HL7, Electronic Health Record (EHR), health integration (eGate), and software testing (test life-cycle, IEEE 829 test documentation, Mercury Quality Center) specialists

Home / HL7 Services / Glossary

HL7 Glossary

CIS
Clinical Information System - a clinical repository of patient data. The term CIS is sometimes used interchangeably with EMR. Typically covers
  • pathology and radiology order entry and results reporting
  • medication prescribing, supply and administration
  • clinical work lists
  • problem lists
  • clinical notes
  • decision support

HL7 messaging required to support interactions between a CIS and external applications typically include:
  • HL7 pathology and radiology order entry and results reporting messages
  • HL7 medication prescribing, supply and administration messages
  • HL7 PMI/ADT messages
  • HL7 emergency episode messages
  • HL7 theatre/operation details messages
Gillogley services has experience in providing services for CIS HL7 planning.


Cloverleaf
Cloverleaf is a interface engine product from the commercial company Quovadx. Cloverleaf provides typical interface engine functionality including communication connectivity, HL7 message translation and mapping, routing of HL7 messages, store and forward of HL7 messages. Gillogley services has experience in Cloverleaf interface engine based interface development and testing.


eGate
eGate (e*Gate) is a interface engine product from the commercial company SeeBeyond (now Sun microsystems). eGate provides communication connectivity, HL7 message translation and mapping, routing of HL7 messages, store and forward of HL7 messages. Since the release of SeeBeyond's new ICAN product suite eGate has been re-badged as eGate Integrator. Gillogley services has experience in eGate interface planning.


HL7
HL7 or Health Level 7 is a health communications protocol for exchange of information between applications. HL7 is an ANSI accredited international standard developed by the standard development organisation HL7. HL7 version 2 is the currently most commonly implemented version of this HL7 standard. HL7 version 2.5 covers messaging of patient demographics, inpatient and emergency episode details, outpatient scheduling, referrals, pathology/radiology orders and results, prescribing/dispensing/administration and more. The next version, HL7 version 3 is being refined and is expected to gradually replace HL7 version 2 implementations


HL7 ADT
HL7 Admission Discharge and Transfer (ADT) messages are used to communicate to episode details (typically inpatient episode details but may also be used for emergency details) to external applications. Examples of ADT messages include:
  • When the patient is admitted to hospital sending a HL7 Admit Patient message (HL7 ADT:A01)
  • When the patient is transferred from one ward to another sending a HL7 Transfer message (HL7 ADT:A02)
  • When the patient is discharged from hospital sending a HL7 Discharge message (HL7 ADT:A03)
  • When the patient swaps beds with another patient sending a HL7 Discharge message (HL7 ADT:A17)
  • Other transactions exist for reversing above events (e.g. cancel admit HL7 ADT:A11, cancel transfer HL7 ADT:A12, cancel discharge HL7 ADT:A13)


HL7 Emergency Details
HL7 Admission Discharge and Transfer (ADT) messages are used to communicate to episode details to external applications. These details may include:
  • Emergency episode start sent as HL7 Admit Patient message (HL7 ADT:A01)
  • Updates to emergency episode details sent as HL7 Update message (HL7 ADT:A08) including triage date/time seen by doctor/nurse, presenting complaint, procedures and interventions, diagnosis
  • When the patient is discharged from emergency sending a HL7 Discharge message (HL7 ADT:A03)
  • Other transactions exist for reversing above events (e.g. cancel admit HL7 ADT:A11, cancel discharge HL7 ADT:A13)


HL7 Enterprise Master Patient Index
Enterprise Master Patient Index (EMPI) describes an cross facility (e.g. state-wide) index of patient registrations. For example a patient may have attended three hospitals and had a medical record created at each facility. Therefore the patient has three Medical Record Numbers (MRNs) created. The challenge for a person-centred medical record is to present a single patient record that includes the records across all the facilities. EMPIs typically communicate with external patient registration systems on the following basis:
  • HL7 New registrations created in external applications (such as Patient Administration Systems) are notified to the EMPI via HL7 Add person messages (HL7 ADT:A28). This may result in a new person being created (new EMPI entry with a new unique EMPI identifier) or may match to an existing record in the EMPI (add the MRN + facility to the existing EMPI entry).
  • HL7 Updates to records that already exist in external applications are sent to the EMPI as HL7 update person records (HL7 ADT:A31). This updates the demographic details in the EMPI based on implementation based business rules
  • HL7 Merges in external applications are notified to the EMPI via HL7 Merge person messages (such as HL7 ADT:A40). Such a HL7 transaction combines two EMPI entries at the EMPI identifier level and also combines the MRNs attached to each EMPI record.
  • HL7 Unmerges in external applications are also notified to the EMPI via HL7 Unmerge messages (such as HL7 ADT:37)


PAS
Patient Administration System - an application responsible for recording and reporting administrative details of a patients encounter in a hospital. HL7 PMI/ADT messages are typically used for communication between the PAS and external applications.


HL7 Pathology Orders and Results
HL7 messages are used to communicate events that occur in the clinical order entry module of the CIS/EHR as well as events that occur in the Pathology Information System (LIS). These include
  • Creating, amending and canceling a pathology request in the CIS/EHR sent as HL7 order messages (HL7 ORM)
  • Creating, amending and canceling a pathology request in the LIS sent as HL7 order messages (HL7 ORM)
  • Progressing the pathology test in the LIS (specimen registration) sent as HL7 order messages (HL7 ORM)
  • Notifying the CIS of a pathology report (result) being available (interim, final, corrected) sent as HL7 result messages (HL7 ORU)


HL7 Pharmacy Orders Management
HL7 messages are used to communicate events that occur in the clinical order entry module of the CIS/EHR as well as events that occur in the Pharmacy Information System. These include
  • Creating, amending and canceling a pharmacy script in the CIS/EHR sent as HL7 order messages (HL7 ORM)
  • Creating, amending and canceling a pharmacy script in the Pharmacy Information System sent as HL7 order messages (HL7 ORM)
  • Progressing the pharmacy script in the Pharmacy Information System (script entered, script encoded by pharmacist, medication dispensed) sent as HL7 order messages (HL7 ORM)
  • Notifying external applications of drug administration details sent as HL7 result messages (HL7 ORU)


HL7 PMI
HL7 Patient Master Index (PMI) messages are used to communicate to external applications. PMI messages typically include:
  • New registrations sent as HL7 Add person messages (HL7 ADT:A28 or HL7 ADT:A04 messages)
  • Updates to patient demographics sent as HL7 update person records (HL7 ADT:A31 or ADT:A08 messages).
  • Merges sent as HL7 Merge person messages (such as HL7 ADT:A40)
  • Unmerges in sent as HL7 Unmerge messages (such as HL7 ADT:37)


HL7 PMI/ADT
The superset of messages described by:


HL7 Radiology Orders and Results
HL7 messages are used to communicate events that occur in the clinical order entry module of the CIS/EHR as well as events that occur in the Radiology Information System (RIS). These include
  • Creating, amending and canceling a radiology request in the CIS/EHR sent as HL7 order messages (HL7 ORM)
  • Creating, amending and canceling a radiology request in the RIS sent as HL7 order messages (HL7 ORM)
  • Progressing the exam in the RIS (arrival, exam start, exam complete sent as HL7 order messages (HL7 ORM)
  • Notifying the CIS of a radiology report (result) being available (interim, final, corrected) sent as HL7 result messages (HL7 ORU)


HL7 Theatre details
HL7 messages are used to communicate events that occur in the theatre management system. In HL7 Version 2 the HL7 standard does not have a specific set of messages to communicate theatre details. It may be appropriate to use HL7 ORU messages. Details required to be communicated include:
  • Surgery booking details (planned procedures, date/time, surgical staff)
  • Operation details (in anaesthetic time, operation start time, procedures (start and end times), surgical staff
  • Recovery details


HL7 Version 2.1
HL7 Version 2.1 is an older version of the HL7 standard. HL7 2.1 is still used today by some health applications, especially where the software has not been updated for a number of years. The standard covered:


HL7 Version 2.2
HL7 Version 2.2 like HL7 V2.1 is an older version of the HL7 standard. HL7 2.2 is also used today by some health applications. HL7 version 2.2 like HL7 version 2.1 covered:


HL7 Version 2.3
HL7 Version 2.3 was approved as an ANSI standard in May 1997 and introduced:
  • HL7 document management messages
  • HL7appointment servicing messages
  • HL7patient referrals messages
  • HL7track patient goals messages

HL7 Version 2.3 also As well as updated to:


HL7 Version 2.3.1
HL7 Version 2.3.1 was approved as an ANSI standard in April 1999 and represents a significant proportion of live interfaces in use today. HL7 version 2.3.1 included updates to:


HL7 Version 2.4
HL7 Version 2.4 was approved as an ANSI standard in October 2000. While there where some differences to HL7 version 2.3.1 they are not huge is unlikely to significantly effect HL7 interface specification for PMI/ADT, EMPI, Pathology and radiology orders and results as well as medication order management implementations.


HL7 Version 2.5
HL7 Version 2.5 was approved as an ANSI standard in June 2003. HL7 version 2.5 again extends HL7 version 2.4 but does not significantly effect HL7 implementations for PMI/ADT, EMPI, Pathology and radiology orders and results as well as medication order management.


HL7 Version 3
SIgnificant Australian and international effort is currently focused on HL7 version 3. From a HL7 planning perspective, despite the fact that it has been through several ballots HL7 version 3 is still really a work in progress.


ITIL
The IT Infrastructure Library (ITIL) represents best practice in IT service management. ITIL was created by the UK Government agency CCTA and consists of six volumes:
  • Service Support
  • Service Delivery
  • Planning to Implement Service Management
  • ICT Infrastructure Management
  • Applications Management
  • The Business Perspective
Gillogley services has experience in ITIL based systems management planning.


Valid XHTML 1.0! Valid CSS!