Welch Allyn Medical Diagnostic Equipment 2.5x User's Manual
Contents
1. Overview Inbound HL7 ADT 88 42 How an Acuity System uses ADT information 200000 43 ADT messages accepted and 5 64 5 46 Examples of ADT messages nnna eects 52 Reconfiguration Ot ADT ServIcess a en a aed ot Ane ee dee es 54 iv Contents Welch Allyn Connectivity Server 7 XMbLunterface ikv t eX eR nk alee 55 8 Contacts and Specifications Less do uae Le ER i 57 Contact informations miens ack excels A dee rb heen ewan e eder d 57 SPCCIICATIONS ez Gh hea altcr ua A aa tng xar 57 Introduction Intended use The Welch Allyn Connectivity Server WACS is an option to the Welch Allyn Acuity Central Monitoring System WACS consists of a server platform on which one or more of the following software options are installed The Web Server option makes Adobe Portable Document Format PDF printout files available from the Acuity System to certain Web browsers The AcuityLink option consists of Clinician Notifier software for non proprietary mobile devices and administrative software for WACS Mobile devices running the Clinician Notifier software deliver patient alarm information and realtime waveforms gathered from patient monitors connected to the Acuity Central Monitoring System The software enables administrators to track the status of clinician patient assignments and it e2. Welch Allyn Connectivity Server HL7 attributes of OBX observation result segments Table 10 HL7 attributes OBX observation result segment SEO LEN DT OPT RP TBL ITEM Element name WACS requirement 1 4 SI 0 00569 Set ID OBX R 2 2 ID C 0125 00570 Value Type R 3 250 CE R 00571 Observation Identifier R 4 20 ST C 00572 Observation Sub ID C 5 655362 C yb 00573 Observation Value R 6 250 CE 0 00574 Units R 7 60 ST 0 00575 References Range C 8 5 IS 0 Y 5 178 00576 Abnormal Flags C 9 5 NM 0 00577 Probability 0 2 ID 0 Y 0080 00578 Nature of Abnormal Test N 1 1 ID R 0085 00579 Observation Result Status N 2 26 TS 0 00580 Date Last Observation Normal N Value 13 20 ST 0 00581 User Defined Access Checks N 4 26 TS 0 00582 Date Time of the Observation 15 250 CE 0 00583 Producer s ID 6 250 XCN 0 00584 Responsible Observer 17 250 CE 0 00936 Observation Method N 18 22 El 0 01479 Equipment Instance Identifier 9 26 TS 0 01480 Date Time of the Analysis N a The length of the observation field is variable depending upon value type See OBX 2 value type b May repeat for multipart single answer results with appropriate data types e g CE TX and FT data types OBX segment example OBX 1 ST Heart Rate Heart Rate WAP S0 BPMIIIIIIl 20090127093400 000 0800 Programmer s Guide WACS outbound HL7 protocols 21 Outbound patient identification fields Patient ID information is confirmed at the Acuity Central Station
3. 2006 14 25 03 lt Timestamp gt GuestName Jon L Doe lt GuestName gt lt GuestPhysicalLocation gt Zone1 101A lt GuestPhysicalLocation gt lt Parameters gt Propag 202 DA005491 Parameters DestinationList lt DestinationID gt Nurse1 lt DestinationID gt lt DestinationList gt lt Emergin gt lt xml version 1 0 encoding UTF 8 gt lt Emergin Version 70 gt lt Command gt Reset lt Command gt lt ApplicationID name WelchAllyn gt lt MessagelD gt EVENT 001 MessagelD lt DestinationList gt lt DestinationID gt Nurse1 lt DestinationID gt lt DestinationList gt lt Emergin gt Welch Allyn Connectivity Server 57 ri Contacts and Contact information specifications If you encounter a problem that cannot be corrected by ordinary operating procedures described in this manual please contact Welch Allyn Technical Services Phone within the U S A Phone worldwide Fax email Internet Specifications General WACS Table 25 WACS 2 5x compatibility 1 800 289 2501 1 503 530 7500 ask for Technical Service 1 503 526 4970 solutions welchallyn com http Awww welchallyn com support default hAtm Acuity System Component Software version compatible with WACS 2 5x Acuity Central Monitoring System WACS Web Server option Operating systems browser combinations supported by WACS WACS AcuityLink Clinician Notifier option 8 1x Windows XP SP 1 2
4. Programmer s Guide WACS outbound HL7 protocols 25 Accessing the WACS program HL7 Manager pages For detailed instructions on accessing and using the WACS HL7 Manager pages see the Welch Allyn Connectivity Server VVACS directions for use That document also provides message examples that show message formats before and after HL7 setting adjustments are made Only WACS users who have been designated with a WACS biomedical engineer role can access the WACS HL7 pages ih HL7 Manager Configure the general settings for the Query Manager For more information on default ranges for any variable simply click the entry in the table below Reboot or HL Restart is required for these changes to take effect Wee 0 E 9 D Sting PAD You can reconfigure settings by taking these steps 1 Access the WACS program via certain internet browsers on any computer in your facility s intranet 2 Open the WACS HL7 Manager pages in the WACS program 26 WACS outbound HL7 protocols Welch Allyn Connectivity Server 27 WACS outbound HL7 messages This chapter provides this information e Description of outbound WACS observation segments and acknowledgement segments and examples of observation messages and acknowledgement messages e Descriptions of outbound WACS query segments and reply segments and examples of query messages and reply messages Certain message formats can vary based on settings made i
5. source table IS assigning authority HD gt name type code ID identifier check digit ST gt code identifying the check digit scheme employed ID identifier type code IS assigning facility HD date time action performed TS range start date time TS gt range end date time TS gt repeat pattern IS gt explicit time interval ST gt parameter class IS gt parameter value IS quantity CQ interval gt duration gt start date time TS gt end date time 5 priority ID gt condition ST gt text TX conjunction ID order sequencing gt 52 Inbound ADT HL7 messages Welch Allyn Connectivity Server Examples of ADT messages WACS returns acknowledgements for accepted messages and error messages for non accepted messages Acceptable ADT ACK message and acknowledgement The following is an example of an A03 message and acknowledgement in HL7 version 2 3 formats ADT AO03 message Wed Jan 14 19 34 20 2009 HL7Log Responder got message MSH A amp REG RMH RMH 20090114193305 00000600 ADT A03 2271605 P 2 3EVN 03 200901 14 193305 0000 0600 AKM 1 UNREAL STEWART PID 2006275669 2006275669 SAMPLE MELISSA T 19600915193300 00000600 F l l 006276 69 PV1 E ER 1 B002 EXAMPLE KEVIN P ER 7 BO02 EXAMPLE KEVIN P ER 1064398 WCY IIlIII 1 20090114182049
6. 553 2 USA INOT A VETERAN N PV1 1 O 2E 237 02 1 3 E 237 02 1370 TEST TEST AccMgr CI 1370 TEST TEST AccMgr CI TWM l1 I1370 WESTPFAL EDITH AccMgr CI 67 6943809 AccMgr VN 1 200 TESTYIIIIDUIUUULT 20081008111700 20081009180000 3083 9 3083 9 0 PV2 SOBANO 20081008111700 WACS error message MSH 4 amp I 20090130160831 875 0500 ACK 5804 P 2 4 MSAJAE 6139110482 The phone number component must be supplied and should be in the following format 999 9999 ERR A44207 amp Application Internal Error amp HL 70357 54 Inbound ADT HL7 messages Welch Allyn Connectivity Server Reconfiguration of ADT services If your WACS system receives inbound ADT messages from your CIS and you need to reconfigure certain ADT service settings such as the CIS server IP address or the CIS server port number please contact Welch Allyn Technical Services see Contact information on page 57 A Technical Service representative can help you access ADT settings in the WACS program s HL7 General Settings page shown below which is beneath the WACS HL7 Manager tab ADT settings in this page are only visible to Welch Allyn personnel You can access the WACS program via certain internet browsers on any computer in your facility s intranet For instructions on accessing the WACS HL7 Manager pages see the Welch Allyn Connectivity Server WACS Directions for Use Note If Welch Allyn personnel assist you in
7. Acuity LT Central Monitoring Systems directions for use Acuity Central Monitoring System in service guide English Installation guides printed Mobile Acuity LT System installation guide En Fr Ger Sp It Pol Quick card Acuity System icons English printed Welch Allyn Monitors Micropag Monitor directions for use CD ROM multilanguage PropaqLT Monitor directions for use CD ROM multilanguage Propag CS Monitor directions for use CD ROM multilanguage Propag Encore Monitor directions for use CD ROM multilanguage Welch Allyn 1500 Patient Monitor directions for use CD ROM multilanguage 3 4 Introduction Welch Allyn Connectivity Server E System overview Welcome The Acuity Central Monitoring System is a real time patient monitoring system that collects and displays vital sign information for multiple patients over the Welch Allyn FlexNet network Welch Allyn patient monitors Acuity Central Station Welch Allyn Connectivity Server WACS AcuityLink option Web Server option HL7 Interface option Third Party Data Stream Interface option Within the network Mobile devices running the Clinician Notifier program Facility computer used by administrators This document contains specifications intended as a guide for software developers to develop the HL7 or XML interface between a facility controlled clinical information system CIS or HIS and an Acuity System It is assumed that users of this gu
8. As listed in page Field entry allowed Table 28 Non supported features Simultaneous clients WACS sends data to only one CIS HL7 batch processing WACS only sends data at a regular interval or in response to a query Wildcards WACS does not accept wildcards Index 59 A ADT acceptable messages from 52 data types accepted from 47 erroneous messages 52 HL7 messages 41 how Acuity System uses information 43 message formats accepted from 46 WACS messaging rules 44 C CIS ADT messages 41 configuring HL7 interface 5 D Data interface 6 transfer and storage in Acuity System 7 types accepted 47 Delimiters accepted HL7 46 documents related 3 E Error messages sent by WACS 52 F Formats accepted HL7 message 46 H Health Level Seven Standard 11 Help 57 HL7 configuration by qualified personnel 2 interface configuring 5 entry sequence 44 where entered in system 43 Inbound HL7 ADT Data module 41 Interface data 6 M Message ADT error sent by WACS 52 ORU ACK example 29 OBP RSP example 39 QBP RSP example 35 37 QRY ORF example 32 36 38 time date example 13 types and formats received by WACS 46 O Outbound HL7 Vital sign Observations module 15 Overview system 5 P Patient ID entry sequence 44 where entered in system 43 S segment level protocol HL7 12 server 5 specifications 57 T Technical Service Welch Allyn 57 Troubleshooting 57 V Vital sign Observatio
9. Microsoft Internet Explorer 6 x and 7 x Firefox 2 Firefox 3 1 3x Table 26 WACS Hardware Rackmount server Video card none Display none Fthernet interfaces IP addresses multiple one connected to the Acuity System network one to the facility network Wireless LAN none no wireless card Electromagnetic compliance Refer to the Acuity and Mobile Acuity LT Central Monitoring Systems Directions for Use 58 Contacts and specifications Welch Allyn Connectivity Server WACS HL7 Interface option Outbound messaging Table 27 Configuration variables under HL7 tab HL7 Manager page Numeric data filter Numeric data filter for NIBP HL7 General Settings page Default setting Median can be mean for Alternate settings Closest most recent even number of samples Closest most recent Median can be mean for even number of samples HL7 versions supported 24 2 31 2 3 Allow observations for multiple patients in one HL7 message Off On Number of seconds to be retrieved when a new patient is 7200 Field entry allowed connected Allow multiple observations for a patient in one HL7 message Off On Number of times the server will try to send an HL7 message to 5 Field entry allowed client before disconnecting Message delay seconds for push 420 Field entry allowed HL7 Push on Event Settings page Each vital sign listed in page Off On HL7 Observation Identifiers page Vital sign labels
10. System patient identification windows can autopopulate with admit discharge transfer ADT data from your CIS The information in this chapter is organized as follows Overview Inbound HL7 ADT 8 8 42 How an Acuity System uses ADT 43 ADT messages accepted and stored 5 46 Examples of ADT messages Reconfiguration of ADT Services 2 oe ce ae wee eee ee ee 54 42 Inbound ADT HL7 messages Welch Allyn Connectivity Server Overview Inbound HL7 ADT Data module ADT information is transferred to the WACS server in this sequence Patient identification process 1 At Acuity System open Patient ID Setup window 2 Insert patient ID number 3 Press Enter on keyboard Acuity queries Patient Name server and then the WACS SQL database for Database schema demographics including patient name Patient ID number 16 characters and patient location Patient name 50 characters 4 Respond to patient confirmation prompt 7 Patient location 15 characters Remaining patient fields autopopulate N a 10 30 1 41 port 5601 SQL database Initiate connection to CIS IP port Acuity System network Clinical information system A01 A03 A04 A05 CIS WACS A08 A11 A13 messages Inbound HL7 ADT messaging 1 WACS initiates a connection to a facility s CIS on
11. VIaW ix ac Beene iet ede teri PR RU pa aT owes qe ER ound 5 VECON ETa iit acer A eo RA Deer hrs p af al ecd Lap nes sit ica MR A Lacer 5 Data interface provided by the Welch Allyn Connectivity Server WACS 6 Data transfer and storage within the Acuity System network 7 3 HL7 standard pEFOIOGOlS 2 6 eas DROP EE UE ES 11 He alth Level Seven Standard Ree es ees 11 HL low level protocol rus Bee nema Poa As 12 HL7 segment level 12 4 WACS outbound 7 ee 15 Overview Outbound 7 Vital sign Observations module 16 Labels and attributes of outbound 58 8 5 17 Outbound patient identification fields 2 20 0 ee 21 Outbound vital sign tags and filters 0 ee 22 Reconfiguring WACS outbound observation settingS 24 5 WACS outbound 7 6958965 27 Unsolicited observation message ORUAROIWACKARON s tik ett ee bind bo Peak 28 Query for results of observation message ORY ROZ ORF ARDOA si rrea eee ens Bh ad int Se dhe ie dae EA 30 Query by parameter OBPAOM RSPAZI0 248 uat dee ed Re o DAS t et ELS 33 QUSE by cha remote erae ta a o Mate Pare one ERN 36 Query e DOT e D e PR D 38 6 1 7 6658 65
12. X99999 B99999 C any text telecommunication use code ID telecommunication equipment type ID lt email address ST gt country code NM gt lt area city code NM gt phone number NM gt extension NM any text ST Inbound ADT HL7 messages Table 23 Data type descriptions Welch Allyn Connectivity Server Data type Definition Data format attributes and notes Specialty Waveform CD Channel definition MA Multiplexed array NA Numeric array ED Encapsulated data Price data CP Composite price Patient administration Financial information FC Financial class Extended queries OSC Query selection criteria QIP Query input parameter list RCD Row column definition channel identifier gt channel number NM channel name ST gt gt electrode names channel sensitivity units calibration parameters sampling frequency NMJ minimum maximum data values sample 1 from channel 1 NM sample 1 from channel 2 NM gt sample 1 from channel 3 lt sample 2 from channel 1 NM gt sample 2 from channel 2 NM gt sample 2 from channel 3 NM value1 NM value2 NM gt value3 NM gt value4 NM gt Supports ASCII MIMEencoding of binary data source application HD main type of data ID data subtype ID gt e
13. a preconfigured TCP port usually in the range of 5600 5700 2 Once a session is established WACS listens for and accepts particular ADT message types from the CIS 3 WACS updates and stores the data on a local SOL database Programmer s Guide Inbound ADT HL7 messages 43 How an Acuity System uses ADT information When a facility s CIS sends a patient s ADT information to WACS the Acuity System uses the ADT information to autopopulate identification fields in the patient s Acuity System patient ID setup windows Where a patient ID number is entered An Acuity System user enters a patient ID number in one of these two places to confirm a new patient into the Acuity System e Atthe Acuity Central Station in the Patient ID Setup window Clear All Confirm Undo Close e For systems that include the WACS option with the AcuityLink option at a mobile device running the AcuityLink Clinician Notifier program in the Setup Patient ID screen Clinician Notifier 2 q 2 22 3 No alarms 44 Inbound ADT HL7 messages Welch Allyn Connectivity Server Sequence of events when ID number is entered This is the sequence of events that occurs within Acuity Systems that include the WACS option with the Inbound HL7 ADT module 1 Ina patient ID setup window the user enters the patient ID number or an amended patient ID number and presses the Return or Enter key 2 The Acuity System queries the Acuity System patient name ser
14. accessing certain ADT settings do not change ADT settings beyond those with which you are assisted Changing other ADT settings can render the WACS system inoperable HL7 General Settings Configure the HL7 general settings For more information on default ranges for any variable simply click the entry in the table below B ladt server s601 ee Gee IDs to be used for queries a LOCATION BASED C in one HL7 message M MULTIPLE OBSERVATIONS PER PATIENT Allow observations for multiple patients in one HL7 message MULTIPLE PA PER HL7 MESSAGE Enable HL7 ADT message Listen Mode ADT ED Enable HL7 message push PUSH_ALLOWED be 15 SERES jlocalhost HL7 Version 23 HL7 VERSION t je Delay seconds Message Dl so Number of seconds to be delayed for push event 60 PUSH DELAY Number of seconds to be retrieved when a new amie is connected MAX HISTORY Number cf times the server vill try to send an HL7 message to client before s 2 MAX_RETRY_OUTPUT Port Number naor u 5600 7200 600 A CIS server IP address used for inbound ADT messages to WACS B CIS server port used for inbound ADT messages to WACS C WACS enabled listening for CIS ADT data XML interface 55 The optional Third Party Data Stream Interface option provides a means of moving patient identification and patient numeric data between the Acuity Central Station and a facility s information system To receive XML messages
15. in the Patient ID Setup window WACS forwards an outbound patient ID segment that includes at least one of these ID fields PID 2 PID 3 and PID 18 By default all of the fields are populated Export multiple ID fields from WACS such as name and ID number This enables detection of obvious identification errors Since monitors can move easily from location to location patient room number alone is an unreliable means of identifying patients WACS can export these patient ID fields e Patient ID number A primary identification number such as a medical record number account number or a patient s personal ID number such as a social security number If this number is input incorrectly it cannot be altered e Amended patient ID number An alternate ID that can be associated with the patient This ID can be entered in the Acuity System Patient ID Setup window in the Amended ID field e Patient last name e Patient first name e Patient middle initial Note The Acuity System accepts middle initial only not middle name e Patient location A room number 22 WACS outbound HL7 protocols Welch Allyn Connectivity Server Outbound vital sign tags and filters WACS generates the vital sign tags and filters described in this section By default missing tags or tag errors cause the HL7 interface to reject the request or query If part of a message or reply is valid WACS ignores or rejects the erroneous portion and returns only the valid r
16. transmitted for each vitals component such as Heart rate or RR BR For updated information regarding this standard see www hl7 org 12 HL7 standard protocols Welch Allyn Connectivity Server HL7 low level protocol This section describes the low level format of HL7 packet frames Packet frames HL7 frames that are exchanged between the server and the client describe both sent and received data Table 5 HL7 packet frame low level format Packet description Content Size bytes Start block 0x0B ASCII VT 1 Body variable bytes variable End block 0x1C ASCII FS 1 Carriage return 0x0D ASCII CR 1 HL7 segment level protocols This section describes HL7 message hierarchy and delimiters segment notation and date time format Message hierarchy and message delimiters Fields amp components amp subcomponents ii Segment notation Table 6 HL7 segment notation mandatory optional and repeating Notation example Definition PID This segment is mandatory PID This segment is optional IN1 This segment is mandatory and it can repeat NK1 This segment is both optional and repeating Programmer s Guide HL7 standard protocols 13 Time date in HL7 segments When importing vital sign data into an electronic patient charting application use the timestamp associated with the OBR for the vital signs record in the chart Format Date and time in the HL7 segments are repres
17. understand all warnings and cautions in the manual 2 Introduction Welch Allyn Connectivity Server Conventions C The CE Mark and Notified Body Registration Number signify that the 0297 product meets all essential requirements of European Medical Device Directive 93 42 EEC A WARNING Indicates conditions or practices that could lead to illness injury or death Warning and note A WARNING HL7 configuration must be performed only by qualified personnel who are familiar with the HL7 Standard and with local implementation of the WACS HL7 Interface Improper configuration of the HL7 Interface can cause unexpected and unintended cessation of patient vital signs data transfer Note In compliance with the U S Department of Health and Human Services Health Insurance Portability and Accountability Act HIPAA do not transfer or save patient data or information using any unsecured or public computer Programmer s Guide Introduction Related documents Document Welch Allyn Connectivity Server WACS Welch Allyn Connectivity Server WACS CD ROM English Welch Allyn Connectivity Server directions for use Welch Allyn Connectivity Server programmer s guide AcuityLink Clinician Notifier directions for use Acuity and Mobile Acuity LT Central Monitoring System Directions for use Acuity and Mobile Acuity LT Central Monitoring Systems directions for use and in service guide CD ROM multilanguage Acuity and Mobile
18. 00 000 0800 2 VITALS Vital Signs WAP 20030624115002 000 0800 1 2 ST Heart Rate Heart Rate4WAP 80 0 4BPMM I 20030624115001 000 0800 ST RR BRARR BRAWAP 20 0 4Br Ml ll 20030624 115001 000 0800 Programmer s Guide WACS outbound HL7 messages 37 QBP RSP format query segments Segment OPD Query parameter definition OPD 3 List of Patient s ID OPD 5 Required Start End Time and Interval OPD 6 List of Data Requested OBP RSP query and reply example QBP query MSH A amp Van Goe Edgar A l 20030624121816 101 0800 OBP Q111 20030624121816101b P 2 4 QPDI GA003560 4 amp 14420030624115000 0800 20030624115002 0800 HR RR RCP RSP reply MSH A amp WAPAWAP 20030624 121817 248 0800 RSPAZ90 20030624121817250c P 2 4 QPDI GA003560 4 amp 14420030624 115000 080020030624115002 0800 HR RR PID 1 GA003560 GA003560 BR 1 VITALS Vital SignsWAPI 20030624115001 000 0800 BX 1 ST Heart Rate Heart Rate WAP 80 0 ABPM 20030624115000 000 0800 BX 2 STIRR BRARR BRAWAP 20 0 4Br MI ll 20030624115000 000 0800 BR 2 VITALS Vital SignsWAP 20030624115002 000 0800 BX 1 ST Heart Rate Heart Rate WAP J80 0 BPMIIlIII 20030624115001 000 0800 BX 2 STIRR BRARR BRAWAP 20 0 4Br MI Il 20030624115001 000 0800 38 WACS outbound HL7 messages Welch Allyn Connectivity Server Query by location This section covers these two formats for Query by loc
19. 0000 0600 20090114185400 0000 0600 ACK acknowledgement lt Wed Jan 14 19 34 20 2009 gt HL7Log Responder sending message MSH A A amp WAPAWAP 20090114193420 3160600 ACK A03 20090114193420316e9 P 2 3 MSA AA 2271605 Programmer s Guide Inbound ADT HL7 messages 53 Unacceptable ADT messages and WACS error messages WACS returns error messages to the CIS HIS ADT server in response to these messages e Message types other than A01 A03 A04 A05 A08 A011 or A13 and your system has not been programmed to block messages other than these e HL7 messages containing noncompliant format In these cases WACS rejects the entire content of the message WACS error message non accepted message type WACS error message MSH A amp I 20090203130308 435 0500 ACK 16249 P 2 4 MSA AR 613958749 No appropriate destination could be found to which this message could be routed ERR 207 amp dApplication Internal Error amp HL 70357 ADT ACK error message noncompliant format Note The Acuity System accepts middle initial only not middle name in messages In this example the telephone number highlighted below in bold text is a noncompliant format ADTAA01 message MSH A amp AccMgr 1 20090130160820 ADTA03 6139110482 P 2 3 1 EVN A03 20090130160819 PID 1 841940444AccMgr4PN 500138979444AccMgrAMRA1 SAMPLEPATIENTAL 19920722 F T EST TEST W 2001 SAMPLE RD SAMPLE NY 132110000 M 318005551212 E S NOJ6943809 AccMgr VN 1 099809
20. 0624115002 000 0800 BX 1 ST Heart Rate Heart RateWAP 80 0 ABPMI I I 20030624115001 000 0800 BX 2 STIRR BRARR BRAWAP 20 0 4Br Mllll 20030624115001 000 0800 36 WACS outbound HL7 messages Welch Allyn Connectivity Server Query by D This section covers these two formats for Query by ID ORY ORF OBP RSP QRY ORF format ORY RO02 query segments Segment ORD Query definition QRD 2 R ORD 3 I ORD 8 List of Patient s IDs QRD 9 RES Segment ORF Query filter ORF 4 List of Data Requested ORF Start End Time and Interval ORY ORF query and reply example Get the heart rate and respiration rate of Patient ID GAO03560 from 2003 06 24 11 50 00 to 2003 06 24 11 50 02 interval of 1 sec ORY query MSH A amp Van GoeAEdgar A 20030624121618 151 0800 QRYR02 200306241216181517 P 2 4 QRDJ20030624121618 191 0800 R l Q1056482178191 l GA003560 RES QRF Heart Rate RR BRI amp 1 20030624115000 0800 20030624115002 0800 ORF reply MSH Q PI RD A amp WAPAWAP 20030624 12 1744 994 0800 ORF R04 20030624121744995a P 2 4 20030624121618 191 0800 R 0 1056482178191 GA003560 RES Heart Rate RR BR amp 1 20030624115000 0800 20030624115002 0800 GA003560 GA003560 1 VITALS Vital Signs WAP 20030624115001 000 0800 Heart Rate Heart Rate4WAP 80 0 4BPM 20030624115000 000 0800 2 STIRR BRARR BRAWAP 20 0 4Br M 200306241150
21. IBP IBP 1 DIA SYS MEAN mmHg mmHg unlabeled IBP1 arterial ART intracranial ICP umbilical artery UA umbilical vein UV pulmonary artery PA central venous CVP IBP 2 DIA SYS MEAN mmHg mmHg unlabeled IBP2 arterial ART intracranial ICP umbilical artery UA umbilical vein UV pulmonary artery PA central venous CVP PVCRate PVC Min 1 min PVC Min 1 min PVC 9 10 System overview Welch Allyn Connectivity Server 11 3 HL7 standard protocols This chapter describes basic HL7 data structure as outlined in the Health Level Seven Messaging Standard Information in this chapter is organized as follows Health Level Seven Standard HL7 low level i ns 12 7 segment level protocols Health Level Seven Standard The Welch Allyn HL7 Interface option closely follows the data structure outlined in the Health Level Seven Version 2 4 Messaging Standard The following excerpt is taken from section 73 and section 74 of this standard Many report headers OBR may be sent beneath each patient segment with many separate observation segments OBX beneath each OBR Note segments NTE may be inserted after any of the above segments The note segment applies to the entity that immediately precedes it i e the patient if it follows the PID segment the observation if it follows the OBR segment and the individual result if it follows the OBX segment One result segment OBX is
22. RO1 acknowledgement lt Tue Jan 27 09 36 02 2009 gt HL7 HL7Log Initiator received message MSH A amp WAP WAP 20090127093601 105 0800 ACK RO1 20090127093601106c5 P 2 4 MSA AA 20090127093601106c5 30 WACS outbound HL7 messages Welch Allyn Connectivity Server Query for results of observation message QRY RO2 ORF R04 This query response model supports Solicited Poll and User Initiated Query Segments ORY RO02 query segments Table 17 2 query for results of observation message Segment Description WACS segment Note requirement MSH message header R QRD query definition R ORF query filter C implementation dependent Segment ORD Query definition ORD 1 Ignored ORD 2 Required must be R ORD 3 Required must be I ORD A4 Ignored ORD 5 Ignored ORD 6 Ignored ORD 7 Ignored ORD 8 Conditionally required Patient IDs ORD 9 Required must be RES ORD 10 Ignored ORD 11 Ignored ORD 12 Ignored Segment ORF Query filter QRF 1 Conditionally required Unit Name ORF2 Ignored ORF 3 Ignored ORF 4 Required Data Requested QRF 5 Conditionally required Room and Bed QRF 6 Ignored ORF 7 Ignored QRF 8 Ignored ORF 9 Required Start End Time and Interval Programmer s Guide ORF R04 reply segments WACS outbound HL7 messages Table 18 ORF R04 observational report reply 31 Segment Description WACS segment requirement MSH Message Header R MSA Me
23. Rate WAP 80 0 BPMIIIII 20030624115001 000 0800 OBX 2 STIRR BRARR BRAWAP 20 0 4Br M I 20030624 115001 000 0800 Programmer s Guide WACS outbound HL7 messages 33 Query by parameter QBP Q11 RSP Z90 Segments query segments and their HL7 attributes Table 19 OBP 011 query by parameter message Segment Description WACS segment requirement MSH Message Header R QPD Query Parameter Definition Segment R Optional Query by Example Segments RCP Response Control Parameters DSC Continuation Pointer Segment OPD Query parameter definition OPD 1 Ignored OPD 2 Ignored QPD 3 Conditionally required Patient IDs QPD 4 Conditionally required Patient Location QPD 5 Required Start End Time and Interval QPD 6 Required Data Requested Table 20 HL7 attributes OPD query parameter definition SEO LEN DT OPT RP TBL Item Element name 1 250 CE R 0471 01375 Message Query Name 2 32 ST C 00696 Query Tag 3 CX C Y Patient IDs 4 PL C Y Patient Location 5 R N Timing Quantity 6 ST R Y Parameter 34 WACS outbound HL7 messages RSP Z90 reply segments Table 21 RSP Z90 segment pattern response Welch Allyn Connectivity Server Segment Description Group control Comment MSH MSA ERR OAK OPD RCP PID PDI NK1 NTE PV1 PV2 ORC OBR NTE CTD OBX NTE DSC Message Header Message Ack
24. Welch Allyn Connectivity Server Programmer s guide Software version 2 5x WelchAllyn Advancing Frontline Care ii Welch Allyn Connectivity Server 2011 Welch Allyn All rights are reserved To support the intended use of the product described in this publication the purchaser of the product is permitted to copy this publication for internal distribution only from the media provided by Welch Allyn No other use reproduction or distribution of this publication or any part of it is permitted without written permission from Welch Allyn Welch Allyn assumes no responsibility for any injury to anyone or for any illegal or improper use of the product that may result from failure to use this product in accordance with the instructions cautions warnings or statement of intended use published in this manual Welch Allyn Acuity AcuityLink Propag Micropag are registered trademarks of Welch Allyn Sun Solaris and Java are registered trademarks of Sun Microsystems Inc Emergin is a registered trademark of Emergin Inc Software in this product is copyright Welch Allyn or its vendors All rights are reserved The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide Under such laws the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embed
25. ame and ID number for organizations XTN Extended telecommunications number street address ST lt other designation ST gt city ST gt state or province ST zip or postal code ST country ID address type ID other geographic designation ST gt family name ST gt given name ST middle initial or name ST gt suffix e g JR or Ill ST gt prefix e g DR ST gt degree e g MD ST NN 999 999 9999 X99999 B99999 C any text In Version 2 3 replaces the AD data type street address ST gt other designation ST gt city ST gt state or province ST gt zip or postal code ST country ID address type ID gt other geographic designation ST gt county parish code IS gt census tract IS In Version 2 3 replaces the PN data type family name ST gt given name ST middle initial or name ST gt suffix e g JR or Ill ST gt prefix e g DR ST degree e g MD ST gt name type code ID organization name ST gt organization name type code IS ID number NM check digit NM gt code identifying the check digit scheme employed ID assigning authority HD gt identifier type code IS assigning facility ID HD In Version 2 3 replaces the TN data type NNN 999 999 9999
26. ammer s Guide WACS outbound HL7 messages 39 QBP RSP format segment definition Segment OPD Query parameter definition OPD 4 List of Patient s Location OPD 5 Start End Time and Interval OPD 6 List of Data Requested OBPARSP query and reply example Get the heart rate and respiration rate of Patient in Unit MEDICAL Room 1310A from 20030624115000 to 20030624115002 interval of 1 sec OBP query MSH A amp Van Goe Edgar Al l 20030624121816 101 0800 OBP4Q11 20030624121816101b P 2 4 QPD MEDICALA1310A 4 amp 14420030624115000 0800420030624115002 0800 Heart Rate RR BR RCP RSP reply MSH A amp WAPAWAP 20030624121817 248 0800 RSPAZ90 20030624121817250c P 2 4 OPD 1310A 4 amp 1 4420030624 115000 0800 20030624115002 0800 Heart Rate RR BR PID 1 GA003560 GA003560 PV1 1 MEDICAL 1310A OBR 1 VITALSA Vital SignsWAP 20030624115001 000 0800 OBX 1 ST Heart Rate Heart Rate4WAP 80 0 A4BPM 20030624115000 000 0800 OBX 2 ST RR BRARR BRAWAP 20 0 4Br M 20030624115000 000 0800 OBR 2 VITALS Vital Signs WAP 20030624115002 000 0800 OBX 1 ST Heart Rate Heart Rate4WAP 80 0 4BPM 20030624115001 000 0800 OBX 2 ST RR BRARR BRAWAP 20 0 4Br M I 20030624 115001 000 080 40 WACS outbound HL7 messages Welch Allyn Connectivity Server Inbound ADT HL7 messages If your facility includes the WACS Inbound HLT ADT Data module patient information fields in Acuity
27. ation e ORY ORF e QBP RSP format ORY RO02 query segments Segment ORD Query definition QRD 2 R QRD 3 I QRD 9 Res Segment ORF Query filter QRF 1 List of Patient s Unit point of care ORF 4 List of Data Requested QRF 5 List of Patient s Room Room Bed QRF 9 Required Start End Time and Interval ORY ORF query and reply example Get the heart rate and respiration rate of Patient in Unit MEDICAL Room 1310A from 20030624115000 to 20030624115002 interval of 1 sec ORY query MSH A amp Van Goe Edgar A 20030624120505 544 0800 OQRY RO2 20030624120505544e P 2 4 QRDJ20030624120505 544 0800 R I Q1056481505544 RES Heart Rate RR BR 1310A amp 1 20030624115000 0800 20030624115002 0800 ORF reply MSH A amp WAPAWAP I 20030624 121744 994 0800 ORFAR04 20030624121744995alP 2 4 QRD 20030624120505 544 0800 R I Q1056481505544 I RES QRF MEDICAL Heart Rate RR BR 1310A I amp 1 4420030624 115000 080020030624115002 0800 PID 1 GA003560 GA003560 OBRI 1 VITALS Vital SignsAWAP 20030624115001 000 0800 OBX 1 ST Heart Rate Heart Rate WAP 80 0 4BPM I 20030624 115000 000 0800 OBX 2 STIRR BRARR BRAWAP 20 0 4Br MI I l 20030624115000 000 0800 OBRIQ VITALS Vital SignsAWAP 20030624115002 000 0800 OBX 1 ST Heart Rate Heart Rate WAP 80 0 4BPMI III 20030624 115001 000 0800 OBX 2 STIRR BRARR BRAWAP 20 0 4Br M II 20030624 115001 000 0800 Progr
28. ded The software may not be copied decompiled reverse engineered disassembled or otherwise reduced to human perceivable form This is not a sale of the software or any copy of the software all right title and ownership of the software remain with Welch Allyn or its vendors For information about any Welch Allyn product call the nearest Welch Allyn representative USA 1 800 535 6663 Australia 4 61 2 9638 3000 1315 685 4560 800 074 793 1 800 289 2501 USA Technical Service 1 503 530 7500 Technical Service 1 503 526 4970 Fax Technical Service Canada 1 800 561 8797 China 86 216 327 9631 European Call Center 353 46 906 7790 France 33 1 60 09 33 66 Germany 49 7477 92 7186 Japan 81 3 3219 0071 Latin America 1 305 669 9003 Netherlands 31 15 7505000 Singapore 65 6419 8100 South Africa 42711777 7555 United Kingdom 44 20 7365 6780 Sweden 46 8 58 53 65 51 REF 104215 Manual 80016731 Ver A 2011 05 www welchallyn com es EC REP Welch Allyn Protocol Inc Welch Allyn Ltd 8500 SW Creekside Place Navan Business Park Beaverton Oregon 97008 7101 Dublin Road Navan County Meath Republic of Ireland WelchAllyn Contents TS Introductio Mesne ete MR ceca Be ee uw 1 mtended uses eel in m Pate e 1 CONVENTIONS 25 24 cei CUI eI eR exe Pe EU ete Us s 2 WA FMING AN GSMOLG HS sso opp POTE RU HERI S EARN RO eR 2 Related documents cec stet e E e eae Dre eu eats 3 2 System over
29. ented in this format YYYYMMDDHHMMSS mmm TZTZ e Displayed time is local e Hours are in the range 0 23 e Seconds SS are followed by the following 3 digit millisecond value which appears as 000 if no other value is provided ora 4 digit time zone code Example of HL7 time date format 26 January 2009 at 0 193 seconds past 12 22 02 PM Pacific time 8 hours behind GMT 20090126122202 193 0800 14 HL7 standard protocols Welch Allyn Connectivity Server 15 WACS outbound HL7 protocols The WACS Outbound HL7 Vital sign Observations module uses Java processes to read patient data files from an Acuity System and forward the messages to a CIS server This chapter describes WACS protocols used in the Outbound HL7 Observations module The WACS protocols closely follow the data structure outlined in the Hea th Level Seven Version 2 4 Messaging Standard Information in this chapter is organized as follows Overview Outbound HL7 Vital sign Observations module 16 Labels and attributes of outbound segments 00 ee eee 17 Outbound patient identification fields 0 0 00 llle 21 Outbound vital sign tags and filters eee 22 Reconfiguring WACS outbound observation 56 5 24 16 WACS outbound HL7 protocols Welch Allyn Connectivity Server Overview Outbound HL7 Vital sign Observations module Patient vital sign observations are transferred to the CIS server in this
30. eply This setting is configurable in the WACS HL7 Manager pages see the Welch Allyn Connectivity Server directions for use Vital sign tags Vital sign tags include vital sign name tags unit tags and optional status fields Table 11 WACS HL7 sublevel tags for vital signs OBX 4 Vital sign sub level HL7 OBX 4 tag Temperature 1 Temperature 1 Temperature 2 Temperature 2 Systolic Blood Pressure IBP 1 IBP 2 NIBP SYS Diastolic Blood Pressure IBP 1 IBP 2 NIBP DIA Mean Blood Pressure IBP 1 IBP 2 NIBP MEAN Table 12 WACS HL7 tags for units OBX 6 BPM 1 min DegC C DegF F Percent mmHg kPa Br M 1 min PVC Min 1 min Table 13 Optional WACS HL7 status fields OBX 8 abnormal flag segment OBX 8 abnormal Patient monitor Acuity Description flag segment System notation Valid value Under range below absolute low on the instrument scale gt Over range above absolute high on the instrument scale 7 Invalid For example no valid SpO2 numeric is produced when the Sp02 sensor is removed from the patient s finger Programmer s Guide WACS outbound HL7 protocols 23 Vital sign numerics filters One of the following vital sign numerics filters must be configured for the WACS server Table 14 WACS vital sign filters Filter Function Median Closest For an odd number of sample points WACS sorts the data in descending order and return
31. from WACS a CIS HIS opens a TCP IP socket and listens When the Welch Allyn Connectivity Server detects an event it connects to the socket and sends a message The interface provides the following parameters Table 24 XML interface parameters Parameter Content Note Command Set When the alarm starts Reset When the alarm ends SourcelD Patient ID or Acuity uses this as the unique patient identifier across Amended ID the Acuity network Sensitivity Lethal High Parameter ApplicationID Welch Allyn Text free format text Alarm type A valid alarm string e g Heart Rate 250 MessagelD Event ID For WACS internal use only Timestamp time of the alarm GuestName Full name of the patient GuestPhysicalLocation Assigned location of the patient Unit and room number Parameter he alarming monitor Model name and serial number of DestinationList Target recipient ID Present only if Clinician Notifier option is licensed Event Delivery Mode Escalation At least one Primary Respondent assigned 56 XML interface For example lt xml version 1 0 encoding UTF8 gt lt Emergin Version 70 gt lt Command gt Set lt Command gt lt SourcelD gt MRN 0001 lt SourcelD gt lt Sensitivity gt Lethal lt Sensitivity gt lt ApplicationID name WelchAllyn gt lt Text gt Asystole lt Text gt lt MessagelD gt EVENT 001 MessagelD lt Timestamp gt June 4
32. gt code identifying the check digit scheme employed ID assigning authority HD gt ID number ST gt family name ST given name ST gt middle initial or name ST gt suffix e g JR or Ill ST gt prefix e g DR ST gt degree e g MD 5 source table IS gt lt assigning authority HD gt ID ST gt check digit ST code identifying the check digit scheme employed ID lt assigning authority HD gt identifier type code IS lt assigning facility HD In Version 2 3 use instead of the CN data type ID number ST gt family name ST given name ST middle initial or name ST suffix e g JR or Ill ST gt prefix e g DR ST degree e g MD ST gt source table IS gt assigning authority HD name type code ID identifier check digit 5 code identifying the check digit scheme employed ID gt identifier type code IS gt assigning facility HD gt No new CM s are allowed after HL7 Version 2 2 Hence there are no new CM s in Version 2 3 Programmer s Guide Table 23 Data type descriptions Inbound ADT HL7 messages 49 Data type Definition Data format attributes and notes Demographics AD Address PN Person name TN Telephone number XAD Extended address XPN Extended person name XON Extended composite n
33. ide are familiar with applicable HL7 standards or XML standards and that users have standards available for reference For information about further configuring the WACS HL7 settings for your facility see the Welch Allyn Connectivity Server Directions for Use which describes using the WACS HL7 Manager pages to configure the HL7 interface 6 System overview Welch Allyn Connectivity Server Data interface provided by the Welch Allyn Connectivity Server WACS The WACS option to the Acuity Central Monitoring System is able to provide these data interface options e HL7 Health Level 7 Interface option e Third Party Data Stream Interface option XML format Either WACS data interface option can include one or both of these distinct modules e Inbound HL7 ADT Data module Admit discharge transfer ADT data from your CIS or HIS to WACS WACS uses the Acuity System network to send ADT information to the Acuity Central Monitoring System for storage e Outbound 7 Vital sign Observations module Numeric patient vital sign observations from WACS to your facility controlled clinical or hospital information system CIS or HIS Hardwired Welch Allyn monitors Acuity network Terminal server Acuity Central Switch Station Welch Allyn Connectivity Server WACS Facility backbone CIS HIS Facility network Programmer s Guide System overview Data transfer and storage within the Acuity System netwo
34. in each message This section enables you to select and document which delimiters will be used in your interface and to identify related issues early for example conflicts with ASCII characters that have special meaning in EBCDIC Table 22 Delimiters HL7 System A System B Segment terminator CR CR CR Field separator hex 0D Component separator Sub componentseparator Repetition Separator Escape Character Programmer s Guide Data types Inbound ADT HL7 messages 47 The 7 Standard allows for different data formats for each of the following data types This section documents general attributes of each data format Table 23 Data type descriptions Data type Definition Data format attributes and notes Alphanumeric ST String TX Text data FT Formatted text Numerical Composite quantity with units quantity NMJ units MO Money quantity denomination ID gt NM Numeric SI Sequence ID SN Structured numeric comparator num1 cseparator suffix num2 NM gt Identifier IS Coded values for HL7 tables IS Coded value for user defined tables HD Hierarchic designator namespace ID IS gt universal ID ST gt universal ID type ID gt Used only as part of El and other data types El Entity identifier entity identifier ST gt namespace ID I5 universal ID ST gt universal ID t
35. manner A ooo 10 250 100 201 5600 Acuity System SQL database Initiate connection to network WACS IP port Pe N gg Clinical information system ts 4 HL7 outbound CIS WACS message Outbound HL7 patient data messaging 1 WACS is configured to accept requests on a preconfigured TCP port usually in the 5600 5700 range 2 Once a connection is established between the WACS system and the CIS and once the optional handshake and optional authentication are complete The HL7 session begins 3 WACS sends observations to the CIS in one of these ways depending on the configured model e Push model WACS sends information to the CIS at configurable intervals e Pull model WACS listens for incoming queries from the CIS The system maintains an open connection for as long as possible Connections can be re established if fatal errors or program crashes occur on either end The WACS master program uses exit codes and return values of the interface components to manage child processes Programmer s Guide WACS outbound HL7 protocols 17 Labels and attributes of outbound segments The following table defines requirement labels for outbound segments Table 7 Requirement labels for outbound segments Label Requirement Description R Required Causes an error condition if missing 0 Optional May be used by WACS CIS if present C Conditionally Required May cause an error condition if missing dependent on other facto
36. ment continued SEQ LEN DT OPT RP TBL Item Element name WACS requirement 25 1 ID C 0123 00258 Result Status N 26 400 CM 0 00259 Parent Result N 2 200 TO 0 Y 00221 Quantity Timing N 28 250 XCN 0 Y 5 00260 Result Copies To N 29 200 CM 0 00261 Parent N 30 20 ID 0 0124 00262 Transportation Mode N 31 250 CE 0 Y 00263 Reason for Study N 32 200 CM 0 00264 Principal Result Interpreter N 33 200 CM 0 Y 00265 Assistant Result Interpreter N 34 200 CM 0 00266 Technician N 35 200 CM 0 00267 Transcriptionist N 36 26 TS 0 00268 Scheduled Date Time N 37 4 NM 0 01028 Number of Sample Containers 38 250 CE 0 Y 01029 Transport Logistics of Collected Sample 39 250 CE 0 Y 01030 Collector s Comment N 40 250 CE 0 01031 Transport Arrangement N Responsibility 41 30 ID 0 0224 01032 Transport Arranged N 42 1 ID 0 0225 01033 Escort Required 43 250 CE 0 Y 01034 Planned Patient Transport N Comment 44 250 CE 0 0088 00393 Procedure Code 45 250 CE 0 Y 0340 01316 Procedure Code Modifier N 46 250 CE 0 Y 0411 01474 Placer Supplemental Service N Information 47 250 CE 0 Y 0411 01475 Filler Supplemental Service N Information OBR segment example OBR lVITALS Vital Signs WAP 20090127093400 000 0800 Programmer s Guide HL7 attributes of PID patient ID segments Table 9 HL7 attributes PID patient ID segment WACS outbound HL7 protocols 19 SEQ LEN DT OPT RP TBL Item Element name WACS requi
37. n module Outbound HL7 15 60 Index W WACS Help 57 troubleshooting 57 warning 2 Welch Allyn Technical Service 57 X XML interface 55 Welch Allyn Connectivity Server
38. n the WACS program HL7 Manager pages To view examples of message format changes that occur after specific HL7 settings are adjusted see the Welch Allyn Connectivity Server WACS directions for use The information in this chapter is organized as follows Unsolicited observation message 28 Query for results of observation message ORY RO2 ORF RO04 30 Query by parameter OBPAQ11 RSPAZ90 2 ee 33 USD UE Ht iu We Ee ee ee Sa 36 Query by oci ok acus daanin 38 28 WACS outbound HL7 messages Unsolicited observation message ORU ROT ACK RO01 Segments ORU RO message segments Table 15 ORU RO01 unsolicited observation message Welch Allyn Connectivity Server Segment Description WACS segment requirement MSH Message Header R PID Patient Identification R PD1 Additional Demographics NK1 Next of Kin Associated Parties NTE Notes and Comments PV1 Patient Visit C PV2 Patient Visit Additional Info ORC Order common OBR Observations Report ID R NTE Notes and comments CTD Contact Data OBX Observation Result R Notes and comments FT1 Financial Transaction CTI Clinical Trial Identification DSC Continuation Pointer Programmer s Guide WACS outbound HL7 messages 29 ACKARO1 acknowledgement segments Each ORU message must be acknowledged with a corresponding ACKARO1 ackn
39. nables clinicians to track respond to and view Acuity System patient alarms view realtime patient waveforms and view historical alarm details and waveforms e The HL7 Interface options support the following features using HL7 messaging protocol export of vital signs data from the Acuity Central Monitoring System to hospital CIS HIS systems and import of ADT data from hospital clinical information systems hospital information systems CIS HIS to the Acuity System e The WACS Barcode Scanner option allows clinicians to enter patient IDs and room numbers into the Acuity System using barcode scanners on some mobile devices running Clinician Notifier software The Third Party Data Stream Interface option supports sending patient alarms and equipment alerts in XML format to third party interfaces WACS is to be used by authorized health care professionals using standard institutional procedures and good clinical practice guidelines for patient monitoring Staff training in the operation of WACS is essential for optimal use Users should be skilled at the level of clinicians clinical administrators and hospital administrators with the knowledge and experience to acquire and interpret patients vital signs Each of these roles is assigned and associated with specific privileges and scopes Access privileges are controlled through passwords Individuals using WACS should be familiar with its operation as described in this manual and they should
40. ncoding ID gt data ST gt In Version 2 3 replaces the MO data type price MO price type ID gt from value NM gt to value NM range units CE gt range type ID financial class ID effective date TS name of field ST relational operator ID lt value ST gt relational conjunction field name ST value1 ST amp value2 ST amp value3 ST lt HL7 item number ST lt HL7 data type ST maximum column width NM gt Programmer s Guide Table 23 Data type descriptions Inbound ADT HL7 messages 51 Data type Definition Data format attributes and notes Master files DLN JCC VH Driver s license number Job code class Visiting hours Medical records Information management PPN Time series DR RI SCV T Performing person time stamp Date time range Repeat interval Scheduling class value pair Timing Quantity license number ST issuing state province country IS expiration date DT job code IS gt job class IS start day range ID end day range ID gt start hour range end hour range TM ID number ST gt family name ST gt given name ST gt middle initial or name ST gt suffix e g JR or III ST prefix e g DR ST gt degree e g MD 5
41. nowledge Error Query Acknowledge Query Parameter Definition Response Control Parameter PIDG Patient Identification Additional Demographics Next of Kin Associated Parties Notes and Comments for PID Patient Visit Patient Visit Additional Info ORCG Common Order Observation Report ID Notes and comments for ORC OBR Contact Data OBXG Observation Result Notes and Comments for OBX Continuation Pointer Query Result Cluster Begin PID Group End PID Group Begin ORC Group Each ORC OB combination constitutes a hit Begins OBX Group End OBX Group End ORC Group End Query Results Programmer s Guide WACS outbound HL7 messages 35 QBP RSP query and reply example Get Heart Rate and RR BR of Patient ID GA003560 from 2003 06 24 11 50 00 to 2003 06 24 11 50 02 interval of 1 sec query MSH A amp Van Goe Edgar A l 20030624121816 101 0800 QBP Q11 20030624121816101b P 2 4 QPD GA003560 4 amp 1 4420030624115000 080020030624115002 0800 Heart Rate RR BR RCP RSP4Z90 reply MSH A amp WAPAWAP 20030624 121817 248 0800 RSPAZ90 20030624121817250c P 2 4 QPDI GA003560 4 amp 14420030624115000 080020030624115002 0800 Heart Rate RR BR PID 1 GA003560 GA003560 BR 1 VITALS Vital SignsWAPI 20030624115001 000 0800 BX 1 ST Heart Rate Heart Rate WAP 80 0 ABPM 20030624115000 000 0800 BX 2 STIRR BRARR BRAWAP 20 0 4Br MI l 20030624115000 000 0800 BRI2 VITALS Vital SignsWAP 2003
42. owledgment message If no acknowledgement is received the ORU message is retransmitted at a configurable interval defaultz30 seconds The message is retransmitted until it has been sent a configurable number of times default 5 or until an acknowledgement is received Table 16 ACK R01 acknowledgment message required Segment Description MSH Message header MSH 9 MSH 11 P MSH 12 Version 2 3 2 3 1 2 4 MSA Message acknowledgement MSA 1 AA MSA 2 Original message ID ORU ACK message and acknowledgement example ORU RO1 message Tue Jan 27 09 36 02 2009 gt HL7 HL7Log Initiator sending message SH A4 amp WAPAWAP 20090127093601 105 0800 O RU RO1 20090127093601106c5 P 2 4 D 1 867509 867509 Van GoeAEdgar A B67509 BR 1 VITALS4Vital SignsWAP 20090127093400 000 0800 ST Heart Rate Heart Rate4WAP 80 4BPM 20090127093400 000 0800 ST Temperature4 Temperatures WAP 1 98 6 4 F 20090127093400 000 0800 ST Temperature4 Temperature4WAP 2 97 5 4 FI 20090127093400 000 0800 ST SPO24SPO24WAP 97 4 20090127093400 000 0800 ST CO2 In CO2 In AWAPI 0 0 4 2009012 7093400 000 0800 ST CO2 Ex CO2 Ex AWAP 5 0 4 2009012 7093400 000 0800 ST RR BRARR BRAWAP 12 4Br M 20090127093400 000 0800 ST PVCAPVCAWAP 0 0 4PVC Min 20090127093400 000 0800 is ivo Pas UN S gt ACKA
43. port to WACS Acuity System data storage configuration WACS capability for data receipt Zero hours Continuous 24 hours Query for most recent 24 hours 96 hours Query for most recent 96 hours a Data is available for a period up to the Acuity Full Disclosure capability but unsolicited push interfaces are usually configured to a shorter period to avoid swamping the CIS HIS Storage after Acuity disconnects from WACS or patient monitor Table 3 Examples of Acuity System data export after disconnection WACS HL7 message configuration 2 hour disconnect period Behavior upon reconnection Unsolicited observation push from WACS to CIS 15 minute intervals Patient monitor disconnected from Acuity Acuity System sends 8 sets of vital System sign observations covering the last two hours Or Acuity System disconnected from WACS server Programmer s Guide Data exported from the Acuity System to WACS The Acuity System exports the following vital sign data Table 4 Numeric vital sign data exported from Acuity Systems to WACS System overview Vital sign Units Default units Preferred HL7 tag OBX 3 Heart rate BPM 1 min BPM 1 min Heart Rate Temperature 1 2 DegF F DegC C Temperature DegC C Sp0 Per cent 96 Per cent 96 SP02 CO In mmHg kPa 96 mmHg CO2 In 007 Ex mmHg kPa 96 mmHg CO2 Ex RESP Br M 1 min Br M 1 min RR BR NIBP DIA SYS MEAN mmHg mmHg N
44. rement 1 4 Sl 0 00104 Set ID PID R 2 20 CX B 00105 Patient ID R 3 20 CX R Y 00106 Patient Identifier List R 4 20 CX B Y 00107 Alternate Patient ID PID 5 48 XPN R Y 00108 Patient Name 0 6 48 XPN 0 Y 00109 Mother s Maiden Name 7 26 TS 0 00110 Date Time of Birth 8 1 IS 0 0001 00111 Sex 9 48 XPN 0 00112 Patient Alias 10 80 CE 0 0005 00113 Race 11 106 XAD 0 00114 Patient Address 12 4 IS B 0289 00115 County Code 13 40 XTN 0 00116 Phone Number Home 14 40 XTN 0 00117 Phone Number Business 15 60 CE 0 0296 00118 Primary Language 16 80 CE 0 0002 00119 Marital Status 17 80 CE 0 0006 00120 Religion 18 20 CX 0 00121 Patient Account Number C 19 16 ST B 00122 SSN Number Patient 20 25 DLN 0 00123 Driver s License Number Patient 21 20 CX 0 00124 Mother s Identifier 22 80 CE 0 0189 00125 Ethnic Group 23 60 ST 0 00126 Birth Place 24 1 ID 0 0136 00127 Multiple Birth Indicator 25 2 NM 0 00128 Birth Order 26 80 CE 0 Y 0171 00129 Citizenship 27 60 CE 0 0172 00130 Veterans Military Status 28 80 CE 0 0212 00739 Nationality 29 26 TS 0 00740 Patient Death Date and Time 30 1 ID 0 0136 00741 Patient Death Indicator PID segment examples Edgar A Van Goe with Primary ID 9582173 and no Amended ID PID 1 9582173 9582173 Van Goe4 Edgar A 9582173 Edgar A Van Goe with Primary ID 9582173 and Amended ID 867509 PID 1 867509 867509 Van GoeAEdgarAAl 867509 20 WACS outbound HL7 protocols
45. rk The Acuity System stores patient data for variable amounts of time depending upon Acuity System license configuration Data export from patient monitors to the Acuity System Welch Allyn portable patient monitors store vital sign data and send it to the Acuity System in the following ways Table 1 Patient monitor data storage and export to the Acuity System Patient Monitor Means of data export to Mode of data Patient monitor Data export to Acuity System export to Acuity data storage Acuity System System during during temporary after temporary normal conditions disconnectionor disconnection or dropout dropout Hardwired monitors Unshielded twisted pair Stream Data stored up to Trends data only Propag Encore UTP monitor storage sent in batch mode Propaq CS capacity Hardwired Welch Ethernet Stream Data stored up to 24 Trends data only Allyn 1500 Patient hours sent in batch mode Monitor Wireless monitors 802 11 wireless LAN Stream Propaqs Data stored Propaqs Trends data Propaq CS Propaq LT up to monitor only sent in batch and Micropaq storage capacity mode Micropaq No Micropaq data lost storage 8 System overview Welch Allyn Connectivity Server Data storage at the Acuity System The Acuity System stores data for a period determined by the Full Disclosure license configuration Storage during Acuity connection to WACS Table 2 Acuity System data storage configurations and Acuity System data ex
46. rs or fields N Not used Causes an error condition if present Ignored Not used whether present or missing F Future Not used whether present or missing HL7 attributes of OBR observation request segments Table 8 HL7 attributes OBR observation request segment SEO LEN DT OPT RP TBL Item Element name WACS requirement 1 4 Sl 0 00237 Set ID OBR R 2 22 El C 00216 Placer Order Number C 3 22 El C 00217 Filler Order Number N 4 250 CE R 00238 Universal Service Identifier R 5 2 ID X 00239 Priority OBR N 6 26 TS X 00240 Requested Date Time R 7 26 TS C 00241 Observation Date Time N 8 26 TS 0 00242 Observation End Date Time 9 20 CQ 0 00243 Collection Volume N 10 250 XCN 0 Y 00244 Collector Identifier 11 1 ID 0 0065 00245 Specimen Action Code 12 250 CE 0 00246 Danger Code 13 300 ST 0 00247 Relevant Clinical Information 14 26 TS C 00248 Specimen Received Date Time 15 300 CM 0 0070 00249 Specimen Source 16 250 XCN 0 Y 00226 Ordering Provider 17 250 XTN 0 Y 2 00250 Order Callback Phone Number 18 60 ST 0 00251 Placer Field 1 N 19 60 ST 0 00252 Placer Field 2 N 20 60 ST 0 00253 Filler Field 1 N 21 60 ST 0 00254 Filler Fleld 2 N 22 26 TS C 00255 Results Rpt Status Chng N Date Time 23 40 CM 0 00256 Charge to Practice N 24 10 ID 0 0074 00257 Diagnostic Serv Sect ID 18 WACS outbound HL7 protocols Welch Allyn Connectivity Server Table 8 HL7 attributes OBR observation request seg
47. s the middle median data point For example for the values 56 72 96 82 and 78 the returned value is 78 For an even number of sample points WACS returns either the average mean or one of the two middle points For example for the values 56 72 70 96 82 and 78 the returned value is either the mean value 76 or one of the middle values 72 or 78 Returns the data closest to the given reference point Example Heart rate values are calculated every minute over a period of five minutes For example heart rate values of 56 72 96 82 and 78 are collected and then the HL7 message is constructed at the five minute reference point The HL7 message is contains only the heart rate value of 78 which is the value closest to the reference point 24 WACS outbound HL7 protocols Welch Allyn Connectivity Server Reconfiguring WACS outbound observation settings Welch Allyn preconfigured your Welch Allyn Connectivity Server WACS based on your facility s specified requirements Once your system is built and programmed and once data is flowing from the WACS server to the CIS you can adjust and customize WACS default settings Common outbound setting adjustments Common HL7 setting adjustments are as follows HL7 version Seconds of historical data retrieval Push intervals Push on event settings Number of resend attempts Observations per patient Patients per message Observation label formats OBX sub IS specification
48. ssage Acknowledgment R QRD Query Definition R ORF Query Format C PID Patient ID R PV1 Patient location enabled only for patient based site NTE Notes and Comments OBR Observation request R NTE Notes and comments OBX Observation Result R Notes and comments CTI Clinical Trial Identification ERR Error C OAK Query Acknowledgement C DSC Continuation Pointer 32 WACS outbound HL7 messages Welch Allyn Connectivity Server QRY ORF query and reply example Get the heart rate and respiration rate of Patient ID GAO03560 from 2003 06 24 11 50 00 to 2003 06 24 11 50 02 interval of 1 sec ORY R02 query MSH A amp Van Goe Edgar A 20030624121618 151 0800 ORY R02 200306241216181517 P 2 4 QRDJ20030624121618 191 0800 R I Q1056482178191 GA003560 RES ORF Heart Rate RR BR I amp 1 20030624115000 0800 20030624115002 0800 ORF R04 reply MSH A amp WAP WAP II 20030624121744 994 0800 ORF R04 20030624121744995a P 2 4 QRDJ20030624121744 615 0800 R IJQ1056482264615 l GA003560 RES QRFI l Heart Rate RR BR I 4 amp 1 4420030624 115000 080020030624115002 0800 PID 1 GA003560 GA003560 OBR VITALS Vital SignsWAP 20030624115001 000 0800 OBX 1 ST Heart Rate Heart RateAWAP 80 0 4BPM I I 20030624 115000 000 0800 OBX 2 STIRR BRARR BRAWAP 20 0 Br MI I l 20030624115000 000 0800 OBRI2 VITALS Vital Signs WAP 20030624115002 000 0800 OBX 1 ST Heart Rate Heart
49. sure configuration After autopopulated information is confirmed it can be modified ID numbers can be revised with an amended ID number and amended ID numbers can be amended For more information about entering and revising patient information in the Acuity System see the Acuity and Mobile Acuity LT Central Monitoring Systems directions for use 46 Inbound ADT HL7 messages Welch Allyn Connectivity Server ADT messages accepted and stored by WACS WACS accepts the message types and formats described in this section Accepted message types WACS receives and stores these types of messages Welch Allyn suggests that you consider configuring your CIS HIS ADT server to block messages other than these e ADT ACT Admit visit notification event A01 e ADT ACK Discharge end visit event A03 e ADT ACK Register a patient event A04 ADT ACK Pre admit a patient event A05 e ADT ACK Update patient information event event A08 e ADT ACK Cancel admit visit notification event A11 e ADT ACK Cancel discharge end visit event A13 Note The Acuity System accepts middle initial only not middle name in messages Accepted message formats Delimiters WACS accepts standard HL7 2 3 2 4 delimiters and data types as defined in this section taken from the Health Level Seven Implementation Support Guide for HL7 Standard Version 2 3 The interface parses incoming messages for delimiters and the delimiters might differ
50. ver deamon PNSD for the ID number s and patient information associated with the number s If a match is not found the Acuity System queries the WACS database SQL for the ID number s and patient information associated with the number s 3 Atthe Acuity Central Station in the Patient ID Setup window the Acuity System responds in one of these ways e f no associated information was found the curser moves to the next field in the window e f associated information was found this confirmation message appears within two seconds SIMULATING 4 The user responds in one of these ways e fthe user clicks Accept the remaining fields of the window autopopulate and existing information in the fields is replaced The autopopulate action cannot be undone e fthe user clicks Go Back the user can manually type the correct information into the blank text fields 5 The user clicks Confirm The patient information is distributed and confirmed Programmer s Guide Inbound ADT HL7 messages 45 Rules regarding Acuity System patient IDs These rules apply within the Acuity System A patient ID number an amended ID number or both may be entered Letter case is ignored when ID numbers are compared to the PSND and WACS databases An autopopulate search can match a currently monitored Acuity System patient or a patient discharged from the Acuity System for a period of 24 96 hours depending upon the system s Full Disclo
51. ype ID gt RP Reference pointer pointer ST application ID HD gt type of data ID gt subtype ID gt PL Person location point of care IS gt room IS gt bed IS gt facility HD location status IS gt person location type IS gt building IS floor IS gt location description ST PT Processing type processing ID ID processing mode ID Date Time DT Date YYYY MMIDD Time HH MMISSLSIS S SIIIL 2ZZZ TS Time stamp YYYY MMI DD HHMMISS S S S SIIMML 222Z degree of precision 48 Inbound ADT HL7 messages Table 23 Data type descriptions Welch Allyn Connectivity Server Data type Definition Data format attributes and notes Code values CE CF CK CN CX XCN Generic CM Coded element Coded element with formatted values Composite ID with check digit Composite ID number and name Extended composite ID with check digit Extended composite ID number and name Composite identifier ST gt text ST gt name of coding system ST alternate identifier ST gt alternate text ST name of alternate coding system ST identifier ID gt formatted text FT name of coding system ST gt alternate identifier ID gt alternate formatted text FT gt name of alternate coding system ST ID number NM gt check digit NM
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