HL7 Interface SpecificationsMerge AIMS
8.3
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Doc # Revision Date Description
AIMS-1068 1 10/15/12 Initial release for 8.3.
Contents
Inbound Interfaces
Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
HL7 Version Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Inbound Interface Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Admit/ Discharge- ADT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Supported ADT Event Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Scheduling - SIU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Supported SIU Event Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Lab Results - ORU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Supported ORU Event Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Outbound Interfaces
Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
HL7 Version Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Charge Utilization - DFT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Charge Utilization Interface Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
DFT^P03 Message Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Charge Utilization Message Example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Post Case - ORU. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Post Case Interface Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
ORU^R01 Message Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Post-Case Message Example. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Clinical Data - Outbound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Clinical Data Interface Functionality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
HL7 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Clinical Data Message Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Clinical Data Message Example . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
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Chapter 1 Inbound Interfaces
The Merge Healthcare Anesthesia Information Management System (AIMS) supports three types of inbound interfaces: ADT, Scheduling, and Lab Results. This portion of the document defines the interface specifications that support the transmission of data from the HIS system to the AIMS system. The specific HL7 events supported by the AIMS system as well as the fields to which the data are assigned within the application are defined.
Communication● Protocol: TCP Streaming Sockets (WinSock2 TCP Socket)
● Port Number: The AIMS system accepts all inbound connections through one configurable port.
● Acknowledgement Sent: Commit-level MSA structure
HL7 Version SupportThe Merge Healthcare AIMS system currently supports HL7 versions 2.1 to 2.4 for all inbound ADT, SIU, and ORU messages.
Inbound Interface FunctionalityHL7 messages can be routed from various hospital systems into the HIS HL7 engine on multiple sockets, and then into the HL7 Inbound Interface on a single socket connection. Conversely, multiple senders can send directly to the interface using the same destination IP address and port number, where no HL7 engine is available. The interface accepts unsolicited HL7 messages over a TCP streaming socket and returns a commit-level HL7 ACK on the same socket. Application-level ACK and custom error messages are not supported (for example: delayed acknowledgement on a different socket). The HL7 Inbound Interface is unidirectional.
HL7 event types will control the behavior of the message processing. The message handling logic will follow different paths depending upon the particular message's event type. Messages with event types not configured for processing will be discarded.
The Interface will decide which logical path to follow based upon the event type of the message found in the HL7 message header segment (MSH: 9). The parser will then find the various data elements within the segments of the message and send the information into SQL
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Server. A message lacking the system's required fields will not be processed into the database.
The HL7 Inbound Interface can be configured to populate the various fields in the SQL Server database from virtually any HL7 message element. The base configuration has been adequate for most installations, but adjustments to the base mappings can be made to suit a particular situation. Actual configuration settings will be negotiated between the HIS department and the Merge Healthcare development team during implementation.
Admit/ Discharge- ADTThe ADT information is used to update the patient demographic and visit information in the AIMS system database. This information can be viewed and/or updated manually through the AIMS PAE and AIMS Anesthesia products. Any changes to the patient's demographic and/or visit information recorded through the HIS system will automatically update the database such that the data will be available through AIMS PAE and AIMS Anesthesia. These are some of the benefits of having an ADT interface:
● Patient demographics and visit information will be available to the OR in a timely fashion
● Updates to patient information are available immediately
Supported ADT Event Types
The Merge Healthcare AIMS system currently supports these ADT event types to:
● Create new patient record
● Update patient record
● Merge patient records
Trigger Event Definition Action
ADT^A01 Admit a Patient If patient record does not exist in the AIMS system, it is created.
ADT^A02 Transfer a Patient If patient record exists, it is updated; otherwise, the record is created.
ADT^A04 Register a Patient If patient record exists, it is updated; otherwise, the record is created.
ADT^A05 Pre-Admit If patient record exists, it is updated; otherwise, the record is created.
ADT^A06 Transfer an Outpatient to Inpatient
If patient record exists, it is updated; otherwise, the record is created
ADT^A07 Change Inpatient to Outpatient
If patient record exists, it is updated; otherwise, the record is created
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ADT^A08 Update Patient Information
If patient record exists, it is updated; otherwise, the record is created.
ADT^A13 Cancel Discharge If patient record exists, it is updated; otherwise, the record is created.
ADT^A18 Merge Patient Information
This merge event is non-specific and is retained in HL7 for backwards compatibility. It is supported by the system; however, exact functionality is determined on an individual basis with accounts
ADT^A34 Merge Patient - Internal ID (MRN)
If prior MRN is found in our system, it will be changed to the "surviving" MRN, or merged with the "surviving" MRN if that already exists.
ADT^A35 Merge Patient Information - Account Number
If prior Account is found in our system, it will be changed to the "surviving" Account, or merged with the "surviving" Account if that already exists.
ADT^A36 Merge Patient Information
If prior MRN is found in our system, it will be changed to the "surviving" MRN, or merged with the "surviving" MRN if that already exists.
ADT^A40 Merge Patient - Internal ID (MRN)
If prior MRN is found in our system, it will be changed to the "surviving" MRN, or merged with the "surviving" MRN if that already exists.
ADT^A41 Merge Patient Information - Account Number
If prior Account is found in our system, it will be changed to the "surviving" Account, or merged with the "surviving" Account if that already exists.
ADT^A42 Merge Visit - Visit Number
Visit number update
ADT^A44 Move Account Account will be moved to, or created on, the specified MRN
ADT^A45 Move Visit Visit number update
ADT^A47 Change MRN If prior MRN is found in our system, it will be changed to the "surviving" MRN, or merged with the "surviving" MRN if that already exists.
Trigger Event Definition Action
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HL7 Definitions
The Merge Healthcare AIMS system currently supports these segments for HL7 ADT messages:
ADT^A49 Change Account Number
If prior Account is found in our system, it will be changed to the "surviving" Account, or merged with the "surviving" Account if that already exists.
ADT^A50 Change Visit Number Visit number update
ADT^P01 Add Patient Account If patient record exists, it is updated; otherwise, the record is created.
ADT^A60 Add/Update/Delete Patient Allergy
Properly drug-framework codified patient allergies will be updated in the patient record.
Trigger Event Definition Action
1. MSH Message Header
2. PID Patient Identification
3. PV1 Patient Visit
4. DG1 Diagnosis
5. IN1 Insurance Info
6. OBX Observation
7. NTE Notes and Comments
8. ORC Common Order
9. RXE Pharmacy/Treatment Encoded Order
10. RXR Pharmacy/Treatment Route
11. MRG Patient Merge
12. AL1 Patient Allergy
13. IAM Patient Allergy (A60)
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Within each supported segment, the system can capture and process these elements:
Table 1-1: MSH Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
MSH 1 R Field Separator |
MSH 2 R Encoding Characters Literal "^~\&"
MSH 3 O Sending Application
MSH 4 O Sending Facility
MSH 9 1 R Message Type ADT
MSH 9 2 R Trigger Event A01-A60
MSH 10 R Message Control ID Unique Message ID
MSH 12 R HL7 Version 2.1 to 2.4
Table 1-2: PID Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
PID 2 O External ID
PID 3 1 R Patient MRN
PID 5 1 R Patient Last Name
PID 5 2 R Patient First Name
PID 5 3 O Patient Middle Name
PID 7 O Patient Date of Birth Format: YYYYMMDD
PID 8 O Patient Sex
PID 18 R Patient Account Number
PID 19 O Patient SSN Number Format: XXX-XX-XXXX
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Table 1-3: PV1 Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
PV1 2 O Patient Class I, O, U (Inpatient, Outpatient, Unknown)
PV1 3 4 O Patient Facility
PV1 5 O Pre-admit Number Prior T Account Number
PV1 10 O Hospital Service
PV1 17 1 O Admitting Doctor ID
PV1 17 2 O Admitting Doctor Last Name
PV1 17 3 O Admitting Doctor First Name
PV1 17 7 O Admitting Doctor Degree
PV1 19 1 O Patient Visit Number
PV1 44 O Admit Date/Time Format: YYYYMMDDHHmm
PV1 50 O Alternate Visit ID Prior T Account Number
Table 1-4: DG1 Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
DG1 1 O Set ID
DG1 2 O Diagnosis Coding Method
I9, etc.
DG1 3 1 O Diagnosis Code/Identifier
DG1 4 O Diagnosis Description
DG1 5 O Diagnosis Date/Time Format: YYYYMMDDHHmm
DG1 6 O Diagnosis Type A,W, F (Admitting, Working, Final)
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Table 1-5: IN1 Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
IN1 2 1 O Insurance Plan ID
IN1 4 1 O Insurance Company Name
Table 1-6: OBX Definition for Height/Weight
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 O Observation Identifier Indicator (Height, Weight, etc)
OBX 5 1 O Observation Value Patient Height or Weight
OBX 6 1 O Observation Units Recognized height units include cm, centimeter(s), mm, millimeter(s), m, meter(s), ft, foot, feet; otherwise inches is assumed.
Recognized weight units include kg, kilo(s), kilogram(s), oz, ounce(s); otherwise pounds is assumed.
Table 1-7: OBX Definition for Surgical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier External key such as SURG_HX; mapped in System Config utility.
OBX 5 1 R Observation Value Procedure name or description
OBX 7 1 O Reference Range Anesthesia Type; mapped in System Config utility
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OBX 8 1 O Abnormal Flags "Y" for complications checkbox; other flags ignored.
OBX 11 1 O Observation Result Status
"D" Delete will remove item. "F" Final or "C" Correction (or any other value) will add or update the item.
OBX 14 1 O Observation date-time
Surgical procedure date: "yyyymmddHHMM" or "yyyymmdd"
OBX 15 1 and 3 C Producer's ID and Name of coding system
Internal ID from source system and name of source system.
Conditionally required, necessary to process deletes.
Table 1-8: OBX Definition for Family History of Anesthesia
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier External key matching
● None
● Problems
● No Problems
● Unknown
As mapped in System Config utility.
Table 1-7: OBX Definition for Surgical History (Continued)
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
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Table 1-9: OBX Definition for NPO Status
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Either of two values
(Date-time value or Since Midnight checkbox) mapped in System Config utility.
OBX 5 1 C Observation Value If Identifier matches to checkbox, then Value field indicates checkbox state (T, True, F False)
OBX 14 1 C Observation date-time
If Identifier matches to date-time, NPO since this date-time
Table 1-10: OBX Definition for PreOp or PostOp Vital Signs
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Group identifier indicating PreOp or Post-Op, as mapped in System Config utility
OBX 4 R Observation Sub-Id Identifies the particular measurements, including:
● Blood Pressure
● Temperature
● Temperature Mode
● Pulse
● Respiration
● SpO2
● Room Air
● Percent Oxygen
The Identifiers are mapped in System Config utility.
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OBX 5 1 R Observation Value Value of the specific measurement; numeric except for Temperature Mode and Room Air
OBX 6 1 C Units Required for Temperature (F or C)
OBX 14 1 R Observation date-time
Vitals timestamp; the single latest timestamp per set is saved in AIMS.
Table 1-11: OBX Definition for Medical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Identifies the particular Condition as mapped in the System Config utility.
OBX 5 1 O Observation Value See note below
OBX 11 1 R Observation Result Status
"D" Delete will remove item. "F" Final or "C" Correction (or any other value) will add or update the item.
OBX 14 1 R Observation date-time
Timestamp
Table 1-12: OBX Definition for Timed Events
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Identifies the particular Event as mapped in the System Config utility.
OBX 5 1 O Observation Value Can optionally be used instead of OBX-14 for event date-time
OBX 14 1 R Event date-time Timestamp of event
Table 1-10: OBX Definition for PreOp or PostOp Vital Signs (Continued)
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
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Chapter 1 Inbound Interfaces
The patient’s medication profile of Home and Current medications is sent in a RDE^O11 message. The MSH, PID, and PV1 segments are described above. Each medication must be sent in a separate message, with a single ORC and RXE segment.
Note regarding medical history Value field: The value field is not explicitly required. If all possible medical history items have multiple-choice style answers (T/F, Y/N, selection lists), then it is possible to combine OBX-3 and OBX-5 into a composite identifier, and map those to groups of conditions in PAE. For example, a question "Do You Smoke?" with Y/N answers could map to a PAE "Smoker" and "Non-smoker" conditions.
However, if any medical history items have free-response answers, then it is recommended to map the Value field as the comment associated with the individual question. For example, a question "Who is your cardiologist?" with a text response would map to a PAE "Cardiologist" condition and its associated comment field.
Examples:
OBX|3|TX|NURAASS12^NURSM1^Do you now/did you ever smoke?||Y||||||F|||201206281413
OBX|4|TX|NURAASS12^NURSMH1^Qty.||1:1 pack/day||||||F|||201206281413
Table 1-13: NTE Definition for Surgical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Surgical History item Comment
Table 1-14: NTE Definition for Family History of Anesthesia
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Family History Comment
Table 1-15: NTE Definition for NPO Status
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment NPO Comment (25 character max)
Table 1-16: NTE Definition for PreOp or PostOp Vital Signs
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Physiologic Status Comment
Table 1-17: NTE Definition for Medical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Condition Comment
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Table 1-18: ORC Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
ORC 2 1 C Order Identifier Used as the Source ID; necessary to process deletes
ORC 5 1 C Order Status "D" or other configured value will remove item with matching ID, Source, and Source ID
ORC 9 1 C Documentation Date-time
Updates are only processed if newer than existing data
ORC 10 1 C User Name Free text, can also be configured to RXE-13
ORC 21 1 C Ordering Facility Name
Used as Source; necessary to process deletes
Table 1-19: RXE Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
RXE 1 1-2 O Frequency Free text
RXE 2 1 R Medication Identifier
RXE 2 2 R Medication Description
RXE 2 3 R Identifier Type
RXE 4 1 O Dose Amount Free text
RXE 5 1 O Dose Units Concatenated with Dose Amount
RXE 7 1 O Comment Free text
RXE 18 1 O Last Taken Free text
Table 1-20: RXR Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
RXR 1 2 O Route Free text
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Table 1-21: MRG Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
MRG 2 R Prior Patient ID Prior MRN
MRG 3 R Prior Account Number
Prior Account Number
Table 1-22: AL1 Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
AL1 2 1 R Allergen Type Code "DA" (Drug Allergy), "FA" (Food Allergy)
AL1 3 1 R Allergen Code/ID
AL1 3 2 R Allergen Code/Text
AL1 3 3 R Allergen Code/Type
AL1 3 4 O Alternate Identifier
AL1 3 6 O Allergy Source System
AL1 5 O Allergic Reaction
Table 1-23: IAM Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
IAM 2 1 R Allergen Type Code "DA" (Drug Allergy), "FA" (Food Allergy)
IAM 3 1 R Allergen Code/ID
IAM 3 2 R Allergen Code/Text
IAM 3 3 R Allergen Code/Type
IAM 5 O Allergic Reaction
IAM 6 1 O Allergy Action/Identifier
IAM 7 1 C Allergy Unique Identifier
IAM 7 2 C Allergy Source System
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Scheduling - SIUThe SIU information is used to update the scheduling information in the AIMS system database. This information can be viewed and/or updated manually through the AIMS PAE and AIMS Anesthesia products. Any updates to the surgical procedure scheduling recorded through hospital scheduling system will automatically update the AIMS system database such that the data will be available through AIMS PAE and AIMS Anesthesia. These are some of the benefits of having a scheduling interface:
● Procedure scheduling information will be available to the OR in a timely fashion
● Updates to scheduling information are available almost immediately
● It will eliminate the need to manually enter procedure, scheduling and patient demographics within the system
Supported SIU Event Types
The Merge Healthcare AIMS system currently supports these SIU event types for:
● New scheduled surgery appointment (also known as a "Case")
● Scheduled appointment update
● Scheduled appointment cancellation
IAM 9 1 O Sensitivity to Causative Agent code
"IN" Intolerance
Any other value for a true allergy
IAM 17 1 O Allergy Clinical Status Code
Table 1-23: IAM Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
Trigger Event Definition Action
SIU^S12 New Appointment (Surgical Procedure)
Case record is created. This includes patient information. If patient record exists, it will be attached and updated as needed.
SIU^S13 Reschedule Surgery If case record exists, it is updated; otherwise, the record is created.
SIU^S14 Change Surgical Appointment Details
If case exists, it is updated; otherwise, the record is created.
SIU^S15 Cancel Surgery Case is canceled
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HL7 Definitions
The Merge Healthcare AIMS system currently supports these segments for HL7 SIU messages:
Within each supported segment, the system can capture and process these elements:
1. MSH Message Header
2. SCH Appointment Identification
3. PID Patient Identification
4. PV1 Patient Visit
5. OBX Event Timestamps
6. NTE Notes and Comments
7. ORC Common Order
8. RXE Pharmacy/Treatment Encoded Order
9. RXR Pharmacy/Treatment Route
10. AIS Surgical Procedure Information
11. AIL Operating Room Location (Scheduled Date/Time)
12. AIP Hospital personnel
Table 1-24: MSH Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
MSH 1 R Field Separator |
MSH 2 R Encoding Characters Literal "^~\&"
MSH 3 O Sending Application
MSH 4 O Sending Facility
MSH 9 1 R Message Type SIU
MSH 9 2 R Trigger Event S12-15
MSH 10 R Message Control ID Unique Message ID
MSH 12 R HL7 Version 2.1 to 2.4
Table 1-25: SCH Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
SCH 2 1 R Filler Appointment ID Medical Procedure Appointment ID
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Table 1-26: PID Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
PID 2 O External ID
PID 3 1 R Patient MRN
PID 5 1 R Patient Last Name
PID 5 2 R Patient First Name
PID 5 3 O Patient Middle Name
PID 7 O Patient Date of Birth Format: YYYYMMDD
PID 8 O Patient Sex
PID 18 R Patient Account Number
PID 19 O Patient SSN Number Format: XXX-XX-XXXX
Table 1-27: PV1 Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
PV1 2 O Patient Class I, O, U (Inpatient, Outpatient, Unknown)
PV1 3 4 O Patient Facility
PV1 5 O Pre-admit Number Prior T Account Number
PV1 10 O Hospital Service
PV1 17 1 O Admitting Doctor ID
PV1 17 2 O Admitting Doctor Last Name
PV1 17 3 O Admitting Doctor First Name
PV1 17 7 O Admitting Doctor Degree
PV1 19 1 O Patient Visit Number
PV1 44 O Admit Date/Time Format: YYYYMMDDHHmm
PV1 50 O Alternate Visit ID Prior T Account Number
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Table 1-28: OBX Definition for Height/Weight
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 6 1 O Observation Units Recognized height units include cm, centimeter(s), mm, millimeter(s), m, meter(s), ft, foot, feet; otherwise inches is assumed.
Recognized weight units include kg, kilo(s), kilogram(s), oz, ounce(s); otherwise pounds is assumed.
Table 1-29: OBX Definition for Surgical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier External key such as SURG_HX; mapped in System Config utility.
OBX 5 1 R Observation Value Procedure name or description
OBX 7 1 O Reference Range Anesthesia Type; mapped in System Config utility
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OBX 8 1 O Abnormal Flags "Y" for complications checkbox; other flags ignored.
OBX 11 1 O Observation Result Status
"D" Delete will remove item. "F" Final or "C" Correction (or any other value) will add or update the item.
OBX 14 1 O Observation date-time
Surgical procedure date: "yyyymmddHHMM" or "yyyymmdd"
OBX 15 1 and 3 C Producer's ID and Name of coding system
Internal ID from source system and name of source system.
Conditionally required, necessary to process deletes.
Table 1-30: OBX Definition for Family History of Anesthesia
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier External key matching
● None
● Problems
● No Problems
● Unknown
As mapped in System Config utility.
Table 1-29: OBX Definition for Surgical History (Continued)
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
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Table 1-31: OBX Definition for NPO Status
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Either of two values
(Date-time value or Since Midnight checkbox) mapped in System Config utility.
OBX 5 1 C Observation Value If Identifier matches to checkbox, then Value field indicates checkbox state (T, True, F False)
OBX 11 1 C Observation date-time
If Identifier matches to date-time, NPO since this date-time
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Table 1-32: OBX Definition for PreOp or PostOp Vital Signs
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Group identifier indicating PreOp or Post-Op, as mapped in System Config utility
OBX 4 R Observation Sub-Id Identifies the particular measurements, including:
● Blood Pressure
● Temperature
● Temperature Mode
● Pulse
● Respiration
● SpO2
● Room Air
● Percent Oxygen
The Identifiers are mapped in System Config utility.
OBX 5 1 R Observation Value Value of the specific measurement; numeric except for Temperature Mode and Room Air
OBX 6 1 C Units Required for Temperature (F or C)
OBX 14 1 R Observation date-time
Vitals timestamp; the single latest timestamp per set is saved in AIMS.
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Chapter 1 Inbound Interfaces
The patient’s medication profile of Home and Current medications is sent in a RDE^O11 message. The MSH, PID, and PV1 segments are described above. Each medication must be sent in a separate message, with a single ORC and RXE segment.
Table 1-33: OBX Definition for Medical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Identifies the particular Condition as mapped in the System Config utility.
OBX 5 1 O Observation Value See note below
OBX 11 1 R Observation Result Status
"D" Delete will remove item. "F" Final or "C" Correction (or any other value) will add or update the item.
OBX 14 1 R Observation date-time
Timestamp
Table 1-34: OBX Definition for Timed Events
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 3 1 R Observation Identifier Identifies the particular Event as mapped in the System Config utility.
OBX 5 1 O Observation Value Can optionally be used instead of OBX-14 for event date-time
OBX 14 1 R Event date-time Timestamp of event
Table 1-35: NTE Definition for Surgical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Surgical History item Comment
Table 1-36: NTE Definition for Family History of Anesthesia
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Family History Comment
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Note regarding medical history Value field: The value field is not explicitly required. If all possible medical history items have multiple-choice style answers (T/F, Y/N, selection lists), then it is possible to combine OBX-3 and OBX-5 into a composite identifier, and map those to groups of conditions in PAE. For example, a question "Do You Smoke?" with Y/N answers could map to a PAE "Smoker" and "Non-smoker" conditions.
However, if any medical history items have free-response answers, then it is recommended to map the Value field as the comment associated with the individual question. For example, a question "Who is your cardiologist?" with a text response would map to a PAE "Cardiologist" condition and its associated comment field.
Examples:
OBX|3|TX|NURAASS12^NURSM1^Do you now/did you ever smoke?||Y||||||F|||201206281413
OBX|4|TX|NURAASS12^NURSMH1^Qty.||1:1 pack/day||||||F|||201206281413
Table 1-37: NTE Definition for NPO Status
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment NPO Comment (25 character max)
Table 1-38: NTE Definition for PreOp or PostOp Vital Signs
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Physiologic Status Comment
Table 1-39: NTE Definition for Medical History
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Condition Comment
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Chapter 1 Inbound Interfaces
Table 1-40: ORC Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
ORC 2 1 C Order Identifier Used as the Source ID; necessary to process deletes
ORC 5 1 C Order Status "D" or other configured value will remove item with matching ID, Source, and Source ID
ORC 9 1 C Documentation Date-time
Updates are only processed if newer than existing data
ORC 10 1 C User Name Free text, can also be configured to RXE-13
ORC 21 1 C Ordering Facility Name
Used as Source; necessary to process deletes
Table 1-41: RXE Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
RXE 1 1-2 O Frequency Free text
RXE 2 1 R Medication Identifier
RXE 2 2 R Medication Description
RXE 2 3 R Identifier Type
RXE 4 1 O Dose Amount Free text
RXE 5 1 O Dose Units Concatenated with Dose Amount
RXE 7 1 O Comment Free text
RXE 18 1 O Last Taken Free text
Table 1-42: RXR Definition for Home/Current Medications
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
RXR 1 2 O Route Free text
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The first AIS segment becomes the primary procedure. Any subsequent AIS segments will become Additional scheduled procedures for the case. There is no limit on the number of additional procedures for a case.
Multiple staff are supported, in that there can be multiple surgeons, multiple CRNAs, multiple Anesthesiologists, multiple nurses, etc., but the system will determine their role in the case based upon the database setting for that clinician. Typically, only the surgeon is sent across on the schedule; but other team members can be sent as well.
Table 1-43: AIS Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
AIS 3 4 R Universal Service ID - Code
Medical Procedure Type ID
AIS 3 5 O Universal Service ID - Text
Medical Procedure Type Text
Table 1-44: AIL Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
AIL 3 2 R Location ID (Room) Medical Procedure Location/Room
AIL 6 1 R Start Date/Time Procedure Date and Time
Format: YYYYMMDDHHmm
Table 1-45: AIP Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
AIP 3 1 R Personnel ID Medical Procedure Staff ID
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Chapter 1 Inbound Interfaces
Lab Results - ORUThe Lab Result information will be sent from the hospital's lab system and stored in the AIMS system database. This information can be viewed in the AIMS PAE and AIMS Anesthesia products. Any changes to the patient's lab result information recorded through either the LIS or the HIS system will automatically update the database such that the data will be available through AIMS PAE and AIMS Anesthesia. These are some of the benefits of having a lab results interface:
● Patient lab results information will be available to the clinician
● Updates to patient lab results information are available immediately
Supported ORU Event TypesThe Merge Healthcare AIMS system currently supports these ORU event types to:
● Populate the lab results
● Update lab results based on Date/Time of observation for each visit
HL7 Definitions
The Merge Healthcare AIMS system currently supports these segments for HL7 ORU messages:
Trigger Event Definition Action
ORU^R01 Unsolicited Lab Result If matching Patient account and lab test type are found in the database, lab results will be added to the patient record.
1. MSH Message Header
2. PID Patient Identification
3. OBR Observation Request Information (Date/Time, etc)
4. OBX Observation (Lab Results)
5. NTE Comments
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Within each supported segment, the Merge Healthcare AIMS system can capture and process these elements:
Table 1-46: MSH Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
MSH 1 R Field Separator |
MSH 2 R Encoding Characters Literal "^~\&"
MSH 3 O Sending Application
MSH 4 O Sending Facility
MSH 9 1 R Message Type ORU
MSH 9 2 R Trigger Event R01
MSH 10 R Message Control ID Unique Message ID
MSH 12 R HL7 Version 2.1 to 2.4
Table 1-47: PID Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
PID 2 O External ID
PID 3 1 R Patient MRN
PID 5 1 R Patient Last Name
PID 5 2 R Patient First Name
PID 5 3 O Patient Middle Name
PID 7 O Patient Date of Birth Format: YYYYMMDD
PID 8 O Patient Sex
PID 18 R Patient Account Number
PID 19 O Patient SSN Number Format: XXX-XX-XXXX
Table 1-48: OBR Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBR 7 R Observation Date/Time
Lab Result Date and Time
Format: YYYYMMDDHHmm
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Chapter 1 Inbound Interfaces
Table 1-49: OBX Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
OBX 1 R Set ID
OBX 2 R Value Type Only "ST" and "NM" will be processed
OBX 3 1 R Observation Identifier Lab Results Lab Type
OBX 5 1 R Observation Value Lab Results Observation Value
OBX 6 1 O Observation Units
OBX 7 O Reference Range
OBX 8 O Abnormal Flag
Table 1-50: NTE Definition
Segment Field SubfieldReq/Opt/Cond
HL7 Definition Comment
NTE 3 O Comment Lab Results Observation Comments
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Chapter 2 Outbound Interfaces
The Merge Healthcare AIMS system supports three outbound interfaces: Clinical Data, Charge Utilization, and the Post Case interface. This portion of the document defines the interface specifications that support the transmission of data from the AIMS system to the client’s interface engine for further processing, or directly to the HIS system(s).
Communication● Protocol: TCP Streaming Sockets
● Target IP address and Port Number: Configurable
● Acknowledgement Received: MSA message structure - commit level acknowledgement (same socket)
HL7 Version Support● Clinical Data Interface: HL7 Version 2.4
● Charge Utilization Interface: HL7 Version 2.3
● Post Case Interface: HL7 Version 2.3.1
Charge Utilization - DFTThis interface is designed to provide information regarding the items and quantities of drugs and supplies used during an anesthesia procedure. These are some of the benefits of having a Charge Utilization interface:
● Billing system, pharmacy and/or materials management will know what was used during an anesthesia case immediately upon close of case.
● Manual paperwork for charging is eliminated.
● Auditing report is available.
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Charge Utilization Interface Functionality
The HL7 Charge Utilization Interface runs as a Windows service, and communicates with the database via the AIMS system web service, over HTTPS. It polls the database for new utilization data, and sends out HL7 DFT^P03 messages if new data is found.
At the close of an anesthesia case, the system parses out the case data sent in from the AIMS Anesthesia client machine in the OR where the case ran. Some of that parsed data will be entered into the three utilization tables in the SQL database. This will trigger the outbound interface to send out the utilization messages for that case.
The three utilization types are:
● OR Drugs
● IV Bag Solutions
● Supply Items
The outbound interface can be configured to send out any or all of the three utilization types. There will be one HL7 transaction per item type per case. The case utilization data is grouped and aggregated by charge code and Product ID. Overall utilization quantities are calculated for each combination of charge code and Product ID for that anesthesia case. If five different drugs were given during that case, five HL7 transactions are produced - regardless of how many individual syringes were used to deliver those drugs. There will be one HL7 transaction per drug, showing the total usage quantity of that drug.
The financial transaction is completed after the HL7 ACK message is received, at which time the transaction is posted back to the database where the utilization records involved with that transaction are marked with an Export Date/Time.
HL7 Definitions
The Merge Healthcare AIMS system supports these segments for HL7 DFT messages:
Within each supported segment, the Merge Healthcare AIMS system can process and export these elements:
1. MSH Message Header
2. PID Patient Identification
3. PV1 Patient Visit
4. FT1 Financial Transaction
Table 2-1: MSH Definition
Segment Field Subfield HL7 Definition Comment
MSH 1 Field Separator |
MSH 2 Encoding Characters Literal "^~\&"
MSH 3 Sending Application Literal "MERGEAIMS"
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Chapter 2 Outbound Interfaces
MSH 4 Sending Facility Sending facility for multi-facility customers, or “Default” for single-facility customers
MSH 9 1 Message Type Literal "DFT"
MSH 9 2 Trigger Event Literal "P03"
MSH 10 Message Control ID [msg_control_id]
MSH 11 Processing ID Literal "P"
MSH 12 HL7 Version Literal "2.3"
MSH 15 Accept Ack Type Literal "AL"
MSH 16 Application Ack Type Literal "NE"
Table 2-2: PID Definition
Segment Field Subfield HL7 Definition Comment
PID 3 1 Patient MRN [patient_mrn]
PID 5 1 Patient Last Name [patient_last_name]
PID 5 2 Patient First Name [patient_first_name]
PID 18 Patient Account Number [patient_account_number]
Table 2-3: PV1 Definition
Segment Field Subfield HL7 Definition Comment
PV1 2 Patient Class [patient_class]
PV1 3 1 Patient Facility [use_location] -- OR Name
PV1 19 1 Patient Visit Number [visit_number]
Table 2-4: FT1 Definition
Segment Field Subfield HL7 Definition Comment
FT1 2 Transaction ID [transaction_id]
FT1 4 1 Use Date [use_date] -- Date/Time of use
FT1 5 Posting Date [posting_date]
FT1 6 Debit/Credit Indicator [debit_credit] -- "D" or "C" (Configurable)
FT1 7 1 Charge Code [charge_code] -- Hospital Charge Code
Table 2-1: MSH Definition
Segment Field Subfield HL7 Definition Comment
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DFT^P03 Message Template
MSH|^~\&|MERGEAIMS|[sending_facility]|[target_app]|[target_facility]|[message_date_time]||DFT^P03|[msg_control_id]|P|2.3|||
AL|NE|USA|EVN|P03|[message_date_time]|PID|||[patient_mrn]^^^[patient_facility]||[patient_last_name]^[patient_first_name]^[patient_middle_name]|
||||||||||||[patient_account_number]||PV1||[patient_class]|[use_location]||||||||||||||||[visit_number]|FT1||[transaction_id]||[use_date]|[posting_date]|[debit_credit]|[charge_code]^[product_name]^^[product_id]|
N4[product_ndc]ML[amount_delivered]||[quantity]||||||[department_code]||||[staff_id]^[staff_lastname]^[staff_firstname]|||||[procedure_code]|
Charge Utilization Message Example
MSH|^~\&|MERGEAIMS|Default|DataGateSimulator|FDBMain|20100915120430||DFT^P03|20100915120427170|P|2.3|||AL|NE|USA|EVN|P03|20100915120430|PID|||MRNU07.420^^^||KOPTAN_07.420^ASHTON^|||||||||||||ANU07.420||PV1||I|OR 01||||||||||||||||VN07.420|FT1||I0af36e13-a22d-46e1-bc6a-821c8853a644||20100820112327|20100915120430|CH|54354^Morphine 500mg / 500mL
NS^^N409998768098ML500^|||1||||||FDBMainPharm||||^^||||||
FT1 7 2 Product Name [product_name]
FT1 7 4 Product ID [product_id]
FT1 8 1 NDC Quantity N4[product_ndc]ML[amount_delivered]
FT1 10 7 Quantity [quantity] -- Billable Quantity
FT1 16 1 Department Code [department_code]
FT1 20 1 Staff ID [staff_id]
FT1 20 2 Staff Last Name [staff_lastname]
FT1 20 3 Staff First Name [staff_firstname]
FT1 25 1 Procedure Code [procedure_code]
Table 2-4: FT1 Definition (Continued)
Segment Field Subfield HL7 Definition Comment
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Chapter 2 Outbound Interfaces
Post Case - ORUThis interface is designed to provide information indicating various aspects of an anesthesia procedure. The outbound message is triggered upon close-of-case. Here is one of the benefits of having a Post Case interface:
● Destination system will be appraised of various case aspects immediately upon close of case.
Post Case Interface Functionality
The HL7 Post-Case Interface runs as a Windows service, and communicates with the system database via the AIMS system web service, over HTTPS. It polls the database for newly-closed anesthesia cases, and sends out an HL7 ORU R01 message for any cases closed since the previous polling interval (generally set at 1 minute).
At the close of an anesthesia case, the system parses out the case data sent to the server from the AIMS Anesthesia client machine in the OR where the case ran. The case data are parsed out and stored in the relational database (SQL Server). The final action of close-of-case processing is the triggering of the outbound Post-Case HL7 transaction. This is achieved via a database trigger populating a polling table.
Any open transactions will be found in this 'ClosedCasePolling' table. There will be one HL7 transaction per case. The Post-Case interface service will poll the database for any open transactions (which it has not yet processed). Cases will be processed in the order in which they were closed.
HL7 Definitions
The Merge Healthcare AIMS system currently supports these segments for HL7 ORU messages:
Within each supported segment, the Merge Healthcare AIMS system can process and export these elements:
1. MSH Message Header
2. PID Patient Identification
3. OBR Observation Request Information
4. OBX Observation
Table 2-5: MSH Definition
Segment Field Subfield HL7 Definition Comment
MSH 1 Field Separator |
MSH 2 Encoding Characters Literal "^~\&"
MSH 3 Sending Application Literal "MERGEAIMS"
MSH 5 Receiving Application DestApp
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MSH 7 Message Date/Time [message_date_time]
MSH 9 1 Message Type Literal "ORU"
MSH 9 2 Trigger Event Literal "R01"
MSH 10 Message Control ID [msg_control_id]
MSH 11 Processing ID Literal "P"
MSH 12 HL7 Version Literal "2.3.1"
MSH 15 Accept Ack Type Literal "AL"
MSH 16 Application Ack Type Literal "NE"
MSH 17 Country Code Literal "USA"
Table 2-6: PID Definition
Segment Field Subfield HL7 Definition Comment
PID 3 1 Patient MRN CX:5 = "AN"
MRN CX:5 = "MR"
Case number CX:5 = "CASE"
SS# CX:5 = "SS"
PID 5 1 Patient Last Name [patient_last_name]
PID 5 2 Patient First Name [patient_first_name]
PID 5 3 Patient Middle Name [patient_middle_name]
PID 7 Patient Date of Birth [patient_DOB]
PID 8 Patient Sex [patient_sex]
PID 18 1 Patient Account Number [patient_account_number]
PID 19 Patient Social Sec Number [patient_SS]
Table 2-7: OBR Definition
Segment Field Subfield HL7 Definition Comment
OBR 3 Observation Identifier [filler_appt_id]
OBR 4 1 Universal Service ID Literal "5000.8"
OBR 4 2 Universal Service Text Literal "ANESTHESIA"
OBR 4 3 Name of Coding System Literal "AS4"
Table 2-5: MSH Definition
Segment Field Subfield HL7 Definition Comment
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Chapter 2 Outbound Interfaces
NOTE: If a particular event did not occur during the case, such as no PREOPSTART event ever happened, then the OBX segment which would ordinarily have represented that event will not be present in the HL7 message. Therefore, the SET ID of the OBX will not be a reliable means of locating a particular piece of information for parsing out. Instead, the code found in OBX:3.1, or OBX:3.2 must be used to locate which OBX instance contains the needed information from OBX:5
The default indicators are as follows:
● PRIMARYPROCEDURE = 1
● ANESTHESIATYPE = 2
● ASACLASS = 3
● PREOPSTART = 4
● INROOMSTART = 5
● ANESTHESIASTART = 6
● INCISIONSTART = 7
● INCISIONEND = 8
● INCISIONMINUTES = 9
● INROOMEND = 10
● ANESTHESIAEND = 11
● PACUEND = 12
The preceding codes can be reconfigured to match codes or descriptions in your system, but the meaning of the information they represent must be carefully preserved if such reconfiguration is considered.
Table 2-8: OBX Definition
Segment Field Subfield HL7 Definition Comment
OBX 1 Set ID [setid] -- Identifies Give Instance of OBX
OBX 2 Value Type HL7 Data Type found in OBX-5
OBX 3 1 Observation Identifier/ID Indicates which element of the case data this particular OBX contains.
OBX 3 2 Observation Identifier/Text Text version of the ID in OBX-3
OBX 5 1 Observation Value Actual Information: Date/Time, procedure type, etc.
OBX 11 Observation Result Status Literal "F"
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ANESTHESIA TYPE: The anesthesia types used will be limited to those found in the system database. No mapping to other systems is currently available. Any desired mapping of anesthesia types must be done within the receiving system.
ORU^R01 Message Template
MSH|^~\&|MERGEAIMS||DestApp||[message_date_time]||ORU^R01|[msg_control_id]|P|2.3.1|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^^MR~[filler_appt_id]^^^^CASE~[patient_account]^^^^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account]^^^^AN|[patient_SS]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|CE|1^PRIMARYPROCEDURE^99PSD||^[value]^99PS||||||F|
OBX|[setid]|CE|2^ANESTHESIATYPE^99PSD||[value_id]^[value]^99DS||||||F|
OBX|[setid]|CE|3^ASACLASS^99PSD||[value_id]^[value]^99DS||||||F|
OBX|[setid]|TS|4^PREOPSTART^99PSD||[value]||||||F|
OBX|[setid]|TS|5^INROOMSTART^99PSD||[value]||||||F|
OBX|[setid]|TS|6^ANESTHESIASTARTTIME^99PSD||[value]||||||F|
OBX|[setid]|TS|7^INCISIONSTART^99PSD||[value]||||||F|
OBX|[setid]|TS|8^INCISIONEND^99PSD||[value]||||||F|
OBX|[setid]|NM|9^INCISIONMINUTES^99PSD||[value]|Min|||||F|
OBX|[setid]|TS|10^INROOMEND^99PSD||[value]||||||F|
OBX|[setid]|TS|11^ANESTHESIASTOPTIME^99PSD||[value]||||||F|
OBX|[setid]|TS|12^PACUEND^99PSD||[value]||||||F|
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Chapter 2 Outbound Interfaces
Post-Case Message Example
MSH|^~\&|MERGEAIMS||DestApp||20050628141450||ORU^R01|20050628444|P|2.3.1|||AL|NE|USA|
PID|1||444-44-4444^^^^SSN~FMRN100^^^^MR~444^^^^CASE~FACCT100^^^^AN||LASTNAME^FIRSTNAME^MID
OBR|1||444|5000.8^ANESTHESIA^AS4|
OBX|1|CE|1^PRIMARYPROCEDURE^99PSD|1|^PROC_ID3^99PS||||||F|
OBX|2|CE|2^ANESTHESIATYPE^99PSD|1|EPIGEN^Epidural and General^99DS||||||F|
OBX|3|CE|3^ASACLASS^99PSD|1|^IV^99DS||||||F|
OBX|4|TS|6^ANESTHESIASTARTTIME^99PSD|1|20050628135606||||||F|
OBX|5|TS|11^ANESTHESIASTOPTIME^99PSD|1|20050628135915||||||F|
OBX|6|TS|7^INCISIONSTART^99PSD|1|20050628135755||||||F|
OBX|7|TS|8^INCISIONEND^99PSD|1|20050628135757||||||F|
OBX|8|TS|5^INROOMSTART^99PSD|1|20050628135719||||||F|
OBX|9|TS|10^INROOMEND^99PSD|1|20050628135811||||||F|
OBX|10|TS|4^PREOPSTART^99PSD|1|20050628135610||||||F|
OBX|11|TS|12^PACUEND^99PSD|1|20050628135922||||||F|
OBX|12|NM|9^INCISIONMINUTES^99PSD|1|1|Min|||||F|
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Clinical Data - OutboundThis interface is designed to share discrete clinical information documented in the PreAnesthesia Evaluation (PAE) and in the anesthesia record. The outbound messages are triggered differently depending on the data:
● Allergies can be documented in either the PAE or the Anesthesia record, and are sent when saved (real-time).
● Timed events (Patient In Room, Procedure Start, etc) are documented in the anesthesia record, and are sent when saved (real-time). This supports a shared intraoperative workflow between anesthesia and nursing.
● Other data documented in the PAE are sent when the PAE is signed and/or Finalized.
● Other data documented in the anesthesia record are sent when the record is signed and closed, including closing an appended case.
The clinical data interface is intended to support shared workflows and shared discrete data.
● Combined with the inbound clinical data interface, duplicate data entry is minimized (ie, data entered by Nursing within the Nursing system becomes available in the Anesthesia system, and data entered by Anesthesia becomes available within the Nursing system).
● Patient safety is enhanced by sharing codified allergy and medication lists.
Clinical Data Interface Functionality
The HL7 Clinical Data Interface runs as a Windows service, and communicates with the system database via the AIMS system web service, over HTTPS. It polls the database for updated records, and sends out the appropriate HL7 messages for any data since the previous polling interval (generally set at 1 minute).
Any open transactions will be found in the 'Outbound Clinical Data Polling' table. There may be multiple transactions per case (per patient). The Outbound interface service will poll the database for any open transactions (which it has not yet processed).
HL7 Definitions
The Merge Healthcare AIMS system currently supports these segments for HL7 ORU messages:
1. MSH Message Header All
2. PID Patient Identification All
3. PV1 Patient Visit All
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Chapter 2 Outbound Interfaces
Within each supported segment, the Merge Healthcare AIMS system can process and export these elements:
4. OBR Observation Request Information NPO Status
Medical history conditions
Family anesthesia history
Surgical history
PreOp vital signs
PostOp (PACU) vital signs
Timed events
Fluid outputs & balance
Anesthesia type & ASA
5. OBX Observation
6. AL1 or IAM
Patient Allergy and Adverse Reaction information
Allergies
6. DG1 Diagnosis ICD-9 coding
7. PR1 Procedures Surgical procedures & times
CPT coding
8. ORC Common Order Medications delivered
Infusions delivered
9. RXE and RXR
Pharmacy Encoded Order
Pharmacy Route
Medications delivered
Infusions delivered
10. RXC Pharmacy Component Order Infusions delivered (base solution and additives)
11. NTE Notes and Comments Various
Table 2-9: MSH Definition
Segment Field Subfield HL7 Definition Comment
MSH 1 Field Separator |
MSH 2 Encoding Characters Literal "^~\&"
MSH 3 Sending Application Literal "MERGEAIMS"
MSH 4 Sending Facility Sending facility for multi- facility customers, or "Default" for single-facility customers
MSH 5 Receiving Application "CLINICALHIS" or other literal value
MSH 7 Message Date/Time [message_date_time]
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MSH 9 1 Message Type Configured literal (such as "ORU"), or for Allergies "ADT"
MSH 9 2 Trigger Event Configured literal (such as "R01") or for Allergies: "A08" or "A60"
MSH 10 Message Control ID [msg_control_id]
MSH 11 Processing ID Literal "P"
MSH 12 HL7 Version Literal "2.4"
MSH 15 Accept Ack Type Literal "AL"
MSH 16 Application Ack Type Literal "NE"
MSH 17 Country Code Literal "USA"
Table 2-10: PID Definition
Segment Field Subfield HL7 Definition Comment
PID 3 1 Patient MRN Account Number CX:5 = "AN"
MRN CX:5 = "MR"
Case number CX:5 = "CASE"
SS# CX:5 = "SS"
Note: Can also be configured similar to Charge Interface
PID 5 1 Patient Last Name [patient_last_name]
PID 5 2 Patient First Name [patient_first_name]
PID 5 3 Patient Middle Name [patient_middle_name]
PID 7 Patient Date of Birth [patient_DOB]
PID 8 Patient Sex [patient_sex]
PID 18 1 Patient Account Number [patient_account_number]
PID 19 Patient Social Sec Number [patient_SS]
Table 2-9: MSH Definition (Continued)
Segment Field Subfield HL7 Definition Comment
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Chapter 2 Outbound Interfaces
Table 2-11: PV1 Definition
Segment Field Subfield HL7 Definition Comment
PV1 2 Patient Class [patient_class]
PV1 19 1 Patient Visit Number [visit_number]
Table 2-12: OBR Definition (optionally included in any messages using OBX segments)
Segment Field Subfield HL7 Definition Comment
OBR 3 Observation Identifier [filler_appt_id]
OBR 4 1 Universal Service ID Literal "5000.8" or other configured value
OBR 4 2 Universal Service Text Literal "ANESTHESIA" or other configured value
OBR 4 3 Name of Coding System Literal "AS4" or other configured value
Table 2-13: OBX Definition (message structure defined here. See table below for values specific to each type of data)
Segment Field Subfield HL7 Definition Comment
OBX 1 Set ID [setid]
OBX 2 Value Type [value_type]
OBX 3 1 Observation Identifier/ID [observation_ID]
OBX 3 2 Observation Identifier/Text [observation_text]
OBX 3 3 Observation Coding System
[observation_name_of_coding_system]
OBX 4 Observation Sub-ID [observation_sub_id]
OBX 5 Observation Value [value]
OBX 6 Units [value_units]
OBX 7 Reference Range [references_range]
OBX 8 Abnormal Flags [abnormal_flags]
OBX 11 Observation Result Status [observation_result_status]
OBX 14 Observation Date-Time [observation_date_time]
OBX 15 1 Producer's ID Identifier [source_id]
OBX 15 3 Producer's ID Coding System
[source]
OBX 16 Responsible Observer XCN structure as defined below [responsible_observer]
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Merge AIMS 8.3 HL7 Interface Specification
The following tables show how the OBX segments may be populated with the data applicable to each message type.
Table 2-14: NTE Definition (comments)
Segment Field Subfield HL7 Definition Comment
NTE 1 Set ID [setid]
NTE 3 Comment [comment]
Table 2-15: XCN Definition (staff identifier data structure)
Sequence HL7 Definition Comment
1 ID number Interface ID
2 Family name Last name
3 Given name First name
4 Second and further given names or initials
Middle name
5 Suffix (e.g., JR or III) Suffix
6 Prefix (e.g., DR) Prefix
7 Degree (e.g., MD) Credentials
Table 2-16: NPO Status - a set of 2 OBX segments; the first is always included, and the second is included only if the date-time is documented.
Field Content
[setid] 1 for Since Midnight checkbox
2 for NPO date-time
[value_type] Set ID 1: CE
Set ID 2: TS
[observation_ID] Set ID 1: NPOSINCEMIDNIGHT or other mapped value
Set ID 2: NPO or other mapped value
[observation_text] Set ID 1: NPO since midnight (checkbox)
Set ID 2: NPO since the specified time
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
[value] Set ID 1: True or False
Set ID 2: NPO date-time
[value_units] <null>
[references_range] <null>
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Chapter 2 Outbound Interfaces
[abnormal_flags] <null>
[observation_result_status] Literal "F"
[observation_date_time] Set ID 1: Last Saved date-time
Set ID 2: Patient's NPO date-time
[source_id] <null>
[source] <null>
[responsible_observer] <null>
NTE comment segment Included following each/both segments, when comment is present
Table 2-17: Medical history conditions - zero to many OBX segments, one per each condition in the PAE. Note that deleted (= inactive) are also included.
Field Content
[setid] Incremented counter
[value_type] CE
[observation_ID] Condition mapped identifier; will be <null> is not mapped
[observation_text] Print Description
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
[value] "True" if active
"False" if inactive or deleted
[value_units] <null>
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" if active
"D" if inactive or deleted
[observation_date_time] Last Updated date-time
[source_id] <null>
[source] <null>
Table 2-16: NPO Status - a set of 2 OBX segments; the first is always included, and the second is included only if the date-time is documented. (Continued)
Field Content
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Merge AIMS 8.3 HL7 Interface Specification
[responsible_observer] XCN structure of saved-by staff, or Username if staff not available (eg, data received from external system)
NTE comment segment Included when a comment is present
Table 2-18: Family anesthesia history - one OBX segment
Field Content
[setid] 1
[value_type] CE
[observation_ID] Mapped identifier
[observation_text] One of four possible values: "PROBLEMS", "NO PROBLEMS", "NO HISTORY", or "UNKNOWN"
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
[value] One of four possible values: "PROBLEMS", "NO PROBLEMS", "NO HISTORY", or "UNKNOWN"
[value_units] <null>
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" Final
[observation_date_time] Last Updated date-time
[source_id] <null>
[source] <null>
[responsible_observer] XCN structure of saved-by staff, or Username if staff not available (eg, data received from external system)
NTE comment segment Included when a comment is present
Table 2-19: Surgical history - zero to many OBX segments, one per surgical history row
Field Content
[setid] Incremented counter
[value_type] TX
Table 2-17: Medical history conditions - zero to many OBX segments, one per each condition in the PAE. Note that deleted (= inactive) are also included.
Field Content
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Chapter 2 Outbound Interfaces
[observation_ID] Mapped identifier for Surgical History
[observation_text] Description of surgery
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
[value] Description of surgery
[value_units] <null>
[references_range] Mapped identifier for anesthesia type, or SWKey if no mapping present.
[abnormal_flags] T or F from the "Perioperative complications?" checkbox
[observation_result_status] "F" Final
[observation_date_time] Date of surgery. If documented as year-only, will be sent as January 1st ("2002" = "20020101000000").
[source_id] <null> unless result was received from external system
[source] <null> unless result was received from external system
[responsible_observer] XCN structure of saved-by staff, or Username if staff not available (eg, data received from external system)
NTE comment segment Included when a comment is present
Table 2-20: PreOp and PostOp (PACU) vital signs - a collection of OBX segments, one per measurement
Field Content
[setid] Incremented counter
[value_type] NM Numeric value except for:
BLOODPRESSURE = TX
TEMPERATUREMODE = TX
PATIENTONROOMAIR = CE
PATIENTONOXYGEN = CE
[observation_ID] Mapped ID such as PREOP_VITALS or POSTOP_VITALS
[observation_text] "PreOp Vital Signs" or "PACU Vital Signs"
Table 2-19: Surgical history - zero to many OBX segments, one per surgical history row
Field Content
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Merge AIMS 8.3 HL7 Interface Specification
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] HEIGHT
WEIGHT
HEIGHT and WEIGHT are literal (not mapped). All others are "Mapped IDs corresponding to the following:"
SYSTOLIC
DIASTOLIC
BLOODPRESSURE
TEMPERATURE
TEMPERATUREMODE
PULSERATE
RESPIRATIONRATE
SPO2
PATIENTONROOMAIR
PATIENTONOXYGEN
OXYGENSETTING
[value] Numeric value except for:
BLOODPRESSURE = Systolic/Diastolic as a combined field "120/80"
TEMPERATUREMODE = string value "Oral"
PATIENTONROOMAIR = True or False
PATIENTONOXYGEN = True or False
Table 2-20: PreOp and PostOp (PACU) vital signs - a collection of OBX segments, one per measurement (Continued)
Field Content
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Chapter 2 Outbound Interfaces
[value_units] Configurable for HEIGHT
Configurable for WEIGHT
mmHg for SYSTOLIC
mmHg for DIASTOLIC
mmHg for BLOODPRESSURE
Configurable for TEMPERATURE
<null> for TEMPERATUREMODE
BPM for PULSERATE
BPM for RESPIRATIONRATE
% for SPO2
<null> for PATIENTONROOMAIR
<null> for PATIENTONOXYGEN
% or L/min for OXYGENSETTING
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" (Final)
[observation_date_time] Date time of the collection of vitals (single value shared for all measurements)
[source_id] <null>
[source] <null>
[responsible_observer] <null>
NTE comment segment Included when a comment is present (single NTE after the collection of OBXs)
Table 2-21: Timed events - zero to many OBX segments, one per event
Field Content
[setid] Incremented counter
[value_type] TS
[observation_ID] Mapped identifier; <null> if not mapped
[observation_text] Display name of event
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
Table 2-20: PreOp and PostOp (PACU) vital signs - a collection of OBX segments, one per measurement (Continued)
Field Content
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Merge AIMS 8.3 HL7 Interface Specification
[value] Date-time of event
[value_units] <null>
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" (Final)
[observation_date_time] Date-time of event
[source_id] <null>
[source] <null>
[responsible_observer] <null>
Table 2-22: Fluid outputs & balance - one to many OBX segments, one per output plus one for fluid balance
Field Content
[setid] Incremented counter
[value_type] NM
[observation_ID] SWKey of output fluid
NETBALANCE for fluid balance
[observation_text] Display name of output fluid
"Net perioperative fluid balance"
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null>
[value] Numeric balance (sum of input infusions and fluids, minus sum of output fluids; can be negative)
[value_units] "mL"
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" (Final)
[observation_date_time] <null>
[source_id] <null>
[source] <null>
[responsible_observer] <null>
Table 2-21: Timed events - zero to many OBX segments, one per event
Field Content
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Chapter 2 Outbound Interfaces
The patient's medication profile of Home and Current medications (documented in PAE; this is not the anesthesia-delivered medications) is sent in RDE^O11 messages. The MSH, PID, and
Table 2-23: Anesthesia type & ASA - one to many OBX segments, one for ASA class plus one for each anesthesia type documented.
Field Content
[setid] Incremented counter
[value_type] CE
[observation_ID] ASA
ATYP for primary anesthesia type
AATYP for additional types
[observation_text] "ASA Class"
"Anesthesia Type (Primary)"
"Additional Anesthesia Type"
[observation_name_of_coding_system] Literal "MergeAIMS"
[observation_sub_id] <null> for ASA
Mapped identifier for anesthesia type, or SWKey if no mapping present.
[value] ASA Physical Status description, typically roman numeral I through V or IE through VE where E indicates an emergency surgery
CE structure with mapped identifier, anesthesia type display name, and "MergeAIMS"
[value_units] <null>
[references_range] <null>
[abnormal_flags] <null>
[observation_result_status] "F" (Final)
[observation_date_time] <null>
[source_id] <null>
[source] <null>
[responsible_observer] <null>
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Merge AIMS 8.3 HL7 Interface Specification
PV1 segments are described above. Each medication is sent in a separate message, with a single ORC, RXE, and RXR segment.
Table 2-24: Definition for Home/Current Medications
Segment Field Subfield HL7 Definition Comment
ORC 2 1 Placer Order Number Row ID from database (GUID)
ORC 5 1 Order Status "IP" (In Process)
ORC 9 1 Date/Time of Transaction Documentation date-time
ORC 10 1 Entered By XCN structure of saved-by staff, or Username if staff not available (eg, data received from external system)
ORC 21 1 Ordering Facility Name "DOCUSYS" if entered by Anesthesia; other value if data received from external system
ORC 21 3 Ordering Facility ID Numeric ID if entered by Anesthesia; other value if data received from external system
Table 2-25: RXE Definition for Home/Current Medications
Segment Field Subfield HL7 Definition Comment
RXE 1 1-2 Quantity/Timing Frequency (split at first space " " character)
RXE 2 1 Give Code - Identifier Identifier (varies based on installed Drug Information Framework)
FDB = Drug Name ID
Multum = D Number
Micromedex = Generic Formulation Code
RXE 2 2 Give Code - Description Name of medication
RXE 2 3 Give Code - Identifier Type Varies based on installed Drug Information Framework:
FDB = "DNID"
Multum = "DNUM"
Micromedex = "GFC"
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Chapter 2 Outbound Interfaces
RXE 2 4 Give Code - Alternate Identifier
Identifier (varies based on installed Drug Information Framework)
FDB = Dispensable Drug ID
Multum = Synonym ID
Micromedex = <null> but may include the NDC if data received from external system
RXE 2 6 Give Code - Alternate Identifier Type
Varies based on installed Drug Information Framework:
FDB = "MEDID"
Multum = "SYN"
Micromedex = "NDC"
RXE 3 1 Give Amount Dose field (up to first space " " character)
Note: Not guaranteed numeric.
RXE 5 1 Give Units Dose field (after first space " " character)
RXE 7 1 Administration Instructions Comment
RXE 18 1 Date-Time of most recent refill or dose
Last Taken
Note: This comes from a text field, so it generally won't be a well-formatted date and may be null.
Table 2-26: RXR Definition for Home/Current Medications
Segment Field Subfield HL7 Definition Comment
RXR 1 2 Route - text Route
Table 2-25: RXE Definition for Home/Current Medications (Continued)
Segment Field Subfield HL7 Definition Comment
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Merge AIMS 8.3 HL7 Interface Specification
The patient's medication profile of anesthesia-delivered medications is sent in an ORM^O01 message. The MSH, PID, and PV1 segments are described above. Each delivery is sent in an ORC, RXE, and RXR segment group. Multiple deliveries are included in a single message.
Table 2-27: ORC Definition for Delivered Medications
Segment Field Subfield HL7 Definition Comment
ORC 2 1 Placer Order Number Row ID from database (GUID)
ORC 5 1 Order Status "CM" = completed
ORC 7 1 Quantity/Timing "1" = a single delivery
ORC 9 1 Date/Time of Transaction Date-time of delivery
ORC 12 Ordering Provider XCN structure of staff
ORC 21 1 Ordering Facility Name Source system = "MergeAIMS"
ORC 21 3 Ordering Facility ID Source ID = Row ID from database (GUID)
Table 2-28: RXE Definition for Delivered Medications
Segment Field Subfield HL7 Definition Comment
RXE 2 1 Give Code - Identifier Charge Code as configured in AIMS Formulary
RXE 2 2 Give Code - Description Primary display name of medication
RXE 2 3 Give Code - Identifier Type "CHARGECODE"
RXE 2 4 Give Code - Alternate Identifier
Identifier (varies based on installed Drug Information Framework)
FDB = Routed Medication ID
Multum = Synonym ID
Micromedex = Generic Formulation Code
RXE 2 5 Give Code - Alternate Text Mapped Drug Name from Drug Information Framework, as configured in AIMS Formulary
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Chapter 2 Outbound Interfaces
RXE 2 6 Give Code - Alternate Identifier Type
Varies based on installed Drug Information Framework:
FDB = "RMID"
Multum = "SYN"
Micromedex = "GFC"
RXE 3 1 Give Amount Delivery amount
Note: Will be 0 for "By Each" medications.
RXE 5 1 Give Units Delivery units; typically a drug weight unit such as "mg"
RXE 7 1 Administration Instructions <null>
RXE 18 1 Date-Time of most recent refill or dose
<null>
RXE 23 1 Give Rate Amount <null>
RXE 24 1 Give Rate Units <null>
RXE 25 1 Give Strength Alternate delivery amount. If a "By Each" type of medication, this is the quantity; otherwise this is the delivery volume.
RXE 26 1 Give Strength Units Alternate units; "Each" or "mL"
RXE 31 1 Supplementary Code - ID NDC number, as configured in AIMS Formulary
RXE 31 2 Supplementary Code - Text NDC Description as configured in AIMS Formulary
RXE 31 3 Supplementary Code - Identifier type
"NDC"
RXE 31 4 Supplementary Code - Alternate ID
Billing NDC, as configured in AIMS Formulary
RXE 31 5 Supplementary Code - Alternate Text
NDC Description as configured in AIMS Formulary
RXE 31 6 Supplementary Code - Alternate Identifier type
"BILLINGNDC"
Table 2-28: RXE Definition for Delivered Medications (Continued)
Segment Field Subfield HL7 Definition Comment
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Merge AIMS 8.3 HL7 Interface Specification
The patient's medication profile of anesthesia-delivered infusions (plain fluids and drug infusions) is sent in an ORM^O01 message. The MSH, PID, and PV1 segments are described above. Each delivery is sent in an ORC, RXE, RXC (if additives present), and RXR segment group. Multiple deliveries are included in a single Message. For infusions documented by rate, each change of rate is treated as a separate delivery.
Table 2-29: RXR Definition for Delivered Medications
Segment Field Subfield HL7 Definition Comment
RXR 1 1 Route - ID Route of delivery SWKey
RXR 1 2 Route - text Route of delivery name
Table 2-30: ORC Definition for Delivered Infusions
Segment Field Subfield HL7 Definition Comment
ORC 2 1 Placer Order Number Row ID from database (GUID)
ORC 5 1 Order Status "CM" = completed
ORC 7 All Quantity/Timing TQ structure, defined below
ORC 9 1 Date/Time of Transaction Date-time of delivery, or end time if rate-based.
ORC 12 Ordering Provider XCN structure of staff
ORC 21 1 Ordering Facility Name Source system = "MergeAIMS"
ORC 21 3 Ordering Facility ID Source ID = Row ID from database (GUID)
Table 2-31: RXE Definition for Delivered Infusions
Segment Field Subfield HL7 Definition Comment
RXE 2 1-6 Give Code If the infusion is a plain fluid, then RXE-2 (subfields 1-6) is similar to medication delivery, above.
If the infusion includes drug additives, then RXE-2 is <null> and the RXC segment contains the detailed infusion definition.
RXE 3 1 Give Amount Delivery volume
RXE 5 1 Give Units Volume units, "mL"
RXE 7 1 Administration Instructions Infusion final disposition, such as "Completed" or "Transferred"
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Chapter 2 Outbound Interfaces
RXE 18 1 Date-Time of most recent refill or dose
<null>
RXE 23 1 Give Rate Amount <null> if documented as a volume;
Rate value if documented as a rate
RXE 24 1 Give Rate Units <null> if documented as a volume;
"mL/hr" if documented as a rate
RXE 25 1 Give Strength <null>
RXE 26 1 Give Strength Units <null>
RXE 31 1 Supplementary Code - ID NDC number, as configured in AIMS Formulary (for infusion, not additive)
RXE 31 2 Supplementary Code - Text NDC Description as configured in AIMS Formulary
RXE 31 3 Supplementary Code - Identifier type
"NDC"
RXE 31 4 Supplementary Code - Alternate ID
Billing NDC, as configured in AIMS Formulary
RXE 31 5 Supplementary Code - Alternate Text
NDC Description as configured in AIMS Formulary
RXE 31 6 Supplementary Code - Alternate Identifier type
"BILLINGNDC"
Table 2-32: RXC Definition for Delivered Infusions - repeated for base solution and additive(s)
Segment Field Subfield HL7 Definition Comment
RXC 1 1 Rx Component Type "B" for base solution;
"A" for additive(s)
RXC 2 1-6 Component Code Component (base solution or additive) identifiers, similar to RXE-2 for medication deliveries
Table 2-31: RXE Definition for Delivered Infusions (Continued)
Segment Field Subfield HL7 Definition Comment
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Merge AIMS 8.3 HL7 Interface Specification
RXC 3 1 Component Amount Infusion initial volume for base solution (bag volume);
Additive initial amount (amount of additive in bag)
RXC 4 1 Component Units Volume units, "mL" for base solution
Additive units, typically a drug weight unit such as "mg"
RXC 5 1 Component Strength <null> for base solution;
Original concentration of additive (before it was diluted into infusion)
RXC 6 1 Component Strength Units <null> for base solution;
Original concentration units for additive
RXC 7 1 Supplementary Code NDC information for component (base solution or additive), similar to RXE-31
Table 2-33: RXR Definition for Delivered Infusions
Segment Field Subfield HL7 Definition Comment
RXR 1 1 Route - ID Route of delivery SWKey
RXR 1 2 Route - text Route of delivery name
Table 2-32: RXC Definition for Delivered Infusions - repeated for base solution and additive(s)
Segment Field Subfield HL7 Definition Comment
Table 2-34: TQ Definition (Timing/Quantity data structure for infusions)
Sequence HL7 Definition Comment
1 Quantity "1" one delivery
2 Interval <null> if documented as a volume
"C" if documented as a rate
3 Duration <null> if documented as a volume
"M" and the duration in minutes if documented as a rate (ex: "M60")
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Chapter 2 Outbound Interfaces
Diagnosis codes can be documented in the PAE and also in AIMS Anesthesia. Procedure coding can only be documented in AIMS Anesthesia. Coding data are sent when the PAE is signed and when the Anesthesia record is signed. Coding data consists of 1) zero to many DG1 diagnosis segments, 2) zero to many PR1 surgical procedure segments, and 3) zero to many PR1 procedure coding segments, which include both surgeon-performed and personally-performed procedures.
4 Start date-time <null> if documented as a volume
Rate start time if documented as a rate
5 End date-time Delivery time if documented as a volume
Rate end time if documented as a rate
Table 2-34: TQ Definition (Timing/Quantity data structure for infusions)
Sequence HL7 Definition Comment
Table 2-35: DG1 Definition for Diagnosis Code(s)
Segment Field Subfield HL7 Definition Comment
DG1 1 Set ID Incremented counter
DG1 3 1 Diagnosis Code/ Identifier Diagnosis code (number)
DG1 3 2 Diagnosis Code/ Text Diagnosis description
DG1 3 3 Diagnosis Code/ Identifier Type
"I9" = ICD-9
DG1 5 Diagnosis Date/Time PAE: when the PAE was signed
AIMS Anesthesia: when the code was documented
DG1 6 Diagnosis Type "W" = Working
DG1 15 Diagnosis Priority "0" = not ranked
DG1 16 Diagnosing Clinician XCN structure of staff who signed the anesthesia record; if record not yet signed (PAE signing trigger event) then this will be the PAE signer.
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Merge AIMS 8.3 HL7 Interface Specification
DG1 17 Diagnosis Classification "D" = Diagnosis
DG1 19 Attestation Date/Time PAE: when the PAE was signed
AIMS Anesthesia: when the record was signed
Note: Associated with DG1-16. Either the anesthesia record signer/signed time, or if that's not signed yet then it's the PAE signer/signed time.
Table 2-36: PR1 Definition for Procedure Code(s) personally performed by Anesthesia staff
Segment Field Subfield HL7 Definition Comment
PR1 1 Set ID Incremented counter
PR1 3 1 Procedure Code/ Identifier Procedure code (number)
PR1 3 2 Procedure Code/ Text Procedure description
PR1 3 3 Procedure Code/ Identifier Type
"C4" = CPT-4
PR1 5 Procedure Date/Time When the code was documented
PR1 6 Procedure Functional Type "I" Personally performed procedures (codes for IV, catheter, etc)
PR1 7 Procedure Minutes <null>
PR1 8 Anesthesiologist <null>
PR1 9 Anesthesia Code <null>
PR1 10 Anesthesia Minutes <null>
PR1 11 Surgeon <null>
PR1 12 Procedure Practitioner XCN structure of Linked staff member, if documented
PR1 14 Procedure Priority <null> Procedure codes are not ranked
PR1 15 Associated Diagnosis Code <null>
PR1 16 Procedure Code Modifier <null>
Table 2-35: DG1 Definition for Diagnosis Code(s) (Continued)
Segment Field Subfield HL7 Definition Comment
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Chapter 2 Outbound Interfaces
Table 2-37: PR1 Definition for Procedure Code(s) not personally performed
Segment Field Subfield HL7 Definition Comment
PR1 1 Set ID Incremented counter
PR1 3 1 Procedure Code/ Identifier Procedure code (number)
PR1 3 2 Procedure Code/ Text Procedure description
PR1 3 3 Procedure Code/ Identifier Type
"C4" = CPT-4
PR1 5 Procedure Date/Time Individual procedure start time if code linked to actual procedure, otherwise the overall Incision Start Time
PR1 6 Procedure Functional Type "P" Procedure for Treatment (codes for the surgery)
PR1 7 Procedure Minutes Individual procedure time if code linked to actual procedure, otherwise the overall Incision Time. This is a duration (number of minutes, can be a decimal value) not a timestamp.
PR1 8 Anesthesiologist XCN structure of Anesthesia staff who signed the record
PR1 9 1 Anesthesia Code/ Identifier Anesthesia crosswalk code (number)
PR1 9 2 Anesthesia Code/ Text Anesthesia crosswalk description
PR1 9 3 Anesthesia Code/ Identifier Type
"XWALK" Crosswalk
PR1 10 Anesthesia Minutes Anesthesia Time duration (total for case)
PR1 11 Surgeon XCN structure of Surgeon linked to code, if documented; otherwise primary surgeon for the case
PR1 12 Procedure Practitioner Same as PR1-11 Surgeon
PR1 14 Procedure Priority <null> Procedure codes are not ranked
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Merge AIMS 8.3 HL7 Interface Specification
The anesthesia record may cover a single surgery, or can document multiple "actual" surgical procedures (there can also be multiple scheduled procedures, but those are not relevant here). Each surgical procedure will be sent as a PR1 segment within an ORU^R01 message.
PR1 15 1 Associated Diagnosis Code/ Identifier
Linked diagnosis code, if documented (either linked to same actual procedure as this CPT code, or the first "linked code" among the diagnosis codes)
PR1-15 is <null> if none found.
PR1 15 2 Associated Diagnosis Code/ Description
Linked diagnosis description
PR1 15 3 Associated Diagnosis Code/ Identifier Type
"I9" ICD-9
PR1 16 (can repeat)
1 Procedure Code Modifier/ Identifier
Modifier code(s)
PR1 16 2 Procedure Code Modifier/ Description
Modifier description(s)
PR1 16 3 Procedure Code Modifier/ Identifier type
"CPTM" CPT Modifier
Table 2-37: PR1 Definition for Procedure Code(s) not personally performed (Continued)
Segment Field Subfield HL7 Definition Comment
Table 2-38: PR1 Definition for Surgical Procedure(s)
Segment Field Subfield HL7 Definition Comment
PR1 1 Set ID Incremented counter
PR1 3 1 Procedure Code/ Identifier Hospital scheduling code if scheduled
<null> if added by anesthesia user
PR1 3 2 Procedure Code/ Text Procedure description
PR1 3 3 Procedure Code/ Identifier Type
"ScheduledProcedure" if scheduled
"MergeAIMS" if added by anesthesia user
PR1 3 4 Procedure Code/ Alt Identifier
CPT code, if linked to actual procedure (otherwise <null> for subfields 4-6)
PR1 3 5 Procedure Code/ Alt Text CPT description
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Chapter 2 Outbound Interfaces
Allergy messages are sent whenever the AIMS user updates the patient allergy profile. Either of two message styles are supported: an ADT^A08 with AL1 segments, or an ADT^A60 with IAM segments.
PR1 3 6 Procedure Code/ Alt Identifier Type
"C4" = CPT-4
PR1 5 Procedure Date/Time Procedure Start time. Same as Incision Start time if only one procedure.
PR1 6 Procedure Functional Type "P" = Procedure
PR1 7 Procedure Minutes Procedure duration in minutes. Same as Incision Time duration if only one procedure.
PR1 8 Anesthesiologist <null>
PR1 9 Anesthesia Code <null>
PR1 10 Anesthesia Minutes <null>
PR1 11 Surgeon XCN structure of primary surgeon
PR1 12 Procedure Practitioner <null>
PR1 14 Procedure Priority Procedure rank (1, 2, etc)
PR1 15 1 Associated Diagnosis Code/ Identifier
Diagnosis code, if linked to actual procedure (otherwise <null>)
PR1 15 2 Associated Diagnosis Code/ Description
Linked diagnosis description
PR1 15 3 Associated Diagnosis Code/ Identifier Type
"I9" ICD-9
PR1 16 (can repeat)
1 Procedure Code Modifier/ Identifier
Modifier code(s, if any) for CPT in PR1-3.4
PR1 16 2 Procedure Code Modifier/ Description
Modifier description(s)
PR1 16 3 Procedure Code Modifier/ Identifier type
"CPTM" CPT Modifier
Table 2-38: PR1 Definition for Surgical Procedure(s) (Continued)
Segment Field Subfield HL7 Definition Comment
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Merge AIMS 8.3 HL7 Interface Specification
For the AL1 style, only active (non-deleted) allergies are included. For the IAM style, both active and deleted allergies are included.
Table 2-39: AL1 Definition
Segment Field Subfield HL7 Definition Comment
AL1 1 1 Set ID Incremented counter
AL1 2 1 Allergen Type Code Configured value such as "DA" (Drug Allergy)
AL1 3 1 Allergen Code/ID Substance identifier (ID from Drug Information Framework)
"-1" if No Known Drug Allergies
AL1 3 2 Allergen Code/Text Substance description
"NKDA" if No Known Drug Allergies
AL1 3 3 Allergen Code/Type Configured value, as appropriate based on Drug Information Framework
AL1 3 5 Allergen Code/ Alternate Text
Comment (free text)
AL1 5 1, can repeat
Allergic Reaction Reaction(s)
AL1 7 1 Sensitivity Code "IN" or other configured value if allergy is marked as an Intolerance
"AL" for allergies
Table 2-40: IAM Definition
Segment Field Subfield HL7 Definition Comment
IAM 1 1 Set ID Incremented counter
IAM 2 1 Allergen Type Code Configured value such as "DA" (Drug Allergy)
IAM 3 1 Allergen Code/ID Substance identifier (ID from Drug Information Framework)
"-1" if No Known Drug Allergies
IAM 3 2 Allergen Code/Text Substance description
"NKDA" if No Known Drug Allergies
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Chapter 2 Outbound Interfaces
IAM 3 3 Allergen Code/Type Configured value, as appropriate based on Drug Information Framework
IAM 3 5 Allergen Code/ Alternate Text
Comment (free text)
IAM 5 1 (can repeat)
Allergic Reaction Reaction(s)
IAM 6 1 Allergy Action "U" Update for active allergies
"D" Delete for inactive allergies
IAM 7 1 Allergy Unique Identifier Source ID from external system if originally documented externally
Numeric identifier if documented by AIMS user
IAM 7 2 Allergy Source System Source Name from external system if originally documented externally
"DOCUSYS" if documented by AIMS user
IAM 9 1 Sensitivity to Causative Agent code
"IN" or other configured value if allergy is marked as an Intolerance
"AL" for allergies
IAM 17 1 Allergy Clinical Status Code C Confirmed or verified
D Doubt raised
E Erroneous
I Confirmed but inactive
P Pending
S Suspect
U Unconfirmed
Table 2-40: IAM Definition (Continued)
Segment Field Subfield HL7 Definition Comment
63
Merge AIMS 8.3 HL7 Interface Specification
Clinical Data Message Template
Template for NPO Status Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ADT^A08|[msg_control_id]|P|2.4|||AL|NE|USA|
EVN||[message_date_time]|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
NTE
Template for Medical History Conditions Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
NTE
Template for Family Anesthesia History Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
64
Chapter 2 Outbound Interfaces
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
NTE
Template for Surgical History Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
NTE
Template for Vital Signs Messages
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
NTE
Template for Timed Events Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
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Merge AIMS 8.3 HL7 Interface Specification
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
Template for Fluid Output & Balance Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
Template for Anesthesia Types and ASA Class Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
OBR|1||[filler_appt_id]|5000.8^ANESTHESIA^AS4|
OBX|[setid]|[value_type]|[observation_ID]^[observation_text]^[observation_name_of_coding_system]|[observation_sub_id]|[value]|[value_units]|[references_range]|[abnormal_flags]|||[observation_result_status]|||[observation_date_time]|[source_id]^^[source]|[responsible_observer]||
Template for Home/Current Medications Messages
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||RDE^O11|[msg_control_id]|P|2.4|||AL|NE|USA|
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Chapter 2 Outbound Interfaces
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
ORC||[order_identifier]|||[order_status]||||[order_date_time]|[user_name]|||||||||||[source]^^[source_id]|
RXE|[frequency_quantity]^[frequency_interval]|[medication_identifier]^[medication_description]^[medication_identifier_type]^[medication_alt_identifier]^^[medication_alt_identifier_type]|[dose_amount]||[dose_units]||[comment]|||||||||||[last_taken]|
RXR|^[route_of_administration]|
Template for Delivered Medications Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORM^O01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
ORC||[order_identifier]|||[order_status]||[quantity_timing]||[order_date_time]|[user_name]||[ordering_provider]|||||||||[source]^^[source_id]|
RXE||[medication_identifier]|[dose_amount]||[dose_units]||[comment]|||||||||||[last_taken]|||||[rate_amount]|[rate_units]|[alt_dose_amount]|[alt_dose_units]|||||[supplementary_code]|
RXR|[route_of_administration_identifier]^[route_of_administration]|
Template for Delivered Infusions Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORM^O01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
ORC||[order_identifier]|||[order_status]||[quantity_timing]||[order_date_time]|[user_name]||[ordering_provider]|||||||||[source]^^[source_id]|
RXE||[medication_identifier]|[dose_amount]||[dose_units]||[comment]|||||||||||[last_taken]|||||[rate_amount]|[rate_units]|[alt_dose_amount]|[alt_dose_units]|||||[supplementary_code]|
RXR|[route_of_administration_identifier]^[route_of_administration]|
RXC|[component_type]|[component_code]|[component_amount]|[component_units]|[component_strength]|[component_strength_units]|[supplementary_code]|
67
Merge AIMS 8.3 HL7 Interface Specification
Template for Coding Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
DG1|[setid]||[diagnosis_code]||[diagnosis_date_time]|[diagnosis_type]|||||||||[diagnosis_priority]|[diagnosing_clinician]|[diagnosis_classification]||[attestation_date]|
PR1|[setid]||[procedure_code]||[procedure_date_time]|[procedure_type]|[procedure_minutes]|[anesthesiologist]|[anesthesia_code]|[anesthesia_minutes]|[surgeon]|[procedure_practitioner]||[procedure_priority]|[associated_diagnosis_code]|[procedure_code_modifier]|
Template for Surgical Procedures Message
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||ORU^R01|[msg_control_id]|P|2.4|||AL|NE|USA|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
PR1|[setid]||[procedure_code]||[procedure_date_time]|[procedure_type]|[procedure_minutes]|[anesthesiologist]|[anesthesia_code]|[anesthesia_minutes]|[surgeon]|[procedure_practitioner]||[procedure_priority]|[associated_diagnosis_code]|[procedure_code_modifier]|
Template for Allergy Message (AL1)
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||[msg_type]|[msg_control_id]|P|2.4|||AL|NE|USA|
EVN||[message_date_time]|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
AL1|[setid]|[allergy_category]|[allergen_id]^[allergen_description]^[allergen_type]^^[allergen_comment]||[allergy_reaction]||[allergy_sensitivity_code]
68
Chapter 2 Outbound Interfaces
Template for Allergy Message (A60-IAM)
MSH|^~\&|MERGEAIMS|[sending_facility]|CLINICALHIS|[patient_facility]|[message_date_time]||[msg_type]|[msg_control_id]|P|2.4|||AL|NE|USA|
EVN||[message_date_time]|
PID|1||[patient_SS]^^^^SSN~[patient_mrn]^^^[patient_facility]^MR~[filler_appt_id]^^^[patient_facility]^CASE~[patient_account_number]^^^[patient_facility]^AN||[patient_last_name]^[patient_first_name]^[patient_middle_name]||[patient_DOB]|[patient_sex]||||||||||[patient_account_number]^^^[patient_facility]^AN|[patient_SS]|
PV1||[patient_class]|||||||||||||||||[visit_number]|
IAM|[setid]|[allergy_category]|[allergen_id]^[allergen_description]^[allergen_type]^^[allergen_comment]||[allergy_reaction]|[allergy_action]|[allergy_source_id]^[allergy_source]||[allergy_sensitivity_code]||||||||[allergy_status]
Clinical Data Message Example
Sample NPO Status Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073639||ADT^A08|20121012073638436|P|2.4|||AL|NE|USA|
EVN||20121012073639|
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|CE|NPOSINCEMIDNIGHT^NPO since midnight (checkbox)^MergeAIMS||True||||||F|||20121011145625|^^|||
NTE|1||Had a snack at 8pm
OBX|2|TS|NPO^NPO since the specified time^MergeAIMS||20121010200000||||||F|||20121010200000|^^|||
NTE|1||Had a snack at 8pm
?
Sample Medical History Conditions Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073639||ORU^R01|20121012073638045|P|2.4|||AL|NE|USA|
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
69
Merge AIMS 8.3 HL7 Interface Specification
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|CE|SMOKER^Current Smoker^MergeAIMS||True||||||F|||20121011110000|^^|BettySmith||
OBX|2|CE|DIABETES^Diabetes^MergeAIMS||True||||||F|||20121011110000|^^|BettySmith||
OBX|3|CE|^Patient’s usual blood pressure: ^MergeAIMS||True||||||F|||20121011145900|^^|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
NTE|1||180/120
OBX|4|CE|SMOKINGHX^Past history of smoking^MergeAIMS||True||||||F|||20121011110000|^^|BettySmith||
NTE|1||Since age 17.
OBX|5|CE|^Hypertension^MergeAIMS||True||||||F|||20121011145900|^^|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
OBX|6|CE|^Steroid use^MergeAIMS||False||||||D|||20121011145400|^^|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
OBX|7|CE|DIABETESTYPEII^Adult-onset (Type II)^MergeAIMS||True||||||F|||20121011110000|^^|BettySmith||
NTE|1||Adult Onset at age 40.
OBX|8|CE|^Hyperparathyroidism^MergeAIMS||False||||||D|||20121011145400|^^|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
OBX|9|CE|HYPERTENSIONMALIGNANT^Malignant^MergeAIMS||True||||||F|||20121011110000|^^|BettySmith||
?
Sample Family Anesthesia History Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073639||ORU^R01|20121012073638126|P|2.4|||AL|NE|USA|
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|CE|FAMHXPROBLEMS^PROBLEMS^MergeAIMS||PROBLEMS||||||F|||20121011145322|^^|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
NTE|1||Mother had difficult airway and postop N&V.
?
Sample Surgical History Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073639||ORU^R01|20121012073638709|P|2.4|||AL|NE|USA|
70
Chapter 2 Outbound Interfaces
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|TX|SURG_HX^ACL Repair^MergeAIMS||ACL Repair||MAC|T|||F|||20110412000000|31^^MEDITECH|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
NTE|1||Right knee
OBX|2|TX|SURG_HX^Cataract Removal^MergeAIMS||Cataract Removal||GENERAL_MASK|F|||F|||20090222000000|32^^MEDITECH|AMD08031^Test^Anesthesiologist^H.^^^AMD^||
NTE|1||Both eyes.
?
Sample Vital Signs Messages (PreOp and PostOp)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073639||ORU^R01|20121012073638590|P|2.4|||AL|NE|USA|
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|HEIGHT|68|IN|||||F|||20121011145624|^^|||
OBX|2|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|WEIGHT|125|LB|||||F|||20121011145624|^^|||
OBX|3|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|SYSTOLIC|150|mmHg|||||F|||20121011145624|^^|||
OBX|4|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|DIASTOLIC|95|mmHg|||||F|||20121011145624|^^|||
OBX|5|TX|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|BLOODPRESSURE|150/95|mmHg|||||F|||20121011145624|^^|||
OBX|6|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|TEMPERATURE|98.6|F|||||F|||20121011145624|^^|||
OBX|7|TX|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|TEMPERATUREMODE|Oral||||||F|||20121011145624|^^|||
OBX|8|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|PULSERATE|62|BPM|||||F|||20121011145624|^^|||
OBX|9|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|RESPRATE|16|BPM|||||F|||20121011145624|^^|||
OBX|10|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|SPO2|99|%|||||F|||20121011145624|^^|||
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Merge AIMS 8.3 HL7 Interface Specification
OBX|11|CE|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|ROOMAIR|False||||||F|||20121011145624|^^|||
OBX|12|CE|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|ONOXYGEN|True||||||F|||20121011145624|^^|||
OBX|13|NM|PREOP_VITALS^PreOp Vital Signs^MergeAIMS|OXYGENSETTING|2|L/Min|||||F|||20121011145624|^^|||
NTE|1||Taken in POHA.
?
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110659||ORU^R01|20121012110658469|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|HEIGHT|68|IN|||||F|||20121012110200|^^|||
OBX|2|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|WEIGHT|125|LB|||||F|||20121012110200|^^|||
OBX|3|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|SYSTOLIC|188|mmHg|||||F|||20121012110200|^^|||
OBX|4|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|DIASTOLIC|121|mmHg|||||F|||20121012110200|^^|||
OBX|5|TX|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|BLOODPRESSURE|188/121|mmHg|||||F|||20121012110200|^^|||
OBX|6|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|TEMPERATURE|99.2|F|||||F|||20121012110200|^^|||
OBX|7|TX|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|TEMPERATUREMODE|||||||F|||20121012110200|^^|||
OBX|8|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|PULSERATE|55|BPM|||||F|||20121012110200|^^|||
OBX|9|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|RESPRATE|15|BPM|||||F|||20121012110200|^^|||
OBX|10|NM|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|SPO2|98|%|||||F|||20121012110200|^^|||
OBX|11|CE|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|ROOMAIR|False||||||F|||20121012110200|^^|||
OBX|12|CE|POSTOP_VITALS^PACU Vital Signs^MergeAIMS|ONOXYGEN|False||||||F|||20121012110200|^^|||
NTE|1||taken on admit to PACU
?
72
Chapter 2 Outbound Interfaces
Sample Timed Events Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110659||ORU^R01|20121012110658571|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|TS|OR.IN^In Room Time^MergeAIMS||20121012095551||||||F|||20121012095551|^^|||
OBX|2|TS|^Anesthesia Start Time^MergeAIMS||20121012095551||||||F|||20121012095551|^^|||
OBX|3|TS|^%STAFF% - Doing Case^MergeAIMS||20121012095551||||||F|||20121012095551|^^|||
OBX|4|TS|^%STAFF% - Medical Direction/Supervision^MergeAIMS||20121012095551||||||F|||20121012095551|^^|||
OBX|5|TS|^Monitoring Begun^MergeAIMS||20121012095552||||||F|||20121012095552|^^|||
OBX|6|TS|PR.START^Surgery Begun^MergeAIMS||20121012095600||||||F|||20121012095600|^^|||
OBX|7|TS|^Prep Finished^MergeAIMS||20121012095600||||||F|||20121012095600|^^|||
OBX|8|TS|^Induction Begun^MergeAIMS||20121012095600||||||F|||20121012095600|^^|||
OBX|9|TS|^Induction Finished^MergeAIMS||20121012095636||||||F|||20121012095636|^^|||
OBX|10|TS|^Prep Begun^MergeAIMS||20121012095636||||||F|||20121012095636|^^|||
OBX|11|TS|PR.STOP^Surgery Finished^MergeAIMS||20121012104432||||||F|||20121012104432|^^|||
OBX|12|TS|^Dressing On^MergeAIMS||20121012104442||||||F|||20121012104442|^^|||
OBX|13|TS|^Emergence Finished^MergeAIMS||20121012104443||||||F|||20121012104443|^^|||
OBX|14|TS|^Monitoring Finished^MergeAIMS||20121012110612||||||F|||20121012110612|^^|||
OBX|15|TS|OR.OUT^To Recovery^MergeAIMS||20121012110612||||||F|||20121012110612|^^|||
?
Sample Fluid Output & Balance Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110659||ORU^R01|20121012110658178|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
73
Merge AIMS 8.3 HL7 Interface Specification
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|NM|EBL^Estimated Blood Loss^MergeAIMS||20|mL|||||F|||20121012101341|^^|||
OBX|2|NM|NETBALANCE^Net perioperative fluid balance^MergeAIMS||241.12|mL|||||F||||^^|||
?
Sample Anesthesia Types and ASA Class Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110658||ORU^R01|20121012110658021|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
OBR|1||FA01.93|5000.8^ANESTHESIA^AS4|
OBX|1|CE|ASA^ASA Class^MergeAIMS||II||||||F||||^^|||
OBX|2|CE|ATYP^Anesthesia Type (Primary)^MergeAIMS|GENERAL|GENERAL^General Endotracheal Anesthesia^MergeAIMS^^^||||||F||||^^|||
OBX|3|CE|AATYP^Additional Anesthesia Type^MergeAIMS|REGIONAL|REGIONAL^Regional^MergeAIMS^^^||||||F||||^^|||
?
Sample Home/Current Medications Messages (Micromedex)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110553||RDE^O11|20121012110552491|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
ORC||393cbb0d-b112-4d18-a23b-b6e6969f27f2|||IP||||20121011145800|AMD08031^Test^Anesthesiologist^H.^^^AMD^|||||||||||Clinical HIS^^0000381|
RXE|Q4H^|117382^ONDANSETRON 2 MG/ML 2 ML VIAL^GFC^00143989105^^NDC|4||MG|||||||||||||10/11/2012 8am|
RXR|^IV PUSH|
?
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110553||RDE^O11|20121012110552531|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
74
Chapter 2 Outbound Interfaces
ORC||d68b6fb6-fec2-43ba-82b0-f388080a1d1c|||IP||||20121012104700|AMD08031^Test^Anesthesiologist^H.^^^AMD^|||||||||||DOCUSYS^^58|
RXE|as^needed|112655^Clopidogrel Hydrogen Sulfate^GFC^^^NDC|75||MG||||||||||||||
RXR|^Oral|
?
Sample Delivered Medications Message (Micromedex)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110659||ORM^O01|20121012110658344|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
ORC||356340b8-7f44-42dd-a453-ea9073af89e5|||CM||1||20121012095000|||50012^White^Jonathan^Ron^^^AMD^|||||||||MergeAIMS^^356340b8-7f44-42dd-a453-ea9073af89e5|
RXE||330541^Ampicillin^CHARGECODE^100195^AMPICILLIN SODIUM POWDER FOR SOLUTION (Injection (^GFC|1000||mg||||||||||||||||||||10|mL|||||0069-0029-18^Pfizer Laboratories^NDC^00069002918^Pfizer Laboratories^BILLINGNDC|
RXR|IV^IV|
ORC||3121ec95-29f6-46ee-9d4d-ad401f2a796e|||CM||1||20121012095823|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^3121ec95-29f6-46ee-9d4d-ad401f2a796e|
RXE||3330123^FentaNYL 2 mL^CHARGECODE^104349^FENTANYL CITRATE INJECTABLE (Injection (systemic))^GFC|50||mcg||||||||||||||||||||1|mL|||||0409-9093-32^Hospira, Inc.^NDC^00409909332^Hospira, Inc.^BILLINGNDC|
RXR|IV^IV|
ORC||df4daaa1-2a6a-4a2a-9b07-ead51017a203|||CM||1||20121012095900|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^df4daaa1-2a6a-4a2a-9b07-ead51017a203|
RXE||330685^Propofol^CHARGECODE^103285^PROPOFOL EMULSION (Intravenous)^GFC|200||mg||||||||||||||||||||20|mL|||||0703-2856-04^Teva Parenteral Medicines, Inc^NDC^00703285604^Teva Parenteral Medicines, Inc^BILLINGNDC|
RXR|IV^IV|
ORC||d30c8f69-0db5-4304-b7a0-3384870268f3|||CM||1||20121012100000|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^d30c8f69-0db5-4304-b7a0-3384870268f3|
RXE||330558^Rocuronium^CHARGECODE^111553^ROCURONIUM BROMIDE KIT (Injection (systemic))^GFC|40||mg||||||||||||||||||||4|mL|||||^^NDC^^^BILLINGNDC|
RXR|IV^IV|
75
Merge AIMS 8.3 HL7 Interface Specification
ORC||8f4a16ae-7a57-4094-b3be-396e9a86b32e|||CM||1||20121012100000|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^8f4a16ae-7a57-4094-b3be-396e9a86b32e|
RXE||3300025^Afrin Nasal Spray 0.05%^CHARGECODE^106919^OXYMETAZOLINE HYDROCHLORIDE SPRAY (Nasal (systemic^GFC|0||||||||||||||||||||||1|Each|||||^^NDC^^^BILLINGNDC|
RXR|NASAL^Nasal|
ORC||c5597814-e2be-4654-9f2a-a4ce56587162|||CM||1||20121012101500|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^c5597814-e2be-4654-9f2a-a4ce56587162|
RXE||3330123^FentaNYL 2 mL^CHARGECODE^104349^FENTANYL CITRATE INJECTABLE (Injection (systemic))^GFC|50||mcg||||||||||||||||||||1|mL|||||0409-9093-32^Hospira, Inc.^NDC^00409909332^Hospira, Inc.^BILLINGNDC|
RXR|IV^IV|
?
Sample Delivered Infusions Message (Micromedex)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110659||ORM^O01|20121012110658261|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
ORC||9fd44c40-4d33-4ee9-bf53-10dabf912bd7|||CM||1^C^M18^20121012100200^20121012102000^||20121012102000|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^9fd44c40-4d33-4ee9-bf53-10dabf912bd7|
RXE|||31.89||mL||Discontinued||||||||||||||||106.29|mL/hr|||||||00264-1482-55^Dopamine in Dextrose 5% Injection, B Braun^NDC^00264148255^Dopamine in Dextrose 5% Injection, B Braun^BILLINGNDC|
RXR|IV^IV|
RXC|B|330914^D5W^CHARGECODE^101084^DEXTROSE SOLUTION (Intravenous)^GFC|250|mL|||00264-1482-55^Dopamine in Dextrose 5% Injection, B Braun^NDC^00264148255^Dopamine in Dextrose 5% Injection, B Braun^BILLINGNDC|
RXC|A|3305681^DOPamine^CHARGECODE^101262^DOPAMINE HYDROCHLORIDE INJECTABLE (Intravenous)^GFC|400|mg|80|mg/mL|^^NDC^^^BILLINGNDC|
ORC||d5de0969-f482-469a-92dc-bb2127f1f14b|||CM||1^C^M33^20121012102000^20121012105300^||20121012105300|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^d5de0969-f482-469a-92dc-bb2127f1f14b|
RXE|||29.23||mL||Discontinued||||||||||||||||53.15|mL/hr|||||||00264-1482-55^Dopamine in Dextrose 5% Injection, B Braun^NDC^00264148255^Dopamine in Dextrose 5% Injection, B Braun^BILLINGNDC|
RXR|IV^IV|
76
Chapter 2 Outbound Interfaces
RXC|B|330914^D5W^CHARGECODE^101084^DEXTROSE SOLUTION (Intravenous)^GFC|250|mL|||00264-1482-55^Dopamine in Dextrose 5% Injection, B Braun^NDC^00264148255^Dopamine in Dextrose 5% Injection, B Braun^BILLINGNDC|
RXC|A|3305681^DOPamine^CHARGECODE^101262^DOPAMINE HYDROCHLORIDE INJECTABLE (Intravenous)^GFC|400|mg|80|mg/mL|^^NDC^^^BILLINGNDC|
ORC||9e62af2d-941b-4065-8dac-fd7f83406c44|||CM||1^^^^20121012095500^||20121012095500|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^9e62af2d-941b-4065-8dac-fd7f83406c44|
RXE||330011^Lactated Ringers (1,000 mL) IV ^CHARGECODE^102142^LACTATED RINGER’S SOLUTION SOLUTION (Intravenous)^GFC|50||mL||Transferred||||||||||||||||||||||||0338-0117-04^Baxter Healthcare Corporation^NDC^00338011704^Baxter Healthcare Corporation^BILLINGNDC|
RXR|IV^IV|
ORC||87035ed9-c2ec-4038-b2c2-032e39c4becd|||CM||1^^^^20121012100000^||20121012100000|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^87035ed9-c2ec-4038-b2c2-032e39c4becd|
RXE||330011^Lactated Ringers (1,000 mL) IV ^CHARGECODE^102142^LACTATED RINGER’S SOLUTION SOLUTION (Intravenous)^GFC|100||mL||Transferred||||||||||||||||||||||||0338-0117-04^Baxter Healthcare Corporation^NDC^00338011704^Baxter Healthcare Corporation^BILLINGNDC|
RXR|IV^IV|
ORC||be0bd2c6-f0e1-450a-8b5b-b6e96842c374|||CM||1^^^^20121012102557^||20121012102557|||SG9191^Green^Sam^^Jr^^CRNA^|||||||||MergeAIMS^^be0bd2c6-f0e1-450a-8b5b-b6e96842c374|
RXE||330011^Lactated Ringers (1,000 mL) IV ^CHARGECODE^102142^LACTATED RINGER’S SOLUTION SOLUTION (Intravenous)^GFC|50||mL||Transferred||||||||||||||||||||||||0338-0117-04^Baxter Healthcare Corporation^NDC^00338011704^Baxter Healthcare Corporation^BILLINGNDC|
RXR|IV^IV|
?
Sample Coding Message (PAE Diagnosis Coding)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012073638||ORU^R01|20121012073637870|P|2.4|||AL|NE|USA|
PID|1||111111111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19710809000000|F||||||||||AN01.93^^^FAC1^AN|111111111|
PV1||O|||||||||||||||||VN01.93|
DG1|1||401.0^MALIGNANT ESSENTIAL HYPERTENSION^I9^^^||20121012073600|W|||||||||0|AMD08031^Test^Anesthesiologist^H.^^^AMD^|D||20121012073600|
DG1|2||250.02^TYPE II OR UNSPECIFIED TYPE DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION, UNCONTROLLED^I9^^^||20121012073600|W|||||||||0|AMD08031^Test^Anesthesiologist^H.^^^AMD^|D||20121012073600|
77
Merge AIMS 8.3 HL7 Interface Specification
?
Sample Coding Message (Complete Coding from Anesthesia Record)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012172054||ORU^R01|20121012172052745|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONG_01.93^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
DG1|1||844.1^SPRAIN OF MEDIAL COLLATERAL LIGAMENT OF KNEE^I9^^^||20121012100156|W|||||||||0|AMD08031^Test^Anesthesiologist^H.^^^AMD^|D||20121012172009|
DG1|2||401.0^MALIGNANT ESSENTIAL HYPERTENSION^I9^^^||20121012095549|W|||||||||0|AMD08031^Test^Anesthesiologist^H.^^^AMD^|D||20121012172009|
DG1|3||250.02^TYPE II OR UNSPECIFIED TYPE DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION, UNCONTROLLED^I9^^^||20121012095549|W|||||||||0|AMD08031^Test^Anesthesiologist^H.^^^AMD^|D||20121012172009|
PR1|1||22556^ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); THORACIC^C4^^^||20121012100243|P|41.82|AMD08031^Test^Anesthesiologist^H.^^^AMD^|00626^ANESTHESIA FOR PROCEDURES ON THE THORACIC SPINE AND CORD, VIA AN ANTERIOR TRANSTHORACIC APPROACH; UTILIZING 1 LUNG VENTILATION^XWALK^^^|68.21|FT9876^Thornton^Frank^^^^MD^|FT9876^Thornton^Frank^^^^MD^|||||
PR1|2||22585^ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)^C4^^^||20121012095600|P|48.53|AMD08031^Test^Anesthesiologist^H.^^^AMD^|-00003^*** NOT A PRIMARY PROCEDURE CODE ***^XWALK^^^|68.21|FT9876^Thornton^Frank^^^^MD^|FT9876^Thornton^Frank^^^^MD^|||||
PR1|3||22585^ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)^C4^^^||20121012095600|P|48.53|AMD08031^Test^Anesthesiologist^H.^^^AMD^|-00003^*** NOT A PRIMARY PROCEDURE CODE ***^XWALK^^^|68.21|FT9876^Thornton^Frank^^^^MD^|FT9876^Thornton^Frank^^^^MD^|||||
PR1|4||4048F^DOCUMENTATION THAT ADMINISTRATION OF PROPHYLACTIC PARENTERAL ANTIBIOTIC WAS INITIATED WITHIN 1 HOUR (IF FLUOROQUINOLONE OR VANCOMYCIN, 2 HOURS) PRIOR TO SURGICAL INCISION (OR START OF PROCEDURE WHEN NO INCISION IS REQUIRED) AS ORDERED (PERI 2)^C4^^^||20121012095600|P|48.53|AMD08031^Test^Anesthesiologist^H.^^^AMD^|^^XWALK^^^|68.21|SG9191^Green^Sam^^Jr^^CRNA^|SG9191^Green^Sam^^Jr^^CRNA^|||||
78
Chapter 2 Outbound Interfaces
PR1|5||27658^REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON^C4^^^||20121012095600|P|6.25|AMD08031^Test^Anesthesiologist^H.^^^AMD^|01470^ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, AND FASCIA OF LOWER LEG, ANKLE, AND FOOT; NOT OTHERWISE SPECIFIED^XWALK^^^|68.21|FT9876^Thornton^Frank^^^^MD^|FT9876^Thornton^Frank^^^^MD^|||844.1^SPRAIN OF MEDIAL COLLATERAL LIGAMENT OF KNEE^I9^^^|51^MULTIPLE PROCEDURES^CPTM^^^|
PR1|6||36620^ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITORING OR TRANSFUSION (SEPARATE PROCEDURE); PERCUTANEOUS^C4^^^||20121012171913|I||^^^^^^^|||^^^^^^^|50012^White^Jonathan^Ron^^^AMD^|||||
PR1|7||99135^ANESTHESIA COMPLICATED BY UTILIZATION OF CONTROLLED HYPOTENSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY ANESTHESIA PROCEDURE)^C4^^^||20121012095600|P|48.53|AMD08031^Test^Anesthesiologist^H.^^^AMD^||68.21|FT9876^Thornton^Frank^^^^MD^|FT9876^Thornton^Frank^^^^MD^|||||
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Sample Surgical Procedures Message
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012173041||ORU^R01|20121012173040581|P|2.4|||AL|NE|USA|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONG_01.93^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
PR1|1||27658^REPAIR, FLEXOR TENDON, LEG; PRIMARY, W/O Graft^ScheduledProcedure^27658^REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON^C4||20121012095600|P|6.25||||FT9876^Thornton^Frank^^^^MD^|||2|844.1^SPRAIN OF MEDIAL COLLATERAL LIGAMENT OF KNEE^I9^^^|51^MULTIPLE PROCEDURES^CPTM^^^|
PR1|2||22812^SPINAL FUSION, 8+ VERT, ANTERIOR^ScheduledProcedure^22556^ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); THORACIC^C4||20121012100243|P|41.82||||FT9876^Thornton^Frank^^^^MD^|||1|||
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Sample Allergy Message (AL1, Micromedex)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012105800||ADT^A08|20121012105800529|P|2.4|||AL|NE|USA|
EVN||20121012105800|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
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Merge AIMS 8.3 HL7 Interface Specification
PV1||O|||||||||||||||||VN01.93|
AL1|1|Drug|7700060^CEFAZOLIN^MDX^^||N&V||AL
AL1|1|Drug|7700697^HYDROCODONE^MDX^^||Headache||IN
AL1|1|Drug|7702923^PENICILLIN^MDX^^Difficulty breathing, according to mother||Anaphylaxis||AL
AL1|1|Drug|7705145^EGGS^MDX^^||Anaphylaxis||AL
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Sample Allergy Message (A60-IAM, Micromedex)
MSH|^~\&|MERGEAIMS|Default|CLINICALHIS|FAC1|20121012110107||ADT^A60|20121012110107032|P|2.4|||AL|NE|USA|
EVN||20121012110107|
PID|1||111-11-1111^^^^SSN~MRN01.93^^^FAC1^MR~FA01.93^^^FAC1^CASE~AN01.93^^^FAC1^AN||LONGER^AMY^J||19810809000000|F||||||||||AN01.93^^^FAC1^AN|111-11-1111|
PV1||O|||||||||||||||||VN01.93|
IAM|1|DA|7700060^CEFAZOLIN^MDX^^||N&V|U|238^DOCUSYS||AL||||||||C
IAM|1|DA|7700697^HYDROCODONE^MDX^^||Headache|U|242^DOCUSYS||IN||||||||U
IAM|1|DA|7702923^PENICILLIN^MDX^^Difficulty breathing, according to mother||Anaphylaxis|U|^||AL||||||||U
IAM|1|DA|7700223^ACETAMINOPHEN^MDX^^|||D|241^DOCUSYS||AL||||||||I
IAM|1|DA|7705145^EGGS^MDX^^||Anaphylaxis|U|239^DOCUSYS||AL||||||||C
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80