Introduction
Allgemeines zur HL7 Schnittstelle, custo diagnostic 5.6 or above, ACK,
nicht alle nachrichten lizenziert
short description - which shows the typically used fields / options.
custo diagnostic is a server based software (referenced as "software"), intended to support physicians to acquired, analyze, document and report cardio pulmonary observations. The inherent patient, order and observation database can be interfaced via HL7, DICOM and GDT to an superior system. This document describes the typical use of the HL7 interface version 5.6 and above.
Starting from the HL7 Message types, the document describes the conetent of each HL7 segment. The last sections describes the data handling (patient / order / observation / tenant), meaning the typical workflow / lifecycle of the data in custo diagnostichier default beschrieben - Default means in a typical configured custo installation.
General Data Used
Drübergehen DTM Format?
...
optional - not reuqired, in some cases must be activated in custo diagnostic.
i - ignored.
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Supported Message Types
The software supports the following message types.
- ADT
- ORM
- ORU
- ORR
- DFT
- MDM
- ACK
The message types must be licenced individually - which means not in all installations all message types will be available.
HL7 Segments
Optionality Key
Incoming
| r | required | This value is required for a proper function of the software |
| o | optional | This value is not required but may be used for some functionality in custo diagnostic. |
| i | ignored | This value is ignored |
Outgoing
| s | send | This value will be send by default, in case the data is available |
| so | send optiontal | This value will be send, in case it is agreed between the communication partners. |
MSH - Segment
| Field | o/r/i | s/so | Default Usage |
|---|---|---|---|
| MSH-3 | o | so | Sending Application. Incoming: Expected value can be configured (default empty) in custo diagnostic and works as a filter - meaning messages with deviant content in MSH-3 are ignored. Outgoing: Sending Application, e.g. "CUSTO" can be configured in custo diagnostic. |
| MSH-4 | o | so | Sending Facility Incoming: Expected value can be configured in custo diagnostic and works as a filter - meaning messages with deviant content in MSH-4 are ignored. Outgoing: Sending Application, e.g. "CUSTO" can be configured in custo diagnostic. When a tenant system (german "Mandantensystem") is configured, this field contains the information about the tenant. See "Tenant System" below. |
| MSH-5 | o | so | Receiving Application Incoming: Expected value can be configured (default empty) in custo diagnostic and works as a filter - meaning messages with deviant content in MSH-3 are ignored. Outgoing: Receiving Application, can be configured (default empty) in custo diagnostic e.g. "HIS". |
| MSH-6 | o | so | Receiving Facility Incoming: Expected value can be configured in custo diagnostic and works as a filter - meaning messages with deviant content in MSH-3 are ignored. When a tenant system (german "Mandantensystem") is configured, this field should contain the information about the tenant. See "Tenant System" below. Outgoing: Receiving Facility, can be configured (default empty) in custo diagnostic e.g. "HIS". |
| MSH-7 | r | s | Date/Time Of Message, see HL7 Standard. ##DTM## |
| MSH-9 | r | s | Message Type. By default, custo diagnostic sends Messagetype^Event^Message-Structure, e.g. ORU^R01^ORU_R01. |
| MSH-10 | r | s | Message Control ID, see HL7 Standard |
| MSH-12 | r | s | Version ID, Outgoing: Custo diagnostic supports Version 2.3, 2.5 ##Verhalten bei eingehenden Nachrichten noch prüfen, wenn 2.7 2.9 oder 1.5 o.ä. drin steht## |
| MSH-13 | r | s | Sequence Number, see HL7 Standard |
| MSH-15 | s | Accept Acknowledge see below "Accept / Application Acknowledge" | |
| MSH-16 | i | s | Application Acknowledge Receiving: ignroedignored. Sending: Allways Always set to "NE" see below "Accept / Application Acknowledge" |
| MSH-18 | i | os | Character Set ##zu prüfen## Incoming: see Standard Set Receiving messages: custo diagnostic considers the character set specified in MSH-18 (##bitte prüfen). custo diagnostic can be configured to use a specific character set. In general Windows-1252 is used and send out via MSH-18. This one setting is used for alle outgoing messages. Outgoing: By Default empty, ##Tatsächlich verwendetes CodeSet? ???? is used to encode message## |
Accept / Application Acknowledge
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This means, when receiving a message MSH-15 / MSH-16 is ignored, because the general configuration is taken. When sending a message, MSH-15 will depict the configuration in custo diagnostic. MSH-16 will always be "NE".
...
Receiving messages: custo diagnostic considers the character set specified in MSH-18 (##bitte prüfen).
custo diagnostic can be configured to use a specific character set. In general Windows-1252 is used and send out via MSH-18. This one setting is used for alle outgoing messages.
PID - Segment
### Hier bitte alles aus default Mapping übernehmen.###
...
Required sind patienten name/vorname, geburtsdatum?, Patienten-nummer, geschlecht?
| Field | o/r/i | s/so | Default Usage |
|---|---|---|---|
| PID-3 | r | s | PID-3-1 is used to identify the patient in custo diagnostic. It must be unique in one custo diagnostic installation, otherwise an appropriate tenant system must be used (see tenant system below). |
| PID-8 | r ? | s | Administrative Sex. Supported Values are F, M, ?? Other Values are interpeted as ... ##zu prüfen## |
...
Auch die möglichen WErte für PV1-2 und PV1-21 wären interssant.##
| Field | o/r/i | s/so | Default Usage |
|---|---|---|---|
| PV1-19 | r | s | Visit-ID. The visit id is used to identify the visit in custo diagnostic It must be unique in one custo diagnostic installation, otherwise an appropriate tenant system must be used (see tenant system below). |
| PV1-44 | o | - | Admission Date: custo diagnostic can store this information, even it is not shown in the user interface. Its done for future usage. |
| PV1-45 | o | - | Discharge Date/Time: custo diagnostic can store the discharge date/time to filter out discharged patients in patient search lists. It can be defined, how custo diagnostic interpretes an empty discharge date/time - either als missing, unknown information, or as the information, that the discharge date should be deleted in custo diagnostic. |
ORC - Segment
| Field | o/r/i | s/so | Default Usage |
|---|---|---|---|
| ORC-1/ORC-5 | r | The combination of See OBR-1 and / OBR-5 can be configured as order control: | |
| ORC-16 | o | ORC-16-2: Order Control Code Reason / Clinical questions, shown to the user before processing the observation request. |
OBR - Segment
## bitte ##bitte prüfen, ob hier alles aus default mapping nehmen##drin ist
| Field | o/r/i | Default Usage | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OBR-1 / OBR-5 | r | Order Control The combination of OBR-1 and OBR-5 can be configured as order control: Default:
By default, OBR-5 is not evaluated, but can be configured to specific values. In this case the combination of OBR-1 and OBR-5 must match. | |||||||||||||||
| OBR-2 | r | Placer ID | |||||||||||||||
| OBR-3 | o | Outgoing: Consecutive Number with an alphanumeric prefix, e.g. "CM00001234" or some GUID, e.g. "36eea93b-bc1b-4769-a84e-4ebeaaaf387e" | |||||||||||||||
| OBR-4 | r | OBR-4 contains information about the type of observation which should by executed. OBR-4-1 is a coded value which must be defined. OBR-4-2 when uutgoingincomfing, OBR-4-2 is shown to the user, e.g. "Resting ECG" OBR-4-1 and OBR-4-2 is requried, other components optional. ##bitte prüfen - when OBR-4-2 in eingehender Nachricht abweichen zur Konfiguration in "Untersuchung" - welcher Text wird dabei angezeigt - der aus der Konfig, oder der aus der Nachricht? | |||||||||||||||
| OBR-5 | see OBR-1 | ||||||||||||||||
| OBR-20 | o | Incoming: Flexible text-fields which can be used to show additional information regarding this order to the user. | |||||||||||||||
| OBR-21 | o | Incoming: Flexible text-fields which can be used to show additional information regarding this order to the user. |
...
Please note, that most custo diagnostic feature assume, that Patient and Visit IDs are present. In systems where one of these information is not available, some functions will by default not work the way they are defined by HL7. (e.g. Merging/Moving). Please contact custo med in advance, to discuss the appropriate configuration in circumstances where Patient- or Visit-ID are not available.
Creating and Updating Patient / Visit information
...
In case a patient/visit already exists in custo diagnostic, it is updated by default by each ADT message. (see "Null Value").
This behavior can be configured - meaning that it can be stipulated which message creates a patient/visit (e.g. only ADT^A01), and which messages updates a patient/visit information.
Discharge Patient / Visit
When receiving a discharge message (A03) - open observation requests (orders) are deleted. Other behavior can be configured (deletion of visit, deletation delegation of observation etc.)
PV1-45 is used to set the discharge date of the patient. ##bitte prüfen - ich glaube es wird nicht der zeitstempel der nachricht/des events verwnedet, sonddern eben pv1-45. Wie ist dies mit der entlassnachricht`?)
Deleting Patients / Visits
Patients and visits can be deleted in custo diagnostic by A23, A29. A deletion means that it is marked as deleted and will be purged by the next purge-run which by default runs each night.
##bitte prüfen
Tenant System
Tenant Systems can be configured in different ways to separate observation and/or patients/visits.
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