What HL7 messages record an ER visit?

[David Loveluck]

Hi All,

 

I am wondering what a typical flow of HL7 messages would look like when a patient arrives at the Emergency Room.

 

My guess is it varies widely, but when I have (rarely thank goodness – despite years playing rugby) visited the ER I get my details taken, I sit in the waiting room for a while, I get taken to a cubicle, a doctor sees me, I get sent to X-Ray, back to the cubicle, see the doctor again and I eventually leave.

 

Does the ER or HIS systems generate HL7 messages through this process? I guess there is an ADT_A01 or similar generated from the triage systems, but would you normally see any message saying my location has changed from waiting room to a particular cubicle or from the cubicle to X-Ray etc.? What messages are normally used for this and are they timely or hours late?

 

Any comments about what systems do or don’t generate would be very welcome. If you have any test messages that simulate this flow you feel able to share (either here or directly to me if you don’t want to make them public) would be greatly appreciated.

 

Thank you

 

Dave

 

David Loveluck

Ensemble Product Manager

InterSystems Corporation

david.l...@interSystems.com

 

[ybor...@yahoo.com]

Hi Dave,

As you have mentioned in your post, the actual implementation of data
flow will vary from one organization to another but I can give a quick
rundown of our facility. When a person arrives to ER, he or she is
registered with our HIS system (AHS) as ADT 04 transaction with ER
location codes, and this transaction is sent to our ER clinical system
as well as our main clinical system such as MACS/SCM. At any given
moment ADT information could be updated via A08 transaction, which
will also end up in previously mentioned clinical systems. Now, if
patient is required various tests such as blood or Xrays and depending
on the nature or complexity of the tests, the orders (ORM) will be
sent from either ER clinical system (HMED) or main clinical system
MACS/SCM to our ancillary systems like IDX or Sunquest. Next comes
results (ORU) from ancillary systems to MACS/SCM/HMED. However, if
doctors finally decided to admit the patient, he or she will be
"Transfered from outpatient to inpatient location), with ADT 06. This
transaction is of course is sent to other systems as well. Finally,
say 3 days later, patient is discharged with A03 transaction. If
however, patient is released before A06 transactions is generated,
then simply ADT 03 will suffice the entire flow.

If need more detail, please let me know.

Yuriy

On Mar 6, 10:22 pm, "David Loveluck" <David.Lovel...@intersystems.com>
wrote:

> Hi All,
>
> I am wondering what a typical flow of HL7 messages would look like when
> a patient arrives at the Emergency Room.
>

> My guess is it varies widely, but when I have (rarely thank goodness -

> despite years playing rugby) visited the ER I get my details taken, I
> sit in the waiting room for a while, I get taken to a cubicle, a doctor
> sees me, I get sent to X-Ray, back to the cubicle, see the doctor again
> and I eventually leave.
>
> Does the ER or HIS systems generate HL7 messages through this process? I
> guess there is an ADT_A01 or similar generated from the triage systems,
> but would you normally see any message saying my location has changed
> from waiting room to a particular cubicle or from the cubicle to X-Ray
> etc.? What messages are normally used for this and are they timely or
> hours late?
>
> Any comments about what systems do or don't generate would be very
> welcome. If you have any test messages that simulate this flow you feel
> able to share (either here or directly to me if you don't want to make
> them public) would be greatly appreciated.
>
> Thank you
>
> Dave
>
> David Loveluck
>
> Ensemble Product Manager
>
> InterSystems Corporation
>

> david.lovel...@interSystems.com