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HL7 Interface

Specification
HL7 Interface 1.2
May 2004

HL7 Interface 1.2


Specification

TABLE OF CONTENTS

INTRODUCTION ............................................................................................................. 3
1.1

Purpose...................................................................................................................................................3

1.2

Related Documents................................................................................................................................3

IMPLEMENTATION ........................................................................................................ 4

COMMUNICATION PROFILE ........................................................................................ 5

HL7 IMPLEMENTATION ................................................................................................ 6


4.1

Version ....................................................................................................................................................6

4.2

Message Delimiters................................................................................................................................6

4.3

Processing Rules ...................................................................................................................................7

4.4

Original Acknowledgement Mode.........................................................................................................8

4.4.1

Rejection Messages ......................................................................................................................9

4.4.2

Error Messages .............................................................................................................................9

HL7 MESSAGES .......................................................................................................... 10


5.1

5.2

Patient Update ......................................................................................................................................11


5.1.1

ADT^A08 update patient information ......................................................................................11

5.1.2

ADT^A40 merge patient - patient identifier list ........................................................................13

Procedure Scheduled ..........................................................................................................................16


5.2.1

5.3

Procedure Update ................................................................................................................................20


5.3.1

ORM^O01 general order message .........................................................................................16

ORM ^O01 general order message ........................................................................................20

1 Introduction
1.1 Purpose
This document describes the HL7 Interface v. 1.2 based on the IHE Year 3 Technical
Framework.

1.2 Related Documents


The following documents are related to the HL7 Interface 1.2 Specification document:

NEMA 2003, The DICOM Standard: Parts 1 14.

Integrated Healthcare Enterprise (IHE) Technical Framework Year 3, revision 5.5 dated
November 20, 2003. This document is available at: http://www.rsna.org/IHE.

HL 7 Standard version 2.3.1. This document is available at: http://www.hl7.org

2 Implementation
HL7 Interface 1.2 is implemented as a single application entity. Its main functionality is to
facilitate HIS/RIS/PACS integration by converting HL7 messages to DICOM Data Sets. The
interface implementation is in accordance with IHE Year 3 Technical Framework.
The HL7 Interface 1.2 handles Procedure Scheduled, Patient Update and Procedure Update
IHE-defined transactions from HIS/RIS and updates the necessary Emageon-UV products
accordingly. Table 2.1 summarizes supported IHE transactions and their corresponding HL7
messages.
Table 2.1 Supported IHE Transactions
IHE Transactions

HL7 Messages

Procedure Scheduled

ORM^O01 (general order message)

Patient Update

ADT^A08 (update patient information)


ADT^A40 (merge patient - patient identifier list)

Procedure Update

ORM^O01 (general order message)

The HL7 Interface 1.2 is administered with a remote administrative application.

3 Communication Profile
HL7 v. 2.3.1 recommends Minimal Lower Layer Protocol (LLP) to provide an interface
between the HL7 application and the network. Lower Layer Protocol is any protocol residing
in OSI layers one to four. These protocols package, route, verify, and transmit datagrams. A
prime example of one of the protocols is TCP/IP. HL7 Interface 1.2 implements TCP/IP
Minimal LLP and operates in a TCP/ IP network environment.
HL7 messages should conform to the HL7 Minimal LLP block format as follows:

HL7 message starts with 0x0B and ends with 0x1C and 0x0D.

Each HL7 segment is terminated by 0x0D.

4 HL7 Implementation
4.1 Version
HL7 Interface 1.2 supports HL7 version 2.3.1 as specified by IHE Year 3 Technical
Framework.

4.2 Message Delimiters


HL7 Interface 1.2 uses the delimiter values in Table 4.1 as specified by IHE Year 3 Technical
Framework.
Table 4.1 Delimiter Values

Delimiter

Value

Segment Terminator

<cr>

Field Separator

Component Separator

Subcomponent Separator

&

Repetition Separator

Escape Character

4.3 Processing Rules


HL7 Interface 1.2 implements Original Acknowledge Mode. Upon receiving an HL7 message,
HL7 Interface 1.2 implements original acknowledgment rules as follows:
1. Accepts the message.
2. Validates it against the following criteria, in addition to Message Delimiters:
Field

IHE Notes

MSH-3-sending application

Namespace ID is the only sub component used


in HD data type. This field is required.

MSH-4-sending facility

Namespace ID is the only sub component used


in HD data type. This field is required.

MSH-5-receiving application

Namespace ID is the only sub component used


in HD data type. This field is required.

MSH-6-receiving facility

Namespace ID is the only sub component used


in HD data type. This field is required.

MSH-9-message type

As defined by HL7 v2.3.1. This field is required.

MSH-10-message control ID

Unique identifier used to relate the response to


the initial message. This field is required.

MSH-11-processing ID

The value should be the literal P.

MSH-12-version ID

The value should be the literal 2.3.1. This field is


required.

If any of these fields fail, the HL7 Interface 1.2 generates a reject message with AR in
MSA-1-acknowledgment code.
3. If the message passes validation, HL7 Interface 1.2 maps the message to DICOM Data
Set and sends it to the necessary Emageon-UV products. The next action of the HL7
Interface 1.2 is conditional based on one of the following scenarios:

If mapping the message and sending a Data Set to Emageon products passes, HL7
Interface 1.2 generates a successful response with AA in MSA-1-acknowledgment
code.

If mapping the message and sending a Data Set to Emageon products fails due to
error in the message content or format, HL7 Interface 1.2 generates an error
message with AE in MSA-1-acknowledgment code.

If an unexpected error happens during this process that is not related to the
message content or format (e.g., hard disk out of space), HL7 Interface 1.2
generates a reject message with AR in MSA-1-acknowledgment code.

4. HL7 Interface 1.2 sends an ACK message to the initiator.

4.4 Original Acknowledgement Mode


In all responses described above, HL7 Interface 1.2 implements the following
acknowledgement message grammar:
ACK

General Acknowledgement

HL7 v. 2.3.1 Chapter

MSH

Message Header

MSA

Message Acknowledgement

With the following fields value:


MSH Segment

SEQ

Element Name

Value

Field Separator

Encoding Characters

^~\&

Sending Application

MSH-5 Receiving Application from received


message.

Sending Facility

MSH-6 Receiving Facility from received


message.

Receiving Application

MSH-3 Sending Application from received


message.

Receiving Facility

MSH-4 Sending Application from received


message.

Date/Time Of Message

Time stamp when the message is sent

Message Type

Event: ACK
Type: Message Type of the received message.

10

Message Control ID

Same value from the received message.

11

Processing ID

12

Version ID

2.3.1

MSA Segment
SEQ

Element Name

Item #

Acknowledgment Code

Possible values: AA, AE, AR

Message Control ID

MSH-10 Message Control ID from the received


message.

Text Message

Error description, if any

4.4.1 Rejection Messages


Rejection messages usually result from an unexpected exception, so the server logs a
comprehensive message detailing the reason of rejection. Due to the nature of the exception,
it is inadequate to send it in the MSA-3 Text Message. Instead, a descriptive message will be
sent. The interface log should be consulted for full details.

4.4.2 Error Messages


Error messages usually result from message format or context. An MSA-3 Text Message will
have a detailed description of the error.

5 HL7 Messages
HL7 messages related to HL7 Interface 1.2 are mentioned in Section 4 - Implementation.
This section depicts each message grammar based on IHE Year 3 Technical Framework,
describes required fields and HL7 fields to DICOM data elements mapping. An ACK
message is sent to the initiator upon receiving any of these messages. Since a MSH
segment is common to all messages, it will not be provided in the messages semantics.
Segment fields required by IHE Year 3 Technical Framework will not be provided in this
document. Since the interface required fields are a subset of IHE Year 3 Technical
Framework, this document only discusses fields related to the interface. HL7 messages are
grouped based on IHE Transaction naming convention.
In describing messages semantics, the following conventions are used:

Position (sequence within the segment) - Position of the data field within the segment. In
the message semantics tables this information is provided in the column labeled SEQ.

Optionality - Whether the field is required, or optional, the designations are:


R - Required.
O - Optional.
In the message semantics tables, this information is provided in the column labeled OPT.

Repetition - Whether the field may repeat. The designations are:


Empty - No repetition.
Y - The field may repeat an indefinite (or site-determined) number of times.
In the message semantics tables, this information is provided in the column labeled
RP/#.

Value - The value, which is mapped to DICOM data element, is one of the following:
<number> - The number indicates the field SEQ. It means the entire field is mapped into
DICOM data element.
<number.number> - The first part indicated the fields SEQ and the second indicate the
component within that SEQ. For example to refer to a patient last name within a patient
name in the PID segment: 5.1.

10

5.1 Patient Update


5.1.1

ADT^A08 update patient information


Message Grammar

11

ADT

ADT Message

HL7 v. 2.3.1 Chapter #

MSH

Message Header

EVN

Event Type

PID

Patient Identification

PV1

Patient Visit

[ {OBX} ]

Observation/Result

[ {AL1} ]

Allergy Information

ADT^A08 Message Semantics


Segment

SEQ

OPT
IHE/ Archive

EVN

R/O

PID

R/R

PV1

12

RP/#

HL7
Data Type

HL7
Element Name

TS

Recorded Date/Time

CX

Patient Identifier List

(0010, 0020) Patient ID (LO) = 3.1


(0010, 0021) Issuer of Patient ID (LO) = 3.4
(0010, 1000) Other Patient ID (LO) = 3.1 repetition

R/R

XPN

Patient Name

(0010, 0010) Patient Name (PN) = 5

O/O

XPN

Mothers Maiden Name

(0010, 1060) Mother Birth Name (PN) = 6

O/O

TS

Date/Time of Birth

(0010, 0030) Patient Birth Date (DA) = 7 (date part)


(0010, 0032) Patient Birth Date (TM) = 7 (time part)

O/O

IS

Sex

(0010, 0040) Patient Sex (CS) = 8

10

O/O

CE

Race

(0010, 2160) Patient Ethnic Group (SH) = 10

11

O/O

XAD

Patient Address

(0010, 1040) Patient Address (LO) = 11

18

R/O

CX

Patient Account
Number

(0038, 0010) Admission ID (LO) = 18.1


(0038, 0011) Issuer of Admission ID (LO) = 18.4

26

O/O

CE

Citizenship

(0010, 2152) Region of residence (LO) = 26

27

O/O

CE

Veterans Military Status

(0010, 1080) Military Rank (LO) = 27

O/O

PL

Assigned Patient
Location

(0038, 0300) Current Patient Location (LO) = 3

O/O

XCN

Referring Doctor

(0008, 0090) Referring Physicians Name (PN) = 8

15

O/O

IS

Ambulatory Status

(0010, 21c0) Pregnancy Status (US) = 15, if equal to B6

16

O/O

IS

VIP Indicator

(0040, 3001) Confidentiality Constrain on Patient Date (LO) = 16

DICOM Data Element


(group, element) Name (VR) = Value

OBX

AL1

5.1.2

R/O

CE

Observation Identifier

3.2 = Body Weight or Body Height

R/O

CE

Observation Value

(0010, 1030) Patient Weight (DS) = 5; if OBX:3.2 = Body Weight &


OBX:6.2 = kg
(0010, 2010) Patient Size (DS) = 5; If OBX:3.2 = Body Height &
OBX:6.2 = m

R/O

CE

Units

6.2 =kg for Body Weight or m for Body Height

R/O

CE

Allergy Code/
Mnemonic/ Description

(0010, 2110) Contrast Allergies (LO) = 3

ADT^A40 merge patient - patient identifier list


Message Grammar

13

ADT

ADT Message

HL7 v. 2.3.1 Chapter #

MSH

Message Header

EVN

Event Type

PID

Patient Identification

MRG

Merge Information

[ PV1 ]

Patient Visit

ADT^A40 Message Semantics


Segment

SEQ

OPT
IHE/ Archive

EVN

R/O

PID

R/R

PV1

14

RP/#

HL7
Data Type

HL7
Element Name

TS

Recorded Date/Time

CX

Patient Identifier List

(0010, 0020) Patient ID (LO) = 3.1


(0010, 0021) Issuer of Patient ID (LO) = 3.4
(0010, 1000) Other Patient ID (LO) = 3.1 repetition

R/R

XPN

Patient Name

(0010, 0010) Patient Name (PN) = 5

O/O

XPN

Mothers Maiden Name

(0010, 1060) Mother Birth Name (PN) = 6

O/O

TS

Date/Time of Birth

(0010, 0030) Patient Birth Date (DA) = 7 (date part)


(0010, 0032) Patient Birth Date (TM) = 7 (time part)

O/O

IS

Sex

(0010, 0040) Patient Sex (CS) = 8

10

O/O

CE

Race

(0010, 2160) Patient Ethnic Group (SH) = 10

11

O/O

XAD

Patient Address

(0010, 1040) Patient Address (LO) = 11

18

R/O

CX

Patient Account Number

(0038, 0010) Admission ID (LO) = 18.1


(0038, 0011) Issuer of Admission ID (LO) = 18.4

26

O/O

CE

Citizenship

(0010, 2152) Region of residence (LO) = 26

27

O/O

CE

Veterans Military Status

(0010, 1080) Military Rank (LO) = 27

R/O

PL

Assigned Patient Location

(0038, 0300) Current Patient Location (LO) = 3

O/O

XCN

Referring Doctor

(0008, 0090) Referring Physicians Name (PN) = 8

15

O/O

IS

Ambulatory Status

(0010, 21c0) Pregnancy Status (US) = 15, if equal to B6

16

O/O

IS

VIP Indicator

(0040, 3001) Confidentiality Constrain on Patient Date (LO) = 16

DICOM Data Element


(group, element) Name (VR) = Value

15

Segment

SEQ

OPT
IHE/ Archive

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

MRG

R/R

CX

Prior Patient Identifier List


(Internal)

(0010, 0020) Patient ID = 1.1


(0010, 0021) Issuer of Patient ID = 1.4

O/R

CX

Prior Patient ID (External)

(0010, 0020) Patient ID = 3.1


(0010, 0021) Issuer if Patient ID = 3.4

5.2 Procedure Scheduled


5.2.1

ORM^O01 general order message


Message Grammar
ADT

ADT Message

HL7 v. 2.3.1 Chapter #

MSH

Message Header

PID

Patient Identification

PV1

Patient Visit

ORC

Common Order

OBR

Order Detail

ORM^O01 Message Semantics

16

Segment

SEQ

OPT
IHE/ Archive

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

PID

R/R

CX

Patient Identifier List

(0010, 0020) Patient ID (LO) = 3.1


(0010, 0021) Issuer of Patient ID (LO) = 3.4
(0010, 1000) Other Patient ID (LO) = 3.1 repetition

R/R

XPN

Patient Name

(0010, 0010) Patient Name (PN) = 5

O/O

XPN

Mothers Maiden Name

(0010, 1060) Mother Birth Name (PN) = 6

Segment

PV1

ORC

17

SEQ

OPT
IHE/ Archive

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

R/`R

TS

Date/Time of Birth

(0010, 0030) Patient Birth Date (DA) = 7 (date part)


(0010, 0032) Patient Birth Date (TM) = 7 (time part)

R/R

IS

Sex

(0010, 0040) Patient Sex (CS) = 8

10

O/O

CE

Race

(0010, 2160) Patient Ethnic Group (SH) = 10

11

O/O

XAD

Patient Address

(0010, 1040) Patient Address (LO) = 11

18

R/O

CX

Patient Account Number

(0038, 0010) Admission ID (LO) = 18.1


(0038, 0011) Issuer of Admission ID (LO) = 18.4

26

O/O

CE

Citizenship

(0010, 2152) Region of residence (LO) = 26

27

O/O

CE

Veterans Military Status

(0010, 1080) Military Rank (LO) = 27

R/O

PL

Assigned Patient Location

(0038, 0300) Current Patient Location (LO) = 3

O/O

XCN

Referring Doctor

(0008, 0090) Referring Physicians Name (PN) = 8

15

O/O

IS

Ambulatory Status

(0010, 21c0) Pregnancy Status (US) = 3, if 15 equal to B6

16

O/O

IS

VIP Indicator

(0040, 3001) Confidentiality Constrain on Patient Date (LO) = 16

R/R

ID

Order Control = NW

Segment

SEQ

OPT
IHE/ Archive

OBR

SCH

18

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

R/O

CE

Universal Service ID

(0032, 1064) Requested Procedure Coding Sequence (SQ):


>(0008, 0100) Requested Procedure Code Value (SH) = 4.1
>(0008, 0104) Requested Procedure Code Meaning (LO)= 4.2
>(0008, 0102) Requested Procedure Coding Scheme (SH)= 4.3
(0040, 0100) Scheduled Procedure Step Sequence (SQ)
>(0040, 0008) Scheduled Protocol Code Sequence
>>(0008, 0100) Scheduled Procedure Code value (SH)= 4.4
>>(0008, 0104) Scheduled Procedure Code Meaning (LO) = 4.5
>>(0008, 0102) Scheduled Procedure Coding Scheme (SH)= 4.6
(0040, 0007) Scheduled Procedure Description (LO)= 4.5

15

O/O

CM

Specimen Source

(0032, 1060) Requested Procedure Description (LO)= 4.2 + 15.5

18

O/O

ST

Placer Field 1

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0008, 0050) Accession Number (SH) = 15

19

O/O

ST

Placer Field 2

(0040, 1001) Requested Procedure ID (SH) = 19

20

O/O

ST

Filler Field 1 +

(0040, 0009) Scheduled Requested Procedure ID (SH) = 20

24

O/O

ID

Diagnostic Serv Sect ID

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0008, 0060) Modality (CS) = 24

27

O/O

TS

Quantity/Timing

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0040, 0002) Scheduled Procedure Start Date (DA) = 27.4
(date part)
>(0040, 0003) Scheduled Procedure Start Time (TM) = 27.4
(time part)

11

R/O

TQ

Appointment Timing
Quantity

(0008, 0020) Appointment Start Date (DA) = 11.4 (date part)


(0008, 0030) Appointment Start Time (TM) = 11.4 (time part)

19

Segment

SEQ

OPT
IHE/ Archive

ZDS

R/R

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

RP

Study Instance UID

(0020, 000D) Study Instance UID (UI) = 1.1

5.3 Procedure Update


5.3.1

ORM ^O01 general order message


Message Grammar
ADT

ADT Message

HL7 v. 2.3.1 Chapter #

MSH

Message Header

PID

Patient Identification

PV1

Patient Visit

ORC

Common Order

OBR

Order Detail

ORM^O01 Message Semantics

20

Segment

SEQ

OPT
IHE/ Archive

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

PID

R/R

CX

Patient Identifier List

(0010, 0020) Patient ID (LO) = 3.1


(0010, 0021) Issuer of Patient ID (LO) = 3.4
(0010, 1000) Other Patient ID (LO) = 3.1 repetition

R/R

XPN

Patient Name

(0010, 0010) Patient Name (PN) = 5

O/O

XPN

Mothers Maiden Name

(0010, 1060) Mother Birth Name (PN) = 6

Segment

PV1

ORC

21

SEQ

OPT
IHE/ Archive

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

R/R

TS

Date/Time of Birth

(0010, 0030) Patient Birth Date (DA) = 7 (date part)


(0010, 0032) Patient Birth Date (TM) = 7 (time part)

R/R

IS

Sex

(0010, 0040) Patient Sex (CS) = 8

10

O/O

CE

Race

(0010, 2160) Patient Ethnic Group (SH) = 10

11

O/O

XAD

Patient Address

(0010, 1040) Patient Address (LO) = 11

18

R/O

CX

Patient Account Number

(0038, 0010) Admission ID (LO) = 18.1


(0038, 0011) Issuer of Admission ID (LO) = 18.4

26

O/O

CE

Citizenship

(0010, 2152) Region of residence (LO) = 26

27

O/O

CE

Veterans Military Status

(0010, 1080) Military Rank (LO) = 27

R/O

PL

Assigned Patient Location

(0038, 0300) Current Patient Location (LO) = 3

O/O

XCN

Referring Doctor

(0008, 0090) Referring Physicians Name (PN) = 8

15

O/O

IS

Ambulatory Status

(0010, 21c0) Pregnancy Status (US) = 3, if 15 equal to B6

16

O/O

IS

VIP Indicator

(0040, 3001) Confidentiality Constrain on Patient Date (LO) = 16

R/R

ID

Order Control = DC, CA,


XO

Segment

SEQ

OPT
IHE/ Archive

OBR

ZDS

22

RP/#

HL7
Data Type

HL7
Element Name

DICOM Data Element


(group, element) Name (VR) = Value

R/O

CE

Universal Service ID

(0032, 1064) Requested Procedure Coding Sequence (SQ):


>(0008, 0100) Requested Procedure Code Value (SH) = 4.1
>(0008, 0104) Requested Procedure Code Meaning (LO)= 4.2
>(0008, 0102) Requested Procedure Coding Scheme (SH)= 4.3
(0040, 0100) Scheduled Procedure Step Sequence (SQ)
>(0040, 0008) Scheduled Protocol Code Sequence
>>(0008, 0100) Scheduled Procedure Code value (SH)= 4.4
>>(0008, 0104) Scheduled Procedure Code Meaning (LO) = 4.5
>>(0008, 0102) Scheduled Procedure Coding Scheme (SH)= 4.6
(0040, 0007) Scheduled Procedure Description (LO)= 4.5

15

O/O

CM

Specimen Source

(0032, 1060) Requested Procedure Description (LO)= 4.2 + 15.5

18

O/O

ST

Placer Field 1

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0008, 0050) Accession Number (SH) = 15

19

O/O

ST

Placer Field 2

(0040, 1001) Requested Procedure ID (SH) = 19

20

O/O

ST

Filler Field 1 +

(0040, 0009) Scheduled Requested Procedure ID (SH) = 20

24

O/O

ID

Diagnostic Serv Sect ID

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0008, 0060) Modality (CS) = 24

27

O/O

TS

Quantity/Timing

(0040, 0100) Scheduled Procedure Step Sequence (SQ)


>(0040, 0002) Scheduled Procedure Start Date (DA) = 27.4
(date part)
>(0040, 0003) Scheduled Procedure Start Time (TM) = 27.4
(time part)

R/R

RP

Study Instance UID

(0020, 000D) Study Instance UID (UI) = 1.1

23