HL7 Lab Interface Specifications for SOAPwareXchangeHL7

SOAPwareXchangeHL7 is the interface module allowing HL7-compliant interfaces between the SOAPware® charting product and other HL7-compliant systems.This document describes the specific manner in which HL7 is implemented in SOAPwareXchangeHL7, and how the various standard fields will be used.

SOAPwareXchangeHL7 accepts HL7-compliant messages from other systems, and uses them to create formatted reports in the Reports section of the appropriate SOAPware® chart.If the patient described in the PID section of the HL7 message cannot be matched, it will be added to a queue for the SOAPware user to handle.SOAPwareXchangeHL7 uses the matching algorithm below to determine if a patient already exists in SOAPware®:

An incoming record will be considered to be a match to a SOAPware® patient if:

External ID is found in patient map, AND

Birthdate matches, OR

Last name matches

OR

Social Security numbers match, AND

Birthdate matches, AND

Last name matches, AND

First name matches

OR

First name and Last name matches, AND

Birthdate matches, AND

Sex matches

So a match can be made on

First Name AND Last Name AND Birthdate

AND

Sex OR Social Security Number

SOAPwareXchangeHL7 supports file-based or TCP-based interfaces.A file based interface will consist of the interfacing system, or system user, depositing HL7 messages in a specified location on the SOAPwareXchangeHL7 machine.SOAPwareXchangeHL7 will then retrieve and parse these messages.When the messages have been parsed, SOAPwareXchangeHL7 will remove them.

A TCP based interface will require a TCP connection between SOAPwareXchangeHL7 and the sending system.SOAPwareXchangeHL7 will listen for incoming messages, and parse them as they arrive.SOAPwareXchangeHL7 will always return an ACK messages for TCP messages received.

If other communication methods are required, such as dial-up file transfers, the SOAPware®, Inc. programming team can evaluate the possibility of creating a transfer program for an additional fee.

At this time all HL7 interfaces implemented with SOAPwareXchangeHL7 will be results-only.Bi-directional interfaces are being evaluated for future implementation.Because of this, SOAPwareXchangeHL7 only processes results messages (ORU).A standard ORU message would follow this format:

MSH

PID

{

ORC

{[NTE]}

OBR

{[NTE]}

{

OBX

{[NTE]}

}

}

Each segment below in RED is a required segment according to a standard ORU message and is required for any SOAPwareXchangeHL7 interface. 

BOLDED fields are required in each segment. 

Each PID segment requires a unique MSH segment.

The NTE segment can contain any additional information not encoded in the OBX segment.Usually the NTE segment will contain some combination of the following items: text results, canned messages, or result comments.The following section lists all of the segments potentially used in result messages.Fields in boldface are required, all others are optional.Segments not listed in this document may be sent to SOAPwareXchangeHL7, but will be ignored.Fields not listed in these tables may be included at the end of the segment, but will be ignored.

 

 

Segment Descriptions

 

 

 

 

 

The MSH (Message Header) Segment

 

   

MSH-1	Segment Type ID (‘MSH’)
MSH-2	Field Delimiter (‘|’) Component Delimiter (sub-subfield) (‘ ^ ‘) Repeat Delimiter (subfield) ('~') Escape character ('\') Sub-component delimiter ('&')
MSH-3	Sending Application
MSH-4	Sending Facility
MSH-5	Receiving Application
MSH-6	Receiving Facility
MSH-7	Date/Time of Message (YYYYMMDDHHMM)
MSH-8	Security
MSH-9	Message Type
MSH-10	Message Control ID
MSH-11
MSH-12	Version ‘2.1’=Release 2.1 ‘2.2’=Release 2.2
MSH-13	Sequence Number
MSH-14	Continuation Pointer
MSH-15	Accept Acknowledgment Type
MSH-16	Application Acknowledgment Type
MSH-17	Country Code

The Sending Application value in MSH-3 is used by SOAPwareXchangeHL7 to determine the source of the message and the proper parser to invoke.This value will be displayed in the footer of the lab report, as "Sending Application".Messages parsed through this interface will be filed in the "Labs" section of the patient chart.

The value in MSH-4 will be displayed in the footer of the lab report as "Sending Facility".

 

 

 

 

The PID (Patient Identifier) Segment

 

   

	Segment Type ID ('PID')
PID-1	Patient ID
PID-2	External Patient ID
PID-3	Patient ID
PID-4	Alternate Patient ID
PID-5	Patient Name: ·Last Name ·First Name ·Middle Initial ·Suffix (e.g., Jr., III,) ·Prefix (e.g., DR) ·Degree (e.g., MD)
PID-6	Mother’s Maiden Name
PID-7	Patient Birth Date
PID-8	Patient Sex
PID-9	Patient Alias
PID-10	Patient Race
PID-11	Patient Address
PID-12	Patient County Code
PID-13	Patient Home Phone Number
PID-14	Patient Work Phone Number
PID-15	Language – Patient
PID-16	Patient Marital Status ‘S’ = Separated ‘D’ = Divorced ‘M’ = Married ‘I’ =Single ‘W’ = Widowed
PID-17	Patient Religion
PID-18	Patient Account Number
PID-19	Patient SSN Number
PID-20	Patient Driver’s License Number
PID-21	Patient Mother’s Identifier
PID-22	Patient Ethnic Group
PID-23	Patient Birth Place
PID-24	Multiple Birth Indicator
PID-25	Birth Order
PID-26	Citizenship
PID-27	Veterans Military Status

The PatientID in PID-3 will be entered into a matching table.This ID is required to be unique for each patient.First Name, Last Name, Birthdate, Sex, and Social Security Number are all used for the patient matching algorithm.Omitting any of this information may cause the record to be queued for manual assignment.Demographic information included in the PID segment will not be used to update the demographics in the patient chart.

 

 

The ORC (Common Order) Segment

 

   

ORC-1	Order Control :“RE”= Results
ORC-2	Placer Order Number
ORC-3	Accession Number
ORC-4	Placer Group Number ·Unique Group ID ·Placer application ID
ORC-5	Order Status
ORC-6	Response Flag
ORC-7	Quantity Timing
ORC-8	Parent
ORC-9	Date/Time of Transaction (YYYYMMDDHHMMSS)
ORC-10	Entered By
ORC-11	Verified By
ORC-12	Ordering Provider ·ID/UPIN/NPI ·Last Name
ORC-13	Enterer’s Location
ORC-14	Call Back Phone Number
ORC-15	Order Effective Date (YYYYMMDDHHMMSS)
ORC-16	Order Control Code Reason
ORC-17	Entering Organization
ORC-18	Entering Device
ORC-19	Action By

The Accession Number in ORC-3 is used for report matching purposes.When a message comes in with an accession number that already exists in SOAPware®, the existing report will be updated or replaced, depending on the result status of the existing report.Result status from the ORC segment will be displayed as the report status.

   

Existing Report	Incoming Message	Action Taken
Partial/Pending	Final	Existing Report is Replaced
Final/Corrected	Partial/Pending	Incoming Report is Discarded
Final/Corrected	Final/Corrected	Incoming Report is Appended to Existing Report

Ordering Provider information will be read from either ORC-12, or OBR-16.A physician ID of some sort is required in one of those fields.Last Name will be used as well, and makes for easier physician matching.

 

 

The OBR (Observation Request) Segment*

 

   

OBR-1	Sequence Number - OBR
OBR-2	Placer Order Number
OBR-3	Accession Number
OBR-4	Universal Service ID
OBR-5	Priority
OBR-6	Requested Date/Time
OBR-7	Observation Date/Time Format - (YYYYMMDDHHMMSS)
OBR-8	Observation End Time
OBR-9	Collection Volume
OBR-10	Collector Identifier
OBR-11	Action Code
OBR-12	Danger Code
OBR-13	Relevant Clinical Information
OBR-14	Specimen Received Date/Time12( | )
OBR-15	Specimen Source
OBR-16	Ordering Provider · Physician ID / Provider Number · Physician Last Name · Physician First Name
OBR-17	Order Callback Number
OBR-18	Placer Field 1
OBR-19	Placer Field 2
OBR-20	Filler Field 1
OBR-21	Filler Field 2
OBR-22	Date/Time Observations Reported (YYYYMMDDHHMM)
OBR-23	Filler's Charge to Practice
OBR-24	Filler’s Section ID
OBR-25	Order Result Status
OBR-26	Parent Result
OBR-27	Quantity/Timing
OBR-28	Result Copies To
OBR-29	Parent
OBR-30	Transportation Mode
OBR-31	Reason For Study
OBR-32	Principle Interpreter of Results
OBR-33	Assisting Interpreter of Results
OBR-34	Technician
OBR-35	Transcriptionist
OBR-36	Scheduled Date / Time

*At least one OBR must be included under each ORC segment. 

The Accession Number will be read from OBR-3 if it is not present in ORC-3.

Every OBR-4^2 under the same ORC will be combined to form the title of the report in SOAPware®.Each ORC segment will trigger a new report. If any OBR-4^2 is not populated, it will defer to OBR-3 to generate the report title. 

OBR-7 will appear in the report as the Collection Date.An ordering physician ID will be expected in OBR-16 if it was not present in ORC-12.

Result status from OBR-25 will be displayed with each group of results.

The date in OBR-22 will be shown in the report header as the Date Reported.

The OBX (Observation) Segment

   

OBX-1	Sequence Number - OBX
OBX-2	Value Type
OBX-3	Observation Identifier
OBX-4	Observation Sub ID
OBX-5	Observation Value(result)
OBX-6	Units of Measure
OBX-7	Reference Ranges (low - high, ex: 1.5 - 10.2)
OBX-8	Abnormal Flags
OBX-9	Probability
OBX-10	Nature of Abnormal Test
OBX-11	Observation Result Status
OBX-12	Date/Time of Last Change
OBX-13	User-Defined Access Checks
OBX-14	Date/Time of Observation (YYYYMMDDHHMMSS)
OBX-15	Test Facility Code
OBX-16	Responsible Observer

The value of OBX-2 will be used to determine how to display the results.

For all types except TX, OBX-3^2 will be used as the test name.OBX-5 will be displayed in the Value column.OBX-6 will display in the Units column, OBX-7 in the Reference Range column, and OBX-8 in the Abnormal Flags column.OBX-14 will be displayed as the individual test date/time.

If the abnormal flag is H or HH, the result line will be colored red.If the abnormal flag is L or LL, the result line will be colored blue.For all other abnormal values (positive, unknown, etc) the result line will be colored orange.If a result contains abnormal results the report title in the Tasks Manager will begin with "ABN:" and the task list item will have a higher priority.

When the OBX segment has a Type of TX, only OBX-5 will be displayed.The following escape characters are defined in the default lab interface:

   

Escape Character	Replaced With
\S\	^
\T\	&
\.br\	Carriage Return

The NTE (Notes and Comments) Segment

   

NTE-1	Sequence Number - NTE
NTE-2	Comment Source
NTE-3	Comment Text

The XchangeHL7 has a limit on the length of any NTE segment of 35 characters or to the nearest word.

If longer notes are necessary, multiple NTE segments will be required.

 

 

The ZPS Segment

ZPS-2	Facility Code
ZPS-3	Facility Name
ZPS-4	Facility Address
ZPS-5	Facility Phone
ZPS-7	Facility Director

 

 

 

The ZPS segment is used by SOAPwareXchangeHL7 to identify Performing Facility information. In general, a short code for each facility would be sent in OBX-15 for each test. Then a ZPS segment would be sent at the end of the result to define the facility associated with that code.

 

 

Sample Result

MSH|^~\&|SOAPWARE||||20030417123605||ORU^R01|20030417597657260000|P|2.3|||||||

PID|1||TEST01||TEST^PATIENT||20000101|M||||||||||0000011|123456789||||||||||||

ORC|RE||267731||F|||||||TESTDOC^TEST^DOC^||||||||

OBR|1||267731|000^CBC|||20030110152200|||||||||TESTDOC^TEST^DOC^||||||20030114082400||F|||||||||||||||||||

OBX|1|NM|01^WHITE BLOOD CELL COUNT||2.5|THOUS/MCL|3.8-10.8|L|||F|||20030114082400||||

OBX|2|NM|02^RED BLOOD CELL COUNT||2.53|MILL/MCL|4.20-5.80|L|||F|||20030114082400||||

OBX|3|NM|03^HEMOGLOBIN||12.0|G/DL|13.2-17.1|L|||F|||20030114082400||||

OBX|4|NM|04^HEMATOCRIT||37.5|%|38.5-50.0|L|||F|||20030114082400||||

OBX|5|NM|05^MCV||148.2|FL|80.0-100.0|H|||F|||20030114082400||||

OBX|6|NM|06^MCH||47.4|PG|27.0-33.0|H|||F|||20030114082400||||

OBX|7|NM|07^MCHC||32.0|G/DL|32.0-36.0|N|||F|||20030114082400||||

OBX|8|NM|08^RDW||13.2|%|11.0-15.0|N|||F|||20030114082400||||

OBX|9|NM|09^PLATELET COUNT||250|THOUS/MCL|140-400|N|||F|||20030114082400||||

Screenshot of Sample Result in SOAPware®