT^A10, ADT^A11, ADT^A12, ADT^A13, ADT^A14, ADT^A15, ADT^A16, ADT^A18, ADT^A25, ADT^A26, ADT^A27, ADT^A28, ADT^A30, ADT^A31, ADT^A32, ADT^A33, ADT^A34, ADT^A36, ADT^A38, ADT^A39, ADT^A40, ADT^A47. Supported Order events are: ORM^O01, OMG^O19, OMI^O23. Supported Observation event is ORU^R01. Segments are supported for processing: MSH, PID, PD1, AL1, MRG, PV1, PV2, ORC, OBR, OBX Processing of repeating segments is not supported excluding Observation/Result segment (OBX segment). In this reason DCX 3.1 does not support ADT^A17 event, for example. Repeating OBX segment will be processed and saved in internal database. Note: Unsupported and later segment entries will be ignored. For example, only first order will be populated in internal database if several orders will be received within ORM^O01 message. Note: Not all fields are supported for segments. DCX 3.1 supports the message transmission via TCP/IP or shared folder. DCX 3.1 immediately processes message after receiving and then sends acceptance acknowledge message. DCX 3.1 supports only original mode of acceptance acknowledgement. It does not support application acknowledgement. Acknowledge messages may be sent within the same association what the event message is received and may be sent in separate association what is opened specially by DCX 3.1 for sending of acknowledge on listening by IS port. DCX 3.1 supports ADT, Order and Observation message types and provides following services: Early populating of patient demographics, visit and order data (ADT and Order messages). Update of patient demographics, visit and order data in internal database and stored data (ADTand Order messages). Collecting of patient clinical result information (text reports) (Observation messages). Patient demographics and orders are used for reconciliation as most credible and decrease possibility of data entry error. Patient and other details are updated within DICOM data
Interface Specification Intellispace PACS DCX 3.1 Page 5 of 23 during the operation. This is implemented by DCX 3.1 in accordance with the requirements of IHE Radiology Technical Framework for the Image Manager/Image Archive actor in the Scheduled Workflow and Patient Information Reconciliation Integration Profiles. Collection of patient clinical result information (text report) of DCX 3.1 interface is not part of IHE definitions. Primary definitions of communication profile key attributes, message elements and types, segment usage, field mapping and field value conversions and conversion rules are specified in configurable Mapping Profile and Conversion Profile. These Profiles may be customized for tighter synchronization and integration with specific information system which will communicate with DCX 3.1. The profiles are managed by special Profile Builder tool. See 4522 170 19721 R3.1 L1 IntelliSpace PACS DCX Admin Guide Profile Builder Manual for details how to customize the Profiles.
Interface Specification Intellispace PACS DCX 3.1 Page 6 of 23 3. COMMUNICATION PROFILE DCX 3.1 transaction messages are compatible with the Version 2.x and are external system independent. They include an information superset that may be received from external systems. DCX 3.1 can be configured to accept transaction messages either: To process all shared ASCII files at a user defined interval (shared folder mode); To process incoming messages received on the defined socket (TCP/IP mode). After each message is processed, DCX 3.1 can send an acknowledgement back to the external system (if this is configured). The Original mode of Acknowledgment is supported. The Acknowledgment message is sent to an external system in response to a received message. 3.1. TCP/IP Sockect Low Level Protocol The TCP/IP mode is designed to be used in real-time interfaces. DCX 3.1 waits for and receives messages wrapped Minimum Lower Level Protocol. TCP/IP static port need to be defined for listening of incoming connections. By default DCX 3.1 listens port 1040. The Minimal Lower Layer Protocol protocol standard will be observed. With this protocol, messages are enclosed by special characters to form a block. The default start block indicator is the Start Block character (1 byte) (ASCII <VT>, decimal <11>, hex <0B>). The default end block indicator is the End Block character (1 byte) (ASCII <FS>, decimal <28>, hex <1C>) followed by the Carriage Return character (1 byte) (ASCII <CR>, decimal <13>, hex <0D>). Default segment terminator is the Carriage Return character (1 byte) (ASCII <CR>, decimal <13>, hex <0D>). Note: Start and end block indicator and segment terminator are configurable and may be customized on integration with specific IS. Acknowledge messages are built using the same start and end indicators and segment separator as in the messages received from IS. Acknowledge messages may be sent within the same association what the event message is received and may be sent in separate association what is opened specially by DCX 3.1 for sending of acknowledge on listening by IS port. 3.2. Shared Network File Note: batch protocol is not supported. DCX 3.1 works with shared network folder to export and import messages as a file. According to polling interval that is defined during DCX 3.1 configuration, the interface searches for files in the specified shared folder and processes found files. Once processed, the files will be deleted. DCX 3.1 may import several message per file. Messages will be separated by finding of MSH key word by default. Default segment separator is Carriage Return character (1 byte) (ASCII <CR>, decimal <13>, hex <0D>). Note: Message start key word and segment separator are configurable and may be customized on integration with specific IS. Acknowledge messages may be exported to the same shared folder from what the event message was imported and may be exported into other shared folder. Shared folder mode is designed to process the messages from several ASCII files.
Interface Specification Intellispace PACS DCX 3.1 Page 7 of 23 3.3. Messaging Data Flow DCX 3.1 will send an ACK general acknowledgement message which contains the MESSAGE CONTROL ID of the message it received. DCX 3.1 will not send out any application level error messages or any delayed acknowledgement messages. The following response paradigms describe the communication between DCX 3.1 and external information system. If acknowledgment is defined: a) If DCX 3.1 rejects the message for any reason or error occurs during processing, DCX 3.1. Send an error response, providing error information with a value of AE in MSA-1-acknowledgment code and error message in MSA-3-text message b) If the message is parsed and processed successfully, DCX 3.1 generates a functional response message with a value of AA in MSA-1-acknowledgment code. Note: AR acknowledgment code is not used by DCX 3.1.
Interface Specification Intellispace PACS DCX 3.1 Page 8 of 23 4. MESSAGE SPECIFICATION 4.1. Message Definition The message consists of the following elements: The segment level the logical group of data fields, e.g. event of patient visit. The field level the string of characters that defines the specific data element. The component level the part of the field. The subcomponent level the part of the component of the complex field. DCX 3.1 supports encoding rules in the following way: each message consists of data fields that are of variable length and separated by a field separator character. A message is an 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 ADT data from one system to another. A three-character code contained within each message identifies its type. DCX 3.1 does not use message type for determination of message purpose.dcx 3.1 processes messages in accordance to their segment content. For example: messages with MRG segment will invoke patient merge operation within ; data from OBR segment will be populated into database from any message type if the segment exists in the message. Such behavior allows to add/remove supported by DCX 3.1 message (event) types in Mapping Profile. Segments of a message may be required or optional. Required segments must occur. Optional segments may be absent. The segments may be repeated, both required and optional. When fields are transmitted, they are sent as character strings. The DCX 3.1 treats null as an ignoring field value. That means it will not be used to update the PACS database, the old value should remain unchanged. However, the DCX 3.1 will treat an empty string as a valid updated value. That means it will erase the existing value stored in the database. 4.2. Message Delimiters DCX 3.1 uses the delimiters listed in the table below Delimiter Default Value Default Escape Character Field Separator F Component Separator Subcomponent Separator Repetition Separator Escape Character ^ & S T ~ R \ E Data Type Name The value is automatically obtained from MSH-1 field. It is character in third position. The value is automatically obtained from MSH-2 field. It is character in fourth position. The value is automatically obtained from MSH-2 field. It is character in seventh position. The value is automatically obtained from MSH-2 field. It is character in fifth position. The value is automatically obtained from MSH-2 field. It is character in sixth position.
Interface Specification Intellispace PACS DCX 3.1 Page 9 of 23 Field separator is a character that separates two adjacent data fields within a segment. It also separates the segment ID from the first data field in each segment. It is recommended to use as the field separator. The component separator is a character that separates adjacent components of data fields where allowed in event message. It is recommended to use ^ as the component separator. Subcomponent separator is a character that separates adjacent parts of the component of the complex field value in. It is recommended to use & as the subcomponent separator. Repetition separator is a character that informs that field definition will be the same as the previous one, incase when two or more instances of the same field shall be parsed by DCX 3.1. It is recommended to use ~ as the repetition separator. Escape character is used to signal certain special characteristics of portions of the text field. For example, escaped sequence "\H\" indicates that following text shall be highlighted on text displaying. DCX 3.1 uses standard rules for formatting of displaying text. Exclusion is made for escaped characters that may be customized on integration with specific information system. "Escaped" characters are symbols that shall be replaced before text displaying. For example, if field separator is, it cannot be part of text that the text will not be recognized as values of different fields. Escape sequence "\F\" shall be used for representation of " " symbol on text displaying (default value of field separator escaped character is standard value, "F" character). DCX 3.1 will find \F\, parse this combination as field separator and will replace the combination by " " symbol in text. Such usage of escape sequences is relevant also for replacement of other control symbols. 4.3. Supported Messsages DCX 3.1 receives the standard transaction messages from external systems. The standard message types are mapped to static DCX 3.1 internal events. However the received message are processed in accordance to received segments within the message when received values of segment fields update values of mapped fields in DCX 3.1 internal database and corresponding attributes in stored data (DICOM and other structured data). The mapping may be expanded by other standard or proprietary message types using Profile Builder tool. 4.3.1. Patient Related Messages Next messages are mapped to internal PATIENT_UPDATED event in default profile: ADT^A04 - Register a patient ADT^A08 - Update patient information ADT^A28 - Add person information ADT^A31 - Update person information 4.3.2. Merge Patient Messages Next messages are mapped to internal PATIENT_MERGED event in default profile: ADT^A18 - Merge patient information ADT^A30 - Merge person information ADT^A34 - Merge patient information - patient ID only ADT^A36 - Merge patient information - patient ID and account number ADT^A39 - Merge person - patient ID ADT^A40 - Merge patient - patient identifier list ADT^A47 - Change patient identifier list
Interface Specification Intellispace PACS DCX 3.1 Page 10 of 23 4.3.3. Visit Related Messages Next messages are mapped to internal VISIT_UPDATED event in default profile: ADT^A01 - Admit/visit notification ADT^A02 - Transfer a patient ADT^A03 - Discharge/end visit ADT^A05 - Pre-admit a patient ADT^A06 - Change an outpatient to an inpatient ADT^A07 - Change an inpatient to an outpatient ADT^A09 - Patient departing - tracking ADT^A10 - Patient arriving - tracking ADT^A11 - Cancel admit/visit notification ADT^A12 - Cancel transfer ADT^A13 - Cancel discharge/end visit ADT^A14 - Pending admit ADT^A15 - Pending transfer ADT^A16 - Pending discharge ADT^A25 - Cancel pending discharge ADT^A26 - Cancel pending transfer ADT^A27 - Cancel pending admit ADT^A32 - Cancel patient arriving - tracking ADT^A33 - Cancel patient departing tracking ADT^A38 Cancel pre-admit 4.3.4. Order Related Messages Next messages are mapped to internal STUDY_UPDATED event in default profile: ORM^O01 - Order message OMG^O19 - General clinical order OMI^O23 - Imaging order 4.3.5. Observation Related Messages Next messages are mapped to internal REPORT_APPROVED event in default profile: ORU^R01 - Unsolicited transmission of an observation message 4.3.6. Acknoledgement Messages Next messages are sent by DCX 3.1: ACK^xxx General acknowledgement, where 'xxx' event type of message what was sent by IS. 4.4. Supported Messsage Grammars Each message is defined in special notation that lists the segment IDs in the order they would appear in the message. 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. Braces, { }, indicate one or more repetitions of the enclosed group of segments. Of course, the group may contain only a single segment. Brackets, [ ], show that the enclosed group of segments is optional. If a group of segments is optional and may repeat it should be enclosed both in brackets and braces, e.g. [{...}]. The declarations [{ }] and {[...]} are identical. Whenever braces or brackets enclose more than one segment ID a special stylistic convention is used to help the reader understand the hierarchy of repetition.
Interface Specification Intellispace PACS DCX 3.1 Page 11 of 23 Below is the list of messages and segments that are received and processed by DCX 3.1. The mapping between messages and internal DCX 3.1 events is user configurable and defined in Mapping profile. Note: The segments displayed in bold font are required for the message types and shall contain the data. Segments listed in regular font are optional and will be processed and saved in DCX 3.1 only if the data exists for these segments. The segments that are not used by DCX 3.1 default Mapping Profile are not listed. Missing segments and its data will be ignored. Mapping Profile may be customized and missing segments may be used in accordance to newly defined mapping. By Default following mapping is used Message ^ Event types ADT^A04, ADT^A08, ADT^A28, ADT^A31 ADT^A18, ADT^A30, ADT^A34, ADT^A36, ADT^A39, ADT^A40, ADT^A47 ADT^A01, ADT^A02, ADT^A03, ADT^A05, ADT^A06, ADT^A07, ADT^A09, ADT^A10, ADT^A11, ADT^A12, ADT^A13, ADT^A14, ADT^A15, ADT^A16, ADT^A25, ADT^A26, ADT^A27, ADT^A32, ADT^A33, ADT^A38 ORM^O01, OMG^O19, OMI^O23 ORU^R01 ACK^xxx** Supported Grammar MSH PID [PD1] [ARV] [PV1] [AL1] [OBR*] MSH PID [PD1] MRG MSH PID [PD1] [ARV] PV1 [PV2] [AL1] [OBR*] MSH PID [PD1] [ARV] [PV1] [PV2] [AL1] ORC OBR [{OBX}] MSH PID [PD1] [ARV] [PV1] [PV2] [AL1] ORC OBR [{OBX}] MSH MSA Notes: * OBR is not a segment of ADT messages, however some fields in the OBR segment can be mapped to internal patient related attributes, which are part of all ADT and ORM processing. ** 'xxx' event type of message what was sent by IS. 4.5. Supported Attributes The chapter lists attributes that are received and processed by DCX 3.1. The mapping between fields and internal DCX 3.1 attributes is user configurable and defined in Mapping profile. Mapping profile can be customized. The segments and attributes that are not listed here will be used in accordance to newly defined mapping. In describing attributes usage, the following conventions are used: Bold font indicates required fields which must have data value. If such field is missing, contains empty or no value, the segment related entity will not be
Interface Specification Intellispace PACS DCX 3.1 Page 12 of 23 populated in DCX 3.1 database or the whole message will be ignored if required data is missing in Message Control segment or in PID segment. Regular font indicates optional fields for DCX 3.1. The fields that are not listed are not mapped in default Mapping Profile and will be ignored. Repetition of fields is not supported; only first value is used always. Next abbreviations are used: sequence number of field or field component in segment. Number of field and number of its component are separated by dot (e.g. 5.2 second component of fifth field in segment). number of table in standard if it limits valid values for the field. NA not applicable. 4.5.1. MSH- Message Header Segments ELEMENT TABLE Field 1 Field Separator NA E. g. ' ' Encoding 2 Characters NA E.g. '^~\&' 3 Sending Application NA Returned in ACK 4 Sending Facility NA Returned in ACK Receiving 5 Application NA Returned in ACK 6 Receiving Facility NA Returned in ACK Split to two fields. Second Date / Time of Event date 7.1 Event component may represent Message Event time Degree of Precision 9.1 0076 Message Type Study 9.2 0003 Trigger Event NA Protocol Coding Scheme Designator Converted to 'L' (Local coding Scheme for DICOM). See section 5.1.6 for useful values and details Returned in ACK. Converted to DICOM oriented values of Visit Status ID, DICOM (0038,0008). See section 5.1.9 for details 10 Message Control ID NA Returned in ACK 11 Processing ID NA Returned in ACK 12 Version ID NA Returned in ACK 4.5.2. MSA- Message Acknowledgement Segment ELEMENT TABLE Field 1 0008 Acknowledgement Code NA NA 2 Message Control ID NA NA Obtained from MSH.10 3 Text Message NA NA OK for AA acknowledge code or error message
Interface Specification Intellispace PACS DCX 3.1 Page 13 of 23 4.5.3. PID Segment-Patient Information 3.1 ELEMENT TABLE Patient Identifier List Patient 4 Alternate Patient ID Patient Field Patient ID, RIS Patient 5 Patient Name Patient Name 7.1 Date/Time of Birth Patient 8 0001 Sex Patient Sex 9 Patient Alias Patient ID Other Patient ID Date of Birth, Time of Birth Other Patient Names 11 Patient Address Patient Address 13 14 Home Phone Number Business Phone Number Patient Patient Phone number Phone number Used for primary patient matching, Patient ID, DICOM (0010,0020) Used for Other Patient ID, DICOM (0010,1000) Split to Patient's Birth Date, DICOM (0010,0030), and Patient's Birth Time, DICOM (0010.0032). Note: Second component may occur and represent Degree of Precision. Converted to one of DICOM legal values (F, M, O) and used for Patient's Sex, DICOM (0010,0040). See section 5.1.1. Used for Other Patient Names, DICOM (0010,1001). Patient Address, DICOM (0010,1040). Two telephone number source fields are used for Patient s Telephone Numbers attribute with separator '\' (PID.13\PID.14), DICOM (0010,2154) 19 SSN number-patient Patient SSN Social security number 4.5.4. PD1- Patient Demographic Segment ELEMENT TABLE Field 3.1 0223 Living Dependency Patient Comment Conf 4 0136 Protection Indicator Patient Constraint codes are exposed to textual representation of code meaning and stored in Patient, DICOM (0010,4000). See section 5.1.3 Used for Confidentiality Constraint on Patient Data Description, DICOM (0040,3001) and Confidentiality Code, DICOM (0040,1008) 4.5.5. MRG- Merging Segment ELEMENT TABLE Field 1.1 Prior Patient Identifier List Patient Merged Patient ID Used for primary matching of previous patient record. Equals to DICOM (0010,0020)
Interface Specification Intellispace PACS DCX 3.1 Page 14 of 23 4.5.6. ARV- Access Restirctions Segment ELEMENT TABLE Field 5 Special Access Restriction Instructions Patient Conf Constraint Used for Confidentiality Constraint on Patient Data Description, DICOM (0040,3001) and Confidentiality Code, DICOM (0040,1008) 4.5.7. PV1- Patient Visit Information ELEMENT TABLE 2 0004 Patient Class Visit 3 Assigned Patient Location Visit 4 0007 Admission Type Visit 8 0010 Referring Doctor Study 10 0069 Hospital Service Visit 15 0009 Ambulatory Status Patient Field Sched. Patient Institution Residence Current Patient Location Admission Location Referring Physician Patient Institution Residence Pregnancy Status, State, Special Needs 19.1 Visit Number Visit Admission ID 44.1 Admit Date/Time Visit 45.1 Discharge Date/Time Visit Admission Date, Admission Time Discharge Date, Discharge Time Used for Scheduled Patient Institution Residence, DICOM (0038,001E) Used for Current Patient Location, DICOM (0038,0300) Used for Referring Physician s Name, DICOM (0008,0090) Used for Patient s Institution Residence, DICOM (0038,0400) Converted to DICOM oriented values and used for Pregnancy Status, DICOM (0010,21C0), Patient State, DICOM (0038,0500), Special Needs, DICOM (0038,0050).See section 5.1.2 Used for primary visit matching Admission ID, DICOM (0038,0010) Split to Admitting Date, DICOM (0038,0020), and Admitting Time, DICOM (0038,0021). Note: Second component may occur and represent Degree of Precision. Split to Discharge Date, DICOM (0038,0030), and Discharge Time, DICOM (0038,0032). Note: Second component may occur and represent Degree of Precision. 4.5.8. PV2- Patient Visit- Additional Information ELEMENT TABLE 3 Admit Reason Visit Field Admission Diagnose Used for Admitting Diagnoses Description, DICOM (0008,1080)
Interface Specification Intellispace PACS DCX 3.1 Page 15 of 23 8.1 ELEMENT TABLE Expected Admit Date/Time Visit Field Sched. Admission Date, Sched. Admission Time Split to Scheduled Admission Date, DICOM (0038,001A), and Scheduled Admission Time, DICOM (0038, 001B). Note: Second component may occur and represent Degree of Precision. 4.5.9. AL1- Patient Allergy Information Segment 3 ELEMENT TABLE Field Alergy Code/Mnemonic/Descrip Patient Contrast Allergies tion Used for Allergies, DICOM (0010,2110) 4.5.10. ORC- Common Order Segment 2.1 ELEMENT TABLE Placer Order Number Study Field Order Number 5 0038 Order Status Study Study Status 17 Entering Organisation Study Requesting Service Used for Placer Order Number / Procedure, DICOM (0040,1006), Placer Order Number / Imaging Service Request, DICOM (0040,2006), and Placer Order Number / Imaging Service Request, DICOM (0040,2016) Converted to CDP internal values. See section 5.1.5 for useful values. Note: The PACS field may be mapped to ORC.1 Order Control attribute if the specific IS does not send Order Status. In such case incoming value should be converted to CDP internal value using Order_Status_To_Study_Status Conversion table. See section 5.1.4 for details Used for Requesting Service, DICOM (0032,1033) 4.5.11. OBR - Observation Request Segment ELEMENT TABLE Field 1. 3.1 Filler Order Number Study 2. Accession 3. Number 4. Used for study matching, 5. Accession Number, DICOM 6. (0008,0050)
Interface Specification Intellispace PACS DCX 3.1 Page 16 of 23 ELEMENT TABLE Field 11. Used for Code Value, DICOM 4.1 Universal Service ID Study 12. (0008,0100), in Scheduled 7. Study Codes, 13. Protocol Code Sequence, 8. Protocol Code 14. DICOM (0040,0008); 9. Value, 15. Code Value, DICOM 10. Procedure 16. (0008,0100), in Requested Code Value 17. Procedure Code Sequence, DICOM (0032,1064); 33. Used for Study Description, 4.2 Universal Service ID Study 34. DICOM (0008,1030); 18. Study 35. Scheduled Procedure Step 19. Description, 36. Description, DICOM 20. Procedure 37. (0040,0007); Code Meaning, 21. Step 38. DICOM (0008,0104), in 22. Description, 39. Scheduled Protocol Code 23. Protocol Code 40. Sequence, DICOM 24. Meaning, 41. (0040,0008); 25. on 42. on the Scheduled 26. the Scheduled 43. Procedure Step, DICOM 27. Procedure 44. (0040,0400); 28. Step, 45. Requested Procedure 29. Requested 46. Description, DICOM 30. Procedure 47. (0032,1060); 31. Description, 48. Code Meaning, DICOM 32. Requested 49. (0008,0104), in Requested Code Meaning 50. Procedure Code Sequence, DICOM (0032,1064) 52. Completed 8.1 51. Observation End Date/Time Study 53. date, 54. Completed 55. Split to Completed date, Completed time time Patient 57. Used for Medical Alerts, DICOM Medical Alerts (0010,2000) 13 56. Relevant Clinical Info Study 58. Imaging 59. Service 60. Request 61. Used for Imaging Service 62. Request, DICOM (0040,2400) 64. Scheduled 63. 19 Placer Field 2 Study 65. Study 66. Resource 67. May identify scheduled image service resource
Interface Specification Intellispace PACS DCX 3.1 Page 17 of 23 ELEMENT TABLE Field 27.6 Quantity / Timing Study 68. Study Priority 69. Converted to DICOM oriented 70. values. See section 5.1.7 for details 71. 30 0124 72. Transportation 73. Mode 74. Study 75. Patient 76. Transport 77. Arrangement 78. Used for Patient Transport 79. Arrangement, DICOM 80. (0040,1004) 86. Used for Reason for the 81. 31 82. Reason for Study 83. Study 84. Reason for 85. Study 87. Requested Procedure, DICOM 88. (0040,1002) and Reason for the 89. Imaging Service Request, 90. DICOM (0040,2001) 91. 32 92. Principal Result 93. Interpreter 94. Study 95. Reading 96. Physician 97. Used for Name of Physician(s) 98. Reading Study, DICOM 99. (0008,1060) Report 36.1 Scheduled date/time Study Approver Scheduled Study Start Date; Scheduled Study Start Time Split to Scheduled Procedure Step Start Date, DICOM (0040,0002) and Scheduled Procedure Step Start Time, DICOM (0040,0003) 4.5.12. OBX Observation / Result Segment ELEMENT NAME Field 2 0125 Value Type Report Text Format Supported only text format 5 Observation Value Report Report text 11 0085 Observation Result Status Report Report Status 103. Approved Converted to DICOM oriented values. See section 5.1.8 for details 14 100. Date/Time of the 101. Observation 104. Date, 102. Report 105. Approved 106. Time
Interface Specification Intellispace PACS DCX 3.1 Page 18 of 23 5. TO DCX R2.3 DATA VALUES MAPPING 5.1. Default Values Mapping The tables below reflect the default mapping between data values and DICOM oriented values and/orinternal DCX 3.1 data values. The mapping is user-configurable and can be changed by editing default Conversion profile with DCX 3.1 Profile Builder (both default profile and Profile Builder are included to DCX 3.1). 5.1.1. Patient Gender Mapping Source Data Value F M O U A N W Internal DCX 3.1 value (DICOM_Gender) F M O O O O F 5.1.2. Ambulatory Status Mapping Source Data Value Internal DCX 3.1 value Special_Needs Pregnancy A0 No functional limitations 0004 A1 Ambulates with assistive device 0004 A2 Wheelchair/stretcher bound 0004 A3 Comatose; non-responsive 0004 A4 Disoriented 0004 A5 Vision impaired 0004 A6 Hearing impaired 0004 A7 Speech impaired 0004 A8 Non-English speaking 0004 A9 Functional level unknown 0004 B1 Oxygen therapy 0004 B2 Special equipment (tubes, IVs, catheters) 0004 B3 Amputee 0004 B4 Mastectomy 0004 B5 Paraplegic 0004 B6 Pregnant 0003
Interface Specification Intellispace PACS DCX 3.1 Page 19 of 23 5.1.3. Living Dependency Mapping Source Data Value S M C O U Internal DCX 3.1 value (Text) Spouse Dependent Medical Supervision Required Small Children Dependent Other Unknown 5.1.4. Order Control to Study Mapping Source Data Value Internal DCX 3.1 value Procedure Step Status CDP ValueTABLE Description AF SCHEDULED SCHEDULED Order/service refill request approval CA DISCONTINUED DELETED Cancel order/service request CH SCHEDULED SCHEDULED Child order/service CN COMPLETED COMPLETED Combined result CR DISCONTINUED DELETED Canceled as requested DC DISCONTINUED DELETED Discontinue order/service request DE DISCONTINUED DELETED Data errors DF IN PROGRESS SCHEDULED Order/service refill request denied DR DISCONTINUED DELETED Discontinued as requested FU SCHEDULED SCHEDULED Order/service refilled, unsolicited HD SUSPENDED SCHEDULED Hold order request HR SUSPENDED SCHEDULED On hold as requested NA SCHEDULED SCHEDULED Number assigned NW SCHEDULED SCHEDULED New order/service OC DISCONTINUED DELETED Order/service canceled OD DISCONTINUED DELETED Order/service discontinued OE SCHEDULED SCHEDULED Order/service released OF SCHEDULED SCHEDULED Order/service refilled as requested OH SUSPENDED SCHEDULED Order/service held OK READY COMPLETED Order/service accepted & OK OR SCHEDULED SCHEDULED Released as requested PA SCHEDULED SCHEDULED Parent order/service PR SCHEDULED SCHEDULED Previous Results with new order/service RE COMPLETED COMPLETED Observations/Performed Service to follow RF SCHEDULED SCHEDULED Refill order/service request RL SCHEDULED SCHEDULED Release previous hold RO SCHEDULED SCHEDULED Replacement order RP SCHEDULED SCHEDULED Order/service replace request RQ SCHEDULED SCHEDULED Replaced as requested RR SCHEDULED SCHEDULED Request received RU SCHEDULED SCHEDULED Replaced unsolicited SC SCHEDULED SCHEDULED Status changed SN SCHEDULED SCHEDULED Send order/service number SR SCHEDULED SCHEDULED Response to send order/service status request SS SCHEDULED SCHEDULED Send order/service status request UA DISCONTINUED DELETED Unable to accept order/service UC IN PROGRESS SCHEDULED Unable to cancel
Interface Specification Intellispace PACS DCX 3.1 Page 20 of 23 UD IN PROGRESS SCHEDULED Unable to discontinue UF IN PROGRESS SCHEDULED Unable to refill UH IN PROGRESS SCHEDULED Unable to put on hold UM SCHEDULED SCHEDULED Unable to replace UR SCHEDULED SCHEDULED Unable to release UX IN PROGRESS SCHEDULED Unable to change XO SCHEDULED SCHEDULED Change order/service request XR SCHEDULED SCHEDULED Changed as requested XX SCHEDULED SCHEDULED Order/service changed, unsol. 5.1.5. Order Status to Study Mapping Source Data Value Internal DCX 3.1 value Procedure Step Status CDP Value Description A IN PROGRESS SCHEDULED Some, but not all, results available CA DISCONTINUED DELETED Order was canceled CM COMPLETED COMPLETED Order is completed DC DISCONTINUED DELETED Order was discontinued ER DISCONTINUED DELETED Error, order not found HD SUSPENDED SCHEDULED Order is on hold IP IN PROGRESS SCHEDULED In process, unspecified RP DISCONTINUED DELETED Order has been replaced SC SCHEDULED SCHEDULED In process, scheduled 5.1.6. Coding Scheme Designator Mapping Source Data Value ORM OMG OMU Internal DCX 3.1 value (Coding_Scheme_Designator) L L L 5.1.7. Priority Mapping Source Data Value Internal DCX 3.1 value DICOM Value CDP Value S STAT Stat With highest priority A HIGH ASAP Fill after S orders R ROUTINE Routine Default P MEDIUM Preop C MEDIUM Callback T MEDIUM Timing critical PRN LOW As needed
Interface Specification Intellispace PACS DCX 3.1 Page 21 of 23 5.1.8. Observation Result Status Mapping Source Data Value Internal DCX 3.1 value General Purpose Performed Procedure Step Status Comment O SCHEDULED Order received; specimen not yet received I S IN PROGRESS SCHEDULED No results available; specimen received, procedure incomplete No results available; procedure scheduled, but not done A IN PROGRESS Some, but not all, results available P IN PROGRESS C IN PROGRESS Correction to results Preliminary: A verified early result is available, final results not yet obtained R IN PROGRESS Results stored; not yet verified F COMPLETED Final results; results stored and verified. Can only Be changed with a corrected result. X DISCONTINUED No results available; Order canceled. Y DISCONTINUED No order on record for this test. (Used only on queries) Z DISCONTINUED No order on record for this test. (Used only on queries) 5.1.9. Event to Visit Status Mapping Source Data Value Internal DCX 3.1 value Visit Status ID Comment A01 ADMITTED ADT/ACK - Admit/visit notification ADMITTED ADT/ACK - Transfer a patient A02 DISCHARGED ADT/ACK - Discharge/end visit A03 CREATED ADT/ACK - Pre-admit a patient A05 ADMITTED ADT/ACK - Change an outpatient to an inpatient A06 DISCHARGED ADT/ACK - Change an inpatient to an outpatient A07 ADMITTED ADT/ACK - Patient departing - tracking A09 ADMITTED ADT/ACK - Patient arriving - tracking A10 DISCHARGED ADT/ACK - Cancel admit/visit notification A11 ADMITTED ADT/ACK - Cancel transfer A12 ADMITTED ADT/ACK - Cancel discharge/end visit A13 SCHEDULED ADT/ACK - Pending admit A14 ADMITTED ADT/ACK - Pending transfer A15
Interface Specification Intellispace PACS DCX 3.1 Page 22 of 23 A16 A25 A26 A27 A32 A33 A38 ADMITTED ADMITTED ADMITTED DISCHARGED ADMITTED ADMITTED DISCHARGED ADT/ACK - Pending discharge ADT/ACK - Cancel pending discharge ADT/ACK - Cancel pending transfer ADT/ACK - Cancel pending admit ADT/ACK - Cancel patient arriving - tracking ADT/ACK - Cancel patient departing tracking ADT/ACK - Cancel pre-admit
Interface Specification Intellispace PACS DCX 3.1 Page 23 of 23 6. USER CONFIGURABLE OPTIONS DCX 3.1 is configurable regarding the options that are described below. Incoming message general options: o Version (in current version only version 2.x is supported); o IS and DCX 3.1 Application Names (Sending and Receiving Application Names); o IS and DCX 3.1 Facility Names (Sending and Receiving Facility Names); o Flag to send or not sent acknowledgment; o Protocol type (shared folder or TCP/IP) o Used by IS character set; o Mapping and Conversion profiles; o Communication transport settings. The settings depend on transport type and include: For TCP/IP Socket Low Level Protocol (Message exchange type): Listening port for incoming messages; IP Address of IS; Acknowledge sending mode (if the sending is defined): - in the same association what the event message is received; - in separate association what is opened specially (in this mode listening by IS port should be defined). Shared Network File (Shared folder mode): Full path of shared folder for incoming messages; Polling timeout; Full path of shared folder for outgoing messages (Acknowledges, if responding is defined); User credentials for access to shared folders (if it is needed). DCX 3.1 includes Profile Builder tool to create RIS parsing, mapping and conversion profiles. Parsing profile is a set of rules for DCX 3.1 to separate field names, field values and other components of RIS event in the flow of data. Parsing profile contains the following configurable options: o TCP/IP message markers (hexadecimal codes of symbols that inform about start and end of RIS message); o Header segment string (a combination of symbols that will identify the beginning of event message); o Message control characters: Segment Terminator; Field Separator; Component Separator; Subcomponent Separator; Repetition Separator; Escape Character; o Permanent and temporary Patient ID recognition rules (prefixes and/or suffixes for Patient ID that will allow conversion of IS permanent and temporary Patient IDs to DICOM oriented Patient IDs while parsing incoming RIS message). Mapping profile is a set of tables for the mapping between RIS and internal DCX 3.1 events and properties. It contains user configurable: o Event type field (the field that is included to the data section and contains event type string); o Event type field mapping table (e.g. mapping between internal event o PATIENT_UPDATED and events A04, A08, A28 and A31); Properties mapping table (mapping between entity property in the DCX 3.1 and the field in the incoming RIS message, e.g. internal property Patient ID conforms to PID.3.1 property of RIS message). Conversion profile is a set of tables for mapping DICOM oriented DCX 3.1 internal field values and RIS event field values. DCX 3.1 substitutes incoming oriented values for internal DCX 3.1 DICOM oriented values from conversion table if conversion table is used for mapping DCX 3.1 configurable properties.