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Old 06-07-2017, 05:10 AM
MrGesan MrGesan is offline
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Default ADT/HL7 and standard usage

Speaking of best/common practice, I'd like to know if there is a common/standard place in an ADT message to indicate the request order identifications (placer group numbers of ORM/OML messages) previously sent to the services (LIS / RIS / GENETICS ..) where the update person information (in A31/A08 case) should be applied.

I know the common practice is to use the visit number (PV1.19) that should be present in the request messages. But the customer is asking be specified in an ADT message all placer group numbers (ORC.4 of the request messages) sent for which PID information should be update.

For instance, take the following example:

Mike Thorn shows up for the first time in the Green Hospital.
He requests some lab exams.
The EMR user inserts his information and sends two OML messages to LIS, let's say REQ1 and REQ2 with the respective placer group numbers PGN1 and PGN2.
The EMR app receives MDM and OUL messages from LIS and print the documents for the patient.

After some time, Mike Thorn occurs in the Green Hospital again.
He requests new lab exams.
The EMR user finds his information and use them for sending new OML messages to LIS, let's say REQ3 and REQ4 with the respective placer group numbers PGN3 and PGN4.
The EMR app receives MDM and OUL messages from LIS and print the documents but this time the patient notices the home address entered on the documents is wrong (in the meantime he moved to a new city), then he communicates the correct one to EMR user who updates it in the appliation. At this point, EMR should sends an ADT message containing not only the information to be updated (A08) in LIS, but even the request identifiers (PGN3 and PGN4) where these information should be applied (only the last one).

Any suggestions on where PGN3 and PGN4 (placer group number requests) could be placed in the ADT message?

Last edited by MrGesan; 06-07-2017 at 12:47 PM.
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Old 06-07-2017, 12:27 PM
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kirbykn2 kirbykn2 is offline
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Without doing any research. I would say this is a great candidate for a 'Z' segment
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Old 06-07-2017, 01:14 PM
MrGesan MrGesan is offline
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It's a good hint, thank you. To be honest I didn't know the existence of Z segment. I've just discovered it could be used for filling a message of data that do not fit into its HL7 standard structure and this could be a good workaround.

Am I free to add unlimited Z segments into a message or just one?
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Old 06-07-2017, 01:33 PM
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That's the great thing about HL7 v2.x *sarcasm*, you are free to just about anything.

As long as the sending and receiving systems agree on the structure of the Z segments, you should be fine.

I have used them internally and externally for years for various reasons.
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