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 Link to this message Neelam Dugar  posted on Thursday, April 24, 2014 - 12:08 pm Edit Post Delete Post Print Post
Please could I have some comments and suggestions from the HL7 experts as I am trying to resolve HL7 messaging understanding between us and suppliers so that we all can support patient flows in a standardised way in NHS.

HL7 messages used in NHS RIS and PACS

HL7 consists of messages, segments and fields.
Update of information held in these messages should happen by triggers.

RIS and PACS are involved in 3 important messages—ADT, ORM and ORU.

ADT Messages form the patient Banner Information on RIS and PACS.
It consists of 2 main segments of clinical significance on RIS and PACS forming the patient Banner—namely PID and PV1:
1. PID Segment--Patient Demographics Segment
a. Name (Field 5)
b. Date of Birth (Field 7)
c. Gender (Field 8)
d. Address (Field 11)
e. PAS ID (Field 3)
f. NHS No (Field 2)
Triggers used to update PID: The Patient demographics information on RIS and PACS should ONLY be updated by PAS/MPI (NOT by any other system) by the following HL7 ADT triggers
A-28-Inserts a new patient or updates patient demographics
A-40-Merge patient data
A-29-Deletes patient

2. PV1 Segment--Patient Visit Information (Admission to hospital, visit to Outpatient or A&E). The 3 important fields are:
a. Current Patient Location—(Field 2-called Patient Class—Inpatient, Outpatient, A&E)
b. Detailed Current Location (Field 3—called Assigned Patient Location on HL7-Ward and Bed no or Named clinic)
c. Current Responsible Clinician (Field 9—Consulting Doctor-include Name, GMC number, Grade*, Main Specialty**)
PV1 segment Triggers: PV1 segment HL7 ADT should ONLY be updated by PAS (NOT by any other system) by the following ADT message triggers
A-01-Admit Patient
A-02—Transfer patient
A-03-Discharge patient
Patient Location (including Inpatient Location) and Current Consultant on Patient Banner will be blank when NOT in hospital (triggered by A-03 message)
 Link to this message Neelam Dugar  posted on Tuesday, April 29, 2014 - 09:31 pm Edit Post Delete Post Print Post
It is important that ADT messages are kept limited to the minimum dataset required in the patient banner. Hence, here is the updated version of the ADT messaging from PAS to RIS, PACS and Ordercomms:

ADT Messages form the patient Banner Information on RIS and PACS.
It consists of 2 main segments of clinical significance on RIS and PACS forming the patient Banner—namely PID and PV1:
1. PID Segment--Patient Demographics Segment
a. Name (Field 5)
b. Date of Birth (Field 7)
c. Gender (Field 8)
d. Address (Field 11)
e. PAS ID (Field 3)
f. NHS No (Field 2)
Triggers used to update PID: The Patient demographics information on RIS and PACS should ONLY be updated by PAS/MPI (NOT by any other system) by the following HL7 ADT triggers
A-28-Inserts a new patient or updates patient demographics
A-40-Merge patient data
A-29-Deletes patient

2. PV1 Segment--Patient Visit Information.
The 2 key fields are:
a. Detailed Current Location (Field 3—called Assigned Patient Location on HL7-Ward and Bed no)
c. Current Responsible Clinician (Field 9—Consulting Doctor-include Name, GMC number, Grade*, Main Specialty**)
PV1 segment Triggers: PV1 segment HL7 ADT should ONLY be updated by PAS (NOT by any other system) by the following ADT message triggers
A-01-Admit Patient
A-02—Transfer patient
A-03-Discharge patient
Patient Location (including Inpatient Location) and Current Consultant on Patient Banner will be blank when NOT in hospital (triggered by A-03 message)
 Link to this message Neelam Dugar  posted on Wednesday, May 07, 2014 - 07:26 pm Edit Post Delete Post Print Post
http://www.auntminnieeurope.com/index.aspx?sec=sup&sub=ris&pag=dis&ItemID=609815

I have written a column in Auntminnie Europe if you are interested.

Getting basic HL7 ADT, ORM and ORU interpretation right is key to ensuring safe informatics practices. This will help in your RIS or PACS replacement projects. I hope my postings will help non-HL7 experts

ADT Messages form the patient Banner Information on RIS and PACS.
It consists of 2 main segments of clinical significance on RIS and PACS—namely PID and PV1:
1. PID Segment--Patient Demographics
a. Name (Field 5)
b. Date of Birth (Field 7)
c. Gender (Field 8)
d. Address (Field 11)
e. PAS ID (Field 3)
f. NHS No (Field 2)
Triggers used to update PID: The Patient demographics information on RIS and PACS should ONLY be updated by PAS (NOT by any other system) by the following HL7 ADT triggers
A-28-Inserts a new patient or updates patient demographics
A-40-Merge patient data
A-29-Deletes patient

PD1 Segment—Additional Patient Demographics
a. Registered GP Practice NACS Code (Field 3—Patient Primary Facility)
b. Name and National GMC Code for GP (Field 4—Primary Care Provider Name and ID)

2. PV1 Segment--Patient Visit Information (Admission to hospital). The 2 key fields are:
a. Current Location (Field 3—called Assigned Patient Location on HL7-Ward and Bed no)
b. Current Responsible Clinician (Field 9—Consulting Doctor-include Name, GMC number, Grade*, Main Specialty**)
PV1 segment Triggers: PV1 segment HL7 ADT should ONLY be updated by PAS (NOT by any other system) by the following ADT message triggers
A-01-Admit Patient
A-02—Transfer patient
A-03-Discharge patient
PV1 segment ---Patient Location, Inpatient Location and Current Consultant on Patient Banner will be blank when NOT in hospital (triggered by A-03 message)
 Link to this message Neelam Dugar  posted on Monday, January 05, 2015 - 10:48 pm Edit Post Delete Post Print Post
Updated doc
application/pdfUpdated ADT agreement
ADT agreement.pdf (40.3 k)
 Link to this message George Brown  posted on Tuesday, January 06, 2015 - 09:55 am Edit Post Delete Post Print Post
I thought I would post this from the Information Standards Board regarding "Common User Interface - Patient Banner"

ISB 1505

<http://www.isb.nhs.uk/library/standard/136>

<http://www.isb.nhs.uk/documents/isb-1505/dscn-09-2010/>

Regards
 Link to this message Neelam Dugar  posted on Sunday, February 22, 2015 - 09:41 pm Edit Post Delete Post Print Post
Thanks George for pointing me to the ISB guidance on Patient Banner Display.

I have updated the doc to a more tabulated and easy to understand doc. I have incorporated ISB example.

Comments please.
application/pdfPatient Banner--HL7 mapping
Patient Banner HL7mapping.pdf (88.3 k)
 
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