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Version 2.x Messaging Conformance. AbdulMalik Shakir Principal Consultant, Shakir Consulting HL7 Working Meeting September 2012, Baltimore, MD. Abdul- Malik Shakir Principal Consultant, Shakir Consulting, La Verne, CA HL7 Member since 1991 Principal Consultant with Shakir Consulting - PowerPoint PPT Presentation
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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Version 2.x Messaging
ConformanceAbdulMalik Shakir
Principal Consultant, Shakir Consulting
HL7 Working MeetingSeptember 2012, Baltimore, MD
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Abdul-Malik ShakirPrincipal Consultant, Shakir Consulting, La Verne, CA
HL7 Member since 1991
Principal Consultant with Shakir Consulting Director Research Informatics Architecture with City of Hope Co-Chair of the HL7 Modeling and Methodology Committee Member of the HL7 Education Committee Member of the HL7 Public Health and Emergency Response Committee Member of the HL7 Regulated Clinical Research Information Management Committee Member of the HL7 Clinical Interoperability Council
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Session Outline
Part I Background
HL7: What, and Why Message Profile:
Why and When Message Profiles:
What and How Concepts and Constituents Levels and Examples
Part II Messaging Workbench
What and Why Features and Use Reports and Examples Contacts and Help
Sample Projects CADHS ELR CA SIIS SIP
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Health Level SevenWhat and Why
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
An HL7 Messaging Scenario: Why
User InterfaceProgramModuleDataset
User Interface ProgramModule Dataset
Message Creation
Message Parsing
A to BTransformation
Message Parsing
Message Creation
B to ATransformation
Order Entry Application
System
Laboratory Application
System
Lab
Ord
er
Tran
s act
ion
Order Entry Application
System
Laboratory Application
System
Lab
Res
ult
Tran
sact
ion
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Reaching the Limits of Application Interfaces
Lab
Order Entry ADT
Pharmacy Radiology
DecisionSupport
ElectronicHealth Record
AdministrativeSystems
?
EnterpriseSystems
?ExternalSystems
?
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Health Level Seven: Why
• The number of interfaces between N systems is given by the formula I = (N2-N)/2.
• Linking systems only needs 1 interface, ;• Linking 6 systems needs as many as 15 interfaces, (62 – 6) / 2 = 15• The benefits of using the HL7 standard increase rapidly with the
number of systems involved. I = N
3 (32 - 3) / 2 = 3 2 (22 - 2) / 2 = 1 4 (42 - 4) / 2 = 6
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Health Level Seven: WhyInterfaces Required
0
20
40
60
80
100
120
Systems
Inte
rfac
es
W/O HL7 1 3 6 10 15 21 28 36 45 55 66 78 91 105
With HL7 2 3 4 5 6 7 8 9 10 11 12 13 14 15
2 3 4 5 6 7 8 9 10 11 12 13 14 15
Tolerable Painful Intolerable
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Divide and Conquer / Component Reuse
DATA
Next of Kin (NK1)
Insurance (IN1)
Patient Visit (PV1) Patient
Demographics (PID)
Guarantor(GT1)
NK1
IN1
PV1
PID
GT1OBR
OBX
Next of KIN(NK1)
Patient Visit(PV1)
Patient Demographics
(PID)
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Abstract Message Specification
MSH Message HeaderEVN Event TypePID Patient Identification [PD1] Additional Demographics[ { NK1 } ] Next of Kin /Associated PartiesPV1 Patient Visit[ PV2 ] Patient Visit - Additional Info.
…[ { GT1 } ] Guarantor[ { IN1 Insurance [ IN2 ] Insurance Additional Info. [ IN3 ] Insurance Add'l Info - Cert. } ]
…
[ ] optional
{ } may repeat
Segment ID Segment Name
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MSH Segment DefinitionSEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 1 ST R 00001 Field Separator2 4 ST R 00002 Encoding Characters3 180 HD O 00003 Sending Application4 180 HD O 00004 Sending Facility5 180 HD O 00005 Receiving Application6 180 HD O 00006 Receiving Facility7 26 TS O 00007 Date/Time Of Message8 40 ST O 00008 Security9 7 CM R 00009 Message Type10 20 ST R 00010 Message Control ID11 3 PT R 00011 Processing ID12 8 ID R 0104 00012 Version ID13 15 NM O 00013 Sequence Number14 180 ST O 00014 Continuation Pointer15 2 ID O 0155 00015 Accept Acknowledgment Type16 2 ID O 0155 00016 Application Ack. Type17 2 ID O 00017 Country Code18 6 ID O Y/3 0211 00692 Character Set19 60 CE O 00693 Principal Language Of Message
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MSH Segment DefinitionSEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 1 ST R 00001 Field Separator2 4 ST R 00002 Encoding Characters3 180 HD O 00003 Sending Application4 180 HD O 00004 Sending Facility5 180 HD O 00005 Receiving Application6 180 HD O 00006 Receiving Facility7 26 TS O 00007 Date/Time Of Message8 40 ST O 00008 Security9 7 CM R 00009 Message Type10 20 ST R 00010 Message Control ID11 3 PT R 00011 Processing ID12 8 ID R 0104 00012 Version ID13 15 NM O 00013 Sequence Number14 180 ST O 00014 Continuation Pointer15 2 ID O 0155 00015 Accept Acknowledgment Type16 2 ID O 0155 00016 Application Ack. Type17 2 ID O 00017 Country Code18 6 ID O Y/3 0211 00692 Character Set19 60 CE O 00693 Principal Language Of Message
SEQ - position within segment
LEN - length of field
DT - data type for field
OPT - optionality for field
RP/# - repeatability
TBL# - table number for codes
ITEM# - HL7 element number
ELEMENT NAME - name
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HL7 Message Elements
An HL7 message specification is an ordered collection of one or more segment groups where each segment group is an ordered collection of one or more segments. A segment may be part of more than one segment group; it can also appear more than once within the same segment group.
A segment is an ordered collection of fields. Each segment field is an instance of a data element. A data element may appear as a field in more than one segment or as more than one field within the same segment. Each data element is assigned a data type.
A datatype may be simple or composite. A composite datatype is an ordered collection of one or more data type components; a simple datatype has no components. A data type component is an instance of a data element. A data element may appear as a component of more than one composite data type or as more than one component of the same composite data type.
Segment fields and datatype components may be associated with a code table. A code table is a collection of code table items. Each code table item is a code system term from some code system. A code system may be HL7 defined, user defined, or defined by a third party. A code system term may be used as a code table item in more than one code table but may appear only once within the same code table.
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HL7 v2 Message ElementsMessage
Specification
Segment Group
Segment Segment Field
Data ElementMessage Segment
Data Type
Data TypeComponent
Code Table Code Table Item
CompositeData Type Code System
Code System Term
One to One One to Many Many to Many
Relationships
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Sample HL7 v2.x Message
Segments MSH: Message Header PID: Patient Identification OBR: Observation Request OBX: Observation Result
MSH|^~\&|LABGL1||DMCRES||199812300100||ORU^R01|LABGL1199510221838581|P|2.3|||NE|NE
PID|||6910828^Y^C8||Newman^Alfred^E||19720812|M||W|25 Centscheap Ave^^Whatmeworry^UT^85201^^P||(555)777-6666|(444)677-7777||M||773789090
OBR||110801^LABGL|387209373^DMCRES|18768-2^CELL COUNTS+DIFFERENTIAL TESTS (COMPOSITE)^LN|||199812292128||35^ML|||||||IN2973^Schadow^Gunther^^^^MD^UPIN||||||||||^Once||||||CA20837^Spinosa^John^^^^MD^UPIN
OBX||NM|4544-3^HEMATOCRIT (AUTOMATED)^LN||45||39-49||||F|||199812292128||CA20837
OBX||NM|789-8^ERYTHROCYTES COUNT (AUTOMATED)^LN||4.94|10*12/mm3|4.30-5.90||||F|||199812292128||CA20837
Delimiters| Field ^ Component& Subcomponent ~ Repetition\ Escape Character
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Message ProfilesWhy and When
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Reveal Assumptions
Revealing assumptions is an essential component of effective communication.
Yes, I doplay
football.
Do youplay
football?
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Reveal Assumptions
Message Profiles are an effective means of documenting our assumptionsabout message structures
Do you use
HL7?
MSHEVNPID [PD1][ { NK1 } ]
Yes, Iuse HL7.
MSHEVNPID[ NK1 ]OBX
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Reduce Ambiguity
Message Profiles provide a language that allows us to unambiguously express our understanding and assumptions about the information in a message structure used
in a particular scenario
MSHEVNPID [PD1][ { NK1 } ]
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Highlight Conflicts
Sharing message profiles provides an opportunity to identify and reconcile conflicts in our understanding
and to validate our assumptions about message structures.
MSHEVNPID [PD1][ { NK1 } ]
MSHEVNPID[ NK1 ]OBX
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Consolidate Viewpoints
Message Profile Message Profile Message Profile
MSHEVNPID [PD1][ { NK1 } ]
MSHEVNPID[ NK1 ]OBX
MSHEVN{ PID } [PD1][ { GT1 } ]
MSHEVN{ PID } [PD1][ { NK1 } ][ { GT1 } ][ OBX ]
Canonical Message Profile
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Value of Message Profiling
Reveal Assumptions
Reduce Ambiguity
Highlight Conflicts
Consolidate Viewpoints
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Message ProfilesWhat and How
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Message Profile Defined Unambiguous specification of a standard HL7
message for use within a particular set of requirements
Prescribes a set of precise constraints upon one or more standard messages
Supported by use case analysis and interaction modeling
Measurable What data will be passed in a message The format in which the data will be passed The acknowledgement responsibilities of the sender and
receiver
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Message Profile Defined (cont’d) Based on HL7, although may further constrain
Static structure and content of each message The dynamic interactions
Parts of a valid message profile Use Case Model Static Definition Dynamic Definition
Represented as an XML document Can be registered with HL7 May be reused by other HL7 users May be used for documentation
25 of 15
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Conceptual OverviewMessage Profile = Static Profile + Dynamic Profile
Critical Care Unit
ADT System
Response Message
Initiating Message
Initiating Message
Clinical Data Repository
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Use Case Model Documents the scope and requirements for an HL7
Message Profile or set of Message Profiles May include a use case diagram or detailed text Provides a name that clearly and concisely defines the exchange Defines the actors, including the sending and receiving
applications Defines the responsibilities of these actors Documents the situations in which the exchange of a particular
HL7 Message Profile is required Documents the purpose
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Static Definition A specification for a message structure intended to
support the use case Based on a message defined in HL7 Std Defined at the message, segment, and field levels
Follows the HL7 rules (chapter 2) May further constrain
Identifies only those specific elements used in the exchange Removes all instances of optionality, defining explicitly Segments, segment groups, fields and components usage rules Cardinalities Value sets and coding systems Implementation notes
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Static Definition Example
...
...
...
NK1
MSHEVNPID
NK1 NK1 NK1 NK1PV1
PV2OBXAL1
HL7 Message Structure
...
NK1
MSHEVNPID
NK1 NK1 NK1 NK1PV1
PV2OBXAL1
Message Profile
Segments/Segment Groups:• Usage (Optionality) • Cardinality (min, max)
Fields/Components: - Usage (Optionality) - Cardinality (min, max) - Value Sets/Coding system - Descriptions
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Dynamic Definition Defines interaction between the sender and receiver
Acknowledgment mode supported Conditions under which an accept and/or application level
acknowledgment is expected Always Never Only on success Only on error
Interaction Model Defines specific interactions between the applications that support
message profile communication requirements Includes interaction diagrams that illustrate the sequence of trigger event
and resulting message flows between the sending and receiving applications
Dynamic can refer one to many static definitions
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Dynamic Interaction
Vectra
XU
5/90C
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
POTASSIUM 3.5-5.0
BED 1 OFF
POTASSI UM 3.5- 5. 0
POTASSIUM 3.5-5.0
POTASSI UM 3.5- 5. 0
BED 1 OFF
POTASSIUM 3.5-5.0
BED 1 OFF BED 1 OFF
BED 1 OFFBED 1 OFFBED 1 OFF
Critical Care Unit HIS/CIS
Vectra
XU
5/90C
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
BED 1 OFF
POTASSI UM 3.5-5.0
BED 1 OFF
POTASSIUM 3.5-5.0
POTASSIUM 3.5-5.0
POTASSIUM 3.5-5.0
BED 1 OFF
POTASSIUM 3.5-5.0
BED 1 OFF BED 1 OFF
BED 1 OFFBED 1 OFFBED 1 OFF
Clinical Data Repository
A/D/T System
Order Filling Application
Accept Ack
Accept + App ACK
Receiver Responsibility MSH-15,16
No ACK
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How it all ties together
Static Definition – Field LevelVocabulary
SEQ LEN DT Usage Cardinality TBL# ITEM# ELEMENT NAME 1 4 SI X 00104 Set ID - PID 2 20 CX RE [1..1] 00105 Patient ID 3 20 CX R [1..*] 00106 Patient Identifier List 4 20 CX X 00107 Alternate Patient ID - PID 5 48 XPN R [1..*] 00108 Patient Name 6 48 XPN RE [1..*] 00109 Mother’s Maiden Name 7 26 TS RE 00110 Date/Time of Birth 8 1 IS RE 0001 00111 Sex 9 48 XPN X 00112 Patient Alias
10 80 CE X 0005 00113 Race 11 106 XAD RE [1..3] 00114 Patient Address 12 4 IS X 0289 00115 County Code 13 40 XTN RE [1..3] 00116 Phone Number - Home 14 40 XTN RE [1..3] 00117 Phone Number - Business 15 60 CE X 0296 00118 Primary Language 16 80 CE X 0002 00119 Marital Status 17 80 CE X 0006 00120 Religion 18 20 CX X 00121 Patient Account Number 19 16 ST RE 00122 SSN Number - Patient 20 25 DLN X 00123 Driver's License Number - Patient 21 20 CX X 00124 Mother's Identifier 22 80 CE X 0189 00125 Ethnic Group 23 60 ST RE 00126 Birth Place 24 1 ID X 0136 00127 Multip le Birth Indicator 25 2 NM X 00128 Birth Order 26 80 CE X 0171 00129 Citizenship 27 60 CE X 0172 00130 Veterans Military Status 28 80 CE X 0212 00739 Nationality 29 26 TS X 00740 Patient Death Date and Time 30 1 ID X 0136 00741 Patient Death Indicator
: A DT S y s tem : A DT Not ifi c ation Rec ip ient
ADT^A 01
A CK ^A01
Interaction Model
Segment ADT Message Usage Cardinality Chapter
MSH Message Header R [1..1] 2 EVN Event Type R [1..1] 3 PID Patient Identification R [1..1] 3 [ PD1 ] Additional Demographics X [0..0] 3 [{ ROL }] Role X [0..0] 12 [{ NK1 }] Next of Kin / Associated
Parties RE [0..3] 3
PV1 Patient Visit R [1..1] 3 [ PV2 ] Patient Visit - Additional
Info. RE [0..1] 3
[{ ROL }] Role X [0..0] 12 [{ DB1 }] Disability Information X [0..0] 3 [{ OBX }] Observation/Result X [0..0] 7 [{ AL1 }] Allergy Information RE [0..*] 3 [{ DG1 }] Diagnosis Information X [0..0] 6 [ DRG ] Diagnosis Related Group X [0..0] 6 [{ X [0..0] PR1 Procedures X [0..0] 6 [{ ROL }]
Role X [0..0] 12
}] [{ GT1 }] Guarantor X [0..0] 6 [{ X [0..0] IN1 Insurance X [0..0] 6 [ IN2 ] Insurance Additional Info. X [0..0] 6 [{ IN3 }]
Insurance Additional Info - Cert.
X [0..0] 6
[{ ROL }]
Role X [0..0] 12
}] [ ACC ] Accident Information X [0..0] 6 [ UB1 ] Universal Bill Information X [0..0] 6 [ UB2 ] Universal Bill 92 Information X [0..0] 6 [ PDA ] Patient Death and Autopsy X [0..0] 3
Dynamic Definition
Static Definition – Segment Level
P at ie n t
P hy s ic ian
A D T N o t ific a t ion Re c ipien t
A D T S y s tem
A dm it / V is i t No t ific a t ion
is s u b jec t o f au tho riz e s
rec e ives no t if ic a tions e n ds no t i f ic a t ion
Re g is t ra rt rig ge rs
Use Case Model
Static Definition – Message Level
1 Use Case Model
1.1 Use Case: Admit/Visit Notification
2. Dynamic Interaction Model
3 Dynamic Definition: ADT/ACK (Event A01)
3.1 ADT^A013.2 ACK^A01
4 Static Definition: - Message Level -ADT/ACK (event A01)
4.1 ADT^A014.2 ACK^A01
5 Static Defintiion - Segment Level
5.1 MSH – Message Header Segment Definition5.2 EVN - Event Type Segment Definition5.3 PID (Y) - Patient Demographics Segment Definition5.4 PD1 – Patient Additional Demographic Segment Definition5.5 NK1 - Next of kin Segment Definition5.6 PV1 (2) - Admit Visit Info Segment Definition5.7 AL1 - Allergy Segment Definition5.8 MSA - Message Acknowledgment Segment Definition5.9 ERR - Error Segment Definition
6 Static Definition - Field Level
6.1 Table 0001 – Sex6.2 Table 0002 – Marital Status6.3 Table 0003 – Event Type Code6.4 Table 0004 – Patient Class6.5 Table 0005 – Race6.6 Table 0006 – Religion6.7 Table 0007 – Admission Type6.8 Table 0008 – Acknowledgement Code6.9 Table 0009 – Ambulatory Status
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Message ProfilesConcepts and Constituents
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Profiling Concepts Profile Types
HL7 Standard Constrainable Implementable
Generic term ‘message element’ used Segment groups Segments Fields Components Sub-components
Cardinality Usage
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Profile Types HL7 Standard Profile
represents a specific HL7 published standard creation and publication limited to HL7 use
Constrainable May have optionality - not implementable Narrower profiles may be defined based on this Realm Specific (National, Regional, SIGs, etc.) Organization / Application Specific
Implementation Further constrained No optionality
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Cardinality
Identifies minimum and maximum number of repetitions
Special values for cardinality Minimum number of repetitions is 0, the element
may be omitted from a message The maximum value may have no practical limit (In
this case, it may be identified as ‘*’)
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Cardinality ExamplesValue Description
[0..0] Element never present
[0..1] Element may be omitted and it can have at most one Occurrence
[1..1] Element must have exactly one Occurrence
[0..n] Element may be omitted or may repeat up to n times
[1..n] Element must appear at least once, and may repeat up to n times
[0..*] Element may be omitted or repeat for an unlimited number of times
[1..*] Element must appear at least once, and may repeat unlimited number of times
[m..n] Element must appear at least “m” and at most” n” times
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Usage The circumstances under which an element
appears in a message Some elements must always be present others may never be present others may only be present in certain
circumstances Rules governing the expected behavior of
the sending and limited restrictions on the receiving application with respect to the element
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Usage (continued) R - Required
A conforming sending application populate all “R” elements with a non-empty value
A conforming receiving application process (save/print/archive/etc.) or ignore the information conveyed
by required elements must not raise an error due to the presence of a required element, but
may raise an error due to the absence of a required element For complete compatibility with HL7, any element designated as
required in a standard HL7 message definition shall also be required in all HL7 Message Profiles of that standard message
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Usage (continued) RE - Required but may be empty
May be missing from the message, but must be sent by the sending application if there is relevant data
A conforming sending application must be capable of providing all “RE” element if it knows the required values for the element, then it must send that
element if the conforming sending application does not know the required
values, then element will be omitted A conforming receiving applications
will be expected to process (save/print/archive/etc.) or ignore data contained in the element
must be able to successfully process the message if the element is omitted (I.e. no error message should be generated because the element is missing
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Usage (continued) Optional
This code indicates that the Usage for this element has not yet been defined
May NOT be used in ‘Implementation’ profiles (no-optionality profiles)
Conformance cannot be tested on an Optional field
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Usage (continued) C - Conditional
Predicate associated with this element that identifies the conditions under which the element must be present
must be testable and based on other values within the message may be expressed as a mathematical expression or in text and may
utilize operators such as equivalence, logical AND, logical OR and NOT
The conforming sending and receiving applications shall both evaluate the predicate
If the predicate is satisfied: See rules for R (Required)
If the predicate is NOT satisfied: A conformant sending application must NOT send the element A conformant receiving application must NOT raise an error if the
condition predicate is false and the element is not present, though it MAY raise an error if the element IS present
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Usage (continued) CE - Conditional but may be empty
This usage also has an associated condition predicate similar to Conditional (C)
If the predicate is satisfied: See rules for RE (Required but may be empty)
If the predicate is not satisfied: The conformant sending application must NOT send the element The conformant receiving application MAY raise an application error if
the element IS present X - Not supported
Conformant sending applications will NOT send the element Conformant receiving applications MAY ignore the element if it IS
present, or may raise an application error
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Optionality / Usage Relationship Conformance Usage codes are more specific
than HL7 Optionality codesHL7 Optionality Allowed Conformance Usage Comment
R - Required R
O - Optional R, RE, O*, C, CE, X O is only permitted for constrainable profiles
C - Conditional C, CE, R**, RE** ** If satisfied by use case
X – Not Supported X
B – Backward Compatibility
R, RE, O*, C, CE, X O is only permitted for constrainable profiles
W – Withdrawn X
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Usage / Cardinality Relationship Both Usage and Cardinality govern the appearance of a
field in a message Cardinality constrained by the usage code
If Required (R), the minimum and maximum cardinality for the element shall always be >= 1
If the usage of an element is not Required (R) (i.e. any code other than ‘R’), the minimum cardinality shall be 0 except in the following condition:
where an element will not always be present but, when present, must have a minimum number of repetitions greater than one, this may be indicated by specifying
• the non-required Usage code • the minimum cardinality representing the minimum number of repetitions
when the element is present.
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Usage-Cardinality Combinations
Cardinality Usage Interpretation
[1..1] R There will always be exactly 1 repetition present
[1..5] R There will be between 1 and 5 repetitions present
[0..1] R Illegal: Minimum and maximum cardinality must always be at least 1 for ‘Required’ elements
[0..1] RE The element must be supported, but may not always be present
[0..5] C If the condition predicate is true, there will be between 1 and 5 repetitions. If the predicate is false, there will be 0 repetitions
[3..5] RE If any values for the element are sent, there must be at least 3 and no more than 5 repetitions. However, the element may be absent (0 repetitions)
[0..1] CE Under certain circumstances, the element must be supported, but may not always be present
[0..0] X Not supported
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Usage Within Hierarchical Elements Messages are constructed using a hierarchy of
elements At least one lower level element must be present
for the higher level element to be considered to be present
Adds an implicit conditional constraint on elements that enforce the presence of an element
Places constraints on what combinations of usage codes may be used within a hierarchy
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Message ProfilesLevels and Examples
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Message Level Profile Segment Definitions
The set of segments and segment groups included within the message of an HL7 Message Profile shall be defined
Any segments or segment groups that are required by HL7 shall be included
Segment Usage Segment Cardinality Profile does not allow for “empty” segment HL7 abstract message syntax PLUS
Usage Cardinality
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Message Level Profile ExampleADT^A01^ADT_A01 ADT Message Usage Cardinality Chapter MSH Message Header R [1..1] 2 EVN Event Type R [1..1] 3 PID Patient Identification R [1..1] 3 [ PD1 ] Additional Demographics X [0..0] 3 [{ ROL }] Role X [0..0] 12 [{ NK1 }] Next of Kin / Associated
Parties RE [0..3] 3
PV1 Patient Visit R [1..1] 3 [ PV2 ] Patient Visit - Additional
Info. RE [0..1] 3
[{ ROL }] Role X [0..0] 12 [{ DB1 }] Disability Information X [0..0] 3 [{ OBX }] Observation/Result X [0..0] 7 [{ AL1 }] Allergy Information RE [0..*] 3 [{ DG1 }] Diagnosis Information X [0..0] 6 [ DRG ] Diagnosis Related Group X [0..0] 6 [{ X [0..0] PR1 Procedures X [0..0] 6 [{ ROL }] Role X [0..0] 12 }] [{ GT1 }] Guarantor X [0..0] 6 [{ X [0..0] IN1 Insurance X [0..0] 6 [ IN2 ] Insurance Additional Info. X [0..0] 6 [{ IN3 }] Insurance Additional Info -
Cert. X [0..0] 6
[{ ROL }] Role X [0..0] 12 }] [ ACC ] Accident Information X [0..0] 6 [ UB1 ] Universal Bill Information X [0..0] 6 [ UB2 ] Universal Bill 92 Information X [0..0] 6 [ PDA ] Patient Death and Autopsy X [0..0] 3
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Message Level Profile ExampleADT^A01^ADT_A01 ADT Message Usage Cardinality Chapter MSH Message Header R [1..1] 2 EVN Event Type R [1..1] 3 PID Patient Identification R [1..1] 3 [{ NK1 }] Next of Kin / Associated
Parties RE [0..3] 3
PV1 Patient Visit R [1..1] 3 [ PV2 ] Patient Visit - Additional
Info. RE [0..1] 3
[{ AL1 }] Allergy Information RE [0..*] 3
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Message Level Profile Example ADT^A01^ADT_A01 ADT Message Usage Cardinality Chapter MSH Message Header R [1..1] 2 EVN Event Type R [1..1] 3 PID Patient Identification R [1..1] 3 [ PD1 ] Additional Demographics X [0..0] 3 [{ ROL }] Role X [0..0] 12 [{ NK1 }] Next of Kin / Associated
Parties RE [0..10] 3
PV1 Patient Visit R [1..1] 3 [ PV2 ] Patient Visit - Additional
Info. R [1..1] 3
[{ ROL }] Role X [0..0] 12 [{ DB1 }] Disability Information X [0..0] 3 [{ OBX }] Observation/Result X [0..0] 7 [{ AL1 }] Allergy Information RE [0..*] 3 [{ DG1 }] Diagnosis Information X [0..0] 6 [ DRG ] Diagnosis Related Group X [0..0] 6 [{ X [0..0] PR1 Procedures X [0..0] 6 [{ ROL }] Role X [0..0] 12 }] [{ GT1 }] Guarantor X [0..0] 6 [{ RE [0..3] IN1 Insurance R [1..1] 6 [ IN2 ] Insurance Additional Info. RE [0..1] 6 [{ IN3 }] Insurance Additional Info -
Cert. X [0..0] 6
[{ ROL }] Role X [0..0] 12 }] [ ACC ] Accident Information RE [0..1] 6 [ UB1 ] Universal Bill Information X [0..0] 6 [ UB2 ] Universal Bill 92 Information X [0..0] 6 [ PDA ] Patient Death and Autopsy X [0..0] 3
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Message Level Profile Example ADT^A01^ADT_A01 ADT Message Usage Cardinality Chapter MSH Message Header R [1..1] 2 EVN Event Type R [1..1] 3 PID Patient Identification R [1..1] 3 [{ NK1 }] Next of Kin / Associated
Parties RE [0..10] 3
PV1 Patient Visit R [1..1] 3 [ PV2 ] Patient Visit - Additional
Info. R [1..1] 3
[{ AL1 }] Allergy Information RE [0..*] 3 [{ RE [0..3] IN1 Insurance R [1..1] 6 [ IN2 ] Insurance Additional Info. RE [0..1] 6 }] [ ACC ] Accident Information RE [0..1] 6
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Segment Level Profile The set of fields of each instance of a segment within the
Message Profile If a segment occurs multiple times, it may be represented
by different segment profiles Field Usage Field Cardinality Null Syntax (tabular HL7 segment definitions)
Length (updated) Usage (new column) Cardinality (new column)
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Segment Level Profile Example (PID)
SEQ LEN DT Usage Cardinality TBL# ITEM# ELEMENT NAME 1 4 SI X 00104 Set ID - PID
2 20 CX RE [0..1] 00105 Patient ID
3 20 CX R [1..*] 00106 Patient Identifier List
4 20 CX X 00107 Alternate Patient ID - PID
5 48 XPN R [1..*] 00108 Patient Name
6 48 XPN RE [0..*] 00109 Mother’s Maiden Name
7 26 TS RE [0..*] 00110 Date/Time of Birth
8 1 IS RE [0..*] 0001 00111 Sex
9 48 XPN X 00112 Patient Alias
10 80 CE X 0005 00113 Race
11 106 XAD RE [0..3] 00114 Patient Address
12 4 IS X 0289 00115 County Code
13 40 XTN RE [0..3] 00116 Phone Number - Home
14 40 XTN RE [0..3] 00117 Phone Number - Business
15 60 CE X 0296 00118 Primary Language
16 80 CE X 0002 00119 Marital Status
17 80 CE X 0006 00120 Religion
18 20 CX X 00121 Patient Account Number
19 16 ST RE [0..1] 00122 SSN Number - Patient
20 25 DLN X 00123 Driver's License Number - Patient
21 20 CX X 00124 Mother's Identifier
22 80 CE X 0189 00125 Ethnic Group
23 60 ST RE [0..1] 00126 Birth Place
24 1 ID X 0136 00127 Multiple Birth Indicator
25 2 NM X 00128 Birth Order
26 80 CE X 0171 00129 Citizenship
27 60 CE X 0172 00130 Veterans Military Status
28 80 CE X 0212 00739 Nationality
29 26 TS X 00740 Patient Death Date and Time
30 1 ID X 0136 00741 Patient Death Indicator
SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME 1 4 SI O 00104 Set ID - PID
2 20 CX B 00105 Patient ID
3 250 CX R Y 00106 Patient Identifier List
4 20 CX B Y 00107 Alternate Patient ID - PID
5 250 XPN R Y 00108 Patient Name
6 250 XPN O Y 00109 Mother’s Maiden Name
7 26 TS O Y 00110 Date/Time of Birth
8 1 IS O Y 0001 00111 Sex
9 250 XPN B 00112 Patient Alias
10 250 CE O 0005 00113 Race
11 250 XAD O Y 00114 Patient Address
12 4 IS B 0289 00115 County Code
13 250 XTN O Y 00116 Phone Number - Home
14 250 XTN O Y 00117 Phone Number - Business
15 250 CE O 0296 00118 Primary Language
16 250 CE O 0002 00119 Marital Status
17 250 CE O 0006 00120 Religion
18 250 CX O 00121 Patient Account Number
19 16 ST B 00122 SSN Number - Patient
20 25 DLN B 00123 Driver's License Number - Patient
21 250 CX O Y 00124 Mother's Identifier
22 250 CE O Y 0189 00125 Ethnic Group
23 250 ST O 00126 Birth Place
24 1 ID O 0136 00127 Multiple Birth Indicator
25 2 NM O 00128 Birth Order
26 250 CE O Y 0171 00129 Citizenship
27 250 CE O 0172 00130 Veterans Military Status
28 250 CE B 0212 00739 Nationality
29 26 TS O 00740 Patient Death Date and Time
30 1 ID O 0136 00741 Patient Death Indicator
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Segment Level Profile Example (PID)SEQ LEN DT Usage Cardinality TBL# ITEM# ELEMENT NAME
1 4 SI X 00104 Set ID - PID
2 20 CX RE [0..1] 00105 Patient ID
3 20 CX R [1..*] 00106 Patient Identifier List
4 20 CX X 00107 Alternate Patient ID - PID
5 48 XPN R [1..*] 00108 Patient Name
6 48 XPN RE [0..*] 00109 Mother’s Maiden Name
7 26 TS RE [0..*] 00110 Date/Time of Birth
8 1 IS RE [0..*] 0001 00111 Sex
9 48 XPN X 00112 Patient Alias
10 80 CE X 0005 00113 Race
11 106 XAD RE [0..3] 00114 Patient Address
12 4 IS X 0289 00115 County Code
13 40 XTN RE [0..3] 00116 Phone Number - Home
14 40 XTN RE [0..3] 00117 Phone Number - Business
15 60 CE X 0296 00118 Primary Language
16 80 CE X 0002 00119 Marital Status
17 80 CE X 0006 00120 Religion
18 20 CX X 00121 Patient Account Number
19 16 ST RE [0..1] 00122 SSN Number - Patient
20 25 DLN X 00123 Driver's License Number - Patient
21 20 CX X 00124 Mother's Identifier
22 80 CE X 0189 00125 Ethnic Group
23 60 ST RE [0..1] 00126 Birth Place
24 1 ID X 0136 00127 Multiple Birth Indicator
25 2 NM X 00128 Birth Order
26 80 CE X 0171 00129 Citizenship
27 60 CE X 0172 00130 Veterans Military Status
28 80 CE X 0212 00739 Nationality
29 26 TS X 00740 Patient Death Date and Time
30 1 ID X 0136 00741 Patient Death Indicator
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Field Level Profile Field definitions
Each individual field is completely defined to eliminate any possible ambiguity
If HL7 2.x field descriptions are not sufficient, a precise semantic definition shall be specified
Exact allowed value set shall be specified Coded Values (ID and IS)
HL7 tables (ID) may be extended User defined (IS) may be redefined and/or extended
Coded Entry (CE, CF, CWE, and CNE) Composite Data (CM) types
Appendix for 2.3.1 and 2.4 for XML encoding Deprecated and all CM fields are using new data types as of 2.5
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Message Profile Identifier
Uniquely identifies static and dynamic profile The static profile identifier is a means to uniquely identify
a message profile, expressed as an ASN.1 Object Identifier (OID) The sending application uses the profile identifiers to determine
the specific HL7 Message Profile to send Branch from ISO to HL7 and Message Profile
2.16.840.1.113883.9
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MSH-21 Message Profile Identifier Sites may use this field to assert adherence to, or reference, a message
profile. Message profiles contain detailed explanations of grammar, syntax, and usage for a particular message or set of messages.
Repetition of this field allows more flexibility in creating and naming message profiles. Using repetition, this field can identify a set of message profiles that the message conforms to.
the first repetition could reference a vendor's message profile The second could reference another compatible provider's profile or a later version
of the first vendor profile. As of v2.5, the HL7 message profile identifiers might be used for
conformance claims. Prior to v2.5, the field was called Conformance Statement ID. For backward
compatibility, the Conformance Statement ID can be used here.
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Compliance and Conformance
ComplianceMessages that adhere to the rules and conventions for constructing of a specific version of a standard are compliant to that version of the standard.
ConformanceMessages that adhere to the constraints of a precise and unambiguous specification called a message profile are said to be conformant to the profile.
Compliance Conformance
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Conformance Benefits
Consistent Documentation Reuse of Specification Lower Cost of Integration Similar to Version 3
Conformance SIG is developing Implementation guide Chaos -> order Site Specific Profiles
Supports specific needs Required of third-party application vendors RFP Simplifies introduction/acquisition of new applications
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Messaging WorkbenchWhat and Why
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The Messaging Workbench (MWB) For those who:
Design HL7 2.x messages Manage specification repositories Collaborate on varied messaging projects within and outside of
their organizations Free of charge from HL7 Web site (www.hl7.org)
HL7 -> SIG -> Conformance -> Documents Encouraged by the Conformance SIG Open Source Project
Call for participation It will continue to be supported within the VA for the
foreseeable future
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Design Features (1)
Rapid prototyping of message profiles derived from standard libraries, from profile inheritance or from scratch
Quick and easy alteration of existing profiles to meet new requirements
Design time comparison of profiles on an element by element basis
Linkage of data elements or constants to message elements for a more complete specification
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Design Features (2)
Tools for storage and retrieval of profiles as well as updating and customizing message element libraries
The ability to capture and analyze ER7 messages Capability to reverse engineer specifications from
captured messages. A suite of reports that document specifications and
produce example messages in text, xml and html formats Additional style sheets available for PDF
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HL7
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Constrainable
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Constrainable (continued)
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Implementation
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Message Profile
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Messaging WorkbenchFeatures and Use
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Capture/Analyze Message
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Reverse Engineer from Message
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New Profile Using Libraries
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New Profile Using Libraries (cont’d)
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New Profile Using Libraries (cont’d)
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New Profile Using Libraries (cont’d)
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New Profile Using Libraries (cont’d)
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New Profile using copy/paste
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New Profile Copy/Paste (cont’d)
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New Profile Copy/Paste (cont’d)
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Modifying a Profile – HL7
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Modifying a Profile – Constrainable
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Modifying Profile – Constr (cont’d)
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Modifying Profile – Implementation
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Modifying Profile – Impl (cont’d)
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Diagram Drawing Tool
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Messaging WorkbenchReports and Examples
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Reports
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Reports (continued)
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Reports (continued)
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Reports (continued)
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Reports (continued)
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Reports (continued)
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Producing Profile Reports
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Producing Profile Reports (cont’d)
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Producing Profile Reports (cont’d)
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Producing Profile Reports (cont’d)
Browser View
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Producing Profile Reports (cont’d)
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HL7 Message Profile
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Register Profile with HL7
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Messaging WorkbenchContacts and Help
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MWB Contacts The Implementation/Conformance
WorkGroup is interested in your feedback and suggestions for improvement of the tool
Implementation/Conformance WorkGroup list server is a good source for general information about the tool and for making improvement suggestions
For specific questions you may also contact Pete Rontey via Email at [email protected]
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Where to Get More Information MWB On-line help
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Where to Get More Info (cont’d)• MWB On-line help (cont’d)
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Where to Get More Info (cont’) MWB Updates/Downloads
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Where to Get More Info (cont’d) Conformance Tools Forum at Yahoo Groups
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California Department of Health Services
Electronic Laboratory Reporting Project
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Lab MessageSupplier
InboundLaboratoryMessage
InboundMessage Profile
Transform
Translate
InboundMessage Mapping
CanonicalLaboratoryMessage
CanonicalMessage Profile
Transform
Translate
OutboundMessage Mapping
OutboundLaboratoryMessage
Lab MessageConsumer
KnowledgeManagement
Service
KnowledgeManagement
Service
Object GraphGeneration
LaboratoryMessageObjects
ObjectRelationalMapping
LaboratoryMessage
Respository
Object RelationalMap
ELR DatabaseDesign Model
CA Public HealthLogical Data
Model
HL7 RIM &CDC PHLDM
CanonicalMessage Profile
LaboratoryMessage Object
Model
Extract,Transform,and Load
LaboratoryDatamart
BusinessIntelligenceApplication
BusinessIntelligenceApplication
BusinessIntelligenceApplication
OutboundMessage Profile
Extract,Transform,and Load
Additional DataSources
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Inbound Message Processing Outbound Message Processing
Data Persistence Business Intelligence
Lab MessageSupplier
InboundLaboratoryMessage
InboundMessage Profile
Transform
Translate
InboundMessage Mapping
CanonicalLaboratoryMessage
CanonicalMessage Profile
Transform
Translate
OutboundMessage Mapping
OutboundLaboratoryMessage
Lab MessageConsumer
KnowledgeManagement
Service
KnowledgeManagement
Service
Object GraphGeneration
LaboratoryMessageObjects
ObjectRelationalMapping
LaboratoryMessage
Respository
Object RelationalMap
ELR DatabaseDesign Model
CA Public HealthLogical Data
Model
HL7 RIM &CDC PHLDM
CanonicalMessage Profile
LaboratoryMessage Object
Model
Extract,Transform,and Load
LaboratoryDatamart
BusinessIntelligenceApplication
BusinessIntelligenceApplication
BusinessIntelligenceApplication
OutboundMessage Profile
Extract,Transform,and Load
Additional DataSources
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
InboundLaboratoryMessage
InboundMessage Profile
Transform
Translate
InboundMessage Mapping
CanonicalLaboratoryMessage
CanonicalMessage Profile
Transform
Translate
OutboundMessage Mapping
OutboundLaboratoryMessage
Outbound
Lab MessageSupplier
Lab MessageConsumer
KnowledgeManagement
Service
KnowledgeManagement
Service
Object GraphGeneration
LaboratoryMessageObjects
ObjectRelationalMapping
LaboratoryMessage
Repository
Object RelationalMap
ELR DatabaseDesign Model
CA Public HealthLogical Data
Model
HL7 RIM &CDC PHLDM
CanonicalMessage Profile
LaboratoryMessage Object
Model
Extract,Transform,and Load
LaboratoryDatamart
BusinessIntelligenceApplication
BusinessIntelligenceApplication
BusinessIntelligenceApplication
Message Profile
Extract,Transform,and Load
Additional DataSources
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Message Profiles
Describe message structure and anticipated application behavior Identify required, optional, and conditional message elements Identify coding systems or value-sets for coded elements Enable message validation, transformation, and persistence Are essential for achieving system-to-system interoperability
InboundLaboratoryMessage
InboundMessage Profile
Transform
Translate
InboundMessage Mapping
CanonicalLaboratoryMessage
CanonicalMessage Profile
Transform
Translate
OutboundMessage Mapping
OutboundLaboratoryMessage
OutboundMessage Profile
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Message-Level Profile Which Segments are Supported? Which Segments are Required? How are Segments Grouped? What is the order of Segments
and Segment groups Which Segments/Segment
Groups are repeatable? What is the cardinality of
repeating segments/segment Groups?
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Segment-Level Profile
• Which Fields are Supported?• Which Fields are Required?• What is the order of fields within
the segment?• What is the datatype of each
field?• Which fields are repeatable?• What is the cardinality of
repeating fields?• What maximum field length is
supported?• What value tables are associated
with the field?
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Field-Level Profile• Which Field components are
supported?• Which Field components are
Required?• What is the order of components
within a field?• What is the datatype of each field
component?• Which fields components are
repeatable?• What is the cardinality of repeating
fields components?• What maximum length is supported
for field components?• What value tables are associated with
the field components?
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California State Immunization Information System
System Interface Project
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The California State Immunization Information System (SIIS) is a collaboration of
regional immunization registries, local health departments, the California Department of Health
Services Immunization Branch, and a spectrum of key stakeholders
across the state of California. The goal of SIIS is to ensure that
health care providers have rapid access to complete and up-to-date immunization records.
The objective is to eliminate both missed opportunities to immunize and unnecessary duplicate immunizations.
SIIS consists of nine regional registries and two county registries.
SIIS is a system of systems each independently managed and operated.
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Regional and County Registries
Immunization Network of Northern California (INNC) Shots For Tots KIDS Regional Immunization Registry (SFT) Bay Area Regional Immunization Registry (BARR) Imperial County (IMPL) ** Contra Costa County Automated Immunization Registry (CCAIR)** Regional Immunization Data Exchange (RIDE) Central Valley Immunization Information System (CVIIS) Central Coast Immunization Registry (CCIR) Los Angeles-Orange Immunization Network (LINK) VaxTrack Regional Immunization Registry (VaxTrack) San Diego Regional Immunization Registry (SDIR)
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
The scope of the California Statewide Immunization Information System (SIIS) Systems Interface Project (SIP) is to design, construct, and implement a centralized electronic messaging hub that facilitates the automated exchange of immunization related data within the state of California. The objective is to enable registry users to gain access to an individual’s complete immunization history regardless of where that history is maintained.
Project Scope
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
The premise behind the project is that, for many reasons, a person’s immunization history data becomes fragmented over time.
The data are stored and maintained in separate state registries and immunization provider information systems.
Typical scenarios that lead to this situation are changes in a person’s primary residence, changes in a person’s primary healthcare provider, and ad hoc administration of immunizations such as during vacation or emergencies.
Once a person’s immunization data becomes fragmented across multiple registry or provider information systems it can be difficult to ascertain their current immunization status.
This can result in over immunization or under immunization.
Problem Statement
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
A combination of manual and automated processes are employed to address this issue.
First and foremost, providers are encouraged to enroll in regional registries and to record administered immunizations in the registry. All providers within the jurisdiction of the regional registry will then have access to the same data.
Second, a CIR (yellow card) with the person’s immunization history is updated by administering providers and carried by the patient, parent, or guardian to all settings requiring an official immunization record.
Finally, immunization data may be requested from a former provider by phone, email, or fax and then entered into the immunization registry system.
Current Processes
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
There are serious inefficiencies and limitations associated with the current processes used to address the fragmentation of a person’s immunization history data.
The yellow card is often out of date, misplaced or otherwise unavailable.
Some healthcare providers operate in multiple regional registry jurisdictions and find the prospect of coordinating reporting to multiple registries to be too much of an administrative burden.
Some providers would prefer to have an automated means of exchanging data between the regional registry system and their electronic systems. These providers object to entering data into regional registries because it involves redundant data entry.
Current Limitations
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Today immunization information is not easily able to follow the approximately 30,000 CA children moving throughout the state each year.
SIP will address this shortcoming by enabling the electronic exchange of immunization related data.
The SIIS SIP Immunization Information Exchange System will support the electronic request and response for immunization data from one registry to another.
Regional and county registries, healthcare providers, and multi-jurisdictional provider organizations will be able to participate in a SIIS SIP information network and use electronic messages based upon HL7 messaging standards to exchange immunization data.
SIIS SIP SOLUTION
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
HL7 Message Profiling
ad Dynamic View
Health Level Seven CDC / AIRA SIIS SIP Project Team Regional Registry
HL7 v 2.5 Messaging Standard
IZ Messaging Implemenation Guide Prepare Preliminary
Segment Lev el Profile
Preliminary Segment Level Profile
Prepare SIIS SIPConceptual Data Model
SIIS SIP Conceptual Data Model
Map Profile to RegionalSystems
Regional System to Profile Mapping
Prepare Final SegmentLevel Profile
Final Segment Lev el Profile
Prepare SIIS SIP LogicalData Model
SIIS SIP Logical Data Model
Prepare SIIS SIP Phase IMessage Level Profiles
SIIS SIP Phase I Message Level Profiles
Prepare SIIS SIPVocabulary Specification
SIIS SIP Vocabulary Specification
Prepare IZ ImplementationGuide
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
ad Dynamic View
Health Level Seven CDC / AIRA SIIS SIP Project Team Regional Registry
HL7 v 2.5 Messaging Standard
IZ Messaging Implemenation Guide Prepare Preliminary
Segment Lev el Profile
Preliminary Segment Lev el Profile
Prepare SIIS SIPConceptual Data Model
SIIS SIP Conceptual Data Model
Map Profile to RegionalSystems
Regional System to Profile MappingPrepare Final Segment
Lev el Profile
Final Segment Lev el ProfilePrepare SIIS SIP Logical
Data Model
SIIS SIP Logical Data Model Prepare SIIS SIP Phase I
Message Lev el Profiles
SIIS SIP Phase I Message Lev el ProfilesPrepare SIIS SIP
Vocabulary Specification
SIIS SIP Vocabulary Specification
Prepare IZ ImplementationGuide
Prepare IZ messaging implementation guide
Prepare preliminary segment level profile
Prepare SIIS SIP conceptual data model
Map preliminary profile to regional IZ systems
Prepare final segment level profile
Prepare SIIS SIP logical data model
Prepare SIIS SIP phase I message level profiles
Prepare SIIS SIP vocabulary specification
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Immunization Messaging Implementation Guide The Centers for Disease Control and Prevention (CDC) National
Immunization Program (NIP) publishes an implementation guide for immunization data messaging.
The title of the guide is “Implementation Guide for Immunization Data Transactions using version 2.3.1 of the Health Level Seven (HL7) Standard Protocol”.
The intent of the guide is to help familiarize developers of immunization information systems with HL7 immunization message definitions and encoding rules and provide a nationally consistent implementation of those messages.
Changes to the guide are coordinated through the Data Exchange Steering Committee of the American Immunization Registry Association (AIRA) and its associated work groups.
The members of AIRA are committed to advancing the exchange of immunization data using a common protocol.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Immunization Messaging Implementation Guide The guide identifies the set of HL7 messages needed to enable information
systems that maintain immunization records to transmit patient-specific immunization histories electronically to other systems to allow healthcare providers to have access to these records at the time health care is given.
The use cases detailed in the guide indicate that data transmission will occur as the result of four activities:1. a query from one system for a patient’s vaccination record that is held in another
system using the HL7 VXQ message;2. a response to a query containing multiple patient “matches” to the query, but not
returning vaccination records using the HL7 VXX message;3. a response to a query containing the vaccination record using the HL7 VXR
message; and4. an unsolicited update to a vaccination record using the HL7 VXU message.
In addition to the messages used for the four primary activities the guide also includes specifications for transmission confirmation and exception notification messages; ACK and QCK.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Preliminary Segment Level Profile
Message Tree Seq ETyp DTyp Usage Min Max Table Len ReferencePID 011 Segment R 1 1 Set ID - PID 001 Field SI RE 0 1 4 3.4.2.1 Patient ID 002 Field CX RE 0 1 33 3.4.2.2 Patient Identifier List 003 Field CX R 1 0 250 3.4.2.3 Alternate Patient ID - PID 004 Field CX RE 0 1 33 3.4.2.4 Patient Name 005 Field XPN R 1 0 250 3.4.2.5 Mother's Maiden Name 006 Field XPN RE 0 1 250 6.5.7.40 Date/Time Of Birth 007 Field TS RE 0 1 26 15.4.6.6 Administrative Sex 008 Field IS RE 0 1 0001 1 15.4.6.5 Patient Alias 009 Field XPN RE 0 1 250 3.4.2.9 Race 010 Field CE RE 0 1 0005 250 15.4.6.27 Patient Address 011 Field XAD RE 0 1 250 3.4.2.11 County Code 012 Field IS RE 0 1 0289 4 3.4.2.12 Phone Number - Home 013 Field XTN RE 0 1 250 3.4.2.13 Phone Number - Business 014 Field XTN RE 0 1 250 3.4.2.14 Primary Language 015 Field CE RE 0 1 0296 250 6.5.7.34 Patient Account Number 018 Field CX RE 0 1 250 3.4.2.18 SSN Number - Patient 019 Field ST RE 0 1 16 3.4.2.19 Mother's Identifier 021 Field CX RE 0 1 250 3.4.2.21 Ethnic Group 022 Field CE RE 0 1 0189 250 15.4.6.28 Birth Place 023 Field ST RE 0 1 250 3.4.2.23 Multiple Birth Indicator 024 Field ID RE 0 1 0136 1 3.4.2.24 Birth Order 025 Field NM RE 0 1 2 3.4.2.25 Citizenship 026 Field CE RE 0 2 0171 250 6.5.7.33 Veterans Military Status 027 Field CE RE 0 1 0172 250 3.4.2.27 Patient Death Date and Time 029 Field TS RE 0 1 26 3.4.2.29 Patient Death Indicator 030 Field ID RE 0 1 0136 1 3.4.2.30 Last Update Date/Time 033 Field TS RE 0 1 26 3.4.2.33 Production Class Code 038 Field CE RE 0 1 0429 250 3.4.2.38
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Conceptual Data Model
cd Logical Model Patient Demographics
Facility
identi fier: char(20) name: char(50) assigningAuthori tyId: char(20) namespaceId: char(20) streetAddress: char(120) city: char(50) stateOrProvince: char(50) zipOrPostalCode: char(12) country: char(3) addressType: char(3)
Patient
dateTimeOfBirth: timestamp birthState: char(60) multipleBirthIndicator: char(1) administrativeSex: char(1) birthOrder: numeric(2) deathDateTime: timestamp deathIndicator: char(1) lastUpdateDateTime: timestamp lastUpdateFacil ity: char(20) PublicityCodeID: char(20) publicityCodeEffectiveDate: datetime publicityCodeText: char(199) protectionIndicator: char(1) protectionIndicatorEffectiveDate: datetime immunizationRegistryStatus: char(1) immunizationRegistryStatusEffectiveDate: datetime
PersonPostalAddress
streetOrMailingAddress: char(120) streetName: char(50) dwellingNumber: char(12) city: char(50) stateOrProvince: char(50) zipOrPostalCode: char(12) addressType: char(3) countyParishCode: char(20) countryCode: char(3)
PatientLanguageAbility
identi fier: char(20) text: char(199) preferenceIndicator: char(1)
PersonTelecommunicationAddress
telecommunicationUseCode: char(3) areaCityCode: numeric(5) phoneNumber: numeric(9) extension: numeric(5) anyText: char(199)
Person
surname: char(50) givenName: char(30) secondAndFurtherGivenNamesOrIni tialsThereof: char(30) suffix: char(20)
PersonIdentifier
id: char(15) idType: char(6) namespaceId: char(20)
PersonAlternateName
typeCode: char(1) surname: char(50) givenName: char(30) secondAndFurtherGivenNamesOrIni tialsThereof: char(30) suffix: char(20)
PatientRelationship
identi fier: char(20) text: char(199) contactRoleIdenti fier: char(20) contactRoleText: char(199) livingArrangement: char(2)
PatientRace
identi fier: char(20) text: char(199) PatientEthnicGroup
identifier: char(20) text: char(199)
0..*
1
1..*
1
1..*
1
0..1
1
0..*
1
0..*
1
0..* 1..* 0..*1..*
0..*
1
0..* 11..* 1
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Regional System to Segment Profile Mapping
Supp
orte
d?
Source Table Source Column(s)Source
Data type and length
Allowable values (attach
reference if necessary)
Mapping Comments
PIDSetID-PID YPatientIdentifierList
ID Y Patient pt_id intassigningauthority
namespaceID YPatientName
familynamesurname Y Patient pt_lname char(20)
givenname Y Patient pt_fname char(20)secondandfurthergivennamesorinitialsthereof Y Patient pt_mname char(20)suffix(e.g.,JRorIII) Y Patient pt_suffix char(10)
Mother'sMaidenNamefamilyname
surname Y Patient birth_mom_mname char(20)Date/TimeOfBirth
Date/Time Y Patient dob datetimeAdministrativeSex Y Patient sex char(1)PatientAlias
familynamesurname N
givenname Nsecondandfurthergivennamesorinitialsthereof Nsuffix(e.g.,JRorIII) N
Raceidentifier Y Patient race char(2)text Ynameofcodingsystem Y
PatientAddressstreetaddress(SAD)
streetormailingaddress Y PatientAddress addr_1, addr_2 varchar(35)streetname Ndwellingnumber N
city Y PatientAddress city varchar(20)stateorprovince Y PatientAddress state char(2)ziporpostalcode Y PatientAddress zipcode char(10)addresstype Y PatientAddress address_type char(1)county/parishcode Y PatientAddress county varchar(20)
Element Name
DO NOT MAP
DO NOT MAP DO NOT MAP
DO NOT MAP
DO NOT MAP
DO NOT MAP
DO NOT MAP DO NOT MAP
DO NOT MAP
DO NOT MAP
DO NOT MAP
DO NOT MAP
DO NOT MAP
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Regional System to Segment Profile Mapping
Path
LIN
K
SDIR
VAXT
RA
CK
CC
IR
BA
RR
RID
E
INN
C
SFT
CVI
IS
Impe
rial
Prof
ile U
sage
CO
MM
ENT
PID PIDPID.1 SetID-PID Y Y N Y Y N Y Y Y N YPID.3 PatientIdentifierListPID.3.1 ID Y Y N Y Y Y Y Y Y Y YPID.3.4 assigningauthorityPID.3.4.1 namespaceID Y Y N Y Y Y Y Y Y N YPID.5 PatientNamePID.5.1 familynamePID.5.1.1 surname Y Y Y Y Y Y Y Y Y Y YPID.5.2 givenname Y Y Y Y Y Y Y Y Y Y YPID.5.3 secondandfurthergivennamesorinitialsthereof Y Y Y Y Y Y Y Y Y Y YPID.5.4 suffix(e.g.,JRorIII) Y Y Y Y Y Y Y Y Y N YPID.6 Mother'sMaidenNamePID.6.1 familynamePID.6.1.1 surname Y Y Y Y Y Y Y Y Y Y YPID.7 Date/TimeOfBirthPID.7.1 Date/Time Y Y Y Y Y Y Y Y Y Y YPID.8 AdministrativeSex Y Y Y Y Y Y Y Y Y Y YPID.9 PatientAliasPID.9.1 familynamePID.9.1.1 surname N N Y N Y Y Y/Y Y Y Y YPID.9.2 givenname N N Y N Y Y Y/Y Y Y Y YPID.9.3 secondandfurthergivennamesorinitialsthereof N N Y N Y N Y/Y Y Y Y YPID.9.4 suffix(e.g.,JRorIII) N N Y N Y N Y/Y N Y N YPID.10 RacePID.10.1 identifier Y Y Y Y Y Y Y Y Y Y YPID.10.2 text Y N Y Y Y N Y Y Y Y YPID.10.3 nameofcodingsystem Y Y Y Y Y N Y Y Y N YPID.11 PatientAddressPID.11.1 streetaddress(SAD)PID.11.1.1 streetormailingaddress Y Y Y Y Y Y Y Y Y Y YPID.11.1.2 streetname N N N N N N N N N Y NPID.11.1.3 dwellingnumber N N N N N N N N N Y NPID.11.3 city Y Y Y Y Y Y Y Y Y Y YPID.11.4 stateorprovince Y Y Y Y Y Y Y Y Y Y YPID.11.5 ziporpostalcode Y Y Y Y Y Y Y Y Y Y YPID.11.7 addresstype Y Y Y Y Y N Y Y Y Y YPID.11.9 county/parishcode Y Y Y Y Y Y Y Y Y Y Y
Element Name
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Final Segment Level Profile
Message Tree Seq ETyp DTyp Usage Min Max TablePID 009 Segment R 1 1 0396 Set ID - PID 001 Field SI R 1 1 Patient Identifier List 003 Field CX R 1 * ID number 001 Component ST R 1 1 assigning authority 004 Component HD R 1 1 namespace ID 001 SubComponent IS R 1 1 0363 identifier type code 005 Component ID R 1 1 0203 Patient Name 005 Field XPN R 1 1 family name 001 Component FN R 1 1 surname 001 SubComponent ST R 1 1 given name 002 Component ST RE 0 1 second and further given names or initials thereof 003 Component ST RE 0 1 suffix (e.g., JR or III) 004 Component ST RE 0 1 name type code 007 Component ID R 1 1 0200 Mother_s Maiden Name 006 Field XPN RE 0 1 family name 001 Component FN R 1 1 surname 001 SubComponent ST R 1 1 name type code 007 Component ID R 1 1 0200 Date/Time of Birth 007 Field TS R 1 1 time 001 Component DTM R 1 1 Administrative Sex 008 Field IS R 1 1 0001 Patient Alias 009 Field XPN RE 0 * family name 001 Component FN R 1 1 surname 001 SubComponent ST R 1 1 given name 002 Component ST RE 0 1 second and further given names or initials thereof 003 Component ST RE 0 1 suffix (e.g., JR or III) 004 Component ST RE 0 1 name type code 007 Component ID R 1 1 0200 Race 010 Field CE RE 0 1 identifier 001 Component ST R 1 1 0005 text 002 Component ST RE 0 1 name of coding system 003 Component ID R 1 1 0396 alternate identifier 004 Component ST RE 0 1 alternate text 005 Component ST RE 0 1 name of alternate coding system 006 Component ID RE 0 1 0396
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Logical Data Model
cd Logical Model Patient Demographics
Facility
*PK idNumber: int FK providerOrganizationIdNumber: int addressLine1Text: char(120) addressLine2Text: char(120) cityName: char(50) statePostalCode: char(50) postalCode: char(12) countryCode: char(3) addressTypeCode: char(3)
FK+ FK_Facility_ProviderOrganization(int)PK+ PK_Facility(int)
Patient
*PK idNumber: int FK facilityIdNumber: int* birthDate: datetime birthStateCode: char(60) multipleBirthIndicator: char(1)* sexCode: char(1) deathIndicator: char(1)* raceCode: char(20)* ethnicityCode: char(20)* allowableReminderTypeCode: char(20)* primaryLanguageCode: char(20) recordSharingConsentIndicator: char(1) immunizationRegistryStatusCode: char(1)
FK+ FK_Patient_Facility(int)PK+ PK_Patient(int)
PersonPostalAddress
*PK idNumber: int*FK personIdNumber: int addressLine1Text: char(120) addressLine2Text: char(120) cityName: char(50) stateCode: char(50) postalCode: char(12) addressTypeCode: char(3) countyCode: char(20)
FK+ FK_PersonPostalAddress_Person(int)PK+ PK_PersonPostalAddress(int)
PersonTelecommunicationAddress
*PK idNumber: int*FK personIdNumber: int telecommunicationUseCode: char(3) areaCode: numeric(5)* phoneNumber: numeric(9) extensionNumber: numeric(5) concatenatedTelecomNumber: char(199)
FK+ FK_PersonTelecommunicationAddress_Person(int)
Person
*PK idNumber: int surname: char(50) givenName: char(30) middleName: char(30) nameSuffix: char(20)
PK+ PK_Person(int)
PersonIdentifier
*PK idNumber: int FK organizationIdNumber: int* idCode: char(15)*FK personIdNumber: int idTypeCode: char(6)* idAssigningAuthority: char(20)* statusCode: char(2)
FK+ FK_PersonIdentifier_Organization(int)+ FK_PersonIdentifier_Person(int)
PersonAlternateName
*PK idNumber: int*FK personIdNumber: int* typeCode: char(1)* surname: char(50) givenName: char(30) middleName: char(30) nameSuffix: char(20)
FK+ FK_PersonAlternateName_Person(int)
PatientRelationship
*PK idNumber: int*FK patientIdNumber: int* typeCode: char(20)*FK patientIdNumber: int*FK personIdNumber: int* effectiveDate: datetime
FK+ FK_PatientRelationship_Patient(int)+ FK_PatientRelationship_Person(int)PK+ PK_PatientRelationship(int)
Organization
*PK idNumber: int idCode: char(20)* assigningAuthorityIdCode: char(20)* name: char(50)
PK+ PK_ProvderOrganization(int)
FacilityAlternateIdentifier
*PK facilityAlternateId: char(20)*pfK FacilityIdNumber: int FK identifierAssigningAuthority: int identifierTypeCode: bigint
FK+ FK_FacilityAlternateIdentifier_Facility(int)+ FK_FacilityAlternateIdentifier_Organization(int)PK+ PK_FacilityAlternateIdentifier(char, int)
TreatmentRefusal
*PK reasonIdCode: char(20)*pfK vaccineAdministrationIdNumber: int
FK+ FK_TreatmentRefusal_VaccineAdministration(int)PK+ PK_TreatmentRefusal(char, int)
VaccineAdministration
FK administeringProvideridNumber: int*FK patientIdNumber: int*PK idNumber: int*FK FacilityIdNumber: int* doseSequenceNumber: numeric(4)* substanceIdCode: char(20)* startDateTime: datetime* endDateTime: datetime* substanceAdministeredAmount: numeric(20)* routeIdCode: char(20)* substanceUnitOfMeasureCode: char(20)* siteIdCode: char(20) substanceLotNumber: char(20)* substanceDosageFormIdCode: char(20)* substanceManufacturerIdCode: char(20)* systemEntryDateTime: datetime
FK+ FK_VaccineAdministration_Facility(int)+ FK_VaccineAdministration_Patient(int)+ FK_VaccineAdministration_Person(int)PK+ PK_VaccineAdministration(int)
0..*
1
0..*
(identifierAssigningAuthority = idNumber)
0..1
0..*
(personIdNumber = idNumber)
1
0..*
(organizationIdNumber = idNumber)
1
0..*
(providerOrganizationIdNumber= idNumber)
0..1
1..*
(patientIdNumber =idNumber)
1
0..*
(patientIdNumber = idNumber)
1
0..*
(personIdNumber = idNumber)
1
0..*
(administeringProvideridNumber = idNumber)
1
0..*
(personIdNumber = idNumber)
1
0..*
(personIdNumber = idNumber)
1
0..*
(vaccineAdministrationIdNumber = idNumber)
1
0..*
normally receivescare at
1
0..*
(Facil ityIdNumber = idNumber)
1
0..*
(patientIdNumber =idNumber)
1
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Message Level Profiles
HL7 defines a message profile as “an unambiguous specification of one or more standard HL7 messages that have been analyzed for a particular use case”. It prescribes a set of precise constraints upon one or more standard HL7 messages.
A message profile eliminates ambiguity in a HL7 message specification by declaring static and semantic constraints for constituent elements of a message and the expected dynamic behavior of conformant application systems.
The SIIS SIP HL7 message profile is an extension to the NIP Implementation Guide. The profile is based upon version 2.1 of the guide published in September 2002.
The profile extends the specifications included in the guide. The profiles do not conflict with the guide; however, they are more constrained than the guide.
Messages that conform to the profile are conformant with the guide as well; although the converse may not be true.
A message profile has dynamic definition and a static definition.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
HL7 Message Profile Dynamic Definition
The dynamic definition describes the supported use cases, interactions, and acknowledgement requirements.
Use Case ModelThe use case portion of the message profile dynamic definition documents the scope and requirements for an HL7 message profile or set of message profiles. The use case model documents the purpose for each message exchange; defines the actors, including the sending and receiving applications; and document the situations in which the exchange of a particular HL7 message profile is required
Interaction ModelThe Interaction Model illustrates the sequence of trigger events and resulting message flows between 2 or more systems. It may be in literal or graphical form. Graphical form should be a UML activity diagram.
Acknowledgement RequirementsThe specific HL7 acknowledgments required and/or allowed for use with the specified static definition of the HL7 message profile is defined. Specifically, the dynamic definition identifies whether accept and application level acknowledgments are allowed or required. For any one static definition there may be one or more dynamic definitions. The dynamic definition defines the conditions under which accept and application level acknowledgments are expected. Allowed conditions include: Always, Never, Only on success, and Only on error.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
HL7 Message Profile Static Definition
The static definition describes usage rules, cardinalities, and code systems. Usage Rules
Usage refers to the circumstances under which an element appears in a message instance. Some elements must always be present, others may never be present, and others may only be present in certain circumstances. HL7 has defined a set of codes to clearly identify the rules governing the presence of a particular element. These usage codes expand/clarify the optionality codes defined in the HL7 standard.
CardinalityCardinality identifies the minimum and maximum number of repetitions for a particular element (Segment Group, Segment or Field). Cardinalities are expressed as a minimum-maximum pair of non-negative integers. A conformant application must always send at least the minimum number of repetitions, and may never send more than the maximum number of repetitions.
Vocabulary SpecificationVocabulary specifications declare an organized set of code systems and code system terms. Code system terms are coded concepts including concept codes, concept names, and concept relationships. Code system terms are collected into value sets declared as code tables associated with segment fields and data type components. The static definition declares the value sets for tables associated with coded message elements. Some of the value sets are HL7 defined, third party defined, or user defined.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Use Case Diagram ud Use Case Model
Local Registry User
1.0 Immunization History Query
2.0 Patient Demographic
Update
3.0 Vaccine Record Update Prov ider Organization
SIIS Registry Administration
4.0 Immunization Statistical Analysis
Trusted Third PartiesLocal Registry Administration
SIIS Analysis Report
SIIS Analysis Report
SIIS Analysis Report SIIS Analysis Report
Update Confirmation
Update Confirmation
Query Response
Vaccine Record Update
Patient Information Update
Immunization History Request
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Activity Modelad InteractionActiv ityModel
Requesting Registry System SIIS SIP Immunization Information Exchange System Responding Registry System
1.1 Request ImmunizationData «message»
M.01 Immunization Data Request (VXQ)
2.2 Validate ImmunizationData Request Message
«message»M.02 Request Error Message
(ACK)
2.3 Route ImmunizationData Request Message2.4 Notify System
Administrator
«message»
M.03 Immunization Data Request (VXQ)
3.1 Retrive RequestedImmunization Data
«datastore»D.04 Immunization
Registry
3.2 RetrivalResult?
3.2.1 Return "No MatchingRecord" Response
3.2.2 Return "MultipleMatching Records"
Response
3.2.3 Return RequestedImmunization Data
«message»M.04 No Matching
Record Response (QCK)
«message»
M.05 Multiple Matching Records Response (VXX)
«message»
M.06 Requested Immunization Data (VXR)
4.2 Validate ResponseMessage
«message»
M.07 Response Message Error (ACK)
4.3 Route ResponseMessage
4.4 Notify SystemAdministrator
«message»
M.08 No Matching Record Message (QCK)
«message»
M.09 Multiple Matching Record Message (VXX)
«message»
M.10 Requested Immunization Data Message (VXR)
5.1 Refine DemographicData
5.2 Select Desired Record
5.3 Merge ImmunizationData with existing data
«datastore»
D.01 Immunization Registry
[Valid Message][Invalid Message]
[Valid Message]
[No Matching Record]
[Desired Record Not Present]
[Multiple Matching Records]
[Single Matching Record]
[Desired Record Selected]
[Invalid Message]
1
2 3
4
6
5
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIP SIP Interaction Modelsd Interactions
Requesting RegistrySystem
SIIS SIP ImmunizationInformation Exchange
System
Responding RegistrySystem
Vaccination Record Query (VXQ)
[Invalid VXQ Message]: General Acknowledgement (ACK)
[Valid VXR Message]: Vaccination Record Query (VXQ)
[No Matching Record]: Query Acknowledgement (QCK)
[Invalid QCK Message]: General Acknowledgement (ACK)
[Valid QCK Message]: Query Acknowledgement (QCK)
[Multiple Matching Records]: Vaccination Query Response (VXX)
[Invalid VXX Message]: General Acknowledgement (ACK)
[Valid VXX Message]: Vaccination Query Response (VXX)
[Single Matching Record]: Vaccination Query Response (VXR)
[Invalid VXR Message]: General Acknowledgement (ACK)
[Valid VXR Message]: Vaccination Query Response (VXR)
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Acknowledgement RequirementsMessage Source Destinat
ionAcknowledg
ment• Vaccination Record Query
(VXQ)Requester IIES Only on error
• General Acknowledgement (ACK)
IIES Requester
Never
• Vaccination Record Query (VXQ)
IIES Responder
Never
• Query Acknowledgement (QCK) Responder IIES Only on error
• General Acknowledgement (ACK)
IIES Responder
Never
• Query Acknowledgement (QCK) IIES Requester
Never
• Vaccination Query Response (VXX)
Responder IIES Only on error
• General Acknowledgement (ACK)
IIES Responder
Never
• Vaccination Query Response (VXX)
IIES Requester
Never
• Vaccination Query Response (VXR)
Responder IIES Only on error
• General Acknowledgement (ACK)
IIES Responder
Never
• Vaccination Query Response (VXR)
IIES Requester
Never
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Message Profile Static Definitions
The static definition portion of the message profile declares the usage and cardinality constraints for the constituent message elements of the SIIS SIP HL7 messages.
There is a static definition for each message type (VXQ, VXX, VXR, QCK, and ACK).
Each static definition includes a message level, segment level, and field level definition.
The static definition also includes a supported elements definition.
The supported elements definition is a field level definition containing supported message elements only.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
The static definition portion of the message profile declares the usage and cardinality constraints for the constituent message elements of the SIIS SIP HL7 messages.
There is a static definition for each message type (VXQ, VXX, VXR, QCK, and ACK).
Each static definition includes a message level, segment level, and field level definition.
The static definition also includes a supported elements definition.
The supported elements definition is a field level definition containing supported message elements only.
SIIS SIP Message Profile Static Definitions
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Message Profile Static Definitions
The static definition portion of the message profile declares the usage and cardinality constraints for the constituent message elements of the SIIS SIP HL7 messages.
There is a static definition for each message type (VXQ, VXX, VXR, QCK, and ACK).
Each static definition includes a message level, segment level, and field level definition.
The static definition also includes a supported elements definition.
The supported elements definition is a field level definition containing supported message elements only.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Message Profile Vocabulary Specification
The Health Level Seven (HL7) message profile vocabulary specification is a companion document to the California State Immunization Information System System Interface Project HL7 message profiles.
The specification contains the value sets for supported coded message elements identified in the profile.
The values presented in this specification are the primary code values to be used for coded message elements in the SIIS SIP message profile.
Fields with a data type of CE may include an equivalent code drawn from an alternate coding system. However, the values included in this specification must be used as the primary code.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP Message Profile Vocabulary Specification
The Health Level Seven (HL7) message profile vocabulary specification is a companion document to the California State Immunization Information System System Interface Project HL7 message profiles.
The specification contains the value sets for supported coded message elements identified in the profile.
The values presented in this specification are the primary code values to be used for coded message elements in the SIIS SIP message profile.
Fields with a data type of CE may include an equivalent code drawn from an alternate coding system. However, the values included in this specification must be used as the primary code.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Application Testingsd Dynamic View
User Interface Query Initiating Registry Mess ages Query Responding Registry
VXQ: Immunization Query Request1.0 Initiate Immunization
Query Request VXQ: Vaccine Query Mess age
2.0 FormulateImmunization Query
Response
VXX: Multiple Matches Response
QCK: No Matc hing Record Response
3.0 Handle No MatchingRecord Response
4.0 Handle MultipleMatches Response
VXX: Multiple Matches Response
VXR: Immunization Query Response
6.0 Handle ImmunizationQuery Response
VXR: Immunization Query Response
VXQ: Vaccine Query Message w/responder's
patient identifier
5.0 Formulate ImmunizationQuery Response (known
patient)
VXX: Multiple Record Detail Display
[No Matchi ng Record]
[Single Matching Record]
[Multiple Matching Records]
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
act 2.0 Immunization Query Response
VXQ: Vaccine Query Mess age
(from Message Types)
Receive VXQ
2.2 Determine DataRetrival Strategy
2.3 Retrive Data fromRegional Database
2.4 Filter Data Retriv alResponse
2.5 Determine AppropriateResponse Message Type
2.6 Create QCK Message
2.7 Create VXR Message
2.8 Create VXX Message
«database»D3: Tra nsmission Log
Data base
(from Databases)
«database»D2: Vocabulary
Translation Database
(from Databases)
«database»D1: Regional System
Data base
(from Databases)
2.1 Update TransmissionLog
ActivityInitial
QCK: No Matching Record Response
(from Message Types)
VXR: Immunization Query Response
(from Message Types)
VXX: Multiple Matches Response
(from Message Types)
Send QCK
Send VXR
Send VXX
ActivityFinal
[No Records]
[Single Record]
[Multiple Records]
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Test Themes and Scenarios
Valid message syntax, content, and flow
Valid message syntax, content, and invalid flow
Valid message syntax, invalid content
Invalid message syntax
Data content scenarios
Technical problems
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Test Scenarios Valid Message Syntax, Content, and Flow
This set of tests is intended to ensure that the systems produce the appropriate flow of messages, with the proper content, and in the proper syntax. These tests should not result in anything being written to the error log.
VXQ, QCKThis scenario is a query for a patient that is known to have no match in the remote system. The remote system is expected to respond with a QCK. The test data should include patients with varying ranges of matching confidence.
VXQ, VXRThis scenario is a query for a patient that is known to match a single patient in the remote system. The remote system is expected to respond with a VXR.The test data should include patients with varying ranges of matching confidence. A subset of patients should have locked records to test the “locked record” alerting process
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Test Scenarios
Valid Message Syntax, Invalid ContentThis set of tests is intended to ensure that message construction and validation rules are properly implemented. These test are focused on content issues not syntax errors. The message profile and vocabulary specification are the source of validation rules.
Missing required message elementThis scenario involves the omission of required message elements (segments, fields, or components). The omitted items in this test scenario are those that are specified as optional in the standard but declared as required in the SIIS SIP Message Profile. Such an error should result in an ACK message being returned to the message originator and an entry in the error log.
Missing conditionally required message elementThis scenario involves the omission of conditionally required message elements (segments, fields, or components). The omitted items in this test scenario are those that are specified as optional in the standard but declared as conditionally required in the SIIS SIP Message Profile. Such an error should result in an ACK message being returned to the message originator and an entry in the error log.
The test data for this scenario must include a mixture of data values that meet the predicate conditions and others that do not meet the predicate conditions relevant for the conditional elements.
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
SIIS SIP HL7 Message Profile Links
SIIS SIP Message Profile Specification
http://www.ca-siis.org/images/docs/SIIS_SIP_HL7_MessageProfile_V1-1.pdf
SIIS SIP Vocabulary Specification
http://www.ca-siis.org/images/docs/SIIS_SIP_HL7_Message_Profile_Vocabulary_Specification_V1-0.pdf
SIIS SIP Logical Data Model
http://www.ca-siis.org/images/docs/SIIS_SIP_LogicalDataModel_v1-0.pdf
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Questions
© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.
Thank You
AbdulMalik ShakirPrincipal Consultant
Shakir Consulting1407 Foothill Blvd., Suite 145
La Verne, CA 91750
Office: (909) 596-6790 Mobile: (626) 644-4491Email: [email protected]
AbdulMalik Shakir Information Management Strategist
City of Hope1500 East Duarte RoadDuarte, CA 91010-3000
Office: (626) 256-4673 Mobile: (626) 644-4491Email: [email protected]