Standard HL7 Interface Specification - Honeywell Life … • Honeywell HomMed Standard HL7 Interface Specification Confidential Page 4 of 22 5.0 ADT Patient Demographic Import Interface

P4610.01 • Honeywell HomMed Standard HL7 Interface Specification Confidential Page 1 of 22

Standard HL7 Interface Specification

Document Version 1.0 Revised April 12, 2010

Copyright © 2010 Honeywell HomMed. All rights reserved.


Table of Contents

1.0 Overview ................................................................................................................................... 3 2.0 Referenced Documents .......................................................................................................... 3 3.0 Message Composition Rules.................................................................................................. 3 4.0 Legend ...................................................................................................................................... 3 5.0 ADT Patient Demographic Import Interface.......................................................................... 4 5.1. Message Structure ....................................................................................................... 4 5.2. Segment Definitions..................................................................................................... 4 5.2.1. MSH – Message Header........................................................................................... 4 5.2.2. EVN – Event Type .................................................................................................... 4 5.2.3. PID – Patient Identification...................................................................................... 5 5.2.4. NK1 – Next of KIN Information ............................................................................... 6 5.2.5. PV1 – Patient Visit1.................................................................................................. 6 5.2.6. NTE – Notes .............................................................................................................. 7 5.2.7. DG1 – Diagnosis Information ................................................................................. 7 6.0 ORU Patient Vitals Export Interface....................................................................................... 8 6.1. Message Structure ....................................................................................................... 8 6.2. Segment Definitions..................................................................................................... 8 6.2.1. MSH – Message Header........................................................................................... 8 6.2.2. PID – Patient Identification...................................................................................... 9 6.2.3. ORC – Common Order Segment .......................................................................... 10 6.2.4. OBR – Observation Request Segment ................................................................ 10 6.2.5. NTE – Note Header................................................................................................. 10 6.2.6. OBX – Observation Segment ................................................................................ 11 7.0 Project Implementation Information .................................................................................... 14 7.1. Inbound Interface ....................................................................................................... 14 a. Mapping Values .............................................................................................................. 14 b. Business Requirement................................................................................................... 15 c. Search Algorithm and Business Rules............................................................................. 16 7.2. Outbound Interface .................................................................................................... 18 d. Mapping Values .............................................................................................................. 18 e. Business Rules ............................................................................................................... 19 7.3. Message ...................................................................................................................... 20 f. HL7 Version ......................................................................................................................... 20 g. Accepted Event Trigger ................................................................................................. 20 h. Message Structure ......................................................................................................... 21 i. Message Format.................................................................................................................. 21 j. Message Security................................................................................................................ 21 k. Acknowledgement Message.......................................................................................... 22 l. Message Processing .......................................................................................................... 22 7.4. Communication Mode................................................................................................ 22 7.5. Vendor System Information ...................................................................................... 22 7.6. Packet Wrapper .......................................................................................................... 22


1.0 Overview

In order to achieve mutual goals, we are presenting this Honeywell HomMed Standard HL7 Specification. Our Standard HL7 Specification is based on the HL7 v2.5 interface. The specification covers specific import, export, and implementation information for our HomMed telehealth system, and includes other important details. Chapter 2 of the HL7 Version 2.5 Messaging Standard provides details of the data types and data items that are specific to the HL7 standard referred to in this specification. Additional details on these items will not be included within this document. In addition, Section 8 - Project Implementation must be reviewed to insure that the interface specifications between the two companies are compatible. Specification details of the message types, messages, segments, and elements within segments are included within this document.

2.0 Referenced Documents

HL7 Messaging Standard Version 2.5 LOINC Manual 3.0 Message Composition Rules

Honeywell Hommed interface supports only the HL7 default separators:

Char Name <CR> Segment Terminator

| Field Separator ^ Component Separator & Sub-Component Separator ~ Repetition Separator \ Escape Character

4.0 Legend The following legend is used throughout the document:

Symbol Remarks [ ] Optional ( ) Required { } Repetitive R Required O Optional


5.0 ADT Patient Demographic Import Interface

5.1. Message Structure

ADT Patient Demographic message structure

( MSH ) ( EVN ) ( PID ) { [ NK1 ] } ( PV1 ) { [ NTE-1 ] } { [ DG1 ] }

5.2. Segment Definitions

5.2.1. MSH – Message Header Status: Mandatory Description: The MSH segment defines the intent, source, destination, and some specifics of the syntax of a message. Sample: MSH|^~\&|HomeSys|PatientMed|HommedADTInterface|LifeStream|200601060913||ADTÂ01|00030|P^T|2.5

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 File Header R ST 6 00001 MSH 2 Encoding Characters R ST 4 00002 ^~\& 3 Sending Application R ST 25 00003 <Vendor specified> 4 Sending Facility R ST 25 00004 <Vendor specified> 5 Receiving Application R ST 25 00005 <Vendor specified> 6 Receiving Facility R ST 25 00006 “LifeStream” 7 Date/Time of Message R ST 25 00007 Current date and time in

yyyymmddhhmm 9 Message Type R ST 15 00009 “ADTÂ01” or “ADTÂ08”

or “ADTÂ03” or “ADT04” 10 Message Control ID O ST 10 00010 This will be a unique 5 digits

increasing number for each message referring as MessageID

11 Processing ID R PT 3 00011 This will be sent as “P^T” to indicate that this is a production message transmitted at intervals. This field is formatted as follows: <processing ID (ID)> ^ <processing mode (ID)>

12 Version ID R ST 10 00012 0104 2.3

5.2.2. EVN – Event Type Status: Mandatory

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Description: The EVN segment describes event type information. It features event type, update date of patient record. Sample: EVN|ADTÂ01|200601060913|||||

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Event Type R ST 5 00001 EVN 2 Event Type Code R ST 15 00002 “ADTÂ01” or “ADTÂ08”

or “ADTÂ03” or “ADTÂ04”

3 Date/Time of Message R ST 25 00003 Current date and time in yyyymmddhhmm

5.2.3. PID – Patient Identification

Status: Required Description: The PID segment is used as the primary means of communicating patient demographic information. Sample: PID|1|DISTRICT10^31842|||Doe^John^M^Mr||19800606|M|||124 Capitol Way^Milwaukee^WI^53211ÛSA||777-765-9890|777-888-9890||S|||123-234-4455||||||||||||

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – PID R SI 5 00104 “1” 2 Medical Record Number R N ST 25 00106 This value is referring to

Vendor’s patient identifier. Site identifier might be appended as composite field.

3 Medical ID O N CX 20 Patient Medical ID 5 Patient Name R N XPN 00108 * 7 Date of Birth R ST 8 00110 Patient’s date of birth:

YYYYMMDD 8 Sex R N ST 1 00111 001 Mapping table 10 Race O N ST 2 00113 Display text 11 Patient Address R N ST 00114 * 13 Home Phone O N ST 25 00116 777-765-9890 19 SSN O N ST 25 00122 123-234-4455 20 Height O N ST 10 Patient HeightÛOM, for

example: 6.3^feet

* Patient Name

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Last Name R N ST 25 Patient’s Last Name 2 First Name R N ST 25 Patient’s First Name 3 Middle Initial O N ST 5 Patient’s Middle Initial 4 Title O N ST 5 Patient’s Title

* Patient Address

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Address R N ST 50 Patient’s Address 3 City R N ST 25 Patient’s City 4 State R N ST 2 Patient’s State 5 ZIP Code R N ST 50 Patient’s ZIP 6 Country R N ST 20 Patient’s Country

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* Title table DESCRIPTION

Dr. Mr. Mrs. Ms.

5.2.4. NK1 – Next of KIN Information

Status: Optional Description: The Next of Kin information segment contains information about the patient’s other related parties. Sample: NK1|1|NEY^CLIFFORD^C^Mr|CM| 1003 WATERFALL DRIVE^Spring Hill^FL^34608ÛSA |3276982539|3276982537|P|||||||||||||||||||||||||||||||

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – Next of KIN R SI 5 00190 “1” or increasing integer

number 2 Contact Name R ST 00191 * 3 Relationship O ST 2 00192 003 Blank 4 Contact Address R ST 00193 * 5 Phone O ST 25 00194 3276982539 7 Contact Role O ST 1 00196 004 * P = Primary, E =

Emergency, D = Durable Power of Attorney

* Contact Name SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK

1 Last Name R N ST 25 Last Name 2 First Name R N ST 25 First Name 3 Middle Initial O N ST 5 Middle Initial 4 Title O N ST 5 Title

* Contact Address

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Address R N ST 50 Address 3 City R N ST 25 City 4 State R N ST 2 State 5 ZIP Code R N ST 50 ZIP 6 Country R N ST 20 Country

* Contact Role table

ID DESCRIPTION P Primary E Emergency D Durable Power Of

Attorney

5.2.5. PV1 – Patient Visit1

Status: This is an optional field that we can turn on or off. If you want to use this field, then you must follow the field rules. Description: The PV1 segment features admission number, physician info, admit date, admit time, discharge date and time etc.


Sample: PV1|1||||||Aurora^SOLIMAN MD^FAWZI^F^Dr^123 Corporate Way^FairfieldÎA^52556ÛSA^3525960744|||||||||||||||||||||||||||||||||||||20051013000000|20051028153000||||||||

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – Patient Visit R SI 5 00131 “1” 7 Primary Doctor R ST * 8 Managing Doctor O ST * 9 Referring Doctor O ST * 44 Admit Date/Time R YYYYM

MDDHHMMSS

25 00174 20051013000000

45 Discharge Date/Time R YYYYMMDDHHMMSS

25 00175 20051028153000

* Primary/Managing/Referring Doctor

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Physician Identifier O ST 50 “Unique Physician ID” 2 Last Name R ST 25 Soliman MD 3 First Name R ST 25 Fawzi 4 Middle Initial O ST 5 S 5 Title R ST 5 Dr 6 Address R N ST 50 Address 7 City R N ST 25 City 8 State R N ST 2 State 9 ZIP Code R N ST 50 ZIP 10 Country R N ST 20 Country 11 Phone O ST 25 3525960744 12 Specialty R N ST 25 Immunology if null default

case manager

5.2.6. NTE – Notes

Status: Optional Description: The NTE segment is defined for inclusion in messages defined in other chapters. It is a common format for sending notes and comments. Sample: NTE|1||The patient is admitted after having undergone a surgery|

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID R SI 5 00096 “1” or increasing integer

number 3 Notes R ST 250 00098 Notes and comments text

5.2.7. DG1 – Diagnosis Information

Status: This is an optional field that we can turn on or off. If you want to use this field, then you must follow the field rules. Description: The Diagnosis Information segment contains patient diagnosis information of various types, for example diagnoses for a particular patient. Sample: DG1|1||550.90|UNILAT INGUINAL HERNIA|200510130100|||||||||||||||


SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID R SI 5 00375 “1” or increasing integer

number 3 Diagnosis Code R ST 60 00377 550.90 4 Diagnosis Description R ST 120 00378 UNILAT INGUINAL HERNIA 5 Diagnosis Date/Time O YYYYM

MDDHHMM

10 00379 200510130100

6 Diagnosis Type O ST 1 00380 Y= Primary, N = Non Primary

6.0 ORU Patient Vitals Export Interface

6.1. Message Structure

ORU Patient Vitals message structure

( MSH )

( PID ) [ ORC ] ( OBR ) { [ NTE-1 ] } { [ OBX ] }

6.2. Segment Definitions

6.2.1. MSH – Message Header Status: Required Description: The MSH segment defines the intent, source, destination, and some specifics of the syntax of a message.


Sample: MSH|^~\&|HomMedORUInterface||CentralStation||200601060913||ORU^R01|00030|P^T|2.3

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 File Header R ST 6 00001 MSH 2 Encoding Characters R ST 4 00002 ^~\& 3 Sending Application O HD 180 00003 <Vendor Specified> 4 Sending Facility O HD 180 00004 LifeStream 5 Receiving Application O HD 227 00005 <Vendor Specified> 7 Date/Time of Message R TS 26 00007 Current date and time in

yyyymmddhhmmss 9 Message Type R MSG 7 00009 This will be sent from the

HomMed server as “ORU^R32”

10 Message Control ID R ST 20 00010 This will be a unique 5 digits increasing number for each message referring as MessageID.

11 Processing ID R PT 3 00011 This will be sent as “P^T” to indicate that this is a production message transmitted at intervals. This field is formatted as follows: <processing ID (ID)> ^ <processing mode (ID)>

12 Version ID R VID 8 00012 0104 2.5

6.2.2. PID – Patient Identification

Status: Required Description: The PID segment is used as the primary means of referring to patient identification information. Honeywell Hommed will send patient export ID, name and Date of Birth to refer for a patient. Sample: PID|1||DISTRICT10^33||Doe^John^J^Mr||19971102

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – PID R SI 4 00104 “1” 3 Patient Identifier List R N CX 25 00106 Patient’s EXPORTID in

LifeStream. This value is referring to Vendor’s patient identifier. Site ID might be appended as composite field

5 Patient Name R N XPN 250 00108 * 7 Date/Time of Birth R TS 26 00110 Patient’s date of birth:

YYYYMMDD

* Patient Name

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Last Name R N ST 25 Patient’s Last Name 2 First Name R N ST 25 Patient’s First Name 3 Middle Initial R N ST 5 Patient’s Middle Initial 4 Title R N ST 5 Patient’s Title


6.2.3. ORC – Common Order Segment

Status: Optional Description: The Common Order segment (ORC) is used to transmit fields that are common to all orders. Sample: ORC|

6.2.4. OBR – Observation Request Segment

Status: Required Description: The Observation Request (OBR) segment is used to transmit information specific to an order for a diagnostic study or observation, physical exam, or assessment. Sample: OBR|1|1169||29274-8^VITAL SIGNS MEASUREMENTS^LN||200601060913|200601060913||||||||||||||||||F

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – OBR R SI 4 00237 “1” 2 Placer Order Number R EI 22 00216 This value will be a unique

integer value of reading “Packet Id” for a reading /response message, and will be null for other notes

4 Universal Service Identifier

R CE 250 00238 *

6 Request Date/Time R TS 26 00240 YYYYMMDDHHMM

7 Observation Date/Time R TS 26 00241 YYYYMMDDHHMM

25 Result Status C ID 1 00258 0123 This will always be ‘F’ to represent as Final result

* Universal Service Identifier – from LOINC manual

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Identifier R N ST 4 29274-8 3 Text R N ST 250 VITAL SIGNS

MEASUREMENTS 5 Encoding System R N ST 250 LN

Type Identifier Text

Encoding System

Vital 29274-8 VITAL SIGNS MEASUREMENTS LN Response to Vital

11488-4 CONSULTATION NOTE LN

Notes 11536-0 NOTES LN

6.2.5. NTE – Note Header

Status: Optional Description: This segment is used for notes


Sample: NTE|1|O| Auto Acknowledged

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID O SI 4 00096 “1” or increasing unique

integer value 2 Source of Comment O ID 8 00097 0105 Source of Comment, O-

Output 3 Comment O Y FT 65536 00098 Note text

6.2.6. OBX – Observation Segment

Status: Optional Description: This segment is used to send individual vital signs measurement values and answers to questions Sample: OBX|1|NM|8480-6ÎNTRAVASCULAR SYSTOLIC^LN||115|mm|10-200|N|||F|||200509210941

SEQ ELEMENT NAME USE RP DT LEN ITEM TBL REMARK 1 Set ID – OBX R SI 4 00569 1 2 Value Type R ID 2 00570 0125 This will be “NM” for

numeric values and “ST” for sting text

3 Observation Identifier R CE 250 00571 * from LOINC manual and question table or custom vendor identifier

5 Observation Value R * * 00573 This is the value of the vital sign or * answer to the questions

6 Units R CE 250 00574 * 7 Reference Ranges O Y ST 60 00575 * This sequence holds the

limits information for the specified field

8 Abnormal Flags O Y IS 5 00576 0078 * This sequence is used to flag a value as being normal or abnormal

11 Observation Result Status

R ID 1 00579 0085 This is the status of the results and currently will be set to “F” to indicate that the results are final

14 Date/Time of Observation

R TS 26 00582 Date/time that the reading was taken, either the time information was sent from the HomMed Sentry Monitor or when the information was collected for an add-on device. It is formatted as follows: YYYYMMDDHHMM

* Observation Identifier – vitals reading – from LOINC manual

Identifier Text HomMed Field Encoding System

8462-4 INTRAVASCULAR DIASTOLIC Vitals: Diastolic LN 8478-0 INTRAVASCULAR MEAN Vitals: MAP LN 8480-6 INTRAVASCULAR SYSTOLIC Vitals: Systolic LN 8867-4 HEART BEAT Vitals: Heart Rate LN 2710-2 OXYGEN SATURATION Vitals: SpO2 LN 8310-5 BODY TEMPERATURE Vitals:

Temperature LN

29463-7 BODY WEIGHT Vitals: Weight LN


Identifier Text HomMed Field Encoding System

14743-9 GLUCOSE Glucose: Glucose LN 20150-9 VOLUMEÂT 1.0 S POST FORCED EXPIRATION Spirometry: FEV1 LN 19935-6 GAS FLOW.MAX Spirometry: PEF LN 19870-5 CAPACITY.VITAL.FORCED Spirometry: FVC LN 20153-3 VOLUME AT 1.0 S POST FORCED

EXPIRATION/VOLUME.FORCED EXPIRATION.TOTAL

Spirometry: FER LN

99998 GAS FLOW AT 50% OF FORCED EXPIRATION Spirometry: F50 99999 99997 GAS FLOW AT 25% OF FORCED EXPIRATION Spirometry: F25 99999

19927-3 GAS FLOW AT 25-75% OF FORCED EXPIRATION Spirometry: MEF LN 6301-6 COAGULATION TISSUE FACTOR INDUCED.INR PTINR: INR LN 5964-2 COAGULATION TISSUE FACTOR INDUCED PTINR: PT LN 8867-4 HEART BEAT ECG: Heart Rate LN 9952-3 QRS DURATION.LEAD I ECG: QRS LN 30935-1 ST DEVIATION ECG: ST LN 99996 NOISE ECG: NOISE 99999 99995 LENGTH ECG: LENGTH 99999

19935-6 GAS FLOW MAX Peak Flow: PEF LN 20150-9 VOLUME AT 1.0 S POST FORCED EXPIRATION Peak Flow: FEV1 LN 99994 PFTIME Peak Flow: PTIME 99999 99993 QUALITY Peak Flow: Quality 99999

* Observation Identifier – question – from Hommed custom question table

Identifier Text Encoding System

Type

1 DIFFICULTY BREATHING? 99999 normal 2 TIRED? 99999 normal 3 INHALERS? 99999 normal 4 EXTRA PILLOWS? 99999 normal 5 LIMITING ACTIVITY? 99999 normal 6 CLINICIAN CALL? 99999 normal 7 OUT OF MEDICATIONS? 99999 normal 8 TROUBLE TAKING MEDS? 99999 normal 9 DIET DIFFICULTY? 99999 normal 10 NAUSEA? 99999 normal 11 BLOOD SUGAR? 99999 normal 12 PAIN? 99999 normal 13 CHEST PAIN? 99999 normal 14 HEADACHES? 99999 normal 15 ANKLES SWOLLEN? 99999 normal 16 DIFFICULTY STANDING? 99999 normal 17 NUMBNESS/TINGLING? 99999 normal 18 DIZZINESS? 99999 normal 19 BLEEDING? 99999 normal 20 BRUISING? 99999 normal 21 URINATION PROBLEMS? 99999 normal 22 BOWEL PROBLEMS? 99999 normal 23 WOUND SIZE/COLOR? 99999 normal 24 WOUND ODOR? 99999 normal 25 WOUND DRAINAGE? 99999 normal 26 NITROGLYCERIN? 99999 normal 27 OXYGEN? 99999 normal 28 COUGH? 99999 normal 29 DECREASE IN APPETITE? 99999 normal 30 DIFFICULTY SWALLOWING? 99999 normal 31 FALLEN? 99999 normal 32 WOUND CARE DIFFICULTY? 99999 normal 33 HANDS OR FACE SWOLLEN? 99999 normal 34 PROTEIN IN URINE? 99999 normal 35 HEARTBURN? 99999 normal 36 BABY MOVEMENT? 99999 normal 37 BLURRED VISION TODAY? 99999 normal 38 CHANGES IN MEDS? 99999 normal 39 WEIGHT LOSS PLAN? 99999 normal


Identifier Text Encoding System

Type

40 EXERCISE PLAN? 99999 normal 41 ANXIOUS OR UPSET? 99999 normal 42 DEPRESSED? 99999 normal 43 STRESS MANAGEMENT? 99999 normal 44 SMOKING CESSATION? 99999 normal 45 ALCOHOL REDUCTION? 99999 normal 46 UNDERSTAND DIAGNOSIS? 99999 normal 48 WERE YOU ADMITTED TO THE HOSPITAL ANYTIME THIS WEEK? 99999 FC 49 DID YOU VISIT AN EMERGENCY ROOM THIS WEEK? 99999 FC 50 DID YOU HAVE AN UNEXPECTED VISIT TO YOUR PHYSICIAN THIS

WEEK? 99999 FC

51 HAS YOUR DOCTOR ADDED, DELETED, OR CHANGED ANY OF YOUR MEDICATIONS THIS WEEK?

99999 FC

52 Difficulty breathing? 99999 DM 53 Limiting activity? 99999 DM 54 Trouble taking meds? 99999 DM 55 Blood sugar? 99999 DM 56 Headaches? 99999 DM 57 Ankles swollen? 99999 DM 58 Difficulty standing? 99999 DM 59 Dizziness? 99999 DM 60 Cough? 99999 DM 61 Fallen? 99999 DM

1001 SNORE EVERYDAY? 99999 SA 1002 SNORE 3-4 TIMES/WK? 99999 SA 1003 SNORING LOUDER THAN TALKING? 99999 SA 1004 HEAR SNORING IN OTHER ROOM? 99999 SA 1005 SNORING BOTHERS PEOPLE? 99999 SA 1006 QUIT BREATHING EVERYDAY? 99999 SA 1007 QUIT BREATHING 3-4 TIMES/WK? 99999 SA 1008 TIRED AFTER SLEEP? 99999 SA 1009 TIRED WHILE AWAKE EVERYDAY? 99999 SA 1010 TIRED WHILE AWAKE 3-4 TIMES/WK? 99999 SA 1011 NOD OFF/FALL ASLEEP IN CAR EVERYDAY? 99999 SA 1012 NOD OFF/FALL ASLEEP IN CAR 3-4 TIMES/WK? 99999 SA

* Normal: normal question; FC: Focus Care question; SA: Sleep Apnea question * Question Answer – from LifeStream units will be encoded as follows:

Description Value Remarks Yes Y Yes No N No No Information NI No Information

* Units – from LifeStream units for vitals reading

Description Central Station Units Blood Pressure (Systolic, Diastolic, Mean) mm of Hg Heart Rate beats/minute %SpO2 % Temperature¹ °F Weight² Lb Glucose³ mg/dl FEV1, FVC Liters

F50, F25, MEF, Spirometer:PEF liters/second PeakFlow:PEF liters/minute PT Seconds ECG:QRS Ms ECG:ST mV INR (PT/Ptn)ISI

* Observation References Range


This sequence holds the limits information for the specified field. It will be formatted as follows: XXX-YYY, where XXX and YYY are the minimal and the maximal limit values; a special case must be provided for a weight increase of 2 lbs in 1 day and 5 lbs in 7 days, as

follows: o “> 2” for a weight increase of 2 lbs./0.9 kg in 1 day – smart limit o “> 5” for a weight increase of 5 lbs./2.3kg in 7 days – smart limit

For Yes/No answers, the field is filed with the normal answer which defaults to “N”. This sequence may be repeated for weight values when a weight exceeds both its high limit and an increase over a period of time. For example: "> 0.9~80.0-90.0". * Observation Abnormal Flags – from LifeStream will be encoded as follows:

Description Value Below minimum limit L Above maximum limit H Normal, within limits or for "N" answer N Abnormal, for "Y" or "N” answer A No limits set null Exceeded maximum increase over a period of time U

This sequence may be repeated for weight values when a weight exceeds both its high limit and an increase over a period of time. For example: "U~H".

7.0 Project Implementation Information

7.1. Inbound Interface

a. Mapping Values The objective of this section is to see the static values that are used by the HomMed application and decide vendor mapping values that will be used in the project.

Title Table HomMed ID

HomMed Description

Vendor ID Vendor Description

Notes

Dr. Dr. Mr. Mr. Mrs. Mrs. Ms. Ms.

Gender Table HomMed ID

HomMed Description


Notes

M Male F Female


Contact Relationship Table

HomMed ID

HomMed Description


Notes

CM Case Manager

C Child F Friend L Local EMS O Other R Relative S Spouse

Contact Role Table HomMed ID

HomMed Description


Notes

P Primary E Emergency D Durable

Power of Attorney

Phone Type Table HomMed ID

HomMed Description


Notes

Home Home Mobile Mobile Pager Pager FAX FAX Work Work Other Other

b. Business Requirement The objective of this section is to describe business rules that used by HomMed application and decide vendor business rules that will be used in the project.

Section Business Rules Vendor Response

General State in address shall be standard US state having length of 2 chars (MN etc)

Comply

Country in postal address shall be USA Comply

Patient Insert

HomMed requires Person Details

For a complete Patient, HomMed requires first name, last name, DOB, gender, time zone, and site

Only last name is required

Contact Insert

HomMed requires Person Details Only last name is required


Section Business Rules Vendor Response

For a complete Contact, HomMed requires first name, last name

None is required

Insurer Insert

HomMed requires Insurer Name None is required

Physician Insert

HomMed requires Care Provider Details Only last name and physician ID is required

For a complete Care Provider, HomMed requires first name, last name, specialty, and type

Only last name and physician ID is required

Diagnosis Insert

HomMed requires Diagnosis text Comply

Medication Insert

HomMed requires Medication description Comply

Note Insert

HomMed requires Note type and text

c. Search Algorithm and Business Rules The objective of this section is to describe search algorithm and business rules that used by HomMed application and decide vendor search algorithm that will be used in the project.

Section Business Rules and Search Algorithm Vendor Response MSH Triggers

Received A01 and Patient is not found in HomMed -> Insert in HomMed

Comply

Received A01 and Patient is already found in HomMed -> Return error log

Comply

Received A08 and Patient is not found in HomMed -> Return error log

Add as A01

Received A08 and Patient is found in HomMed -> Update in HomMed

Comply

Received A03 and Patient is not found in HomMed -> Return error log

Comply

Received A03 and Patient doesn't have a equipment -> Return error log

Comply

Received A03 and message ignored Comply

Received A03 and multiple Patients are found in HomMed -> Return an error log

Comply Comply

Patient Search Criteria1 : ExpID + Lname

Comply

Criteria2 : ExpID + DOB + Gender Comply

Contact FirstName + LastName First Name, LName,


Section Business Rules and Search Algorithm Vendor Response Search ZIP In case of A08, If one record is found, then update it In case of A08, If zero record is found, then insert it

In case of A08, If more than one record is found, log error and continue processing next segment

In case of A01, Just insert all the contacts In case of A03, Ignore message Insurer Search LastName

Insurance Company Name + Plan ID

In case of A08, If one record is found, then update it In case of A08, If zero record is found, then insert it


In case of A01, Just insert all the insureres In case of A03, Ignore message

Physician FirstName + LastName Physician ID + Last Name

In case of A08, If one record is found, then update it In case of A08, If zero record is found, then insert it


In case of A01, it is going ot behave like A08 In case of A03, Ignore message

Diagnosis Name + ActiveInd(Y) + PrimaryInd Diagnosis date, description, code

In case of A01, Just insert all the Diagnosis In case of A03, Ignore message In case of A08, If zero record found, then insert In case of A08, If 1 record found,then update


Medication Label + TableCode(PMED) + ActiveInd(Y) + Comment Text

In case of A01, Just insert all the medications In case of A03, Ignore message In case of A08, If zero record found, then insert In case of A08, If 1 record found, then update


Notes CommentText + TableCode(GNRL) In case of A01, Just insert all the notes In case of A03, Ignore message

In case of A08, if zero record found Just insert that note record.


7.2. Outbound Interface

d. Mapping Values The objective of this section is to see the static values that used by HomMed application and decide vendor mapping values that will be used in the project. Observation Identifier Mapping

HomMed Field Identifier Text Encoding System

Vitals: Diastolic Vitals: MAP Vitals: Systolic Vitals: Heart Rate

Vitals: SpO2 Vitals: Temperature

Vitals: Weight Glucose: Glucose

Spirometry: FEV1

Spirometry: PEF Spirometry: FVC

Spirometry: FER Spirometry: F50 Spirometry: F25 Spirometry: MEF

PTINR: INR PTINR: PT ECG: Heart Rate ECG: QRS ECG: ST ECG: NOISE ECG: LENGTH Peak Flow: PEF Peak Flow: FEV1

Peak Flow: PTIME

Peak Flow: Quality


* Units – these are unit of measurement mappings from HomMed Central Station to Vendor

Description HomMed Units Vendor Units Agreed Units Vital:Systolic, Vital:Diastolic, Vital:MAP mmHg Vital:Heart Rate, ECG:Heart Rate bpm Vital:SpO2 % Vital:Temperature °F Vital:Weight lb Glucose:Glucose mg/dl Spriometer:FEV1, Spirometer:FVC, PeakFlow:FEV1

l

Spirometer:FER FEV1/FVC

Spirometer:F50, Spirometer:F25, Spiromter:MEF, Spirometer:PEF

l/s

PeakFlow:PEF l/m PT/INR:PT sec ECG:QRS ms ECG:ST mV PT/INR:INR (PT/Ptn)ISI

e. Business Rules The objective of this section is to describe business rules that used by HomMed application and decide vendor business rules that will be used in the project.

Below are the possible use cases and message structures for outbound:

Use Cases HomMed Message Structure

Vendor Message Structure

Agreed Message Structure

Notes

Vitals Only ( MSH ) ( PID ) [ ORC ] ( OBR ) {[ OBX ]}

OBR-2 as packet ID

Vitals and Response to current vitals

( MSH ) ( PID ) [ ORC ] ( OBR ) {[ NTE-1 ]} {[ OBX ]}

OBR-2 as packet ID

Response to Old Vitals

( MSH ) ( PID ) [ ORC ] ( OBR ) {[ NTE-1 ]}

OBR-2 as packet ID

General Notes and Standing Orders

( MSH ) ( PID ) [ ORC ] ( OBR ) {[ NTE-1 ]}

OBR-2 as null


7.3. Message

f. HL7 Version

The objective of this section is to see the difference of HL7 Version used by HomMed interface and vendor interface and to decide ones that will be used in the project.

HomMed HL7 Version

<vendor> HL7 Version

Agreed HL7 Version

Notes

2.5

g. Accepted Event Trigger

The objective of this section is to see the difference of event trigger used by HomMed interface and vendor interface and to decide ones that will be used in the project.

HomMed Event Trigger

<vendor> Event Trigger

Agreed Event Trigger

Notes

ADT A01 Inbound - Patient Admit – New patient will be entered with no monitor assigned

ADT A08 Inbound - Patient Update – Changes to patient information

ADT A03 Inbound - Patient Discharge

ORU – R01 Outbound – Observation reading


h. Message Structure

The objective of this section is to see the difference of message structure used by HomMed interface and vendor interface and to decide ones that will be used in the project. Message Type

HomMed Message Structure

<vendor> Message Structure

Agreed Message Structure

Notes

ADT A01 ( MSH ) ( EVN ) ( PID ) { [ NK1 ] } ( PV1 ) { [ NTE-1 ] } { [ DG1 ] }

Inbound – Patient Admit


Inbound – Patient Update


Inbound – Patient Discharge

ORU R01 ( MSH ) ( PID ) ( ORC ) ( OBR ) { [ NTE-1] } { ( OBX ) }

Outbound – Observation Reading

i. Message Format

What is the message format? ASCII

j. Message Security

How about the message security?

Inbound - Unencrypted Outbound - Unencrypted


k. Acknowledgement Message

There is an acknowledgement message Is there any necessary action if it is an error acknowledgement?

l. Message Processing

Please describe if you can handle only a single message: What, if any, is the file naming convention? ________________ Message frequency: ___________ mins What, if any, is the constraint on file size? : ___________ MB

7.4. Communication Mode

TCP/IP is the standard mode of transfer for Honeywell HomMed. The HL7 messages sent through the communication mode have to comply with Honeywell Hommed HL7 Segment Definitions and other collaborative specifications developed by both sides. Detailed implementation of interface package will also be described in collaborative specifications.

7.5. Vendor System Information

What is your Patient Identifier Field?

Are there any non telemonitored patients data transferred?

How is the association between patient and site?

Are there any custom reports to be developed for user?

Name of vendor software and version 7.6. Packet Wrapper

Please describe any header/trailer segments that you use as a wrapper around your HL7 messages: