The ADT Application

The following is a table of ADT data, that can be effectively transmitted to the CareVue system, other data items are just ignored.

FIELDNAME       CONTENTS        cvHL7           HL7             REMARKS
--------------- --------------- --------------- --------------- -----------
name            string          ZDM, PID        PID.PatName
Vorname         string          ZDM, PID        PID.PatName
acctNum         Patient ID      ZDM             PID.PatIdIntId  (1)
medRecNum       Visit-No.       ZDM, PID        PV1.VisitNum    (1)
sex             sex-code        ZDM             PID.Sex
DOB             date            ZDM             PID.DateOfBirth
admDate         date            ZDM             PV1.AdmitDateTime
attendMD        dept.-code      ZDM             PV1.ConSulDoc   (2)
Bett            bed-code        PV1             PV1.AssPatLoc
Zimmer          bed-code        PV1             PV1.AssPatLoc
Station         dept.-code      PV1             PV1.AssPatLoc
Entlass.grund   discharge-code  PV1             PV1.DisDis
service         code            ZDM             PV1.HosSer      (3)
Diagnose        string          ZDM             DG1.DiaGnoDes
diagnose        code            ZDM             DG1             (3)
originalSeverity apache-score   ZDM             OBX
currentSeverity  apache-score   ZDM             OBX
allergy1        string          ZDM             AL1[0].AllCodeMneDes.Text
allergy2        string          ZDM             AL1[1].AllCodeMneDes.Text
allergy3        string          ZDM             AL1[2].AllCodeMneDes.Text
nextKin         string          ZDM             NK1.Name        (6)
kinPhone        string          ZDM             NK1.PhoneNum[0] (6)
kinPhonezwei    string          ZDM             NK1.PhoneNum[1] (6)
kinPhonedrei    string          ZDM             NK1.PhoneNum[2] (6)
Blutgruppe      code            ZDM             OBX             
ht              measure         ZDM             OBX             (5)
admitWt         measure         ZDM             OBX             (5)
age             measure         ZDM             --             (4)
BSA             measure         ZDM             OBX             (4,5)
Adresse         string          ZDM             PID.PatAdd      (6)
Telephon        string          ZDM             PID.PhoneNumHome (6)
Hausarzt        string          ZDM             NK1.Name        (6)
HArztTel        string          ZDM             NK1.PhoneNum[0] (6)  

Remarks:

(1)

Visit-No. and Patient-ID are configured such that they must be exchanged.

(2)

The "attending medical doctor" is used as a department here, however there is no implication from this usage, since it is a free text field.

(3)

This field is currently not used.

(4)

A derived measure that will be calculated by CareVue and therefore need not be transmitted.

(5)

It is impossible to transmit this value neither via the HL7 ADT interface nor via CLI.

(6)

The next of kin (also called `associated party' since HL7 version 2.3) must be qualified by the contact role code, which is `user defined' --- meaning undefined yet. The following values will be used:

CODE MEANING            GERMAN
---- ------------------ ----------------------
  EM emergency address  Not-Adresse
  NK next of kin        (anderer) Angehöriger
  FD family doctor      Hausarzt

The discharge-code uses the following values:

`HOME'

Home

`FACILITY'

other facility

`DECEASED'

deceased

`AMA'

against medical advice

`OTHER'

other

`NONE'

no discharge status (= NULL value?)

The ZDM segment is configured as follows:

  demogPropNames[1]  = "name",
  demogPropNames[2]  = "Vorname",
  demogPropNames[3]  = "acctNum",
  demogPropNames[4]  = "medRecNum",
  demogPropNames[5]  = "sex",
  demogPropNames[6]  = "DOB",
  demogPropNames[7]  = "admDate",
  demogPropNames[8]  = "attendMD",
  demogPropNames[9]  = "Diagnose",
  demogPropNames[10] = "allergy1",
  demogPropNames[11] = "allergy2",
  demogPropNames[12] = "allergy3",
  demogPropNames[13] = "nextKin",
  demogPropNames[14] = "kinPhone",
  demogPropNames[15] = "kinPhonezwei",
  demogPropNames[16] = "kinPhonedrei",
  demogPropNames[17] = "Hausarzt",  
  demogPropNames[18] = "HArztTel",  
  demogPropNames[19] = "Adresse",  
  demogPropNames[20] = "Telephon",  
  demogPropNames[21] = "originalSeverity",  

Before a ADT request is forwarded to CareVue, the gateway must check the state of the CareVue census regarding this request in order to make sure that:

• the patient is not already admitted
• the assigned patient location is not already occupied
• the assigned location is occupied because the already admitted patient was assigned to the location specified

Moreover, a newly admitted patient must have database spaces reserved for admission height, weight and BSA values. These are accepted by the gateway as OBX segments in the ADT messages. There is, however, no other way to register these values into CareVue other than by directly use the IDB. There is a shell script `/usr/hl7/etc/idb_direct' that performs these tasks, see section Direct Access to CareVue's Database.

The apache score can be sent for CareVue's "Original Severity" in an OBX segment. According to HL7 v2.2 chapter 7, its observation identifier will be `1000.17^APACHE SCORE^AS4', unless there is a LOINC code for it. No unit is applicable here.