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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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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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While you don't need to take your exam before the end of 2022, the vouchers provided to the UK&I Summit 2022 must be redeemed before January 1, 2023. Please register for an exam before time runs out.

You can find additional information about the InterSystems Certification Program here.

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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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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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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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I'm testing an HL7 2.4 -> HL7 2.3.1 set of transformations. For the time being the source (service) and sink (operation) are file adapters. What I'd really like is to be able to save the output file with a name matching/containing the input file name - but as the DTL transformation in between uses "new" rather than "copy" it looks like I'm losing (some of?) the metadata, including the "Source" field (Body tab, message viewer).

Is there any way of preserving the Source field so the OutboundAdapter has access to it?

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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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Morning everyone,

I would appreciate some advice please- hopefully there is plenty of experts out there.

We are setting up an sFTP share between hospital trusts here in the UK and I have set the outbound operation up using a custom extension of EnsLib.HL7.Operation.FTPOperation.

We are configuring a VPN tunnel to run between the sites also so there is a bit of firewall / network routing to take place to enable the connection but to add in a complication we are on a mirrored cluster and usually present on a Virtual IP address.

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VetsEZ is looking for an InterSystems Technology Platform - Practice Lead to serve our Federal healthcare customers. As a lead systems integrator, VetsEZ has been delivering large-scale implementations for various federal customers, including the Department of Veterans Affairs (VA), with the world's largest footprint of InterSystems technologies. InterSystems Technology Platform comprises core technologies, including HealthShare, Caché, IRIS, Ensemble, DeepSee, and iKnow.

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Hi all.

I have a scenario where I am receiving NACKs and I'd like to adjust the error handing of the operation based on the content of the NACK.

For example, I could receive the following and want to move onto the next message:

MSH| ^~\&|||||20221025083135.489+0100||ACK ^A02^ACK|9271|D|2.5.1
MSA|AE|1664378390234
ERR|||207 ^Application internal error ^HL70357^^^^^^Cannot transfer patient, encounter is cancelled.|E

However, I could also receive the following and want to keep retrying:

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HI Dev's

I dont work for Intersystems but i have found this training course very helpful and wanted to make sure others know about it.

Advanced Data Transformations

Advanced Data Transformations

Add a for each loop.
Create and use utility functions.
Create and use lookup tables.
Use counting.
Create and implement a subtransformation.
Add a code action.
Add a group of actions to organize relevant actions.

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Hi all.

I have setup a HL7 Operation using the HTTP adapter, and I'm getting what seems to me as an unusual response. When sending a sample message to the operation, I am getting a nested ACK. For example:

MSH|^~\&|||xxx|xxx|202209230806||ACK^HTTP^200|00|D|2.1|1
MSA|AA|RWSD7V5iuEC5F6zscDWz|HTTP ACK 'HTTP/1.1 200 OK' : MSH|^~\&|yyy|yyyy|xxx|xxx|20220923080633||ACK^A01|1663916793965||2.3||||||
MSA|CR|RWSD7V5iuEC5F6zscDWz|Error Message Goes Here.

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I am trying to split a HL7 message (RDE O11) into several messages depending on how many RXC segments there are in the message (Two RXC segments would need to two separate HL7 messages)

I have seen a couple of posts regarding this but am struggling with my BP using ObjectScript, the idea is to take the receiving message and split this before passing it onto another BP

Here is my code so far

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Question
Andrew Neilson · Sep 12, 2022
Routing ACKS.

I'm trying to get an ACK routed to a different process in our Test environment and here is the router setup:

I have a rule in the target router to send to an operation.

The problem I'm running into is that the HL7 ACK coming back is marked as "Discarded", so it's not even getting to the second router.

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Hi everyone!

I am recruiting on a fully remote Intersystems Developer. This role will be a long term contract to begin with high likelihood of extensions or conversion permanent. Please check out the job description down below and feel free to send me an email with your resume: Spencer.Frey@insightglobal.com

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Hi ,

We have inbound HL7 message we want to transform. Is it possible to copy inbound NTE segments at ORC level to PID group level in the transformed messages? I see functions for insert / append / set etc but they appear to be related to specific properties / fields of segments as iodised to the entire segment.

thanks

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