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CardioSoftTM to EMR System Interface

1. 59 MDM TXA Transcription Document 61 MDM OBX 63 MDM MSA Message Acknowledgment 64 ADT Admission Discharge and 5 64 ADT Message Segments 65 ADT MSH Message Header 65 ADT EVN Event Type 2 2 2 2222222 2 2 67 ADT PID Patient Identification 67 ADT MSA Message Acknowledgment 69 Appendix A Interpretation of HL7 Data Types 70 Character S Esso ed tree e OR eig e uM Ne AS te 70 ST String TX Text and FT Formatted Text 70 DT Date and TS Timestamp 70 PN or PN Person bb ty tease ees 71 CN or XCN Composite ID Number and n INDEX uiae 73 ii CardioSoft to EMR Revision B 2023324 206 Revision History Limitations Reference Documents Conventions Each page of the document has the document part number and revision letter at the bottom of the page The revision letter changes each time the document is updated Revision History PN 2023324 206 Revisio
2. Items of Interest MSH 3 MSH 4 Names reversed to indicate opposite send direction OBR 4 Test Name SPIRO Spirometry OBR 18 Document Type DR Diagnostic Report Other OBR 25 Result status F indicates normal status OBX 3 Observation Name Obs name e g History Reason Height Weight OBX 5 Observation Value Numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value Question 1 amp Question 2 The value field contains both the question and answer OTHER_REF Value for this OBX is the reference to the test CardioSoft creates and stores an HL7 file internally to reference the conducted test This filename is located in the OBX segment with OBX 3 OTHER_REF and must be used by the EMR to edit view this test When no test is started and button Back to EMR is pressed an Abort message is sent The Abort message has the following format MSH 5 CARDIOSOFT 20040812174812 ORU 20040812174812001 P 2 3 INE PID 1 EMR PID MARKHAM STEVE 19650101 M W 1 5 120040812174812 111 120040812174812 20040812174812 x 1 87 test 11 CardioSoft to EMR 31 2023324 206 Interface Specification Items of Interest OBR 4 Test Name Stress ECG OBR 18 Document Type DR Diagnostic Report Other OBR 25 R
3. CardioSoft to EMR 69 2023324 206 Appendix A Interpretation of HL7 Data Types Appendix A Interpretation of HL7 Data Types Character Set m In V6 0 the used character set is not delivered interpreted within the MSH segment CardioSoft uses for all languages except the list below the ANSI ISO 8859 1 character set Windows 1252 For Chinese language the Chinese Simplified GB2312 character set is used Windows 936 For Japanese language the Shift JIS character set is used Windows 982 For Polish Hungarian Czech languages the Central Europe ISO 8859 2 character set is used Windows 1250 For Russian language the Cyrillic ISO 8859 5 character set is used Windows 1251 Please also See MDM MSA Message Acknowledgment on page 64 m CardioSoft doesn t interpret or otherwise support check digit schemes employed within compound data types m Onimport the NULL string can be used to replace an existing string field with a NULL value ST String TX Text and FT Formatted Text These data types are treated identically The following escape sequences are defined where represents the escape delimiter defined in MSH Delimiter Description F Field separator S Component separator T Subcomponent separator R Repetition separator E Escape character br Line break All other escape sequences are removed from the data DT Date and TS T
4. Conditional N Not Used U Used OBR Segment CardioSoft Applicability Seq Length id Element Name Import Export 1 4 51 Set ID OBR N N 2 75 Placer Order Number N N 3 75 El Filler Order Number N N 4 200 CE Universal Service ID R 0 U 0 5 2 ID Priority N N 6 26 TS Requested Date Time N N 7 26 TS Observation Date Time N U 1 8 26 TS Observation End Date Time N N 9 20 CQ Collection Volume N N 10 60 XCN Collector Identifier N N 11 1 ID 0065 Specimen Action Code N N Revision B CardioSoft to EMR 51 2023324 206 HL7 Messages OBR Segment CardioSoft Applicability Seq Length 1 Element Name Import Export 12 60 CE Danger Code N N 13 300 ST Relevant Clinical Information N N 14 26 TS Specimen Received Date Time N U 1 15 300 0070 Specimen Source N N 16 80 XCN Ordering Provider 0 2 N 17 40 XTN Order Callback Phone Number N N 18 60 ST Placer Field 1 N 0 3 19 60 ST Placer Field 2 N N 20 500 ST Filler Field 1 N N 21 60 ST Filler Field 2 N N 22 26 TS Results Rpt Status Chng Date Time N U 23 40 Charge to Practice N N 24 10 ID 0074 Diagnostic Service Sect ID N N 25 1 ID 0123 Result Status N U 4 26 400 CM Parent Result N N 2 200 TQ Quantity T iming N N 28 150 XCN Result Copies To N N 29 150 CM Pare
5. Max BP Systolic mmHg Blood pressure systolic maximum exercise Max BP Diastolic mmHg Blood pressure diastolic maximum exercise Max Load METS Maximum load treadmill Max Load Watt Maximum load ergometer Max ST Level mv Maximum ST level maximum ST depression Max TWA uV Maximum TWA T Wave alternans Protocol Text Protocol as in load sequence of a stress test such as Bruce Naughton Cornell etc Total Test Time Text Exercise tolerance test total test time Interpretation Text Stress electrocardiogram interpretation Comment Text Any comment workflow personal non clinical data 60 char max 26 CardioSoft to EMR Revision B 2023324 206 Interface Specification Cardio Soft ID Unit Description Question 1 Text Short note containing a question and response 52 char max Question 2 Text Short note containing a question and response 52 char max Stress Test Type Text Stress test type Treadmill Egometer Persantine Baseline HR bpm Resting HR Reas For Term Text Reason for Termination Fatigue Total Ex Time Text Time in Exercise Example for Stress ECG Observation Results S_ECG_80 TEST011_43 car MSH amp CARDIOSOFT CPO_EMR 20040812175140 ORU 20040812175140001 P 2 3 NE PID 1 EMR_PID MARKHAM STEVE 19650101 M W OBR 1 S_ECG 20040812175027 11 20040812175027 EK 20040812175027 F OBX 1 TX OTHER REF 000002 5 ECG
6. Value for this OBX is the reference to the test CardioSoft creates and stores an HL7 file internally to reference the conducted test This filename is located in the OBX segment with OBX 3 OTHER_REF and must be used by the EMR to edit view this test When no test is started and button Back to EMR is pressed an Abort message is sent The Abort message has the following format MSH amp CARDIOSOFT CPO_EMR 20040812174812 ORU 20040812174812001 P 2 3 NE PID 1 EMR PID MARKHAM STEVE 19650101 M W OBR 1 S_ECG 20040812174812111111120040812174812 EK 11120040812174812 IX OBX 1 ST Comment No test performed ll F Items of Interest OBR 4 Test Name S_ECG Stress ECG OBR 18 Document Type EK EKG Report OBR 25 Result status X indicates aborted test OBX record 15 used to return comment providing the reason for aborting the test The commentis generated by the application Itis not entered by the user After the button Back to EMR is pressed the car file described above is written again when the test was modified during Post Test Review 28 CardioSoft to EMR 2023324 206 Revision B Interface Specification Spirometry Example for launching CardioSoft to conduct a Spirometry test SPIRO 80 TESTO11 44 emr PID 1 EMR PID MARKHAM STEVE 19650101 M W PV1 1 SOUTH Winston Harry S Ref L Ref F OBX 1 ST
7. 60 char max Question 1 Text Short note containing a question and response 52 char max Question 2 Text Short note containing a question and response 52 char max Day aver BPsyst mmHg Day Time Average Systolic Day aver BP dia mmHg Day Time Average Diastolic Night aver BP syst mmHg Night Time Average S ystolic Night aver BP Dia mmHg Night Time Average Diastolic ABP Tot Rec Time Text Total Recording Time Example for Observation Results Data from ABP Device BPMOND_80 TEST011_46 car MSH amp CARDIOSOFT 20040812175140 ORU 20040812175140001 P 2 3 NE PID 1 EMR PID MARKHAM STEVE 19650101 M W 1 20040812175548 11120040812175548 20040812175548 F OBX 1 TX OTHER REF 000003 BPMOND 20040812175548 csoft OBX 1 ST Comment This is a comment F OBX 1 ST Question 1 Smoker Yes lllllF OBX 1 ST Question 2 Athlete Yes lllllF OBX 1 ST Interpretation l l ll F OBX 1 ST 24h aver BPsys 133 3 mmHg l F OBX 1 ST 24h aver BPdia 86 6 mmHg F OBX 1 ST Day aver BPsyst 133 3 mmHg l l F OBX 1 ST Day aver BPdia 86 6 mmHg l F OBX 1 ST Night aver BPsyst mmHg l F OBX 1 ST Night aver BPdia mmHg IF OBX 1 ST ABP Tot Rec Time 0 10 hj IIIIF Items of Interest MSH 3 MSH 4 Names reversed to indicate opposite send direction OBR 4 Test Name BPMOND ABP Read Data from ABP Device
8. Examples for launching CardioSoft in View Only Mode View a Resting ECG test C NCardioNCardio exe 000002 20050802135947 csoft or directly launch 000002 ECG 20050802135947 csoft View a Stress ECG test C Cardio Cardio exe 000008 5 ECG 2005090214594 csoft or directly launch 000003 5 ECG 2005090214594 7 csoft View a Spirometry test C Cardio Cardio exe 000004 SPIRO 20051002155947 csoft or directly launch 000004 SPIRO 20051002155947 csoft Revision B CardioSoft to EMR 39 2023324 206 Interface Specification View an ABP test C Cardio Cardio exe 000005_BPMOND_20051102165947 csoft or directly launch 000005 BPMOND 20051102165947 csoft After having clicked Back to EMR no data is passed back Functions Initiated by CardioSoft CardioSoft is started directly via an icon on the desktop Data Upload of Existing CardioSoft Tests to EMR In those cases where an EMR is newly installed into an environment that CardioSoft has been in for some time CardioSoft provides one time upload of data from CardioSoft to the EMR This ensures that a chart exists in the EMR for every patient on CardioSoft In addition CardioSoft provides document references that allows access to test reports For each patient in the CardioSoft database a demographics file 1s created then for each test a document reference file is created All files are copied to a folder or
9. OBR 25 Result status X indicates aborted test OBX record Is used to return comment providing the reason for aborting the test The comment is generated by the application It is not entered by the user After the button Back to EMR is pressed the car file described above is written again when the test was modified during Post Test Review CardioSoft to EMR 2023324 206 37 Interface Specification Edit Test CardioSoft is launched in Edit Mode by the EMR with the parameters EMR E lt internal patient id modality time of teststamp gt csoft The EMR needs to take the filename with the extension csoft this is the document reference out of the car file that was written to the Write To folder by CardioSoft after a new test was finished It is located in OBX 5 of that OBX segment whose OBX 3 value is OTHER REF Examples for launching CardioSoft in Edit Mode Edit a Resting ECG test C NCardioNCardio exe E 000002 ECG 20050802135947 csoft Edit a Stress ECG test C Cardio Cardio exe EMR_E 000003 5 ECG 20050902145947 csoft Edit a Spirometry test C Cardio Cardio exe 000004 SPIRO 20051002155947 csoft Edit an ABP test C Cardio Cardio exe 000005 20051102165947 csoft Path name See Win ini Folder C Winnt or C Windows in section CARDIO CardioInstallPath C Cardio After having clicked Back to EMR data is passed back as
10. car file even if no changes were made The format is identical as described in Resting ECG on page 21 for Resting ECG Stress ECG on page 25 for Stress ECG Spirometry on page 29 for Spirometry and ABP Read Data from ABP Device on page 34 for ABP Read Data The ID in the car filename is identical to that one that was received within the emr filename when this test initially was conducted The EMR is responsible to delete the file 38 CardioSoft to EMR Revision B 2023324 206 Interface Specification View Test CardioSoft is launched in View Only Mode by the EMR with the parameters EMR_O lt internal patient id gt _ lt modality gt _ lt time of teststamp gt csoft The EMR needs to take the filename with the extension csoft this is the document reference out of the car file that was written to the Write To folder by CardioSoft after a new test was finished It is located in OBX 5 of that one OBX segment that has the string OTHER REF as OBX 3 With the CardioSoft Install program m the system variable Path is expanded with the location of the csoft file m and the file extension csoft is mapped to lt CardioSoft Local Install Folder gt Cardio exe lt xxx gt csoft So to view tests CardioSoft can be started m either by using Cardio exe and reading the Path name out of Win ini as stated 1n Edit Test on page 38 m directly by launching the csoft file
11. contains the unique CardioS oft Observation Identifier m Other imported Identifiers as listed below are disregarded no error 2 OBX 6 Units is populated as follows The first component Identifier contains the appropriate unit m Other imported units for the listed Identifiers are treated as error 3 Table of supported OBX Identifiers Units see 3 table below 4 OBX 11 Observation Result Status is always set to F Final 54 CardioSoft to EMR 2023324 206 Revision B HL7 Messages 3 Imported Identifiers Units Values Cardio Soft Units Value TE ID OBX 3 OBX 6 OBX 5 History Text Medical History of patient If multiple OBX segments with this ID are used the text is appended Reason Text Reason for test Recommended use separate OBX segments for each reason for test Medication Text Text Medications and dose e g 5 MG Recommended use separate OBX segments for each medication OBX 6 is used as Dose separate field in CardioS oft test information Height CM or IN Numeric Value Height of Patient e g 178 178 6 Use this ID only once Weight KG or LB Numeric Value Weight of patient e g 75 75 6 Use this ID only once Pacemaker Y orN Pacemaker patient Use this ID only once NOTE Exported Identifiers are listed separately for each modality in this document see corresponding tables MDM Docu
12. 20040812175027 csoft OBX 1 ST Max HR 60 bpm F OBX 1 ST Max predicted HR 158 bpm l F OBX 1 ST Max BP Systolic 155 mmHg l F OBX 1 ST Max BP Diastolic 99 mmHg l l l F OBX 1 ST Stress Test Type Treadmill Stress Test lllF OBX 1 ST Baseline HR 60 bpm F OBX 1 ST Reas for Term Leg discomfort l lF OBX 1 ST Max Load 2 90 METS F OBX 1 ST Protocol BRUCE I F OBX 1 ST Total Ex Time 01 05 IIF OBX 1 ST Total Test 01 42 111 OBX 1 ST Interpretation Reasons for Termination Leg discomfort br Summary Resting ECG normal Functional Capacity above average gt 20 br Conclusion This is the conclusion ll F OBX 1 ST Comment This is comment F OBX 1 ST Question 1 Smoker OBX 1 ST Question 2 Athlete Items of Interest MSH 3 MSH 4 Names reversed to indicate opposite send direction OBR 4 Test Name S_ECG Stress ECG OBR 18 Document Type EK EKG Report OBR 25 Result status F indicates normal status OBX 3 Observation Name Obs name e g History Reason Height Weight OBX 5 0bservation Value Numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value Revision B CardioSoft to EMR 27 2023324 206 Interface Specification Items of Interest Question 1 amp Question 2 The value field contains both the question and answer OTHER_REF
13. 206 HL7 Messages ORU Message Segments ORU MSH Message Header Legend R Required O Optional C Conditional N Not Used U Used MSH Segment CardioSoft Applicability Seq Length x Import Export 1 1 ST Field Separator R U 2 4 ST Encoding Characters R U 3 40 HD Sending Application 0 U 4 20 HD Sending Facility 0 U 5 40 HD Receiving Application N 1 6 30 HD Receiving Facility N 2 7 26 5 Date Time Of Message 0 U 8 40 ST Security N N 9 7 CM 0076 Message Type R 3 U 3 10 20 ST Message Control ID R 4 U 4 11 3 PT 0103 Processing ID R 5 U 12 8 ID 0104 Version ID R 6 U 13 15 NM Sequence Number N N 14 180 ST Continuation P ointer N N 15 2 ID 0155 Accept Ack Type 0 7 N 16 2 ID 0155 Application Ack Type N 8 0 8 17 2 ID Country Code N N 18 6 ID 0211 Character Set N N 19 60 CE Principal Language Of Message N N Note 1 MSH 5 contains MSH 3 of the initiating system if we are the responder 2 MSH 6 contains MSH 4 of the initiating system if we are the responder Revision B CardioSoft to EMR 45 2023324 206 HL7 Messages Note Description 3 The supported values for Message Type include m ORU Unsolicited transmission of an observation m ACK General acknowledgment message Note The second component trigger event is ignored
14. CARDIOSOFT 20040327110218 ORU 20040327110218001 P 2 3 INE PID 1 EMR 19650101 M W PV1 1 SOUTH Winston Harry S Ref L Ref F OBR 1 S_ECG 120040327110218 1111 lOrdering Ordering L Ordering F OBX 1 ST History ANGINA FUNCTIONAL CLASS III ICD 786 5 OBX 1 ST Reason Abnormal ECG OBX 1 ST Reason Chest Discomfort OBX 1 ST Reason Vascular Disease OBX 1 ST Reason Pre Op Evaluation OBX 1 ST Reason Evaluation OBX 1 ST Height 72 IN OBX 1 ST Weight 160 LB OBX 1 ST Pacemaker Y OBX 1 ST Medication LISINOPRIL 80mg tablets OBX 1 ST Medication HEXORAL 500m1 OBX 1 ST Medication ASPIRIN 100mg OBX 1 ST Medication ASPIRIN 1320mg OBX 1 ST Medication ISOSORB 75mg OBX 1 ST Medication LISINOPRIL 180mg tablets OBX 1 ST Medication HEXORAL 1500m1 OBX 1 ST Medication ASPIRIN 1100mg OBX 1 ST Medication ASPIRIN 13200mg OBX 1 ST Medication ISOSORB 175mg Items of Interest MSH 3 S ending App CPO EMR MSH 4 Receiving App CARDIOSOFT MSH 10 Message Control ID Unique ID MSH 11 0 perating mode P Production D Debug PID 3 Patient ID EMR Internal Patient ID PID 4 Alternate ID CardioSoft ID if one exists PID 5 P atient Name used lastfirst middle PID 7 Date of Birth yyyymmdd 8 5 PID 10 Race See Spec for correct values PV1 7 Attending Phys used last first middle d
15. History DEPRESSION ICD 311 OBX 1 ST Reason Respiratory problems OBX 1 ST Reason Shortness of breath OBX 1 ST Reason OBX 1 ST Reason Follow up OBX 1 ST Height 72 IN OBX 1 ST Weight 160 LB OBX 1 ST Pacemaker Y OBX 1 ST Medication LISINOPRIL 180mg tablets OBX 1 ST Medication HEXORAL 1500m1 OBX 1 ST Medication ASPIRIN 1100mg OBX 1 ST Medication ASPIRIN 13200mg OBX 1 ST Medication ISOSORB 175mg MSH amp CPO_EMR CARDIOSOFT 20040327110218 ORU 20040327110218001 P 2 3 INE OBR 1 SPIRO 20040327110218 111111 Ordering ordering L Ordering F Items of Interest MSH 3 Sending App CPO_EMR MSH 4 Receiving App CARDIOSOFT MSH 10 Message Control ID Unique ID MSH 11 Operating mode P Production D Debug PID 3 Patient ID EMR Internal Patient ID PID 4 Alternate ID CardioS oft ID if one exists PID 5 Patient Name used lastfirst middle PID 7 Date of Birth yyyymmdd PID 8 Sex M F U PID 10 Race See Spec for correct values PV1 7 Attending Phys used last first middle degree PV1 8 Referring P hys used last first middle degree OBR 4 Test Name SPIRO Spirometry OBR 16 Ordering Phys used last first middle degree OBX 3 0bservation Name obs name e g History Reason Height Weight OBX 5 Observation Value numeric or text value for observation OBX 6 Units If applic
16. Internal Patient ID PID 4 Alternate ID CardioS oft ID if one exists PID 5 P atient Name used last first middle 32 CardioSoft to EMR Revision B 2023324 206 Interface Specification Items of Interest PID 7 Date of Birth yyyymmdd PID 8 S ex M F U PID 10 Race See Spec for correct values PV1 7 Attending Phys used last first middle degree PV1 8 Referring Phys used last first middle degree OBR 4 Test Name BPMONC ABP Configuration OBR 16 Ordering Phys used last first middle degree OBX 3 Observation Name obs name e g History Reason Height Weight OBX 5 0bservation Value numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value NOTE The Medication Observation name is reused for each medication sent Each med is delivered with the medication name in OBX 3 and the dose in OBX 5 ABP modality is started and clinical data Attending Physician Referring Physician Ordering Physician Reason for Test up to 4 rest is discarded Medical History Medication up to 5 rest 1s discarded are stored in CardioSoft EMR should use the CardioSoft default list in the Reason for Test combo box Medical History and Medication are read only in CardioSoft In the ABP modality the user can clear data in the device and program the device The button Download Data is disabled After the button Back to EMR 1s pressed the Con
17. N 24 2 ID 0136 Multiple Birth Indicator N 25 2 NM Birth Order N 26 4 IS 0171 Citizenship N 27 60 CE 0172 Veterans Military Status N 28 80 CE Nationality N 29 26 TS Patient Death Date and Time N 30 1 ID 0136 Patient Death Indicator N 68 CardioSoft to EMR Revision B 2023324 206 HL7 Messages Note Description 1 PID 3 Patient ID Internal ID is assumed to contain the patient identifier of CardioS oft 2 PID 4 Alternate Patient ID is assumed to be the CardioSoft s Patient s ID that was previously uploaded to the EMR database data migration of existing patients and tests If available PID 4 is used primarily to access to existing CardioS oft s Patient IDs Although HL7 states a length of 20 with CardioS oft a maximum length of 30 is possible due to data migration of existing patients and tests 3 The supported values for Sex include F Female M Male O Other treated as Unknown U Unknown 4 The supported values for Race include Value Definition gt gt CardioS oft On Export if not supported Asian 0 Oriental Asian Unknown is used Black B Black Caucasian W White Hispanic H Hispanic Native American N Native American Oriental 0 Oriental Asian Pacific Islander P Pacific Islander Unknown U Undetermined default ADT MSA Message Acknowledgment See MDM MSA segment See MDM MSA Message Acknowledgment on page 64 Revision B
18. Name Import Export 1 4 S Set ID Patient ID N N 2 20 CX Patient ID External N ID 3 20 CX Patient ID Internal R 1 U 1 ID 46 CardioSoft to EMR Revision B 2023324 206 HL7 Messages PID Segment CardioS oft Applicability Seq Length Element Import Export 4 30 CX Alternate Patient ID O 2 0 2 PID 5 48 XPN Patient Name R 0 6 48 XPN Mother s Maiden N N Name 7 26 TS Date Time of Birth 0 0 8 1 IS 0001 Sex 0 U 9 48 XPN Patient Alias N N 10 1 IS 0005 Race o 0 11 106 XAD Patient Address N N 12 4 IS County Code N N 13 250 XTN Phone Number N N Home 14 250 XTN Phone Number N N Work 15 60 CE 0296 Primary Language N N 16 1 IS 0002 Marital Status N N 17 3 IS 0006 Religion N N 18 20 CX Patient Account N N Number 19 11 ST SSN Number N N Patient 20 25 DLN Driver s License N N Number P atient 21 20 CX Mother s Identifier N N 22 3 IS 0189 Ethnic Group N N 23 60 ST Birth Place N N 24 2 ID 0136 Multiple Birth N N Indicator 25 2 NM Birth Order N N 26 4 IS 0171 Citizenship N N Revision B CardioSoft to EMR 2023324 206 47 HL7 Messages PID Segment CardioSoft Applicability Data HL7 Seq Length Type Table Element Name Import Export 2 60 CE 0172 Veterans Military N N Status 28 80 CE Nationality N N 29 26 TS PatientD
19. R Required O Optional C Conditional N Not Used U Used PID Segment CardioSoft Applicability Seq Length Data HL7 Table Element Name Export 1 4 S Set ID Patient ID N 2 20 CX Patient ID External ID N 3 20 CX Patient ID Internal ID U 1 4 30 CX Alternate Patient ID P ID 0 2 5 48 XPN Patient Name U 6 48 XPN Mother s Maiden Name N 7 26 TS Date Time of Birth 0 8 1 IS 0001 Sex U 3 9 48 XPN Patient Alias N 10 1 IS 0005 Race 0 4 11 106 Patient Address N 12 4 IS County Code N 13 250 XTN Phone Number Home N 14 250 XTN Phone Number Work N 15 60 CE 0296 Primary Language N 16 1 IS 0002 Marital Status N 17 3 IS 0006 Religion N 18 20 CX Patient Account Number N Revision B CardioSoft to EMR 59 2023324 206 HL7 Messages PID Segment CardioSoft Applicability Seq Length DataType HL7 Table Element Name Export 19 11 ST SSN Number Patient N 20 25 DLN Driver s License Number Patient N 21 20 CX Mother s Identifier N 22 3 IS 0189 Ethnic Group N 23 60 ST Birth Place N 24 2 ID 0136 Multiple Birth Indicator N 25 2 NM Birth Order N 26 4 IS 0171 Citizenship N 27 60 CE 0172 Veterans Military Status N 28 80 CE Nationality N 29 26 TS Patient Death Date and Time N 30 1 ID 0136 Patient Death Indicator N Note Description 1 PID 3 Patient
20. by the EMR as document reference 56 CardioSoft to EMR Revision B 2023324 206 HL7 Messages MDM Message Segments MDM MSH Message Header Legend R Required O Optional C Conditional N Not Used U Used MSH Segment CardioS oft Applicability Seq Length HL7 Table Element Table Export ype 1 1 ST Field Separator U 2 4 ST Encoding Characters U 3 40 HD Sending Application U 4 20 HD Sending Facility U 5 40 HD Receiving Application 1 6 30 HD Receiving Facility 2 7 26 5 Date Time Of Message U 8 40 ST Security N 9 7 CM 0076 Message Type U 3 10 20 ST Message Control ID U 4 11 3 PT 0103 Processing ID U 5 12 8 ID 0104 Version ID U 6 13 15 NM Sequence Number N 14 180 ST Continuation Pointer N 15 2 ID 0155 Accept Ack Type N 16 2 ID 0155 Application Ack Type U 7 17 2 ID Country Code N 18 6 ID 0211 Character Set N 19 60 CE Principal Language Of Message N Note Description 1 MSH 5 contains MSH 3 of the initiating system if we are the responder 2 MSH 6 contains MSH 4 of the initiating system if we are the responder Revision B CardioSoft to EMR 57 2023324 206 HL7 Messages MDM EVN Event Type Note Description 3 The supported values for Message Type include m ORU Unsolicited transmission of an observation m ACK General acknowled
21. data is sent via TCP IP communication See System Configuration gt gt EMR Tab Acknowledging is configurable manually in HL7 ini See HL7 Settings on page 18 HL7 settings Patient Demographics File HL7 message ADT A04 Filename pid modality hd PID CardioS oft Internal P atient ID Modality R ECG S ECG SPIRO BPMOND Example for a Demographics File Name 000002 S ECG hd Format MSH amp CARDIOSOFT LINLOGIC LOGICIAN 20040327110218 ADT A04 20040327110218001 P 2 3 INE EVN A04 20040327110218 PID 1 Cardiosoft PID MARKHAM STEVE 19650101 M W 40 CardioSoft to EMR Revision B 2023324 206 Interface Specification Document Reference File HL7 message MDM 02 Filename pid modality time of testtimestamp gt ht PID CardioS oft Internal Patient ID Timestamp time of test yyyymmddhhmmss time of test Modality R ECG S ECG SPIRO BPMOND Example for Document Reference File Name 000002 20040504140211 ht Format MSH amp CARDIOSOFT LINKLOGIC LOGICIAN 20040327110218 MDM TO2 20040327110218001 P 2 3 INE EVN T02 20040504140211 PID 1 Cardiosoft_PID MARKHAM STEVE 19650101 M W TXA 20040504140211 20040504140211111111000002 20040504140211111111 OBX 1 ST CASE CardioSoft Resting ECG IF OBX 1 ST br br br To review the test click o
22. on import and not used on export 4 On Import MSH 10 is used as a unique ID to log potential errors of this HL7 message In this case the HL7 message is stored with MSH 10 as filename lt MSH 10 gt log Reason of error plus reference to this filename is stored in file HL7 ERR Log For the error file location see setting in tab in system configuration screen of CardioSoft On Export the creation time of the message is used for MSH 10 time stamp yyyymmddhhmmssxxx where xxx is a sequence number in case of identical time stamp 5 The supported values for Processing ID include m D Debugging m P Production Note D is used if interface is in test mode with simulated patient data See Interface Configuration for Test Mode on page 17 6 The supported values for Version ID include m 2 0 Release 2 0 Sept 1988 m 2 00 Release 2 00 Oct 1988 m 2 1 Release 2 1 March 1990 m 2 2 Release 2 2 December 1994 m 2 3 Release 2 3 April 1997 U In this mode only NE Never is supported 8 Application acknowledgment is currently unsupported on import and export On export the value NE is used The Ack types are still validated for import ORU PID Patient Identification Legend R Required O Optional C Conditional N Not Used U Used PID Segment CardioSoft Applicability Data HL7 Seq Length Type Table Element
23. on page 40 and Data Upload of External Tests from ECG Writers on page 42 Legend R Required O Optional C Conditional I Ignored 64 CardioSoft to EMR 2023324 206 Revision B HL7 Messages ADT Message Segments ADT MSH Message Header ADT A04 Message Segments Import 0 Export MSH R EVN R PID R MSH 5 Note Description 0 ADT Import currently is not supported Legend R Required O Optional C Conditional N Not Used U Used MSH Segment CardioS oft Applicability Seq En gt 1 E Element Name Export 1 1 ST Field Separator U 2 4 ST Encoding Characters U 3 40 HD Sending Application U 4 20 HD Sending Facility U 5 40 HD Receiving Application C 1 6 30 HD Receiving Facility 2 7 26 5 Date Time Of Message U 8 40 ST Security N Revision B CardioSoft to EMR 65 2023324 206 HL7 Messages MSH Segment CardioS oft Applicability Seq gt gt Element Name Export 9 7 CM 0076 Message Type U 3 10 20 ST Message Control ID U 4 11 3 PT 0103 Processing ID U 5 12 8 ID 0104 Version ID U 6 13 15 NM Sequence Number N 14 180 ST Continuation Pointer N 15 2 ID 0155 Accept Ack Type N 16 2 ID 0155 Application Ack Type U 7 17 2 ID Country Code N 18 6 ID
24. or shared file m EMR needs to read the HL7 messages create patients chart and assign tests 3 EMR Client on PC2 Launch CardioS oft for viewing the test m Reference to the testis used by EMR 4 CardioS oft on PC2 View CardioS oft test Revision B CardioSoft to EMR 2023324 206 Interface Overview Workflow Scenario 3 Manual Reception of Resting ECGs via ECG Writer Workflow Scenario 3 User interactions within Ellipse 1 CardioSoft Start 2 CardioSoft Go into receive mode application 3 ECG Writer Send selected test 4 EMR Initiate to view the test 5 CardioSoft View test EB Writer Mac 200 5 PC 1 CardioSqft Workstation PC 2 CardioS ft Workstation CardioSpft Client CardioSpft Client plus EMR Client plus EMR client NETWORK EMR CardioSoft Server Server Note CardioSoft and EMR client need to be installed on one Workstation 8 CardioSoft to EMR Revision B 2023324 206 Interface Overview Workflow Scenario 3 Client Workstation amp Application Action Description 1 CardioS oft on PC1 Start CardioS oft directly via Icon on the desktop 2 CardioS oft on Go into the receive mode System Configuration gt gt Receive data from ECG device 3 ECG Writer Send the test via serial interface On end of transmission m CardioS oft on PC1 O Automatic manual assignment selecta
25. rM 21 Stress ECG sii Vesa Repo ERR RACE RR 25 5 pirometby ado ce e dte A Neenah eben aides 29 ABP Configuration of ABP Device 32 ABP Read Data from Device 34 ie EMEPTPEPEROETTZERPRAERPSNURESETRTRPUS 38 Revision CardioSoft to EMR i 2023324 206 Test ioc DOE ORE Ee ER 39 Functions Initiated by 50 40 Data Upload of Existing CardioSoft Tests to EMR 40 Data Upload of External Tests from Writers 42 HL7 Messages 42 42 toe do ob regebat o dee ede 43 ORU Observation Reporting 43 ORU Message Segments 45 ORU PID Patient Identification 46 ORU PV1 Patient Visit 49 ORU OBR Observation Request 51 ORU OBX Observation Result 53 MDM Document Management 55 MDM Message Segments 57 MDM MSH Message Header 5 MDM EVN Event Type ccc cece cece eee nmn 58 MDM PID
26. value is 2000ms GEN_MaxSentMess 1 Total number of messages sent before a final error is assumed original message and 1 repetition after first occurrence of error value is valid from 1 to 5 default value is 2 GEN_EndOfSegmWithC RLF 0 End of segments with CR LF that means all segments end with CR and LF 0 means only CR default is 1 The functions New Edit and View are supported through the EMR interface for the Resting ECG Stress Test Spirometry and ABP modalities NOTE Holter and external programs are not supported CardioSoft to EMR Revision B 2023324 206 Interface Specification New Test Launched by EMR General Launching CardioSoft CardioSoft is launched by EMR with the parameters EMR_N and the file name This filename format must be lt Modality gt _ lt ID gt emr File Name Value Definitions lt Modality gt R_ECG Resting ECG S_ECG Stress ECG SPIRO Spirometry BPMONC ABP Configure ABP Device BPMOND ABP Read Data from ABP Device 4 gt Should be used by EMR as a unique ID e g Patient ID plus document number order ID It is stored in CardioS oft for each test and used for the filename of the observation results The emr file must be written by the EMR to the CardioSoft Read from folder that is displayed in System Configuration gt gt EMR tab Example for launching CardioSoft to conduct a Resting ECG c cardi
27. view it later Test results most observation values depend on the type of test For all tests Interpretation Comment any comment Extra Questions 2 short notes containing question and response NOTE Also see Table 1 Resting ECG on page 22 Heart rate BP systolic diastolic PR QT QTc interval QRS duration P T QRS axis P duration Average PP RR Interval CardioSoft to EMR Revision B 2023324 206 Data Transfer CardioS oft EMR For Stress Test NOTE Also see Table 2 Stress Test on page 26 m Max heart rate m Max predicted heart rate m Max BP systolic diastolic m Max load Treadmill Ergometer m Max ST Level m Max TWA T Wave Alternans m Test protocol e g BRUCE m Total test time m Stress test type e g Treadmill Ergometer Persantine m Baseline heart rate Reason for termination m Time in exercise For Spirometry NOTE Also see Table 3 Spirometry on page 30 m Spirometry test type Spirometry Before Bronchodilation After Bronchodilation m Reference values equation e g Knudson m FVC Forced vital capacity m FEV1 Forced expiratory volume in 1st second m FEV1 FVC FEVI as percentage of FVC m Interpretation mode CHS on basis of American Thoracic Society Europe on basis of ECCS m Measurement mode ATS mode Envelope mode For ABP NOTE Also see Table 4 ABP on page 36 m Systolic diastolic blood pressure 24
28. 00mg OBX 1 ST Medication ASPIRIN 13200mg OBX 1 ST Medication ISOSORB 175mg Items of Interest MSH 11 Operating mode MSH 3 Sending App CPO EMR MSH 4 Receiving App CARDIOSOFT MSH 10 Message Control ID Unique ID P Production D Debug PID 3 Patient ID EMR Internal Patient ID PID 4 Alternate ID PID 5 Patient Name CardioS oft ID if one exists used lastfirst middle PID 7 Date of Birth yyyymmdd PID 8 S ex M F U PID 10 Race See Spec for correct values PV1 7 Attending Phys used last first middle degree PV1 8 R eferring P hys used last first middle degree OBR 4 Test Name R_ECG Resting ECG OBR 16 Ordering Phys last first middle degree OBX 3 Observation Name obs name e g History Reason Height Weight OBX 5 Observation Value numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value Revision B CardioSoft to EMR 2023324 206 21 Interface Specification NOTE The Medication Observation name is reused for each medication sent Each med is delivered with the medication name in OBX 3 and the dose in OBX 5 Resting ECG is started and clinical data Attending Physician Referring Physician Ordering Physician Reason for Test up to 4 rest is discarded Medical History Medication up to 5 rest is discarded are stored in CardioSoft EMR should use
29. 0211 Character Set N 19 60 CE Principal Language Of Message N Note Description 1 MSH 5 contains LINKLOGIC 2 MSH 6 contains LOGICIAN 3 he supported values for Message Type include m ADT Admission discharge and transfer message m ACK General acknowledgment message On Export the second component trigger event is always populated with A04 and is identical to EVN 1 Event Type Code 4 On Export the creation time of the message is used for MSH 10 time stamp yyyymmddhhmmssxxx where lt gt 15 a sequence number in case of identical time stamp 5 The supported values for Processing ID include D Debugging m P Production 6 On export 2 3 is used for Version ID 7 The supported values for Accept Ack Type include m AL Always NE Never default If application acknowledgment should be used an entry in HL7 INI needs to be done manually See HL7 Settings on page 18 66 CardioSoft to EMR Revision B 2023324 206 HL7 Messages ADT EVN Event Type Legend R Required Optional Conditional N Not Used U Used EVN Segment CardioS oft Applicability Seq Length Data Type HL7 Table Element Name Export 1 3 ID 0003 Event Type Code U 1 2 26 TS Recorded Date Time U 2 3 26 TS Date Time of Planned Event N 4 3 IS 0062 Event Reason Code N 5 60 XCN 0188 O
30. 36 CardioSoft to EMR Revision B 2023324 206 Interface Specification Items of Interest OBR 18 Document Type DR Diagnostic Report Other OBR 25 Result status F indicates normal status OBX 3 Observation Name Obs name e g History Reason Height Weight OBX 5 Observation Value Numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value Question 1 amp Question 2 The value field contains both the question and answer OTHER REF Value for this OBX is the reference to the test CardioSoft creates and stores an HL7 file internally to reference the conducted test This filename is located in the OBX segment with OBX 3 OTHER REF and must be used by the EMR to edit view this test If no successful download of the data in the APB device was possible an abort message is sent The Abort message has the following format MSH N amp CARDIOSOFT CPO EMR 20040812174812 ORU 20040812174812001 P 2 3 NE PID 1 EMR 19650101 W 1 20040812174812 1 20040812174812 DR 120040812174812 1 7 Ambulatory Blood Pressure test setup not Items of Interest OBR 4 Test Name BPMOND ABP Read Data from ABP Device OBR 18 Document Type DR Diagnostic Report Other
31. Action Description 1 CardioS oft on PC1 Start CardioS oft in Communication Server Mode see CardioS oft Service Manual V6 0 and subsequent The dialog for automatic reception of Resting ECGs via modem comes up receive mode 2 ECG Writer Send the test via modem On end of transmission m CardioSofton PC1 O Automatic assignment of test New patient record is created and test assigned or test is assigned to an existing patient If patient demographics don t match test is stored in a list to assign it manually O Corresponding patient demographics and a reference to the test are sentto EMR HL7 via TCP IP or shared file if the test was assigned successfully m Read HL7 messages create patient s chart and assign test 3 EMR Client on PC2 Launch CardioS oft for viewing test m Reference to the testis used by EMR 4 CardioS oft on PC2 View CardioS oft test Revision B CardioSoft to EMR 2023324 206 11 Data Transfer CardioS oft EMR Data Transfer CardioSoft EMR EMR to CardioSoft CardioSoft to EMR For Resting ECG Patient demographics Patient ID Name DOB Gender Race Test order Start View Edit Test name Stress Resting Spirometry ABP Clinical data Height Weight of patient Pacemaker Attending physician Referring physician Ordering physician Reason for Test Medical History Medication 9999999 Reference to the conducted test to edit
32. CardioSoft to EMR System Interface Specification Reference Guide 2023324 206 Revision B GE Medical Systems Information Technologies gemedical com NOTE The information in this manual applies only to CardioSoft to EMR v6 and subsequent Due to continuing product innovation specifications in this manual are subject to change without notice CardioSoft is a trademark owned by GE Medical Systems Information Technologies a General Electric Company going to market as GE Healthcare All other trademarks contained herein are the property of their respective owners 2005 2007 General Electric Company All rights reserved T 2 CardioSoft to EMR Revision B 2023324 206 14 February 2007 Contents Revision History 1 Limitaliohs o C a Ew ew P o E EC C CX 1 Reference Documents 4 4 1 Conventions ovra ec rae NA E Er EVE VE EY 1 Introductioli 15 ieri eek rer x Eh y Ce rie ree IF T CO CN 2 Md P Um 2 WE 2 Interface Overview 3 FAUMCUONS 2555 date eck aatem detects 3 MOTKTIOW 3o eet ehe di 3 Workflow Scenario 1 Conduct Edit Review View Tests 4 Workflow Scenario 2 Data Upload to EM
33. ID Internal ID is assumed to contain the patient identifier of CardioS oft 2 PID 4 Alternate Patient ID is assumed to be the CardioSoft s Patient s ID that was previously uploaded to the EMR database data migration of existing patients and tests If available PID 4 is used primarily to access to existing CardioS oft s Patient IDs Although HL7 states a length of 20 with CardioS oft a maximum length of 30 is possible due to data migration of existing patients and tests 3 The supported values for Sex include F Female M Male O Other treated as Unknown U Unknown 4 The supported values for Race include 60 CardioSoft to EMR 2023324 206 Revision B HL7 Messages Note Description Value Definition gt gt CardioS oft On Export if not supported Asian 0 Oriental Asian Unknown is used Black B Black Caucasian W White Hispanic H Hispanic Native American N Native American Oriental 0 Oriental Asian Pacific Islander P Pacific Islander Unknown U Undetermined default MDM TXA Transcription Document Header Legend R Required O Optional C Conditional N Not Used U Used TXA Segment CardioSoft Applicability Seq Length Data Type HL7 Table Element Name Export 1 4 S Set ID Document 0 2 30 IS 0270 Document Type U 1 3 2 ID 0191 Document C
34. M W PV1 1 SOUTH Winston Harry S Ref L Ref F OBR 1 BPMOND 20040327110218 IIl I DOrdering Ordering L Ordering F OBX 1 ST History Text of the history goes here OBX 1 ST Reason Reason for Test 1 OBX 1 ST Reason Reason for Test 2 OBX 1 ST Reason Reason for Test 3 OBX 1 ST Reason Reason for Test 4 OBX 1 ST Height 72 IN OBX 1 ST Weight 160 LB OBX 1 ST Pacemaker Y OBX 1 ST Medication LISINOPRIL 180mg tablets OBX 1 ST Medication HEXORAL 1500m1 OBX 1 ST Medication ASPIRIN 1100mg OBX 1 ST Medication ASPIRIN 13200mg OBX 1 ST Medication ISOSORB 175mg Items of Interest MSH 3 S ending App EMR MSH 4 R eceiving App CARDIOSOFT MSH 10 Message Control ID Unique ID MSH 11 0 perating mode P Production D Debug PID 3 Patient ID EMR Internal Patient ID PID 4 Alternate ID CardioS oft ID if one exists 34 CardioSoft to EMR Revision B 2023324 206 Interface Specification Items of Interest PID 5 P atient Name used last first middle PID 7 Date of Birth yyyymmdd 8 5 PID 10 Race See Spec for correct values PV1 7 Attending Phys used last first middle degree PV1 8 R eferring P hys used last first middle degree OBR 4 Test Name BPMOND ABP Read Data from ABP Device 16 0 Phys used last first middle degree OBX 3 Observation Name obs name e g H
35. R for Data Migration 6 Workflow Scenario 3 Manual Reception of Resting ECGs via ECG Writer 8 Workflow Scenario 4 Automatic Reception of Resting ECGs via ECG Writer 10 Data Transfer CardioSoft EMR 12 EMR to CardioSOft cc pore aa e RU Rd cs 12 050740 E MR 2o te Edd teamed oed adi 12 ForRestind ECG 4 eiae cele detto ensi na S 12 For Stress TEST 2 50 Here eben tede een e x 13 For Spirometiy Denk ETE 13 FOLABP cos ERO EE YU E bee d 13 HL7 Dataflow CardioSoft 14 Interface 14 EMR Interface Configuration 15 Initial bites be gor aoi ins 15 Interface Configuration to Control CardioSoftviaEMR 16 Interface Configuration for Data 17 Interface Configuration for Test 17 Interface Configuration in Terms of User Administration 17 HEPES cea dace lata tae arts 18 Functions Initiated by 18 New Test Launched by EMR 19 RESUINGIECG 2
36. able the unit assoc with the value Revision B CardioSoft to EMR 2023324 206 29 Interface Specification NOTE The Medication Observation name is reused for each medication sent Each med is delivered with the medication name in OBX 3 and the dose in OBX 5 Spirometry test is started and clinical data Attending Physician Referring Physician Ordering Physician Reason for Test up to 4 rest is discarded Medical History Medication up to 5 rest 1s discarded are stored in CardioSoft EMR should use the CardioSoft default list in the Reason for Test combo box Medical History and Medication are read only in CardioSoft After the button Post Test Review or Back to EMR is pressed the following data is provided by the Spirometry module Table 3 Spirometry Cardio Soft ID Units Description OTHER_REF Text Internal Reference to test to use by EMR for editing or viewing SpiroTestT ype Text S pirometry test type RefValE quation Text Spirometry reference values equation name of formula used for calculation of reference values such s ECCS Austrian ECCS ZAP Forche NHANESIIII Knudson Finland Brazil Interpretation Text Spirometry interpretation Comment Text Any comment workflow personal non clinical data 60 char max Question 1 Text Short note containing a question and response 52 char max Question 2 Text Short note containing a question and response 52 char m
37. ar max Example for Resting ECG Observation Results R ECG 80 TESTO11 42 car MSH amp CARDIOSOFT 20040812174632 ORU 20040812174632001 P 2 3 NE PID 1 EMR_PID MARKHAM STEVE 19650101 M W 1 R_ECG 20040812174627 1 1120040812174627 EK 20040812174627 F OBX 1 TX OTHER REF 000005 20040812174627 csoft OBX 1 ST HR 60 bpm F 1 5 Systolic mmHg F OBX 1 ST BP Diastolic mmHg l l F OBX 1 ST PR 164 ms F 1157 0 364 ms F OBX 1 ST OTC 364 ms IF OBX 1 ST ORSD 86 ms IF OBX 1 ST P Axis 34 llIF OBX 1 ST T Axis 48 I IF OBX 1 ST EKG ORS 441 9 OBX 1 ST P 88 ms F OBX 1 ST PP 1000 ms IF OBX 1 ST RR 1000 ms IF OBX 1 ST Interpretation Normal sinus rhythm br Normal 111 OBX 1 ST Comment This is the comment I F OBX 1 ST Question 1 Smoker Yes lllllF OBX 1 ST Question 2 Athlete No F Items of Interest MSH 3 MSH 4 Names reversed to indicate opposite send direction OBR 4 Test Name R_ECG Resting ECG OBR 18 Document Type EK EKG Report OBR 25 Result status F indicates normal status OBX 3 Observation Name Obs name e g History Reason Height Weight OBX 5 Observation Value Numeric or text value for observation OBX 6 Units If applicable t
38. as a tag to identify on different clients what belongs together 4 CardioSoft to EMR 2023324 206 Revision B Interface Overview Workflow Scenario 1 Client Workstation amp Application Action Description 1 EMR Clienton PC1 Enter patient demographics 2 EMR Client on PC2 Enter order for a new test 3 EMR Client on PC3 J oin entered order and launch CardioS oft for New Test m Patient demographics clinical data and type of test are transferred to CardioSoft EMR order ID is part ofthe filename 4 CardioSoft on PC3 Conduct test Finish test m end of test when going to Post test Review screen the defined observation values results are transferred back EMR order ID is part of the filename m Go back to EMR button The defined observation values results are transferred back again if changes were made in Post test review screen 5 EMR Client on PC3 Retrieve Results manually by button automatically m EMR reads stores observation values and a reference to this test 6 EMR Client on PC2 J oin open order and launch CardioS oft to review the test m Reference to the test is used by EMR 7 CardioS oft Client on PC2 Edit Review test m Go Back to EMR button m Defined observation values results are transferred back with the originally EMR order ID in filename 8 EMR Client on PC2 Retrieve Results manually by button automatically Sign doc
39. ataflow ended ar ren eA 14 CardioSoft 14 HEZ Selling Ee tb 18 document reference file FALE ZN OIL RUDI 18 MOM eR Les 41 HE7 ERREQG iiem eden 42 Arm EMPRESA 41 interface configuration EMR parameters data 17 80 TESTO11 45 33 testmode NE IMS 17 80 TESTO011 45 emr 32 user administration 17 BPMOND 80 57011 46 36 L BPMOND 80 TESTO011 46 emr 34 1 EMR eee 19 login screen 17 R ECG 80 TESTO11 42 Cal s o3 09 8 ECG 80 TESTO011 42 21 M S ECG 80 TESTO011 43 27 41 S 80 TESTO11 43 25 message segments SPIRO 80 5 7011 44 31 ADISEVI 226 67 SPIRO 80 TESTO011 44 29 ADT MS A ecrit ener ar e e eek dad 69 25 15 65 EMRE eie ein 38 bebes debe sedet 67 EMP D rien vis LI Et 39 MDNMESEVIN isi irt ens
40. ator N N 22 2 IS 0045 Courtesy Code N N 23 2 IS 0046 Credit Rating N N 24 2 IS 0044 Contract Code N N 25 8 DT Contract Effective Date N N 26 12 NM Contract Amount N N 2 3 NM Contract P eriod N N 28 2 IS 0073 Interest Code N N 29 1 IS 0110 Transfer to Bad Dept Code N N 30 8 DT Transfer to Bad Dept Date N N 31 10 IS 0021 Bad Debt Agency Code N N 32 12 NM Bad Debt Transfer Amount N N 33 12 NM Bad Debt Recovery Amount N N 34 1 IS 0111 Delete Account Indicator N N 35 8 DT Delete Account Date N N 36 3 IS 0112 Discharge Disposition N N 37 25 CM 0113 Discharged to Location N N 38 2 IS 0114 Diet Type N N 39 2 IS 0115 Servicing Facility N N 40 1 IS 0116 Bed Status N N 41 2 IS 0117 Account Status N N 42 80 PL Pending Location N N 43 80 PL Prior Temporary Location N N 44 26 TS Admit Date Time N N 45 26 TS Discharge Date Time N N 50 CardioSoft to EMR Revision B 2023324 206 HL7 Messages PV1 Segment CardioS oft Applicability Seq Length a Element Name Import Export 46 12 NM Current Patient Balance N N 41 12 NM Total Charges N N 48 12 NM Total Adjustments N N 49 12 NM Total Payments N N 50 20 CX 0192 Alternate Visit ID N N 51 1 IS 0326 Visit Indicator N N 52 60 XCN 0010 Other Healthcare Provider N N Note Description 1 Attending and Referring Doctor Part of CardioS oft test information ORU OBR Observation Request Legend R Required O Optional C
41. ax FVC liters Forced vital capacity FEVI liters Forced expiratory volume in 15 second FEVIFVC percent FEVI FVC FEV1 as a percentage of FVC SPI Interpr Mode Text Interpretation Mode 2 modes are available CHS on the basis of ATS American Thoracic Society Europe on the basis of ECCS SPI Meas Mode Text Measurement Mode ATS mode mostly used in US or Envelope mode 30 CardioSoft to EMR Revision B 2023324 206 Interface Specification Example for Spirometry Observation Results SPIRO_80 TEST011_44 car MSH amp CARDIOSOFT 20040812175140 ORU 20040812175140001 P 2 3 NE PID 1 EMR 19650101 M W 1 SPIRO 120040812175548 1 1120040812175548 DRI 120040812175548 1 000003_SPIRO_20040812175548 csoft 1 7 This is the comment F OBX 1 ST Question 1 Smoker Yes llllF OBX 1 ST Question 2 Athlete 1 1157 1 11 OBX 1 ST RefValEquation Knudson l F OBX 1 ST SpiroTestType Spirometry l l lF OBX 1 ST FVC 3 28 1 I IF OBX 1 ST FEV1 2 88 1 IF OBX 1 ST FEVIFVC 87 111 OBX 1 ST SPI Interpr Mode CHS l lllF OBX 1 ST SPI Meas 1 11
42. ble in dialog of the test New patient record is created and test assigned or test is assigned to an existing patient If patient demographics don t match testis stored in a list to assign it manually Corresponding patient demographics and a reference to the test are sent to EMR HL7 via TCP IP or shared file if the test was assigned successfully m EMR ORead HL7 messages create patient s chart and assign test 4 EMR Client on PC2 5 CardioS oft on PC2 Launch CardioS oft for viewing the test m Reference to the testis used by EMR View CardioS oft test Revision B CardioSoft to EMR 2023324 206 10 Interface Overview Workflow Scenario 4 Automatic Reception of Resting ECGs via ECG Writer Workflow Scenario 4 User interactions within Ellipse CardioSoft Start application in comm server moce 2 ECG Writers Send tests 3 EMR Initiate to view the test 4 CardioSoft View test Modem1 2 Modem3 55521 soos Modem1 2 55521 55521 odem3 PC 1 CardioSoft Communication PC 2 CardioSqft Workstation Serve mode CardioSpft Client plus EMR client plus EMR Client NETWORK CardioSoft Server Note CardioSoft and EMR client need to be installed on one Workstation CardioSoft to EMR Revision B 2023324 206 Interface Overview Workflow Scenario 4 Client Workstation amp Application
43. ds two communication folders for importing exporting the HL7 files for Observation Reporting These folders can be identical m CardioSoft imports the lt xxx gt emr files from the Read from folder The EMR system needs to write these files CardioSoft is responsible for deleting them m CardioSoft exports lt xxx gt car files to the Write To folder The EMR system reads these files and is responsible for deleting them These communication folders are written and read from the file Your EMR Install Path gt CardioSoft CardioSoft ini It is intended that the EMR system creates this file and writes the entries for the communication folders to be used by CardioSoft However this file is also created by CardioSoft if it doesn t exist Important Folder EMR Install Path gt CardioSoft must exist In this case the default values for the communication folders are used TMP path of the system with folders csoft emr and emr csoft appended 16 CardioSoft to EMR Revision B 2023324 206 Interface Specification See the entries below that are used within the file CardioSoft ini READDIR lt dir path gt CardioS oft output directory Write to in system configuration dialog WRITEDIR lt dir path CardioSoft input directory Read from in system configuration dialog Interface Configuration for Data Upload Data upload patient demographics and links to the tests is conducted m Manua
44. e tr Re 58 example for MBM MSA widen fae te Vl ete go ex dnos 64 a Demographics 40 MDM MSH 57 Document Reference File 41 MDM QBYX 63 2023324 206B CardioSoft to EMR 73 ii heel siete 59 61 tieu te eines 43 IU 43 45 iniecto 51 ORU OBX 53 ORU PID zii thee es 46 dig ether ence tee tel cards 49 messages ADT ie 64 tu cr EcL 55 RW 43 tenent aibi 42 Observation reporting 16 OLE LINKA ie ae 15 option code XEMR 336i p c pec lang eae 15 P password 2 17 patient demographics file 40 40 R BREADDIR RM Ee ei a 17 T UP 41 lest mode one ettet eatenus 17 AEEA 1 U user 17 workflow scenario 1 conduct edit review view tests 4 scenario 2 data upload to EMR for data migration 6 scenario 3 manual reception of Resting ECGs via SCA i 8 scenar
45. eath Date N N and Time 30 1 ID 0136 Patient Death N N Indicator Note Description 1 2 PID 3 Patient ID Internal ID is assumed to contain the patient identifier of the EMR system used to match the import data with a CardioS oft patient ID if PID 4 is not available See General on page 42 PID 4 Alternate Patient ID is assumed to be the CardioSoft s Patient s ID that was previously uploaded to the EMR database data migration of existing patients and tests If available PID 4 is used primarily to access to existing CardioSoft s Patient IDs Although HL7 states a length of 20 with CardioSoft a maximum length of 30 is possible due to data migration of existing patients and tests 3 The supported values for Sex include F Female Male 0 Other treated as Unknown U Unknown 4 The supported values for Race include Value Definition gt gt CardioS oft On Import if not supported CardioS oft B Black Black uses lt Unknown gt Chinese Asian H Hispanic Hispanic Japanese Asian N Native Am Native American 0 Orient Asian Asian P Pacific Isl r Pacific Islander W White Caucasian T Other Unknown U Undeterm Unknown Default 48 CardioSoft to EMR 2023324 206 Revision B HL7 Messages Note Description Value Definition gt gt CardioS oft On Export if not supported lt Unknown gt is Asian 0 Oriental Asian used Blac
46. egree PV 1 8 R eferring Phys used last first middle degree OBR 4 Test Name S ECG Stress ECG OBR 16 Ordering Phys used last first middle degree OBX 3 Observation Name obs name e g History Reason Height Weight Revision B CardioSoft to EMR 2023324 206 25 Interface Specification Items of Interest OBX 5 Observation Value numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value NOTE The Medication Observation name is reused for each medication sent Each med is delivered with the medication name in OBX 3 and the dose in OBX 5 Stress test is started and clinical data Medical History Attending Physician Referring Physician Ordering Physician Reason for Test up to 3 rest is discarded Medication up to 10 rest 1s discarded are stored in CardioSoft EMR should use the CardioSoft default list in the Reason for Test combo box Medical History and Medication are read only in CardioSoft After the button Post Test Review or Back to EMR is pressed the following data is provided by the Stress ECG module Table 2 Stress Test Cardio Soft ID Unit Description OTHER REF Text Internal Reference to test to use by EMR for editing or viewing Max HR bpm Maximum heart rate achieved Max predicted HR bpm Maximum predicted heart rate
47. endix A Interpretation of HL7 Data Types For your notes 72 CardioSoft to EMR Revision B 2023324 206 Index A Observation Results Data from ABP Device 36 POA cousin er 40 resting ECG Observation Results 23 40 Spirometry Observation Results 31 C Stress ECG Observation Results 27 pas example for launching CardioSoft in Edit Mode 38 READDIR eie i 17 n WRITBDIRL id E 17 SdrdiasolEin view ONY Mode se ES CITRIX 1 CardioSoft Ipiconaueba Resting ECG test 21 CURRENTUSER 18 Cardio Solr te Conduct SpIremely TOST gives CURRENTUSERID 18 ATTICS OIL 29 CardioSoft to configure an ABP device 32 D CardioSoft to read data from an ABP device 34 data types F e NIE 71 file mcr e ro P ern ott Y EE 70 S NR CNN CMM 70 CI 16 EME e END 16 PN 71 A i communication 16 vatur a hate eism 70 enone 3 Jpn mE ee er ne a ee eo PAR CI IG ewe EU Qu CET CY ap cR 70 H pp MM 71 HL7 data iUupload inei ete ett rs 17 petet heh RE TREE 14 d
48. esult status X indicates aborted test OBX record 15 used to return comment providing the reason for aborting the test The comment is generated by the application It is not entered by the user After the button Back to EMR 1s pressed the car file described above is written again when the test was modified during Post Test Review ABP Configuration of ABP Device Example for launching CardioSoft to configure an ABP device BPMONC 80 TESTO11 45 emr MSH amp EMR CARDIOSOFT 20040327110218 ORU 20040327110218001 P 2 3 NE PID 1 EMR PID MARKHAM STEVE 19650101 M W PV1 1 SOUTH Winston Harry S Ref L Ref F 1 20040327110218 11111 DOrdering Ordering L Ordering F OBX 1 ST History Text of the history goes here OBX 1 ST Reason Therapy outcome control OBX 1 ST Reason Suspected sleep apnea syndrome OBX 1 ST Reason Kidney transplant OBX 1 ST Reason Reason for Test 4 OBX 1 ST Height 72 IN OBX 1 ST Weight 160 LB OBX 1 ST Pacemaker Y OBX 1 ST Medication LISINOPRIL 180mg tablets OBX 1 ST Medication HEXORAL 1500ml OBX 1 ST Medication ASPIRIN 1100mg OBX 1 ST Medication ASPIRIN 13200mg OBX 1 ST Medication ISOSORB 175mg Items of Interest MSH 3 Sending App EMR MSH 4 Receiving App CARDIOSOFT MSH 10 Message Control ID Unique ID MSH 11 Operating mode P Production D Debug PID 3 P atient ID EMR
49. f test thatis referenced by this message 1st OBX segment The 2nd OBX segment can be ignored The 3rd OBX segment Identifier OTHER REF shall be used by the EMR as document reference test reference Revision B CardioSoft to EMR 2023324 206 63 HL7 Messages MDM MSA Message Acknowledgment Legend R Required O Optional C Conditional N Not Used U Used MSA Segment CardioSoft Applicability Data Seq Length T HL7 Table Element Name Import ype 1 2 ID 0008 Acknowledgement COde R 1 2 20 ST Message Control ID R 3 80 ST Text Message 0 4 15 NM Expected Sequence Number N 5 1 ID 0102 Delayed Ack Type N 6 100 CE Error Condition N 1 The supported values for Acknowledgment Code include m AA Original mode Application Acknowledgment Accept AR Original mode Application Acknowledgment Reject AE Original mode Application acknowledgment Error NOTE Receipt of either AR or AE initiates message re send events ADT Admission Discharge and Transfer The ADT message is used to export patient demographics data of CardioSoft patient records ADT messages are uploaded once to the EMR for data migration all already existing patient records in the database ADT messages are uploaded at any time when CardioSoft receives Resting ECG tests that were conducted on an ECG Writer See Data Upload of Existing CardioSoft Tests to EMR
50. figuration Initial Steps To run CardioSoft with an EMR system EMR mode the following steps must be done On EMR side 1 Create the file emr ini in the system folder c winnt or c windows with the following content Installation LogicianInstallPathTo lt Your EMR Install Path gt 2 Create folder lt EMR Install Path gt CardioSoft before starting CardioSoft On CardioSoft side 1 Enter a valid Option Code XEMR in the CardioSoft System Configuration screen gt Option Code tab Revision B CardioSoft to EMR 15 2023324 206 Interface Specification Interface Configuration to Control CardioSoft via EMR After completing the steps in EMR Interface Configuration on page 15 the EMR tab in System Configuration is available System Configuration General Devices Modem MUSE Option Code County Settings EMR Communication Folder Read from EBNES TET B fe Pepe LRL Wiite to D Logician CardioS off CardioSoft inbox Settings for data upload C Data transfer via shared direc Data transfer via the network Host name 3 243 54 28 Port number 3400 HLZ Header n HL Traer 0 Error logging Folder DTemper View error log Upload to EMR database O cardiosys Objsys Release Patients 4 Examinations 30 SK Latest upload December 13 2004 12 15 47 Patients 4 Examinations 23 Cancel m CardioSoft nee
51. figuration Status is provided by the ABP module Example for ABP Observation Results Configuration Status BPMONC 80 TESTO11 45 car MSH amp CARDIOSOFT 20040812174812 ORU 20040812174812001 P 2 3 NE PID 1 EMR PID MARKHAM STEVE 19650101 M W 1 20040812174812 1120040812174812 DR 20040812174812 IX OBX 1 ST Comment Setup of BP device successfully completed l l F Revision B CardioSoft to EMR 33 2023324 206 Interface Specification Items of Interest OBR 4 Test Name BPMONC ABP Configuration OBR 18 Document Type DR Diagnostic Report Other OBR 25 Result status X indicates aborted test OBX record Is used to return comment providing the configuration status The commentis generated by the application It is not entered by the user This configuration status is only informational CardioSoft does not store configuration status An abort message is sent when CardioSoft cannot establish a connection to the ABP device The OBX record OBX 5 returns the reason for aborting the test Message as shown above ABP Read Data from ABP Device Example for launching CardioSoft to read data from an ABP device BPMOND 80 TESTO11 46 emr MSH amp CARDIOSOFT 20040327110218 ORU 20040327110218001 P 2 3 NE PID 1 EMR 19650101
52. gment message The second component trigger event is ignored on import and not used on export 4 Export the creation time of the message is used for MSH 10 time stamp yyyymmddhhmmssxxx where xxx is a sequence number in case of identical time stamp 5 The supported values for Processing ID include D Debugging P Production 6 On export 2 3 is used for Version ID 7 The supported values for Accept Ack Type include AL Always NE Never default If application acknowledgment should be used an entry in HL7 INI needs to be done manually See HL7 Settings on page 18 Legend R Required O Optional C Conditional N Not Used U Used EVN Segment CardioSoft Applicability Seq Length Data Type HL7 Table Element Name Export 1 3 ID 0003 Event Type Code U 1 2 26 TS Recorded Date Time U 2 3 26 TS Date Time of Planned Event N 4 3 IS 0062 Event Reason Code N 5 60 XCN 0188 Operator ID N 6 26 TS Event Occurred N 58 CardioSoft to EMR Revision B 2023324 206 HL7 Messages Note Description 1 The supported values for Event Type Code include m 702 Original document notification and content m Trigger event T02 is always used 2 EVN 2 Date Time of Event is populated with the creation date time of the test referenced document MDM PID Patient Identification Legend
53. he unit assoc with the value Question 1 amp Question 2 The value field contains both the question and answer Prompt value OTHER REF Value for this OBX is the reference to the test Revision B CardioSoft to EMR 23 2023324 206 Interface Specification CardioSoft creates and stores an HL7 file internally to reference the conducted test This filename is located in the OBX segment with OBX 3 OTHER_REF and must be used by the EMR to edit view this test When no test is started and button Back to EMR is pressed an Abort message is sent The Abort message has the following format MSH amp CARDIOSOFT CPO_EMR 20040812174812 ORU 20040812174812001 P 2 3 NE PID 1 EMR 19650101 W OBR 1 R 20040812174812 120040812174812 EK 20040812174812 IX OBX 1 ST Comment No test performed 11 Items of Interest OBR 4 Test Name Resting ECG OBR 18 DocumentType EK EKG Report OBR 25 Result status X indicates aborted test OBX record 15 used to return comment providing the reason for aborting the test The comment is generated by the application It is not entered by the user 24 CardioSoft to EMR Revision B 2023324 206 Interface Specification Stress ECG Example for launching CardioSoft to conduct a Stress ECG test S ECG 80 TESTO11 43 emr MSH amp CPO_EMR
54. hr average m Systolic diastolic blood pressure day time average m Systolic diastolic blood pressure night time average m Total recording time Revision B CardioSoft to EMR 13 2023324 206 Interface Specification HL7 Dataflow CardioSoft EMR Initiator Cardi Data Upload for Data migration Tests received from ECG Writers Demographic Data Export HL7 ADT A04 message Shared file with extension or via TCPIP CardioSoft Document Link Export HL7 MDM T02 message Shared file with extension or via TCPIP Initiator EMR New test Document Link Import Edit test Document feference that was part of View test the of previpusly exported HL7 ORU message rust be used as parameter Internally this document reference is a stored MDM T02 message Edit Test Cardio E lt xxx gt csoft View Test Cardio EMR O xxx soft Observation Reporting Export Observation Reporting Import HL7 ORU message HL7 mdssage Shared file with car extension Shared file with emr extension Observation results andthe link to Test demographics the examination Clinical New Testy Cardio EMR_N xxx emr Interface Specification This interface uses HL7 Version 2 3 For importing HL7 messages CardioSoft also accepts Versions 2 2 2 1 2 0 or 2 0d 14 CardioSoft to EMR Revision B 2023324 206 Interface Specification EMR Interface Con
55. imestamp Unless otherwise specified the format for date and timestamp fields must be YYYYMMDDHHMMSS Although the month and day are considered optional in the HL7 specification of the date format CardioSoft requires them 70 CardioSoft to EMR Revision B 2023324 206 Appendix A Interpretation of HL7 Data Types PN or PN Person Name Components lt family name ST gt lt given name ST gt lt middle initial or name ST suffix e g JR or IID ST gt prefix e g DR ST gt degree e g MD ST gt CardioSoft only uses family name given name middle initial or name example PID 5 All other components are ignored HL7 CardioSoft patient name patient demographics Jones Robin D ll Dr MD Last Name ones First Name Robin D CN or XCN Composite ID Number and Name Components ID number ST family name ST gt given name ST middle initial or name ST gt suffix e g JR or IID ST gt prefix e g DR ST degree e g MD ST source table 15 gt assigning authority HD CardioSoft only uses family name given name middle initial or name and degree Example PV1 7 PV1 8 OBR 16 All other components are ignored HL7 CardioSoft doctors name for test information rjones J ones Robin D ll Dr MD One String J ones MD Robin D Revision B CardioSoft to EMR 71 2023324 206 App
56. io 4 automatic reception of Resting ECGs via ECG writer 22 42 10 WRITEDIR 17 X XEMR option 15 74 CardioSoft to EMR 2023324 206B GE Medical Systems Information Technologies gemedical com World Headquarters GE Medical Systems Information Technologies Inc 8200 West Tower Avenue Milwaukee WI 53223 USA Tel 1 414 355 5000 1 800 558 5120 US only Fax 1 414 355 3790 European Representative GE Medical Systems Information Technologies GmbH Munzinger StraBe 3 5 D 79111 Freiburg Germany Tel 49 761 45 43 0 Fax 49 761 45 43 233 Asia Headquarters GE Medical Systems Information Technologies Asia GE China Co Ltd 24th Floor Shanghai MAXDO Center 8 Xing Yi Road Hong Qiao Development Zone Shanghai 200336 P R China Tel 86 21 5257 4650 Fax 4 86 21 5208 2008
57. irming the reports in Post Test Review screen and event logging System Configuration gt gt User List gt gt Log Setup To achieve this the EMR needs to create the file Your EMR install path gt cfw ini Revision B CardioSoft to EMR 17 2023324 206 Interface Specification HL7 Settings Functions Initiated by EMR Each time a user logs in the EMR writes the current User ID and Name as follows CURRENTUSER George A Johnson CURRENTUSERID gjohnson lt Your EMR Install Path gt is defined in emr ini See EMR Interface Configuration on page 15 NOTE If the EMR doesn t provide the User ID Name confirmation of reports within CardioSoft and event logging is possible but without User ID Name it doesn t make much sense All settings in terms of HL are stored in the file HL7 ini in section GENERAL This file is stored on the CardioSoft server network folder and is valid for all CardioSoft clients Most settings are accessed by using the EMR tab of CardioSoft However there are additional settings that can be changed manually by modifying HL7 ini Please see those entries and their description below HL7 Setting Setting Description GEN RegAckFromResponderzl in Original Mode Application Acknowledge mode only with TCP IP default value is 0 GEN AckTimeout 1000 Timeout after an expected Acknowledge Message from the Responder in ms value is valid from 500 to 5000ms default
58. istory Reason Height Weight OBX 5 Observation Value numeric or text value for observation OBX 6 Units If applicable the unit assoc with the value NOTE Note that the Medication Observation name is reused for each medication sent Each med is delivered with the medication name in OBX 3 and the dose in OBX 5 ABP test is started and clinical data Attending Physician Referring Physician Ordering Physician Reason for Test up to 4 rest is discarded Medical History Medication up to 5 rest 1s discarded are stored in CardioSoft EMR should use the CardioSoft default list in the Reason for Test combo box Medical History and Medication are read only in CardioSoft After connection to the ABP device is established the user can download data from the BP monitor The buttons to program and clear data in the ABP device is disabled After the button Download Data is pressed the following results are provided by the ABP module Revision B CardioSoft to EMR 35 2023324 206 Interface Specification Table 4 ABP Cardio Soft ID Units Description OTHER REF Text Internal Reference to test to use by EMR for editing or viewing 24h aver BPsys mmHg Systolic blood pressure 24 hr average 24h aver BP dia mmHg Diastolic blood pressure 24 hr average Interpretation Text Blood pressure interpretation ambulatory Comment Text Any comment workflow personal non clinical data
59. k B Black Caucasian W White Hispanic H Hispanic Native American N Native American Oriental 0 Oriental Asian Pacific Islander P Pacific Islander Unknown U Undetermined default ORU PV 1 Patient Visit Legend R Required O Optional C Conditional N Not Used U Used PV1 Segment CardioS oft Applicability Seq Length 5 Rud Element Name Import Export 1 4 S Set ID PV1 N N 2 1 IS 0004 Patient Class N N 3 80 PL Assigned Patient Location N N 4 2 IS 0007 Admission Type N N 5 20 CX Preadmit Number N N 6 80 PL Prior Patient Location N N 7 60 XCN 0010 Attending Doctor 0 1 N 8 60 XCN 0010 Referring Doctor 0 1 N 9 60 XCN 0010 Consulting Doctor N N 10 3 IS 0069 Hospital Service N N 11 80 PL Temporary Location N N 12 2 IS 0087 Pre admit Test Indicator N N 13 2 IS 0092 Readmission Indicator N N 14 3 IS 0023 Admit Source N N 15 2 IS 0009 Ambulatory Status N N 16 2 IS 0099 VIP Indicator N N Revision B CardioSoft to EMR 49 2023324 206 HL7 Messages PV1 Segment CardioS oft Applicability Seq Length a Element Import Export 17 60 XCN 0010 Admitting Doctor N N 18 2 IS 0018 Patient Type N N 19 20 CX Visit Number N N 20 50 FC 0064 Financial Class N N 21 2 IS 0032 Charge Price Indic
60. lly for data migration initially existing patient records and tests within CardioSoft m Automatically when tests from ECG Writers are received and assigned within CardioSoft The settings for the upload are available within the tab see dialog above Depending on how you want to transfer the data select the corresponding settings For HL7 specification see See Functions Initiated by CardioSoft on page 40 Interface Configuration for Test Mode CardioSoft can be launched in test mode This means the test is conducted without acquisition modules with simulated patient data To achieve this the following settings in the MSH and PID segments of the emr file need to be edited Set MSH 11 Processing ID to D Set PID 5 Patient Name TEST DEMO Set PID 4 Patient ID TEST DEMO 000000 Set PID 7 DOB 19680428 not required internal data is taken Set PID 8 SEX M not required internal data is taken Set PID 10 RACE U not required internal data is taken Oe OOV ape SOS bon uis The result file car reflects these data Interface Configuration in Terms of User Administration CardioSoft in EMR mode bypasses the Login Screen because from the workflow standpoint the EMR client on this workstation already provides the user authentication If CardioSoft has enabled the Password function System Configuration gt gt User List a mechanism is implemented to use the EMR User ID Name for conf
61. ment Management The MDM message is used to export document references of already conducted CardioSoft tests Data upload of already existing tests or new tests that are conducted on an ECG Writer and received by CardioSoft See Data Upload of Existing CardioSoft Tests to EMR on page 40 and Data Upload of External Tests from ECG Writers on page 42 The document reference is transferred within an OBX segment with the Identifier OTHER REF Legend R Required O Optional C Conditional I Ignored Revision B CardioSoft to EMR 55 2023324 206 HL7 Messages MDM T02 Message Segments Import Export MSH EVN 20 D PID PV1 1 TXA R 2 OBX R 3 MSH MSA ERR Note Description 0 MDM Importis only internally supported because all document references that are exported by CardioS oft are also stored internally as a MDM T02 message The EMR only uses the exported document reference to view or edit the test 1 Although the HL7 specification considers this message segment to be required CardioS oft does not use it on export 2 The message segment is always exported as part of an MDM message 3 The first exported OBX segment states the type of test that is referenced by this message The 2nd OBX segment can be ignored The 3rd OBX segment Identifier OTHER REF shall be used
62. n Date Comment A 25 October 2005 Initial release B 14 February 2007 Page 15 revised ECO 086753 The EMR Interface is not validated with Russian Japanese Chinese Polish Hungarian and Czech languages The EMR Interface is not validated within a Thin Client e g CITRIX environment m CardioSoft Service Manual V6 0 and subsequent m CardioSoft Software Installation Guide English V6 0 and subsequent The following list is a collection of helpful hints and general guidelines m Items shown in Bold text are keys on the keyboard text to be entered or hardware items such as buttons or switches on the equipment m Italicized items are software terms which identify menu items buttons or options in various windows Revision B CardioSoft to EMR 1 2023324 206 Introduction Purpose Legal Notice This document is intended to be used as a technical description of the CardioSoft EMR Interface for external EMR systems The objective is to provide a quick and easy mechanism for launching the CardioSoft application via an EMR system CardioSoft receives patient demographics and clinical data from the EMR and sends test data for Resting ECG Stress ECG Spirometry and Ambulatory Blood Pressure ABP to the EMR CardioSoft is launched by the EMR to run edit or view a test in any of the four modalities The EMR interface is available from CardioSoft V6 0 and higher This document has been created to be con
63. n the paperclip icon to the right l lllF OBX 1 TX OTHER REF 000002 R ECG 20040504140211 csoft Items of interest TXA 2 Document Type DR for Diagnostic Report other or EK for EKG Report TXA 4 Time of Test TXA 6 Time of Test TXA 12 Unique Document number internal patient id modality time of test Modality S ECG SPIRO BPMOND To support legacy tests from CardioS oft releases prior V5 0 R ECG42 S ECG42 are used These are old versions of stress and Resting ECG First OBX 5 Text CardioS oft lt Modality gt report OTHER_REF Value for this OBX is the reference to the test NOTE If the EMR wants to launch a new test with one of the uploaded patient IDs EMR must use PID 4 of the uploaded A04 messages for PID 4 of the emr file and use the EMR patient ID for PID 3 of the emr file Revision B CardioSoft to EMR 41 2023324 206 HL7 Messages Data Upload of External Tests from ECG Writers HL7 Messages General When a test is received from an ECG Writer System Configuration gt gt Receive Data from ECG Device CardioSoft does the Patient ID matching as follows m If External Patient ID found If Patient s Last Name and First Name and Gender and Date Of Birth are identical empty fields of received data don t care Assign test in CardioSoft to the patient s chart If different assign the test manually Side by Side Dialog come
64. nt N N 30 20 ID 0124 Transportation Mode N N 31 300 CE Reason for Study N N 32 200 CM Principal Result Interpreter N N 33 200 CM Assistant Result Interpreter N N 34 200 CM Technician N N 35 200 CM Transcriptionist N N 36 26 TS Scheduled Date Time N N 37 4 NM Number of Sample Containers N N 38 60 CE Transport Logistics of Collected N N Sample 39 200 CE Collector s Comment N N 52 CardioSoft to EMR Revision B 2023324 206 HL7 Messages ORU OBX Observation Result OBR Segment CardioSoft Applicability Data HL7 Seq Length Type Table Element Name Import Export 40 60 CE Transport Arrangement Responsibility N N 4l 30 ID 0224 Transport Arranged N N 42 1 ID 0225 Escort Required N N 43 200 CE Planned Patient Transport Comment N N Note Description 0 OBR 4 Universal Service IDs is populated as follows First component Identifier m for Resting ECG test mS ECG for Stress ECG test m SPIRO for Spirometry test m BPMONC for ABP Configure ABP Device m BPMOND for ABP Read Data from ABP Device 1 Date Time of conducted CardioS oft test 2 Ordering Provider Part of CardioS oft test information 3 OBR 18 Placer Field 1 is populated with the document type ID Additional to HL7 table 270 Used IDs m EK EKG Report for Resting ECG and Stress Test m DR Diagnostic Report Other for Spirometry and ABP test 4 OBR 25 Res
65. o EMR or Post Test Review is clicked The observation result filename is lt Modality gt _ lt ID gt car whereas lt ID gt is identical with the incoming lt ID gt of the emr file This file is written by CardioSoft to the Write to folder that is displayed in System Configuration gt gt EMR tab The units of the result values are static and don t depend on the CardioSoft System Configuration settings File Handling CardioSoft deletes the emr file after processing The EMR is responsible for deleting the car file 20 CardioSoft to EMR Revision B 2023324 206 Interface Specification Resting ECG Example for launching CardioSoft to conduct a Resting ECG test R ECG 80 TESTO11 42 emr MSH amp EMR CARDIOSOFT 20040327110218 ORU 20040327110218001 P 2 3 INE PID 1 EMR PID MARKHAM STEVE 19650101 M W PV1 1 SOUTH Winston Harry S Ref L Ref F 11 R_ECG 120040327110218 111111 lOordering Ordering L Ordering F OBX 1 ST History CORONARY ARTERY DISEASE ICD 414 00 OBX 1 ST Reason Therapy outcome control 1 87 Checkup 1 87 discomfort OBX 1 ST Reason Confirm Rule out CAD OBX 1 ST Reason Angina Pectoris OBX 1 ST Height 72 IN OBX 1 ST Weight 160 LB OBX 1 ST Pacemaker Y OBX 1 ST Medication LISINOPRIL 180mg tablets OBX 1 ST Medication HEXORAL 1500m1 OBX 1 ST Medication ASPIRIN 11
66. o cardio exe 80 TESTO11 42 emr Path name See Win ini Folder C Winnt or C Windows CardioInstallPath C Cardio Matching of Patient ID The functions New Patient Record Edit Patient Data Delete Patient Record and Delete Examination are completely disabled in CardioSoft in EMR Mode So all patient IDs come from the EMR except two special cases Data migration see See Data Upload of Existing CardioSoft Tests to EMR on page 40 and reception of external tests e g from an ECG Writer see See Data Upload of External Tests from ECG Writers on page 42 It is assumed that the EMR system has unique patient IDs Patient Management of CardioSoft searches for the patient referenced in the message by PID 4 If PID 4 is empty PID 3 is used Use always PID 3 for the EMRs patient ID Additionally use PID 4 for existing CardioSoft patient IDs in case of data migration if data was initially uploaded to the EMR database or in case of receiving tests from ECG Writers Revision B CardioSoft to EMR 19 2023324 206 Interface Specification If there is a record in the database for this patient this patient is selected and patient demographics are updated in the CardioSoft database If there is no record found for this patient a new record is created and this patient is selected Observation Results Observation results depend on the selected modality The results are written when Back t
67. ontent Presentation U 2 4 26 TS Activity Date Time U 3 5 60 XCN Primary Activity Provider Code Name N 6 26 TS Origination Date Time U 3 7 26 TS Transcription Date Time N 8 26 TS Edit Date Time N 9 60 XCN Originator Code Name N 10 60 XCN Assigned Document Authenticator N 11 48 XCN Transcriptionist Code Name N 12 30 Unique Document Number U 4 13 16 ST Parent Document Number 5 14 22 Placer Order Number N 15 8 Filler Order Number N 16 30 ST Unique Document File Name N Revision B CardioSoft to EMR 61 2023324 206 HL7 Messages TXA Segment CardioSoft Applicability Seq Length Data Type HL7 Table Element Name Export 17 2 ID 0271 Document Completion Status U 6 18 2 ID 0272 Document Confidentiality Status N 19 2 ID 0273 Document Availability Status N 20 2 ID 0275 Document Storage Status N 21 30 ST Document Change Reason N 22 60 PPN Authentication Person Time Stamp N 23 60 XCN Distributed Copies Code and Name of N Recipients Note Description 1 CardioS oft uses the following document types for Resting ECG and Stress ECG m DR for Ambulatory Blood Pressure and Spirometry 2 On Export the supported values for Document Content Presentation are shown below TX Machine readable text document 3 TXA 4 6 is populated with the creation date time of the exported document 4 TXA 12 Unique Document Numbe
68. patient demographics and reference to the test can be performed automatically User Interface is adapted in EMR mode automatic detection No additional installation for the EMR interface is needed Option Code XEMR Data format is HL7 V2 3 Both CardioSoft and EMR client need to be installed on one workstation if interaction is needed for Conduct Edit Review View tests Revision B CardioSoft to EMR 3 2023324 206 Interface Overview Workflow Scenario 1 Conduct Edit Review View Tests Workflow Scenario 1 EMR Enter a new order ID x for a test 3 EMR Join open order ID x and start the test 4 CardioSoft Conduct Finish the test EMR Join open order ID x and initiate to review CardioSoft Review test 8 EMR Retrieve results Sign document L1 PC 3 CardioSoft Workstafion plus EMR Client CardioSoft Acquisition devices NETWORK User interactions within Ellipse EMR Retrieve results 9 EMR Initiate to view the selected test 10 CardioSoft View test L1 PC 4 CardipSoft Client plus EMR Client EMR CardioSoft Server Note CardioSoft and EMR client need to be installed on one Workstation The order management is completely done in the EMR CardioSoft stores the order ID x in its database This ID is part of the filename of the shared in out files and can be used by the EMR
69. perator ID N 6 26 TS Event Occurred N Note Description 1 The supported values for Event Type Code include m A04 Register a patient 2 EVN 2 Date Time of Event is populated with the creation date time of the message ADT PID Patient Identification Legend R Required O Optional C Conditional N Not Used U Used PID Segment CardioSoft Applicability Seq Length DataType HL7 Table Element Name Export 1 4 S Set ID Patient ID N 2 20 CX Patient ID External ID N 3 20 CX Patient ID Internal ID U 1 4 30 CX Alternate Patient ID PID 0 2 5 48 XPN Patient Name U 6 48 XPN Mother s Maiden Name N 7 26 TS Date Time of Birth 0 Revision B CardioSoft to EMR 67 2023324 206 HL7 Messages PID Segment CardioS oft Applicability Seq Length Data Type HL7 Table Element Name Export 8 1 IS 0001 Sex U 3 9 48 XPN Patient Alias N 10 1 IS 0005 Race 0 4 11 106 XAD Patient Address N 12 4 IS County Code N 13 250 XTN Phone Number Home N 14 250 XTN Phone Number Work N 15 60 CE 0296 Primary Language N 16 1 IS 0002 Marital Status N 17 3 IS 0006 Religion N 18 20 CX Patient Account Number N 19 11 5 SSN Number Patient N 20 25 DLN Driver s License Number Patient N 21 20 CX Mother s Identifier N 22 3 IS 0189 Ethnic Group N 23 60 ST Birth Place
70. r of referenced CardioS oft document internal patient ID modality identifier creation date time of document 5 TXA 13 Parent Document Number For internal use used in MDM T02 message of the csoft files for storing the EMR document ID order ID that is part of the emr filename 6 TXA 17 On Export always IP is used 62 CardioSoft to EMR Revision B 2023324 206 HL7 Messages MDM OBX Observation Result Legend R Required O Optional C Conditional N Not Used U Used OBX Segment CardioS oft Applicability Seq Length Data Type Lu Element Name Export able 1 10 S Set ID Observation Simple N 2 2 ID 0125 Value Type U 1 3 590 CE Observation Identifier C 2 4 20 ST Observation Sub ID N 5 65536 ST Observation Value U 3 6 60 CE Units N 7 60 ST Reference Range N 8 10 ID 0078 Abnormal Flags N 9 5 NM Probability N 10 5 ID 0080 Nature of Abnormal Test N 11 2 ID 0085 Observation Result Status N 12 26 TS Date Last Obs Normal Values N 13 20 ST User Defined Access Checks N 14 26 TS Date Time of the Observation N 15 200 CE Producer s ID N 16 80 XCN Responsible Observer N 17 60 CE Observation method N Note Description 1 OBX 2 is always populated with ST or TX 2 OBX 3 is populated with OTHER REF if the document reference test reference is used in OBX 5 3 OBX 5 Observation value Type o
71. rdioSoft exports data in this field ORU Observation Reporting The ORU message supports the import patient demographics observation request and clinical data and export of observation data including link to the report It uses a subset of the complete HL7 message set for Observation Reporting and only includes support for the ORU message Each ORU message contains one OBR message segment in which observations were documented Nested under the OBR message segment are one or more OBX message segments one for each documented observation Legend R Required O Optional C Conditional I Ignored ORU Message Segments Import Export MSH R R PID R 0 R 0 NTE Revision CardioSoft to EMR 43 2023324 206 HL7 Messages ORU PV1 0 ORC OBR R 1 R 1 NTE 0BX 0 0 NTE DSC 2 2 MSH 3 3 5 C 3 C 3 ERR Note Description 0 Although this message segment is considered optional in the HL7 specification CardioS oft requires it One PID segment per message is allowed 1 One OBR segment per message is allowed 2 The application specific HL7 message continuation protocol is not supported 3 Acknowledging is only supported in Upload mode 44 CardioSoft to EMR Revision B 2023324
72. s up m If External Patient ID not found Use received Patient ID and patient demographic data to create a new patient record in the database Assign this test For each test that is received from an ECG Writer and assigned to the CardioSoft database a patient demographics file and a document reference file will be created and written to a folder or sent via TCP IP to the EMR Acknowledging is configurable manually in HL7 ini See HL7 Settings on page 18 HL7 settings The same settings are used as for data migration of existing CardioSoft tests in Data Upload of Existing CardioSoft Tests to EMR on page 40 See System Configuration gt gt EMR Tab Format of Patient demographics file and document reference file are identical to Data Upload of Existing CardioSoft Tests to EMR on page 40 The abstract message definition syntax used to describe the supported HL7 messages is consistent with the syntax used in the HL7 specification version 2 8 Although not required it is preferred that Ignored or Not Used message segments not be included in a supported HL7 message When present Ignored message segments are ignored and CardioSoft performs no data validation When present Not Used message segments are parsed and CardioSoft validates the data If there is invalid data CardioSoft generates an error and does not import the file or the segment with the invalid data HL7 Errors are logged in HL7_ERR LOG with
73. sistent with CardioSoft V6 0 Our equipment contains several fields which can be filled in before performing an ECG Some of these fields must be filled in before performing an exam some are optional and therefore left to the user to assess whether they are needed to perform the exam A field RACE is one of these optional fields It has been acknowledged by the medical profession as useful to analyze some pathologies You should be aware that in some jurisdictions the processing of data revealing an individual s racial origin is subject to legal requirements such as obtaining the patient s prior consent If you elect to collect this type of data it 1s your responsibility to ensure that you comply with all applicable legal requirements CardioSoft to EMR Revision B 2023324 206 Interface Overview Interface Overview Functions Workflow Receive patient demographics and clinical data Startup in acquisition mode of a selected modality Send results and a reference to the test after the test is completed Selection of patient and modality is provided by the EMR system Changing patient demographics is only possible via EMR system Edit View an existing test The reference to the test is sent to the EMR and is used by the EMR to edit view the test Data migration is possible to update the EMR Database with existing CardioSoft patient demographics and references to existing tests Data upload of received tests from ECG Writers
74. the CardioSoft default list in the Reason for Test combo box Medical History and Medication are Read Only in CardioSoft After the button Post Test Review or Back to EMR is pressed the following data is provided by the Resting ECG module Table 1 Resting ECG CardioS oft ID Unit Description or Note OTHER_REF Text Internal Reference to test to use by EMR for editing or viewing HR bpm Heart rate on electrocardiogram BP Systolic mmHg Blood pressure systolic BP Diastolic mmHg Blood pressure diastolic PR ms PR interval electrocardiogram QT ms QT interval electrocardiogram QTc ms Qt interval qt interval electrocardiogram corrected for heart rate QRSD ms QRS duration electrocardiogram P Axis deg P wave axis electrocardiogram T Axis deg T wave axis electrocardiogram EKG QRS axis deg Electrocardiogram QRS axis P ms P duration from P onset to P offset PP ms Average PP interval RR ms Average RR interval Interpretation Text Electrocardiogram interpretation clinical interpretation of diagnosis Comment Text Any comment workflow personal non clinical data 60 char max CardioSoft to EMR Revision B 2023324 206 Interface Specification CardioSoft ID Unit Description or Note Question 1 Text Short note containing a question and response 52 char max Question 2 Text Short note containing a question and response 52 ch
75. timestamp reason of error plus reference to the HL7 Message The HL7 message itself is completely stored by using MSH 10 as filename lt MSH 10 gt log The erroneous field is marked to identify the issue If MSH 10 is not available the type of error is only logged in HL7_ERR LOG 42 CardioSoft to EMR Revision B 2023324 206 HL7 Messages Legend The following legend is used throughout the document Value Description R Required This field is required to have valid data Missing or invalid data causes CardioSoft to generate an error and to not import the file or the segment with the missing or invalid data 0 Optional This field is not required to have data On import if data is provided itis validated If the data is invalid CardioS oft generates an error and does not import the file or the segment with the invalid data On export if CardioS oft has data it exports it C Conditional Data may be either required or optional depending on the condition For further clarification read the associated footnote Ignored Data is not required and it is not used in CardioS oft If there is data CardioS oft does not validate it N Not Used Data is not required and it is not used in CardioSoft However if data is present CardioSoft parses and validates the data If the data is invalid CardioSoft generates an error and does not import the file or the segment with the invalid data U Used Ca
76. ult Status m F Final for completed tests m X Deleted for aborted tests Legend R Required O Optional C Conditional N Not Used U Used OBX Segment CardioSoft Applicability Data Seq Length Type HL7 Table Element Name Import Export 1 10 51 SetID Observation Simple N N 2 2 ID 0125 Value Type 0 0 U 0 3 590 CE Observation Identifier R U 1 3 Revision B CardioSoft to EMR 53 2023324 206 HL7 Messages OBX Segment CardioSoft Applicability Seq Length fee HL7 Table Element Name Import Export 4 20 ST Observation Sub ID N N 5 2000 ST Observation Value 0 3 U 3 6 60 CE Units 0 2 3 2 3 7 60 ST Reference Range N N 8 10 ID 0078 Abnormal Flags N N 9 5 NM Probability N N 10 5 ID 0080 Nature of Abnormal Test N N 11 2 ID 0085 Observation Result Status N U 4 12 26 TS Date LastObs Normal Values N 13 20 ST User Defined Access Checks N N 14 26 TS Date Time of the Observation N 15 200 CE Producer s ID N N 16 80 XCN Responsible Observer N N 17 60 CE Observation method N N Note Description 0 OBX 2 Value On Import Value types must be one of ST FT or TX On Export only value type ST and TX only for Identifier OTHER_REF is used 1 OBX 3 Observation Identifier is populated as follows m The first component Identifier
77. ument m EMR reads stores observation values and a reference to this test m Sign Document to make it part of the patients chart from now only view this test 9 EMR Client on PC4 Launch CardioS oft for viewing test m Reference to the test is used by EMR 10 CardioSoft Client on PC4 View CardioS oft test Revision B CardioSoft to EMR 2023324 206 Interface Overview Workflow Scenario 2 Data Upload to EMR for Data Migration NETWORK CardioSoft Start 2 CardioSoft Start Upload in an PC 1 CardioSqft Workstation CardioSpft Client plus EMR Client EMR Server Note CardioSoft and EMR client need to be installed on one Workstation Workflow Scenario 2 User interactions within Ellipse 3 EMR Initiate to view a selected test 4 CardioSoft View test L1 PC 2 CardioS ft Workstation CardioS ft Client plus EMR client CardioSoft Server CardioSoft to EMR 2023324 206 Revision B Interface Overview Workflow Scenario 2 Client Workstation amp Application Action Description 1 CardioS oft on PC1 Start CardioS oft directly via Icon on the desktop 2 CardioS oft on Start upload in System Configuration gt gt EMR tab m Patient demographics of all existing patients and references to all existing tests that are stored in the CardioS oft database are sent to the EMR HL7 via TCP IP

CardioSoftTM to EMR System Interface

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