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#HL7

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Health Level-7 or HL7 refers to a set of international standards for the transfer of clinical and administrative data between software applications used by various healthcare providers

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Hi Community,

In this article, I will introduce my application iris-fhir-bridge

IRIS-FHIR-Bridge is a robust interoperability engine built on InterSystems IRIS for Health, designed to transform healthcare data across multiple formats into FHIR and vice versa. It leverages the InterSystems FHIR Object Model (HS.FHIRModel.R4.*) to enable smooth data standardization and exchange across modern and legacy healthcare systems.

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Profiling CCD Documents with LEAD North’s CCD Data Profiler
Ever opened a CCD and been greeted by a wall of tangled XML? You’re not alone. Despite being a core format for clinical data exchange, CCD's are notoriously dense, verbose, and unfriendly to the human eye. For developers and analysts trying to validate their structure or extract meaningful insights, navigating these documents can feel more like archaeology than engineering.

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One of the pain points for maintaining HL7 interfaces is the need to run a reliable regression test upon deployment to new environments and after upgrades. The %UnitTest class allows unit tests to be created and packaged alongside interface code. Test data can also be maintained within the unit test class, allowing for quick and easily repeatable smoke-testing and regression testing.

Resources:

  • Standard %UnitTest class

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Background:

This guideline provides an overview of how to design and implement a REST API interface for querying patient demographic data from an Electronic Patient Record (EPR) system using HealthConnect. The process involves sending a query request with the patient's identification number, retrieving the response from the EPR system, extracting the required patient demographic data from the HL7 message, and sending it as a JSON response to the supplier. The high-level process diagram is shown below (Screenshot 1).

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High-Performance Message Searching in Health Connect

The Problem

Have you ever tried to do a search in Message Viewer on a busy interface and had the query time out? This can become quite a problem as the amount of data increases. For context, the instance of Health Connect I am working with does roughly 155 million Message Headers per day with 21 day message retention. To try and help with search performance, we extended the built-in SearchTable with commonly used fields in hopes that indexing these fields would result in faster query times. Despite this, we still couldn't get some of these queries to finish at all.

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Your Mission

Let's pretend for a moment that you're an international action spy who's dedicated your life to keeping the people of the world safe from danger. You recieve the following mission:

Good day, Agent IRIS,

We're sorry for interrupting your vacation in the Bahamas, but we just received word from our London agent that a "time bomb" is set to detonate in a highly populated area in Los Angeles. Our sources say that the "time bomb" is set to trigger at 3:14 PM this afternoon.

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image

Hi Community,

In this article, I will introduce my application iris-HL7v2Gen .

IRIS-HL7v2Gen is a CSP application that facilitates the dynamic generation of HL7 test messages. This process is essential for testing, debugging, and integrating healthcare data systems. The application allows users to generate a wide variety of HL7 message types, validate their structure against HL7 specifications, explore the message hierarchy, and transmit messages over TCP/IP to production systems. These features are particularly useful in settings where compliance with HL7 standards is mandatory for interoperability between different healthcare organizations or systems.


Application Features

  • Dynamic HL7 Message Generation: Instantly create HL7 messages for a range of message types, facilitating comprehensive testing.
  • Message Structure Exploration: Visualize the structure of generated messages based on HL7 specifications.
  • Value Set Visualization View predefined sets of allowable coded values for specific fields.
  • Message Validation: Validate messages against HL7 standards to ensure compliance.
  • TCP/IP Communication: Easily transmit messages to production using TCP/IP settings.
  • Broad Message Type Support: Supports 184 different HL7 message types, ensuring versatility for various healthcare integration needs.
  • ClassMethod: Generate a Test Message by Invoking a Class Method
  • Version Support: Currently Supports HL7 Version 2.5

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Like many others probably find themselves, we were stuck doing live data mapping in our Interface Engine that we really didn't want to do, but had no good alternative choice. We want to only keep mappings for as long as possibly needed and then purge expired rows based upon a TTL value. We actually had 4 use cases for it ourselves before we built this. Use cases:

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Article
· Oct 17, 2024 2m read
ORU to MDM with large HL7 v2 messages.

I was working on a DTL but kept getting ERROR #5002... MAXSTRING errors. The problem was that most of the DTL GUI action steps only support the string data type when working with the segments. A %String has a limit of 3,641,144 characters and my OBX5.1 was 5,242,952 characters long as the example provided. Of course PACS admin stated ultra high quality up to and including 4K resolution files were needed, so we could not get the vendor to compress or reformat these files to compressed jpg or something similar.

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In this article we are going to see how we can use the WhatsApp instant messaging service from InterSystems IRIS to send messages to different recipients. To do this we must create and configure an account in Meta and configure a Business Operation to send the messages we want.

Let's look at each of these steps in more detail.

Setting up an account on Meta

This is possibly the most complicated point of the entire configuration, since we will have to configure a series of accounts until we can have the messaging functionality.

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Sometimes we need to convert FHIR message to HL7 V2, e.g. to register a patient to the PACS system.
In this article, I will explain the steps to achieve the desired by using IRIS FHIR Server production.

Below are the steps we need to follow:

  1. Make sure FHIRServer production is started.
  2. Register Business Service with FHIRServer endpoint.
  3. Define Business Processes to convert FHIR message to SDA and then Convert SDA to HL7 v2.
  4. Post JSON resource to FHIRServer endpoint and get HL7 V2 response.

Let's review the steps in detail.

Step 1. Make sure FHIRServer production is started

Open the production page and make sure Production is started. In the next step, we need to make sure business service HS.FHIRServer.Interop.Service is registered with FHIRServer

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Do you ever spend an age entering criteria in the message viewer page, trying to find a message just to realise you're in the wrong instance of IRIS?

Or get lost in a sea of message tabs struggling to spot that Visual Trace page your were JUST looking at?

Well, have you tried the IRIS WHIZ browser extension and its suite of tools designed to help you avoid such unpleasantness?

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Article
· Jan 31, 2024 2m read
What is iris-hl7?

An App that converts HL7 messages to JSON objects. About a year ago I started a GitHub repo for collecting stuff related to HL7. Recently my team added an HL7 interface to our Interoperability Production and we were asked to persist HL7 messages. We created a Kafka topic to receive HL7 messages. We use Kafka Bridges to send messages to Kafka topics. Kafka messages are sent to the Kafka Bridge in JSON format.

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In part I of this article, we have already learned more about HL7, its messages, structure, segments, and fields. In this part II, we will show you how to transform proprietary/custom data into HL7 using IRIS for Health. For our sample, we used the data generated by the SYNTHEA bulk data generation project (https://synthea.mitre.org/downloads). So, we will show you how to convert 1000 patients from a CSV file to HL7 v2, using the Interoperability features of IRIS for Health.

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Introduction

This article aims to explore how the FHIR-PEX system operates and was developed, leveraging the capabilities of InterSystems IRIS.

Streamlining the identification and processing of medical examinations in clinical diagnostic centers, our system aims to enhance the efficiency and accuracy of healthcare workflows. By integrating FHIR standards with InterSystems IRIS database Java-PEX, the system help healthcare professionals with validation and routing capabilities, ultimately contributing to improved decision-making and patient care.

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Written in reply to community post for can Python create HL7 Message dynamically.

Pre-requisites and setup

Use an integration enabled namespace.
Note: USER namespace is not enabled for interoperability by default.
If following suggest create a new interoperatibility namespace to explore functionality.

# Switch to
ZN "[Interoperability Namespace Name]"

# Launch interactive Python shell:
Do $SYSTEM.Python.Shell()

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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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Fun or No Fun - how serious is it?


Large language models are stirring up some phenomena in recent months. So inevitably I was playing ChatGPT too over last weekend, to probe whether it would be a complimentary to some BERT based "traditional" AI chatbots I was knocking up, or rather would it simply sweep them away.

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Introduction

Say you have a receiving system that accepts HL7 and provides error messages in field ERR:3.9 in the ACK it returns. You require a different reply code action depending on the error message, however the Reply Code Actions settings for the operation do not provide this level of granularity. One option could be to create a process that takes the ACK and then completes the action you were expecting, however things can get a bit messy if the action is to retry the message, especially when trying to view a message trace.

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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
· 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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