RIS PD160 CRIS Outbound Interface Specification
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1.
RIS_PD160
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 1 of 38 Contents:
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 2 of 38 1.1 Purpose This document intends to define the transport protocols, message mappings and definitions for integration of CRIS with another system via HL7.
This version of the specification applies to CRIS interface release 2.09.t1b.
1.2 Audience This document is intended for system integrators, third party suppliers and potential customers. The reader is assumed to be familiar with the HL7 standard.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 3 of 38 2 Implementation Model
2.1 Overview
CRIS sends HL7 messages in response to significant activity occurring on the CRIS database. Events such as patient registrations, updates, examination bookings, status changes and results may all generate messages which a connected system may use to maintain its patient’s database, manage work lists and store results. To reduce network traffic unnecessary messages may be suppressed, for instance a results feed system may only require the verified result messages, whereas a PACS or another RIS would likely require all messages.
This document does not describe messaging activity for use with an Order communications system.
2.2 Application Data Flow Messages flow from CRIS to the remote system as a result of user activity on CRIS. All messages are transmitted over TCP/IP using HL7 MLLP.
2.3 HL7 version All messages referenced in this document conform to the 2.4 version of the HL7 standard. Message transport is HL7 MLLP over TCP/IP.
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 4 of 38 3 Message and Activity mapping
3.1 Register a patient When a patient is registered on CRIS an ADT^A04 message is sent to the connected system.
3.2 Update a patients Demographic details When a patients demographic details are changed on CRIS an ADT^A08 message is sent to the connected system.
3.3 Merge two patients When two patient records are found to refer to the same patient the two records are merged and an ADT^A40 message is sent to the connected system.
3.4 Create an appointment When a user on CRIS makes an appointment CRIS will send an OMG^O19 message with order control set to “NW” and a status value of “SC” (scheduled)
3.5 Patient Attends When a patient attends for their examination they will be booked in to the CRIS reception module, at this point CRIS will send an OMG^O19 message. For attendances that had an appointment booked order control will be set to “SC” (status changed), otherwise order control will be “NW” (new). Order status will be “IP” (in process).
3.6 Appointment/Examination Cancelled A user on CRIS may decide to cancel an appointment or an examination. At which point CRIS will send and OMG^O19 message with order control set to “CA” and a status of “CA”
3.7 Appointment/Examination Changed The radiology dept may decide to change the type of procedure being performed. At this point CRIS will send an OMG^O19 message with order control set to “XO” with the revised details.
If the connected system is unable to accept changes to orders working practice will need to be changed, and the previous exam cancelled and a new one entered.
3.8 Examination performed When the procedure has been performed the radiographer enters the screening and projection data on CRIS. At this point CRIS will send an OMG^O19 message with order control set to “SC” and a status of “CM” (complete).
3.9 Report entered When the clinical report is entered on CRIS an ORU^R01 message containing the preliminary report is sent with a result status of “P” (preliminary).
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 5 of 38 3.10 Report verified Once the Radiologist is satisfied with the clinical report it will be verified. At this point CRIS will send an ORU^R01 containing the report with a result status of “F” (final)
3.11 Report amended If for some reason the radiologist later needs to change a previously verified report and addendum will be added. If CRIS is configured to send unverified results then an ORU_R01 containing the report with a result status of “C” (changed) will be transmitted. When the report is subsequently re verified an ORU_R01 will be sent, again with a result status of “C”.
3.12 Pre Admit a Patient When a pre admit message is received from PAS CRIS can be configured to send either an ADT^A05 message or an SIU^S12 message. CRIS may also be configured to buffer these messages until a specified number of days prior to the patient attendance date.
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 6 of 38 4 Message Transport All Messages are transmitted over TCP/IP using MLLP.
4.1 Connections One socket connection is used for messages originating from CRIS. The port numbers to be used will be decided by mutual agreement. CRIS will initiate the connection (acting as client).
4.2 Transport level Acknowledgements Each message will be acknowledged by the receiving system prior to delivery of the next message. Messages that are NAK’d will by logged by CRIS and should also be logged by the receiving system.
4.3 Framing Characters Standard HL7 MLLP framing characters will be used, these are
<0B> start of message <1C> end of message
In addition MLLP requires that each message be followed by the segment delimiter which is carriage return <0D>
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 7 of 38 5 Error handling
CRIS logs errors that are encountered when generating and processing messages as well as any error messages in the MSA segments received in response to outbound messages. It is expected that the connected system will also maintain its own logs.
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 8 of 38 6 Data Mappings 6.1 Patient Identifiers All known patient identifiers will be passed in PID:3. Components 1, 4 & 5 are populated, component 2 is optional and is for the NHS number only, and other components are left blank. The primary key to be used is determined at configuration time. The order of identifiers sent is configurable so that the remote systems preferred primary key can be sent first if necessary.
Sequence Name Usage 1 ID Number Patient Identifier 2 Check Digit Optional, for NHS number use only. If required then you must request that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set FALSE, if set TRUE then we put this value in PID:32. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)
4 Assigning Authority NameSpace ID contains: “NHS” for nhs number “CHI” for chi number “CRIS” for CRIS number Otherwise the code identifying a hospital for hospital numbers. 5 Identifier Type Code “NH” for nhs number/ chi number “MR” for hospital numbers “PI” for CRIS number
Note that on CRIS the only patient identifier that is guaranteed to be present at all times is the CRIS number. If another identifier (such as a hospital number for a particular hospital) is selected to be used as primary key CRIS will send a dummy value for that identifier if it is not present, when the required identifier is subsequently provided CRIS will send a merge message with the dummy value as the source patient id.
As an example, suppose that hospital numbers for hospital RNZ04 have been selected as primary key, a patient attendance is entered on CRIS but no hospital number yet exists, however an NHS number and CRIS number are both available. In this case the PID:3 segment will be populated as so:
3289329^^^CRIS^PI~8772332778^^^NHS^NH~CRIS3289329^^^RNZ04^MR
As you can see the hospital number for RNZ04 was not available so CRIS generated a temporary dummy hospital number by inserting the string “CRIS” at the beginning of the CRIS number.
Sometime later a hospital number of A786345 is allocated to the patient, CRIS will then generate a merge (ADT^A40) message with PID:3 populated as:
3289329^^^CRIS^PI~8772332778^^^NHS^NH~A786345^^^RNZ04^MR and a merge segment as follows: MRG|CRIS3289329^^^RNZ04^MR
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 9 of 38 6.2 Time Stamp values CRIS will always populate time stamps with as much data as is available, in some cases this will include year, month, day , hours, minutes, seconds, milliseconds and time zone offset, in other cases hours, minutes seconds milliseconds and time zone may not be available. The connected system should follow the standard HL7 guidelines for processing of time stamps.
6.3 Messages CRIS sends six messages, ADT^A04, ADT^A08, ADT^A05 or SIU^S12, ADT^A40, OMG^O19 and ORU^R01.
6.4 ADT^A04 Patient registration This message is sent when a patient is first registered on CRIS.
6.5 ADT^A08 Patient demographic update This message is sent when a patients demographic details are changed on CRIS.
6.6 ADT^A05 Pre Admit, SIU^S12 Scheduling If CRIS receives ADT^A05 or SIU^S12/S13 messages from PAS these messages are in turn passed through this outbound interface either as ADT^A05 or as SIU^S12 messages.
6.7 ADT^A40 Patient Merge Merge messages in sent either when two patients’ details are merged on CRIS, or when the connected systems preferred primary key changes for a patient.
6.8 OMG^O19 Order Message The order message is used to pass status information, new examinations booked on CRIS and cancellations. The meaning of an order message is specified in ORC:1 - Order Control.
Code Message Type NW New order booked CA Cancellation of an existing order XO Change order request SC Status Changed
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 10 of 38 6.9 ORU^R01 Clinical Report The ORU^R01 message is used to transmit clinical reports to OCMS. ORC:1 will always contain “SC” for status change with a status value , ORC:5, of “CM” for complete.
On CRIS multiple examinations/orders may be performed in the same attendance, the clinical report entry screen allows the user to create a clinical report comprised of multiple sections, one section for the attendance summary plus one section for each examination.
For Example, two examinations are ordered, a Left Foot and a Right Arm. The radiology department decides to perform the two examinations on the one attendance the following three section report is entered.
Summary This person can neither walk nor write.
Left Foot Left foot appears to be missing
Right Arm The right arm is mostly complete; however the patient is missing four fingers and a thumb.
CRIS has several configuration options available that affect the generation of clinical report messages and OBX segments, these are configured by HSS and should be chosen according to the capabilities and requirements of the receiving system.
Setting Description Unique By Event Normally, a report message is generated for each exam, with this setting enabled one report message is generated for the event, so PACS would in the above example receive 1 message instead of two. Send Report For All This setting is normally enabled and causes CRIS to send the entire report text for the Exams attendance in each message, so for the above example each message would contain
This person can neither walk nor write.
Left foot appears to be missing
The right arm is mostly complete, however the patient is missing four fingers and a thumb.
If this setting is disabled the message for the Left Foot exam would contain
This person can neither walk nor write.
Left foot appears to be missing
And the message for the right arm would contain
This person can neither walk nor write.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 11 of 38 The right arm is mostly complete, however the patient is missing four fingers and a thumb.
Note that summary text is sent in each report message regardless.
This setting should not disabled if Unique By Event is enabled as report content would be missed. Send Examination Normally only the text entered by the user is sent in OBX:5, with this setting enabled Names In Report the above example would generate a message with the following contents
[Summary Report] This person can neither walk nor write.
[Left Foot] Left foot appears to be missing
[Right Arm] The right arm is mostly complete, however the patient is missing four fingers and a thumb.
Individual Exams In This setting affects the population of the OBX:3 segment, by default OBX:3 is populated Observation ID with the examination code of the exam that generated the report message, so will contain the same value as OBR:4.
With this setting enabled each OBX:3 will contain the examination code of the exam relating to the report text contained in OBX:5, so in the example above, the following OBX segments would be generated (note that only OBX:3 and OBX:5 are shown for clarity and examination codes are examples only)
OBX|||SUMMARY^Report Summary||This person can neither walk nor write OBX|||SUMMARY^Report Summary|| OBX|||FOOL^Left Foot||Left foot appears to be missing OBX|||FOOL^Left Foot|| OBX|||ARMR^Right Arm||The right arm is mostly complete, however the patient is missing four fingers and a thumb. OBX|||ARMR^Right Arm|| ReportMargin Specifies a right margin for the report text. By default there is no margin and each OBX:5 will contain text up to the next carriage return. If PACS is unable to wrap long lines a suitable manner for display purposes a suitable value should be chosen for ReportMargin. With margin set to 60 the report text would be as follows This person can neither walk nor write.
Left foot appears to be missing
The right arm is mostly complete, however the patient is missing four fingers and a thumb.
Note that an additional line break is inserted between the words “is” and “missing”.
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 12 of 38 Send Unverified Normally CRIS will only transmit report messages for verified reports. This setting Reports allows unverified reports to also be sent.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 13 of 38 6.10 Order control and status summary The following table lists the order control and status value combinations that will be produced by CRIS.
Message Order Status Meaning Type Control OMG^O19 NW SC New appointment booked IP New attendance - patient in dept SC SC Status change, appointment booked IP Status change, patient in dept CM Status change, examination performed CA CA Order cancelled XO SC Order changed, appointment booked IP Order changed, patient in dept ORU^R01 SC CM Clinical report
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 14 of 38 7 MSH MSH appears on all messages
Position Name Notes 1 Field Separator Always Populated with “|” 2 Encoding Characters Always Populated with “^~\&” 3 Sending Application Defaults to “CRIS” may be configured to send any fixed value. 4 Sending Facility Defaults to “LIVE” may be configured to send any fixed value. 5 Receiving Application Default is empty, may be configured to send any fixed value. 6 Receiving Facility Default is empty, may be configured to send any fixed value. 7 Date Time of Message Populated with the date and time that the message was generated, century, year, month, day, hour, minute, second, millisecond and time zone offset are all present. 9 Message Type The type of the message. CRIS sends the messages OMG^O19 ORG^O20 ORU^R01 10 Message Control ID Populated with a unique id for the message 11 Processing ID Set to “P” 12 Version ID Set to “2.4”
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 15 of 38 8 EVN EVN appears on ADT messages
Position Name Notes 1 Event Type Code Contains the event type code (ADT) 2 Recorded Date & Time Contains the date the that the event occurred on CRIS 5 Operator ID The ID of the user on CRIS that performed the event that resulted in the transmission of this message
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 16 of 38 9 PID PID appears on all messages
Position Name Notes 3 Patient ID Internal Will contain a list of the patient identifiers known by CRIS, refer to the notes on patient identifiers. 3.1 ID 3.2 Check Digit Optional, for NHS number use only. If required then you must request that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set FALSE, if set TRUE then we put this value in PID:32. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)
3.4 Assigning Authority 3.5 Identifier Type Code 5 Patient Name
8 Patient Sex This field may require translation, values on CRIS are F Female M Male I Indeterminate U Unknown 10 Race Patient’s race. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE
11 Address CRIS has four lines of address. The first line is placed in
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 17 of 38 13 Phone number home Patients home telephone number, email address and mobile number. Home Telephone number is the first sub field, Email address is the 4th subfield Mobile telephone number is placed in the next repeating instance Eg |0115874245^^^[email protected]~07785342542|
14 Phone number business Patients work telephone number
15 Primary Language Primary language. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE 16 Marital Status Marital Status. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE 17 Religion Religion. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE 18 Patient Account Number Patient Account Number. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE 22 Ethnic Group This field may require translation 26 Citizenship Citizenship. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE 29 Patient Death Date and For Deceased patients this will contain the date of death, century, year, Time month and day are present. Otherwise this field will contain null (“”)
30 Patient Death Indicator For deceased patients this field will contain “Y” otherwise it will be “N” 32 Identity Reliability Code Optional, for NHS number use only. If required then you must request that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set TRUE, if set FALSE then we put this value in PID:3.2. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 18 of 38 10 MRG The MRG segment is present for merge (ADT^A40) messages
Position Name Usage 1 Prior Patient ID Internal The primary key for the source patient of the merge. Refer to the notes on patient identifiers above.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 19 of 38 11 PD1 The PD1 segment is present for ADT and OMG messages when a patient has a registered GP stored on CRIS
Position Name Notes 3 Patient Primary Facility Patients registered General Practice
4 Patient Primary Care Provider Patients registered General Practitioner name & ID no
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 20 of 38 12 PV1 The PV1 segment is present for ADT^A05 messages, SIU^S12 messages and OMG^O19/ORM^O01* messages with order control “NW” (new orders booked on CRIS).
* Message type sent depends upon which PACS provider the message is being sent to.
Position Name Usage 3 Assigned patient location The ward/clinic code the patient is to be admitted to. This field is populated on ADT^A05 messages. 9 Consulting Doctor The Consultant the patient is to be admitted under. This field is populated on ADT^A05 messages. 18 Patient Type Patient Type (Inpatient, Outpatient etc). This field is populated on OMG^O19 / ORM^O01 messages dependent upon the PACS being communicated to. 19 Visit Number Episode identifier from OCMS. This is populated with the value taken from the first received order on the attendance. This field is populated on OMG^O19 / ORM^O01 messages dependent upon the PACS being communicated to.
44 Admit Date/Time The date (and possibly time) that the patient is to be admitted. This field is populated on ADT^A05 messages.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 21 of 38 13 AL1
This segment may appear on ADT^A08 messages but by default it does not. If required you must request SendAlarms=TRUE and GENERAL.UpdateMessageOnAlarmChange=YES
Example segments; AL1|1|R|^SNEEZES^^^PAS ALARM||ALLERGY1 AL1|2|R|^CONTRAST ALLERGY^^^Mild Reaction||CONALL
Position Name Max Usage Width 1 Set ID 4 Incremental counter (1,2,3,…etc) 2 Allergy Type 2 Alarm types (W=Warning, R=Reaction, I=Info, S=Special Case)
3.2 Description 250 } Allergy description 3.5 250 } Allergy Description 5 Allergy Code 15 Allergy reaction code
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 22 of 38 14 SCH The SCH segment is only present for SIU^S12 messages.
Position Name Usage 5 Schedule ID Identifier contains “EP”, Text contains “EXAMPULL”. 11 Appointment Timing Quantity Start Date/Time contains the date that the patient is expected to attend.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 23 of 38 15 ORC This is present on all messages
Position Name Notes 1 Order Control Populated according to order control and status summary table above. 2 Placer Order Number Contains the placer order number received from and Order communications system. If no order communications system is in use or this event was not received electronically this field will be blank. 3 Filler Order Number Contains with the CRIS allocated examination key. 5 Order status Populated according to order control and status summary table above. 7 Quantity/Timing
Optional, if you require all 2099 type dates to be removed then you must specify that BlankWaitingDate is set to TRUE (default is FALSE). This will remove the date from ORC:7, OBR:27, OBR:34.2 and OBR:34.3 9 Date Time of transaction Date and time of the user action on CRIS that resulted in this message. 10 Entered By
For messages of type “UC”
NF – Unable to find order OS – order already scheduled OI – order already in process IE – Internal error
For messages of type “UA”
OE – Order already exists US – Unknown universal service code UL – Unknown enterers location UR – Unknown referrer IE – Internal Error © Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 24 of 38 17 Entering Organization
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 25 of 38 16 OBR This is present on all messages
Position Name Notes 2 Placer Order Number Contains the placer order number received in the original new order message. In unsolicited result messages this field will be blank. This field contains the same value as ORC:2 3 Filler Order Number Contains the CRIS allocated examination key. This field contains the same value as ORC:3 4 Universal Service ID
Optional, if you require all 2099 type dates to be removed then you must specify that BlankWaitingDate is set to TRUE (default is FALSE). This will remove the date from ORC:7, OBR:27, OBR:34.2 and OBR:34.3 28 Result copies to Details of the “Copy To” referrer in the event details 31 Reason For Study Optional,
If the new attribute SendReasonForExam is set to TRUE then OBR:31.2 will be populated with the Reason for exam. This field will be split into multiple repetitions whenever the text exceeds length 300, or whenever a line break appears in the text. 32 Principal Result For order messages, if a radiologist has been assigned
For report messages
Optional, if you require all 2099 type dates to be removed then you must specify that BlankWaitingDate is set to TRUE (default is FALSE). This will remove the date from ORC:7, OBR:27, OBR:34.2 and OBR:34.3 35 Transcriptionist Populated on report messages only
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 27 of 38 17 OBX OBX segments are present on clinical report messages. There will be one OBX segment for each line of report.
Position Name Notes 1 Set ID Sequence, first OBX in a message will be 1, followed by 2 etc.
2 Value Type Set to “TX” 3 Observation Identifier
5 Observation Value Contains one line of the textual report. 8 Urgency Populated if the “SendUrgentFlag” is set TRUE, default is FALSE. Produces an additional OBX line in the message containing one of ‘R’, ‘C’, ‘U’ or ‘S’, meaning Routine, Critical, Urgent or Significant finding.
An example OBX is as follows:
OBX|5|TX|URGENT^^CRIS3|||||U
11 Observation Result Only populated on reports Status Indicates the status of the report on CRIS P Preliminary report F Final Report C Changed report 14 Date & Time Of Only populated on reports The Observation This will contain the last date and time that the report was typed, verified or changed (depending on result status)
16 Responsible Observer Either the last reporting radiologist or (in the case of a verified report) the radiologist that verified the report.
17.1 Scanned Documents
If scanned documents are to be sent by the query interface they will be included as OBX segments as follows:
Value Type ED Observation Identifier
REFERAL=Referral Letter REQCARD=Request card
All other document types will have a
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 28 of 38 Observation Value ED type
17.2 IEP Remote Sending
If an event is sent from another system via an OMG^O19 message, the following OBX segments may be included in the message:
Observation Identifier Value Observation Value Type SND_REASON_CD CE
SND_REASON_NTE TX Free text note, optionally added when selecting a send reason.
STUDY UID TX Study UID, if it exists. EVENT_SUMMARY TX Summary of the event and status history. REASON TX Reason for exam text field from the information field on the Event Info tab. HISTORY TX Clinical history text field from the information field on the Event Info tab. COMMENT TX Event comment text field from the information field on the Event Info tab. SAFETYQ TX Clinical safety questions text field from the information field on the Event Info tab.
If the event has a report or the OBX report segments will also be sent in the OMG^O19 message.
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 29 of 38 18 NTE NTE segments are present on order and clinical report messages when clinical notes exist.
Position Name Notes 1 Set ID Sequence, first NTE in a message will be 1, followed by 2 etc. 3 Comment Each comment section will contain 1 line of the clinical history, however if SendAdditionalNTEInfo is set to TRUE then there will be additional lines, example;
NTE|1||Clinical history|CH NTE|2||Protocol info|PR NTE|3||Resource group 1~Group 1 description|RG NTE|4||Resource group 2~Group 2 description|RG NTE|5||Event Comment|RE NTE|6||Clinical safety questions|QN
4 Comment Type Optional field, you need to request SendAdditionalNTEInfo is set to TRUE. In addition to this for Resource Groups (RG) you need to have GENERAL.ResourceManagementModuleAvailable = 'Yes' for the EJBSERVER user
CH = Clinical History, PR = Protocol info, RG = Resource group, RE = Event comment, QN = Clinical safety question
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 30 of 38 19 ZDS A ZDS segment present on order messages if CRIS is configured to send study UID.
Position Name Notes
1 Study UID Study UID generated on CRIS
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 31 of 38 20 Sample Messages
MSH|^~\&|CRIS|LIVE|ACUO||20160728102516||ADT^A04|IQXKATZ7:1RP|P|2.4 EVN|ADT|20160728102508|||HSS PID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI|| TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|N PD1|||^^V81999|G9999998|
MSH|^~\&|CRIS|LIVE|ACUO||20160728102516||ADT^A08|IQXKATZ7:1RO|P|2.4 EVN|ADT|20160728114035|||HSS PID|||CRIS60146157^^^RR201^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI|| TEST^PATRICK^^^MR||19700101|M||1|SALISBURY DISTRICT HOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ|E10000024|~||012|N|B5|||||||||826|||""|N PD1|||^^V81999|G9999998|
MSH|^~\&|CRIS|LIVE|||20160728102946||OMG^O19|IQXKATZ7:1S0|P|2.4 PID|||RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101| M|||SALISBURY DISTRICTHOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ|| ~||||||||||||||||""|N PD1|||^^V81999|G9999998 PV1||||||||||||||||||A ORC|NW||60895679^CRIS||IP||^^^201607281029^^1||201607281029|HSS|| C2638281^LEWIS SJ|RNZ02CCU||201607280000||320|HSSTERMINAL|HSS||^^RNZ02 OBR|||60895679^CRIS|CAAAG^CT Angiogram Aorta||||||||||||||||60800373| RNZ60895679|||C|||^^^201607281029^^1|||||||^20160728^20160728^^^^RNZ02 NTE|1||Test clinical history line 1 NTE|2 ZDS|1.2.826.0.1.2112370.46.1.60895679|
MSH|^~\&|CRIS|LIVE|||20160728103706||ORU^R01|IQXKATZ7:1SO|P|2.4 PID|||RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101| M|||SALISBURY DISTRICTHOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ|| ~||||||||||||||||""|N PD1|||^^V81999|G9999998 ORC|SC||60895680^CRIS||CM||^^^201607281031^^1||201607281035|HSS|| C4547657^Rachel JOHNSON|GP||201607280000||620|HSSTERMINAL|HSS||^^Y02578 OBR|||60895680^CRIS|CHANR^CT Hand Rt||||||||||||||||60800374|RNZ60895680| 201607281035||C|||^^^201607281031^^1|||||HSS&HSS User^201607280000||HSS&HSS Support User^20160728^20160728^^^^RNZ02|HSS&HSS User^201607281035 NTE|1||Test clinical history NTE|2 OBX|1|TX|CHANR^CT Hand Rt^CRIS3||Clinical History : ||||||F|||201607281035|| HSS^HSS User OBX|2|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User OBX|3|TX|CHANR^CT Hand Rt^CRIS3||Test clinical history||||||F||| 201607281035||HSS^HSS User OBX|4|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User OBX|5|TX|CHANR^CT Hand Rt^CRIS3||CT Hand Rt : ||||||F|||201607281035||HSS^HSS User
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 32 of 38 OBX|6|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User OBX|7|TX|CHANR^CT Hand Rt^CRIS3||This is a test report added by HSS.|||||| F|||201607281035||HSS^HSS User OBX|8|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User|
MSH|^~\&|CRIS|LIVE|ACUO||20160728104127||ADT^A40|IQXKATZ7:1ST|P|2.4 EVN|ADT|20160728104122|||HSS PID|||CRIS60146087^^^RNZ02^MR~60146087^^^CRIS^PI||TEST^PATIENT||19950717| M|||||~||||||||||||||||""|N MRG|RNZ7654321^^^RNZ02^MR|
MSH|^~\&|CRIS|LIVE|ACUO||20160728104668||ADT^A05|IQXKATZ7:1SW|P|2.4 EVN|ADT|20160728000146|||EJBSERVER PID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI|| TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|N PV1|||V81999||||||G9999998|||||||||A||||||||||||||||||||||||||20160728102600|
MSH|^~\&|CRIS|LIVE|ACUO||20160728104668||SIU^S12|IQXKATZ7:1SZ|P|2.4 SCH|||||EP^EXAMPULL^L||||||^^^201607281246 EVN|ADT|20160728000146|||EJBSERVER PID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI|| TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITAL^ODSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|N PV1|||V81999||||||G9999998|||||||||A||||||||||||||||||||||||||20160728102600|
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 33 of 38 21 Configuration Questionnaire Please answer the following questions regarding the preferred configuration of the CRIS HL7 Interface.
Item Description Required Value IP Address IP Address to send messages to Port Number TCP Port number to send messages to Preferred Primary Key This should be the assigning authority code of a patient identifier. If this is not specified the only identifier that is guaranteed to appear on every message is CRIS number. Identifier Order If you require patient identifiers to be listed in a particular order specify it here as a list of assigning authority codes. NHS Number format Do you require the NHS in its default format of 3-3-4 or without spaces? Unverified Reports If you require unverified reports to be sent specify here. The default is to not send them.
Demographic messages Do you require demographic (ADT) messages? Note even if these are to be suppressed, if Preferred Primary Key is set you will still receive ADT^A40 messages in response to changes of primary key. The default is to send demographic messages.
Order Messages Do you require order messages? The default is to send order messages. Study UID Do you require a ZDS segment containing study UID. The default is NOT to send study UID
Unique By Event Refer to the section on ORU^R01 Examination Names in Refer to the section on ORU^R01 report Send report for all exams Refer to the section on ORU^R01
Individual exams in Refer to the section on ORU^R01 observation ID Report Margin Refer to the section on ORU^R01 SendPrefetchAsSIU Do you require ADT^A05 messages or SIU^S12 messages for pre fetching. The default is to send ADT^A05 messages. BufferPrefetchDays Should pre fetch messages be buffered until a specific number of days prior to the date of attendance or sent immediately. The default is to send pre fetch messages immediately.
Send Scanned Documents Should scanned documents be sent along with the (Y/N)? report
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 34 of 38 ScannedDocumentTypes can be used to filter the type sent out eg. REQCARD, MRI). By default it is just REQCARD Send Diagnosis Codes Do you want to send events diagnosis codes in an OBX segment (Y/N)? Send “Copy To” location Default is NO. If set YES this will populate an extra (Y/N)? OBX segment OBX:3.1 and OBX3.2 with the exam code and the “Copy To” location
© Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 35 of 38 22 Quick Reference Where to find common data useful for building work lists etc. 22.1 Patient Data Field Patient Identifier PID:3 Name PID:5 DOB PID:7 Sex PID:8
22.2 Referral Data Field Referring physician ORC:12 Referring location ORC:13 Practice for GP referrals ORC:21
22.3 Performing Data Field Procedure OBR:4 Accession no OBR:21 Study UID ZDS:1 Required Date OBR:27 Modality OBR:24 Room procedure is to be performed in OBR:34 Hospital procedure is to be performed at OBR:34 CRIS workstation where the procedure was booked ORC:18
22.4 Reporting Data Field Report text OBX:5 Report status OBX:11 Date reported last entered/changed OBX:13 Radiologist OBR:32 Typist OBR:35
22.5 Pre fetching Data Field Ward PV1:3 Consultant PV1:9 Date of expected admission PV1:44 Or SCH:11 if using SIU messages.
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 36 of 38 Document Control
Title RIS_PD160_ Owner Steve Verdon Date Created 01/06/2006 File Ref. RIS_PD160_ CRIS Version Change History Issue Date Author / Editor Details of Change 1.0 01/06/2006 Alan Shields First Draft, created from PACS interface specification. 1.1 23/10/2006 Alan Shields Added SIU^S12 message. Added examination end time to OBR segment. 1.2 21/04/2008 Alan Shields Updated radiologist, secretary and technician fields 1.3 21/12/2008 Neil Twist Added information on a flag 1.4 14/01/2010 Neil Twist Updated to 2.09.10 specification 1.5 05/03/2010 Steven Verdon Added OBR:16 1.6 09/09/2010 Alan Shields Added transmission of scanned documents/images 1.7 28/02/2011 Julia Paul IEP additions 1.8 29/01/2012 Steven Verdon Title version corrected PV1 segment, added OMG^O19 (12) Urgency field added to OBX (16) Added NHS formatting to configuration questionnaire (20) OBX:14 + 16 changed to state “LAST” d&t or person Added scanned documents (IEP) to configuration questionnaire (20) Added event diagnostic codes to configuration questionnaire (20) Added “Copy To” query to configuration questionnaire (20) Added OBX:28 – Send copies to 1.9 19/09/2012 Steven Verdon OBR:16 not used Updated review panel 1.10 25/09/2012 Steven Verdon PV1, Patient Type description misleading 1.11 18/04/2013 Steven Verdon Document review 1.12 28/05/2013 Steven Verdon Re-worded OBR:34 description 1.13 09/12/2013 Steven Verdon Document review 1.14 29/12/2014 Steven Verdon Document review, primary key highlighted in 6.1 1.15 16/10/2015 Steven Verdon OBR:11 Request category AL1 section added NTE:4 added OBR:31.2 reason for exam added ScannedDocumentTypes added to Configuration Questionnaire Option to remove 2099 (waiting) dates from ORC:7, OBR:27, OBR:34.2 and OBR:34.3. NHS number check digit added for inclusion in outbound messages (optional). Inclusion of PID3.2/PID:32 for the NHS number check digit (optional). © Healthcare Software Solutions 2015 All Rights Reserved Information Classification: Unclassified Public Effective Date – SJV 17/10/2015 HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 37 of 38 1.16 19/10/2015 Andrea Hardy Updated template 1.17 05/04/2016 Steven Verdon OBR:31.2 and NTE:3/4 detail added. Additional patient details added (PID:10/12/15/16/17/18/26) 1.18 15/07/2016 Steven Verdon PD1 segment corrected 1.19 08/08/2016 Steven Verdon Sample messages updated
Review Date April 2017
© Healthcare Software Systems 2013 All Rights Reserved Commercial In Confidence Effective Date – INITIALS DD/MM/YYYY HSS Doc ref: 066c56d2e9eb9dfa761fa6673c6f096d.docx Page 38 of 38