SOAPwareXchangeHL7 Radiology Interface Specifications
SOAPwareXchangeHL7 is the interface module allowing HL7-compliant interfaces between the SOAPware® charting product and other HL7-compliant systems.
This lesson describes the specific manner in which HL7 is implemented in SOAPwareXchangeHL7, and how the various standard fields will be used.
SOAPwareXchangeHL7 accepts HL7-compliant messages from other systems, and uses them to create formatted reports in a chart section of the appropriate SOAPware® chart. If the patient described in the PID (patient identifier) section of the HL7 message cannot be matched, it will be added to a queue for the SOAPware user to handle manually. SOAPwareXchangeHL7 uses the matching algorithm below to determine if a patient already exists in SOAPware®
Patient Matching Process
An incoming record will be considered to be a match to a SOAPware® patient if:
External ID is found in patient map, AND
Birthdate matches, OR
Last name matches
Social Security numbers match, AND
Birthdate matches, AND
Last name matches, AND
First name matches
First name and Last name matches, AND
Birthdate matches, AND
So a match can be made on:
First Name AND Last Name AND Birthdate
Sex OR Social Security Number
At this time all HL7 interfaces implemented with SOAPwareXchangeHL7 will be results-only. Bi-directional interfaces are being evaluated for future implementation. Because of this, SOAPwareXchangeHL7 only processes results messages (ORU).
A standard ORU message would follow this format:
Matters of communication are between the and the site. SOAPware®, Inc does not provide communication services.
SOAPwareXchangeHL7 supports file-based or TCP-based interfaces. A file based interface will consist of the interfacing system, or system user, depositing HL7 messages in a specified location on the SOAPwareXchangeHL7 machine. SOAPwareXchangeHL7 will then retrieve and parse these messages. When the messages have been parsed, SOAPwareXchangeHL7 will remove them.
A TCP based interface will require a TCP connection between SOAPwareXchangeHL7 and the sending system.SOAPwareXchangeHL7 will listen for incoming messages, and parse them as they arrive.SOAPwareXchangeHL7 will always return an ACK messages for TCP messages received.
File based communication is the preferred communication method and allows for easiest troubleshooting for SOAPware Support. All incoming lab messages should be deposited to the same directory.This directory must be reserved for the sole purpose of incoming messages; no other file types or information should be stored there.SOAPwareXchangeHL7 will remove each file after processing.
Current versions of SOAPwareXchangeHL7 are only capable of monitoring a single port.If multiple labs are interfaces to the same site, one lab may use the TCP connection.The other labs must use a file-based method, depositing result files into the same directory.
The TCP connection should not be closed after each send, as this will require the SOAPwareXchangeHL7 user to reset the connection from their end.
The XchangeHL7 will automatically send an ACK after each report is received. This cannot be controlled or altered via the XchangeHL7 GUI.
While we realize the value of TCP connections and offer these, we do not have the resources to troubleshoot them, and will recommend a file-based solution if problems turn up with the connection. If a sending facility/application has issues with connecting to a specific port on a clients local network, SOAPware staff will recommend contacting the clients IT personnel for further troubleshooting.
SOAPware, Inc. does offer connectivity services when none are available through the Lab company for an additional setup and subscription fee. Speak with the SOAPware Sales Team if these services are needed.
Segment Descriptions and Legend
The MSH (Message Header) Segment
SOAPwareXchangeHL7 requires the MSH segment to be the first in the file. We do not accept FHS, BHS, or any other information before the MSH segment.
A separate MSH segment is required for each PID segment in the file.
The Sending Application value in MSH-3 is used by SOAPwareXchangeHL7 to determine the source of the message and the section in SOAPware the report will be translated. This value should remain consistent for any interfaces using the same delivery application/company.
The generic and preferred value to be used when sending radilogy reports should be "RAD".
Messages parsed through this interface will be filed in the Radilogy section of the patient chart.
The PID (Patient Identifier) Segment
The Patient ID in PID-3 will be entered into a matching table. This ID can be anything, as long as it is unique and consistent per patient. First Name, Last Name, Birthdate, Sex, and Social Security Number are all used for the patient matching algorithm. Omitting any of this information may cause the record to be queued for manual assignment. Demographic information included in the PID segment will not be used to update the demographics in the patient chart.
Certain elements from the PID segment and other segments will form a report header at the top of each radiology report. This inlcludes; First and Last name, ordering date, ordering provider, and others general information.
While SSN is marked as a required field, this may not be the case if a match can be based on all other data items in the patient matching algorithm.
The ORC (Common Order) Segment
The Accession Number in ORC-3 or OBR-3 is used for report matching purposes. When a message comes in with an accession number that already exists in SOAPware®, the existing report will be updated or replaced, depending on the result status of the existing report. Result status from the ORC segment will be displayed as the report status.
The OBR (Observation Request) Segment*
*At least one OBR must be included under each ORC segment.
The Accession Number will be read from OBR-3 if it is not present in ORC-3.
Every OBR-4^2 under the same ORC will be combined to form the title of the report in SOAPware®. Each ORC segment will trigger a new report. If any OBR-4^2 is not populated, it will defer to OBR-3 to generate the report title.
The date in OBR-22 will be shown in the report header as the Date Reported. An ordering physician ID will be expected in OBR-16 if it was not present in ORC-12.
The SOAPwareXchangeHL7 will currently only accept and process results for Ordering Providers, and will not process CC providers from OBR-28.
The OBX (Observation) Segment*
Sample HL7 Message and Screenshot of the Result in SOAPware
OBR|1|RX001232769| - ABDOMEN 2V FLAT/UPRIGHT|ABD2V^ - ABDOMEN 2V FLAT/UPRIGHT^RAD|S||201101032157|||||||||ARROYO123^TESTDOC^NOVO|||||||||F|||||||OYO123
OBX|1|TX|001232769^ - ABDOMEN 2V FLAT/UPRIGHT|1| \.br\ Testing Facility Name: FAKE,FAKE\.br\ 123 W.Crossover RD. Phys: Doctor,Test\.br\ Fayetteville, AR 99999 DOB: 99/99/9999 Age: 9 Sex: M\.br\ Acct: G99999999999 Loc: G.ER \.br\ Phone #: 999-999-9999 Exam Date: 99/99/9999 Status: REG ER\.br\ Fax #: 999-999-9999 Radiology No: \.br\ Unit No: G999999999\.br\ \.br\ \.br\ \.br\ \.br\ \.br\ Exams: 999999999 ABDOMEN 9V FLAT/UPRIGHT\.br\ \.br\ Abdominal series\.br\ \.br\ CLINICAL INDICATION: Pain, nausea\.br\ \.br\ COMPARISON: None\.br\ \.br\ FINDINGS:\.br\ Two abdominal views demonstrate normal bowel gas pattern without bowel\.br\ dilatation or free air. Surgical clips in the left upper quadrant are\.br\ seen.\.br\ \.br\ IMPRESSION:\.br\ \.br\ 9. No evidence for bowel obstruction.\.br\ 9. No free air. \.br\ 9. Postsurgical clips in the left upper quadrant. \.br\ \.br\ \.br\ ** Electronically Signed by Test Doctor M.D. on 99/99/9999 at 9999 ** \.br\ Reported and Signed by: Test Doctor, M.D.\.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ \.br\ CC: \.br\ \.br\ Technologist: Tech, CRT \.br\ Transcribed Date/Time: 99/99/9999 (9999)\.br\ Transcriptionist: GRADVR\.br\ Printed Date/Time: 99/99/9999 (9999) Batch No: N/A \.br\ \.br\ PAGE 9 Signed Report