V2.

x Module, Unit 1:

Introduction to HL7 V2.x

Activity

Language: English ©2014 HL7 Argentina & HL7 International V2.0

 HL7 Fundamentals Course - V2.x - Unit 1: Introduction to HL7 V2.x - Activity

Table of Contents
Table of Contents ................................................................................................................................. 2
Activity Overview ................................................................................................................................. 3
1. Introduction ......................................................................................................................... 4
Overview.......................................................................................................................................... 4
Task 1: Where do I Start?................................................................................................................. 4
Task 2: How do I Continue? ............................................................................................................. 5
Activity Summary ................................................................................................................................. 7

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 HL7 Fundamentals Course - V2.x - Unit 1: Introduction to HL7 V2.x - Activity

Activity Overview
This Activity will help you get started in understanding how HL7 V2.x messages are used to imple-
ment the many transactions that happen every day in healthcare. First, you will see how all the
transactions that happen within a large hospital as well as to Community Care and insurance com-
panies can be done using HL7 V2.x standards. Then you will see how a single V2.x chapter can
communicate the many phases of a typical hospital stay.

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 HL7 Fundamentals Course - V2.x - Unit 1: Introduction to HL7 V2.x - Activity

1. Introduction
So, where do you start to build an HL7 interface? You may be asking yourself "How do I know if
my case is covered by HL7 V2.x?" and "In which one of the V2.x chapters can I find the right mes-
sage?" This activity will help you learn how to answer these questions!

Overview

The Goodhealth Hospital (GHH) has a number of healthcare systems and applications:

GHH's Patient Administration System (GHH_ADT)

The Laboratory Information System (LIS) in the GHH LAB (GHH_LIS)
The Radiology Information System (RIS) in the GHH Imaging Department (GHH_RIS)
The PACS in the GHH Imaging Department (GHH_PACS)
The Goodhealth Hospital Medical Record Manager (GHH_MRM)
A pharmacy application in the Good Neighbor Pharmacy (GNB_PHA)
A scheduling application in the Community Health Clinic (CHC_SCH)
An automatic authorization system for HC Payor, Inc. (HC_AUT)
The regional Healthcare Authority Electronic Healthcare Record Repository (HA_EHR)
A referral application in the Community Health Clinic (CHC_REF)
The Billing System at the Community Health Clinic (CHC_BILL)

Task 1: Where do I Start?

This task will teach you how to find the right V2.x message for the communication of healthcare
information.

For each one of the following seven interoperability scenarios in the Goodhealth Hospital, please
identify the right HL7 V2.8 chapter you should use:
1. Send admission data from the GHH's Patient Administration System (GHH_ADT) to the GHH
Radiology Information System (GHH_RIS)
2. Send a medicines prescription from the GHH Medical Record Manager (GHH_MRM) to the
Good Neighbor Pharmacy (GNB_PHA).
3. Send chemistry and hematology results from the GHH Laboratory Information System
(GHH_LIS) to the GHH_MRM
4. Send a referral request from the GHH MRM to the electrophysiologist (Ed Electrode) in Com-
munity Health Clinic (CHC_REF)
5. Send a scheduling request from GHH_MRM to the electro-physiologist (Ed Electrode) in Com-
munity Health Clinic (CHC_SCH)
6. Send a lab order from the GHH MRM to GHH_LIS

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7. Send an authorization request for a series of lab tests from the Billing System at the Communi-
ty Health Clinic (CHC_BILL) to the electronic authorization system (HC_AUT) of the patient's in-
surance company (HC Payor Inc.)

So for each of the seven transactions listed above, please identify and note the right chapter num-
ber of the HL7 v2.8 standard that contains the message required to communicate the information.

Task 2: How do I Continue?

Now you know how to identify the right chapter for an interoperability transaction. The next step
is to select a trigger event and a message type from the HL7 V2.x standards that can do the
healthcare information exchange.

Read the following story and for each of the fifteen steps, please identify the right trigger / mes-
sage. You will be using the Chapter 3 from HL7 v2.8 to do this task. For example, for step 1 "The
pre-admission is completed", the correct ADT event/message/trigger is "Pre-Admit a Patient" A05.

Pre-Admission
1. Mr. Adam Everyman is a patient scheduled for lung surgery at the Goodhealth Hospital. He
was born on 23 May 1965 and his address is 2101 Webster, Rightown. He will arrive for surgery
at 6am on June 29, 2014. The pre-admission is completed and the number assigned by the
GHH_ADT system is P11051968.
2. To get his details, the admission clerk Andy Clark uses the GHH_ADT application and a patient
identifier cross-reference manager to query the patient demographic information after reading
the patient id 5555-5555 from Adam's magnetic card.

Admission
3. Early morning on June 29, 2014, Mr. Everyman arrives using a wheelchair at the Goodhealth
Hospital admitting office. He says his admission reason is "the surgery on his lung" and that his
primary care physician / general practitioner, Dr. Primary had referred him to Dr. Cutter for the
thoracic surgery. Dr. Cutter will be Mr. Everyman's attending physician. Alice Admin, the GHH
admissions clerk, reviews Mr. Everyman's pre-admission record. She records that Mr. Every-
man is a patient of the surgical department and will be staying in Ward B on the fourth floor,
room 416, bed #1. His admission type is "elective" and his assigned visit number is V484897.
Because Mr. Everyman has a history of heart problems, his cardiologist Dr. Patrick Pump is en-
tered as the consulting physician for the inpatient encounter for Mr. Everyman. The admitting
diagnosis "? ca lung" is also entered. Mr. Everyman stated that the emergency contact for this
visit is his mother Nancy Dahl. Alice enters the emergency contact name and her phone num-
ber is 5555-4554. Alice then notices a note attached to Mr. Everyman's record indicating that
he is a large benefactor to the Good Health Hospital and therefore is to receive a special cour-
tesy during any stay at GHH. Mr. Everyman stated that he did not have any valuables on his
person. Alice submits this information to the hospital information system to notify all depart-
ments about the admission.

Update Patient Information

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4. Later, Mr. Everyman calls the admission department and informs Alice (the admitting clerk)
that he needs to change the emergency contact information. His mother, Nancy Dahl, has un-
expectedly had to travel to help with his sister's new baby. Mr. Everyman says that the emer-
gency contact would now be his son, James Everyman. Alice enters James' phone number and
address and submits the updated information to the hospital information system.
5. At 3 pm, Mr. Everyman is transferred to the Operating Room B and Dr. Cutter performs investi-
gative thoracic surgery on Mr. Everyman in order to either rule out or confirm lung cancer.
6. After the surgery, Dr. Cutter consults with Dr. Dunst, pulmonologist and determines based on
the surgical results that Mr. Everyman does not have a lung cancer. Mr. Everyman is transferred
to the recovery room #B12 in the same floor, next to the OR.
7. Dr. Cutter decides that Mr. Everyman can be discharged home the next Monday and does not
require longer-term follow-up care.

Complications Arise
8. During Sunday night, a day before Mr. Everyman's planned discharge, night shift nurse Nelly
Nightingale notices an elevated temperature and breathing problems. His pulse and respirato-
ry rhythm are also of concern. Therefore, his planned discharge for the next day is cancelled.
9. At 3am, Everyman is transferred to the ICU, bed 102 on the first floor.
10. He is now under supervision of Dr. John Fast, an attending physician in ICU.
11. Two days later, after being stabilized, an infection on his left lung is detected and Everyman is
transferred to the high-care isolated ward.
12. In the isolation ward, Dr. Microman (Infectologist) is responsible for Mr. Everyman's care as his
physician.
13. After six days in the isolation ward, Mr. Everyman's infection is healed and he is moved back to
a regular room.
14. Back on the fourth floor and after a day of observation, Mr. Everyman is now scheduled for dis-
charge on July 9.

Discharge
15. On 9 July 2014, the day of Mr. Everyman's planned discharge, Christopher Clark, a GHH nursing
unit clerk, completes the discharge information for Mr. Everyman and discharges him from the
GHH Inpatient Unit.

OK, you know the answer for step one of Mr Everyman's story - so please now identify the right
ADT messages for the remaining steps 2-15!

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Activity Summary
You have seen how V2.x chapter 3 can communicate the many phases of a typical hospital stay!

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