Medtronic PASCV Reference Guide
Connected Systems Gateway
Connectivity Guide
Federal Law (USA) restricts the device to sale by or on the order
of a physician (or a properly licensed practitioner).
Trademarks in this manual
The names of actual companies and products mentioned herein may be the trademarks of their respective owners.
The following are trademarks of Medtronic:
Medtronic, Medtronic CareLink, SessionSync, and Paceart
Contents
Connected Systems Gateway.....................................................................................................2
Connected Systems Gateway Software Prerequisites.....................................................6
Installing the Connected Systems Gateway.........................................................................9
Paceart-CareLink Scheduling Integration............................................................................15
HL7 Integration Overview...........................................................................................................17
Paceart XML Schema....................................................................................................................61
Connectivity Guide | Contents | i
Explanation of symbols..............................................................................................................2
Indications....................................................................................................................................2
Precautions..................................................................................................................................3
Contraindications........................................................................................................................4
Paceart authorized users............................................................................................................4
Technical Support........................................................................................................................5
Installing .Net 3.5 Framework Service Pack 1..........................................................................6
Installing and Configuring MS Message Queuing for Windows XP.......................................6
Installing and Configuring MS Message Queuing for Windows Server 2003.......................7
Installing and Configuring MS Message Queuing for Windows Vista...................................7
Creating a Connected Systems Gateway user for the Paceart database..............................7
Creating a CareLink user to use with the Connected Systems Gateway..............................8
Connected Systems Gateway Configuration Manager..........................................................10
Starting the Connected Systems Gateway.............................................................................14
Scheduling integration requirements......................................................................................15
Troubleshooting scheduling connectivity problems.............................................................16
Medtronic Connected Systems Gateway HL7 Overview.......................................................17
HL7 Inbound Message Flow.....................................................................................................19
HL7 Message Acknowledgement............................................................................................19
Inbound Patient Administration Messages (ADT)..................................................................19
Inbound Message Segments....................................................................................................21
Inbound Scheduling Messages (SIU)......................................................................................23
Inbound Message Segments....................................................................................................25
Outbound Event Observation Reporting (ORU).....................................................................29
OBX:3 Coded Element...............................................................................................................34
Identifiers...................................................................................................................................39
OBX:4 Sub-ID Numbering and Data Relationship..................................................................50
Troubleshooting HL7 connectivity problems.........................................................................60
Programmer Acquisition service cannot start Event Log message..........................60
Parameter valid values..............................................................................................................61
Paceart XML export...................................................................................................................64
Lookup tables..................................................................................................................64
Patient records................................................................................................................69
2 | Connectivity Guide | Connected Systems Gateway
Connected Systems Gateway
In order to simplify the process of connecting and sharing demographic, scheduling, and device data between
Medtronic applications andelectronic medical record systems (EMRs), Medtronichas developed the Connected
Systems Gateway (CSG). This software application serves as the primary tool to move and share data for
device patients.The CSG helps to streamline the implementation and on-going maintenance of data movement
between applications.
The Connected Systems Gateway is an optional component of the Paceart System.
The CSG is used to do the following:
• Exchange scheduling data between CareLink and Paceart
• Bring in demographic and scheduling information from electronic medical record systems or practice
management systems via HL7
• Export device data to electronic medical record systems via HL7
Explanation of symbols
Consult instructions for use
Conformité Européenne (European Conformity). This
symbol means that the device fully complies with
European Directive MDD 93/42/EEC.
For US audiences only
Authorized Representative in the European Community
Manufacturer
Lot number
Reorder number
Date of Manufacture
Indications
The Paceart System is intended for use as a 12-lead electrocardiograph, pacemaker artifact analyzer, and
transtelephonic ECG receiving station. It also acts as a database for cardiac patients with or without pacemakers
or implantable cardioverter defibrillators.
Connectivity Guide | Connected Systems Gateway | 3
Precautions
Storage and installation
• Avoid moisture or contact with water.
• Avoid excessive or extreme air pressure.
• Avoid vibration and mechanical shock while moving.
• Place on a level floor.
• Use AC power that corresponds in frequency, voltage, and allowable current capacity.
• Use the isolation transformer as the source of AC power during in-clinic follow-ups.
• Use a grounded 3-wire AC power plug.
• The outside of the Paceart Module can be cleaned with a clean, dry cloth.
• Use the isolation transformer as the source of AC power and plug it directly into a grounded wall outlet.
• Use a grounded 3-wire AC power cable to connect the PC to the isolation transformer.
• Ensure there is no condensed moisture on the Paceart software CD-ROMs.
• Paceart software CD-ROMs must be stored within the following conditions:
Storage Environment
-20°C to +50°CTemperature
5% to 90%Relative Humidity
System operation
Before system operation:
• Check that the system components are working properly.
• Check that the cords are connected to the system correctly.
• Ensure that the system is not being used with other instruments that may result in misdiagnosis or other
problems.
• Check to be sure that there is no damage to the circuitry that connects directly to the patient.
• Ensure there is no condensed moisture on the Paceart software CD-ROMs.
• Paceart software CD-ROMs must be operating in an environment within the following conditions:
Operating Environment
-25°C to +70°CTemperature
10% to 95%Relative Humiditiy
During system operation:
• Maintain constant observation of the patient to ensure that significant events are detected immediately.
• The system can be switched off when necessary to ensure the patient's safety.
After system operation:
• The system and all the accessories should be carefully cleaned after use to prepare them for the next
session.
Additional precautions
• Do not modify the original system in any way. This includes adding any software product.
4 | Connectivity Guide | Connected Systems Gateway
• The system and its components should undergo regular maintenance inspections.
• If the system is stored for a long period of time without use, make sure that the system is in perfect condition
prior to operation.
• Use only ECG disposable electrodes in proper working condition.
• Use electrode gel or electrolytic pads to ensure that good electrode contact is obtained.
• Ensure that the proper lead colors are connected to the correct electrode sets.
• Do not use the equipment in an explosive atmosphere.
• Do not use liquid on top of the equipment.
• Ensure that all patient records are updated and permanently stored before turning the PC power off.
• Do not use the instrument in an environment with excessive temperature and humidity.
• Double-check the data before typing the data into the system.
• Call customer service or your biomedical department for service and repairs.
• Ensure that the report to be printed reflects the proper leads. The operator selects which leads will be shown
in the printed report.
• The operator should not touch the computer and patient simultaneously when the patient is connected to
the ECG electrodes.
• ECG electrodes should not contact other conductive parts, including earth.
• The Paceart ECG module is not suitable for direct cardiac applications.
Transmission and transmitter settings
• The transmitter transmission speed must match the transmit speed setting in Paceart.
• The transmitter transmit format must match the transmit format setting in Paceart.
• Discrepancies between the transmission speed or the transmission format will result in incorrect
measurements that may lead to incorrect ECG interpretations.
• The Date Given field must have a date that is the same or prior to the date the transmission is recorded.
• A patient may only have one active transmitter.
• The Paceart operator is responsible for setting the speed and format settings.
ECG noise
The following may cause noise affecting artificial pacemaker spikes:
• Pacemaker programmers
• Poor electrode contact
• Electrical interference due to grounding problems
Caution: Make sure that the PC used to record pacemaker clinic ECGs is connected to AC power using an
isolation transformer and a grounded three-wire power cable.
Contraindications
No known contraindications.
Paceart authorized users
Medtronic representatives provide the Paceart System orientation and training materials at the time of the
installation. All users should be familiar with the Paceart documents, including the online Help, before using
Connectivity Guide | Connected Systems Gateway | 5
the Paceart System. The designated system administrator should also read the Paceart System Administrator's
Guide for information on using the Paceart System software user interface for function and control.
An authorized person, preferably a physician, must verify the implantable device and electrode specifications
entered into the database or modified in the database. An authorized person, preferably a physician, must
verify the test results that are automatically entered into the database by the instrument. The data obtained
from this device must be interpreted in conjunction with other clinical data and the results of other independent
tests.
Technical Support
For technical support contact your local Medtronic office. In the US and Canada, call 1-800-PACEART.
6 | Connectivity Guide | Connected Systems Gateway Software Prerequisites
Connected Systems Gateway Software Prerequisites
Before you install and configure the Connected Systems Gateway software you must complete the following
prerequisites:
• Install .Net 3.5 Framework Service Pack 1.
• Install and Configure MS Message Queue.
• Create a Connected Systems Gateway user on the Paceart Database if you are using SQL Server
authentication (not needed if using Windows Authentication).
Paceart-CareLink scheduling integration prerequisites
Before you enable scheduling integration you must complete the following prerequisites:
• Create a CareLink account to use with the Connected Systems Gatewaywith the Transmission Permission
selection of View changes transmission status from new to viewed.
• Configure Paceart appointments and patient records for scheduling integration.
HL7 integration prerequisites
Before you enable scheduling integration you must complete the following prerequisite.
• Review Paceart patient data to verify that each patient has the correct patient ID and there are no duplicate
patient IDs in the Paceart database. If the HL7 adapter encounters multiple patients in Paceart with the
same patient ID as the patient ID in the message, it will log an error message in the Paceart Data Exchange
Log Viewer and the Connected Systems Gateway log.
Installing .Net 3.5 Framework Service Pack 1
You must have .Net 3.5 Framework Service Pack 1 installed before you install the Connected Systems Gateway.
The .Net Framework Service Pack 1 files are located on the Connected Systems Gateway CD. You do not
need to be connected to the internet to install the files.
1. Insert the Connected Systems Gateway CD into your disk drive.
2. Browse to the CD and double-click on dotnetfx35.exe.
Installing and Configuring MS Message Queuing for Windows XP
1. Open the Control Panel.
2. Double-click Add or Remove Programs.
3. Click Add/Remove Windows Components.
4. Select Message Queuing from the Windows Components Wizard dialog.
5. Click Next.
6. Click Details.
7. Select Common from the list of Subcomponents of Message Queuing.
8. Click OK on the Message Queuing dialog.
9. Click Next on the Windows Components Wizard dialog.
Connectivity Guide | Connected Systems Gateway Software Prerequisites | 7
10. When the installation completes click Finish.
Installing and Configuring MS Message Queuing for Windows Server 2003
1. Open the Control Panel.
2. Double-click Add or Remove Programs.
3. Click Add/Remove Windows Components.
4. Select Application Server from the Windows Components Wizard dialog.
5. Click Next.
6. Select Message Queuing.
7. Click Details.
8. Select Common from the list of Subcomponents of Message Queuing.
9. Click OK on the Message Queuing dialog.
10. Click Next on the Windows Components Wizard dialog.
11. When the installation completes click Finish.
Installing and Configuring MS Message Queuing for Windows Vista
1. Click Start > Control Panel.
2. Click Programs.
3. Under the Windows and Features section, click Turn Windows features on or off.
4. Under the Microsoft Message Queue (MSMQ) Server option, check the Microsoft Message Queue
(MSMQ) Server Core option. This enables all of the MSMQ Server Core subfeatures.
5. Click OK.
Creating a Connected Systems Gateway user for the Paceart database
If you are using SQL Server authentication, you must create a Connected Systems Gateway user on your
Paceart database. The user must have database reader and database writer privileges.
1. Open the Paceart System Database Manager.
2. Click Paceart_Database.
3. Click Users.
4. Click New User.
5. Click Next.
6. In login section select <new> and click Next.
7. In the Authentication window select SQL Server and click Next.
8. In the Login name field enter the user name you will use for the Connected Systems Gateway.
9. In the Password field enter and confirm your password.
10. In the Roles window accept the default and click Next.
11. Click Next through the wizard.
12. Click Finish.
8 | Connectivity Guide | Connected Systems Gateway Software Prerequisites
Creating a CareLink user to use with the Connected Systems Gateway
You must create a dedicated CareLink user for the Connected Systems Gateway to connect to. Do not use a
clinical staff login.
You may use the same dedicated CareLink user allocated for downloading CareLink Transmissions into Paceart
via Paceart Gateway Services.
1. Login to the Medtronic CareLink website.
2. Open the Create User Profile page.
3. From the Manage My Clinic page select Create a New CareLink User, or from the CareLink Users tab
click Add User.
4. Click the Active CareLink User button.
5. Enter a first and last name.
6. Enter a user ID. The user ID must by 7-12 characters long. At least one character must be numeric (0-9).
The user ID is case-sensitive.
7. If you are using the satellite clinic feature, select the clinics for Assigned Clinics. If you have access to more
than one clinic, use the Clinic Security section to specify which clinics the external system can access. An
integrated system can be granted access to a single clinic, a group of clinics, or all of the clinics within the
system.
Ensure that the CareLink account has access to the sub-clinics' patients that are integrated with Paceart.
8. Select the View only (not permitted to enroll clinicians or patients) option from the Administrative
Privileges list.
9. Select the View changes transmission status from new to viewed option from the Transmission
Privilege list.
10. Click Submit.
Connectivity Guide | Installing the Connected Systems Gateway | 9
Installing the Connected Systems Gateway
Complete the items listed in the prerequisites section before you install and configure the Connected Systems
Gateway software.
1. To start the installation, insert the Connected Systems Gateway installation CD into the computer. The
setup program will automatically start. If you are installing on a Windows 2003 Server, you must manually
start the installation program by clicking the csginstall.msi on the installation CD.
If the setup program does not automatically start, you can manually start the installation program by clicking
csginstall.msi on the installation CD.
2. Click Next.
3. Enter a destination folder. Click Change to change from the default location of C:\Program
Files\Medtronic\Connected Systems Gateway\.
4. Click Next.
5. Click Install.
A progress bar shows the installing progress.
6. After the installation is finished click Next.
The Completed Installation window is displayed.
7. Select Launch CSG Configuration Manager, and then click Finish to finish and exit the installation wizard
and open the Connected Systems Gateway Configuration Manager.
8. In the CSG Feature Selecter window, select which features you want to configure and click Next.
• If you selected the Paceart/CareLink Scheduling Integration feature, the Connected Systems Gateway
Configuration Manager opens.
• If you selected the Paceart HL7 Integration feature, NeoIntegrate will be installed if it is not already
installed.
Note: NeoIntegrate installation is only launched one time. If you cancel the installation or need to re-execute
the installation, you must first delete the following file to allow NeoIntegrate installation to be launched
again:C:\Program Files\Medtronic\Connected Systems
Gateway\HL7SubSystem\Installed. (The path will be different if the destination folder was modified
it in step 3.)
a) In the NeoIntegrate - InstallShield Wizard window click Next.
b) Read the license agreement. Click Next to accept it.
c) Specify a destination folder. Click Change to change the default location, and then click Next.
d) Select a setup type. The default is NeoIntegrate. Click Next.
e) If your Paceart Systems uses SessionSync you will have a port conflict. Specify which alternate ports
you would like to use, and then click Next.
f) Enter an Administrator password and click Next.
g) Click Install to install NeoIntegrate.
h) When the installation is complete you have the option to launch the license manager. If you already have
your license string select this option and click Finish.
Note: If you do not have your license string deselect the Launch the License Manager option and
call Technical Support for licensing information.
After you click Finish the Log on dialog is displayed. The Connected Systems Gateway Configuration
Manager also opens in front of the Log on dialog. Move the Configuration Manager window out of the
way.
i) Enter the username and password you specified in step f, and then click OK.
10 | Connectivity Guide | Installing the Connected Systems Gateway
j) In the LicenseManager window, click License wizard.
The License Wizard will start.
k) Click Next.
l) Select the I have a license string to run this product on this machine option, and then click Next.
m) On the Machine/license description dialog enter a description of how this license will be used, and
then click Next.
For example "St. Elsewhere Hospital Production Server"
n) On the Connection and login dialog enter your implementation information and click Next.
o) Click Connect to contact NeoTool.com to obtain your license.
p) After you have connected to NeoTool.com click Next.
q) Click Finish.
r) On the LicenseManager window click Exit.
9. In the Connected Systems Gateway Configuration Manager, enter the applicable values for the features
you selected.
Connected Systems Gateway Configuration Manager
The Connected Systems Gateway consists of adapters.
Connectivity Guide | Installing the Connected Systems Gateway | 11
Paceart_GCIII_SourceAdapter tab
This adapter is for sending data out of Paceart.
ExplanationField name
PaceartDatabaseServer
PaceartDatabaseName
UseWindowsAuthentication
SQLServerUserName
SQLServerPassword
The name of the machine hosting the SQL Server database that the adapter will
be using to interface with Paceart.
The database instance name of the database that the adapter will be using to
interface with Paceart.
A Boolean value indicating that Windows Authentication should be used to connect
to the SQL Server database. A setting of false will use the SQL User Name and
SQL Password configuration values to connect. The default is "False".
The user name used to connect to the SQL Server database. Not used if "Use
Windows Authentication" is True.
The password used to connect to the SQL Server database. Not used if "Use
Windows Authentication" is True.
CareLink_Scheduling_DestinationAdapter tab
This adapter is used for configuring Paceart-CareLink Scheduling integration.
ExplanationField name
CareLinkSchedulingService
CareLinkSchedulingServiceSite
The name of the CareLink scheduling service that the adapter will be using. The
default is "Endpoint_CSA_basicHttpsBinding".
The fully qualified path of the CareLink scheduling service that the adapter will be
using. The default is
"https://clscheduling.medtroniccarelink.net/SchedulingGateway/SchedulingGateway.svc".
CareLinkUserID
CareLinkUserPassword
SendPatientFirstName
SendPatientMiddleName
SendPatientGender
The name of the dedicated user that will be used to connect to the CareLink
Scheduling service.
The password that will be used to authenticate the CareLink User ID with the CareLink
Scheduling service.
A Boolean value indicating if the Patient First Name value is sent to CareLink. If
"True", it will be used by CareLink for patient matching. The default value is "True".
A Boolean value indicating if the Patient Middle Name value is sent to CareLink. If
"True", it will be used by CareLink for patient matching. The default value is "True".
A Boolean value indicating if the Patient Gender value is sent to CareLink. If "True",
it will be used by CareLink for patient matching. The default value is "True".
Paceart_GCIII_DestinationAdapter Tab
This adapter is used for Paceart HL7 integration.
ExplanationField name
PaceartDatabaseServer
PaceartDatabaseName
The name of the machine hosting the SQL Server database that the adapter will be
using to interface with Paceart.
The database instance name of the database that the adapter will be using to interface
with Paceart.
12 | Connectivity Guide | Installing the Connected Systems Gateway
ExplanationField name
UseWindowsAuthentication
SQLServerUserName
SQLServerPassword
PatientMatchingUseLastName
PatientMatchingUseMiddleName
PatientMatchingUseFirstName
PatientMatchingUseDateOfBirth
A Boolean value indicating that Windows Authentication should be used to connect
to the SQL Server database. A setting of "False" will use the SQL User Name and the
SQL Password configuration values to connect.
Windows Authentication is a login method that uses a Windows domain login to
authenticate to the database. Some SQL Servers are configured to only allow
connections via Windows logins. If you select Windows login, you must configure the
HL7 services to run under the desired domain login.
The default is "False".
The user name used to connect to the SQL Server database. Not used if "Use Windows
Authentication" is "True".
The password used to connect to the SQL Server database. Not used if "Use Windows
Authentication" is "True".
If true, the patient last name will be used for demographic matching. The default is
"True".
If true, the patient middle name will be used for demographic matching. The default
is "False"
If true, the patient first name will be used for demographic matching. The default is
"False".
If true, the patient date of birth will be used for demographic matching. The default is
"True".
If true, the patient gender will be used for demographic matching. The default is "True".PatientMatchingUseGender
HL7_DestinationAdapter Tab
This adapter is used for Paceart HL7 integration.
ExplanationField name
OutboundSendingApplicationNamespaceID
OutboundSendingApplicationUniversalID
OutboundSendingApplicationUniversalIDType
This field uniquely identifies the sending application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
This information is included in the MSH segment 3, component 1.
The default is "Paceart".
This field uniquely identifies the sending application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
This information is included the MSH segment 3, component 2.
This field uniquely identifies the sending application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
This information is included the MSH segment 3, component 3.
Connectivity Guide | Installing the Connected Systems Gateway | 13
ExplanationField name
OutboundSendingFacilityNamespaceID
OutboundSendingFacilityUniversalID
OutboundSendingFacilityUniversalIDType
OutboundReceivingApplicationNamespaceID
OutboundReceivingApplicationUniversalID
This field further describes the sending application. Entirely
site-defined.
This information is included the MSH segment 4, component 1.
The default value is "Medtronic".
This field further describes the sending application. Entirely
site-defined.
This information is included the MSH segment 4, component 2.
This field further describes the sending application. Entirely
site-defined.
This information is included the MSH segment 4, component 3.
This field uniquely identifies the receiving application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
This information will be in MSH, field 5, component 1.
This field uniquely identifies the receiving application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
OutboundReceivingApplicationUniversalIDType
OutboundReceivingFacilityNamespaceID
OutboundReceivingFacilityUniversalID
OutboundReceivingFacilityUniversalIDType
OutboundProcessingID
This information will be in MSH, field 5, component 2.
This field uniquely identifies the receiving application among all other
applications within the network enterprise. The network enterprise
consists of all those applications that participate in the exchange of
HL7 messages within the enterprise. Entirely site-defined.
This information will be in MSH, field 5, component 3.
This field identifies the receiving application among multiple identical
instances of the application running on behalf of different organizations.
Entirely site-defined.
This information will be in MSH, field 6, component 1.
This field identifies the receiving application among multiple identical
instances of the application running on behalf of different organizations.
Entirely site-defined.
This information will be in MSH, field 6, component 2.
This field identifies the receiving application among multiple identical
instances of the application running on behalf of different organizations.
Entirely site-defined.
This information will be in MSH, field 6, component 3.
Defines in the MSH header whether the message is part of a
production, training, or debugging system. D=Debugging,
P=Production, T=Training.
This information will be in MSH, field 11, component 1.
14 | Connectivity Guide | Installing the Connected Systems Gateway
ExplanationField name
The default value is "P".
OutboundProcessingIDMode
OutboundHL7Version
OutboundIncludeEpisodeObservations
OutboundPatientVisitPatientClass
CommunicationQueue
HL7_SourceAdapter Tab
Defines in the MSH header the processing mode. A=Archive,
R=Restore from archive, I=Initial load, T=Current processing
transmitted at intervals.
This information will be in MSH, field 11, component 2.
Version of HL7 listed in the HL7 message header.
This information will be in MSH, field 12.
Default is "2.3.1".
Boolean value providing an option to include episode data in the HL7
message sent to the receiving system. Inclusion of this data may add
to the size of the message.
Default value is "False" (do not send episode data).
The default value is"U" and corresponds to a Patient Class of
"Unknown". This information will be in PV1, field 2.
Used by the implementation to communicate with a third-party HL7
engine.
The default is "HL7Destination".
This adapter is used for Paceart HL7 integration.
ExplanationField name
CommunicationQueue
Used by the implementation to communicate with a third-party HL7
engine.
The default is "HL7Source". Do not change this value.
Starting the Connected Systems Gateway
During installation and configuration, you should manually start the Connected Systems Gateway service.
After you have verified that your implementation was successful you can choose to automatically restart the
service.
1. To start the Connected Systems Gateway go to Start > Administrative Tools > Services.
2. Right-click the Connected Systems Gateway service and select Start.
If you restart your computer you will have to restart this service.
3. After you verify that your implementation was successful you can set this service to automatically connect.
Go to Start > Administrative Tools > Services.
4. Right-click the Connected Systems Gateway service and select Automatic.
If you restart your computer this service will automatically restart.
Connectivity Guide | Paceart-CareLink Scheduling Integration | 15
Paceart-CareLink Scheduling Integration
The Paceart-CareLink Scheduling Integration feature provides a way to automatically synchronize scheduling
between the CareLink Network and the Paceart System. If you schedule an appointment in CareLink, it will be
downloaded to the Paceart System; if you schedule an appointment in Paceart, it will be sent to CareLink.
Paceart regularly requests status information for appointments scheduled in CareLink. Schedules are either
updated nightly or when a clinician makes a request from the Paceart System.
If an appointment is created in CareLink, CareLink retains ownership until the appointment is sent to Paceart.
Once the Paceart System is updated to reflect the CareLink Network appointment, the appointment is owned
by Paceart.
If a remote appointment is created or modified in Paceart, the appointment is automatically created or updated
in CareLink. Ownership of the appointment remains with the Paceart System.
Paceart receives appointment status information that reflects the last known status as reported by CareLink.
The remote status is displayed in patient appointment information on the Paceart System. Paceart records the
completion and failure status details of this information in its log. Paceart scheduling requests that violate
CareLink Network scheduling rules are displayed as errors in the Paceart System Remote Status field.
Scheduling integration requirements
You must ensure that Paceart patient records and appointments meet the following criteria before you use
Paceart-CareLink scheduling integration.
• The Paceart patient record for patients followed on CareLink must have a birth date and a valid patient ID
number. If either the birth date or the patient ID number is not in Paceart, appointments will not be sent to
CareLink.
• Appointments created or updated in Paceart must have the patient remote follow-up service set to Medtronic
CareLink Network, and the patient must have an active Medtronic ICD or pacemaker that is supported by
the Medtronic CareLink Network. To find out if a device is supported, log into CareLink and click Resources
> CareLink Supported Implanted Devices.
Paceart/CareLink patient matching for a single patient
The primary match is on the patient ID number and the birth date. If either of these are not present in the Paceart
System, appointments will not be sent to CareLink. If the patient ID number is not present in the CareLink
system, a demographic match is performed. The configurable matching criteria include first name, middle
initial, and gender in addition to the last name and birth date which are always used. If the demographic match
succeeds, CareLink will record the patient number so future matches will be simpler and quicker.
This matching is performed on CareLink and is used when adding, updating and removing appointments, and
when updating remote appointment status.
Paceart/CareLink patient matching for a batch download
In this scenario, the Paceart System downloads a list of all CareLink patients and appointments and then
matches CareLink patients to Paceart patients. The primary matching is on the patient ID number and the birth
date. If the patient ID number is not present in the CareLink system a much stricter demographic match is
performed. This requires a match on the first name, middle initial, last name, gender, and birth date.
16 | Connectivity Guide | Paceart-CareLink Scheduling Integration
Troubleshooting scheduling connectivity problems
CareLink
• Verify that the CareLink account used to connect to the Connected Systems Gateway has a Transmission
Permission selection of View changes transmission status from new to viewed.
• Verify that the CareLink account used to connect to the Connected Systems Gateway does not have an
expired password.
• If the CareLink clinic has sub-clinics, verify that the CareLink account used to connect to the Connected
Systems Gateway has access to the sub-clinics' patients integrated with Paceart.
• Verify that scheduling integration has not been unlinked. Go to the CareLink Network website and click
Manage My Clinic > Clinic Profile > External Systems Integration.
Paceart
• Verify that the Paceart database has a Connected Systems Gateway user.
• Verify the Paceart database password associated with the Connected Systems Gateway user.
• Verify that the patient's Scheduling tab in Paceart has the patient remote follow-up service set to Medtronic
CareLink Network, and that the patient has a Medtronic ICD or pacemaker that is supported by the
Medtronic CareLink Network. To view the CareLink Network supported devices list login to the CareLink
website and go to Resources > CareLink Supported Implantable Devices.
• Verify that the Paceart patient record has a date of birth and a valid patient ID number.
Connected Systems Gateway
• Verify that the Connected Systems Gateway software and adapters were properly installed and configured.
• Verify that the correct CareLink hosting system was entered in the
CareLink_Scheduling_DestinationAdapter tab of the Connected Systems Gateway Configuration
Manager. The CareLink hosting system must match what was entered in the Remote Acquisition tab of
the Paceart Gateway Services.
• Verify that the SQL Server user name and password were correctly entered in the
Paceart_GCIII_SourceAdapter tab of the Connected Systems Gateway Configuration Manager if you
are not using Windows authentication.
• Verify that the Paceart database name and server were correctly entered in the
Paceart_GCIII_SourceAdapter tab of the Connected Systems Gateway Configuration Manager.
• Verify that the Connected Systems Gateway service was started.
Connectivity Guide | HL7 Integration Overview | 17
HL7 Integration Overview
The Paceart System supports the HL7 protocol which allows Paceart to integrate with your existing HL7-based
Electronic Health Record (EHR) and Practice Management Systems. This allows you to import patient
demographic and scheduling information into Paceart and to export transtelephonic, in-clinic, and remote event
data from Paceart to EHR systems.
The information contained in this section assumes an understanding of the HL7 Message Specification and a
working knowledge of Paceart.
Medtronic Connected Systems Gateway HL7 Overview
Paceart Patient Identifiers
The Paceart System supports a single value for a patient ID number. The Medtronic Connected Systems
Gateway (CSG) requires that the sending system provide a single, unique patient ID number in every HL7
message. This patient ID number will be stored in the Paceart database as the patient ID number and will be
used for patient matching.
Paceart does not support multiple patient identifiers. The patient ID number must be unique. The patient ID
number in the Paceart System and the patient ID number in the EMR/PM system must match.
Patient Matching
Patient matching must be selected in the Connected Systems Gateway Configuration Manager. As part of
implementing HL7 integration, the Paceart patient data must be reviewed to verify that each patient has the
correct patient ID and that there are no duplicate patient IDs in the Paceart database.
Paceart has a process for matching patient data from the received HL7 message to the patients existing in the
Paceart database. When an HL7 message is received, the Paceart database is searched to see if there is a
Paceart patient ID that matches the patient ID from the HL7 message.
• If no match is found, then the patient does not exist in the Paceart System.
• If a match is found and the Paceart ID is HL7Confirmed, then this is considered a match and the patient
exists in the Paceart System.
• If a match is found and the Paceart ID is not HL7Confirmed, then the customer-defined patient matching
criteria is used to determine if this is the same person.
If the Paceart patient information matches the HL7 message patient information according to the matching
criteria, then the Paceart ID is marked as HL7Confirmed. This is considered a match and the patient exists
in the Paceart System.
If the verification criteria does not match between the HL7 message patient and the Paceart patient, Paceart
will log an error message in the Paceart Data Exchange Log Viewer and the Connected Systems Gateway
log. No data will be added or updated in Paceart.
The following diagram illustrates the process used by the HL7 adapter to determine if there is a patient in
Paceart that matches the patient information in the HL7 message.
18 | Connectivity Guide | HL7 Integration Overview
Verification Criteria
Patient matching must be configured in the Connected Systems Gateway Feature Selector by the administrator
during implementation. One or more of the following patient demographic fields can be configured to ensure
the match:
• Last name
• First name
• Middle initial
• Date of birth
• Gender
If multiple fields are selected, then they all must match (i.e. multiple criteria are treated as a logical AND
statement).
Connectivity Guide | HL7 Integration Overview | 19
HL7 Inbound Message Flow
Segments and Fields
Field definitions for message segments have been included in this document for easy reference.
A three character segment identifierSeg
Represents the position of the field within the segmentField
The descriptive name of the fieldName
Indicates whether the field may repeat, with the following designations:Repeating
• N - No repetition
• Y - The field may repeat an indefinite or site-determined number of times
• (Integer) - The field may repeat up to the number of times specified by the
integer
This indicates the field designation using one of the following designators:OPT
• R - Required
• O - Optional
• C - Conditional on the trigger event or another field
• X - Not used with this trigger event
• B - Field remains for backward compatibility with previous version of HL7
HL7 Length
This is the maximum length specified in the HL7 specifications. It is the maximum
number of characters that one occurrence of the data field may occupy.
HL7 Message Acknowledgement
Acknowledgement Message
The CSG HL7 adapter supports both HL7 original and enhanced acknowledgement mode for inbound messages.
Refer to the Configuring reciever ACKnowledgement behavior topic in the NeoIntegrate online Help.
The acknowledgement messages that are sent to the sending systems are determined by the message status
and the acknowledgement type that was requested in the MSH segment of the sending system.
Inbound Patient Administration Messages (ADT)
Purpose
The CSG HL7 adapter can receive demographic information from any system or interface engine that is using
HL7 messaging. This allows for consistent patient demographic information across systems and reduces
duplication of data entry.
20 | Connectivity Guide | HL7 Integration Overview
The patient administration transaction set provides for the transmission of new or updated demographic
information about patients. Information that is entered in a patient administration system can be passed to
Paceart as an unsolicited HL7 message.
The CSG HL7 adapter supports a wide array of ADT trigger events to allow you to configure the HL7 integration
to capture the desired changes to patient demographic information.
Default Configured HL7 Triggers
A04, A08, A28, A29, A47
Supported Transaction Types
DescriptionTransaction Type
Add new patient to Paceart (demographic
information)
Update existing Paceart patient demographics
Mark patient for delete
If the patient does not exist in Paceart, then add the patient
demographic information as a new record.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log
Viewer of the Client application and in the Connected Systems
Gateway Log.
If the patient exists in Paceart, then update the patient
demographic information.
If the patient does not exist in Paceart, then no Paceart data
is updated.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log
Viewer of the client application and in the Connected Systems
Gateway Log.
If the patient exists in Paceart, then change the Paceart Status
field to inactive ("X").
If the patient does not exist in Paceart, then no Paceart data
is updated.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log
Viewer of the client application and in the Connected Systems
Gateway Log.
Change the patient ID of a patient
If the current ID exists in Paceart and the new ID does not
exist, then change the patient ID from current ID to new ID.
If the current ID does not exist in Paceart, then no Paceart data
is changed.
If the current ID exists in Paceart and the new ID also exists
in Paceart, then no Paceart data is updated and an error is
logged in the Connected Systems Gateway Log.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log
Viewer of the client application and in the Connected Systems
Gateway Log.
Connectivity Guide | HL7 Integration Overview | 21
Paceart Patient Data
The following Paceart database fields can be updated by the Paceart HL7 processing of ADT messages:
PA LengthPA Req.PA FieldPA Table
20YPatientIDMaster
32YNameMaster
14NFirst_NameMaster
1NMiddle_IniMaster
DT8NBirth_DateMaster
1NSexMaster
50NAddressMaster
50NAddr_Line2Master
20NCityMaster
10NStateMaster
10NZipMaster
50NCountryMaster
20NPhoneNum1Master
20NPhoneNum2Master
The following Paceart labels are used to reference data only when the patient is added by the Paceart HL7
processing:
PA LengthPA Req.PA FieldPA Table
1NStatusMaster
6NAffilMaster
Inbound Message Segments
MSH - Message Header Segment (Required)
The following table shows the standard HL7 format for the message segment.
Field lengthOPTRPTNameFieldSeg
1RNField Separator1MSH
4RNEncoding Characters2MSH
180ONSending Application3MSH
180ONSending Facility4MSH
180ONReceiving Application5MSH
180ONReceiving Facility6MSH
22 | Connectivity Guide | HL7 Integration Overview
Field lengthOPTRPTNameFieldSeg
26ONDate/Time of message7MSH
40ONSecurity8MSH
7RNMessage Type9MSH
20RNMessage Control ID10MSH
3RNProcessing ID11MSH
60RNVersion ID12MSH
15ONSequence Number13MSH
180ONContinuation Pointer14MSH
2ONAccept Acknowledgement Type15MSH
2ONApplication Acknowledgement Type16MSH
2ONCountry Code17MSH
16OYCharacter Set18MSH
60ONPrincipal Language of Message19MSH
20MSH
scheme
ENV - Event Type Segment (Optional)
Event type segments are optional in the Paceart HL7 implementation.
PID - Patient Identification Segment (Required)
The following table shows the standard HL7 format for the patient identification segments (PIDs). The shaded
fields show the fields being updated in the Paceart database.
Set ID1PID
Patient ID2PID
Patient Identifier List3PID
Check Digit3.2PID
Check digit scheme employed3.3PID
20ONAlternate Character Set handling
Paceart fieldsField lengthNameFieldSeg
Patient ID20ID3.1PID
Assigning authority3.4PID
Identifier type code3.5PID
Assigning facility3.6PID
Alternate Patient ID - PID4PID
Patient Name5PID
Last Name32Family Name5.1PID
First Name14Given Name5.2PID
Connectivity Guide | HL7 Integration Overview | 23
Paceart fieldsField lengthNameFieldSeg
Middle initial or name5.3PID
Suffix5.4PID
Prefix5.5PID
Degree5.6PID
Name Type Code5.7PID
Mother's Maiden Name6PID
Date of Birth26Date/Time of Birth7PID
Patient Sex1Sex8PID
Patient Alias9PID
Race10PID
Patient Address11PID
Address 150Street Address11.1PID
Address 250Other designation11.2PID
City20City11.3PID
State10State or province11.4PID
Zip Code10Zip or postal code11.5PID
Country50Country11.6PID
Address Type11.7PID
Country Code12PID
Phone Number 120Phone Number Home13PID
Phone Number 220Phone Number Business14PID
MRG - Patient Identification Segment (Required for ADT^A47)
The following table shows the standard HL7 format for the patient identification segments (MRGs). The shaded
fields show the fields being updated in the Paceart database.
Paceart fieldsField lengthNameFieldSeg
Patient ID20Prior Patient Identifier List1MRG
Prior Alternate Patient ID2MRG
Prior Patient Account Number3MRG
Inbound Scheduling Messages (SIU)
Purpose
The Connected Systems Gateway HL7 adapter can accept unsolicited schedule notification messages (SIU)
from a scheduling filler application. The HL7 standard defines four roles that the system can assume in scheduling
24 | Connectivity Guide | HL7 Integration Overview
integration. Paceart operates as an Auxiliary application or an "interested third-party." This allows for existing
scheduling systems to serve as the Filler application and to send schedule notification messages to the Paceart
System. The Filler application is said to "own" the schedule for the specified resources or, in other words, is
the authoritative source for scheduling information.
Default Configured HL7 Triggers
S12, S13, S14, S15
Supported Transaction Types
The schedule notification messages can be processed to not only create and modify appointments in Paceart,
but also can be used to add to or modify patient information. This allows for a patient to be added to Paceart
based on their first appointment with a device clinic.
Updating, rescheduling, or canceling an appointment can only be performed as long as the appointment exists
in Paceart. A Paceart appointment is said to exist if the appointment ID and associated Patient ID match the
filler appointment ID and patient ID in the HL7 message. Appointments created by an HL7 message cannot
be modified in the Paceart application, but they can be deleted from within the Paceart application. Paceart
also removes appointments once an applicable event has been created for the patient. Appointments created
by HL7 messages are processed in Paceart the same as appointments created directly in the Paceart application.
DescriptionTransaction Type
Add new patient to Paceart (demographic
information)
Update existing Paceart patient
demographics
Create new appointment for a patient that
exists in Paceart
Reschedule an existing HL7-created Paceart
appointment
If the patient does not exist in Paceart, then add the patient
demographic information as a new record.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log Viewer
of the Client application and in the Connected Systems Gateway
Log.
If the patient exists in Paceart, then update the patient
demographic information.
If the patient does not exist in Paceart, then no Paceart data is
updated.
If multiple patients match in Paceart, then no Paceart data is
updated and an error is logged in the Data Exchange Log Viewer
of the Client application and in the Connected Systems Gateway
Log.
Create a new appointment in Paceart if the appointment ID does
not already exist in Paceart. If the appointment does exist then
no appointment will be added.
Reschedule the appointment in Paceart if the appointment ID
already exists in Paceart. If the appointment does not exist then
no appointment will be rescheduled.
Modify an existing HL7-created Paceart
appointment
Cancel an existing HL7-created Paceart
appointment
Modify the appointment in Paceart if the appointment ID already
exists in Paceart. If the appointment does not exist then no
appointment will be modified.
Cancel/Remove the appointment in Paceart if the appointment
ID already exists in Paceart. If the appointment does not exist
then no appointment will be cancelled/removed.
Connectivity Guide | HL7 Integration Overview | 25
Paceart Scheduling Data
The following Paceart database fields are updated by the Paceart HL7 processing of SIU messages.
PA LengthPA Req.PA FieldPA Table
75 charactersYAppointmentIDEventData
DT8YEventDateEventData
255 charactersYEventTypeEventData
255 charactersNCommentEventData
75 charactersNVisit_IDEventData
AppointmentType Mapping
The schedule notification message should contain information on what type of appointment has been booked.
The information can be transformed in the message to map to one of the following values. If no event type
information is available in the scheduling messages, the appointment will fail to add/update the Paceart database.
The default configuration looks for this value in AIG-3.1.
Paceart Scheduled Event TypeAppointmentType
Arrhythmia TTM1
Arrhythmia Clinic2
Pacemaker TTM3
Pacemaker Clinic4
ICD Clinic6
Programming8
Miscellaneous10
Pacemaker Implant12
Pacemaker Remote13
ICD Implant14
ICD Remote15
Inbound Message Segments
The following is a list of inbound message segments. Some of the segments listed are required and others are
optional.
MSH and PID-Patient Identification Segment (Required)
For information on the PID segment, see the "Inbound Patient Administration Messages (ADT)" section of this
manual.
SCH-Schedule Activity Information Segment (Required)
The SCH segment contains the general information about the scheduled appointment.
26 | Connectivity Guide | HL7 Integration Overview
The following table lists schedule activity information segments. The shaded fields show the fields being
updated in the Paceart database.
Placer Appointment ID1SCH
Occurrence Number3SCH
Placer Group Number4SCH
Schedule ID5SCH
Event Reason6SCH
Appointment Reason7SCH
Appointment Type8SCH
Appointment Duration9SCH
Appointment Duration Units10SCH
Appointment Timing Quantity11SCH
Paceart fieldField lengthNameFieldSeg
Appointment ID75Filler Appointment ID2SCH
Quantity11.1SCH
Interval11.2SCH
Duration11.3SCH
Appointment date/time26start date/time11.4SCH
end date/time11.5SCH
Priority11.6SCH
PV1-Patient Visit Segment (Optional)
The following table lists patient visit segments. The shaded fields show the fields being updated in the Paceart
database.
Paceart fieldField lengthNameFieldSeg
Set ID1PV1
Patient Class2PV1
Assigned Patient Location3PV1
Admission Type4PV1
Preadmit Number5PV1
Prior Patient Location6PV1
Attending Doctor7PV1
Referring Doctor8PV1
Consulting Doctor9PV1
Hospital Service10PV1
Temporary Location11PV1
Preadmit Test Indicator12PV1
Readmission Indicator13PV1
Admit Source14PV1
Ambulatory Status15PV1
VIP Indicator16PV1
Admitting Doctor17PV1
Patient Type18PV1
RGS-Resource Group Segment (Optional)
Set ID - RGS1RGS
Segment Action Code2RGS
Connectivity Guide | HL7 Integration Overview | 27
Paceart fieldField lengthNameFieldSeg
Visit ID20Visit Number19PV1
Field lengthNameFieldSeg
Resource Group ID3RGS
AIS- Appointment Information - Service Segment (Optional)
Set ID - AIS1AIS
Segment Action Code2AIS
Universal Service ID3AIS
Start Date/Time4AIS
Start Date/Time Offset5AIS
Start Date/Time Offset6AIS
Duration7AIS
Duration Units8AIS
Allow Substitution Code9AIS
Filler Status Code10AIS
AIG-Appointment Information - General Resource Segment (Optional)
Field lengthNameFieldSeg
The shaded fields show the fields being updated in the Paceart database.
Set ID - AIG1AIG
Segment Action Code2AIG
Resource ID3AIG
Field lengthNameFieldSeg
255Identifier3.1AIG
28 | Connectivity Guide | HL7 Integration Overview
AIL - Appointment Information - General Resource Segment (Optional)
Set ID - AIL1AIL
Segment Action Code2AIL
Location Resource ID3AIL
Location Type-AIL4AIL
Location Group5AIL
Start Date/Time6AIL
Start Date/Time Offset7AIL
Start Date/Time Offset Units8AIL
Duration9AIL
Duration Units10AIL
Allow Substitution Code11AIL
Field lengthNameFieldSeg
Filler Status Code12AIL
AIP - Appointment Information - Personnel Resource Segment (Optional)
Set ID - AIL1AIP
Segment Action Code2AIP
Personnel Resource ID3AIP
Resource Role4AIP
Resource Group5AIP
Start Date/Time6AIP
Start Date/Time Offset7AIP
Start Date/Time Offset Units8AIP
Duration9AIP
Duration Units10AIP
Allow Substitution Code11AIP
Paceart fieldField lengthNameFieldSeg
Appointment reason
code/visit type
Filler Status Code12AIP
NTE - Notes and Comments Segment (Optional)
The shaded fields show the fields being updated in the Paceart database.
Set ID - NTE1NTE
Source of Comment2NTE
Paceart fieldField lengthNameFieldSeg