NeoTool — Singular Focus, Healthcare Integrated

Posted in HL7 Messaging, HL7 Standard

In an earlier post on HL7 acknowledgement (ACK) messages, I highlighted the important value of ACKs and defined the concept of original mode acknowledgement in HL7 messaging.

A sending application should review each response and verify three things:

  1.   The response is an HL7 formatted message.

To do this, the application simply needs to review the format of the response that was received and verify that it appears to be formatted in a typical HL7 standard pipe-and-hat format.

  2.   The response is a positive HL7 ACK.

To verify this, the application needs to review the MSA segment of the ACK message. MSA-1 will contain the acknowledgment status of the message. Below are the typical values you will find in this field:

• AA - Application Accept
• AE - Application Error
• AR - Application Reject

  3.   The response received is for the last HL7 message that was system sent.

The third piece of qualifying the response is verifying that the message control ID value in MSA-2 of the ACK message matches the message control ID that was in MSH-10 of the message that was originally sent.

To illustrate this point, take a look at the following HL7 message, followed by the corresponding HL7 acknowledgment message that would be returned:

HL7 Order Message:
MSH|^~\&|AcmeHIS|StJohn|CATH|StJohn|20061019172719||ORM^O01|MSGID12349876|P|2.3
PID|||20301||Durden^Tyler^^^Mr.||19700312|M|||88 Punchward Dr.^^Los Angeles^CA^11221^USA|||||||
PV1||O|OP^^||||4652^Paulson^Robert|||OP|||||||||9|||||||||||||||||||||||||20061019172717|20061019172718
ORC|NW|20061019172719
OBR|1|20061019172719||76770^Ultrasound: retroperitoneal^C4|||12349876

HL7 Acknowledgment:
MSH|^~\&|CATH|StJohn|AcmeHIS|StJohn|20061019172719||ACK^O01|MSGID12349876|P|2.3
MSA|AA|MSGID12349876

Qualification 1:  The ACK message is a properly formatted HL7 message.
Qualification 2:  The ACK message has the value ‘AA’ in MSA-1, this means the application successfully received the message.
Qualification 3:  The message control ID in MSA-2 of the ACK matches the message control ID sent in MSH-10 of the message.

When interfacing in the real world, it is important to remember that not every system will handle acknowledgments the same way. You will interface with systems that send you HL7 standard messages and do not wait for a response of any kind prior to sending the next message. In this scenario, your system will not be able to send back acknowledgment messages. This type of message delivery is never recommended. 

Last 5 posts by Mike Stockemer

• Comparing HL7 Messages to HL7 Documents - January 25th, 2008
• Monitoring and Alerting for HL7 Interfaces - October 22nd, 2007
• Variations of the HL7 ORU^R01 Message Format - September 10th, 2007
• Point-to-Point Interface vs. Interface Engine in Healthcare - August 23rd, 2007
• Getting Started with Your HL7 Interface - August 16th, 2007