NeoTool — Singular Focus, Healthcare Integrated

HL7 terms to better understand what is HL7. In the HL7 Standard, the Detailed Financial Transactions (DFT) messages describe a financial transaction transmitted between the DSS/Order Filler and the Charge Processor.

The DSS/Order Filler verifies that the procedure has been completed.

The Charge Processor receives patient demographics, account information, etc. for ADT/Patient Registration. The Charge Processor also receives the posted charges and serves as a component of the financial system.

In HL7 messaging, the trigger events for a DFT message include:

• Procedure ordered
• Procedure scheduled
• Procedure completed
• Future will define Report events for professional fees

HL7 terms to better understand what is HL7. In the HL7 Standard, an Observation Result (ORU) is usually in response to an order and provides clinical observations.

In HL7 messaging, ORU messages provide structured patient-oriented clinical data between systems (e.g., EKG results to a physician’s office). ORU messages also can be used for linking orders and results to clinical trials (e.g., new drugs or new devices).

Clinical observations can include:

• Clinical laboratory results
• Imaging studies (i.e., text)
• EKG pulmonary function studies
• Interpretation

HL7 terms to better understand what is HL7. In the HL7 Standard, an order (ORM) is any request for materials (e.g., 500 ml of 2.5% saline) or services (e.g., a range of motion study, an EKG, a lipid panel, etc.).

Orders are usually for a particular patient, but they can also be for a department (e.g., floor stock) or for a non-patient (e.g., an environment study where no specific patient is involved.)

The transmission of clinical orders occurs between the application placing the order (the placer) and the clinical application filling the order (the filler).

Typically, the caregiver (e.g., physician) is entering orders on the HIS application which acts as the placer application in HL7 messaging parlance. The system to which the order is targeted (e.g., the lab in the case of a complete blood count order) is the filler of the order.

HL7 terms to better understand what is HL7. Patient Administration (ADT) messages are used to exchange the patient state within a healthcare facility. ADT messages keep patient demographic and visit information synchronized across healthcare systems.

ADT is the most commonly used HL7 messaging type, with most clinical applications enabled to receive key ADT messages.

ADT messages within the HL7 standard are typically initiated by the Hospital Information Systems (HIS), or a registration application, to inform ancillary systems that a patient has been admitted, discharged, transferred, merged, that other demographic data about the patient has changed (name, insurance, next of kin, etc.) or that some visit information has changed (patient location, attending doctor, etc.).

HL7 terms to better understand what is HL7. There are four primary HL7 standard message types:

• Patient Administration (ADT)
• Orders (ORMs)
• Results (ORUs)
• Charges (DFTs)

HL7 terms to better understand what is HL7. Each HL7 standard message is composed of groups and segments where:

• Groups contain segments or groups
• Segments contain fields
• Fields contain components
• Components contain sub-components

Cardinality for these groups, segments, fields, components, and sub-components are defined using the following markers:

[Square Brackets] indicate something is optional; and
{Curly Brackets} indicate something is repeatable.

To explain how these markers are used to indicate segment cardinality, the ADT^A01 message fragment is defined below:

MSH Exactly one required message header
EVN Exactly one event segment
PID Exactly one patient ID segment
[PD1] Zero or one demographic segment
[ { NK1 } ] Zero to n next-of-kin segments
PV1 Exactly one patient visit segment
…
[ Start of optional, repeatable group
{ IN1 If group is in message, exactly one IN1
[ IN2 ] For each group in message, 0 or 1 IN2
[ IN3 ] For each group in message, 0 or 1 IN3
}
] End of optional, repeatable group