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Proposal for Improving the Consistency of Chapter 4 (Order Entry) Prof. Dr. Joachim Dudeck Institut fuer Medizinische In

Proposal for Improving the Consistency of Chapter 4 (Order Entry) Prof. Dr. Joachim Dudeck Institut fuer Medizinische Informatik Justus-Liebig-Universitaet Gießen E-Mail: jwd@uni-giessen.de. Improving the Consistency of HL7. 1. Problem - Missing Definitions

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Proposal for Improving the Consistency of Chapter 4 (Order Entry) Prof. Dr. Joachim Dudeck Institut fuer Medizinische In

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  1. Proposal for Improving the Consistency of Chapter 4 (Order Entry) • Prof. Dr. Joachim Dudeck • Institut fuer Medizinische Informatik • Justus-Liebig-Universitaet Gießen • E-Mail: jwd@uni-giessen.de CH4 Modifications San Diego

  2. Improving the Consistency of HL7 • 1. Problem - Missing Definitions • 2. Proposals for Consistent Definitions 3. ORM / ORR - General Order Message 4. Specific Order Entry Messages 5. Diet Orders 6. Supply Orders 7. Pharmacy / Treatment Orders 8. Other Messages CH4 Modifications San Diego

  3. 1. Problem - Missing Definitions A Communications Standard should be easy implementable But in HL7 the most important message control parameters • Message Types • Trigger Events • Action Control Codes • are not consistently used in different parts of the standard due to a lack of clear and unequivocal definitions CH4 Modifications San Diego

  4. 2. Proposals for Consistent Definitions • Message Type • The Message Type defines the structure of the message • One Message Type should be allocated to one specific sequence of mandatory and / or optional segments. • If the cardinality, the sequence or the optionality of segments is changed - a new message type had to be introduced CH4 Modifications San Diego

  5. 2. Proposals for Consistent Definitions • Trigger Event • defines the event, the change occurred in the environment which initiates the transmission of the message (i.e. admission or discharge of a patient, delivering of a new order) • defines on a message levelthe action(s) to be carried out in the target system after having received the message CH4 Modifications San Diego

  6. Message Structure Identifier • introduced in version 2.3.1 to identify unambiguously the message structure • the inconsistencies in the message type definitions could be overcome without changing the standard to seriously CH4 Modifications San Diego

  7. 2. Proposals for Consistent Definitions • Action Code / Message Control Code • define the action to be carried out in the receiving system on a data / segment level • have to be used if this action can not be defined on the message level, i.e. if a message consists of repeatable segments which can initiate different actions (add, update, delete) • required in particular in repeatable segments CH4 Modifications San Diego

  8. 3. ORM/ORR - General Order Message • ORM / ORR Messages • Several Order Detail Segments can occur in these messages like OBR, RQD, RQ1, RXO, ODS and ODT • Messages can also be transmitted without any Order Detail Segments • The currently used Event Types O01 and O02 do not transmit any additional information • The structure of a ORM /ORR message can therefore not be recognized neither from the message type nor from the event code CH4 Modifications San Diego

  9. 3. ORM/ORR - General Order Message • Proposal for restructuring ORM / ORR Messages • ORM / ORR messages should be used • with the OBR segment only • applying the following Trigger Events • ONW New Order • OMM Order Modification (including cancel) • OCM Order Control Message • with the “Message Structure Identifier” ORM_O01 and ORR_O02 CH4 Modifications San Diego

  10. 3. ORM/ORR - General Order Message CH4 Modifications San Diego

  11. 3. ORM/ORR - General Order Message CH4 Modifications San Diego

  12. 3. ORM/ORR - General Order Message CH4 Modifications San Diego

  13. 4. Specific Order Entry Messages • Further Order Entry Message Types OMD/ORD Diet Order (Segments ODS / ODT) OMS/ORS Supply Orders (Segment RQD) OMN/ORN Nonstock Supply Orders (Segments RQD, RQ1) RDO/RRO Pharmacy / Treatment Order Message (Segment RXO) RDE/RRE already defined CH4 Modifications San Diego

  14. 5. Diet Orders CH4 Modifications San Diego

  15. 5. Diet Orders CH4 Modifications San Diego

  16. 5. Diet Orders CH4 Modifications San Diego

  17. Further Order Entry Message Types OMD/ORD Diet Order (Segments ODS / ODT) OMS/ORS Supply Orders (Segment RQD) OMN/ORN Nonstock Supply Orders (Segments RQD, RQ1) RDO/RRO Pharmacy / Treatment Order Message (Segment RXO) RDE/RRE already correctly defined CH4 Modifications San Diego

  18. 6. Supply Orders CH4 Modifications San Diego

  19. 6. Supply Orders CH4 Modifications San Diego

  20. 6. Supply Orders CH4 Modifications San Diego

  21. 6. Supply Orders • Supply Messages • the “RQ1” Segment - “Nonstock requisition details”is an optional Segment • It is therefore not necessary to distinguish between “stock” and “non-stock” supply messages • One Supply Order Message would be sufficient (OMS / ORS) CH4 Modifications San Diego

  22. Further Order Entry Message Types OMD/ORD Diet Order (Segments ODS / ODT) OMS/ORS Supply Orders (Segment RQD) OMN/ORN Nonstock Supply Orders (Segments RQD, RQ1) RDO/RRO Pharmacy / Treatment Order Message (Segment RXO) RDE/RRE already defined CH4 Modifications San Diego

  23. 7. Pharmacy / Treatment Orders CH4 Modifications San Diego

  24. 8. Other Messages • Vaccine Administration Data • Message Types Trigger Events • VXQ Query Vacc.Rec V01 • VXX Response mult. V02 • VXR Response single V03 • VXU Unsolic. Update V04 • Message Type and Trigger Event carry the same information CH4 Modifications San Diego

  25. 8. Other Messages • Clinical Trials and Product Experiences • Message Type and Event Type definitions are already used according to the new definitions CH4 Modifications San Diego

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