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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 5.6.4 and above and addresses the HL7 communication partner. (The intention is not, to give a deep insight about the configuration in our service applications to configure this options).
Starting from the HL7 Message types, the document describes the content 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 diagnostictypical data handling / workflows regarding patients, orders, tenants ("Mandant"), etc the last sections covers the typically used segments to establish these usage.
Typical use / default does not imply, that the software has activated this options out of the box. Some manual configuration work is necessary by the authorized custo diagnostic vendor / implementer.
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This must be a biunique definition, meaning one specific code for MSH-6 should point to one specific tenant and vice versa. In case several facilities should be part of one tenant in custo diagnostic, we strictly recommend to solve this on the HIS side.
Sample:
| Tenant (Description) | Receiving (e.g. ORM) MSH-6 (code) | Sending (e.g. ORU) MSH-4 | |
|---|---|---|---|
| Sea View Hospital | SVH | SVH | |
| Lake Hospital | LH | LH |
By default, custo diagnostic send back the tenant code in MSH-4.
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When receiving an order, the software also supports additional information (optional):
| OBX-3-1 | OBX-3-2 |
|---|---|
| BODY WEIGHT | Weight |
| BODY HEIGHT | Height |
| MEDICATION | Medication |
Even this information is transfered with an order - it is stored/updates the visit information.
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The following events can be activated:
| Activity/Event | ORC-1 / ORC-5 |
|---|---|
| Order request accepted | by default not activated |
| Order request updated | by default not activated |
| Examination starts | SC / SC |
| Examination is finished | SC / CM |
| Order request will be deleted | SC / CA |
| Order request will be reset | by default not activated |
| Examination will be deleted | by default not activated |
Observation Result Status
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##bitte nochmal OBX prüfen. Stimmt OBX-25?
| OBX-11/OBR-25 | Meaning |
|---|---|
| R | The results are entered or automatically generated. |
| P | The results are preconfirmed, in general not by an accountable person. |
| F | The results are confirmed by an accountable person. |
| D | The order was canceled / the evaluation was deleted. |
Observation Results (ORU)
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When the orders are processed, custo diagnostic adds an internal "Filler ID" . This can be configured by a fixed length consecutive number, with an arbitrary alphanumeric prefix, e.g. "CM00001234", or an GUID (OBR-3, ORC-3)
OBX-Segment
| Field | o/r/i | s/so | Default Usage |
|---|---|---|---|
| OBX-1 | 1) | s | Set-ID |
| OBX-2 | 1) | s | Value Type (ST, NM, FT, RP, ED) |
| OBX-3 | 1) | so | observation identifier, see below OBX-3-1 code, OBX-3-2 text/human readable |
| OBX-5 | 1) | so | observation value, see below |
| OBX-6 | 1) | so | OBX-6-1 empty, OBX-6-2 units |
| OBX-11 | so | Observation Result Status. (see above, section "Observation Result Status") |
1) Incoming: See section "Orders" above.
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custo diagnostic can send specific observation data. The most common one is the manually typed in report (referenced as AKT_BEF) or the entire observation (referenced as FILE_PDF) as PDF / base64 embedded, but more than hundred specific numeric values can be defined which are described more specific below. One or more of the listed observation data can be exported in the same message. Alternatively one message per observation data can be send.
Most used OBX-3 Codes:
| OBX-2 | OBX-3-1 (Code) | OBX-3-2 (Human Readable Text) | OBX-5-1 | OBX-5-3 | OBX-5-4 |
|---|---|---|---|---|---|
| FT | AKT_BEF | Report | Formatted Report, as typed in or automatcially generated by the software | ||
| RP | FILE_PDF | PDF File | Points to an PDF-File, including path. | ||
| ED | FILE_PDF | PDF File | Base64 | ||
| ST | STUDYUID_DCM | Study Instance UID | In combination with DICOM, that Study Instance UID of the DICOM object. | ||
Sample - Outgoing ORU Message with Formatted-Text Report and Base64-encoded PDF-File
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