Embedding or Sending a CCR Document Inside an HL7 2.X Message

October 18th, 2006 by Dave Shaver

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Posted in CCR, HL7 Messaging, HL7 Standard, HL7 Integration

In prior posts I described the Continuity of Care Record (CCR) and the relationship between HL7 2.X and CCR. This article addresses a need to mix the two formats. Specifically, the desire to move a CCR document via HL7 messaging.

Previously I established that HL7 2.X is typically used to move data within a facility in a real time fashion while CCR was designed to move data between facilities in a summarized fashion.

In HL7 training classes, I talk about the “sphere of influence” of healthcare systems deployment. Mostly what I mean by sphere of influence is that HL7 2.X messaging is often used to move data between clinical systems that are owned by one organization.

That is, I want my hospital information system (HIS) system to talk to my lab information system (LIS) and my radiology information system (RIS). Having purchased these systems and customized them to my institution’s clinical and business work flows, I want them to exchange data in my own special way. The HL7 standard has lots of flexibility built in to support each facility’s “special” needs.

Suppose that you want to move a CCR document between two systems by having the CCR document encapsulated inside an HL7 message? The motivation for this touch point could be that there is already an interface between two applications. For example, an HIS might be delivering ADT (registration) data and lab results to an outpatient clinic. That clinic now wants to use “the same” interface to receive discharge summaries. So, if both the HIS and EMR vendors support this additional data flow, we could package the CCR inside of an HL7 message. How?

From an HL7 2.X standpoint, moving a CCR document is no different than encoding / sending a Word document, PDF file, DICOM image, or even a .wav sound file inside of an HL7 message.

The method proposed by HL7 2.X to move such an object is using an OBX segment with and OBX-5 flavor of encapsulated data (ED) or reference pointer (RP).

The details of this HL7 integration approach are covered in another post here on this site.