This article will describe and include an example of how to embed an external PDF file into an HL7 segment, specifically ADT_A01:2.3.1 OBX(). This can be useful when attempting to insert pictures or other external data into an HL7 message. In this example, the name of the PDF file to be embedded is provided in the incoming HL7 message in OBX(1):ObservationValue field.

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In the previous article, we've discussed the origin of the standard HL7v2, the structure and the types of messages. Let's now look at one of the most used types of messages and an example of its structure. I'm talking about ADT.

HL7 ADT messages (Admit, Discharge, Transfer) are used to communicate basic patient information, visit information and patient state at a healthcare facility. ADT messages are one of the most widely-used and high volume HL7 message types, as it provides information for many trigger events including patient admissions, registrations, cancellations, updates, discharges, patient data merges, etc.

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Because I had no idea how to build an integration solution for HL7 and didn't know where to start, I decided to follow the course Building Basic HL7 Integrations with InterSystems on Learning portal to get at least the idea of where to begin. After I studied all of it, I decided it might be a good idea to share my thoughts and reflections about it with everyone.

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In the previous article, we talked about the flow of data to request the test and receive the results of the requested test. Now let's talk about one of the most important messages of HL7v2 standard.

Every time a receiving application accepts a message and consumes the message data, it is expected to send an ACKnowledgement (ACK) message back to the sending application. The sending application is expected to keep on sending a message until it has received an ACK message. It is done to inform the sending application that its message was successfully received, that it is (not) valid in accordance with HL7 rules and, if it is compliant, that it will be processed at some point.

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Article
Iryna Mykhailova · Nov 29, 2022 6m read
What's HL7v2?!

HL7 (Health Level 7) is a set of technical specifications for computerized exchanges of clinical, financial and administrative data between hospital information systems (HIS). These specifications are variously integrated into the corpus of formal American (ANSI) and international (ISO) standards.

The L7 of HL7 indicates that it is a standard that operates at layer 7, in other words at the application layer, of the OSI model. This means that HL7 does not have to take into account exchange security considerations, or those of message transport (this being ensured by lower-level layers such as SSL/TLS for security or TCP for the transport of data for example). To be more precise, layer 7 supports communications for end-user processes and applications and the presentation of data for user-facing software applications. As the highest layer of the OSI model, and the closest to the end user, layer 7 provides application-specific functions such as identifying communication partners and the quality of service between them, determining resource availability, considering privacy and user authentication, and synchronizing communication, as well as connecting the application to the lower levels of the OSI model.

Returning to the HL7 standard, the HL7 version 2 standard (also known as Pipehat) was originally created in 1989 but is still being used and updated regularly, resulting in versions 2.1, 2.2, 2.3, 2.3.1, 2.4, 2.5, 2.5.1, 2.6, 2.7, 2.7.1, 2.8, 2.8.1, 2.8.2 and 2.9. The v2.x standards are backward compatible (e.g., a message based on version 2.3 will be understood by an application that supports version 2.6) and in higher versions, you will see some fields are left just for it.

Despite it being more than 30 years old, HL7v2 remains the most widely used healthcare interface standard by a large margin according to the HL7.org portal that tells that:

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In the previous article, we've seen the structure of one of the most used types of HL7 message - ADT (Admit, Discharge, Transfer) and an example of ADT^A04 with the description of all its fields. Now let's look at another flow of data having to do with ordering and fulfilling the orders of tests. I'm talking about ORM (as of version 2.5 you should use specific messages to order tests, like OMG, OML, OMD, OMS, OMN, OMI, and OMP), ORL and ORU messages. In a very simplified case, the exchange of data may look like this.

Let's look at these messages in more detail.

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DTL Transformations and GetValueAt/SetValueAt calls on HL7 messages will truncate any fields longer than 32K. To avoid this, the methods GetFieldStreamRaw and StoreFieldStreamRaw must be used when dealing with fields that might be larger than 32K. OBX:5 is a frequent example. These methods have some subtleties and must be used carefully.

This can't be done by simply dragging from left to right in a DTL. It must be done with a code action. Also, the StoreFieldStreamRaw call must be the last edit made to the segment because the segment becomes immutable after that.

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I have attached a document that describes the product I have developed called NiPaRobotica Pharmacy. This is an interface I developed that accepts Pharmacy Dispense Requests and converts the line items on the order into dispense dialogues which it sends to pharmacy robots. I deployed the interface into 3 Hospital pharmacies two of which had 6 robots that were arranged in such a way that the dispense chutes channelled medications to desks by the pharmacists sitting in windows serving 1200 patients a day. The robots cut the average waiting time from 2 hours down to one hour.

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Introduction

InterSystems has recently completed a performance and scalability benchmark of IRIS for Health 2020.1, focusing on HL7 version 2 interoperability. This article describes the observed throughput for various workloads, and also provides general configuration and sizing guidelines for systems where IRIS for Health is used as an interoperability engine for HL7v2 messaging.

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Hi Community!

I'm sharing a little tool (REST service) to download interoperability messages from your browser.

You only need to:
1. Create a web application in Management Portal (e.g. /downloadmsg) and set DispatchClass=Util.DownloadMsg.
2. Call the tool using your browser passing the namespace and the message header id to download.
http://localhost:52773/downloadmsg/ns/mydev/msgid/17441

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InterSystems and Intel recently conducted a series of benchmarks combining InterSystems IRIS with 2nd Generation Intel® Xeon® Scalable Processors, also known as “Cascade Lake”, and Intel® Optane™ DC Persistent Memory (DCPMM). The goals of these benchmarks are to demonstrate the performance and scalability capabilities of InterSystems IRIS with Intel’s latest server technologies in various workload settings and server configurations. Along with various benchmark results, three different use-cases of Intel DCPMM with InterSystems IRIS are provided in this report.

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I'm always on the lookout for tools that make the development and testing of my interfaces more efficient. A couple of years ago I came across HL7 Spy, from Inner Harbour Software. It quickly became my go-to tool for running message comparison reports for interface engine migrations, message statistics gathering, and troubleshooting message receipt and delivery. It also offered enhanced functionality for things like fetching messages via sftp that other tools don't provide.

I've recently been working with HL7 Spy's author, Jon Reis, to enable support for fetching messages directly from the Ensemble message store. Its SQL Loader feature now has native Caché/IRIS support, and I've contributed a small server-side class to support the extraction of messages using it.

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(Originally posted by @Ben Spead on June 25, 2014)

This code snippet generates a list of Ensemble Lookup Tables and Schema documents in the user's current namespace. Run the code by running the class method "test":


Class benspead.EnsTablesSchema
{
    classmethod test() {
        If ##class(%Dictionary.CompiledClass).%ExistsId("Ens.Util.LookupTableDocument") {
            // only supported in Ensemble 2012.1+
            Write !,!,"Exporting Ensemble Lookup Tables..."
            Set sc = $$$OK
            Set rs = ##class(%ResultSet).%New("Ens.Util.LookupTableDocument:List")
            Do rs.Execute()
            While rs.Next() {
                Set item=rs.Data("name")
                Write "document found: "_ item,!
            }
            Do rs.Close()
            Set rs=""
        }
        If ##class(%Dictionary.CompiledClass).%ExistsId("EnsLib.HL7.SchemaDocument") {
            Write !,!,"Exporting Ensemble HL7 Schemas..."
            Set sc = $$$OK
            Set rs = ##class(%ResultSet).%New("EnsLib.HL7.SchemaDocument:List")
            Do rs.Execute()
            While rs.Next() {
                Set item=rs.Data("name")
                Continue:$listfind($lb("2.1.HL7","2.2.HL7","2.3.HL7","2.4.HL7","2.5.HL7","2.6.HL7","2.7.HL7","2.3.1.HL7","2.5.1.HL7","2.7.1.HL7","ITK.HL7")
                                    ,item)
                Write "document found: "_ item,!
            }
            Do rs.Close()
            Set rs=""
        }
    }
}

Here's a link to the code on GitHub: https://github.com/intersystems-community/code-snippets/blob/master/src/...

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EnsLib.HL7.Message.cls provides many API methods for manipulating an HL7 message. RemoveSegmentAt(), for example, can be used to remove a segment by path or index, but only one segment at a time. There may be times that you'll need to remove all segments within a group or even many groups of segments from the HL7 message. Surely you can iterate through each segment in each group and remove them one by one, but there's a much easier way.

With just one command, like below, you can remove all OBX segments in an ORU_R01 message (msg):

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Two fairly common requests we receive from HL7 customers are (1) how to remove all trailing delimiters for fields and segments in HL7 messages and (2) how to "find and replace" for an entire HL7 message (as opposed to one segment/field at a time). The code sample below shows a custom function that solves for item 1 and by extension item 2 above. In other words the same approach can be used for finding/replacing any sequence of chars in an entire HL7 message, with some tweaks to the custom function.

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Article
Brendan Batchelder · Sep 20, 2016 4m read
Diagnosing Framing Errors

Framing refers to the characters that mark the start and end of an HL7 message (or other types of framed messages). Most HL7 services and operations have a Framing setting that allows the user to define this framing. The most common choices are available as defaults, but with the AsciiMM/NN setting, components can be configured to recognize any framing characters.

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Presenter: Matt Spielman
Task: Use the FHIR standard with HealthShare-based solutions
Approach: Provide an overview of how HealthShare will support the evolving FHIR

The next major release of HealthShare will be the first version to support the emerging HL7 FHIR standard. This presentation will discuss InterSystems’ involvement with the FHIR standard, detail the new FHIR functionality, and review our long term plans for FHIR in the HealthShare platform.

Content related to this session, including slides, video and additional learning content can be found here. Please note that this content is available only to HealthShare customers and attendees of the Global Summit. On the learning web site you will be prompted for your Global Summit credentials to access this content.

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Executive Summary

InterSystems HealthShareÆ and InterSystems EnsembleÆ both provide a rapid integration and development platform with built-in capabilities for the high-speed processing of HL7 messages. For the purposes of HL7 v2 message routing the two products are equivalent in performance. For brevity, this document will just say Ensemble in many places but it should be taken to apply equally to both products.

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