understanding an hl7 implementation guide an hl7 implementation guide a primer on it nerd-dom for...
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Understanding an HL7 Implementation Guide A Primer on IT Nerd-dom for Newborn Screening Nerds
NBS HL7 Guides
2
Lab Results Interface (LRI)
2011
Lab Orders Interface (LOI)
NDBS Orders
NDBS Results
2010 20172016
10/2011
11/2011
12/2016
05/2017
NBS HL7 Guides
3
Expert???!
X
NBS HL7 Guides
4
Expert!!!
Riki Merrick, MPH HL7 Expert
What exactly is this HL7 stuff again?
HL7 = Healthcare Esperanto
6
Date of birth
Geburtsdatum
出生日期
syntymäaika
Naskiĝdato
Date of birth
X
X
X
7
Date of birth
Geburtsdatum
出生日期
syntymäaika
Date of birth
Will an Implementation Guide tell me everything I need to start exchanging HL7 messages?
HL7 Project
• Hardware and Software Solution• Laboratory Workflows• HL7 Message Specifications• Technical and Security Documentation• Test Plans and Testing• Partner Recruiting• More Testing• Maintenance
9
Building Blocks Toolkit• Hardware and Software Solution
• Laboratory Workflows
• HL7 Message Specifications
• Technical and Security Documentation
• Test Plans and Testing
• Partner Recruiting
• More Testing
• Maintenance
10
Joshua Miller, MPH Evil Genius
Willie Andrews, BSMT Evil Genius
Building Blocks Toolkit• Hardware and Software Solution
• Laboratory Workflows
• HL7 Message Specifications
• Technical and Security Documentation
• Test Plans and Testing
• Partner Recruiting
• More Testing
• Maintenance
11
Joshua Miller, MPH Evil Genius
Willie Andrews, BSMT Evil Genius
What will the LOI and LRI Implementation Guides tell me?
HL7 Message Specifications
13
MSH|^~\&|NBS|DSHS TEST UAT FACILITY^05723062^|||20170719152202||OML^O21^OML_O21|2F719C80-9372-4D26-A7AF-8280D34C0072|P|2.5.1|PID|1|5858045|M111114^^^DSHS TEST UAT FACILITY&05723062&^MR||Black^Sirius||20170701120300|M| |1002-5^American Indian^HL70005^American Indian||||||||||||||Y|1||NK1|1|Black^Walburga|MTH|12 Grimmauld Place^^CEDAR PARK^TX^78613^|^^PH^^^402^4955652|||||||| |||19760514|||||||||||||||||123456^^^^MA~^^^^SS|||||OBR|1||20170710085000|54089-8^Newborn screening panel AHIC^LN|||20170710085000|||||| |20170710085000||05723062|||||||||F|ORC|NW||||||||||||||||||||DSHS TEST UAT FACILITY^^^^^^^^^05723062|123 Street^SuiteABC^Austin^TX^74321^^^^^^^^^|^PH^555^5555555^|OBX|1|ST|57716-3^State printed on filter paper card [Identifier] in NBS card^LN|1|TX||||||OOBX|2|ST|57723-9^Unique bar code number of Current sample^LN||169105199||||||F|||20170719152202|OBX|3|CE|57721-3^Reason for lab test in Dried blood spot^LN||LA12425-7^Screen - required by law^LN||||||F|||20170719152202|OBX|4|ST|57711-4^Unique bar code number of Initial sample^LN||160105174||||||F|||20170719152202|
HL7 Message Specifications
14
MSH|^~\&|NBS|DSHS TEST UAT FACILITY^05723062^|||20170719152202||OML^O21^OML_O21|2F719C80-9372-4D26-A7AF-8280D34C0072|P|2.5.1|PID|1|5858045|M111114^^^DSHS TEST UAT FACILITY&05723062&^MR||Black^Sirius||20170701120300|M| |1002-5^American Indian^HL70005^American Indian||||||||||||||Y|1||NK1|1|Black^Walburga|MTH|12 GrimmauldPlace^^CEDAR PARK^TX^78613^|^^PH^^^402^4955652|||||||| |||19760514|||||||||||||||||123456^^^^MA~^^^^SS||||OBR|1||20170710085000|54089-8^Newborn screening panel AHIC^LN|||20170710085000|||||| |20170710085000||05723062|||||||||F|ORC|NW||||||||||||||||||||DSHS TEST UAT FACILITY^^^^^^^^^05723062|123 Street^SuiteABC^Austin^TX^74321^^^^^^^^^|^PH^555^5555555^|OBX|1|ST|57716-3^State printed on filter paper card [Identifier] in NBS card^LN|1|TX||||||OOBX|2|ST|57723-9^Unique bar code number of Current sample^LN||169105199||||||F|||20170719152202|OBX|3|CE|57721-3^Reason for lab test in Dried blood spot^LN||LA12425-7^Screen - required by law^LN||||||F|||20170719152202|OBX|4|ST|57711-4^Unique bar code number of Initial sample^LN||160105174||||||F|||20170719152202|
What are the basics of an HL7 message?
NBS HL7 Basics
16
MSH|^~\&|NBS|DSHS TEST UAT FACILITY^05723062^|||20170719152202||OML^O21^OML_O21|2F719C80-9372-4D26-A7AF-8280D34C0072|P|2.5.1|PID|1|5858045|M111114^^^DSHS TEST UAT FACILITY&05723062&^MR||Black^Sirius||20170701120300|M| |1002-5^American Indian^HL70005^American Indian||||||||||||||Y|1||NK1|1|Black^Walburga|MTH|12 Grimmauld Place^^CEDAR PARK^TX^78613^|^^PH^^^402^4955652|||||||| |||19760514|||||||||||||||||123456^^^^MA~^^^^SS|||||OBR|1||20170710085000|54089-8^Newborn screening panel AHIC^LN|||20170710085000|||||| |20170710085000||05723062|||||||||F|ORC|NW||||||||||||||||||||DSHS TEST UAT FACILITY^^^^^^^^^05723062|123 Street^SuiteABC^Austin^TX^74321^^^^^^^^^|^PH^555^5555555^|OBX|1|ST|57716-3^State printed on filter paper card [Identifier] in NBS card^LN|1|TX||||||O
HL7 defines this stuff. Why do we need LOI / LRI?
Why do we need guides?
18
Why do we need guides?
19
DB1 DisabilityDG1 DiagnosisDRG Diagnosis Related GroupDSC Continuation PointerDSP Display DataECD Equipment CommandECR Equipment Command ResponseEDU Educational DetailEQL Embedded Query LanguageEQP Equipment/log ServiceEQU Equipment DetailERQ Event replay queryERR ErrorEVN Event TypeFAC FacilityFT1 Financial TransactionGOL Goal DetailGP1 Grouping/Reimbursement - VisitGP2 Grouping/Reimbursement - Procedure Line ItemGT1 GuarantorIAM Patient Adverse Reaction InformationIIM Inventory Item MasterIN1 InsuranceIN2 Insurance Additional InformationIN3 Insurance Additional Information, CertificationINV Inventory DetailIPC Imaging Procedure Control SegmentISD Interaction Status DetailLAN Language DetailLCC Location Charge CodeLCH Location CharacteristicLDP Location DepartmentLOC Location IdentificationLRL Location RelationshipMFA Master File AcknowledgmentMFE Master File EntryMFI Master File IdentificationMRG Merge Patient InformationMSA Message AcknowledgmentMSH Message HeaderNCK System ClockNDS Notification DetailNK1 Next of Kin / Associated PartiesNPU Bed Status UpdateNSC Application Status ChangeNST Application control level statisticsNTE Notes and CommentsOBR Observation RequestOBX Observation/ResultODS Dietary Orders, Supplements, and PreferencesODT Diet Tray InstructionsOM1 General SegmentOM2 Numeric ObservationOM3 Categorical Service/Test/ObservationOM4 Observations that Require SpecimensOM5 Observation Batteries (SetsOM6 Observations that are Calculated from Other ObservationsOM7 Additional Basic AttributesORC Common OrderORG Practitioner Organization UnitOVR Override SegmentPCR Possible Causal RelationshipPD1 Patient Additional DemographicPDA Patient Death and AutopsyPDC Product Detail CountryPEO Product Experience ObservationPES Product Experience SenderPID Patient IdentificationPR1 ProceduresPRA Practitioner DetailPRB Problem DetailsPRC PricingPRD Provider DataPSH Product Summary HeaderPTH PathwayPV1 Patient VisitPV2 Patient Visit - Additional InformationQAK Query AcknowledgmentQID Query IdentificationQPD Query Parameter DefinitionQRD Original-Style Query DefinitionQRF Original style query filterQRI Query Response InstanceRCP Response Control ParameterRDF Table Row DefinitionRDT Table Row DataRF1 Referral InformationRGS Resource GroupRMI Risk Management IncidentROL RoleRQ1 Requisition Detail-1RQD Requisition DetailRXA Pharmacy/Treatment AdministrationRXC Pharmacy/Treatment Component OrderRXD Pharmacy/Treatment DispenseRXE Pharmacy/Treatment Encoded OrderRXG Pharmacy/Treatment GiveRXO Pharmacy/Treatment OrderRXR Pharmacy/Treatment RouteSAC Specimen Container detailSCH Scheduling Activity InformationSFT Software SegmentSID Substance IdentifierSPM SpecimenSPR Stored Procedure Request DefinitionSTF Staff IdentificationTCC Test Code ConfigurationTCD Test Code DetailTQ1 Timing/QuantityTQ2 Timing/Quantity Relationship
DG1 DiagnosisERR ErrorGT1 GuarantorIN1 InsuranceMSA Message AcknowledgmentMSH Message Header
NK1Next of Kin / Associated Parties
NTE Notes and CommentsOBR Observation RequestOBX Observation/ResultORC Common OrderPID Patient IdentificationPV1 Patient VisitSPM SpecimenTQ1 Timing/Quantity
DG1 DiagnosisERR ErrorMSA Message AcknowledgmentMSH Message Header
NK1Next of Kin / Associated Parties
OBR Observation RequestOBX Observation/ResultORC Common OrderPID Patient IdentificationSPM Specimen
HL7
LOI
State Guide
ODT Diet Tray Instructions
X
Optionality No Optionality
NDBS
Constraining the Standard
20
HL7 2.5.1
LOI and LRI
NDBS Component
StateGuide
Open
Constrained
Data Attributes
21
Attribute Examples / DefinitionUsage R - Required
RE - Required but can be EmptyO - OptionalC - Conditional
Data Type NumericAlphanumericStandard Code
Cardinality # of allowable repeats of the elementValue Set HL7
LOINCSNOMED
Attribute Examples / DefinitionUsage R - Required
RE - Required but can be EmptyO - OptionalC - Conditional
Data Type NumericAlphanumericStandard Code
Cardinality # of allowable repeats of the element
Attribute Examples / DefinitionUsage R - Required
RE - Required but can be EmptyO - OptionalC - Conditional
Data Type NumericAlphanumericStandard Code
Attribute Examples / DefinitionUsage R - Required
RE - Required but can be EmptyO - OptionalC - Conditional
Constraining Usage
22
R
RE
O
C
Optionall
Required but can be Emptyl
Required Conditional
HL7 2.5.1
LOI and LRI
NDBS Component
StateGuide
Standard Level
Collection Date
HL7 2.5.1 O
LRI R
NDBS R
State R
Constraining Usage
23
Standard Level
Collection Date
AnalyteResult
HL7 2.5.1 O O
LRI R O
NDBS R O
State R R
Constraining Data Types
24
Standard Level DOB
HL7 2.5.1 Varies
LOI YYYY – RMMDD - RE
NDBS YYYYMMDD – RMMSS - RE
StateYYYYMMDD – R
MMSS - R+/- ZZZZ - R
Why conform?
25
Why conform?
26
Takeaways•Need an informaticist•Eliminate differences in data•Retain program autonomy•Do it all
9/13/2017 27
NERD
