HL7 Interfacing Presented By: David Hathaway

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HL7 InterfacingPresented By David Hathaway
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A Very Brief History of HL7

• HL7 Health Level 7
• Founded in 1987-
• 2.0 was created in 1988
• 2.1 -gt2.3 1990-1999

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Why it works

• Broad functionality used by many languages
• Highly adaptable - least common denominator
  technology
• Allows many different types of systems to
  communicate via a base format

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Whats the Message

• Messages are the base format used for all HL7
  communication
• Broken by a delimiter for each field
• Each message is divided by Segments
• These Segments contain fields in predetermined
  locations to be sent/received by the parties.

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Types of Messages

• There are several types of messages that can be
  sent to and from data sources.
• The two most common are
• ORU Tells the receiving system that the data
  is result based, such as RAD Reports
• ORM Tells the receiving system that the data is
  order based, such as RAD Orders

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Segments

• Each line in a message is referred to as a
  Segment.
• Each Segment has its own semantic purpose or
  function
• There are over 120 types of Segments that can be
  used.
• Each Segment provides a specific type of data to
  be sent.

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Types of Segments

• MSH - Message Header. This contains information
  about the Sender and Receiver of the message, the
  type of message, time stamps, etc.
• EVN Message Event. This contains information
  about the type of event. Example would be A04,
  and other basic type of the activity or
  transaction

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Types of Segments

• PID contains demographic information about the
  patient like name, date of birth, account number
• PV1 contains information regarding the
  patients stay in the hospital, such as location,
  room, bed, doctor information
• THE ABOVE ARE REQUIRED SEGMENTS FOR MOST HL7
  MESSAGES

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Repeating Segments

• Some segments such as OBX, NTE, NK1, or AL1 can
  be repeating.
• An example is the NK1 segment which shows the
  next of kin/associated parties will repeat
  several times if a person has several next of kin
  relationships

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(No Transcript)
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Sample of Repeating Segments
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Composites

• Composites are the specific fields of a segment.
  The fields can be either a primitive data type
  such as a string number, alpha or alphanumeric or
  it can be made up of other composites
  (components). The components of each composite
  are separated by a character and then
  sub-components of these components themselves can
  be delimited using the character.

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Delimiters

• - FIELD DELIMITER
• - SUB FIELD DELIMITER
• - SUB-SUB FIELD DELIMITER
• - SEPERATOR FOR REPEATING FIELDS
• \- ESCAPE CHARACTER

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Sample of fields
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ACK

• Every time an application accepts a message and
  processes the data it sends an Acknowledgement
  back to the sending application. The important
  part of an ACK is that it means the other systems
  has not only received but processed the message
  that was sent.
• A NACK is an ACK that contains an error in that
  is sent back to the sending application.

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Sample ACK
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Questions ????
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Outbound Vs Inbound

• There is no true definition of what can be
  considered Outbound or Inbound
• The important factor is understanding what the
  main focus is.
• In this case it is Meditech.
• So all data being passed from Meditech to another
  Vendor is called Outbound and all data being
  passed into Meditech is called Inbound

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What is NMI

• NMI stands for Non-Meditech Interface Module.
• It is also called Interoperability.
• The basic function of this module is to provide
  users with the ability to understand and monitor
  data being passed to/from Meditech to/from other
  Vendors.

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Connection Manager

• The connection Manager is actually a collection
  of standard NMI routines that are based in one
  location.
• This allows a user to access multiple sources of
  information in one location for both Inbound and
  Outbound interfaces.

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How this HL7 Looks in NMI

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Connection Manager

• Possible views that can be accessed from this
  routine
• Interface mnemonic and description
• Last message sent with date/time
• First message sent with date/time
• Current status of the Interface

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Connection Manager

• The Connection Manager also allows a user to
  drill down into a specific interface to see data
  related to that current feed.
• There is a verb strip at the top of the routine
  that will allow a user to perform actions that
  produce different results

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Connection Manager
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Connection Manager Verb Strip

• Off turn off currently selected feed
• Restart Toggle currently selected feed
• Messages drills down into the actual messages
  being sent from the feed. This will allow the
  user to see the actual HL7 message.
• Xfer Log activity log for selected feed.
  Provides information such as date/time start or
  stopped, number of messages, etc.

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Connection Manager Verb Strip

• Trap Commands This allows the system to capture
  any messages or errors sent to and from the feed.
• This is a hidden function that is provided but
  not shown on the verb strip.
• This is a very useful tool to see what is
  happening to the feed at a specific point.

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Example of Verb Strip
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Trap Commands

• To execute any of these Trap Commands a user must
  type the following at the command prompt in the
  connection manager
• ST Turn on Trap. User will be prompted with Y/N
  to confirm.
• VT Print trap data file
• DT Delete trap data

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Trap Commands

• Users should consider that since a trap of any
  interface is going to store ALL activity, these
  files may become very large. It is a good idea to
  delete any trap files once they have been used.
• A Green flag will appear on the second line of
  the feed to alert all users that a trap is
  running.

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Trap Commands
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View Paths

• This allows the users to drill down into the
  actual Inbound/Outbound level of the interface.
• Outbound Meditech -gt to other Vendor system
• Inbound Other vendor -gt to Meditech system

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View Paths
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Verb Strip for View Paths

• There are several commands off of this routine
  that will allow users to see a wealth of
  interface data.
• The most relevant is the Msgs command. (which is
  equivalent to the view messages routine off of
  the main menu).

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View Messages
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View Messages

• This routine allows you to perform an F9 lookup
  and see all of the recent activity that has
  occurred for that interface.
• Once a selection is made the view will then
  change to the actual message that was either sent
  or received by NMI.
• Note This is the actual HL7 formatted message.

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View Messages
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Useful Routines

• The Connection Manager is the best routine to see
  what the current state of any interface is at a
  given time.
• With all of the functions provided, any user can
  troubleshoot the connection, stability, message
  format and other very useful actions with this
  one routine.

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Useful Routines

• There are many other routines that will help
  expand on the users ability to troubleshoot any
  NMI feed.
• A very good sub-menu to utilize is the Additional
  List Menu.
• This menu offers a number of searches so that a
  user can find messages for specific patients or
  get very detailed data on a specific message.

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Other Routines in NMI
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Additional Routine

• Under this sub menu there are several search
  routines offered.
• List messages by Account Number
• List messages by Unit Number
• List messages by Other Field
• All of these searches work off the same basic
  principle.

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Additional Routines

• Each will loop through the message for a specific
  piece of data, it could be account number, unit
  number or a user defined field.
• A good part of this is to consider that since the
  HL7 format places these fields in specific
  locations the routine is able to check one spot
  on each message under the feed to find the data.

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Example of a Search Routine
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HL7 Message Detail

• This is one of the better routines that a user
  can use to see the actual HL7 process and data.
• It lists the detail of any HL7 message
• This includes interface name, mnemonic, message
  number, message type, if there was an ACK or
  NACK, segments, fields and any raw data in the
  message.

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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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HL7 Message Detail
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Summary

• As you can see from the HL7 Message Detail
  routine, the HL7 format is a means for both sides
  to communicate.
• This allows for users to troubleshoot issues as
  long as they understand where to look for each
  specific piece of data.

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Questions ????