High level explanation of how you would "attach" nondiscrete documents to a patient record?

Question

Question

Scott Beeson · Nov 9, 2016

#Beginner #HealthShare #Interoperability

I am looking for a general overview of how you would attach a document to a patient record in healthshare. For instance, an Advance Directive or Living Will.

Here are some starter questions:

What format is required, if any? Can it be a PDF or DOC?
How can/should it be submitted? HL7? XDS.b? Embedded in a CCD?

Sorry for the open endedness. Any info would be helpful while I research this.

Discussion (6)0

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Jorge de la Garza · Nov 10, 2016

Hi Scott,

One way you could do this is via an MDM^T02 HL7 message. There is actually an example message containing a PDF document distributed with HealthShare: <install-directory>\Data\Scenario_4.hl7

The document data is encapsulated in a series of OBX segments:

OBX||ED|||^^PDF^Base64^JVBERi0xLjINCiXi48/TDQolICAgICAgICAgIA0KJTEwMDIzMFszMl0NCjEgMCBvYmogDTw8DQov

The critical pieces of this are:

OBX-2: Must be "ED" for "Encapsulated Data"

OBX-5.3: Must be the file type. In this case it's "PDF". If you want to view this document in the HealthShare Clinical Viewer, then you can find a list of supported doc types at websys.Document:ValidTypes in the Access Gateway namespace.

OBX-5.4: Must be "Base64" if the data is base64-encoded, otherwise it can be left blank.

OBX-5.5: The document data

Best,

Jorge

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score 0 · Answer 1 · 2016-11-09T17:12:09-05:00

It might help if you were more specific. What do you mean by "attach"? How are you going to retrieve the documents? Where are the documents coming from?

score 0 · Answer 2 · 2016-11-10T15:58:58-05:00

Scott Beeson · Nov 10, 2016

From another EHR or from the Clinical Viewer. As you know, we are an HIE.

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score 0 · Answer 3 · 2016-11-10T15:59:45-05:00

Scott Beeson · Nov 10, 2016

This is interesting and I will consider. Do you know of any HL7 v3 options?

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score 0 · Answer 4 · 2016-11-16T11:29:34-05:00

Jorge de la Garza · Nov 16, 2016

I suspect this can be done in v3, but I will have to defer to my colleagues who are experts on it.

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score 1 · Answer 5 · 2017-03-09T17:51:09-05:00

Stephen De Gabrielle · Mar 9, 2017

In the UK the answer was HL7v3 ITK Non-Coded CDA Document, though I think FHIR may be an option.

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