Welch Allyn Connectivity Server User Manual

Welch Allyn Connectivity Server

Programmer’s guide

Software version 2.6x

ii Welch Allyn Connectivity Server

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Manual 80018556 Ver A

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www.welchallyn.com

Contents

1 - Introduction .............................................1

2 - System overview.........................................5

iii

Intended use .....................................................1

Conventions .....................................................2

Warning and note .................................................2

Related documents................................................3

Welcome!.......................................................5

Data interface provided by the Welch Allyn Connectivity Server (WACS) ......6

Data transfer and storage within the Acuity System network ...............7

3 - HL7 standard protocols...................................11

Health Level Seven Standard .......................................11

HL7 low-level protocol ............................................12

HL7 segment-level protocols .......................................12

4 - WACS outbound HL7 protocols ............................15

Overview: Outbound HL7 Vital-sign Observations module ................16

Labels and attributes of outbound segments ...........................17

Outbound patient identification fields.................................21

Outbound vital-sign tags and filters ..................................22

Reconfiguring WACS outbound observation settings ....................24

5 - WACS outbound HL7 messages ...........................27

Unsolicited observation message

ORU^R01/ACK^R01 .............................................28

Query for results of observation message

QRY^R02/ORF^R04..............................................30

Query by parameter

QBP^Q11/RSP^Z90 ..............................................33

Query by ID.....................................................36

Query by location ................................................38

6 - Inbound ADT HL7 messages ..............................41

Overview: Inbound HL7 ADT Data module ............................42

How an Acuity System uses ADT information ..........................43

ADT messages accepted and stored by WACS .........................46

Examples of ADT messages........................................52

Reconfiguration of ADT services ....................................54

iv Contents Welch Allyn Connectivity Server

7 - XML interface ..........................................55

8 - Contacts and specifications ...............................57

Contact information ..............................................57

Specifications ...................................................57

Introduction

Intended use

The Welch Allyn Connectivity Server (WACS) is an option to the Welch Allyn Acuity Central Monitoring System. WACS consists of a server platform on which one or more of the following software options are installed:

• The Web Server option makes Adobe®Portable Document Format (PDF) printout files available from the Acuity System to certain Web browsers.

• The AcuityLink®option consists of Clinician Notifier software for non-proprietary mobile devices and administrative software for WACS. Mobile devices running the Clinician Notifier software deliver patient alarm information and realtime waveforms gathered from patient monitors connected to the Acuity Central Monitoring System.

The software enables administrators to track the status of clinician-patient assignments, and it enables clinicians to track, respond to and view Acuity System patient alarms, view realtime patient waveforms and view historical alarm details and waveforms.

• The HL7 Interface options support the following features using HL7 messaging protocol: export of vital-signs data from the Acuity Central Monitoring System to hospital CIS/HIS systems, and import of ADT data from hospital clinical information systems/hospital information systems (CIS/HIS) to the Acuity System.

• The WACS Barcode Scanner option allows clinicians to enter patient IDs and room numbers into the Acuity System using barcode scanners on some mobile devices running Clinician Notifier software.

• The Third Party Data Stream Interface option supports sending patient alarms and equipment alerts in XML format to third party interfaces.

WACS is to be used by authorized health care professionals using standard institutional procedures and good clinical practice guidelines for patient monitoring. Staff training in the operation of WACS is essential for optimal use. Users should be skilled at the level of clinicians, clinical administrators and hospital administrators, with the knowledge and experience to acquire and interpret patients’ vital signs. Each of these roles is assigned and associated with specific privileges and scopes. Access privileges are controlled through passwords.

Individuals using WACS should be familiar with its operation as described in this manual, and they should understand all warnings and cautions in the manual.

2 Introduction Welch Allyn Connectivity Server

Conventions

The CE Mark and Notified Body Registration Number signify that the product meets all essential requirements of European Medical Device Directive 93/42/EEC.

WARNING Indicates conditions or practices that could lead to illness, injury, or death.

Warning and note

WARNING HL7 configuration must be performed only by qualified personnel who are familiar with the HL7 Standard and with local implementation of the WACS HL7 Interface. Improper configuration of the HL7 Interface can cause unexpected and unintended cessation of patient vital-signs data transfer.

Note

In compliance with the U.S. Department of Health and Human Services Health Insurance Portability and Accountability Act (HIPAA), do not transfer or save patient data or information using any unsecured or public computer.

Programmer’s Guide Introduction 3

System overview

Welcome!

The Acuity Central Monitoring System is a real-time patient monitoring system that collects and displays vital-sign information for multiple patients over the Welch Allyn FlexNet™ network.

Welch Allyn patient monitors

Acuity Central Station

Welch Allyn Connectivity Server (WACS)

AcuityLink option Web Server option HL7 Interface option Third-Party Data Stream Interface option

Within the network:

Mobile devices running the Clinician Notifier program Facility computer used by administrators

This document contains specifications intended as a guide for software developers to develop the HL7 or XML interface between a facility-controlled clinical information system (CIS or HIS) and an Acuity System. It is assumed that users of this guide are familiar with applicable HL7 standards or XML standards, and that users have standards available for reference.

For information about further configuring the WACS HL7 settings for your facility, see the Welch Allyn Connectivity Server Directions for Use, which describes using the WACS HL7 Manager pages to configure the HL7 interface.

6 System overview Welch Allyn Connectivity Server

Data interface provided by the Welch Allyn Connectivity Server (WACS)

The WACS option to the Acuity Central Monitoring System is able to provide these data interface options:

• HL7 (Health Level 7) Interface option

• Third-Party Data Stream Interface option (XML format)

Either WACS data interface option can include one or both of these distinct modules.

• Inbound HL7 ADT Data module: Admit/discharge/transfer (ADT) data from your CIS or HIS to WACS. WACS uses the Acuity System network to send ADT information to the Acuity Central Monitoring System for storage.

• Outbound HL7 Vital-sign Observations module: Numeric patient vital-sign observations from WACS to your facility-controlled clinical or hospital information system (CIS or HIS).

Acuity Central Station

VPN

Internet

Hardwired Welch Allyn monitors

Terminal server

Switch Access point

Welch Allyn Connectivity Server (WACS)

Access point Mobile device

Facility backbone

Acuity network

Wireless Welch Allyn monitors

Wireless LAN

NTP server

CIS/HIS

Client browser

Facility network

Programmer’s Guide System overview 7

Data transfer and storage within the Acuity System network

The Acuity System stores patient data for variable amounts of time, depending upon Acuity System license configuration.

Data export from patient monitors to the Acuity System

Welch Allyn portable patient monitors store vital-sign data and send it to the Acuity System in the following ways:

Table 1. Patient monitor data storage and export to the Acuity System

Patient Monitor Means of data export to

Hardwired monitors:

Propaq

Encore,

Propaq CS

Hardwired Welch Allyn 1500 Patient Monitor

Wireless monitors: Propaq CS, Propaq LT and Micropaq

Acuity System

Unshielded twisted pair (UTP)

Ethernet Stream Data stored up to 24

802.11 wireless LAN Stream Propaqs: Data stored

Mode of data export to Acuity System during normal conditions

Stream Data stored up to

Patient monitor data storage during temporary disconnection or dropout

monitor storage capacity

hours

up to monitor storage capacity

Micropaq: No storage

Data export to Acuity System after temporary disconnection or dropout

Trends data only, sent in batch mode

Propaqs: Trends data only, sent in batch mode

Micropaq: data lost

8 System overview Welch Allyn Connectivity Server

Data storage at the Acuity System

The Acuity System stores data for a period determined by the Full Disclosure license configuration.

Storage during Acuity connection to WACS

Table 2. Acuity System data storage configurations and Acuity System data export to WACS

Acuity System data storage configuration WACS capability for data receipt

Zero hours Continuous

24 hours Query for most recent 24 hours

96 hours Query for most recent 96 hours

a. Data is available for a period up to the Acuity Full Disclosure capability, but unsolicited push interfaces

are usually configured to a shorter period to avoid swamping the CIS/HIS.

Storage after Acuity disconnects from WACS or patient monitor

Table 3. Examples of Acuity System data export after disconnection

WACS HL7 message configuration

Unsolicited observation (push) from WACS to CIS 15-minute intervals

2-hour disconnect period Behavior upon reconnection

Patient monitor disconnected from Acuity System

Acuity System disconnected from WACS server

Acuity System sends 8 sets of vitalsign observations, covering the last two hours

Programmer’s Guide System overview 9

Data exported from the Acuity System to WACS

The Acuity System exports the following vital-sign data:

Table 4. Numeric vital-sign data exported from Acuity Systems to WACS

Vital sign Units Default units Preferred HL7 tag

Heart rate BPM (1/min) BPM (1/min) Heart Rate

Temperature 1, 2 DegF (°F),

SpO

In mmHg, kPa, % mmHg CO2(In)

Ex mmHg, kPa, % mmHg CO2(Ex)

RESP Br/M (1/min) Br/M (1/min) RR/BR

NIBP (DIA / SYS / MEAN) mmHg mmHg NIBP

IBP - 1 (DIA / SYS / MEAN)

unlabeled arterial intracranial umbilical artery umbilical vein pulmonary artery central venous

IBP - 2 (DIA / SYS / MEAN)

unlabeled arterial intracranial umbilical artery umbilical vein pulmonary artery central venous

PVCRate PVC/Min (1/min) PVC/Min (1/min) PVC

DegC (°C)

Per cent (%) Per cent (%) SPO2

mmHg mmHg

DegC (°C) Temperature

(OBX-3)

IBP1 ART ICP UA UV PA CVP

IBP2 ART ICP UA UV PA CVP

10 System overview Welch Allyn Connectivity Server

HL7 standard protocols

This chapter describes basic HL7 data structure as outlined in the Health Level Seven Messaging Standard.

Information in this chapter is organized as follows:

Health Level Seven Standard........................................11

HL7 low-level protocol.............................................12

HL7 segment-level protocols........................................12

Health Level Seven Standard

The Welch Allyn HL7 Interface option closely follows the data structure outlined in the

Health Level Seven Version 2.4 Messaging Standard.

The following excerpt is taken from section 7.3 and section 7.4 of this standard: “Many report headers (OBR) may be sent beneath each patient segment, with many separate observation segments (OBX) beneath each OBR. Note segments (NTE) may be inserted after any of the above segments. The note segment applies to the entity that immediately precedes it, i.e., the patient if it follows the PID segment, the observation if it follows the OBR segment, and the individual result if it follows the OBX segment.”

One result segment (OBX) is transmitted for each vitals component (such as Heart rate or RR/BR).

For updated information regarding this standard, see www.hl7.org/.

12 HL7 standard protocols Welch Allyn Connectivity Server

HL7 low-level protocol

This section describes the low-level format of HL7 packet frames.

Packet frames

HL7 frames that are exchanged between the server and the client describe both sent and received data.

Table 5. HL7 packet frame: low-level format

Packet description Content Size (bytes)

Start block 0x0B ASCII <VT> 1

Body variable bytes variable

End block 0x1C ASCII <FS> 1

Carriage return 0x0D ASCII <CR> 1

HL7 segment-level protocols

This section describes HL7 message hierarchy and delimiters, segment notation and date/time format.

Message hierarchy and message delimiters

Group

Groups

Segment notation

Table 6. HL7 segment notation: mandatory, optional and repeating

Segments

|Fields|

&components&

^subcomponents^

Notation example Definition

PID This segment is mandatory.

[PID] This segment is optional.

{IN1} This segment is mandatory, and it can repeat.

[{NK1}] This segment is both optional and repeating.

Programmer’s Guide HL7 standard protocols 13

Time/date in HL7 segments

When importing vital-sign data into an electronic patient-charting application, use the timestamp associated with the OBR for the vital-signs record in the chart.

Format

Date and time in the HL7 segments are represented in this format: YYYYMMDDHHMMSS.mmm±TZTZ

• Displayed time is local.

• Hours are in the range 0-23.

• Seconds (SS) are followed by the following:

3-digit millisecond value (which appears as 000 if no other value is provided)

+ora-

4-digit time-zone code

Example of HL7 time/date format:

26 January 2009, at 0.193 seconds past 12:22:02 PM, Pacific time (8 hours behind GMT):

20090126122202.193-0800

14 HL7 standard protocols Welch Allyn Connectivity Server

WACS outbound HL7 protocols

The WACS Outbound HL7 Vital-sign Observations module uses JavaTMprocesses to read patient data files from an Acuity System and forward the messages to a CIS server.

This chapter describes WACS protocols used in the Outbound HL7 Observations module. The WACS protocols closely follow the data structure outlined in the Health Level Seven

Version 2.4 Messaging Standard.

Information in this chapter is organized as follows:

Overview: Outbound HL7 Vital-sign Observations module .................16

Labels and attributes of outbound segments ...........................17

Outbound patient identification fields .................................21

Outbound vital-sign tags and filters ...................................22

Reconfiguring WACS outbound observation settings .....................24

16 WACS outbound HL7 protocols Welch Allyn Connectivity Server

Overview: Outbound HL7 Vital-sign Observations module

Patient vital-sign observations are transferred to the CIS server in this manner:

Acuity System

network

SQL database

Patient data

WACS

10.250.100.201:5600

Initiate connection to

WACS IP + port

HL7 outbound message

Clinical information system

(CIS)

Outbound HL7 patient data messaging

1. WACS is configured to accept requests on a preconfigured TCP port (usually in the

5600-5700 range).

2. Once a connection is established between the WACS system and the CIS, and once

the optional handshake and optional authentication are complete, The HL7 session begins.

3. WACS sends observations to the CIS in one of these ways, depending on the

configured model:

• Push model: WACS sends information to the CIS at configurable intervals

• Pull model: WACS listens for incoming queries from the CIS

The system maintains an open connection for as long as possible. Connections can be re-established if fatal errors or program crashes occur on either end. The WACS master program uses exit codes and return values of the interface components to manage child processes.

Programmer’s Guide WACS outbound HL7 protocols 17

Labels and attributes of outbound segments

The following table defines requirement labels for outbound segments.

Table 7. Requirement labels for outbound segments

Label Requirement Description

R Required Causes an error condition if missing

O Optional May be used by WACS/CIS if present

C Conditionally Required May cause an error condition if missing; dependent on other factors or fields

N Not used Causes an error condition if present

I Ignored Not used, whether present or missing

F Future Not used, whether present or missing

HL7 attributes of OBR (observation request) segments

Table 8. HL7 attributes – OBR – observation request segment

SEQ LEN DT OPT RP# TBL# Item # Element name WACS

1 4 SI O 00237 Set ID - OBR R

2 22 EI C 00216 Placer Order Number C

3 22 EI C 00217 Filler Order Number N

4 250 CE R 00238 Universal Service Identifier R

5 2 ID X 00239 Priority - OBR N

6 26 TS X 00240 Requested Date/Time R

7 26 TS C 00241 Observation Date/Time N

8 26 TS O 00242 Observation End Date/Time N

9 20 CQ O 00243 Collection Volume N

10 250 XCN O Y 00244 Collector Identifier N

11 1 ID O 0065 00245 Specimen Action Code N

12 250 CE O 00246 Danger Code N

13 300 ST O 00247 Relevant Clinical Information N

14 26 TS C 00248 Specimen Received Date/Time N

15 300 CM O 0070 00249 Specimen Source N

16 250 XCN O Y 00226 Ordering Provider N

17 250 XTN O Y/2 00250 Order Callback Phone Number N

18 60 ST O 00251 Placer Field 1 N

19 60 ST O 00252 Placer Field 2 N

20 60 ST O 00253 Filler Field 1 N

21 60 ST O 00254 Filler FIeld 2 N

22 26 TS C 00255 Results Rpt/Status Chng -

Date/Time

23 40 CM O 00256 Charge to Practice N

24 10 ID O 0074 00257 Diagnostic Serv Sect ID N

requirement

18 WACS outbound HL7 protocols Welch Allyn Connectivity Server

Table 8. HL7 attributes – OBR – observation request segment (continued)

SEQ LEN DT OPT RP# TBL# Item # Element name WACS

25 1 ID C 0123 00258 Result Status N

26 400 CM O 00259 Parent Result N

27 200 TQ O Y 00221 Quantity/Timing N

28 250 XCN O Y/5 00260 Result Copies To N

29 200 CM O 00261 Parent N

30 20 ID O 0124 00262 Transportation Mode N

31 250 CE O Y 00263 Reason for Study N

32 200 CM O 00264 Principal Result Interpreter N

33 200 CM O Y 00265 Assistant Result Interpreter N

34 200 CM O Y 00266 Technician N

35 200 CM O Y 00267 Transcriptionist N

36 26 TS O 00268 Scheduled Date/Time N

37 4 NM O 01028 Number of Sample Containers N

38 250 CE O Y 01029 Transport Logistics of Collected

Sample

39 250 CE O Y 01030 Collector’s Comment N

40 250 CE O 01031 Transport Arrangement

Responsibility

41 30 ID O 0224 01032 Transport Arranged N

42 1 ID O 0225 01033 Escort Required N

43 250 CE O Y 01034 Planned Patient Transport

Comment

44 250 CE O 0088 00393 Procedure Code N

45 250 CE O Y 0340 01316 Procedure Code Modifier N

46 250 CE O Y 0411 01474 Placer Supplemental Service

Information

47 250 CE O Y 0411 01475 Filler Supplemental Service

Information

requirement

OBR segment example

OBR|1|||VITALS^Vital Signs^WAP|||20090127093400.000-0800

Programmer’s Guide WACS outbound HL7 protocols 19

HL7 attributes of PID (patient ID) segments

Table 9. HL7 attributes – PID – patient ID segment

SEQ LEN DT OPT RP# TBL# Item# Element name WACS

1 4 SI O 00104 Set ID - PID R

2 20 CX B 00105 Patient ID R

3 20 CX R Y 00106 Patient Identifier List R

4 20 CX B Y 00107 Alternate Patient ID - PID I

5 48 XPN R Y 00108 Patient Name O

6 48 XPN O Y 00109 Mother’s Maiden Name I

7 26 TS O 00110 Date/Time of Birth I

8 1 IS O 0001 00111 Sex I

9 48 XPN O Y 00112 Patient Alias I

10 80 CE O Y 0005 00113 Race I

11 106 XAD O Y 00114 Patient Address I

12 4 IS B 0289 00115 County Code I

13 40 XTN O Y 00116 Phone Number - Home I

14 40 XTN O Y 00117 Phone Number - Business I

15 60 CE O 0296 00118 Primary Language I

16 80 CE O 0002 00119 Marital Status I

17 80 CE O 0006 00120 Religion I

18 20 CX O 00121 Patient Account Number C

19 16 ST B 00122 SSN Number - Patient I

20 25 DLN O 00123 Driver's License Number -

Patient

21 20 CX O Y 00124 Mother's Identifier I

22 80 CE O Y 0189 00125 Ethnic Group I

23 60 ST O 00126 Birth Place I

24 1 ID O 0136 00127 Multiple Birth Indicator I

25 2 NM O 00128 Birth Order I

26 80 CE O Y 0171 00129 Citizenship I

27 60 CE O 0172 00130 Veterans Military Status I

28 80 CE O 0212 00739 Nationality I

29 26 TS O 00740 Patient Death Date and

Time

30 1 ID O 0136 00741 Patient Death Indicator I

requirement

PID segment examples

Edgar A Van Goe with Primary ID 9582173 and no Amended ID: PID|1|9582173|9582173||Van Goe^Edgar^A|||||||||||||9582173

Edgar A Van Goe with Primary ID 9582173 and Amended ID 867509: PID|1|867509|867509||Van Goe^Edgar^A|||||||||||||867509

20 WACS outbound HL7 protocols Welch Allyn Connectivity Server

HL7 attributes of OBX (observation/result) segments

Table 10. HL7 attributes – OBX – observation/result segment

SEQ LEN DT OPT RP/# TBL# ITEM# Element name WACS

1 4 SI O 00569 Set ID - OBX R

2 2 ID C 0125 00570 Value Type R

3 250 CE R 00571 Observation Identifier R

4 20 ST C 00572 Observation Sub-ID C

5 65536

6 250 CE O 00574 Units R

7 60 ST O 00575 References Range C

8 5 IS O Y/5 0078 00576 Abnormal Flags C

9 5 NM O 00577 Probability I

10 2 ID O Y 0080 00578 Nature of Abnormal Test N

11 1 ID R 0085 00579 Observation Result Status N

12 26 TS O 00580 Date Last Observation Normal

13 20 ST O 00581 User Defined Access Checks N

14 26 TS O 00582 Date/Time of the Observation R

15 250 CE O 00583 Producer's ID N

16 250 XCN O Y 00584 Responsible Observer N

17 250 CE O Y 00936 Observation Method N

18 22 EI O Y 01479 Equipment Instance Identifier N

19 26 TS O 01480 Date/Time of the Analysis N

*CY

00573 Observation Value R

Value

requirement

a. The length of the observation field is variable, depending upon value type. See OBX-2 value type. b. May repeat for multipart, single answer results with appropriate data types, e.g., CE, TX, and FT data types.

OBX segment example

OBX|1|ST|Heart Rate^Heart Rate^WAP||80|^BPM||||||||20090127093400.000-0800

Programmer’s Guide WACS outbound HL7 protocols 21

Outbound patient identification fields

Patient ID information is confirmed at the Acuity Central Station in the Patient ID Setup window. WACS forwards an outbound patient ID segment that includes at least one of these ID fields: PID-2, PID-3, and PID-18. By default, all of the fields are populated.

Export multiple ID fields from WACS, such as name and ID number. This enables detection of obvious identification errors. Since monitors can move easily from location to location, patient room number alone is an unreliable means of identifying patients.

WACS can export these patient ID fields:

• Patient ID number: A primary identification number, such as a medical record number,

account number or a patient’s personal ID number (such as a social security number). If this number is input incorrectly, it cannot be altered.

• Amended patient ID number: An alternate ID that can be associated with the patient.

This ID can be entered in the Acuity System Patient ID Setup window, in the Amended ID field.

• Patient last name

• Patient first name

• Patient middle initial

Note

• Patient location: A room number

The Acuity System accepts middle initial only (not middle name).

22 WACS outbound HL7 protocols Welch Allyn Connectivity Server

Outbound vital-sign tags and filters

WACS generates the vital-sign tags and filters described in this section.

By default, missing tags or tag errors cause the HL7 interface to reject the request or query. If part of a message or reply is valid, WACS ignores or rejects the erroneous portion and returns only the valid reply.

This setting is configurable in the WACS HL7 Manager pages (see the Welch Allyn Connectivity Server directions for use).

Vital-sign tags

Vital-sign tags include vital sign name tags, unit tags and optional status fields.

Table 11. WACS HL7 sublevel tags for vital signs (OBX-4)

Vital-sign sub-level HL7 OBX-4 tag

Temperature 1 (Temperature) 1

Temperature 2 (Temperature) 2

Systolic Blood Pressure (IBP-1, IBP-2, NIBP) SYS

Diastolic Blood Pressure (IBP-1, IBP-2, NIBP) DIA

Mean Blood Pressure (IBP-1, IBP-2, NIBP) MEAN

Table 12. WACS HL7 tags for units (OBX-6)

BPM (1 / min)

DegC (°C)

DegF (°F)

Percent (%)

mmHg

kPa

Br/M (1 / min)

PVC/Min (1 / min)

Table 13. Optional WACS HL7 status fields (OBX-8 abnormal flag segment)

OBX-8 abnormal flag segment

Patient monitor/Acuity System notation

Description

Valid value

< (---) Under range, below absolute low on the instrument scale

> (+++) Over range, above absolute high on the instrument scale

? Invalid For example, no valid SpO2 numeric is produced when the SpO2

sensor is removed from the patient’s finger.

Programmer’s Guide WACS outbound HL7 protocols 23

Vital-sign numerics filters

One of the following vital-sign numerics filters must be configured for the WACS server:

Table 14. WACS vital-sign filters

Filter Function

Median For an odd number of sample points, WACS sorts the data in descending order and returns the middle

Closest Returns the data closest to the given reference point.

(median) data point. For example, for the values 56, 72, 96, 82 and 78, the returned value is 78.

For an even number of sample points, WACS returns either the average (mean) or one of the two middle points. For example, for the values 56, 72, 70, 96, 82 and 78, the returned value is either the mean value (76) or one of the middle values (72 or 78).

Example: Heart rate values are calculated every minute over a period of five minutes. For example, heart rate values of 56, 72, 96, 82, and 78 are collected, and then the HL7 message is constructed at the five-minute reference point. The HL7 message is contains only the heart rate value of 78, which is the value closest to the reference point.

24 WACS outbound HL7 protocols Welch Allyn Connectivity Server

Reconfiguring WACS outbound observation settings

Welch Allyn preconfigured your Welch Allyn Connectivity Server (WACS) based on your facility’s specified requirements. Once your system is built and programmed, and once data is flowing from the WACS server to the CIS, you can adjust and customize WACS default settings.

Common outbound setting adjustments

Common HL7 setting adjustments are as follows:

• HL7 version

• Seconds of historical data retrieval

• Push intervals

• Push on event settings

• Number of resend attempts

• Observations per patient

• Patients per message

• Observation label formats

• OBX sub-IS specification

Programmer’s Guide WACS outbound HL7 protocols 25

Accessing the WACS program HL7 Manager pages

For detailed instructions on accessing and using the WACS HL7 Manager pages, see the Welch Allyn Connectivity Server (WACS) directions for use.

That document also provides message examples that show message formats before and after HL7 setting adjustments are made.

Only WACS users who have been designated with a WACS biomedical engineer role can access the WACS HL7 pages.

You can reconfigure settings by taking these steps:

1. Access the WACS program via certain internet browsers on any computer in your

facility’s intranet

2. Open the WACS HL7 Manager pages in the WACS program

26 WACS outbound HL7 protocols Welch Allyn Connectivity Server

WACS outbound HL7 messages

This chapter provides this information:

• Description of outbound WACS observation segments and acknowledgement segments and examples of observation messages and acknowledgement messages

• Descriptions of outbound WACS query segments and reply segments and examples of query messages and reply messages

Certain message formats can vary based on settings made in the WACS program HL7 Manager pages. To view examples of message format changes that occur after specific HL7 settings are adjusted, see the Welch Allyn Connectivity Server (WACS) directions for use.

The information in this chapter is organized as follows:

Unsolicited observation message ORU^R01/ACK^R01 ...................28

Query for results of observation message QRY^R02/ORF^R04 ............30

Query by parameter QBP^Q11/RSP^Z90 ..............................33

Query by ID .....................................................36

Query by location.................................................38

28 WACS outbound HL7 messages Welch Allyn Connectivity Server

Unsolicited observation message ORU^R01/ACK^R01

Segments

ORU^R01 message segments

Table 15. ORU^R01 unsolicited observation message

Segment Description WACS segment

MSH Message Header R

{

[

PID Patient Identification R

[PD1] Additional Demographics I

[{NK1}] Next of Kin/Associated Parties I

[{NTE}] Notes and Comments I

[

PV1 Patient Visit C

[PV2] Patient Visit - Additional Info I

]

{

[ORC] Order common I

OBR Observations Report ID R

{[NTE]} Notes and comments I

[CTD] Contact Data I

{

[OBX] Observation/Result R

{[NTE]} Notes and comments I

}

[{FT1}] Financial Transaction I

{[CTI]} Clinical Trial Identification I

}

[DSC] Continuation Pointer I

requirement

Programmer’s Guide WACS outbound HL7 messages 29

ACK^R01 acknowledgement segments

Each ORU message must be acknowledged with a corresponding ACK^R01 acknowledgment message.

If no acknowledgement is received, the ORU message is retransmitted at a configurable interval (default=30 seconds). The message is retransmitted until it has been sent a configurable number of times (default=5) or until an acknowledgement is received.

Table 16. ACK^R01 acknowledgment message—required

Segment Description

MSH Message header

MSH-9 ACK^R01

MSH-11 P

MSH-12 Version (2.3, 2.3.1, 2.4)

MSA Message acknowledgement

MSA-1 AA

MSA-2 Original message ID

ORU/ACK message and acknowledgement example

ORU^R01 message:

<Tue Jan 27 09:36:02 2009> HL7# HL7Log Initiator sending message: MSH|^~\&|WAP^WAP||||20090127093601.105-0800||ORU^R01|20090127093601106c5|P|2.4 PID|1|867509|867509||Van Goe^Edgar^A|||||||||||||867509 OBR|1|||VITALS^Vital Signs^WAP|||20090127093400.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80|^BPM||||||||20090127093400.000-0800 OBX|2|ST|Temperature^Temperature^WAP|1|98.6|^°F||||||||20090127093400.000-0800 OBX|3|ST|Temperature^Temperature^WAP|2|97.5|^°F||||||||20090127093400.000-0800 OBX|4|ST|SPO2^SPO2^WAP||97|^%||||||||20090127093400.000-0800 OBX|5|ST|CO2 (In)^CO2 (In)^WAP||0.0|^%||||||||20090127093400.000-0800 OBX|6|ST|CO2 (Ex)^CO2 (Ex)^WAP||5.0|^%||||||||20090127093400.000-0800 OBX|7|ST|RR/BR^RR/BR^WAP||12|^Br/M||||||||20090127093400.000-0800 OBX|8|ST|PVC^PVC^WAP||0.0|^PVC/Min||||||||20090127093400.000-0800

ACK^RO1 acknowledgement:

<Tue Jan 27 09:36:02 2009> HL7# HL7Log Initiator received message: MSH|^~\&|||WAP^WAP||20090127093601.105-0800||ACK^R01|20090127093601106c5|P|2.4 MSA|AA|20090127093601106c5

30 WACS outbound HL7 messages Welch Allyn Connectivity Server

Query for results of observation message QRY^R02/ORF^R04

This query-response model supports “Solicited Poll” and “User Initiated Query”.

Segments

QRY^R02 query segments

Table 17. QRY^R02 query for results of observation message

Segment Description WACS segment

requirement

MSH message header R

QRD query definition R

QRF query filter C implementation-dependent

Segment QRD: Query definition

QRD-1: Ignored QRD-2: Required (must be “R”) QRD-3: Required (must be “I”) QRD-4: Ignored QRD-5: Ignored QRD-6: Ignored QRD-7: Ignored QRD-8: Conditionally required (Patient IDs) QRD-9: Required (must be “RES”) QRD-10: Ignored QRD-11: Ignored QRD-12: Ignored

Segment QRF: Query filter

QRF-1: Conditionally required (Unit Name) QRF-2: Ignored QRF-3: Ignored QRF-4: Required (Data Requested) QRF-5: Conditionally required (Room and Bed) QRF-6: Ignored QRF-7: Ignored QRF-8: Ignored QRF-9: Required (Start/End Time and Interval)

Note

Programmer’s Guide WACS outbound HL7 messages 31

ORF^R04 reply segments

Table 18. ORF^R04 observational report (reply)

Segment Description WACS segment

MSH Message Header R

MSA Message Acknowledgment R

QRD Query Definition R

[QRF] Query Format C

{

[

PID Patient ID R

PV1 Patient location (enabled only for patient-based site)

[{NTE}] Notes and Comments I

]

{

OBR Observation request R

{[NTE]} Notes and comments I

{

[OBX] Observation/Result R

{[NTE]} Notes and comments I

}

{[CTI]} Clinical Trial Identification I

}

[ERR] Error C

[QAK] Query Acknowledgement C

[DSC] Continuation Pointer I

requirement

32 WACS outbound HL7 messages Welch Allyn Connectivity Server

QRY/ORF query and reply example

Get the heart rate and respiration rate of Patient ID GA003560 from 2003/06/24 11:50:00 to 2003/06/24 11:50:02 interval of 1 sec.

QRY^R02 query:

MSH|^~\&|Van Goe^Edgar^A||||20030624121618.151-0800||QRY^R02|200306241216181517|P|2.4 QRD|20030624121618.191-0800|R|I|Q1056482178191||||GA003560|RES QRF||||Heart Rate~RR/BR|||||^&1^^20030624115000-0800^20030624115002-0800

ORF^R04 reply:

MSH|^~\&|WAP^WAP||||20030624121744.994-0800||ORF^R04|20030624121744995a|P|2.4 QRD|20030624121744.615-0800|R|I|Q1056482264615||||GA003560|RES QRF||||Heart Rate~RR/BR|||||^&1^^20030624115000-0800^20030624115002-0800 PID|1|GA003560|GA003560 OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-0800

Programmer’s Guide WACS outbound HL7 messages 33

Query by parameter QBP^Q11/RSP^Z90

Segments

QBP^Q11 query segments and their HL7 attributes

Table 19. QBP^Q11—query by parameter message

Segment Description WACS segment

MSH Message Header R

QPD Query Parameter Definition Segment R

[...] Optional Query by Example Segments I

RCP Response Control Parameters I

[DSC] Continuation Pointer I

Segment QPD: Query parameter definition

QPD-1: Ignored QPD-2: Ignored QPD-3: Conditionally required (Patient IDs) QPD-4: Conditionally required (Patient Location) QPD-5: Required (Start/End Time and Interval) QPD-6: Required (Data Requested)

Table 20. HL7 attributes—QPD (query parameter definition)

SEQ LEN DT OPT RP TBL# Item# Element name

1 250 CE R 0471 01375 Message Query Name

2 32 ST C 00696 Query Tag

3 CX C Y Patient IDs

4 PL C Y Patient Location

5 TQ R N Timing Quantity

6 ST R Y Parameter

requirement

34 WACS outbound HL7 messages Welch Allyn Connectivity Server

RSP^Z90 reply segments

Table 21. RSP^Z90 - segment pattern response

Segment Description Group control Comment

MSH Message Header

MSA Message Acknowledge

[ERR] Error

QAK Query Acknowledge

QPD Query Parameter Definition

RCP Response Control Parameter

{ Query Result Cluster

[ PIDG Begin PID Group

PID Patient Identification

[PDI] Additional Demographics

[{NK1}] Next of Kin/Associated Parties

[{NTE}] Notes and Comments (for PID)

[PV1 Patient Visit

[PV2]] Patient Visit - Additional Info

] End PID Group

{ ORCG Begin ORC Group

ORC Common Order Each ORC/OB combination

OBR Observation Report ID

[{NTE}] Notes and comments (for ORC/OBR)

[CTD] Contact Data

{ OBXG Begins OBX Group

[OBX] Observation/Result

[{NTE}] Notes and Comments (for OBX)

} End OBX Group

} End ORC Group

} End Query Results

DSC Continuation Pointer

constitutes a hit.

Programmer’s Guide WACS outbound HL7 messages 35

QBP/RSP query and reply example

Get Heart Rate and RR/BR of Patient ID GA003560 from 2003/06/24 11:50:00 to 2003/06/ 24 11:50:02 interval of 1 sec.

QBP^Q11 query:

MSH|^~\&|VanGoe^Edgar^A||||20030624121816.101-0800||QBP^Q11|20030624121816101b|P|2.4 QPD|||GA003560||^&1^^20030624115000-0800^20030624115002-0800|Heart Rate~RR/BR RCP

RSP^Z90 reply:

MSH|^~\&|WAP^WAP||||20030624121817.248-0800||RSP^Z90|20030624121817250c|P|2.4 QPD|||GA003560||^&1^^20030624115000-0800^20030624115002-0800|Heart Rate~RR/BR PID|1|GA003560|GA003560 OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-0800

36 WACS outbound HL7 messages Welch Allyn Connectivity Server

Query by ID

This section covers these two formats for Query by ID:

• QRY/ORF

• QBP/RSP

QRY/ORF format

QRY^R02 query segments

Segment QRD: Query definition

QRD-2: R QRD-3: I QRD-8: List of Patient’s IDs QRD-9: RES

Segment QRF: Query filter

QRF-4: List of Data Requested QRF-9: Start/End Time and Interval

QRY/ORF query and reply example

Get the heart rate and respiration rate of Patient ID GA003560 from 2003/06/24 11:50:00 to 2003/06/24 11:50:02 interval of 1 sec.

QRY query:

ORF reply:

MSH|^~\&|WAP^WAP||||20030624121744.994-0800||ORF^R04|20030624121744995a|P|2.4 QRD|20030624121618.191-0800|R|I|Q1056482178191||||GA003560|RES QRF||||Heart Rate~RR/BR|||||^&1^^20030624115000-0800^20030624115002-0800 PID|1|GA003560|GA003560 OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-0800

Programmer’s Guide WACS outbound HL7 messages 37

QBP/RSP format

QBP^Q11 query segments

Segment QPD: Query parameter definition

QPD-3: List of Patient’s ID QPD-5: Required (Start/End Time and Interval) QPD-6: List of Data Requested

QBP/RSP query and reply example

QBP query:

MSH|^~\&|VanGoe^Edgar^A||||20030624121816.101-0800||QBP^Q11|20030624121816101b|P|2.4 QPD|||GA003560||^&1^^20030624115000-0800^20030624115002-0800|HR~RR RCP

RSP reply:

MSH|^~\&|WAP^WAP||||20030624121817.248-0800||RSP^Z90|20030624121817250c|P|2.4 QPD|||GA003560||^&1^^20030624115000-0800^20030624115002-0800|HR~RR PID|1|GA003560|GA003560 OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-0800

38 WACS outbound HL7 messages Welch Allyn Connectivity Server

Query by location

This section covers these two formats for Query by location:

• QRY/ORF

• QBP/RSP

QRY/QRF format

QRY^R02 query segments

Segment QRD: Query definition

QRD-2: R QRD-3: I QRD-9: Res

Segment QRF: Query filter

QRF-1: List of Patient’s Unit - point of care QRF-4: List of Data Requested QRF-5: List of Patient’s Room - Room + Bed QRF-9: Required (Start/End Time and Interval)

QRY/ORF query and reply example

Get the heart rate and respiration rate of Patient in Unit MEDICAL Room 1310A from 20030624115000 to 20030624115002 interval of 1 sec.

QRY query:

MSH|^~\&|Van Goe^Edgar^A||||20030624120505.544-0800||QRY^R02|20030624120505544e|P|2.4 QRD|20030624120505.544-0800|R|I|Q1056481505544|||||RES QRF|MEDICAL|||HeartRate~RR/BR|1310A||||^&1^^20030624115000-0800^20030624115002-0800

ORF reply:

MSH|^~\&|WAP^WAP||||20030624121744.994-0800||ORF^R04|20030624121744995a|P|2.4 QRD|20030624120505.544-0800|R|I|Q1056481505544|||||RES QRF|MEDICAL|||HeartRate~RR/BR|1310A||||^&1^^20030624115000-0800^20030624115002-0800 PID|1|GA003560|GA003560 OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-0800

Programmer’s Guide WACS outbound HL7 messages 39

QBP/RSP format

QBP^Q11 segment definition

Segment QPD: Query parameter definition

QPD-4: List of Patient’s Location QPD-5: Start/End Time and Interval QPD-6: List of Data Requested

QBP^RSP query and reply example

Get the heart rate and respiration rate of Patient in Unit MEDICAL Room 1310A from 20030624115000 to 20030624115002 interval of 1 sec.

QBP query:

MSH|^~\&|VanGoe^Edgar^A||||20030624121816.101-0800||QBP^Q11|20030624121816101b|P|2.4 QPD||||MEDICAL^1310A|^&1^^20030624115000-0800^20030624115002-0800|HeartRate~RR/BR RCP

RSP reply:

MSH|^~\&|WAP^WAP||||20030624121817.248-0800||RSP^Z90|20030624121817250c|P|2.4 QPD||||1310A|^&1^^20030624115000-0800^20030624115002-0800|Heart Rate~RR/BR PID|1|GA003560|GA003560 PV1|1|MEDICAL^1310A OBR|1|||VITALS^Vital Signs^WAP|||20030624115001.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115000.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115000.000-0800 OBR|2|||VITALS^Vital Signs^WAP|||20030624115002.000-0800 OBX|1|ST|Heart Rate^Heart Rate^WAP||80.0|^BPM||||||||20030624115001.000-0800 OBX|2|ST|RR/BR^RR/BR^WAP||20.0|^Br/M||||||||20030624115001.000-080

40 WACS outbound HL7 messages Welch Allyn Connectivity Server

Inbound ADT HL7 messages

If your facility includes the WACS Inbound HLT ADT Data module, patient information fields in Acuity System patient identification windows can autopopulate with admit/ discharge/transfer (ADT) data from your CIS.

The information in this chapter is organized as follows:

Overview: Inbound HL7 ADT Data module .............................42

How an Acuity System uses ADT information ..........................43

ADT messages accepted and stored by WACS .........................46

Examples of ADT messages ........................................52

Reconfiguration of ADT services .....................................54

42 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Overview: Inbound HL7 ADT Data module

ADT information is transferred to the WACS server in this sequence:

Patient identification process

1. At Acuity System, open Patient ID Setup window.

2. Insert patient ID number.

3. Press Enter on keyboard.

Acuity queries Patient Name server and

then the WACS SQL database for demographics including patient name and patient location.

4. Respond to patient confirmation prompt.

Remaining patient fields autopopulate.

Database schema

Patient ID number (16 characters) Patient name (50 characters) Patient location (15 characters)

Acuity System

network

SQL database

WACS

10.30.1.41, port 5601

Initiate connection to

CIS IP + port

A01, A03, A04, A05, A08, A11, A13 messages

Clinical information system

(CIS)

Inbound HL7 ADT messaging

1. WACS initiates a connection to a facility’s CIS on a preconfigured TCP port (usually in the range of 5600-5700).

2. Once a session is established, WACS listens for and accepts particular ADT message types from the CIS.

3. WACS updates and stores the data on a local SQL database.

Programmer’s Guide Inbound ADT HL7 messages 43

How an Acuity System uses ADT information

When a facility’s CIS sends a patient’s ADT information to WACS, the Acuity System uses the ADT information to autopopulate identification fields in the patient’s Acuity System patient ID setup windows.

Where a patient ID number is entered

An Acuity System user enters a patient ID number in one of these two places to confirm a new patient into the Acuity System:

• At the Acuity Central Station, in the Patient ID Setup window

• For systems that include the WACS option with the AcuityLink option, at a mobile device running the AcuityLink Clinician Notifier program, in the Setup Patient ID screen.

44 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Sequence of events when ID number is entered

This is the sequence of events that occurs within Acuity Systems that include the WACS option with the Inbound HL7 ADT module.

1. In a patient ID setup window, the user enters the patient ID number or an amended patient ID number and presses the Return or Enter key.

2. The Acuity System queries the Acuity System patient name server deamon (PNSD) for the ID number(s) and patient information associated with the number(s).

If a match is not found, the Acuity System queries the WACS database (SQL) for the ID number(s) and patient information associated with the number(s).

3. At the Acuity Central Station in the Patient ID Setup window, the Acuity System responds in one of these ways:

• If no associated information was found, the curser moves to the next field in the

window.

• If associated information was found, this confirmation message appears within

two seconds.

4. The user responds in one of these ways:

• If the user clicks Accept, the remaining fields of the window autopopulate, and

existing information in the fields is replaced.

The autopopulate action cannot be undone.

• If the user clicks Go Back, the user can manually type the correct information into

the blank text fields.

5. The user clicks Confirm.

The patient information is distributed and confirmed.

Programmer’s Guide Inbound ADT HL7 messages 45

Rules regarding Acuity System patient IDs

These rules apply within the Acuity System:

• A patient ID number, an amended ID number or both may be entered.

• Letter case is ignored when ID numbers are compared to the PSND and WACS databases.

• An autopopulate search can match a currently monitored Acuity System patient or a patient discharged from the Acuity System for a period of 24-96 hours (depending upon the system’s Full Disclosure configuration).

• After autopopulated information is confirmed, it can be modified. ID numbers can be revised with an amended ID number, and amended ID numbers can be amended.

For more information about entering and revising patient information in the Acuity System, see the Acuity and Mobile Acuity LT Central Monitoring Systems directions for use.

46 Inbound ADT HL7 messages Welch Allyn Connectivity Server

ADT messages accepted and stored by WACS

WACS accepts the message types and formats described in this section.

Accepted message types

WACS receives and stores these types of messages. Welch Allyn suggests that you consider configuring your CIS/HIS ADT server to block messages other than these.

• ADT/ACT - Admit/visit notification (event A01)

• ADT/ACK - Discharge/end visit (event A03)

• ADT/ACK - Register a patient (event A04)

• ADT/ACK - Pre-admit a patient (event A05)

• ADT/ACK - Update patient information event (event A08).

• ADT/ACK - Cancel admit/visit notification (event A11)

• ADT/ACK - Cancel discharge/end visit (event A13

)

Note

The Acuity System accepts middle initial only (not middle name) in messages.

Accepted message formats

WACS accepts standard HL7 2.3-2.4 delimiters and data types, as defined in this section, taken from the Health Level Seven Implementation Support Guide for HL7 Standard Version 2.3.

Delimiters

The interface parses incoming messages for delimiters, and the delimiters might differ in each message.

This section enables you to select and document which delimiters will be used in your interface, and to identify related issues early (for example, conflicts with ASCII characters that have special meaning in EBCDIC).

Table 22. Delimiters

Segment terminator <CR> <CR> <CR>

Field separator | (hex 0D)

Component separator ^

Sub-component separator &

Repetition Separator ~

Escape Character \

HL7 System A System B

Programmer’s Guide Inbound ADT HL7 messages 47

Data types

The HL7 Standard allows for different data formats for each of the following data types. This section documents general attributes of each data format.

Table 23. Data type descriptions

Data type Definition Data format attributes and notes

Alphanumeric

ST String

TX Text data

FT Formatted text

Numerical

CQ Composite quantity with units <quantity (NM)> ^ <units (CE)>

MO Money <quantity (NM)> ^

NM Numeric

SI Sequence ID

SN Structured numeric <comparator> ^ <num1 (NM)>

Identifier

IS Coded values for

HL7 tables

IS Coded value for user-defined tables

HD Hierarchic designator <namespace ID (IS)> ^

EI Entity identifier <entity identifier (ST)> ^

RP Reference pointer <pointer (ST)>^<application

PL Person location <point of care (IS)> ^ <room

PT Processing type <processing ID (ID)> ^

Date/Time

DT Date YYYY[MM[DD]]

TM Time HH[MM[SS[.S[S[S[S]]]]]][+/-ZZZZ]

TS Time stamp YYYY[MM[DD[HHMM[SS[.S[S[

^ <separator/suffix> ^ <num2 (NM)>

<universal ID (ST)> ^ <universal ID type (ID)> Used only as part of EI and other data types.

ID (HD)> ^ <type of data (ID)> ^ <subtype (ID)>

(IS)> ^ <bed (IS)> ^ <facility (HD)> ^ < location status (IS )> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>

S[S]]]]]]]][+/-ZZZZ] ^ <degree of precision>

48 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Table 23. Data type descriptions

Data type Definition Data format attributes and notes

Code values

CE Coded element <identifier (ST)> ^ <text (ST)> ^

CF Coded element with formatted values <identifier (ID)> ^ <formatted

CK Composite ID with check digit <ID number (NM)> ^ <check

CN Composite ID number and name <ID number (ST)> ^ <family

CX Extended composite ID with check

digit

XCN Extended composite ID number and

name

Generic

CM Composite No new CM’s are allowed after HL7

text (FT)> ^ <name of coding system (ST)> ^ <alternate identifier (ID)> ^ <alternate formatted text (FT)> ^ <name of alternate coding system (ST)>

digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)>

<ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD) )> ^ <identifier type code (IS)> ^ < assigning facility (HD)

In Version 2.3, use instead of the CN data type. <ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)>

Version 2.2. Hence there are no new CM’s in Version 2.3.

Programmer’s Guide Inbound ADT HL7 messages 49

Table 23. Data type descriptions

Data type Definition Data format attributes and notes

Demographics

AD Address <street address (ST)> ^ < other

PN Person name <family name (ST)> ^ <given

TN Telephone number [NN] [(999)]999-

XAD Extended address In Version 2.3, replaces the AD

XPN Extended person name In Version 2.3, replaces the PN

XON Extended composite name and ID

number for organizations

XTN Extended telecommunications

number

designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ <address type (ID)> ^ <other geographic designation (ST)>

name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)>

9999[X99999][B99999][C any text]

data type. <street address (ST)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)>

data type. <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <name type code (ID) >

In Version 2.3, replaces the TN data type. [NNN] [(999)]9999999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

50 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Table 23. Data type descriptions

Data type Definition Data format attributes and notes

Specialty

Waveform

CD Channel definition <channel identifier (*)> ^

MA Multiplexed array <sample 1 from channel 1

NA Numeric array <value1 (NM)> ^ <value2

ED Encapsulated data Supports ASCII MIMEencoding

Price data

CP Composite price In Version 2.3, replaces the

Patient administration/Financial information

FC Financial class <financial class (ID)> ^

Extended queries

QSC Query selection criteria <name of field (ST)> ^

QIP Query input parameter list <field name (ST) > ^ <value1

RCD Row column definition <HL7 item number (ST)> ^

(NM)> ^ <sample 1 from channel 2 (NM)> ^ <sample 1 from channel 3 (NM)> ...~<sample 2 from channel 1 (NM)> ^ <sample 2 from channel 2 (NM)> ^ <sample 2 from channel 3 (NM)> ...~

(NM)> ^ <value3 (NM)> ^ <value4 (NM)> ^ ...

of binary data. <source application (HD) > ^ <main type of data (ID)> ^ <data subtype (ID)> ^ <encoding (ID)> ^ <data (ST)>

MO data type. <price (MO)> ^ <price type (ID)> ^ <from value (NM)> ^ <to value (NM)> ^ <range units (CE)> ^ <range type (ID)>

(ST) & value2 (ST) & value3 (ST) ...>

Programmer’s Guide Inbound ADT HL7 messages 51

Table 23. Data type descriptions

Data type Definition Data format attributes and notes

Master files

DLN Driver’s license number <license number (ST)> ^

JCC Job code/class <job code (IS)> ^ <job class

VH Visiting hours <start day range (ID)> ^ <end

Medical records/Information management

PPN Performing person time stamp <ID number (ST)> ^ <family

Time series

DR Date/time range <range start date/time (TS)> ^

RI Repeat interval <repeat pattern (IS)> ^ <explicit

SCV Scheduling class value pair <parameter class (IS)> ^

TQ Timing/Quantity <quantity (CQ)> ^ <interval (*)>

<issuing state, province, country (IS)> ^ <expiration date (DT)

(IS)>

day range (ID)> ^ <start hour range (TM)> ^ <end hour range (TM)>

name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code(ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ < date/time action performed (TS)>

time interval (ST)>

^ <duration (*)> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ID)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ID)> ^ <order sequencing (*)>

52 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Examples of ADT messages

WACS returns acknowledgements for accepted messages and error messages for nonaccepted messages.

Acceptable ADT/ACK message and acknowledgement

The following is an example of an A03 message and acknowledgement in HL7 version 2.3 formats.

ADT^A03 message:

<Wed Jan 14 19:34:20 2009> HL7Log Responder got message: MSH|^~\&|REG|RMH||RMH|20090114193305.00000600||ADT^A03|2271605|P|2.3EVN|03|20090114

193305.0000-0600|||AKM1^UNREAL^STEWART

PID||2006275669|2006275669||SAMPLE^MELISSA^T||19600915193300.00000600|F||||||||||2006276 69 PV1||E|ER|1|||5002^EXAMPLE^KEVIN^P|||ER||||7|||5002^EXAMPLE^KEVIN^P|ER|1064398|WC||||||||| N|||||||01|||||D|||20090114182049.0000-0600|20090114185400.0000-0600

ACK acknowledgement:

<Wed Jan 14 19:34:20 2009> HL7Log Responder sending message: MSH|^~\&|WAP^WAP||||20090114193420.3160600||ACK^A03|20090114193420316e9|P|2.3 MSA|AA|2271605

Programmer’s Guide Inbound ADT HL7 messages 53

Unacceptable ADT messages and WACS error messages

WACS returns error messages to the CIS/HIS ADT server in response to these messages:

• Message types other than A01, A03, A04, A05, A08, A011 or A13, and your system has not been programmed to block messages other than these.

• HL7 messages containing noncompliant format. In these cases, WACS rejects the entire content of the message.

WACS error message: non-accepted message type

WACS error message:

MSH|^~\&|||||20090203130308.435-0500||ACK|16249|P|2.4 MSA|AR|613958749|No appropriate destination could be found to which this message could be routed. ERR|^^^207&Application Internal Error&HL70357

ADT/ACK error message: noncompliant format

Note

The Acuity System accepts middle initial only (not middle name) in messages.

In this example, the telephone number (highlighted below in bold text) is a noncompliant format.

ADT^A01 message:

MSH|^~\&|AccMgr|1|||20090130160820||ADT^A03|6139110482|P|2.3.1EVN|A03|20090130160819 PID|1|841940^^^AccMgr^PN|500138979^^^AccMgr^MR^1||SAMPLE^PATIENT^L||19920722|F|T EST TEST|W|2001 SAMPLE RD^^SAMPLE^NY^132110000^^M|31|8005551212||E|S|NO|6943809^^^AccMgr^VN^1|099809 553|||2|USA||||NOT A VETERAN|||N PV1|1|O|2E^237^02^1|3||2E^237^02|1370^TEST^TEST^^^^^^AccMgr^^^^CI|1370^ TEST ^ TEST ^^^^^^AccMgr^^^^CI||TWM||||1|||1370^ WESTPFAL^EDITH^^^^^^AccMgr^^^^CI|67|6943809^^^AccMgr^VN^1|200^TEST||||||||||||||||1|1|| 1||P|||20081008111700|20081009180000|3083.9|3083.9||||0 PV2||SOB^NO||||||20081008111700

WACS error message:

MSH|^~\&|||||20090130160831.875-0500||ACK|5804|P|2.4 MSA|AE|6139110482|The phone number component must be supplied and should be in the following format [999-9999]. ERR|^^^207&Application Internal Error&HL70357

54 Inbound ADT HL7 messages Welch Allyn Connectivity Server

Reconfiguration of ADT services

If your WACS system receives inbound ADT messages from your CIS, and you need to reconfigure certain ADT service settings, such as the CIS server IP address or the CIS server port number, please contact Welch Allyn Technical Services (see “Contact

information” on page 57).

A Technical Service representative can help you access ADT settings in the WACS program’s HL7 - General Settings page (shown below), which is beneath the WACS HL7 Manager tab. ADT settings in this page are only visible to Welch Allyn personnel.

You can access the WACS program via certain internet browsers on any computer in your facility’s intranet. For instructions on accessing the WACS HL7 Manager pages, see the Welch Allyn Connectivity Server (WACS) Directions for Use.

Note

If Welch Allyn personnel assist you in accessing certain ADT settings, do not change ADT settings beyond those with which you are assisted. Changing other ADT settings can render the WACS system inoperable.

A. CIS server IP address used for inbound ADT messages to WACS

B. CIS server port used for inbound ADT messages to WACS

C. WACS enabled listening for CIS ADT data

XML interface

The optional Third-Party Data Stream Interface option provides a means of moving patient identification and patient numeric data between the Acuity Central Station and a facility’s information system.

To receive XML messages from WACS, a CIS/HIS opens a TCP/IP socket and listens. When the Welch Allyn Connectivity Server detects an event, it connects to the socket and sends a message.

The interface provides the following parameters:

Table 24. XML interface parameters

Parameter Content Note

Command Set

Reset

SourceID [Patient ID or

Amended ID]

Sensitivity Lethal

High Parameter

ApplicationID Welch Allyn

When the alarm starts. When the alarm ends.

Acuity uses this as the unique patient identifier across the Acuity network.

Text [free-format text] Alarm type. A valid alarm string (e.g., Heart Rate 250).

MessageID Event ID For WACS internal use only.

Timestamp [time of the alarm]

GuestName [Full name of the patient]

GuestPhysicalLocation [Assigned location of the patient] Unit and room number.

Parameter [Model name and serial number of

DestinationList [Target recipient ID] Present only if:

the alarming monitor]

- Clinician Notifier option is licensed

- Event Delivery Mode = Escalation

- At least one Primary Respondent assigned

56 XML interface Welch Allyn Connectivity Server

For example:

<?xml version="1.0" encoding="UTF-8"?> <Emergin Version="7.0">

<Command>Set</Command> <SourceID>MRN-0001</SourceID> <Sensitivity>Lethal</Sensitivity> <ApplicationID name="WelchAllyn"/> <Text>Asystole</Text> <MessageID>EVENT-001</MessageID>

<GuestName>Jon L. Doe</GuestName> <GuestPhysicalLocation>Zone1 101A</GuestPhysicalLocation> <Parameters>Propaq 202, DA005491</Parameters> <DestinationList>

<DestinationID>Nurse1</DestinationID>

</DestinationList>

</Emergin>

<?xml version="1.0" encoding="UTF-8"?> <Emergin Version="7.0">

<Command>Reset</Command> <ApplicationID name="WelchAllyn"/> <MessageID>EVENT-001</MessageID> <DestinationList>

<DestinationID>Nurse1</DestinationID>

</DestinationList>

</Emergin>

Contacts and specifications

Contact information

If you encounter a problem that cannot be corrected by ordinary operating procedures described in this manual, please contact Welch Allyn Technical Services:

Phone (within the U.S.A.): 1-800-289-2501

Phone (worldwide): +1 503-530-7500, ask for Technical Service

Fax: +1 503-526-4970

email: solutions@welchallyn.com

Internet: http://www.welchallyn.com/support/default.htm

Specifications

General WACS

Table 25. WACS 2.6x compatibility

Acuity System Component Software version compatible with WACS 2.6x

Acuity Central Monitoring System

WACS Web Server option Operating systems/browser combinations supported by WACS

WACS AcuityLink Clinician Notifier option 1.4x and later

Table 26. WACS Hardware

Rackmount server

Video card: none

Display: none

Ethernet interfaces (IP addresses): multiple; one connected to the Acuity System network, one to the facility network

Wireless LAN: none, no wireless card

Electromagnetic compliance: Refer to the Acuity and Mobile Acuity LT Central Monitoring Systems Directions for Use

8.2x

Windows XP (SP 1.2)/Microsoft Internet Explorer 6.x and 7.x, Firefox 2, Firefox 3

58 Contacts and specifications Welch Allyn Connectivity Server

WACS HL7 Interface option

Outbound messaging

Table 27. Configuration variables under HL7 tab

HL7 Manager page Default setting Alternate settings

Numeric data filter Median (can be mean for

Numeric data filter for NIBP Closest (most recent) Median (can be mean for

HL7 - General Settings page

HL7 versions supported 2.4 2.31, 2.3

Allow observations for multiple patients in one HL7 message Off On

Number of seconds to be retrieved when a new patient is connected

Allow multiple observations for a patient in one HL7 message Off On

Number of times the server will try to send an HL7 message to client before disconnecting

Message delay (seconds) (for push) 420 Field entry allowed

HL7 - Push on Event Settings page

Each vital sign listed in page Off On

HL7 - Observation Identifiers page

Vital-sign labels As listed in page Field entry allowed

even number of samples)

7200 Field entry allowed

5 Field entry allowed

Closest (most recent)

even number of samples)

Table 28. Non-supported features

Simultaneous clients: WACS sends data to only one CIS

HL7 batch processing: WACS only sends data at a regular interval or in response to a query

Wildcards: WACS does not accept wildcards

Index

ADT

acceptable messages from 52 data types accepted from 47 erroneous messages 52 HL7 messages 41 how Acuity System uses information 43 message formats accepted from 46 WACS messaging rules 44

CIS ADT messages 41 configuring HL7 interface 5

Data

interface 6 transfer and storage in Acuity System 7

types accepted 47 Delimiters, accepted HL7 46 documents, related 3

entry sequence 44

where entered in system 43 Inbound HL7 ADT Data module 41 Interface, data 6

Message

ADT error, sent by WACS 52

ORU/ACK example 29

QBP^RSP example 39

QBP/RSP example 35, 37

QRY/ORF example 32, 36, 38

time/date example 13

types and formats received by WACS 46

Outbound HL7 Vital-sign Observations module 15 Overview, system 5

Patient ID

entry sequence 44

where entered in system 43

Error messages sent by WACS 52

Formats, accepted HL7 message 46

Health Level Seven Standard 11 Help 57 HL7

configuration by qualified personnel 2 interface, configuring 5

segment-level protocol, HL7 12 server 5 specifications 57

Technical Service, Welch Allyn 57 Troubleshooting 57

Vital-sign Observation module, Outbound HL7 15

60 Index Welch Allyn Connectivity Server

WACS

Help 57

troubleshooting 57 warning 2 Welch Allyn, Technical Service 57

XML interface 55

Welch Allyn Connectivity Server User Manual

Specifications and Main Features

Frequently Asked Questions

User Manual

Programmer’s guide

Introduction

Intended use

Conventions

Warning and note

Related documents

System overview

Welcome!

Data interface provided by the Welch Allyn Connectivity Server (WACS)

Data transfer and storage within the Acuity System network

HL7 standard protocols

Health Level Seven Standard

HL7 low-level protocol

HL7 segment-level protocols

WACS outbound HL7 protocols

Overview: Outbound HL7 Vital-sign Observations module

Labels and attributes of outbound segments

Outbound patient identification fields

Outbound vital-sign tags and filters

Reconfiguring WACS outbound observation settings

WACS outbound HL7 messages

Unsolicited observation message ORU^R01/ACK^R01

Query for results of observation message QRY^R02/ORF^R04

Query by parameter QBP^Q11/RSP^Z90

Query by ID

Query by location

Inbound ADT HL7 messages

Overview: Inbound HL7 ADT Data module

How an Acuity System uses ADT information

ADT messages accepted and stored by WACS

Examples of ADT messages

Reconfiguration of ADT services

XML interface

Contacts and specifications

Contact information

Specifications

Index