Introduction - Wellbeing Software · Web viewPurpose This document intends to define the transport protocols, message mappings and definitions for integration of CRIS with another

RIS_PD160

© Healthcare Software Solutions 2017 All Rights Reserved Information Classification: Unclassified PublicEffective Date – SJV 10/03/2017HSS Doc ref: document.docx Page 1 of 40

Contents:1 Introduction........................................................................................................................................4

1.1 Purpose............................................................................................................................................................................ 4

1.2 Audience.......................................................................................................................................................................... 4

2 Implementation Model.......................................................................................................................52.1 Overview.......................................................................................................................................................................... 5

2.2 Application Data Flow....................................................................................................................................................... 5

2.3 HL7 version...................................................................................................................................................................... 5

3 Message and Activity mapping.........................................................................................................63.1 Register a patient............................................................................................................................................................. 6

3.2 Update a patients Demographic details...........................................................................................................................6

3.3 Merge two patients........................................................................................................................................................... 6

3.4 Create an appointment..................................................................................................................................................... 6

3.5 Patient Attends................................................................................................................................................................. 6

3.6 Appointment/Examination Cancelled...............................................................................................................................6

3.7 Appointment/Examination Changed.................................................................................................................................6

3.8 Examination performed.................................................................................................................................................... 6

3.9 Report entered................................................................................................................................................................. 6

3.10 Report verified.............................................................................................................................................................. 7

3.11 Report amended........................................................................................................................................................... 7

3.12 Pre Admit a Patient...................................................................................................................................................... 7

4 Message Transport............................................................................................................................84.1 Connections..................................................................................................................................................................... 8

4.2 Transport level Acknowledgements.................................................................................................................................8

4.3 Framing Characters.......................................................................................................................................................... 8

5 Error handling.....................................................................................................................................96 Data Mappings..................................................................................................................................10

6.1 Patient Identifiers............................................................................................................................................................ 10

6.2 Time Stamp values......................................................................................................................................................... 11

6.3 Messages....................................................................................................................................................................... 11

6.4 ADTÂ04 Patient registration.........................................................................................................................................11

6.5 ADTÂ08 Patient demographic update..........................................................................................................................11

6.6 ADTÂ05 Pre Admit, SIU^S12 Scheduling....................................................................................................................11

6.7 ADTÂ40 Patient Merge.................................................................................................................................................11

6.8 OMGÔ19 Order Message............................................................................................................................................11

6.9 ORU^R01 Clinical Report...............................................................................................................................................12

6.10 Order control and status summary.............................................................................................................................14

7 MSH...................................................................................................................................................158 EVN....................................................................................................................................................16


9 PID.....................................................................................................................................................1710 MRG................................................................................................................................................1911 PD1..................................................................................................................................................2012 PV1..................................................................................................................................................2113 AL1..................................................................................................................................................2214 SCH.................................................................................................................................................2315 ORC.................................................................................................................................................2416 OBR.................................................................................................................................................2617 OBX.................................................................................................................................................28

17.1 Scanned Documents.................................................................................................................................................. 29

17.2 IEP Remote Sending.................................................................................................................................................. 30

18 NTE..................................................................................................................................................3119 ZDS..................................................................................................................................................3220 Sample Messages..........................................................................................................................3321 Configuration Questionnaire........................................................................................................3522 Quick Reference............................................................................................................................37

22.1 Patient........................................................................................................................................................................ 37

22.2 Referral....................................................................................................................................................................... 37

22.3 Performing.................................................................................................................................................................. 37

22.4 Reporting.................................................................................................................................................................... 37

22.5 Pre fetching................................................................................................................................................................ 37


1 Introduction

1.1 PurposeThis document intends to define the transport protocols, message mappings and definitions for integration of CRIS with another system via HL7.

This version of the specification applies to CRIS interface release 2.09.t1b onwards.

1.2 AudienceThis document is intended for system integrators, third party suppliers and potential customers. The reader is assumed to be familiar with the HL7 standard.


2 Implementation Model

2.1 Overview

CRIS sends HL7 messages in response to significant activity occurring on the CRIS database. Events such as patient registrations, updates, examination bookings, status changes and results may all generate messages which a connected system may use to maintain its patient’s database, manage work lists and store results. To reduce network traffic unnecessary messages may be suppressed, for instance a results feed system may only require the verified result messages, whereas a PACS or another RIS would likely require all messages.

This document does not describe messaging activity for use with an Order communications system.

2.2 Application Data FlowMessages flow from CRIS to the remote system as a result of user activity on CRIS. All messages are transmitted over TCP/IP using HL7 MLLP.

2.3 HL7 versionAll messages referenced in this document conform to the 2.4 version of the HL7 standard. Message transport is HL7 MLLP over TCP/IP.


3 Message and Activity mapping

3.1 Register a patientWhen a patient is registered on CRIS an ADTÂ04 message is sent to the connected system.

3.2 Update a patients Demographic detailsWhen a patients demographic details are changed on CRIS an ADTÂ08 message is sent to the connected system.

3.3 Merge two patientsWhen two patient records are found to refer to the same patient the two records are merged and an ADTÂ40 message is sent to the connected system.

3.4 Create an appointmentWhen a user on CRIS makes an appointment CRIS will send an OMGÔ19 message with order control set to “NW” and a status value of “SC” (scheduled)

3.5 Patient AttendsWhen a patient attends for their examination they will be booked in to the CRIS reception module, at this point CRIS will send an OMGÔ19 message. For attendances that had an appointment booked order control will be set to “SC” (status changed), otherwise order control will be “NW” (new). Order status will be “IP” (in process).

3.6 Appointment/Examination CancelledA user on CRIS may decide to cancel an appointment or an examination. At which point CRIS will send and OMGÔ19 message with order control set to “CA” and a status of “CA”

3.7 Appointment/Examination ChangedThe radiology department may decide to change the type of procedure being performed. At this point CRIS will send an OMGÔ19 message with order control set to “XO” with the revised details.

If the connected system is unable to accept changes to orders working practice will need to be changed, and the previous exam cancelled and a new one entered.

3.8 Examination performedWhen the procedure has been performed the radiographer enters the screening and projection data on CRIS. At this point CRIS will send an OMGÔ19 message with order control set to “SC” and a status of “CM” (complete).

3.9 Report enteredWhen the clinical report is entered on CRIS an ORU^R01 message containing the preliminary report is sent with a result status of “P” (preliminary).


3.10 Report verifiedOnce the Radiologist is satisfied with the clinical report it will be verified. At this point CRIS will send an ORU^R01 containing the report with a result status of “F” (final)

3.11 Report amendedIf for some reason the radiologist later needs to change a previously verified report and addendum will be added. If CRIS is configured to send unverified results then an ORU_R01 containing the report with a result status of “C” (changed) will be transmitted. When the report is subsequently re verified an ORU_R01 will be sent, again with a result status of “C”.

3.12 Pre Admit a PatientWhen a pre admit message is received from PAS CRIS can be configured to send either an ADTÂ05 message or an SIU^S12 message. CRIS may also be configured to buffer these messages until a specified number of days prior to the patient attendance date.


4 Message Transport All Messages are transmitted over TCP/IP using MLLP.

4.1 ConnectionsOne socket connection is used for messages originating from CRIS. The port numbers to be used will be decided by mutual agreement. CRIS will initiate the connection (acting as client).

4.2 Transport level AcknowledgementsEach message will be acknowledged by the receiving system prior to delivery of the next message. Messages that are NAK’d will by logged by CRIS and should also be logged by the receiving system.

4.3 Framing CharactersStandard HL7 MLLP framing characters will be used, these are

<0B> start of message<1C> end of message

In addition MLLP requires that each message be followed by the segment delimiter which is carriage return <0D>


5 Error handling

CRIS logs errors that are encountered when generating and processing messages as well as any error messages in the MSA segments received in response to outbound messages. It is expected that the connected system will also maintain its own logs.


6 Data Mappings 6.1 Patient IdentifiersAll known patient identifiers will be passed in PID:3. Components 1, 4 & 5 are populated, component 2 is optional and is for the NHS number only, and other components are left blank. The primary key to be used is determined at configuration time. The order of identifiers sent is configurable so that the remote systems preferred primary key can be sent first if necessary.

Sequence Name Usage1 ID Number Patient Identifier2 Check Digit Optional, for NHS number use only. If required then you

must request that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set FALSE, if set TRUE then we put this value in PID:32. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)

4 Assigning Authority NameSpace ID contains:“NHS” for nhs number“CHI” for chi number“CRIS” for CRIS numberOtherwise the code identifying a hospital for hospital numbers.

5 Identifier Type Code “NH” for nhs number/ chi number“MR” for hospital numbers“PI” for CRIS number

Note that on CRIS the only patient identifier that is guaranteed to be present at all times is the CRIS number. If another identifier (such as a hospital number for a particular hospital) is selected to be used as primary key CRIS will send a dummy value for that identifier if it is not present, when the required identifier is subsequently provided CRIS will send a merge message with the dummy value as the source patient id.

As an example, suppose that hospital numbers for hospital RNZ04 have been selected as primary key, a patient attendance is entered on CRIS but no hospital number yet exists, however an NHS number and CRIS number are both available. In this case the PID:3 segment will be populated as so:

3289329^^^CRIS^PI~8772332778^^^NHS^NH~CRIS3289329^^^RNZ04^MR

As you can see the hospital number for RNZ04 was not available so CRIS generated a temporary dummy hospital number by inserting the string “CRIS” at the beginning of the CRIS number.

Sometime later a hospital number of A786345 is allocated to the patient, CRIS will then generate a merge (ADTÂ40) message with PID:3 populated as:

3289329^^^CRIS^PI~8772332778^^^NHS^NH~A786345^^^RNZ04^MR

and a merge segment as follows:MRG|CRIS3289329^^^RNZ04^MR© Healthcare Software Solutions 2017 All Rights Reserved Information Classification: Unclassified PublicEffective Date – SJV 10/03/2017HSS Doc ref: document.docx Page 10 of 40

6.2 Time Stamp valuesCRIS will always populate time stamps with as much data as is available, in some cases this will include year, month, day , hours, minutes, seconds, milliseconds and time zone offset, in other cases hours, minutes seconds milliseconds and time zone may not be available. The connected system should follow the standard HL7 guidelines for processing of time stamps.

6.3 Messages CRIS sends seven messages, ADTÂ04, ADTÂ08, ADTÂ05 or SIU^S12, ADTÂ40, OMGÔ19 and ORU^R01.

6.4 ADTÂ04 Patient registrationThis message is sent when a patient is first registered on CRIS.

6.5 ADTÂ08 Patient demographic updateThis message is sent when a patients demographic details are changed on CRIS.

6.6 ADTÂ05 Pre Admit, SIU^S12 SchedulingIf CRIS receives ADTÂ05 or SIU^S12/S13 messages from PAS these messages are in turn passed through this outbound interface either as ADTÂ05 or as SIU^S12 messages.

6.7 ADTÂ40 Patient MergeMerge messages in sent either when two patients’ details are merged on CRIS, or when the connected systems preferred primary key changes for a patient.

6.8 OMGÔ19 Order MessageThe order message is used to pass status information, new examinations booked on CRIS and cancellations. The meaning of an order message is specified in ORC:1 - Order Control.

Code Message TypeNW New order bookedCA Cancellation of an existing orderXO Change order requestSC Status Changed


6.9 ORU^R01 Clinical ReportThe ORU^R01 message is used to transmit clinical reports to OCMS. ORC:1 will always contain “SC” for status change with a status value , ORC:5, of “CM” for complete.

On CRIS multiple examinations/orders may be performed in the same attendance, the clinical report entry screen allows the user to create a clinical report comprised of multiple sections, one section for the attendance summary plus one section for each examination.

For Example, two examinations are ordered, a Left Foot and a Right Arm. The radiology department decides to perform the two examinations on the one attendance the following three section report is entered.

SummaryThis person can neither walk nor write.

Left FootLeft foot appears to be missing

Right ArmThe right arm is mostly complete; however the patient is missing four fingers and a thumb.

CRIS has several configuration options available that affect the generation of clinical report messages and OBX segments, these are configured by HSS and should be chosen according to the capabilities and requirements of the receiving system.

Setting DescriptionUnique By Event Normally, a report message is generated for each exam, with this setting enabled one

report message is generated for the event, so PACS would in the above example receive 1 message instead of two.

Send Report For All Exams

This setting is normally enabled and causes CRIS to send the entire report text for the attendance in each message, so for the above example each message would contain

This person can neither walk nor write.

Left foot appears to be missing

The right arm is mostly complete, however the patient is missing four fingers and a thumb.

If this setting is disabled the message for the Left Foot exam would contain



And the message for the right arm would contain




Note that summary text is sent in each report message regardless.

This setting should not disabled if Unique By Event is enabled as report content would be missed.

Send Examination Names In Report

Normally only the text entered by the user is sent in OBX:5, with this setting enabled the above example would generate a message with the following contents

[Summary Report]This person can neither walk nor write.

[Left Foot]Left foot appears to be missing

[Right Arm]The right arm is mostly complete, however the patient is missing four fingers and a thumb.

Individual Exams In Observation ID

This setting affects the population of the OBX:3 segment, by default OBX:3 is populated with the examination code of the exam that generated the report message, so will contain the same value as OBR:4.

With this setting enabled each OBX:3 will contain the examination code of the exam relating to the report text contained in OBX:5, so in the example above, the following OBX segments would be generated (note that only OBX:3 and OBX:5 are shown for clarity and examination codes are examples only)

OBX|||SUMMARY^Report Summary||This person can neither walk nor writeOBX|||SUMMARY^Report Summary||OBX|||FOOL^Left Foot||Left foot appears to be missingOBX|||FOOL^Left Foot||OBX|||ARMR^Right Arm||The right arm is mostly complete, however the patient is missing four fingers and a thumb.OBX|||ARMR^Right Arm||

ReportMargin Specifies a right margin for the report text. By default there is no margin and each OBX:5 will contain text up to the next carriage return. If PACS is unable to wrap long lines a suitable manner for display purposes a suitable value should be chosen for ReportMargin. With margin set to 60 the report text would be as followsThis person can neither walk nor write.



Note that an additional line break is inserted between the words “is” and “missing”.


Send Unverified Reports

Normally CRIS will only transmit report messages for verified reports. This setting allows unverified reports to also be sent.


6.10 Order control and status summaryThe following table lists the order control and status value combinations that will be produced by CRIS.

Message Type Order Control

Status Meaning

OMGÔ19 NW SC New appointment bookedIP New attendance - patient in dept

SC SC Status change, appointment bookedIP Status change, patient in deptCM Status change, examination performed

CA CA Order cancelledXO SC Order changed, appointment booked

IP Order changed, patient in deptORU^R01 SC CM Clinical report


7 MSHMSH appears on all messages

Position Name Notes1 Field Separator Always Populated with “|”2 Encoding Characters Always Populated with “^~\&”3 Sending Application Defaults to “CRIS” may be configured to send any fixed value.4 Sending Facility Defaults to “LIVE” may be configured to send any fixed value.5 Receiving Application Default is empty, may be configured to send any fixed value.6 Receiving Facility Default is empty, may be configured to send any fixed value.7 Date Time of Message Populated with the date and time that the message was generated,

century, year, month, day, hour, minute, second, millisecond and time zone offset are all present.

9 Message Type The type of the message. CRIS sends the messagesOMGÔ19ORGÔ20ORU^R01

10 Message Control ID Populated with a unique id for the message11 Processing ID Set to “P”12 Version ID Set to “2.4”


8 EVNEVN appears on ADT messages

Position Name Notes1 Event Type Code Contains the event type code (ADT)2 Recorded Date & Time Contains the date the that the event occurred on CRIS5 Operator ID The ID of the user on CRIS that performed the event that resulted in

the transmission of this message


9 PIDPID appears on all messages

Position Name Notes3 Patient ID Internal Will contain a list of the patient identifiers known by CRIS, refer to the

notes on patient identifiers.3.1 ID3.2 Check Digit Optional, for NHS number use only. If required then you must request

that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set FALSE, if set TRUE then we put this value in PID:32. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)

3.4 Assigning Authority3.5 Identifier Type Code5 Patient Name <Family Name> is populated with surname from CRIS.

Forenames on CRIS is split at the first space character, the substring prior to the space is placed in <Given Name>, the substring after the space is placed in <Middle Initial Or Name>, patients title is placed in <prefix>

7 Date Time Of Birth Patients date of birth, only century, year, month and day are populated

8 Patient Sex This field may require translation, values on CRIS areF FemaleM MaleI IndeterminateU Unknown

10 Race Patient’s race. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE

11 Address CRIS has four lines of address.The first line is placed in <street address>The second line is placed in <other designation>The third line is placed in <city>The Fourth line is placed in <province>The two components of post code are combined and placed in <zip or postal code>

12 County code County code. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE


13 Phone number home Patients home telephone number, email address and mobile number.Home Telephone number is the first sub field,Email address is the 4th subfieldMobile telephone number is placed in the next repeating instanceEg|0115874245^^^[email protected]~07785342542|

14 Phone number business Patients work telephone number

15 Primary Language Primary language. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE

16 Marital Status Marital Status. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE

17 Religion Religion. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE

18 Patient Account Number Patient Account Number. Only populated if SendAdditionalPatientInfo is TRUE. By default this is FALSE

22 Ethnic Group This field may require translation26 Citizenship Citizenship. Only populated if SendAdditionalPatientInfo is TRUE. By

default this is FALSE29 Patient Death Date and

TimeFor Deceased patients this will contain the date of death, century, year, month and day are present. Otherwise this field will contain null (“”)

30 Patient Death Indicator For deceased patients this field will contain “Y” otherwise it will be “N”32 Identity Reliability Code Optional, for NHS number use only. If required then you must request

that SendNHSVerStatus is set TRUE, NHSVerStatusInIDReliabilityCode is set TRUE, if set FALSE then we put this value in PID:3.2. If you only want verified NHS numbers (01) then you must request SendVerifiedNHSNumOnly is set to TRUE (default is FALSE)


10 MRGThe MRG segment is present for merge (ADTÂ40) messages

Position Name Usage

1 Prior Patient ID Internal The primary key for the source patient of the merge. Refer to the notes on patient identifiers above.


11 PD1The PD1 segment is present for ADT and OMG messages when a patient has a registered GP stored on CRIS

Position Name Notes3 Patient Primary Facility Patients registered General Practice

<id number> is populated with the national GP practice codePlease note that <id number> is the third sub field

4 Patient Primary Care Provider name & ID no

Patients registered General Practitioner<id number> is populated with the national GP code


12 PV1The PV1 segment is present for ADTÂ05 messages, SIU^S12 messages and OMGÔ19/ORMÔ01* messages with order control “NW” (new orders booked on CRIS).

* Message type sent depends upon which PACS provider the message is being sent to.

Position Name Usage3 Assigned patient location The ward/clinic code the patient is to be admitted to. This field

is populated on ADTÂ05 messages.

9 Consulting Doctor The Consultant the patient is to be admitted under. This field is populated on ADTÂ05 messages.

18 Patient Type Patient Type (Inpatient, Outpatient etc). This field is populated on OMGÔ19 / ORMÔ01 messages dependent upon the PACS being communicated to.

19 Visit Number Episode identifier from OCMS. This is populated with the value taken from the first received order on the attendance. This field is populated on OMGÔ19 / ORMÔ01 messages dependent upon the PACS being communicated to.

44 Admit Date/Time The date (and possibly time) that the patient is to be admitted. This field is populated on ADTÂ05 messages.


13 AL1

This segment may appear on ADTÂ08 messages but by default it does not. If required you must request SendAlarms=TRUE and GENERAL.UpdateMessageOnAlarmChange=YES

Example segments;AL1|1|R|^SNEEZES^^^PAS ALARM||ALLERGY1AL1|2|R|^CONTRAST ALLERGY^^^Mild Reaction||CONALL

Position Name Max Width

Usage

1 Set ID 4 Incremental counter (1,2,3,…etc)

2 Allergy Type 2 Alarm types (W=Warning, R=Reaction, I=Info, S=Special Case)

3.2 Description 250 } Allergy description

3.5 250 } Allergy Description5 Allergy Code 15 Allergy reaction code


14 SCHThe SCH segment is only present for SIU^S12 messages.

Position Name Usage

5 Schedule ID Identifier contains “EP”, Text contains “EXAMPULL”.

11 Appointment Timing Quantity Start Date/Time contains the date that the patient is expected to attend.


15 ORCThis is present on all messages

Position Name Notes1 Order Control Populated according to order control and status summary table

above.2 Placer Order Number Contains the placer order number received from and Order

communications system. If no order communications system is in use or this event was not received electronically this field will be blank.

3 Filler Order Number Contains with the CRIS allocated examination key.5 Order status Populated according to order control and status summary table

above.7 Quantity/Timing <start date/time> will, for orders that have status “SC”, contain

the date and time that the examination is booked for, for orders with a status of “IP” and clinical results it will contain the date and time that the examination was done.

<priority> will contain the priority of the order, this component may need translation.

Optional, if you require all 2099 type dates to be removed then you must specify that BlankWaitingDate is set to TRUE (default is FALSE). This will remove the date from ORC:7, OBR:27, OBR:34.2 and OBR:34.3

9 Date Time of transaction Date and time of the user action on CRIS that resulted in this message.

10 Entered By <id number> is populated with the ID of the user on CRIS that entered this order/status/result.

12 Ordering Provider <id number> is populated with the code identifying the referrer on CRIS

13 Enterers location <point of care> is populated with the code identifying the ward/location on CRIS

16 Order control code reason This is only populated for ORGÔ20 messages of type UA and UC.<identifier> is populated as follows.

For messages of type “UC”

NF – Unable to find orderOS – order already scheduledOI – order already in processIE – Internal error

For messages of type “UA”

OE – Order already existsUS – Unknown universal service codeUL – Unknown enterers location


UR – Unknown referrerIE – Internal Error

17 Entering Organization <identifier> will contain the specialty of the ordering clinician.18 Entering Device The workstation on CRIS where the order/status/result was

entered.21 Ordering facility name <id number> will contain the code identifying the hospital / gp

practice etc that the request was made from.


16 OBRThis is present on all messages

Position Name Notes2 Placer Order Number Contains the placer order number received in the original new

order message. In unsolicited result messages this field will be blank.This field contains the same value as ORC:2

3 Filler Order Number Contains the CRIS allocated examination key.This field contains the same value as ORC:3

4 Universal Service ID <identifier> contains the examination procedure code from CRIS. <text> contains the examination procedure name from CRIS.

11 Specimen Action Code Optional, Request Category is only populated if SendRequestCat is set to TRUE

20 Filler Field 1 CRIS generated event key. PACS may use this field to identify which orders have been performed as a single attendance.

21 Filler Field 2 CRIS generated Accession number. This field is used by PACS systems to identify the examination.

22 Result rpt status changeDate/time

Populated on report messages onlyThis will contain the date and time that the report was typed, verified or changed (depending on result status)

24 Diagnostic Serv Sect ID Contains the modality of the procedure being performed27 Quantity/Timing <start date/time> will, for orders that have status “SC”, contain

the date and time that the examination is booked for, for orders with a status of “IP” and clinical results it will contain the date and time that the examination was done.

<priority> will contain the priority of the order, this component may need translation.This field contains the same value as ORC:7


28 Result copies to Details of the “Copy To” referrer in the event details31 Reason For Study Optional, <text> only populated if SendReasonForExam is set

TRUE.

If the new attribute SendReasonForExam is set to TRUE then OBR:31.2 will be populated with the Reason for exam. This field will be split into multiple repetitions whenever the text exceeds length 300, or whenever a line break appears in the text.

32 Principal ResultInterpreter

For order messages, if a radiologist has been assigned <id number> of <name> contains the id of the intended radiologist and <family name> of <name> contains the name of the intended radiologist.


For report messages <id number> of <name> contains the id of the first radiologist and <family name> of name contains the name of the first radiologist. <start date/time> contains the date & time the report was created.

33 Assistant ResultInterpreter

Populated on report messages only<id number> of <name> contains the id of the second radiologist. <family name> of <name> contains the name of the second radiologist

34 Technician Note : Both <id number> and <family name> of <name> are populated on status change status “CM” messages only

<id number> of <name> contains the id of the radiographer that performed the procedure<family name> of <name> contains the name of the radiographer that performed the procedure<start date/time> contains the date and time the procedure was performed.<end date/time> contains the date and time that the procedure was completed.<room> contains the examination room that the exam is to be /was performed in.<Facility> contains the hospital that the exam is to be/was performed in.<Building> contains the dept that the exam is to be /was performed in.


35 Transcriptionist Populated on report messages only<id number> of <name> contains the id of the person that typed the report, <family name> of <name> contains the name of the person that typed the report. <start date/time> contains the date & time the report was typed.


17 OBXOBX segments are present on clinical report messages. There will be one OBX segment for each line of report.

Position Name Notes1 Set ID Sequence, first OBX in a message will be 1, followed by 2 etc.

2 Value Type Set to “TX”3 Observation Identifier <identifier> contains the examination code for the order

5 Observation Value Contains one line of the textual report.8 Urgency Populated if the “SendUrgentFlag” is set TRUE, default is FALSE.

Produces an additional OBX line in the message containing one of ‘R’, ‘C’, ‘U’ or ‘S’, meaning Routine, Critical, Urgent or Significant finding.

An example OBX is as follows:

OBX|5|TX|URGENT^^CRIS3|||||U

11 Observation ResultStatus

Only populated on reportsIndicates the status of the report on CRISP Preliminary reportF Final ReportC Changed report

This value will be per section (so clinical history, exam 1, exam 2 and so on). So in the scenario of a multi-exam report where one exam is verified and another has an addendum then the verified exam will present “F” in OBX.11 and the exam with an addendum will present “C” in OBX.11

Please refer to example ORU^R01 message in the “Sample Messages” section

14 Date & Time OfThe Observation

Only populated on reportsThis will contain the last date and time that the report was typed, verified or changed (depending on result status)

16 Responsible Observer Either the last reporting radiologist or (in the case of a verified report) the radiologist that verified the report. <id number> contains the identifier of the radiologist, <family name> contains the name of the radiologist.


17.1 Scanned Documents

If scanned documents are to be sent by the query interface they will be included as OBX segments as follows:

Value Type EDObservation Identifier <identifier> contains the code for the document type – eg REFERAL or REQCARD

<text> contains a description of the document type

REFERAL=Referral LetterREQCARD=Request card

All other document types will have a <text> of “Scanned Document”Observation Value ED type

<Type of Data> = “IM”<Data Sub Type> = “JPEG”<Encoding> = “Base64”<Data> Contains the jpeg image data encoded as base64. CRIS does not split or truncate images where the base64 data exceeds the normal HL7 limit of 64k


17.2 IEP Remote Sending

If an event is sent from another system via an OMGÔ19 message, the following OBX segments may be included in the message:

Observation Identifier Value Type

Observation Value

SND_REASON_CD CE <identifier>, <text> are reason code, reason respectively and will be one of the following:SRMDT, Sent: MDTSRREP, Sent: ReportingSRRFY, Sent: Reference onlySRRFN, Sent: Ref only, no imagesSRARFY, Sent: Reference only (auto)SRARFN, Sent: Ref only,no images(auto)SRRES, Sent: Reported<name of coding system> will be “CRIS3”.

SND_REASON_NTE TX Free text note, optionally added when selecting a send reason.

STUDY UID TX Study UID, if it exists.EVENT_SUMMARY TX Summary of the event and status history.REASON TX Reason for exam text field from the information field on the Event Info

tab.HISTORY TX Clinical history text field from the information field on the Event Info

tab.COMMENT TX Event comment text field from the information field on the Event Info

tab.SAFETYQ TX Clinical safety questions text field from the information field on the

Event Info tab.

If the event has a report or the OBX report segments will also be sent in the OMGÔ19 message.


18 NTENTE segments are present on order and clinical report messages when clinical notes exist.

Position Name Notes

1 Set ID Sequence, first NTE in a message will be 1, followed by 2 etc.

3 Comment Each comment section will contain 1 line of the clinical history, however if SendAdditionalNTEInfo is set to TRUE then there will be additional lines, example;

NTE|1||Clinical history|CHNTE|2||Protocol info|PRNTE|3||Resource group 1~Group 1 description|RGNTE|4||Resource group 2~Group 2 description|RGNTE|5||Event Comment|RENTE|6||Clinical safety questions|QN

4 Comment Type Optional field, you need to request SendAdditionalNTEInfo is set to TRUE. In addition to this for Resource Groups (RG) you need to have GENERAL.ResourceManagementModuleAvailable = 'Yes' for the EJBSERVER user

CH = Clinical History, PR = Protocol info, RG = Resource group, RE = Event comment, QN = Clinical safety question


19 ZDSA ZDS segment present on order messages if CRIS is configured to send study UID.

Position Name Notes

1 Study UID Study UID generated on CRIS


20 Sample Messages

MSH|^~\&|CRIS|LIVE|ACUO||20160728102516||ADTÂ04|IQXKATZ7:1RP|P|2.4EVN|ADT|20160728102508|||HSSPID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|NPD1|||^^V81999|G9999998|

MSH|^~\&|CRIS|LIVE|ACUO||20160728102516||ADTÂ08|IQXKATZ7:1RO|P|2.4EVN|ADT|20160728114035|||HSSPID|||CRIS60146157^^^RR201^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M||1|SALISBURY DISTRICT HOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ|E10000024|~||012|N|B5|||||||||826|||""|NPD1|||^^V81999|G9999998|

MSH|^~\&|CRIS|LIVE|||20160728102946||OMGÔ19|IQXKATZ7:1S0|P|2.4PID|||RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICTHOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|NPD1|||^^V81999|G9999998PV1||||||||||||||||||AORC|NW||60895679^CRIS||IP||^^^201607281029^^1||201607281029|HSS||C2638281^LEWIS SJ|RNZ02CCU||201607280000||320|HSSTERMINAL|HSS||^^RNZ02OBR|||60895679^CRIS|CAAAG^CT Angiogram Aorta||||||||||||||||60800373|RNZ60895679|||C|||^^^201607281029^^1|||||||^20160728^20160728^^^^RNZ02NTE|1||Test clinical history line 1NTE|2ZDS|1.2.826.0.1.2112370.46.1.60895679|

MSH|^~\&|CRIS|LIVE|||20160728103706||ORU^R01|IQXKATZ7:1SO|P|2.4PID|||RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICTHOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|NPD1|||^^V81999|G9999998ORC|SC||60895680^CRIS||CM||^^^201607281031^^1||201607281035|HSS||C4547657^Rachel JOHNSON|GP||201607280000||620|HSSTERMINAL|HSS||^^Y02578OBR|||60895680^CRIS|CHANR^CT Hand Rt||||||||||||||||60800374|RNZ60895680|201607281035||C|||^^^201607281031^^1|||||HSS&HSS User^201607280000||HSS&HSS Support User^20160728^20160728^^^^RNZ02|HSS&HSS User^201607281035NTE|1||Test clinical historyNTE|2OBX|1|TX|CHANR^CT Hand Rt^CRIS3||Clinical History : ||||||F|||201607281035||HSS^HSS UserOBX|2|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS UserOBX|3|TX|CHANR^CT Hand Rt^CRIS3||Test clinical history||||||F|||201607281035||HSS^HSS UserOBX|4|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User


OBX|5|TX|CHANR^CT Hand Rt^CRIS3||CT Hand Rt : ||||||F|||201607281035||HSS^HSS UserOBX|6|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS UserOBX|7|TX|CHANR^CT Hand Rt^CRIS3||This is a test report added by HSS.||||||F|||201607281035||HSS^HSS UserOBX|8|TX|CHANR^CT Hand Rt^CRIS3||||||||F|||201607281035||HSS^HSS User|OBX|9|TX|CHANL^CT Hand Lt^CRIS3||AN ADDENDUM HAS BEEN ENTERED AT THE END OF THIS REPORT||||||F|||201607281035||HSS^HSS UserOBX|10|TX|CHANL^CT Hand Lt^CRIS3||This is a test report for a second exam added by HSS.||||||F|||201607281035||HSS^HSS UserOBX|11|TX|CHANL^CT Hand Lt^CRIS3||line 2||||||F|||201607281035||HSS^HSS UserOBX|12|TX|CHANL^CT Hand Lt^CRIS3||line 3||||||F|||201607281035||HSS^HSS UserOBX|13|TX|CHANL^CT Hand Lt^CRIS3||line 4||||||F|||201607281035||HSS^HSS UserOBX|14|TX|CHANL^CT Hand Lt^CRIS3||line 5||||||F|||201607281035||HSS^HSS UserOBX|15|TX|CHANL^CT Hand Lt^CRIS3||line 6||||||F|||201607281035||HSS^HSS UserOBX|16|TX|CHANL^CT Hand Lt^CRIS3||ADDENDUM START by HSS User 28-Jul-2016 10:55||||||F|||201607281035||HSS^HSS UserOBX|17|TX|CHANL^CT Hand Lt^CRIS3||Some addendum text here||||||F|||201607281035||HSS^HSS User

MSH|^~\&|CRIS|LIVE|ACUO||20160728104127||ADTÂ40|IQXKATZ7:1ST|P|2.4EVN|ADT|20160728104122|||HSSPID|||CRIS60146087^^^RNZ02^MR~60146087^^^CRIS^PI||TEST^PATIENT||19950717|M|||||~||||||||||||||||""|NMRG|RNZ7654321^^^RNZ02^MR|

MSH|^~\&|CRIS|LIVE|ACUO||20160728104668||ADTÂ05|IQXKATZ7:1SW|P|2.4EVN|ADT|20160728000146|||EJBSERVERPID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|NPV1|||V81999||||||G9999998|||||||||A||||||||||||||||||||||||||20160728102600|

MSH|^~\&|CRIS|LIVE|ACUO||20160728104668||SIU^S12|IQXKATZ7:1SZ|P|2.4SCH|||||EPÊXAMPULL^L||||||^^^201607281246EVN|ADT|20160728000146|||EJBSERVERPID|||CRIS60146157^^^RHM01^MR~RNZ7654321^^^RNZ02^MR~60146157^^^CRIS^PI||TEST^PATRICK^^^MR||19700101|M|||SALISBURY DISTRICT HOSPITALÔDSTOCK ROAD^SALISBURY^^SP2 8BJ||~||||||||||||||||""|NPV1|||V81999||||||G9999998|||||||||A||||||||||||||||||||||||||20160728102600|


21 Configuration QuestionnairePlease answer the following questions regarding the preferred configuration of the CRIS HL7 Interface.

Item Description Required ValueIP Address IP Address to send messages toPort Number TCP Port number to send messages toPreferred Primary Key This should be the assigning authority code of a

patient identifier. If this is not specified the only identifier that is guaranteed to appear on every message is CRIS number.

Identifier Order If you require patient identifiers to be listed in a particular order specify it here as a list of assigning authority codes.

NHS Number format Do you require the NHS in its default format of 3-3-4 or without spaces?

Unverified Reports If you require unverified reports to be sent specify here. The default is to not send them.

Demographic messages Do you require demographic (ADT) messages?Note even if these are to be suppressed, if Preferred Primary Key is set you will still receive ADTÂ40 messages in response to changes of primary key. The default is to send demographic messages.

Order Messages Do you require order messages? The default is to send order messages.

Study UID Do you require a ZDS segment containing study UID. The default is NOT to send study UID

Unique By Event Refer to the section on ORU^R01Examination Names in report

Refer to the section on ORU^R01

Send report for all exams Refer to the section on ORU^R01

Individual exams in observation ID

Refer to the section on ORU^R01

Report Margin Refer to the section on ORU^R01SendPrefetchAsSIU Do you require ADTÂ05 messages or SIU^S12

messages for pre fetching. The default is to send ADTÂ05 messages.

BufferPrefetchDays Should pre fetch messages be buffered until a specific number of days prior to the date of attendance or sent immediately. The default is to send pre fetch messages immediately.

Send Scanned Documents (Y/N)?

Should scanned documents be sent along with the report


ScannedDocumentTypes can be used to filter the type sent out eg. REQCARD, MRI). By default it is just REQCARD

Send Diagnosis Codes Do you want to send events diagnosis codes in an OBX segment (Y/N)?

Send “Copy To” location (Y/N)?

Default is NO. If set YES this will populate an extra OBX segment OBX:3.1 and OBX3.2 with the exam code and the “Copy To” location


22 Quick ReferenceWhere to find common data useful for building work lists etc.

22.1 PatientData FieldPatient Identifier PID:3Name PID:5DOB PID:7Sex PID:8

22.2 Referral Data FieldReferring physician ORC:12Referring location ORC:13Practice for GP referrals ORC:21

22.3 PerformingData FieldProcedure OBR:4Accession no OBR:21Study UID ZDS:1Required Date OBR:27Modality OBR:24Room procedure is to be performed in OBR:34Hospital procedure is to be performed at OBR:34CRIS workstation where the procedure was booked ORC:18

22.4 ReportingData FieldReport text OBX:5Report status OBX:11Date reported last entered/changed OBX:13Radiologist OBR:32Typist OBR:35

22.5 Pre fetchingData FieldWard PV1:3Consultant PV1:9Date of expected admission PV1:44

Or SCH:11 if using SIU messages.


Document Control

Title RIS_PD160_Owner Steve Verdon Date Created 01/06/2006File Ref. RIS_PD160_CRIS VersionChange HistoryIssue Date Author / Editor Details of Change1.0 01/06/2006 Alan Shields First Draft, created from PACS interface specification.1.1 23/10/2006 Alan Shields Added SIU^S12 message. Added examination end time

to OBR segment.1.2 21/04/2008 Alan Shields Updated radiologist, secretary and technician fields1.3 21/12/2008 Neil Twist Added information on a flag1.4 14/01/2010 Neil Twist Updated to 2.09.10 specification1.5 05/03/2010 Steven Verdon Added OBR:161.6 09/09/2010 Alan Shields Added transmission of scanned documents/images1.7 28/02/2011 Julia Paul IEP additions1.8 29/01/2012 Steven Verdon Title version corrected

PV1 segment, added OMGÔ19 (12)Urgency field added to OBX (16)Added NHS formatting to configuration questionnaire (20)OBX:14 + 16 changed to state “LAST” d&t or personAdded scanned documents (IEP) to configuration questionnaire (20)Added event diagnostic codes to configuration questionnaire (20)Added “Copy To” query to configuration questionnaire (20)Added OBX:28 – Send copies to

1.9 19/09/2012 Steven Verdon OBR:16 not usedUpdated review panel

1.10 25/09/2012 Steven Verdon PV1, Patient Type description misleading1.11 18/04/2013 Steven Verdon Document review1.12 28/05/2013 Steven Verdon Re-worded OBR:34 description1.13 09/12/2013 Steven Verdon Document review1.14 29/12/2014 Steven Verdon Document review, primary key highlighted in 6.11.15 16/10/2015 Steven Verdon OBR:11 Request category

AL1 section addedNTE:4 addedOBR:31.2 reason for exam addedScannedDocumentTypes added to Configuration QuestionnaireOption to remove 2099 (waiting) dates from ORC:7, OBR:27, OBR:34.2 and OBR:34.3.NHS number check digit added for inclusion in outbound messages (optional).Inclusion of PID3.2/PID:32 for the NHS number check digit (optional).


1.16 19/10/2015 Andrea Hardy Updated template1.17 05/04/2016 Steven Verdon OBR:31.2 and NTE:3/4 detail added. Additional patient

details added (PID:10/12/15/16/17/18/26)1.18 15/07/2016 Steven Verdon PD1 segment corrected1.19 08/08/2016 Steven Verdon Sample messages updated1.20 02/12/2016 Steven Verdon Detail added around presentation of OBX.11 for

reports with/without addendums. Updated ORU^R01 message as a reference

1.21 10/03/2017 Steven Verdon Document reviewTable headings aligned with other PDxxx specifications

Review Date March 2018
