IntelliSpace Perinatal Rev. K.00.12 Integration Guide 4535 648 45721 (ENG)

I nt e g r a ti o n G ui de
IntelliSpace Perinatal
Rev. K.00
Pa tie n t Monit o ring
4535 648 45721

Software revision K.00.12
Published in Germany 05.2019
Internal Code: 20190506
1Table Of Contents
1 Overview 1
Who This Book is For 1

Interface Overview and Integration Points 2
What’s New in Rev. K.00? 2
Features 2
HL7 2
IHE Profiles (HL7) 3
Patient and User Context Synchronization (Single Sign-On) 3
DOX Signature Events 4
Enhancements and Fixed Issues 4
What’s New in Rev. J.00? 6
Features 6
Patient and User Context Synchronization (Single Sign-On) 6
Built-In HL7 Support 6
Automated ADT Workflow Option (ADT Inbound) 6
EPIC Device Data Interface (ORU Outbound) 7
Incoming Custom Charting Notes (ORU inbound) 7
Enhancements and Fixed Issues 7
Specific CIE functionality no longer available 9
2 Document Export (DOX) 11
Process Overview 12
General Setup 12
Requirements for Optional HL7 Notifications 12
Document Export Module 13
IntelliSpace Perinatal Events 13
Exported Documents 15
Target Directory 15
User Credentials to Access the Target Directory 15
Document Export Requests 16
Export Retries 16
HL7 MDM Export 16
Origination Date/Time Details 17
Delete on Acknowledge Feature 17
Copy MDM Message to Target Directory 17
DOX Requester Command Line Tool 18
Examples: 19
Limits 19
Throughput 20
Maximum Throughput 20
Throughput Considerations 20
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3 NICU Interface 23
4 Fetal Monitor LAN Connection 25
Features 25
Triplets 25
Trace Buffering and Fast upload 25
Dynamic hosting of Avalon Fetal Monitors 26
Static hosting of Avalon Fetal Monitors 26
Network Specification / Infrastructure 26
Setting Network Parameters in Avalon Fetal Monitors 27
Implementation Examples 28
Automatic distribution of Network Parameters.
Fetal Monitors and the IntelliSpace Perinatal system are in one network 28
Automatic distribution of Network Parameters.
Fetal monitors and the IntelliSpace Perinatal system are in different network segments 29
Manual assignment of Network Parameters.
Fetal monitor and the IntelliSpace Perinatal host computer are in different network segments 30
DHCP/BOOTP Address Reservation 31
Bed Assignment 33
Information Display 34
At the Fetal Monitor 34
Transmitted by IntelliSpace Perinatal and Displayed on the FM (ADT) 34
Transmitted by the FM to IntelliSpace Perinatal 34
Restrictions 35
Fetal Monitor Data Loss 35
Fetal Monitor Notes 35
Status Notes 36
5 HL7 Interface 37
Infrastructure 38
Installation Overview 38
Restrictions 38
HL7 Revisions 38
Administrative Episodes 39
Time Zone Support 39
Communication 40
Inbound Messages 40
Outbound Messages 43
Acknowledgement Modes 43
HL7 Message Content 44
Filters 45
Patient Identification 45
Processing of Coded Elements (CE) Fields 46
Field Length Limitation/Truncation 47
ADT Message Consumer 47
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ADT Operating Modes 47
ADT Buffer 47
Free Occupied Bed 47
Unknown Care Units 48
Limitation 48
Update of Patient Demographic Data 48
Processing of Allergy Data 49
Enabled/Disabled Patient Records 49
Messages for Patient Records that Don’t Exist in IntelliSpace Perinatal 49
Allergy Identification 49
Category Assignment 49
Allergy Reaction Code Mapping 49
Entry Date 49
Ownership 49
Uniqueness 50
Allergy Data Received in AL1 Segments 50
Allergy Data Received in IAM Segments 51
Limitation 52
Encounter Identifiers 52
Apply Episode Identifiers (A01, A08,...) 52
Change Episode Identifiers (A49/A50) 53
Consumed Encounter Identifiers 53
HIS Ownership 53
Enabled/Disabled Patients 53
Entry Date 53
Limits 53
Field Length Limitation/Truncation 54
Processing Examples 54
Configuring Locations 55
Configuring Routes for Incoming ADT Messages 56
Supported HL7 Trigger Events and System Actions 59
ADT Message Supplier 63
General Conditions 63
Outgoing Messages for Newborn Patients 63
Observation Reporter 63
ORU Sending 63
Query for Results of Observations (R02, R04) 64
Who Subject Filter (QRD-8) 64
Query Result Content 64
HL7 Batch Protocol 65
Notes Documentation 66
Notes Sequencing Within ORU Messages 68
ORU Message Structure 68
ORU Message Data 68
Notes Identification 68
Outgoing Medication Notes 69
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Fetus Index 69
OBR-4 Universal Service Identifier 69
OBX-3 Observation Identifier 69
Notes with Fetus Index 70
Notes Deletion 71
Deleting a Whole Chain of Medication Notes 71
Configuring an Outgoing Observation Route 72
Configuring an Outgoing ORU Route for an EPIC Incoming Device Data Interface 75
Configuring an Outgoing Observation Query Interface 78
Observation Consumer 80
Patient Identification 80
Acknowledgement 80
Data Validity and Logging 80
Mapping and Storing 81
Applying OBR/OBX Data 83
Configuring the Mapping of Incoming Lab Data 83
Denied mappings 85
Configuring Automapping 85
Field Description 85
Flag Important Patient Information 85
Lab Reminders 85
Limitations 86
Troubleshooting 86
Configuring Routes for Incoming ORU Messages for Incoming Custom Charting Elements 87
Mapping for Incoming Lab Values 89
Mapping Custom Charting Elements to ORU-in Messages 89
Message Segments 91
Legend for the Segment Tables 91
Supported HL7 Data Types 92
MSH - Message Header Segment 94
EVN - Event Type Segment 96
PID Patient Identification Segment 99
PV1 - Patient Visit Segment 104
IN1 - Insurance Segment 107
NK1 - Next of Kin Segment 107
ERR - Error Segment 108
MRG - Merge Patient Information Segment (ADT IN only) 108
AL1- Allergy Segment 108
IAM- Allergy Segment 109
Medical Document Management (MDM) 110
OBR - Observation Request Segment (ORU Out) 111
OBX - Observation Result Segment - (ORU Out) 113
OBR - Observation Request Segment (ORU Incoming) 115
OBX - Observation Result Segment (ORU Incoming) 116
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Query/Report for Results of Observation 119
MSA - Message Acknowledgement Segment 120
Example Messages 121
ADT inbound 121
Admission / Pre-Admission (A01, A04, A05) 121
Transfer (A02) 122
Discharge (A03) 122
Change Outpatient / Inpatient (A06, A07) 122
Update patient information with allergies (A08) 123
Swap Patients (A17) 123
Merge a Patient (A18, A24, A40) 123
Unlink a Patient (A37) 124
Cancel Pre-Admit (A38) 124
Change Patient Identification (A47) 124
Change Account Number (A48) 124
Change Visit Number (A50) 124
Update Adverse Reaction (A60) 125
Observation Inbound 125
Incoming ORU (R01) 125
Incoming Labs (R01) 126
ADT Outbound 127
Create / Admission (A01) 127
Transfer (A02) 127
Close / Discharge (A03) 127
Observation Outbound 128
Query for results of observation (R02, R04) 128
Unsolicited Observations (R01) 130
MDM outbound 150
Acknowledgment 150
Original Mode 150
Enhanced Mode 151
Additional Information 152
6 IntelliSpace Perinatal Link 153
System Requirements 153

Time Information for Linked IntelliSpace Perinatal Systems 154
Setting Up and Using Linked Systems 154
7 Context Synchronization 155
Startup Patient Context 155

XML Context Synchronization 156
Vendor-neutral XML Integration 157
Patient Context 157
User Context 157
Vendor-Neutral XML File Definition 158
EPIC XML-based PACS Integration 159
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Patient Context 159
User Context 159
XML Integration Simulator Tool 160
Context Synchronization Configuration 162
8 Diagnostics and Repair 163
Co-residency 163
Network 163
Domain Integration 164
HL7 Link 164
9 Third Party Co-residency and Network Integration 165
Integration Responsibility 165

Third Party Co-residency 166
Network Integration 166
Non-Production System 166
HL7 Link 166
System Support Strategy 167
Full Support 167
Limited Support 167
Limited Support / Division-Validated (LS/D) 167
Limited Support / Customer-Validated Implementation (LS/C) 167
No Support 168
Customer Responsibility 168
System Status Indicator 170
Integration Support 171
Hardware 171
Software 172
Network 173
Virtualization 175
Other Features 176
10 Integration Tests 177
Mandatory Integration Testing 178

Integration Re-testing 178
When Integration Testing is Not Required 179
When Integration Re-testing is Not Required 179
What if the Integration Test Fails? 180
Integration Test Scenarios 181
Basic Functionality Test (Test Scenario 1) 181
Full Integration Test (Test Scenario 2) 181
System Essential Test 182
Individual Integration Test 184
Recording the Results 194
11 Glossary 197
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1
1 Overview
This guide tells you about the integrated and extended/enhanced implementation of the following
optional features and third party solutions with an IntelliSpace Perinatal system.
• HL7-based communication
• IntelliSpace Perinatal to IntelliSpace Perinatal link
• Integration/co-residency of third party applications
• Integration of alternative hardware components
• Data export for statistical or report generation
• Integration of an IntelliSpace Perinatal system into the hospital network infrastructure.
It contains planning information, including requirements, limitations, restrictions and integration tests
to allow you to determine whether the integration has been successful (that is, so that the function of
IntelliSpace Perinatal is not impaired).
1.1 Who This Book is For

This book is for authorized and qualified IntelliSpace Perinatal implementation specialists. Technical
understanding and competence to implement the IT strategies discussed in this book are prerequisites.
A good knowledge of English is essential.
4535 648 45721 - IntelliSpace Perinatal Integration Guide - 1

1 Overview Interface Overview and Integration Points
1.2 Interface Overview and Integration Points
Clients Other Vendor Systems Philips Systems
ADT System EHR System LIS System

Remote Desktop Session Philips IntelliSpace
HL7 (ADT) HL7 HL7 (ORU) Critical Care and Anesthesia
Network See HL7 Interface See HL7 Interface See HL7 Interface NICU Interface (SQL)
[This Guide] [This Guide] [This Guide] See NICU Interface
[Site Preparation Guide]
[This Guide]
Network HL7
[Installation Guide] See HL7 Interface
[This Guide]
Philips IntelliBridge
Client
Enterprise
IntelliSpace Perinatal Link
See IntelliSpace Perinatal Link
LAN / RS232 [This Guide]
Peripherals see Fetal Monitor LAN Connection
Philips IntelliSpace Perinatal
[This Guide]
Context Synchronization
Network / USB Single-Sign-On Document Export
[Site Preparation Guide]
[This Guide] See Document Export (DOX) Another
AppLink LDAP [This Guide] IntelliSpace Perinatal
[Configuration Guide] [Site Preparation Guide]
Fetal AppLink System
Reporting Word/Excel
[Configuration Guide]
Monitor AppLink [Data Field Reference Guide]
[Configuration Guide]
SQL Queries
[External Database Guide]
Printer, PDF/XPF
Web Service XDS External Applictions Active Directory Document Repository
Applications & Services Infrastructure
1.3 What’s New in Rev. K.00?

This section lists the most important new features and improvements to the product and its user
interface. Further information is provided in other sections of this book. You may not have all of these
features, depending on the configuration purchased by your institution.
1.3.1 Features
1.3.1.1 HL7
• QRY/ORF - Query For Results Of Observation (Events R02, R04)
(see HL7 standard chapter 7.3.3)
– Configurable "who subject filter (QRD-8)"
– Response contains the last value of each note type (configurable)
• HL7 batch protocol
(see HL7 standard chapter 2.10.3)
• RAS O17 pharmacy/treatment administration support with IBE B.11 (K.00.12)
– Receive medication administrations as a custom charting element
– see IBE B.11 Implementation Guide for IntelliSpace Perinatal
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What’s New in Rev. K.00? 1 Overview
• Allows to configure a patient identifier with label and type code

(see HL7 table 0203 identifier type)
• Allows to configure the used encounter identifier Visit Number (PV1-19) or Account Number
(PID-18)
– German only: Changed translation of visit number to "Fallnummer" and MRN to "Patienten
Fallnummer"
• Patient and encounter identifier protection for open episodes (configurable) (K.00.12):
– Prevent update of already entered patient identifiers, except change via A47
– Prevent update of already entered account number, except change via A49
– Prevent update of already entered visit number, except change via A50
• Responsible observer mapping to ISP users (K.00.12):
– Inbound ORU: Responsible Observer (OBX-16.1 and OBX-16.2) will be mapped to configured
ISP user. ISP user name is shown for notes received by HIS instead of “HL7”
– Outbound ORU: Observations will be exported with Account name (OBX-16.1) and Display
name (OBX-16.2) of Responsible Observer (configurable)
• Uniqueness options for exported Notes (configurable) (K.00.12):
– All observations (OBX segments) will be grouped into a single OBR per message
– Send each observation identifier only once per message (messages will be split once an identifier
already exists)
– Only send observations with the same date/time in a message (messages will be split once an
observation has a different date/time)
– Only send observations done by the same Responsible Observer (messages will be split once an
observation has a different Responsible Observer)
1.3.1.2 IHE Profiles (HL7)

• Patient Administration Management Profile [IHE PAM]
– Actor: Patient Demographics Consumer [ITI-30 Patient Identity Management]
• Support ADT merge/unmerge events A18, A24, A37, A40
• Support ADT swap event A17
– Actor: Patient Encounter Consumer [ITI-31 Patient Encounter Management]
• Patient Care Device Profile [IHE PCD]
– Actor: Device Observation Reporter (DOR) [PCD-01 Communicate PCD Data]
• IBE required to map observation identifier codes to MDC nomenclature
• HL7 version 2.6 (MSH-11)
• Message Profile identifier stated (MSH-20)
1.3.1.3 Patient and User Context Synchronization (Single Sign-On)

• Vendor-independent xml file interface to synchronize user and patient context with applications of
other vendors (e.g. Meditech)
• New context synchronization configuration (K.00.12), which allows to configure trigger-based
actions, e.g. to minimize/maximize ISP

1 Overview What’s New in Rev. K.00?
1.3.1.4 DOX Signature Events

• New DOX event triggers for signatures in form-based documentation.
1.3.2 Enhancements and Fixed Issues

• Time zone support
Date and Time values are sent with or without time zone information depending on the route
configuration.
Restriction:
The time zone information of the sending system at message creation time is sent. Thus it could be
different from the time the data is entered, especially during a time zone change (DST).
• Support name type code "L" for legal name and "A" for alias name (PID-5.7 name type code)
• Assigning authorities of MRN, SSN, PID, Visit Number and Account Number are stored/exported
when received via HL7 (PID-3.4 Assigning Authority)
• Send date of birth as date without time for maternal patients, while newborn date of time still comes
as date and time (PID-7 Date/Time of Birth)
• Send unique Placer and Filler Order Number (OBR-2 Placer Order Number; OBR-3 Filler Order
Number)
• ADT incoming: New demographics fields added:
– Patient Alias (PID-9 or PID-3 with name type code "A" Alias)
– Emergency contact (NK1-2 Name, NK1-5 Phone)
– Insurance [repeatable] (IN1-4 Insurance Name, IN1-17 Relationship to patient, IN1-49 Insured
person's ID Number)
• ADT incoming: Sex code (K.00.12):
– Other “O” will be accepted as valid option (PID.8)
– Unknown or not supported values will not result in error, patient will be admitted/updated
• Observations outbound: Sends multi-selection as repeatable values with HL7 separator "~" instead
of semicolon separated (Observation Value OBX-5)
• Observations outbound: Sends line breaks as escaped special character "\X0A" instead of whitespace
(Observation Value OBX-5).
• Observations outbound: Send fetus index as type code appendix. Backward compatibility
configuration option exist (Observation Identifier OBX-3).
Example:
Before:
OBX|1|NM|NTE053-1^FetusIndex^99POB||0|||…
OBX|2|NM|NTE053-2^pH^99POB||7,00||||…
After:
Fetus 1:
OBX|1|NM|NTE053-2.FX0^pH^99POB||7,00||||…
Fetus 2:
OBX|1|NM|NTE053-2.FX1^pH^99POB||7,00||||…

What’s New in Rev. K.00? 1 Overview
• Observations outbound: Send categories of assessment note types as separated OBX segments
instead of concatenated summary string (Observation Value OBX-5). The observation identifier
(OBX-3) needs a configured folder code (VTE).
Example:
Before:
OBX|1|ST|NTE204-1^Status^99POB||T||||…
OBX|2|ST|NTE204-2^Summary^99POB||(Reassessment: No changes, See below; General
Symptoms: Coping well with circumstances, Appropriate interactions; Interventions: Questions
answered, Supported to grieve)||||||F|||20150907174328||Witt, Sebastian
OBX|3|ST|NTE204-3^Comment^99POB||Comment||…
New segments:
OBX|4|ST|<Code FROM VTE>^Reassessment^99POB||No changes~See below|||…
OBX|5|ST|<Code FROM VTE>^General Symptoms^99POB||Coping well with circumsta…
OBX|6|ST|<Code FROM VTE>^Bereavement^99POB|||…
OBX|7|ST|<Code FROM VTE>Înterventions^99POB||Questions answered~Supported…
• Observations outbound: Event notes (NTE-046) observation identifier (OBX-3) is configurable in
VTE (K.00.12)
Example:
With compatibility option (code as value):
OBX|1|ST|NTE046-1Êvent^99POB||Event: Difficult to Trace [TestCode-01]|||…
Without compatibility option (code as identifier):
OBX|1|ST|TestCode-01Êvent^99POB||Event: Difficult to Trace||…
• Observations outbound: Send user name of user who originally entered the observation instead of
user who deleted the observation (OBX-16) (configurable) (K.00.12)
• Observations outbound: Export interval can be changed (configurable) (K.00.12)
• Observations inbound: support for data type CNE, CWE and TX (OBX-2 value type)
• Observations inbound: Custom charting elements are mapped by code and coding system only,
name is not required anymore (K.00.12)
• Observations inbound: Custom charting elements are mapped by Universal Service Identifier
(OBR-4) when mapping with Observation Identifier (OBX-3) yields no results (K.00.12)
• MDM outbound: Send patient location in MDM message (PV1-3 patient location)
• MDM outbound: TXA-12.3 is filled with the configurable Application Name (see HL7
configuration - general settings; TXA-12.3 Unique Document Number Universal ID)

1 Overview What’s New in Rev. J.00?
1.4 What’s New in Rev. J.00?

This section lists the most important new features and improvements to the product and its user
interface. Further information is provided in other sections of this book. You may not have all of these
features, depending on the configuration purchased by your institution.
1.4.1 Features
1.4.1.1 Patient and User Context Synchronization (Single Sign-On)

• Support of EPIC interface to synchronize user and patient context with other applications
• Configurable encryption key
1.4.1.2 Built-In HL7 Support

• No separate interface machine required. CIE cannot connect any more. See “Specific CIE
functionality no longer available” on page 9 for further information.
• All routes must be configured in ISP (Ports, Acknowledgment-Mode, …)
• Routes can be activated, deactivated and copied
• HL7 Training mode for sent messages when DEMO system is used (MSH-11 Processing ID)
• System console allows tracking and analyzing of HL7 messages
• Performance counters available in Windows Performance Monitor
1.4.1.3 Automated ADT Workflow Option (ADT Inbound)

Automatic or Manual+ ADT Operation mode must be configured.
For backward compatibility to Rev. H keep default: Manual ADT Operation mode.
• Admission, Transfer and Discharge events are supported
• Patient records are created automatically if not already existing
• Episodes are started automatically
• Patients are transferred to other locations (bed, room, facility, …)
• Unknown care units handling options (J.00.21)
– Admit all patients
– Keep patients on transfer
• Free-bed option allows transferring patients in occupied beds
• Patients are transferred to discharge locations
• Patient records can be closed automatically after a configurable time
• Cancellation events are supported:
– A11 Cancel Admit: Patient will be discharged.
– A12 Cancel Transfer: Patient is transferred into the previous location that must be given in the
assigned location field (PV1-3 Assigned location)
– A13 Cancel Discharge: Patient will be re-admitted.
– A38 Cancel Pre-Admit: Patient will be removed from HIS Patient Buffer list

What’s New in Rev. J.00? 1 Overview
1.4.1.4 EPIC Device Data Interface (ORU Outbound)

• Exports the data from the connected fetal monitors only
• Data include the identifier of the device (OBR-10 Collector identifier, OBX-18 Equipment
Instance Identifier)
1.4.1.5 Incoming Custom Charting Notes (ORU inbound)

Custom charting elements have to be configured with the same name, code and coding system in
flowchart and HL7 message.
• A new ORU inbound route option allows creating custom charting notes
1.4.2 Enhancements and Fixed Issues

• HL7 Version changed from 2.4 to 2.5 (MSH-12 Version ID)
• Full qualified message types. E.g. ORU^R01ÔRU_R01 instead of ORU_R01 (MSH-9 Message
type)
• Send serial number of the fetal monitor, if available (OBX-18 Equipment Instance Identifier)
• Multiple birth indicator of newborn patients (PID-24 Multiple birth indicator)
• No rejection of messages with stated time zone information (J.00.21 SP1)
• ADT inbound: The date of birth of a newborn patient is not updated anymore. In most cases the
time of birth was lost when receiving date of birth of other systems (PID-7 Date/Time of birth)
• ADT inbound: Visit number is selected automatically if an ADT message with visit number is
received (PV1-19 Visit number)
• ADT outbound: Set ADT event time instead of message sending time to EVN segment (EVN-2
Recorded Date/Time)
• ORU inbound: Code of incoming lab measurements was shown instead of a readable text (OBX-3
Observation Identifier)
• ORU inbound: Accept formatted text (FT) datatype for incoming custom charting elements
(OBX-2 Value Type) (J.00.21)
• ORU outbound: Coding system changed to ISO for the following measurement units mL, l, g, kg,
Min instead of 99POB (OBX-6 Unit)
Example:
OBX|2|NM|NTE327-2^TotalIntake^99POB||0|mL^ÎSO|...
• ORU outbound: Observation Set ID (OBX-1 Set ID) and Identifier appendix (OBX-3.1
Observation identifier / Identifier) always begin with 1. Used to be 0 for the following notes:
– Fetal Monitor Fast Upload Info NTE309
– Onset of Labor NTE181
– Full Dilation NTE104
– Newborn Initial Examination Start NTE234
– Newborn Initial Examination End NTE235
– Newborn Final Examination Start NTE236
– Newborn Final Examination End NTE237
– Alarm Acknowledged NTE038

– Fetal Monitor Marker Pressed NTE062

– System: Stop NTE 101
Example:
Before: OBX|0|ST|NTE181-0^^99POB||||||||F|||20050628151400||Test
After: OBX|1|ST|NTE181-1^^99POB||||||||F|||20141121112413||Test
• ORU outbound: Identifier appendix removed (-1) from the identifier of custom charting elements.
(OBX-3.1 Observation identifier / Identifier)
Example:
Configured Custom charting element:
Name = CustNote1, Code = CNTE-01, Coding System = NHCS
Before: OBX|1|ST|CNTE-01-1^CustNote1^NHCS||5||||||F|||20150324094036||Test
After: OBX|1|ST|CNTE-01^CustNote1^NHCS||5||||||F|||20150324094036||Test
• ORU outbound: Configuration option to send null value ("" double quotes) instead of omitted in
case of deleted (OBX-11 = "D") results (OBX-5 Observation value)
• ORU outbound: Send following PID values in each ORU message:
– Administrative Sex (PID-8)
– Patient Account Number (PID-18)
• ORU outbound: Responsible observer (User name) sent in first component
(OBX-16.1 ID Number instead of OBX-16.2 Family name)
• ORU outbound: Changed identifier in deceleration note from
NTE177-6^SevereDecel^99POB
to
NTE177-6^SevereVariableDecel^99POB (OBX-3 Observation identifier)
• ORU outbound: Multi-selection values of custom charting elements sent as repeated values instead
of repeated OBX segments.
Example: Configured Custom charting element:
Name = Test1, Code = 11, Coding System = SNOMED, Type: VTSelection (Multi-selection)
Before:
OBR|1||-12ÔBTV|11^Test1^SNOMED|||20150616144057||||||||||||||||||F
OBX|1|CE|11^Test1^SNOMED|1|10^Wert1^SNOMED||||||F|||20150616144057||User
After:
OBR|1||-12ÔBTV|11^Test1^SNOMED|||20150616144057||||||||||||||||||F
OBX|2|CE|11^Test1^SNOMED|1|10^Wert1^SNOMED~20^Wert2^SNOMED~30^Wert3^SNOMED||||||
F|||20150616144057||User
• ORU/MDM outbound: Send the following PID values in each ORU/MDM message (J.00.10):
– Administrative Sex (PID-8)
– Patient Account Number (PID-18)
• ORU outbound: Responsible observer (User name) sent in first component (OBX-16.1 ID Number
instead of OBX-16.2 Family Name) (J.00.10)

What’s New in Rev. J.00? 1 Overview
• ORU outbound: Changed identifier in deceleration note from NTE177-6^SevereDecel^99POB to

NTE177-6^SevereVariableDecel^99POB (OBX-3 Observation identifier) (J.00.10)
• ORU outbound: Send alarm condition priority of alarm notes (NTE039) (J.00.20)
• ORU outbound: Always send OBX-2 value type; this was missing if OBX-11 was "D (delete)"
(J.00.20 SP1)
1.4.3 Specific CIE functionality no longer available

• No message content mapping engine. You have to use IBE or another mapping engine to make
message content manipulations if required.
• No message content filters (e.g. Bed, Point of care, Facility, …)
• No dual port connection. It is not possible to send and receive messages of the same route with
different ports.
• No support for ASTM, File Stream or LIS2 protocols - TCP MLLP support only (without
configurable header and trailer characters)


2
2Document Export (DOX)

The Document Export feature is intended to support integration with a Document Management
System or a Clinical Data Repository (CDR). It offers the automated generation of electronic
documents in various formats (e.g. .pdf, .xps).
Document Export covers two main activities:
1. IntelliSpace Perinatal automatically generates electronic documents and stores the results in a
configurable target folder. For further information please refer to the Installation and Service Guide.
2. If the IntelliSpace Perinatal system has an HL7 interface configured, IntelliSpace Perinatal
optionally sends HL7 MDM-T01 messages to inform a remote system about the document
creation. For further details please refer to the System Administration and Configuration Guide.
The Document Export feature is not available for Quick Admissions and for NO ARCHIVING
patients and cannot be shared across multiple IntelliSpace Perinatal systems (e.g. linked systems).

2 Document Export (DOX) Process Overview
2.1 Process Overview
2.2 General Setup

The general Document Export (DOX) setup procedure involves:
• Determining a non-data-acquisition computer that will host the DOX interface
• IntelliSpace Perinatal Setup
• IntelliSpace Perinatal DOX Configuration: Export Map (including triggers)
• Identifying the Output Directory and configuring access credentials
• For optional Word report printing install and configure MS Office on the same computer (For
details please refer to the Site Preparation and IT Specification Guide)
2.2.1 Requirements for Optional HL7 Notifications

• IntelliSpace Perinatal Configuration: HL7 MDM Route
• IntelliSpace Perinatal DOX Configuration: MDM Route

Document Export Module 2 Document Export (DOX)
2.3 Document Export Module

The DOX Export Module is implemented as a separate module of the IntelliSpace Perinatal system
architecture. It can be added to the system during IntelliSpace Perinatal Setup when Document Export
functionality is required. Otherwise, it is not started and it does not require any resources.
The DOX Module consists of two separate components:
1. DOX Manager
2. DOX Document Generator
The interface must not be installed on computers performing data acquisition. The interface can be
installed on Internal Server machines and on High-End Small Architecture systems but then MS
Office-based documents are not available. MS Office (if Document export involves Word reports) has
to be installed on the same computer as the Document Export interface.
NOTE • It is necessary to run the IntelliSpace Perinatal application on the computer where the document
export is hosted. The document export manager service will check for the running application on
the Document Export computer. When the application is not running, a system message is
generated.
• For MS Office document export it is recommended to use a dedicated client machine. Do not install
the feature on the External Server machine if MS Office-based document export is required.
• Do not manually use MS Office on the Document Export computer. When shutting down
IntelliSpace Perinatal on the Document Export computer, all Office processes will be terminated
automatically.
• If using printer drivers for document export:
– Do not use the document export printer drivers for manual printing.
– A dedicated windows user is recommended on the Document Export computer.
As IntelliSpace Perinatal uses the printing preferences of the logged-on Windows user, manual
printing may interfere with automated document export.
2.4 IntelliSpace Perinatal Events

The following events can initiate a document export:
IntelliSpace Perinatal Event Short Description Maternal Newborn SAT
Event Name patient patient
(only for DOX
Requester)
Transfer from departmental location

Transfer out of
XI2O to non-departmental location. Yes Yes No
department
Transfer out of care
XU2O Transfer from a specific care unit. Yes Yes No
unit
Transfer out of
XL2O Transfer from a specific location. Yes Yes No
location
Transfer from non-departmental
Transfer into
XO2I location to departmental location. Yes Yes No
department
Transfer into care
XO2C Transfer to a specific care unit Yes Yes No
unit
Transfer in location XO2L Transfer to a specific location Yes Yes No

2 Document Export (DOX) IntelliSpace Perinatal Events
Episode closed
(Only Non-Admin CEP Close of an episode. Yes Yes No
episodes!)
Maternal episode
closed (undelivered) Close of an episode in an
CEPUDL Yes No No
(Only Non-Admin undelivered pregnancy case.
episodes!)
Maternal episode
closed (delivered) Close of an episode in a delivered
CEPDL Yes No No
(Only Non-Admin pregnancy case.
episodes!)
Pregnancy closed CPCY Close of a pregnancy documentation Yes No
Administrative
CEPAD Close of an administrative episode. Yes Yes No
episode closed
Signature - Page signed. Yes Yes No
Grid Row Signature - Grid row signed. Yes Yes No

Episode manual
REP Manual export of a retrieved episode. Yes Yes No
export
Daily snapshot of
Automatic, when the System Audit
system audit trail DSAT No No Yes
Trail is closed and archived
Event Parameters:
Some route events require an additional parameter such as a care unit or a bed. Routes containing such
events initiate a document export if an IntelliSpace Perinatal event occurs that matches both the event
and the parameter.
Event Parameter 1 Parameter 2
(mandatory) (optional)
Transfer out of care unit Care unit n/a
Transfer out of location Location n/a
Transfer into care unit Care unit n/a
Transfer into location Location n/a
Page Signed Signature n/a
Grid Row Signed Signature "Parameter"
• Grid Row Signed Event Optional Parameter 2:

– Omitted: a document export is initiated for any row that is signed with the configured signature
– Specified: a document export is initiated for a row signed with the configured signature if the
name of the signed row matches parameter 2.

Exported Documents 2 Document Export (DOX)
2.5 Exported Documents

The set of documents and the file format is configured in Document Export Maps. Each document is
exported as a separate file. For details on how to configure Document Export Maps, please refer to the
IntelliSpace Perinatal System Administration and Configuration Guide.
The default file name of a generated document consists of a unique document GUID plus the file
name extension configured in the Document Export Map.
(e.g. “2a0c524b-34e7-4a94-985a-1c3ae496d011.PDF”)
For details on how to customize filenames, please refer to the IntelliSpace Perinatal System
Administration and Configuration Guide.
2.6 Target Directory

The generated files are deposited in a configured directory either on an IntelliSpace Perinatal computer
or on another IT system. The target directory is configured per Route. Please refer to the System
Administration and Configuration Guide for details about configuring Document Export Routes.
IntelliSpace Perinatal does not automatically clean up the target directory. However, the Delete on
Acknowledge Feature can be configured to delete generated files from target directory. Make sure that
the target directory has sufficient capacity and throughput. The required size and throughput of the
directory depends on the IntelliSpace Perinatal system size, on how extensively the feature is being used
and whether the documents are being erased after post processing. The following list shows the
maximum required size (conditions: 3 fetuses, all notes included, print area of normocardia, PDF-A):
– 480 hours trace: 1100 MB
– 1hour trace: 2.4 MB
– 10 min. trace: 0.4 MB
There is a compression algorithm in place that reduces the file size, so the actual size will usually be
smaller than given in the list.
2.6.1 User Credentials to Access the Target Directory

Document Export Route configuration provides the ability to configure a user and a password.
IntelliSpace Perinatal will use these user credentials to access the target directory. The configured user
account must have full access to the target directory.

2 Document Export (DOX) Document Export Requests
2.7 Document Export Requests

IntelliSpace Perinatal internally utilizes a queue of Document Export requests. The queue size and the
maximum age of the queued Document Export requests are limited.
Please refer to “Limits” on page 19.
A Document Export request is initiated by an IntelliSpace Perinatal event or by the DOX Requester.
There is no “just in time” processing of export requests. The documents are generated based on the
actual data at export time. The time span between the initiating event and finalization of the
Document Export is not specified. After a maximum of 72 hours a Document Export request is
considered “timed out”.
2.7.1 Export Retries

If the transfer of a document fails, the transfer is repeated after a period of time (time out). The
number of retries and the time out are configurable in the Document Export route definition. The
value Timeout (in minutes) must not exceed a maximum of 72 hours (4320 minutes).
2.8 HL7 MDM Export

If configured, IntelliSpace Perinatal sends an MDM message for each exported document. Only the
message type MDM^T01 is supported.
Message format:
MDM^T01^MDM_T01 Original Document Notification

MSH Message Header
EVN Event Type
PID Patient Identification
PV1 Patient Visit
TXA Document Notification
A non-empty HIS-ID in the IntelliSpace Perinatal patient record is not required in order to send an
MDMOut message.
When all the patient identifiers are missing an MDMOut will be generated without IDs but with the
identifier code of the configured HIS ID.
Example of a PID segment in a HL7 MDMOut message for a patient without identifiers when the
configured HIS ID is MRN:
PID|1||^^^^MR||Smith^Sara||
The MDM message is sent after the document transfer has finished. The following elements of the
TXA segment are used:
SEQ Length Element Name Description
1 4 Set ID- TXA Always set to 1.
2 30 Contains document title as appears in DOX Configuration dialog - e.g.
Document Type
“Flow Chart (AP/IP)”
6 26 Origination Date/Time See details below.
12 120 Unique Document Number Field is of type EI (Entity Identifier) comprised of:
12.1 Entity Identifier (EI.1): GUID of the document (same as used for the file name)
12.2 Namespace ID (EI.2): always set to “Philips.OBTV.DocExport”
12.3 Universal ID (EI.3): Application Name configured on the “HL7Links” configuration page
12.4 Universal ID Type (EI.4): <empty>

HL7 MDM Export 2 Document Export (DOX)
16 250 The name has the following format: (according to UNC format)
//<Server>/<doc share>/<filename.ext> where:
·<Server>: server or remote machine where the document is
Unique Document File Name
located
·<doc share>: document file share name
·<filename.ext>: file name of the document including extension
17 2 Document Completion Status Always DO (Documented).
NOTE The length for TXA-12 and TXA-16 are exceeding the HL7 specified length.
2.8.1 Origination Date/Time Details

The TXA-6 (Origination Date/Time) field is filled with the date/time when the document was
generated by IntelliSpace Perinatal, except when the data of a retrieved episode are exported.
For retrieved episodes the EndTS timestamp of the episode is used instead. If the retrieved episode is a
corrected episode, then the CorrEndTS timestamp is used.
2.8.2 Delete on Acknowledge Feature

The “Delete on Acknowledge” feature is available only in combination with MDM Export. If
configured, a positive acknowledgment on a MDM^T01 message causes IntelliSpace Perinatal to
delete the file that it had deposited in the target directory. If “Copy the MDM message to target
directory” is configured, then the MDM file is also removed from target directory.
The "Delete on Acknowledge" feature in DOX makes sense only if combined with an HL7 route
having a timeout greater than zero because a timeout of zero seconds instructs the HL7 module not to
request (nor accept) an acknowledgement.
If no positive acknowledgement is received, the export of the corresponding document is considered as
failed. IntelliSpace Perinatal does not delete any file in this case.
NOTE The following combination of parameters should be avoided:

• On HL7 config page the Outgoing MDM route is configured with a timeout of zero seconds
AND
• on the DOX config page the "Delete on Acknowledgement" feature is ON
2.8.3 Copy MDM Message to Target Directory

If configured, an XML version of the MDM message is deposited in the target directory, to facilitate
system integration when the destination system does not support MDM. Copying the XML file to the
target directory is possible even if the HL7 interface of IntelliSpace Perinatal is not installed.
The XML file uses the same GUID as the corresponding document for the file name; the file name
extension is “.MDM.xml”.
(e.g. “2a0c524b-34e7-4a94-985a-1c3ae496d011.MDM.xml”)

2 Document Export (DOX) DOX Requester Command Line Tool
2.9 DOX Requester Command Line Tool

The DOX Requester is a command line tool which allows generation of Document Export requests.
Such requests are processed the same way as requests induced by an IntelliSpace Perinatal event.
There is no way to notify the caller when the request is done.
The DOX Requester requires administrative rights in Windows.
There are two different orientations:
1. Event orientation
The DOX Requester is started with an Event Short Name parameter.
2. Document Export Route orientation
The DOX Requester is started with the name of a Document Export Route as parameter. Route names
containing space characters must be enclosed with quotation marks.
Patient Context: To generate a Document Export request with a patient context, either SubcaseID,
MRN, SSN or PatientIdentification must be given as command line parameter.
Command line syntax:
DOXRequester [-s <subcaseid>]
[-mrn <MRN>]
[-ssn <SSN>]
[-pid <Patient ID>]
[–e <event name> [[<Location name>]|[<Care Unit name>]] ]
[-r <route name>]
[-h]
[-t <trace mode>]
-s <SubcaseID> …SubcaseID as GUID; only for requests w/ patient context;
-mrn <MRN> …MRN (Medical Record Number) of a patient; only for requests
w/ patient context; data of the last episode are exported; cannot be used for
retrieved episodes
-ssn <SSN> …SSN (Social Security Number) of a patient;
only for requests w/ patient context; data of the last episode are exported;
cannot be used for retrieved episodes
-pid <PatientID> …Patient ID of a patient
only for requests w/ patient context; data of the last episode are exported;
cannot be used for retrieved episodes
–e <event name> …Short Name of the IntelliSpace Perinatal Event
only for Event oriented requests; “-e” and “-r” parameters are mutually exclusive
<Location name> …Name of a Location in IntelliSpace Perinatal
only for Events with Location reference (e.g. “Transfer in Location”)
<Care Unit name> …Name of a Care Unit in IntelliSpace Perinatal
only for Events with Care Unit reference (e.g. “Transfer from Care Unit”)

Limits 2 Document Export (DOX)
-r <route name> …Name of the Document Export Route to activate

only for Document Export Route oriented requests; “-e” and “-r” parameters
are mutually exclusive
-h …Help
-t <trace mode> …Trace level: “on” |”off” |”silent”.
The “–s”, “-mrn”, “-ssn” and –“pid” parameters are mutually exclusive.
The “-e” and “-r” parameters are mutually exclusive.
Parameter tags are not case sensitive.
2.9.1 Examples:
C:\TV2\prog> DOXRequester –s “7c613703-af58-46b5-9220-766e557f4cc7” –e CEP –t on
Simulates a “Close Episode” (CEP) event for the episode with id “7c613703-…”. The trace mode is
on.
C:\TV2\prog> DOXRequester –mrn “C5552461” –r “CDR Export”

This command generates a Document Export request for the patient with MRN “C5552461”. The
Document Export Route “CDR Export” is applied.
2.10 Limits
In order to prevent the system from overload, the amount of data needs to be limited.
Type of Protection Limit Behavior

Number of pending Document 500 A system message is displayed if the limit is
Export requests exceeded. Document Export requests are
Number of previously-generated 5000 processed none the less.
documents (but not yet trans- Also, a warning message containing some de-
ferred towards the target folder) tails (e.g. number of queued requests) is writ-
Disk space required for not yet 5000 MB ten to the log file.
transferred documents
Number of pending DOX Re- 1000 The DOX Requester refuses the attempt to
quester-generated Document Ex- generate further Document Export requests.
port requests
Number of pages in an MS Excel- 1000 The attempt to generate the document is re-
based report document fused.
A system message is displayed locally on the
Document Export computer, indicating that a
document export has failed.

2 Document Export (DOX) Throughput
2.11 Throughput
The throughput of the Document Export module depends on factors like:
• IntelliSpace Perinatal System load
• Performance/ Load of the Document Export computer
• Content/Size of the generated documents
• Performance of the virtual printer drivers
2.11.1 Maximum Throughput

Conditions:
a. A typical Document Export Map containing the following documents:
– Trace
– Note List (all available note types)
– Microsoft Word reports:
• “Admission”
• “Discharge Summary”
• “FCAssessByTime”
• “Labor and Delivery”
• “Teaching”
b. Printer driver: Adobe PDF.
c. Document export runs on a RP5700 machine with 4 GB RAM
Maximum throughput:
900 requests / 24 hours
38 requests per hour
5000 documents / 24 hours
210 documents per hour
2.11.2 Throughput Considerations

• IntelliSpace Perinatal event “CEPAD”
IntelliSpace Perinatal may automatically generate Administrative Episodes, e.g. induced by an
incoming HL7 message. That’s why the use of the IntelliSpace Perinatal event “CEPAD” - Close of
an administrative episode as a Document Export Trigger may lead to a high number of Document
Export requests and the system performance may descend.
Therefore, the “CEPAD” event should not be used as a trigger to generate a large amount of
documents. It is recommended to use the “CEPAD” event very carefully.

Throughput 2 Document Export (DOX)
• Statistics and logs

The Document Export Map defines the set of documents generated for a Document Export request.
It can be configured in the Printing module. Statistics are available as well. However, Statistics are
rather reflect data over a time period than the data concerning a certain patient. Therefore Statistic
documents should not be part of Document Export requests triggered by IntelliSpace Perinatal
events. In addition to that Statistics may have a strong performance impact which may influence the
IntelliSpace Perinatal System performance.

2 Document Export (DOX) Throughput

3
3NICU Interface
IntelliSpace Perinatal can interface to the Philips ICCA system if ICCA has the appropriate feature
pack installed. The ICCA users select the patient whose details they require, via the patient identifier in
the ICCA menu. The ICCA users can also select the individual fields they want.
ICCA contacts the IntelliSpace Perinatal external server via dotNet remoting. A special query on the
external database is executed to extract the required data.
ICCA pulls data from IntelliSpace Perinatal, there is no active push and no user interface at
IntelliSpace Perinatal.
A table giving the timestamp of the most recent patient data update (PatientLastDataUpdate) in the
database makes it possible for ICCA to determine which data to pull over.
The IntelliSpace Perinatal user is not involved in this, it occurs completely in the background.
Fields for NICU-I/F cannot be accessed via the IntelliSpace Perinatal Insert New Field taskpane and
cannot be placed into IntelliSpace Perinatal templates.
SQL queries for NICU-I/F cannot be customized.
Prerequisites are:
• At IntelliSpace Perinatal:
– Rev F.xx or higher
– External database
– Physical connection to ICCA
• At ICCA:
– ICCA Software Revision supporting IntelliSpace Perinatal NICU-I/F installed.
– Installed Sybase DB client. This is not included with ICCA and requires a license.
– In the ICCA system editor the connection to the external database server must be configured.
– The mapping of IntelliSpace Perinatal field names must be configured to ICCA representation.
– IntelliSpace Perinatal can interface to the Philips ICCA system if ICCA has the appropriate
functionality.
What is new in IntelliSpace Perinatal to support this connection?
• PatientLastTS table (read timestamp of last patient update).
• Special query to extract the data, stored as a procedure.
• Some special ICCA fields with special formatting (for example, Apgar).

3 NICU Interface

4
4Fetal Monitor LAN

Connection
Philips Avalon FM20/30/40/50 fetal monitors can be connected to IntelliSpace Perinatal via the classic
RS232 connection or by a direct LAN connection via RJ45 connector.
The fetal monitors are described in the fetal monitor Instructions for Use and their service and
configuration guides.
IntelliSpace Perinatal setup is described in the IntelliSpace Perinatal Installation and Service Guide.
IntelliSpace Perinatal configuration, both classic and LAN, is described in the Instructions for Use.
This chapter discusses FM LAN connection to IntelliSpace Perinatal.
4.1 Features
The following describes the features that are available with the fetal monitor LAN protocol.
4.1.1 Triplets
Triplets can be monitored when the FM20/30/40/50 monitors are interfaced to IntelliSpace Perinatal
using the LAN or RS-232 connection.
4.1.2 Trace Buffering and Fast upload

Avalon FMs can buffer traces and notes for a minimum of one hour in order to cover a temporary LAN
interruption or system unavailability. The feature is not intended to cover power outage.
Fast upload to IntelliSpace Perinatal when a fetal monitor is reconnected occurs automatically if the
buffered traces for an admitted patient are more recent than those contained in IntelliSpace Perinatal.
It occurs at a speed factor ten times faster than normal transmission. No user interaction is necessary.
Current online CTG data is held back until the fast upload has finished.
The buffer is a continuous ring buffer and upload cannot be initiated manually. The patient must have
an open episode, therefore fast upload does not work if a patient is not admitted to IntelliSpace
Perinatal.
The uploaded traces can be viewed after the upload is complete; the display shows a continuous trace
(with no gap during the buffered period).
There is no retrospective IntelliSpace Perinatal alarming for the uploaded section of trace.
There is no upload for temporary patients (e.g. Quick Admit). The upload can take place for patients
in the “FM Discharge” location.

4 Fetal Monitor LAN Connection Network Specification / Infrastructure
4.1.3 Dynamic hosting of Avalon Fetal Monitors

The Avalon FM20/30/40/50 sends Connection Indication messages that IntelliSpace Perinatal
processes to automatically establish an Ethernet connection to the fetal monitor. In case the current
hosting computer of the fetal monitor becomes unavailable, the fetal monitor sends out the
Connection Indication messages again in order to be hosted by an available data acquisition host
computer. The data that is currently being acquired is buffered until a new connection to a host
computer can be established.
The Connection Indication messages are of a broadcast type and hence do not cross routed
connections. As a result, dynamic hosting is only possible if at least one IntelliSpace Perinatal data
acquisition computer resides in the same network as the fetal monitor.
At least two data acquisition computers are required in order to fully benefit from the feature of
“failsafe operation” in case one data acquisition computer becomes unavailable.
Philips recommends this setup if more than one hosting computer is available in the system.
4.1.4 Static hosting of Avalon Fetal Monitors

It is possible to assign a dedicated host computer to an Avalon Fetal Monitor. This requires that the
hosting computer has an IP address, which does not change (e.g. fixed). In addition, this IP address
needs then to be entered into the field IP OB Server in the fetal monitor and stored as default in the
CONFIG mode.
4.2 Network Specification / Infrastructure

• The Avalon fetal monitors with LAN connection can use the hospital network infrastructure. LAN
connection to an IntelliSpace Perinatal switch is possible. It is not necessary to have a dedicated
switch. Direct cross-over cable connection to the hosting client is supported.
• LAN fetal monitors require a unique equipment label.
• The fetal monitor connects to a LAN at 10 Mbit/s line speed and operates in half duplex mode. The
hosting client requires a minimum of 100 Mbit/s, full duplex.
• The FMs are responsive to the ping-utility.
• There is no impact on IntelliSpace Perinatal bandwidth calculation. The typical transmission rate is
4 Kbps, and 40 Kbps during buffer uploads.
• The utilized protocol is UDP/IP.
With the UDP protocol packet loss is possible. This is recognized by IntelliSpace Perinatal and
documented in the logfile.
• Avalon uses UDP port numbers 24005, 24010. IntelliSpace Perinatal uses dynamic ports. DHCP
servers for BOOTP addresses are using UDP ports 67 and 68.

Network Specification / Infrastructure 4 Fetal Monitor LAN Connection
4.2.1 Setting Network Parameters in Avalon Fetal Monitors

In order to automatically distribute network parameters such as
• IP address
• subnet mask
• default gateway (if required)
to Avalon fetal monitors, a DHCP/BOOTP server is required.
In an isolated network, it is possible to configure the following IntelliSpace Perinatal computers with a
DHCP / BOOTP address scope:
• Internal Server
• External Server
• IntelliSpace Perinatal Data Acquisition Server
It is not recommended to use an IntelliSpace Perinatal Remote Desktop Session Host (RDSH) Server
for this task.
In case the IntelliSpace Perinatal system is integrated into a domain, a domain DHCP server needs to
provide the network parameters.
BOOTP address requests are typically not routable. If Avalon fetal monitors are being used in different
networks, either a DHCP server is required, or dedicated BOOTP servers are required for each
segment.
It is strongly recommended to distribute the network parameters to Avalon fetal monitors
automatically using a DHCP/BOOTP Server. Only if this is not possible, the network parameters
could be configured manually in the fetal monitor(s).
CAUTION In case of a manual IP address configuration it is mandatory that the configuration is performed by
experienced, authorized and qualified service personnel. Great care must be taken during installation to
avoid problems such as duplicate IP addresses, non-matching subnet mask, etc.
Documentation of all related configuration details is mandatory and needs to be updated with each
change, to ensure network reliability especially when exchanging, repairing or adding devices on the
network at a later time.
The customer is responsible for complying with common network configuration rules.
NOTE In DHCP restricted mode, any true BOOTP responses are ignored by the Fetal Monitor. Please refer
to the Avalon Fetal Monitor documentation for further information on IP Config settings.

4.2.2 Implementation Examples
4.2.2.1 Automatic distribution of Network Parameters.

Fetal Monitors and the IntelliSpace Perinatal system are in one network
All IntelliSpace Perinatal computers and Fetal Monitors are in one network. The system is not domain
integrated and the Internal Server machine acts as DHCP and BOOTP server.

Network Specification / Infrastructure 4 Fetal Monitor LAN Connection
4.2.2.2 Automatic distribution of Network Parameters.

Fetal monitors and the IntelliSpace Perinatal system are in different network
segments
In this example, the IntelliSpace Perinatal servers are located in a server farm and the IntelliSpace
Perinatal data acquisition computers and the fetal monitors are in other network segments. The
IntelliSpace Perinatal computers may or may not be integrated into the domain.

4.2.2.3 Manual assignment of Network Parameters.

Fetal monitor and the IntelliSpace Perinatal host computer are in different network
segments
In this third example, there is no DHCP/BOOTP server available. As a result, the FM’s IP address,
subnet mask and default gateway (190.10.1.1) have to be entered manually.
In addition, there is no IntelliSpace Perinatal hosting computer in the 190.10. subnet. This requires
entering the IP address of a hosting computer in the IP OB Server field of the fetal monitor, which in
this example is 190.20.1.24.
Such a setup is not recommended because it does not allow to maintain the FM network addresses at a
central place and the fix hosting prevents the FM from automatically “failing over” to another host
computer.

DHCP/BOOTP Address Reservation 4 Fetal Monitor LAN Connection
4.3 DHCP/BOOTP Address Reservation

In addition to using a DHCP server for serving out IP addresses to Philips Avalon LAN based fetal
monitors, it is recommended to create and maintain an address reservation. The address reservation
further minimizes the likelihood of having duplicate fetal monitor IP addresses in a network. This is
accomplished by coupling an IP address of the DHCP scope with the MAC address of a fetal monitor.
The following shows an example for the required steps which are to be performed on the DHCP/
BOOTP server for an address reservation on a BOOTP server.
1. Create a dedicated DHCP scope. For that, navigate to the advanced settings of the scope and
enable DHCP, BOOTP or Both as required.

4 Fetal Monitor LAN Connection DHCP/BOOTP Address Reservation
2. In the scope right click on Reservations and select New reservation…
3. It is recommended to add the equipment label and the MAC address of the fetal monitor to the
reservation name as shown below.
4. This supports the legibility of the list that can be exported and used as a record during service
events. Right click Reservations and select Export list…
With this format you see all relevant data at a glance.

Bed Assignment 4 Fetal Monitor LAN Connection
NOTE If the mainboard of a fetal monitor needs to be replaced, the new part comes with a different MAC
address. In this case the reservation has to be updated and a new list should be exported.
4.4 Bed Assignment

In the Classic mode, beds are assigned to COM ports. LAN fetal monitors are, however, connected
directly to a bed.
Mobile LAN fetal monitors in a centralized setup need to be configured as mobile or upload in
IntelliSpace Perinatal. In mobile mode the bed assignment is deleted when the fetal monitor is
disconnected from LAN or switched off. After re-connecting the fetal monitor at the new bedside, a
new bed location has to be assigned first.
Mobile mode is intended for bedside monitors that are moved from one room to another wherever
they are needed. Data that is acquired offline by monitors in this mode is only uploaded when online
data acquisition resumes for that monitor.
The upload mode is intended for transport monitors that are used to monitor multiple patients in a
consecutive fashion without having a network connection and regardless of the bed assignment.
The patient data is uploaded whenever such a monitor is connected to the network. Online data
acquisition for a dedicated bed is not possible in this mode.
If the bed assignment is set to permanent in IntelliSpace Perinatal, the bed assignment will not be
deleted automatically. For further information refer to the IntelliSpace Perinatal Instructions for Use.

4 Fetal Monitor LAN Connection Information Display
4.5 Information Display

If the monitor starts a session without an admitted IntelliSpace Perinatal patient, a new “No
Archiving” patient is created automatically.
4.5.1 At the Fetal Monitor

The fetal monitor displays the following connection information:
• FM serial number
• FM IP address
• FM MAC address
• FM equipment label
• IP address of hosting computer
It also shows the connection status, i.e. whether there is a LAN connection present, and also whether
this LAN is currently connected to IntelliSpace Perinatal.
4.5.2 Transmitted by IntelliSpace Perinatal and Displayed on the FM

(ADT)
After successful connection to the monitor, IntelliSpace Perinatal locks all demographic fields in the
monitor. IntelliSpace Perinatal keeps the fields updated and synchronized; there is no conflict
resolution handling. Previously entered demographic data at the monitor is overwritten or blanked by
the system.
• Patient Name (First Name, Last Name and Middle Initial, or Alias Name)
• Bed Label
• Patient Visit Number
• Current Gestational Age (week/days)
• Patient Date of Birth
• Life Time Identifier (Medical Record Number, Patient ID or Social Security Number)
(can be selected in the IntelliSpace Perinatal system configuration)
4.5.3 Transmitted by the FM to IntelliSpace Perinatal

FM equipment label, FM Mac address, FM IP address, FM status, and hosting client.
The IP address the fetal monitor had when it was last active is shown in a second line in the field "Last
Activity". The hosting client address is not displayed.

Restrictions 4 Fetal Monitor LAN Connection
4.6 Restrictions
• The LAN connection is available for OB TraceVue Rev E and higher, and FM20/30/40/50 with
software revision D and higher.
• A fixed fetal monitor IP address is possible with Avalon Fetal Monitor Software Revision F or higher.
• The FM Spy tool is not available for the LAN connection.
• The LAN interface supports transfer of Roman8 character sets. Text messages from IntelliSpace
Perinatal, such as alarm notes, are shown as black square boxes in Japanese, Traditional and
Simplified Chinese.
4.6.1 Fetal Monitor Data Loss

Routed network connections can impact the transmission speed. The transfer quality on a real life
network may also vary. Depending on the network topology, data packets could also get out of
sequence. Neither the UDP protocol nor IntelliSpace Perinatal can reconstruct the original sequence,
and missing data is not resent.
Consequently, fetal monitor data packets are missing and IntelliSpace Perinatal detects this as data loss.
Depending on signal loss alarm settings, signal loss is detected and notified. Visible gaps in the trace
might occur.
Missing fetal monitor data packages are tolerated if less than 10 seconds are lost.
If more that 10 seconds are lost, the connection to the fetal monitor is closed to prevent further loss.
The fetal monitor can then reconnect to the system, and, depending on the system setup, even to an
alternative host via a different path, and buffered data can be fast uploaded.
The following parameters are affected: FHR1/2/3, MHR, Toco, FSpO2
In case of data loss, corresponding entries are recorded in the log file and displayed in the System
Console.
4.6.1.1 Fetal Monitor Notes

The following single (one-time transmission) note messages from fetal monitors may be lost on
unreliable network conditions:
• Fetal monitor detects an internal problem, e.g. battery empty
• Fetal monitor identification (product/serial number, FM software revision)
• Maternal Blood Pressure & heart rate (NBP)
• Maternal Temperature
• Maternal Oxygen Saturation and heart rate
• Recorder Status: Recorder On/Off, paper-out detection
• User Notes (Text notes entered via fetal monitor user interface, e.g. “Patient Repositioned”)
• Event Message: FM marker pressed

4 Fetal Monitor LAN Connection Restrictions
4.6.1.2 Status Notes

The following status notes, which are included (repeated) in each package, may be lost during
unreliable network conditions. Status notes may be delayed as long as packages are lost. They will be
available along with Fetal Traces:
• Fetal Movement Profile (FMP) Status enabled/disabled
• DECG logic artifact elimination on/off
• HR Cross Channel Verification detected yes/no (HR Coincidence)
• Telemetry on/off
• Transducer modes (Ultrasound, DECG, MECG, …)

5
5HL7 Interface
The optional IntelliSpace Perinatal HL7 interface is a bi-directional data integration link based on
Health Level 7 (HL7) Version 2.5. It allows IntelliSpace Perinatal and an external system (such as a
hospital information system, or a third party system) to share patient data.
CAUTION Continuous data export to other systems is for documentation purposes only. It is neither intended nor
qualified for monitoring or alarming.
The HL7 interface supports:
• Consumer:
– ADT - Handling of incoming Admission/Discharge/Transfer (ADT) messages:
• Patient Administration Management [IHE_PAM]
• Patient Demographics Consumer [IHE_PAM_PDC]
• Patient Encounter Consumer [IHE_PAM_PEC]
• Support of patient merge/link/unlink [IHE_PAM_PDC]
• Support of Allergy data update (A60)
– ORU - R01
• Support of incoming charting data
• Support of incoming laboratory data
• Reporter:
– ORU - R01
• Device Observation Reporter [IHE_DEC_DOR]
• Export of data of the patient’s record flow sheet
– QRY - R02/R04
• Support of Queries for outgoing observations
– MDM - T01
• Sending of Medical Document Management (MDM) messages
• Support:
– System Console: Overview of the HL7 Messages

5 HL7 Interface Infrastructure
5.1 Infrastructure
The IntelliSpace Perinatal HL7 interface software is installed on a client without data acquisition (HL7
gateway computer) or on the external server. The latter is not recommended. However, the HL7
interface can be installed on Small Architecture systems.
5.2 Installation Overview

Installation is comprised of:
1 IntelliSpace Perinatal HL7 interface installation, as documented in the IntelliSpace Perinatal
Installation and Service Guide.
2 IntelliSpace Perinatal HL7 configuration.
5.3 Restrictions
5.3.1 HL7 Revisions
IntelliSpace Perinatal uses HL7 Rev 2.5. It will not reject incoming messages with HL7 Rev. 2.3.1
formatting, but all outgoing messages from IntelliSpace Perinatal to HIS are in HL7 Rev. 2.5 format.
The corresponding HIS system, when running HL7 Rev. 2.3.1, must be able to handle messages
received from IntelliSpace Perinatal with the following characteristics:
• All outgoing messages will have fixed version ID in MSH-12 “2.5”. This also applies to acknowledge
messages for incoming messages. A HIS system with HL7 Rev. 2.3.1 might expect the HL7 revision
to be 2.3.1.
• IntelliSpace Perinatal uses MSH-15/16 fields to identify acknowledge requirements. These fields are
typically used with HL7 Rev. 2.5 to process “acknowledge enhanced” mode. If enhanced mode is
not supported, the original mode can be used.
• The patient account number is provided with A01 outgoing message in PID-18. It has a dynamic
length of up to 24 characters, although HL7 specifies 20 characters for Rev. 2.3.1, and 250
characters for Rev. 2.5. A HIS system with HL7 Rev. 2.3.1 might expect only 20 characters.
• The alternate visit ID is provided with A01 outgoing message in PV1-50 with a fixed length of 43
characters and with the following content:
subcase-ID (internal episode ID) + “OBTV” (fix string) + “EID” (fix string) although HL7 specifies
20 characters for Rev. 2.3.1 and 250 characters for Rev. 2.5. A HIS system with HL7 Rev. 2.3.1
might expect only 20 characters.
• HL7 revisions less than 2.3.1 are not supported
• Outgoing ORU communication is not supported when using HL7 Rev. 2.3.1
• The Device Observation Reporter Profile uses HL7 version 2.6

Restrictions 5 HL7 Interface
5.3.2 Administrative Episodes

If an inbound ADT message or an ORU message that is configured for Forms requires a change to a
patient's data, IntelliSpace Perinatal updates the patient data even if the patient has no open episode.
The changes are immediately available within the IntelliSpace Perinatal Forms user interface. If the
patient has no open episode, IntelliSpace Perinatal creates an "administrative episode" for that patient.
24 hours must elapse after the update before this can occur. A new episode is opened and immediately
closed. This administrative episode contains all changes of its patient's data within the last 24 hours.
This avoids multiple administrative episodes per patient within 24 hours.
Only with this administrative episode is the changed patient data available on the External Database
for Report Printing, Statistics/Logs and on the Archive to be retrieved.
5.3.3 Time Zone Support

Date and Time values are sent with or without time zone information, depending on the route
configuration.
Restriction:
The time zone information of the sending system at message creation time is sent. Thus it could be
different from the time the data is entered, especially during a time change (DST).

5 HL7 Interface Communication
5.4 Communication
5.4.1 Inbound Messages
The HIS or Laboratory system sends inbound ADT or ORU messages to IntelliSpace Perinatal.
Depending on both the acknowledge mode configured and on the acknowledge parameter in the
MSH-15/MSH-16, IntelliSpace Perinatal will send an acknowledgement back.
IntelliSpace Perinatal filters on “Application Name” and “Facility Name”, and then creates new
admissions, places them into the ADT buffer (depending on the ADT operation mode), updates
existing patients or performs updates in the ADT buffer.
Each incoming ADT or ORU message that changes a closed patient causes the delayed creation of an
“administrative episode”. See “Restrictions” on page 38 for details.
ADT or ORU messages for patients with open episodes do not create administrative episodes.
The following message types are supported as incoming messages from HIS to IntelliSpace Perinatal.
HL7 Event IntelliSpace Perinatal Message Handling1 ADT Operating Mode

• If patient does not exist: • Automatic
– New patient is created depending on the • Manual+
A01 - Admit configuration
• Manual
• If patient exists:
– Update patient
• Location is found and empty: • Automatic
– Transfer the patient into the assigned location. • Manual+
• Location is found and non-empty:
A02 - Transfer
– Free-bed option
• Location is unknown or not in message:
– Transfer location is used
• If patient has an open episode: • Automatic
– Transfer patient to the HOME location. • Manual+
A03 - Discharge
– The episode is still open for a configurable
period of time (auto-close).
• Automatic
A04 - Register Patient Same procedure as for A01. • Manual+
• Manual
• If patient does not exist: • Automatic
– Add patient to HIS buffer • Manual+
A05 - Pre-Admit
• If patient exists: • Manual
– Update patient in HIS buffer
• Automatic
A06 - Change to ‘in‘ patient Same procedure as for A02.
• Manual+

Communication 5 HL7 Interface

• Automatic
A07 - Change to ‘out‘ patient Same procedure as for A02.
• Manual+
• If patient exists: • Automatic
A08 - Update – Update patient • Manual+
• Manual
• Automatic
A09 - Patient departing Same procedure as for A02.
• Manual+
• Automatic
A10 - Patient arriving Same procedure as for A02.
• Manual+
• Automatic
A11 - Cancel Admit Same procedure as for A03.
• Manual+
• Automatic
A12 - Cancel Transfer Same procedure as for A02.
• Manual+
• Automatic
A13 - Cancel Discharge Same procedure as for A01. • Manual+
• Manual
• Automatic
A14 - Pending Admit Same procedure as for A05. • Manual+
• Manual
• Automatic
A17 - Swap patients Same procedure as for A02.
• Manual+
• If Patient 1 (target) exists (1. PID segment) AND • Automatic
Patient 2 (source) exists (2. PID or MRG • Manual+
segment):
– Merge/Link source patient to target patient.
A18 - Merge patient information
target patient is further available. Source will
be hidden.
– Source patient is unmerged/unlinked from
other target patient
• Automatic
A24 - Link patient information Same procedure as for A18.
• Manual+
• Automatic
A28 - Add patient information Same procedure as for A05. • Manual+
• Manual
• Automatic
A31 - Update person information Same procedure as for A08. • Manual+
• Manual


Same procedure as for A18. • Automatic
A37 - Unlink patient information
• Manual+
• If patient exists in HIS buffer: • Automatic
A38 - Cancel Pre-Admit
– Delete patient from HIS buffer
A40 - Merge patient - • Automatic
Same procedure as for A18.
Patient Identifier List • Manual+
Changes Patient IDs in Patient or HIS buffer. (All • Automatic
IntelliSpace Perinatal-ID-Fields coming in PID-3
• Manual+
are changed. Patient is identified by HIS-ID in
A47 - Change Patient Identifier List MRG segment otherwise message is rejected (AR)2). • Manual
(PID-3)
Reject Message (AR2) if correct target identifier is
already used within the system (uniqueness con-
flict.)
• Automatic
Changes patient account number in Patient or HIS
A49 - Change Account Number • Manual+
buffer.
• Manual
Changes visit number in Patient record or HIS Buf- • Automatic
fer. (IntelliSpace Perinatal visit numbers coming in
• Manual+
A50 - Change Visit Number PV1-19 are changed. The patients visit number is
identified by the visit number in the MRG seg- • Manual
ment.)
• Automatic
If the patient exists (as regular Patient or in HIS
A60 - Update Adverse Reaction Infor-
Buffer) then the patient's allergy data is inserted/up- • Manual+
mation
dated/deleted.
• Manual
1. HL7 update messages that update existing patient data are applied only if the local system has responsibility for that patient
data.
2. In previous software revisions, the reject message was “AE”.
HL7 Event IntelliSpace Perinatal Message Handling
ORU^R01 IntelliSpace Perinatal uses ORU messages from HIS to populate the
flowchart and forms

5.4.2 Outbound Messages

HL7-based outbound communication requires the partnering third-party system to be ready to accept
IntelliSpace Perinatal ORU messages and map them appropriately into the third-party database. This
requires the involvement of professional services from Philips and from the third party, which needs to
be charged and managed.
IntelliSpace Perinatal sends outbound ADT messages to HIS based on trigger settings configured in
IntelliSpace Perinatal.
IntelliSpace Perinatal sends ORU messages to HIS for pre-defined notes types for all patients.
The following outgoing messages are supported:
HL7 Event IntelliSpace Perinatal Message Handling
If patient exists (as regular Patient or in HIS buffer), then update -
ADT A01 - Admit
else store in HIS buffer.
ADT A02 - Transfer (reduced set of demographic data)
ADT A03 - Discharge /
(reduced data set)
End Visit
ORU R01 See “ADT Message Supplier” on page 63
MDM T01 See “HL7 MDM Export” on page 16
QRY/ORF R02, R04 See “Query for Results of Observations (R02, R04)” on page 64
If an episode gets closed, but the HL7 interface is not working, a message is buffered in IntelliSpace
Perinatal for 72 hours, after which it is discarded.
The number of attempts to resend on failure is configurable per route.
5.4.3 Acknowledgement Modes

A sending HIS receives an Accept-acknowledge, and an Application-acknowledge from IntelliSpace
Perinatal, if configured.
If “number of retries” and “time out” are configured to “0” (zero) in the IntelliSpace Perinatal
configuration, IntelliSpace Perinatal does not expect an acknowledge from the HIS. It will ignore any
HIS acknowledge, and will not make any reply. If “number of retries” and “Time out” is configured to
more than “0”, IntelliSpace Perinatal will request an Accept-acknowledge, and an Application-
acknowledge from HIS, if configured, and will perform the configured number of retries if the
acknowledge is not received.
The Accept-acknowledge is a syntax check, the Application-acknowledge is a content check.
The route configuration allows two different acknowledge modes with the following processing (see
HL7 standard, chapter 2, for reference):
1 Original Mode
a. processing of incoming messages (HIS -> IntelliSpace Perinatal)
IntelliSpace Perinatal does not create Accept-acknowledge, but returns Application-
acknowledge to the sending HIS.
b. processing of outgoing messages (IntelliSpace Perinatal -> HIS)
HIS does not generate Accept-acknowledge but sends the Application-acknowledge to
IntelliSpace Perinatal and IntelliSpace Perinatal will react to this acknowledgement according
to the configuration of “number of retries” and “time out”.

2 Enhanced Mode - this defines acknowledge mode (per message) in the message header MSH-15
(Accept) and MSH-16 (Application) with the following parameters:
– AL = always
– NE = never
– ER = errors only
– SU = success-acknowledge only
– empty = same as NE (never)
a. processing of incoming messages (HIS -> IntelliSpace Perinatal)
Depending on the parameter setting in MSH-15 and MSH-16, IntelliSpace Perinatal creates
Accept- or Application-acknowledge, or both, or none, to the sending HIS.
b. processing of outgoing messages (IntelliSpace Perinatal -> HIS).
HIS sends acknowledge to IntelliSpace Perinatal, depending on IntelliSpace Perinatal
configuration of “number of retries” and “time out”. This is reflected in MSH15/16 of
outgoing messages.
• if timeout is configured in IntelliSpace Perinatal, IntelliSpace Perinatal fills MSH-15 and 16
with ”AL”, waits for Accept- and Application-acknowledge from HIS for the length of this
timeout, and then retries.
• If timeout is set to “0” in IntelliSpace Perinatal, IntelliSpace Perinatal fills MSH-15 and 16
with “NE”/”NE” and does not wait for application-acknowledge from HIS. It does not retry.
3 “None” - No acknowledge is sent in either direction. The timeout configuration in IntelliSpace
Perinatal HL7 configuration must be set to 0 (zero). This acknowledge mode is not recommended.
You should always use either “Original Mode”, or “Enhanced Mode”.
5.4.4 HL7 Message Content

An HL7 message field can:
– supply a value (that is, a non empty character string)
– contain a null value (transmitted as two double quote marks (““)
– be omitted (not sent, for an optional data field).
See “Example Messages” on page 121 for example messages.
Content that is explicitly delivered (not omitted) by another system is changed automatically to read-
only (HIS ownership, exceptions mentioned in the corresponding chapters). No further changes are
possible to these attributes through the user interface.
Content in HL7 message Content in IntelliSpace Appearance in IntelliSpace

Perinatal Perinatal
Value supplied Value is changed Display-only
Null value supplied, empty string Value is set to null Display-only
Unchanged (writeable or dis-
Value omitted Value left unchanged
play-only)

5.4.5 Filters
Filters can be defined in the IntelliSpace Perinatal configuration as “Application Name”, and “Facility
Name”.
5.4.6 Patient Identification

Patients are identified by one of the following, depending on configuration in IntelliSpace Perinatal:
– Patient ID
When Patient ID is selected as Patient Identification, it can be replaced by any identifier type
from 'HL7 Table 0203 - Identifier type' under section '2.A.14.5 Identifier Type Code (ID)' from
Chapter 2A in HL7 Standard 2.5.
– MRN
– SSN (not for newborn patients)
PID-3 contains this patient identifier. The HL7 specification defines PID-3 as holding the identifier
list which can be MRN, and SSN, and configured PID. If multiple identifiers are provided, the
corresponding type code must be supplied and the field elements must be separated as specified by the
HL7 specification. See the example message in “Example Messages” on page 121. PID-3 will then
populate the IntelliSpace Perinatal fields for MRN, SSN, and configured PID. If only one identifier is
provided, then the type code can be omitted, since it must be the identifier configured in IntelliSpace
Perinatal. Outgoing messages contain the complete identifier list.
IntelliSpace Perinatal populates three items of the patient identifier list: Patient ID, MRN, SSN (not
for newborn). Only one of these items can be configured as the HIS ID (for example MRN, not the
concatenated string MRN^SSN^PID), but the other items (SSN and PID) will also populate the
demographics. All three items are checked to be unique. PID-2 and PID-4 are not processed, data in
these fields will be ignored.

5.4.7 Processing of Coded Elements (CE) Fields

Coded Elements (HL7 Data Type CE) will be processed according to the following rules:
1 If name, code and coding system is sent, all values are copied to the patient record.
2 If the name component is not sent, a name completion is done.
a. Search in the appropriate folder in Value Table Editor
b. If the code is not found, use code as name
3 If the coding system is not sent, only the code is used
Outgoing messages contain both code value and the decoded label.

ADT Message Consumer 5 HL7 Interface
5.4.7.1 Field Length Limitation/Truncation

If a coded element sent within an HL7 message exceeds the length limitation, then the data is
truncated.
HL7 Field Part Length Limit
The whole list 200 for the whole list
CE.1 - Code 16
CE.2 - Label 100
CE.3 - Coding System 30
Repeatable Coded Elements are not supported and processed different. Only the text attributes are
saved and displayed as a new line-separated list. If the element is sent, the code and coding system is
completed by the Value Table.
Example: The field PID-10 is repeatable.
PID|1||a1_MRN||a1â1|||||I^Native American~BÂfrican American|
The text attribute is saved and displayed as a list and the items are separated with a new line.
"Native American\r\n African American"
5.5 ADT Message Consumer

Received ADT data fields are write-protected in IntelliSpace Perinatal; empty data fields are not. If null
values are received, on update they will delete anything already contained in the IntelliSpace Perinatal
data field.
5.5.1 ADT Operating Modes

• Manual: ADT message does not create a new patient record, but creates the patient only in the ADT
buffer. Manual admission, transfer and discharge is required to create the patient record.
• Manual +: the ADT message updates an existing patient record directly. However, if the patient
record is new, the patient is only created in the ADT buffer.
• Automatic: the ADT message creates or updates the patient record directly, not in the ADT buffer.
5.5.1.1 ADT Buffer

Received messages reside in a temporary buffer. There are different buffers for maternal and newborn.
New patients can be created from the buffer, or merged with existing patients if appropriate as
described in the IntelliSpace Perinatal Instructions for Use.
Messages in the patient buffer that are not yet applied, and which are older than a configurable time,
are automatically deleted from the patient buffer selection list. For each supported admission type a
separate timeout can be configured. This prevents the lists from being overfilled with old messages.
5.5.1.2 Free Occupied Bed

When this option is used, the bed where the patient should go to according to the message will be freed
automatically. If another patient is in this bed already, that patient will be moved to the configured
Transfer location automatically.

5 HL7 Interface ADT Message Consumer
5.5.1.3 Unknown Care Units

The following options are used to handle messages without adequate care unit information:
• Admit all patients:
– Checked: patients are admitted to the system care unit (---) if the care unit is unknown
– Unchecked: patients are not admitted if the care unit is unknown (message ignored)
• Keep all patients:
– Checked: patients are transferred to the system care unit (---) if the care unit is unknown
– Unchecked: patients are discharged (meaning: transferred to the discharge location of the unit)
if the care unit is unknown
5.5.2 Limitation

A system message is displayed if the limit is exceeded.
Max. number of patient records Incoming HL7 messages are processed none the less.
100.000
in HIS buffer Furthermore a warning message containing some details
is written to the HL7 log file.
5.5.3 Update of Patient Demographic Data

Typically, ADT A08 messages are used to update demographic data but IntelliSpace Perinatal also
accepts other messages for updates (see “Inbound Messages” on page 40).
• The patient to be updated is identified via PID-3. Demographics data of disabled (red cross) patient
records are also updated.
• If the patient was originally admitted via ADT, then HIS responsibility (H) applies to this patient.
In this case, only the patient identifier (PID-3) is used for identification and all other demographics
can be updated.
• If the patient was manually admitted into IntelliSpace Perinatal, then HIS responsibility (H) does
not apply. Here, a “strong identification check” is processed, which requires, in addition to the
patient identifier (PID-3), that the last name, first name, middle name, and date of birth must
match. When these match, the update takes place, and HIS responsibility (H) is applied. This check
is not case-sensitive. It is applied only if the data fields are not empty.
Demographics that are subject to strong identification cannot be updated if the HIS responsibility
(H) does not apply.
• If the strong identification test fails for an A08-update, the IntelliSpace Perinatal rejects the message.
• If the strong identification test fails for an A01-update, IntelliSpace Perinatal accepts the message
but will not update the demographics. The further process depends on the ADT operation mode:
– Manual ADT operation mode: IntelliSpace Perinatal places the new message into the HIS buffer
for a manual merge with an existing patient. This HIS buffer message is identified by .
– Automatic ADT operation mode: IntelliSpace Perinatal creates a new patient.

5.5.4 Processing of Allergy Data

Please note that although the HL7 interface supports allergies sent in ADT messages for both maternal
and newborn patients, IntelliSpace Perinatal does not offer a forms page for newborns' Allergies.
Therefore, allergy data sent in ADT messages cannot be viewed and/or edited in IntelliSpace Perinatal.
Allergies of newborn patients are available in the external database.
5.5.4.1 Enabled/Disabled Patient Records

Allergy data are only applied to enabled patient records. This excludes disabled (red cross) and patient
records that have been used as merge source patient.
5.5.4.2 Messages for Patient Records that Don’t Exist in IntelliSpace Perinatal
In Manual ADT operation mode only: Allergy information for patient records that don’t exist in
IntelliSpace Perinatal is kept with other data of the received HL7 message in the HIS buffer. The
Allergy data is applied when the user creates a new patient data set for the arriving HL7 message or
merges it to an existing data set.
5.5.4.3 Allergy Identification

The content of the AL1-3 (Allergen Code/Mnemonic/Description) is used to identify Allergies. The
AL1-3 field is required. At least the AL1-3 CE1 (Code) or AL1-3 CE2 (Label) part must be filled. If
both field parts are empty the Allergy is considered invalid and the ADT message is rejected (AR).
5.5.4.4 Category Assignment

Allergies are assigned to IntelliSpace Perinatal Categories. The field AL1-2 CE2 (Label) is used to
identify the Category name. If the Label in AL1-2 CE2 (Label) is empty then AL1-2 CE1 (Code) is
used instead. If both AL1-2 CE1 (Code) and AL1-2 CE2 (Label) are empty or the AL1-2 field is empty
completely then the Allergy is assigned to the default category (“---”). Categories are created on
demand (same handling for IAM-2 fields).
5.5.4.5 Allergy Reaction Code Mapping

The field AL1-5 is repeatable. IntelliSpace Perinatal performs no mapping of the Allergy Reaction
Code. The values in AL1-5 are kept as they are. Multiple Reactions are sent in AL1-5 as tilde (~)
separated list. Tilde is the default HL7 delimiter character for repeating fields.
AL1|1|Type1|Code1ÂllergenCode1^99OB|MO|Reaction1~Reaction2~Rection3
In IntelliSpace Perinatal, the multiple reactions are displayed as a comma-separated list:
“Reaction1,Reaction2,Reaction3”
5.5.4.6 Entry Date

The Entry Date is created from AL1-6 (resp. IAM-13). If AL1-6 is not available, MSH-7 (Date/Time
of Message) is used. If neither AL1-6 nor MSH-7 are available the current time of the IntelliSpace
Perinatal computer is used. It is stored as is and interpreted as local time according to the current
IntelliSpace Perinatal time zone settings.
5.5.4.7 Ownership
IntelliSpace Perinatal distinguishes between two modes of ownership:

1 HIS-owned allergies are received within an HL7 message.

HIS-owned allergies are displayed as read only. They cannot be changed. Only the Comment field
and Attention flag can be changed.
2 Manually entered allergies are not HIS-owned
Manually entered allergies can only be deleted by the user.
The Attention flag of an individual allergy is set upon any insert or change of HIS-owned allergies
in the patient record by received HL7 messages.
5.5.4.8 Uniqueness
For Allergies that are not HIS owned there is no uniqueness check because it is possible to enter an
allergy twice manually.
For HIS-owned Allergies a uniqueness check is in place. If an ADT message contains more than one
allergy having the same set of identifiers (see Identification of Allergies) IntelliSpace Perinatal keeps
only the last one.
5.5.4.9 Allergy Data Received in AL1 Segments

Allergy data received in AL1 segments are inserted/updated/deleted following the ‘Snapshot mode
update’ approach (Quote from HL7 Standard version 2.4, final standard, chapter 2.15.4.1 “Snapshot
mode update definition”):
In the snapshot mode, the group of repeating segments from the incoming message replaces
the prior group of repeating segments on the receiving system. This is equivalent to a
deletion of the prior group followed by the addition of the new group.
This means, if an incoming HL7 message contains one or more AL1 segments, the allergies of the
received HL7 message replace the existing set of allergies of the patient.
For incoming HL7 messages without AL1 segments no allergy processing takes place. According to the
Snapshot mode update approach a single AL1 segment containing “delete data” in an incoming HL7
messages leads to deletion of all allergies of the addressed patient. An AL1 segment is interpreted as a
“delete data” segment if it contains null values in the fields AL1-2, AL1-3, AL1-4 and AL1-5, e.g.
AL1|1|””|””|””|””||
Only HIS-owned allergies are replaced. Manually entered allergies are not altered.
Allergy in Matching Allergy Ownership Action

HL7 Found
Message
No n/a
No Not HIS-owned No change
Yes
HIS-owned Delete the allergy; the Comment gets lost!
Insert a new HIS-owned allergy
No n/a
Set the Attention flag
Yes Not HIS-owned No change
Yes Update the allergy; Keep the Comment
HIS-owned
Set the Attention flag if there are changes

5.5.4.10 Allergy Data Received in IAM Segments

Unlike the snapshot approach of the AL1, the IAM segment provides an action code indicating
whether to add, delete, or update an allergen. Only the CNE.1 part of the IAM-6 element is
supported. IntelliSpace Perinatal supports the HL7 standard suggested values:
IAM-6 Description
“Allergy Action Code”
A Add/Insert
D Delete
U Update
Action Code Matching Allergy Found Action

(IAM-6)
no Insert a new HIS-owned Allergy
Add/Insert
yes Update the Allergy; keep the Comment
no Insert a new HIS-owned Allergy
Update
yes Update the Allergy; keep the Comment
no Nothing to do
Delete
yes Delete the Allergy; the Comment gets lost!
Only the HIS-owned allergies are updated / deleted. Manually entered allergies are not altered.

5.5.4.11 Limitation

Max. number of AL1 resp. IAM
100 Message is rejected (AE)
segments per HL7 message
Number of Allergies per patient 2000 A system message is displayed if the limit is
Number of Allergies per patient exceeded. Incoming HL7 messages are processed
2000 none the less.
in HIS buffer
Furthermore a warning message containing some de-
Total number of Allergies tails (e.g. list of patients exceeding the limit) is writ-
1.000.000
in HIS buffer ten to the HL7 log file.
5.5.5 Encounter Identifiers

A patient can have zero or more encounter identifiers assigned (encounter identifier list). An episode
can have one encounter identifier of each type assigned.
Encounter identifiers are:
• Visit Number
• Account Number
5.5.5.1 Apply Episode Identifiers (A01, A08,...)

For existing patients:
• with open episode
Insert the encounter identifier to the encounter identifier list, if it does not already exist. Encounter
identifier assignment depends on configured ADT option (see “Configuring Routes for Incoming
ADT Messages” on page 56).
• without open episode
Handling depends on the ADT operation mode:
– Automatic Mode: Add encounter identifier to a new created episode
– Manual Mode: Add encounter identifier to list
For HIS Buffer patients:
Insert the encounter identifier to the episode identifier list, if it does not already exist.
A null value ("") is ignored!
For unknown patients:
Handling depends on the ADT operation mode:
– Automatic Mode: Add encounter identifier to a newly created patient
– Manual Mode: Add patient with encounter identifier to HIS Buffer

5.5.5.2 Change Episode Identifiers (A49/A50)

For existing patients:
• with open episode and prior encounter identifier found:
Change the encounter identifier.
• without open episode, or prior encounter identifier not found:
Insert the encounter identifier to the encounter identifier list, if it does not already exist.
For HIS Buffer patients:
• prior encounter identifier found:
Change the encounter identifier.
• prior encounter identifier not found:
Insert the encounter identifier to the encounter identifier list, if it does not already exist.
For unknown patients:
No processing
5.5.5.3 Consumed Encounter Identifiers

If an encounter identifier should be inserted or updated that is already assigned to a closed episode
(consumed), anew encounter identifier is created and the existing will remain unchanged.
5.5.5.4 HIS Ownership

Encounter identifiers that are inserted or updated by an HL7 message are marked as HIS-owned.
Unlike demographics data, the encounter identifiers of a Patient that are received via HL7 can be
changed manually.
5.5.5.5 Enabled/Disabled Patients

Encounter identifiers are only applied to enabled patient records. This excludes disabled (red cross) and
hidden patient records.
5.5.5.6 Entry Date

The entry date of an encounter identifier is inserted with the current time of the IntelliSpace Perinatal
computer when the HL7 message is processed. The entry date is used for pre-selection and ordering.
When an encounter identifier is updated, the entry date of the encounter identifier is updated
accordingly.
5.5.5.7 Limits
In order to prevent the system from overload, the amount of data (per patient and total) is limited.
50 + (number of If the limit is reached, the oldest unas-

Number of encounter identifiers
episodes of that signed encounter identifier of this type is
per type and per patient
patient) removed.

5.5.5.8 Field Length Limitation/Truncation

The length limitation for encounter identifiers in IntelliSpace Perinatal is 30 characters.
If an encounter identifier sent within an HL7 message exceeds the length limitation, then the
encounter identifier is truncated.
5.5.5.9 Processing Examples

Encounter identifier process after patient is admitted or created in buffer:
HL7 Message OBTV DB Behavior
Event Type Number Prior Patient Number Actions Number List ACK
Number (Episode) (Patient or
Buffer)
<omit> w/e ignore unchanged 0815 AA
open unassign empty 0815 AA
<null> closed ignore unchanged 0815 AA
buffer ignore unchanged 0815 AA
Apply
A01 A08 n/a w/e insert and 4711,
open 4711 AA
... assign1 0815
4711,
4711 closed insert unchanged AA
0815
4711,
buffer insert unchanged AA
0815
<omit> w/e ignore unchanged 0815 AA
<omit> ignore unchanged 0815 AA
<null> ignore unchanged 0815 AA
<null> empty
0815 change2 empty AA
(if assigned)
no 0815 ignore unchanged 0815 AA
Change open/ 4711,
<omit> w/e insert unchanged AA
A50 A49 buffer 0815
4711,
<null> insert unchanged AA
0815
4711
changed
0815 change1 4711 AA
(if assigned)
4711,
no 0815 insert unchanged AA
0815
1. Assignment of encounter identifier for current episode as configured in “Configuring Routes for In-
coming ADT Messages” on page 56
2. If the number is already consumed (used in a closed episode), the number is not changed. The new number
is inserted and assigned.

5.5.6 Configuring Locations

The IntelliSpace Perinatal location setup must be synchronized with the way locations are described in
the incoming messages. IntelliSpace Perinatal locations are unambiguously identified by six
components of the HL7 person location (PL) data type:
Four of the components are mapped to one IntelliSpace Perinatal location:
– Building (HL7 field 3.7 in segment PV1)
– Floor (HL7 field 3.8 in segment PV1)
– Room (HL7 field 3.2 in segment PV1)
– Bed (HL7 field 3.3 in segment PV1, corresponds to ‘Name’ in IntelliSpace Perinatal)
In IntelliSpace Perinatal, these parameters can be configured in Configuration - Locations:
Two of the components are mapped to one IntelliSpace Perinatal care unit:
– Facility (HL7 field 3.4 in PV1)
– Point of care (HL7 field 3.1 in PV1, corresponds to ‘Unit name’ in IntelliSpace Perinatal)
The care unit can be configured in Configuration - Care Units: (Unit name ‘UNIT_A’ is assigned to
Unit label ‘Unit1’)
In the above example, the bed with label B1.10 has complete information about location (building,
floor, room and bed/name) and care unit (facility and point of care/unit name). The corresponding
syntax of an HL7 ADT-in Admit message would be:
PV1||I|UNIT_A^10^B10^Hospital_H^^^LOCÎI.^|

5.5.7 Configuring Routes for Incoming ADT Messages

To configure an ADT-in route:
Click Configuration - HL7 Configuration.
Select existing route in the Route Configuration section and click Edit Route,
or
click Create New Route.
Click through the Route Configuration wizard step by step to define:
• General Settings:
– Route name
– Route type: Incoming ADT
For Acknowledgment see “Acknowledgement Modes” on page 43.

– Time stamps with time zone: Send time stamps with time zone information
• Incoming Route (also see “HL7 Message Content” on page 44):
– Sending Application and Sending Facility (EMR). If Enable Filter is marked, only messages from
the systems specified here will be accepted.
• Incoming ADT General Configuration:
– Settings:
• Operation mode: see “ADT Operating Modes” on page 47.
• Free occupied bed: see “Free Occupied Bed” on page 47.
• Unknown care units: see “Unknown Care Units” on page 48.
– Buffer Retention Time: Time in buffer for Admission, Register and Pre-Admission before
automatic deletion

• Incoming ADT Configuration for Maternal and Newborn (separately):

– Process allergies: if checked, AL1 segments are processed and A60 messages are accepted.
– Protect patient identifiers of open episodes: if checked, existing patient identifiers of open
episodes are not overwritten by the contents of PID-3.
– Protect Account Number of open episodes: if checked, existing Account Numbers of open
episodes are not overwritten by the contents of PID-18.
– Protect Visit Number of open episodes: if checked, existing Visit Numbers of open episodes are
not overwritten by the contents of PV1-19.
• Communication Point:
Example settings:
– Port Type: Server
– Local Port: 10010
After route definition, the desired route needs to be activated by clicking the Activate Route button.
The active route is displayed with a green status bar on the left.

5.5.8 Supported HL7 Trigger Events and System Actions

The following table shows the supported HL7 trigger events and the corresponding system actions:
Actions New patient/ Insert Create new episode Trans- Update Update Replace Update Change Change Change Delete Merge Un-
From buffer2 + encounter fer demogr. encounter allergies allergies account identi- visit from patient merge
1
buffer identifiers identifiers (IAM) no.3 fier3 number3 buffer
Pre-conditions
Nothing X X X
Patient in
X X X X X X X X X
buffer
Episode
X X X X X X X X X
closed
Episode
X X X X X X X X X
open
Parameter
Patient
Identifica- X X X X X X X X X X X X X X
tion
Patient
X X X (X) (X)
Name
Patient
X
demogr.
Assigned
X X
location
Prior
location
X
Visit no. X X X
Prior visit
X
no.
Account
number
X X
Prior
account X
number
Allergies X X
Prior identif. X

Actions New patient/ Insert Create new episode Trans- Update Update Replace Update Change Change Change Delete Merge Un-
From buffer2 + encounter fer demogr. encounter allergies allergies account identi- visit from patient merge
1
buffer identifiers identifiers (IAM) no.3 fier3 number3 buffer
Merge
X X
patient4
Post-conditions
Patient in
X X X X X X X X
buffer
Episode
X X X X X X X X X
closed
Episode
open
X X X X X X X X X X X X
1. not for newborn
2. only executed if patient does not already exist
3. if MRG segment is included
4. MRG or second PID segment
Actions New Insert Create Trans- Update Update Replace Update Change Change Change Delete Merge Un-
patient/ buffer2 new fer demogr. encounter allergies allergies account identi- visit from patient merge
From episode + identifiers (IAM) no.3 fier3 number3 buffer
buffer1 encounter
identifiers
Events
A01 ADMIT/VISIT
X X4 X X X5 X6 X
NOTIFICATION
A02 TRANSFER A
X X X X5 X6
PATIENT
A03 DISCHARGE /
X
END A VISIT
A04 REGISTER A
same as A01
PATIENT
A05 PRE-ADMIT A
X X5 X6 X
PATIENT

buffer1 encounter
identifiers
A06 CHANGE TO AN
X X X X5 X6 X X
INPATIENT
A07 CHANGE TO AN
same as A06
OUTPATIENT
A08 UPDATE
X5 X6 X
PATIENT INFORM.
A09 PATIENT
DEPARTING - same as A02
TRACKING
A10 PATIENT
ARRIVING - same as A02
TRACKING
A11 CANCEL
same as A03
ADMIT/VISIT
A12 CANCEL
same as A02
TRANSFER
A13 CANCEL
same as A01
DISCHARGE
A14 PENDING
same as A05
ADMIT
A17 SWAP
X
PATIENTS7
A18 MERGE PATIENT
X8 X
INFORMATION7
A24 LINK PATIENT7
X8 X
INFORMATION
A28 ADD PATIENT
same as A05
INFORMATION
A31 UPDATE
same as A08
PERSON INFORM.
A37 UNLINK
X
PATIENT INFORM.7

buffer1 encounter
identifiers
A38 CANCEL
X
PRE-ADMIT
A40 MERGE
X8 X
PATIENT7
A47 CHANGE
X
PATIENT IDENT.
A49 CHANGE
X
ACCOUNT NUMBER
A50 CHANGE VISIT
X
NUMBER
A60 UPDATE
X
ADVERSE REACT.
1. not for newborn
2. only executed if patient does not already exist
3. if MRG segment is included
4. Buffer is used if configuration option operation Mode "Manual" or "Manual+" is set. In error case if the assigned care unit is unknown or not in the HL7 mes-
sage.
5. Updates Patient Identifiers (which are not Patient Lifetime ID) as configured in “Configuring Routes for Incoming ADT Messages” on page 56
6. Select new (incoming) encounter identifiers for current episode as configured in “Configuring Routes for Incoming ADT Messages” on page 56
7. new in Rev. K.00
8. Change the patient identifier of the source patient if the target patient is not found

ADT Message Supplier 5 HL7 Interface
5.6 ADT Message Supplier

5.6.1 General Conditions
The export cycle time (update interval) for outgoing ADT messages is 10 seconds under normal
conditions. An ADT message is sent within 10 seconds after the ADT event has occurred.
5.6.2 Outgoing Messages for Newborn Patients

Newborn is identified by patient class “I” (inpatient) in PV1-2, and admission type “N” in PV1-4.
The data for Newborn are “multiple birth indicator” in PID-24, and “multiple birth #” in PID-25.
5.7 Observation Reporter

The observation reporter interface allows to keep another application in sync with IntelliSpace
Perinatal without further interaction in that application. Observations are all notes data like:
• Flowchart data (vital signs, assessments, custom charting elements, Labs, ...)
• Fetal Monitor data (vital signs, monitor mode, ...)
5.7.1 ORU Sending

• The following operation modes are supported:
– All Notes: Notes from flowchart, alarms, alarm-acknowledge, vital signs, derived parameters, and
system notes are exported.
– EPIC Incoming Device Data Interface: Only notes from an external device are exported, e.g.
data that are received from the fetal monitor. The device identifier is sent in the OBR-10
Collector Identifier. See “Notes Documentation” on page 66 for information about which notes
are supported in this mode.
– Device Observation Reporter: see IHE Patient Care Device - Technical Framework (IHE PCD
TF-1) for reference.
• Forms data and traces are NOT exported.
• The selection of individual notes types for sending is configurable, selected during IntelliSpace
Perinatal configuration. It is possible to have a different selection for maternal and newborn.
• The export cycle time (update interval) for outgoing ORU messages is 30 seconds under normal
conditions. An observation message is sent within 30 seconds after entry of the associated note.
• ORU outgoing messages are not buffered. If the HL7 I/F computer goes down before retries are
exhausted then the pending HL7-msg will be re-constructed when the I/F computer is operational
again to ensure that no messages get lost.
• If the receiving HIS system is down and the IntelliSpace Perinatal HL7 I/F is up and running, since
an acknowledgement is expected but not received from HIS, IntelliSpace Perinatal will perform
retries as configured. The number of retries and retry cycles are both configurable, but a period of up
to 72 hours is covered. After the number of retries has become exhausted, the exports are dropped
and will not be recovered.

5 HL7 Interface Observation Reporter
5.7.2 Query for Results of Observations (R02, R04)

This interface allows to use the HL7 query/response model for the retrieval of result values from
IntelliSpace Perinatal. Another system can request patient data by transmitting a query that identifies
the patient of interest, a start date/time, and an end date/time. Over the same socket connection, an
acknowledgement to the query, including the full result data set, will be sent.
This message contains all configured data for the specified patient from the supplied start date/time up
through the supplied end date/time.
5.7.2.1 Who Subject Filter (QRD-8)

The patient is identified by the Who subject filter field (QRD-8). Supported identifiers are the
configured encounter identifier or HIS identifier.
5.7.2.2 Query Result Content

Only data within the given timespan (ORF 2,3) of the patient's current open episode will be exported.
Two options can be configured:
• All Notes
All valid notes in the given timespan at the time of export.
• Last note
The last valid note of each note type in the given timespan at the time of export

Observation Reporter 5 HL7 Interface
5.7.2.3 HL7 Batch Protocol

A configuration option allows the usage of the batch file protocol. With this options the result data set
is copied to a file instead of the acknowledgment message. In this case a complete shared folder/
filename path is sent after the file is created. Once this acknowledgement is received, the other system
will retrieve and process the result file from the shared folder.
This result file contains all configured data for the specified patient from the supplied start date/time
up through the supplied end date/time.
UNC path/file format:
<configured shared folder>/<HL7 Application Name>_<Who subject Filter (QRD-8)>_<Patient
sequence number>_<creation timestamp>.txt
Example: //share/OBTV_PatAccount123_0_20160225074946.txt

5.7.3 Notes Documentation

The file Notes-Documentation.xls holds a reference list of all notes that can be transmitted out by
ORU; it represents the coding table for the outgoing ORU messages. This is a non-standard local code.
It is contained on the IntelliSpace Perinatal distribution medium. Information in the file may be
helpful for HL7 ORU, and reports and statistics configuration.
Any columns not included in this table are for Philips Division internal use only.
Column Heading Description
Note Description Description of the note

Note Element Elements of the note
Note Type ID Value: unique identifier of the note type
Maternal: note is available for maternal patients
Patient
Newborn: note is available for newborn patients
Autocharted: note is autocharted
Autocharting
Ackn. Note: note type ID of the acknowledged “version” of this note type.
Has User Note has a “user” associated with it.
Keep on external These types of notes remain on the external database until the regular data-
database base purge occurs. They are not purged after 96 hours (“short term notes”).
Last revision: last revision of IntelliSpace Perinatal where it was possible to
Obsolescence
enter this type of note. Only specified for note types that were not replaced.
In: notes of this type are accepted inbound via HL7.
HL7
Out: notes of this type are sent outbound via HL7.
Data type of the note element
The data types shown in the notes documentation are mapped to the HL7
send data types according to the following schema:
HL7 send data type: Notes data type

Numeric (NM): NM, int, bool*, double
Type Datetime (DT): DT, date
Timestamp (TS)
Coded Element (CE): only for Custom Notes of type VT Selection
String (ST): ST, string, all other notes data types
*bool(ean) data are sent using the numeric value 0 or 1,

0 representing false/no selections and 1 representing true/yes selections.
Range Data range of the note element
Unit Unit of the note element
Optional/Condi-
Additional information (e.g. when item is sent)
tion
Remarks
HL7 OBX Example Contains examples in HL7 format

All description lines in the file NotesDocumentation.xls (that is, the lines with a light green background)
reference a note type, such as “Medication Start”. These notes types are represented in the ORU-msg as
an OBR segment. They can be selected individually for transmission. Expanding the description
display multiple data lines, such as name, dose, unit and so forth as shown in the illustration above.
This notes data is represented in the ORU message as the OBX segment.

5.7.3.1 Notes Sequencing Within ORU Messages

IntelliSpace Perinatal exports three different kinds of notes. All notes are sent in the sequence order of
the data entry of the user.
Note type Comment Note handle
DB notes stored in the IntelliSpace Perinatal database <0

File notes stored in a notes file >0
Notes having a reference to other notes, e.g. delete note,
Referencing notes <0
marker notes.
5.7.4 ORU Message Structure

IntelliSpace Perinatal supports the following subset structure of the ORU^R01 message:
ORU Message Structure

Segment Notes/Comments
MSH Message Header Segment
PID Patient Identification
PV1 Patient Visit
{
OBR Observation Request Segment
{
OBX Observation / Result Segment
}
}
An IntelliSpace Perinatal ORU message contains data from one episode of a single patient.
Each note is mapped to one OBR segment and one or more OBX segments.
Each attribute of a note is mapped to a separate OBX segment within the OBR.
5.7.5 ORU Message Data

The ORU message data comprises:
• PID segment with minimal demographic data (such ADT A01) and PV1.
• OBR segments containing notehandle, description, coding-information, display time and result
status.
• OBX segments containing notehandle, description, coding information, data values-type (eg:
numeric), notes data, units, result status (prelim./final/delete), display time and user info.
5.7.6 Notes Identification

The identifier of the patient episode given in PV1-50 (see “PV1 - Patient Visit Segment” on page 104),
together with the note handle given in OBR-3, uniquely identifies a patient note.
The notehandle itself uniquely identifies one note within one patient’s episode.

5.7.7 Outgoing Medication Notes

Specific medications are not individually identified by name in the Notes Documentation, and are
therefore not sent out with individual OBR segments. For example, there is no mapping of aspirin to
an OBR type. This is because medication types, not individual medications, are selected for ORU
transmission. These types are:
a. Medication doses - all medications that are given as a dose (that is, medications not given on a
time line). These are represented by the ORU segment “Medication Dose”.
b. Continuous medications - all medications that are given on a time line. Represented by the
following notes types and ORU segments: Medication Start, Medication Change, Medication
Bolus, Medication Stop, Medication Restart, and Medication Update.
c. Infusions - all infusions. Represented by the following notes types and ORU segments: Infusion
Start, Infusion Change, Infusion Bolus, Infusion Stop, Infusion Restart, Infusion Update,
Infusion Medication.
When you select the medication type (medication dose, continuous medication, infusion), all
medications and infusions entered with this type are transmitted.
When medications are changed, these alterations are stored as a linear chain of entries. Each
medication note - except the medication start - refers to its predecessor.
For example, Start -> Stop -> Restart -> Change
Therefore, OBR segments representing a medication note contain a separate OBX segment to transmit
the predecessor reference.
5.7.8 Fetus Index

All notes having a relation to a fetus will get an appendix to the note type. This is an addition/change
to the previous notes types definition.
The fetus index is zero-based. This means fetus index of 2 is related to fetus 3 (Index is n-1).
5.7.8.1 OBR-4 Universal Service Identifier

The appendix format is: NTE<note type id>_FX[Fetus index]
Example: NTE123_FX2
(where 123 is the note type Id and 2 is the Fetus index).
5.7.8.2 OBX-3 Observation Identifier

The appendix format is: NTE<note id>-<seq.#>.FX[Fetus index]
Example: NTE123-2.FX2 (Where 123 is the note type Id and 2 is the Fetus index).
Index is n-1.

5.7.8.3 Notes with Fetus Index

Fetal notes derived from fetal monitor data (auto-charted):
FHR Fetus Index Appendix in OBR 4

1 0 Yes
2 1 Yes
3 2 Yes
Membranes and Station/Position Notes:

These notes relations to fetuses are optional, they are considered as maternal data like the other Vag.
Exam notes Dilation and Effacement.
Only for multiples it can be interesting to distinguish between different fetuses, and only in these cases
a fetus index would be sent.
Fetus Selection Fetus Index Appendix in OBR 4

no fetus selected empty No
fetus selected >=0 Yes
The fetus index in these messages directly reflects the value of the Fetus field in the note. This field is
always empty/read-only for a single fetus and can be empty (default), or 1, 2, … for multiples.

5.7.9 Notes Deletion

From IntelliSpace Perinatal Revision H on, deletion of notes via HL7 is handled by sending an ORU
message with an OBR segment and the same number of OBX segments like the original note.
NID_NTE_DELETE and NID_NTE_INVISIBLE share the same behavior.
The information contained in the delete note should be interpreted as follows:
• OBR: Contains information of the “delete note”:
– OBR-3: subcase identifier and note handle of the original note
– OBR-4: coded note type of the original note
– OBR-7: display time of the original note
– OBR-25: “X” - deleted
• OBX
– OBX-2: empty (except for fetus index)
– OBX-3: coded note type of the original note
– OBX-4: empty (except for VT_Selection custom notes)
– OBX-5: empty (except for fetus index)
– OBX-11: “D” - deleted
– OBX-14: display time of the original note
– OBX-16: name of the user who executed the delete action (name of the user who deleted the note
referenced by OBR-3)
Delete notes are only sent for note types being configured for export.
5.7.9.1 Deleting a Whole Chain of Medication Notes

The deletion of a whole chain of medication notes is performed by deleting the medication start note
(i.e. when the medication start note is deleted, IntelliSpace Perinatal sends a delete note for each note
in the chain to the HIS).

5.7.10 Configuring an Outgoing Observation Route

This section describes how to configure a route for sending Observation messages:
Click Create New Route.
Click through the Route Configuration wizard step by step:
– Route name
– Route type: Outgoing Observations
– Message type: ORU (Unsolicited observation message)
– Acknowledgement: see “Acknowledgement Modes” on page 43.
• Outgoing Route Configuration:

– Receiving Application and Receiving Facility: the system specified here will receive the
Observation message.
– Retries and Timeout: Configure the number of retries and the wait time until timeout when the
receiving system is not available.

• Outgoing Observations:
– Operation mode: All, EPIC, or IHE-DEC
– Export interval: Outgoing messages are exported at the configured intervals.
The export interval applies to all outgoing ORU routes.
Attention: Do not change this value without an HL7 load test. Shortening the interval results in
more sent messages and can impact the system performance.
– Compatibility Options:
• Fetus identifier OBX segment:
if checked: sends fetus index as separate OBX segment with OBX-3 "FetusIndex"
if unchecked: sends fetus index as appendix ".FX" in OBX-3
• Null value for deleted results:
if checked: sends a null value ("") as observation value (OBX-5) if the result status (OBX-11) is
deleted ("D")
if unchecked: sends an omitted value (empty) as observation value (OBX-5) if result status
(OBX-11) is deleted ("D")
• Semicolon separator:
if checked: sends multiple values, semicolon-separated
if unchecked: sends multiple values, separated by HL7 separator "~".
• User name of deleted observations:
if checked: name of the user who originally entered the observation
if unchecked: name of the user who deleted the observation
• Display name instead of account name:
if checked: display name is used
if unchecked: account name is used (OBX-16.2 contains the display name)
• Send NTE046 event code as value:
if checked: the event code is sent as appendix to the observation value (OBX-5)
if unchecked: the event code is sent as observation identifier code (OBX-3.1)
• Force the uniqueness within a message of:
- OBR segment
if checked: all OBX segments are grouped into a single OBR
if unchecked: a separate OBR segment is used for each OBX
- OBX-3: observation identifier
if checked: each observation identifier appears only once per message
if unchecked: multiple observations with identical identifier are allowed in a single message
- OBX-14: date/time of observation
if checked: all observations in a message have the same date/time
if unchecked: observations with different date/time are allowed in a single message
- OBX-16: responsible observer
if checked: all observations in a message have the same responsible observer
if unchecked: observations with different responsible observer are allowed in a single message

– Outgoing Observations (Maternal): Select all the data elements that you want in the HL7
messages.
A simple click moves them from list of available elements to the list of selected elements, and vice
versa. Select All moves them all at once.
• Outgoing Observations (Newborn): Select all the data elements that you want in the HL7 messages
Example settings:

5.7.11 Configuring an Outgoing ORU Route for an EPIC Incoming

Device Data Interface
This section describes how to configure a route for sending ORU messages from the fetal monitors to
EPIC using the EPIC Incoming Device Data Interface, with the monitor’s device ID as a required part
of the message. There are two ways of providing the device ID for a fetal monitor:
1 Automatic:
For connected Philips Avalon fetal monitors, as well as for all other Philips/Agilent/HP monitors,
the serial number of the monitor is automatically used as device ID. The fetal monitor sends its
serial number through the interface as part of the message. The field Device ID in the Classic Fetal
Monitor Connections tab (see screen below) must be left blank to allow the automatic mode.
2 Manual:
The device ID is configured manually for a COM port in the Classic Fetal Monitor Connections
tab (see screen below). This configuration is required if the connected fetal monitor does not send
a serial number. Note that the manually configured device ID is in fact associated to a COM port
and not to a monitor. A connection change of a monitor to a different COM port may require
changing the device ID.

How to configure a route:


– Route name
• Outgoing Route Configuration:
– Receiving Application and Receiving Facility (EPIC).
– Operation Mode: Select EPIC Incoming Device Data Interface to set up a route for device data
export mode.
• Outgoing Observations (Maternal): Select all the FM data elements that you want in the HL7
messages.

Example settings:
With this route configuration, the device ID is sent in OBR-10, additionally to OBX-18.
HL7 Message Example (with FM Serial No. 3125G0098 as a device ID):
MSH|^~\&|||||20141016141609||ORU^R01ÔRU_R01|C1016141609088c240df|T|2.5
PID|||578647856^^^^MR||Weller^Wilma||19880606000000
PV1||B|DEFAULT^^BED198|||||||||||||||||||||||||||||||||||||||||||||||5ca45a14
-98cc-4303-90e4-19c44d33b9e6^^ÔBTVÊID
OBR|1||2420ÔBTV|NTE218^Maternal
Temperature^99POB|||20141016051500|||3125G0098|||||||||||||||F
OBX|1|NM|NTE218-
1^Temperature^99POB||37.1|Cel^ÎSO|||||F|||20141016051500||||3125G0098
OBX|2|ST|NTE218-2^Source^99POB||||||||F|||20141016051500||||3125G0098
OBR|2||2588ÔBTV|NTE215^Maternal Blood
Pressure^99POB|||20141016060000|||3125G0098|||||||||||||||F
OBX|1|NM|NTE215-
1^Systolic^99POB||160|mm(hg)^ÎSO|||||F|||20141016060000||||3125G0098
OBX|2|NM|NTE215-
2^Diastolic^99POB||90|mm(hg)^ÎSO|||||F|||20141016060000||||3125G0098
OBX|3|NM|NTE215-
3^Mean^99POB||0|mm(hg)^ÎSO|||||F|||20141016060000||||3125G0098
OBX|4|ST|NTE215-4^Source^99POB||left arm||||||F|||20141016060000||||3125G0098
OBR|3||2684ÔBTV|NTE216^Maternal Heart
Rate^99POB|||20141016060000|||3125G0098|||||||||||||||F
OBX|1|NM|NTE216-1^Rate^99POB||88|/
Min^ÎSO|||||F|||20141016060000||||3125G0098
OBR|4||2768ÔBTV|NTE217^Maternal
SpO2^99POB|||20141016060000|||3125G0098|||||||||||||||F
OBX|1|NM|NTE217-1^SpO2^99POB||98|%^ÎSO|||||F|||20141016060000||||3125G0098

5.7.12 Configuring an Outgoing Observation Query Interface

This section describes how to configure a route for receiving Observation queries.

– Route name
– Message type: QRY/QRF (Query for Result of Observation)
– Operation mode: All, EPIC, or IHE-DEC
– Compatibility Options:
• Fetus identifier OBX segment:
if checked: sends fetus index as separate OBX segment with OBX-3 "FetusIndex"
if unchecked: sends fetus index as appendix ".FX" in OBX-3
• Null value for deleted results:
if checked: sends a null value ("") as observation value (OBX-5) if the result status (OBX-11) is
deleted ("D")
if unchecked: sends an omitted value (empty) as observation value (OBX-5) if result status
(OBX-11) is deleted ("D")
• Semicolon separator:
if checked: sends multiple values, semicolon-separated
if unchecked: sends multiple values, separated by HL7 separator "~".
• User name of deleted observations:
if checked: name of the user who originally entered the observation
if unchecked: name of the user who deleted the observation
• Display name instead of account name:
if checked: use display name
if unchecked: use account name (OBX-16.2 contains the display name)

• Send NTE046 event code as value

if checked: the event code is sent as appendix to the observation value (OBX-5)
if unchecked: the event code is sent as observation identifier code (OBX-3.1)
– Query:
• Who Subject Filter (QRD-8): Select the required patient identifier: HIS identifier, Visit
Number, or Account Number
• Only send last value of each note type:
if checked: only the last valid note of each note type in the given time span will be sent
if unchecked: all valid notes within the given time span will be sent
• Outgoing Observations (Maternal): Select all the data elements that you want in the HL7 messages.
• Outgoing Observations (Newborn): Select all the data elements that you want in the HL7 messages
– Port:
Example settings:
• Port Type: Server
• Local Port: 10010
– HL7 Batch Protocol:
If Use HL7 batch protocol is checked, the HL7 messages will be written to the Output folder
defined hereafter (see “HL7 Batch Protocol” on page 65).

5 HL7 Interface Observation Consumer
– Encoding: select the required codepage

5.8 Observation Consumer

IntelliSpace Perinatal receives ORU messages sent by the HIS to populate, as appropriate, the
flowchart and forms. Only ORU^R01 (Observation Result Unsolicited) messages are supported.
Two operation modes can be configured:
• LAB (Lab interface): The content of a message is interpreted as a Lab result and can be mapped to
the flowchart or forms labs.
• Custom Charting Element: The content of a message is interpreted as a charting element if the
corresponding custom charting element is configured.
One message may contain multiple observations from multiple patients.
5.8.1 Patient Identification

Each incoming observation result must be unambiguously assigned to an IntelliSpace Perinatal patient.
If an observation result cannot be unambiguously assigned, it is ignored. For incoming ORU messages,
only the patient identifier must match.
When IntelliSpace Perinatal unambiguously identifies the patient, a search is made for an existing
observation item in the patient record in the forms and flowchart. The incoming observation result is
then mapped to IntelliSpace Perinatal Observation Items.
Forms: A new Observation Item is created if the patient has a record, open or closed, but closed not
longer than 28 days.
An Observation Item can be updated up to 28 days (192 hours) after it was received, or the last update
was applied and the last episode is not closed longer than 28 days.
For updates of an Observation Item received after 28 days a new Observation Item is created.
Flowchart: For patients with an open episode and an observation item configured for the flowchart, an
existing Lab note is updated, or a new Lab note created instantly.
5.8.2 Acknowledgement
An ORU^R01 message may contain observation results for more than one patient. A positive
acknowledgement is sent if at least one observation result is valid. Ignored observation results are
considered to be valid.
5.8.3 Data Validity and Logging

Lab Mode: Observations older than 28 days are ignored.
An ORU^R01 message is valid if at least one Observation Report (OBR) is valid. An Observation
Report is valid only if all its OBX segments are valid.
An ORU^R01 message is called valid when it conforms to the HL7 standard format.

Observation Consumer 5 HL7 Interface
IntelliSpace Perinatal has additional checks for specific content. For example: DateTime fields having
zero values only:
OBR|1||03|TestID^^|||000000000||||||||||||||||||P|
Valid data is acknowledged. Invalid data is rejected and, depending on the logging level, can be
recorded in a log file.
Events Logging Level
Error Warning Announce Trace

Message rejected N Y Y Y
Unknown patient N Y Y Y
Invalid Observation Report (OBR or OBX
N N Y Y
segments beneath OBR)
Invalid OBX N N N Y
5.8.4 Mapping and Storing

Observation results are mapped to IntelliSpace Perinatal Observation Items and stored in the patient’s
category-item structure, either into Forms or in the Flowchart. Where the Observation Items are stored
depends on the mapping configuration.
a. Observation items to be stored in Flowchart:
• Lab Mode: Observation items are stored as IntelliSpace Perinatal Notes of the type LAB/HL7
Measurement.
• Custom Charting Element Mode: Observation items are stored as Custom charting notes if
they are configured, otherwise the items are ignored.
Custom Charting Elements are stored, if configured. They are attached to the open episode. If
no open episode exists, the Observation items are ignored.
b. Observation items to be stored in Forms:
The way in which results are applied depends on the status of the most recent patient record
(Prenatal Visit, Admission, etc.) in IntelliSpace Perinatal. A suitable patient record is defined as a
record which is not older than 28 days.The 28-Day Time Clock begins when the Record (e.g.
Prenatal Visit) has been closed. Provided that a suitable patient record exists, Observation items
are processed and stored in Forms although the episode is already closed.
Scenario 1: No patient found.
Scenario 2: Patient found but no open episode and no suitable patient record exists.
Scenario 3: Patient found, but without an open episode although a suitable patient record exists, the
record has been closed less than 28 days ago.
Scenario 4: Patient found, an open episode exists but no suitable patient record exists.
Scenario 5: Patient found, and both an open episode and suitable patient record exist.

Scenario Patient Open Record not Activity

Found Episode older than
28 Days
1 No n/a n/a Ignore/reject observation results.
Ignore observation results.
2 No
No observation result note created in flowchart.
For maternal patients:
Map observation results to IntelliSpace Perinatal obser-
vation items.
Create and assign (apply) observation items to the new-
est record of the patient (if Forms is configured as re-
No ceiver in the mapping table and the record is not
disabled). Items are archived on next open/close epi-
3 Yes sode.
No observation result note is created in the flowchart.
For newborn patients:
If the Newborn Documentation is open, then Observa-
Yes
tion Items are applied the same way as for maternal pa-
tients. Otherwise, if the Newborn Documentation has
been closed the observation results are ignored.
vation items.
4 No
Insert/update observation result note in flowchart if the
flowchart is configured as receiver in the mapping table.
Yes vation items.
Apply observation items to the newest record of the pa-
5 Yes tient (if Forms is configured as receiver in the mapping
table and the record is not disabled).
Insert/update observation result note in flowchart if the
flowchart is configured as receiver in the mapping table.

5.8.5 Applying OBR/OBX Data
5.8.5.1 Configuring the Mapping of Incoming Lab Data

The following table gives all mappings between external observation IDs and the internal Lab
Categories and Lab Items. These should be configured as part of IntelliSpace Perinatal configuration.
Columns Default Type Digits Remark Permission

to change
• Maternal System
Mapping Type n/a Select - Manager
• Newborn
Choose where to store and display this lab result:

• Flowchart
Flowchart or System
Receiver
copied form
Select -
• Forms Manager
last modified
mapping • <IGNORE> (select this to prevent a specific
ORU item form being added to the patient
record)
Icon
• checked: indicates that the map was added
Auto unchecked bool 1 automatically and not edited. Read only
• unchecked: indicates that the map was added
manually or edited.

Columns Default Type Digits Remark Permission

to change
Observation
Identifier Specifies the external lab result ID that can be found in
(individual test empty string 250 OBX-3 and composite field CE.1 for a certain lab result.
name) This is a required field and must be configured
(OBX-3/CE.1)
Observation empty, or
The CE.3 may contain a coding system, in the OBR-3
Identifier copied from
string 250 field. The coding system is optional and required only
Coding System last modified System
when the result ID has no unique meaning.
(OBX-3/CE.3 mapping Manager
Universal (The dialog is
Service Specifies the lab test ID that can be found in OBR-4 and
read only for
Identifier composite field CE-1 for a certain lab result. Lab results
empty string 250 users.)
(OBR-4/CE.1) with the same result ID may belong to different lab tests.
By specifying a test ID, the lab results can be categorized.
Test category
Universal
Service empty or
Identifier The CE.3 may contain a coding system, in the OBR-4
copied from
Coding System string 250 field. The coding system is optional and required only
last modified
(OBR-4/CE.3) when the result ID has no unique meaning.
mapping
Category
Allows you to select the lab category/lab item from the
value table viewer dialog. The related paths in the value System
Edit/Select Lab table editor are: Manager
n/a button -
Item
Maternal\LAB/H7 LAB\Measurements sub dialog
Newborn\LAB/H7 LAB\Measurements
Descriptive name with which the item is identified in
IntelliSpace Perinatal. The format is:
Lab Item n/a character -
Lab Item (Lab Item Code - Lab Item Coding System).
Select this from the VTE.
Add Category n/a character - Lab Category

5.8.5.2 Denied mappings

If neither Forms nor Flowchart visibility of a mapping are configured the mapping is considered
denied. Observation Results matching those mappings are ignored.
5.8.5.3 Configuring Automapping

Lab results that are not found in the current mappings can be mapped automatically to a category
named "---". The checkbox in the configuration screen allows you to enable/disable this automatic
mapping.
If auto-mapping is checked, you can select the automatic action for the receiver. The auto-mapped lab
results can be added to the patient record into Flowchart or into Forms. The choice of receiver applies
to all automapped items; all items are imported into either the flow chart or forms, or are all ignored.
To enable auto-mapping without automatically adding the items to the patient record, select
<IGNORE>.
You can select the desired IntelliSpace Perinatal Identification for automatically generated mappings.
Mapping Attributes Automapping value
Observation Identifier OBX-3 CE.1 (Observation Identifier)
Observation Identifier
OBX-3 CE.3 (name of coding system (IS))
Coding System
HL7 Type identification
Universal Service Identifier OBR-4 CE.1 (Universal Service Identifier)
Universal Service Identifier
OBR-4 CE.3 (name of coding system (IS))
Coding System
Auto ‘T’ (fix)
Name of the pre-defined category for auto mapped
Category Name Observation Results ("---")
IntelliSpace Perinatal type (fix)
identification
OBX-3 CE.1 (Observation Identifier)
Item Name
(Truncated to OBTV limit of 50 characters if necessary.)
Visible in Forms like configured
OBTV presentation
Visible on Flowchart like configured
5.8.6 Field Description

See “OBX - Observation Result Segment (ORU Incoming)” on page 116 for a description of the
individual fields.
5.8.7 Flag Important Patient Information

The HL7 module supports the “Flag important patient information” feature as follows:
If an observation result (OBX-8) is considered “Abnormal” then the IntelliSpace Perinatal note is
marked as ‘flagged’. The “Flag important patient information” feature of the HL7 module can be
configured.
5.8.8 Lab Reminders

The HL7 module supports the “Lab reminders” feature.
A new Lab Reminder is created…
• when an observation result is successfully processed, …

• … but not for ignored observation results and …

• … only if there is not already a Reminder for that patient.
• both on Insert and Update of a Lab Item.
• for both Lab Items in Forms and Flowchart (Notes).
The time stamp of a Lab Reminder is set only once, when the Reminder is created.
5.8.9 Limitations
The system can process approximately 100 small messages (containing one observation result) or up to
three messages containing 1000 observation results per minute.
To ensure system performance, incoming ORU data is limited to:
• 30,000 maximum number of IntelliSpace Perinatal Database Notes per episode.
• 2,000 lab results per patient (in open and closed episodes). If this is exceeded, a system alarm
message is displayed, but incoming HL7 messages are processed. You should delete lab results in the
lab form if the limit is exceeded.
This applies when importing into forms, but not when importing into the flowchart. The flowchart
import does not have a specific lab-result limit; notes of categories Alarm, Assessment, Vag. Exam,
and LAB (including lab-notes) have a maximum of 5,000 per episode.
• 1,000 mappings, including auto mappings system wide. A system alarm message is displayed, but
incoming HL7 messages are processed. You should delete lab mappings in the HL7 Messages
configuration if the limit is exceeded.
• 1,000,000 characters maximum size of an incoming message. Messages are rejected, and no
processing occurs.
• 32,000 characters maximum per segment. Messages are rejected and no processing occurs.
• 100 maximum number of OBX segments beneath an OBR segment. Any more are ignored, and a
warning written to the HL7 log file.
5.8.10 Troubleshooting
If, once you have mapped unknown incoming ORU messages to an IntelliSpace Perinatal category, the
result does not display where you expect it to, consider the following points.
• Check the logfile first to ensure that IntelliSpace Perinatal received it. IntelliSpace Perinatal sends an
acknowledge message.
• Check that you looking in the right place for the result. For example, are you looking in the forms
for a message that is configured to appear in the flowchart, or vice versa? See the IntelliSpace
Perinatal System Administration and Configuration Guide for further details.
• Is the lab test is older than 28 days? If so, it is not displayed.
• If the message is a flowchart message, you may need to scroll back in the chart to see it.

5.8.11 Configuring Routes for Incoming ORU Messages for Incoming

Custom Charting Elements
To configure routes for incoming HL7 observation result messages (ORU-in) in IntelliSpace Perinatal:
Select existing route in the Route Configuration section and click Edit Route,
or
click Create New Route.
Click through the Route Configuration wizard step by step to define:
– Route name
– Route type: Incoming ORU

– Acknowledgement: see “Acknowledgement Modes” on page 43

• Incoming Route Configuration:
– Sending Application and Sending Facility (EMR). If Enable Filter is marked, only messages from
the systems specified here will be accepted.
• Incoming ORU Configuration:
– Message Type:
• LAB: if you select this route type, Lab items will be created for incoming observation results.
• Custom Charting Element: if you select this route type, Custom Charting Elements will be
created for incoming observation results.

– Flag abnormal values: If this option is enabled, Lab Items / Custom Charting Elements will be
flagged if their corresponding incoming observation result message has set its abnormal value flag.
Example settings:
5.8.11.1 Mapping for Incoming Lab Values

IntelliSpace Perinatal receives the incoming observation data exactly as the lab sends it. Incoming lab
results can be mapped to a predefined term in IntelliSpace Perinatal. This means that you are not
forced to use the lab’s term, but can define what your institution requires. You define these terms
within the Lab Categories and Lab Items of the Value Table Editor. You can create up to 1000
mappings.
Mapping is done on an individual lab test basis, not per patient or per result. You cannot map the same
lab test to both forms and the flowchart.
For linked systems, it is recommended to configure identical VTE Lab Categories/Items and identical
mappings. This allows lab data of transferred patient records to be displayed identically on both
systems. It is possible to import LAB routes from IntelliSpace Perinatal config backup files. A button
Import Mapping becomes visible when you highlight an ORU incoming route on the HL7 messages tab
in the configuration screen. This way, LAB routes can be restored or cloned for linked systems.
Configuring incoming lab data allows you to configure IntelliSpace Perinatal to display lab results with
a descriptive name. Once you have completed these steps, the next time IntelliSpace Perinatal receives
a result from an external lab, it will display with the descriptive name to which you have mapped the
lab result.
Incoming ORU must be installed during setup.
1 Verify and/or modify the new VTE default set for lab.
2 In IntelliSpace Perinatal configuration mode, configure the new route for ORU incoming.
3 Configure/define the mapping of lab tests to IntelliSpace Perinatal values as defined in the VTE
and assign them to the receiving forms or flowchart. Do this for each lab test. You cannot copy the
mapping to a linked system.
4 Enable and configure auto-mapping, if required.
5 In flowchart configuration, select the lab page and the individual lab items for display.
5.8.11.2 Mapping Custom Charting Elements to ORU-in Messages

As a prerequisite to displaying observation results from ORU-in messages in the Flow Chart, new
custom charting elements must be created and mapped to the content of the ORU-in messages. To do
this, proceed as follows:
NOTE Make sure Enable definition of charting elements is checked in the System Manager’s Configuration
page.

Start the Flow Chart in configuration mode (press Shift+Ctrl while clicking the Flow Chart symbol).
Click on the tab of the page where you want to add the element (e.g. Vital Signs), right-click a grid
button and select Add  New from the menu.
In the Add Custom Charting Element dialog:
1 Enter a label.
2 Select the data type Text.
3 Click to the button in the Identification group box to configure the identification details.
Observe the following mapping:

Code corresponds to HL7 field OBX-3.1 / OBR-4.1
Name corresponds to HL7 field OBX-3.2 / OBR-4.2 (not required)
Coding system corresponds to HL7 field OBX-3.3 / OBR-4.3.
The coding system can be typed in or selected from the combo box.
The combination Name / Code / Coding System must be unique within the current Flow Chart mode
and cannot be changed once the element is defined.
The mapping lookup is done with the OBX-3 fields, and if no Custom Charting Element (CCE)
definition was found, an additional lookup with the OBR-4 fields is done. If both lookups result in no
CCE definition being found, the Observation is ignored.
CCE Definition found for OBX-3: Observations are mapped to the corresponding CCE.
CCE Definition found for OBR-4: All Observations under this Observation Request (OBR) which
have no separate mapping to a CCE are mapped to the corresponding CCE.
VTE configuration is described in the System Administration and Configuration Guide.

Message Segments 5 HL7 Interface
5.9 Message Segments

Segments and attributes supported by the IntelliSpace Perinatal HL7 interfaces are listed here. All
other segments and attributes are accepted but ignored (incoming only).
5.9.1 Legend for the Segment Tables

The tables in this section specify the supported HL7 segments. Each bulleted point defines a field of a
segment.
• SEQ: Position (sequence within the segment)
• LEN: Maximum length
• DT: Data type (see “Supported HL7 Data Types” on page 92).
• OPT: Optional
Whether the field is required, optional, or conditional in a segment. The designations are:
• R - required
• O - optional (may be omitted)
• C - conditional on the trigger event or on some other field(s)
• X - not used with this trigger event
• B - left in for backward compatibility with previous versions of HL7
Coded optional items (admission type, marital status, and patient class) can be omitted but if they
are used, you must use the valid values.
• Admission Type: A (accident), E (emergency), L (labor/delivery), R (routine), N (Newborn).
• Marital Status: A (separated), M (married), D (divorced), S (single), W (widowed).
• Patient Class: E (emergency), I (inpatient), O (outpatient), P (preadmit), R (recurring
patient), B (obstetrics).
• RP/#: Repetition
Whether the field may repeat. The designations are:
• N - no repetition
• Y - the field may repeat an indefinite or site determined number of times
• (int) - the field may repeat up to the number of times specified in the integer
• TBL#: Table
An entry in the TBL column indicates that you can find the valid values for this attribute in the
corresponding table number in the HL7 standard, Appendix A. For example, look in table 7 of the
standard to see which values are acceptable in the PV1 segment attribute “Admission type”.
• ITEM#: ID number
Small integer that uniquely identifies the data field throughout the Standard.
• ELEMENT NAME: Name of the data item.
• TVSIN / TVSOUT: IntelliSpace Perinatal Support
Whether the HL7 Interface supports and uses the field (TVSIN:incoming, TVSOUT:outgoing).
• R - the field is required by the HL7 Interface and may not be omitted. Messages are rejected if
this field is missing.
• Y- the field is supported by the HL7 Interface but not required

5 HL7 Interface Message Segments
• (empty) - the field is accepted but not used by the HL7 Interface
Note: these fields are updated according to the data dictionary.
• TV DB: IntelliSpace Perinatal Database Association
Where data received/sent is stored/fetched in the IntelliSpace Perinatal database. Messages where
these attributes are used are listed in parentheses. Additionally the direction of the messages is added
(in => store / out => fetch).
5.9.2 Supported HL7 Data Types

This refers to the column “DT” in the segment tables.
Supported HL7 Data Types

Data Type Data Type Name Notes/Format
Category/Data type
Alphanumeric
ST String
Numerical
NM Numeric
SI Sequence ID
Identifier
Coded values for HL7
ID Can be configured using Value Table Editor.
tables
<entity identifier (ST)> ^ <namespace ID (IS)> ^
EI Entity identifier
<universal ID (ST)> ^ <universal ID type (ID)>
Date/Time
DT Date YYYY[MM[DD]]
YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-
ZZZZ]^<degree of precision>
However, only the following are evaluated:
YYYYMMDD[HHMM[SS]]
Date: YYYYMMDD is required in exactly this for-
TS Time stamp mat.
Hour/minute: HHMM is optional. Set to 0000 if
omitted.
Seconds: SS is optional. Set to 00 if omitted.
All other precision and time zone values are ignored.
Code Values
<identifier (ST)> ^ <text (ST)> ^ <name of coding
system (ST)> ^ <alternate identifier (ST)> ^ <alter-
CE Coded element
nate text (ST)> ^ <name of alternate coding system
(ST)>


Category/Data type
<ID number (NM)> ^ <check digit (NM)> ^ <code
Composite ID with
CK identifying the check digit scheme employed (ID)> ^
check digit
< assigning authority (HD)>
<ID number (ST)> ^ <family name (ST)> ^ <given
name (ST)> ^ <middle initial or name (ST)> ^ <suf-
Composite ID number
CN fix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^
and name
<degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <as-
signing authority (HD)>
system (ID)> ^ <alternate identifier (ST)> ^ <alter-
Coded element with no nate text (ST)> ^ <name of alternate coding system
CNE
exception (ID)> ^ <coding system version ID (ST)> ^ <alter-
nate coding system version ID (ST)> ^ <original text
(ST)>
system (ID)> ^ <alternate identifier (ST)> ^ <alter-
Coded element with nate text (ST)> ^ <name of alternate coding system
CWE
exception (ID)> ^ <coding system version ID (ST)> ^ <alter-
nate coding system version ID (ST)> ^ <original text
(ST)>
<ID (ST)> ^ <check digit (ST)> ^ <code identifying
the check digit scheme employed (ID)> ^ < assigning
Extended composite
CX authority (HD)> ^ <identifier type code (ID)> ^ <
ID with check digit
assigning facility (HD)> ^ <effective date (DT)> ^
<expiration date (DT)>
Generic
CM Composite
<nurse unit>^<room>^<bed (ST)>^<facility
Location
ID>^<bed status>
<patient ID (ST)>^<check digit (NM)>^<check digit
Patient ID (internal) scheme (ID)>^<assigning facility ID (ST)>^<type
(ID)>
Demographics
<street address (ST)> ^ < other designation (ST)> ^
<city (ST)> ^ <state or province (ST)> ^ <zip or post-
XAD Address
al code (ST)> ^ <country (ID)> ^ <address type
(ID)> ^ <other geographic designation (ST)>


Category/Data type
<family name (ST)> ^ <given name (ST)> ^ <middle
initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)>
XPN Person name
^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD)
(ST)>
<organization name (ST)> ^ <organization name
extended composite type code (IS)> ^ <ID number (NM)> ^ <check digit
name and identifica- (NM)> ^ <code identifying the check digit scheme
XON
tion number for orga- employed (ID)> ^ <assigning authority (HD)> ^
nizations <identifier type code (IS)> ^ <assigning facility ID
(HD)> ^ <name representation code(ID)>
<surname (ST)>^<own surname prefix (ST)>^<own
FN Family Name
surname (ST)>
[NN] [(999)]999-9999[X99999][B99999][C any
XTN Telephone number
text]
5.9.3 MSH - Message Header Segment
MSH - Message Header Segment
TVS OUT
Comment
Element
TVS IN
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
1 1 ST R 00001 Field Separator “|” Constant

according to
Used by for XML
v2.XML
2 4 ST R 00002 Encoding Characters conversion “^~\&” encoding
standard
Sending Application
Filter
3 180 HD O 0361 00003 Sending Application HL7 Route
Configuration
IntelliSpace
Perinatal global
Sending Facility configuration
Filter
4 180 HD O 0362 00004 Sending Facility HL7 Route
Configuration
Receiving Checked against

5 180 HD O 0361 00005
Application IntelliSpace Perinatal
general IntelliSpace
configuration Perinatal Route
6 180 HD O 0362 00006 Receiving Facility Otherwise, the configuration
message is not
processed

TVS OUT
Comment
Element
TVS IN
ITEM
Name
TBL#
RP/#
OPT
LEN
SEQ
DT
Used in ORU IN as
default for
Date/Time of Observation Date/ Date/Time of
7 26 TS O 00007
Message Time if neither internal creation
OBR-7 nor OBX-14
is available.
ADTÂxx^
ADTÂxx ADT_Axx,
9 7 CM R 00009 Message type
ORU^R01 ORU^R01^
ORU_R01 See
9.1 ID R 0076 00009 Message type ADT, ORU ADT ORU supported
messages
9.2 ID R 0003 Trigger event Axx, R01 Axx, R01
ADT_A01,
9.3 ID O 0354 Message structure Ignored
ORU_R01
GUID
Used for Application (IntelliSpace
10 20 ST R 00010 Message Control ID
Acknowledge Perinatal
generated)
“P” for
productive
11 3 PT R 00011 Processing ID Ignored systems,
“T” for demo
systems
2.6 is only
used with
“2.5” always device
12 60 VID R 0104 00012 Version ID Ignored
(“2.6”) observation
reporter
(IHE-DEC)
Route
“NE”, “AL”, “ER”, configuration
Accept “SU” "NE",
15 2 ID O 0155 00015 Acknowledgement Used for Enhanced (Timeout = 0)
Type Acknowledgement "AL"
Mode (Timeout > 0)
Route
“NE”, “AL”, “ER”, configuration
Application “SU” “NE”
16 2 ID O 0155 00016 Acknowledgement Used for Enhanced (Timeout=0)
Type Acknowledgement “AL”
Mode (Timeout > 0)

TVS OUT
Comment
Element
TVS IN
ITEM
Name
TBL#
RP/#
OPT
LEN
SEQ
DT
IHE_PCD_001 only used
ÎHE with device
Message Profile
21 427 EI O 01598 ignored PCD^1.3.6.1.4. observation
Identifier
1.19376.1.6.1.1 reporter
.1ÎSO (IHE-DEC)
only used
with device
21.1 ST O Entity Identifier ignored IHE_PCD_001 observation
reporter
(IHE-DEC)
only used
with device
21.2 ST O Namespace ID ignored IHE_PCD observation
reporter
(IHE-DEC)
only used
with device
1.3.6.1.4.1.193
21.3 ST O Universal ID ignored observation
76.1.6.1.1.1
reporter
(IHE-DEC)
only used
with device
21.4 ID O Universal ID Type ignored ISO observation
reporter
(IHE-DEC)
5.9.4 EVN - Event Type Segment
EVN - Event Type Segment

TVS OUT
TV DB
Element
TVS IN
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
1 3 ID B 0003 00099 Event Type Code Ignored Copy of MSH-9.2

2 26 TS R 00100 Recorded Date/Time Ignored Copy of MSH-7

Context Overview of Message Segments from Chapters 5.9.5 to 5.9.8, Maternal:

Context Overview of Message Segments from Chapters 5.9.5 to 5.9.8, Newborn:

5.9.5 PID Patient Identification Segment

See the pictures on page 97 and on page 98 for a user interface context overview of message segments.
PID - Patient Identification Segment
demographics page
TVS ORU IN
TVS ADT IN
Filled in Out
TVS OUT
Examples
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
Msg
(D)
DT
e.g.
“MRN4711^^^^MR”
MDM Out: For System
Audit Trail the patient Patient.PatientMRN (D)
Y/ Patient List identifiers are all empty. Patient.PatientIdentification
3 250 CX R 00106 R R R In this case PID-3 (D)
3 Identifier contains just the
Patient.PatientSSN (D)
identification code of the
configured HIS ID, e.g.
" ^^^^MR"
IN: This is the HIS-ID in case of missing

TypeCodes (retain backward compatibility).
3.1.1 ID ID R R R
OUT: HIS-ID in first position for OUT msgs
(retain backward compatibility)
Assigning
3.1.4 HD Y Y Y
authority
identifier type ALL
3.1.5 ID Y Y Y
code
3.2.1 ID ID Y Y Y
Assigning
3.2.4 HD Y Y Y
authority
identifier type
3.2.5 ID code Y Y Y
3.3.1 ID ID Y Y Y
Assigning
3.3.4 HD Y Y Y
authority
identifier type
3.3.5 ID code Y Y Y

demographics page
TVS ORU IN
TVS ADT IN
Filled in Out
TVS OUT
Examples
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
Msg
(D)
DT
e.g.
“Brown&&White^
Jody^PT”
MDM Out: for
5.1 250 XPN R Y 0020 00108 Patient name R R R System Audit Trail
the name is:
"System Audit
Trail"
5.1.1 FN family name R R R

Patient.PatientName_La
5.1.1.1 ST family name R R R
st (D)
own family Patient.PatientName_M
5.1.1.3 ST Y Y Maternal only
name aiden (D)
ALL
Patient.PatientName_Fir
5.1.2 ST given name Y Y
st (D)
second and
further given Patient.PatientName_M
5.1.3 ST Y Y
names or initials I (D)
thereof
IN: L or nothing
Name Type for legal name
5.1.7 ID Y Y Y
Code
OUT; always L
e.g.
5.2 250 XPN R Y 0020 00108 Patient Name Y Y Y
"Alias^^^^^Â"
5.2.1 FN Family Name Y Y Y
Name Type IN/OUT: A for
5.2.7 IN Y Y Y
Code Alias
Date/Time or Precision: full
7 26 TS O 00110 Y Y Patient.DateOfBirth (D) ALL
Birth seconds.
Supported values Patient.SexID (D)

are: Only newborn uses all
Administrative
8 1 IS O 0001 00111 Y Y “F, M, U, A, O”. values. ALL
Sex
All others are Maternal always requires
ignored “F”.
IN Only: used if
9 250 XPN O 00112 Patient Alias Y Y PID-5 contains no ALL
Alia
9.1 FN Family Name Y Y ALL
Patient.PatientName_Ali
9.1.1 ST Surname R R ALL
as

demographics page
TVS ORU IN
TVS ADT IN
Filled in Out
TVS OUT
Examples
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
Msg
(D)
DT
10 250 CE O Y 0005 00113 Race Y Y

VTE code if mapped,
VTE code
10.1 ST Identifier Y Y else Patient. PatientRace
mapping A01
(D)
Filled with text if
10.2 ST Text Y Patient.PatientRace (D)
VTE mapped
11 250 XAD O Y 00114 Patient Address Y Y A01
Patient.PatientAdr_Stree
11.1.1 ST Street Address Y A01
t (D)
Patient.PatientAdr_City
11.1.3 ST City Y Y A01
(D)
State or Patient.PatientAdr_State
11.1.4 ST Y Y A01
province (D)
Zip or postal Patient.PatientAdr_Zip
11.1.5 ST Y Y A01
code (D)
Phone Number Patient.PatientHome_P
13 250 XTN O Y 00116 Y Y A01
- Home hone (D)
Phone Number Patient.PatientOther_Ph
14 250 XTN O Y 00017 Y Y A01
- Business one (D)
Primary
15 250 CE O 0296 00118 Y Y A01
language
VTE code Patient.PatientLanguage
15.1 ST Identifier Y Y A01
mapping (D)
Patient.
Filled with text if
15.2 ST Text Y Y PatientMaritalStatus A01
VTE mapped
(Maternal D)
Out:
15.3 ST Coding System Y Y VTE coding A01

system if mapped
else empty
This is an optional,
coded item. It may be
omitted, but if used
16 250 CE O 0002 00119 Marital State Y requires a correct value. A01
A (separated), M
(married), D (divorced),
S (single), W (widowed).
VTE code if mapped,
else Patient.
VTE code PatientMaritalStatus
mapping (Maternal D)

demographics page
TVS ORU IN
TVS ADT IN
Filled in Out
TVS OUT
Examples
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
Msg
(D)
DT
Filled with text if Patient.

16.2 ST Text Y A01
VTE mapped PatientMaritalStatus (D)
Out:
VTE coding
16.3 ST Coding System Y Y
system if mapped
else empty
17 250 CE O 0006 00120 Religion Y Y A01
VTE code if mapped,
VTE code else
mapping Patient.PatientReligion
(D)
Filled with text if Patient.PatientReligion
17.2 ST Text Y A01
VTE mapped (D)
Out:
VTE coding
system if mapped
else empty
Patient Account
18 250 CX O 00121 Y Y Incoming
Number
Patient.PatientAccount
18.1.1 ID ID Y Y
Nr (D) ALL
Out, only if
Assigning
18.1.4 HD Y Y authority was in
Authority
incoming message
SSN Number -
19 16 ST B 00122 Y Y Maternal only Patient.Patient SSN (D) A01
Patient
22 250 CE O Y 0189 00125 Ethnic Group Y Y A01
Out: VTE code if mapped,
22.1 ST Identifier Y Y VTE code if else Patient. A01
mapped else text PatientEthnicity (D)
Filled with text if Patient. PatientEthnicity
22.2 ST Text A01
VTE mapped (D)

demographics page
TVS ORU IN
TVS ADT IN
Filled in Out
TVS OUT
Examples
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
Msg
(D)
DT
Out:
VTE coding
system if mapped
else empty
Patient.PatientPlaceOfBi
23 250 ST O 00126 Birth Place Y Y A01
rth (D)
Newborn only,
OUT only: A01,
Multiple Birth Newborn.BirthOrderID
24 1 ID O 0136 00127 Y Y Newborn.BirthOrd A02,
Indicator (D)
erID=NULL? A03
N/Y
Newborn only A01,

Newborn.BirthOrderID
25 2 NM O 00128 Birth Order Y Y A02,
1....8 (D)
A03

5.9.6 PV1 - Patient Visit Segment

PV1 - Patient Visit Segment
Filled in Out Msg

Notes/Examples
TVS ADT OUT
TVS ADT IN
Element
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
DB
OUT only:
“I” for Newborn CaseTypeID
Patient (inpatient) (Pregnancy(P) or
2 1 IS R Y ALL
Class Newborn (N))
“B” for Maternal (OUT)
(obstetric)
Transfer patient
in given location Subcase Location /
(IN) Care Unit (IN)
Assigned
3 80 PL O 00133 Patient Y Y Patient HL7MsgIndex
Location transferred event CurLocation /
(OUT) CurCareUnit
(OUT)
HL7MsgIndex.Ca
Care Unit reUnit (IN)
Point of
3.1 Is Y Y Config: Care
Care Subcase.CurCare
Unit Name
Unit (OUT)
LocationConfig:
3.2 IS Room Y Y
Room ALL
HL7MsgIndex.Be
dlocation (IN)
LocationConfig:
3.3 IS Bed Y Y
Name Subcase.
CurLocation
(OUT)
Care Unit
3.4 IS Facility Y Y Config: Care
Unit Facility
LocationConfig:
3.7 IS Building Y Y
Building
LocationConfig:
3.8 IS Floor Y Y
Floor
CaseTypeID
(Pregnancy(P) or
“N” for newborn
Admission Newborn(N))
4 2 IS O 00134 Y Y omitted for (OUT) ALL
Type
Maternal
HL7MsgIndex.Ca
seTypeID (IN)

Filled in Out Msg

Notes/Examples
TVS ADT OUT
TVS ADT IN
Element
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
DB
Prior
6 80 PL O 00136 Patient Y
Location
HL7MsgIndex.Pr
Care Unit evCareUnit (IN)
Point of
6.1 IS Y Config: Care
care Subcase.PrevCare
Unit Name
Unit (OUT)
LocationConfig:
6.2 IS Room Y Y
Room
A01, A02,
OUT: previous
Subcase.PrevLocat A03
6.3 IS Bed Y Y patients unit of
ion (OUT)
the last episode
Care Unit
6.4 IS Facility Y Y Config: Care
Unit Facility
LocationConfig:
6.7 IS Building Y Y
Building
LocationConfig:
6.8 IS Floor Y Y
Floor

Filled in Out Msg

Notes/Examples
TVS ADT OUT
TVS ADT IN
Element
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
DB
OUT: Visit Number currently
assigned to patients episode
19 250 CX O 00149 Visit ID Y Y ADT IN:
• A01, A04, A05, A08, A31,
A50
PatVisitNo
19.1 ST ID Y Y referenced in
current subcase
Out, only if
Assigning authority was in
19.4 HD Y Y
Authority incoming
message ALL, except
device
OUT only, used as:
observation
-episode (subcase) Identification for reporter
external DB queries (IHE-
Alternate
50 250 CX O Y - longitudinal identification of a Note DEC)
Visit ID
(together with OBR Filler Order
Number = Notehandle) within a
patient case having multiple episodes
Subcase.SubcaseI
50.1 ST ID Y
D
assigning
50.4 HD Y -
authority
namespace
50.4.1 IS Y Always “OBTV” -
ID
identifier Always “EID”
50.5 ID Y -
type code (Episode - ID)

5.9.7 IN1 - Insurance Segment

IN1 - Insurance Segment
TVS ADT IN
OUT Msg
Examples
Filled in
Element
TV DB
ITEM
TBL#
Name
Notes
RP/#
OPT
LEN
SEQ
DT
1 4 SI R 00426 Set ID - IN1

2 250 CE R 0072 00368 Insurance Plan ID
3 250 CX R Y 00428 Insurance Company ID
Insurance Company
4 250 XON O Y 00429 Y
Name
Patient.PatientIns
4.1 ST Organization name Y
urance
Insured's Relationship
17 250 CW O Y/3 0063 00442 Y
to Patient
Patient.Insurance
17.1 ST Identifier Y
Holder
Insured’s IDNumber
49 250 CX O Y/3 01230 Y
Patient.InsurdsID
49.1 ST IDNumber Y
Number
5.9.8 NK1 - Next of Kin Segment

NK1 - Next of Kin Segment

TVS OUT
Element
TVS IN
TV DB
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
DT
1 3 SI R 00190 Set ID - NK1 Ignored

2 250 XPN O 00191 Name Y
2.1 FN Family name Y
Patient.PatientEmgcy
2.1.1 ST Surname Y
Name_Last
Patient.PatientEmgcy
2.2 ST Given name Y
Name_First
Second and further given Patient.PatientEmgcy
2.3 ST Y
names or initials thereof Name_MI
5 250 XTN Phone Number Y
Telephone Number Patient.PatientEmgcy
5.1 ST Y
Phone

5.9.9 ERR - Error Segment
ERR - Error Segment

SEQ LEN DT OPT RP/# TBL# ITEM Element Name OB OBTV DB
TVS
1 80 CM R Y 00024 Error code and location R
5.9.10 MRG - Merge Patient Information Segment (ADT IN only)

MRG - Merge Patient Information Segment (In only)
OUT Msg
Examples
Filled in
Element
TVS IN
ITEM
Name
TBL#
Notes
RP/#
OPT
LEN
SEQ
DT
Original identifier list

Prior Patient for example
1 250 CX R Y/3 00211 R
Identifier List “MRN4711^^^^MR”
Used for A46, A47
Patient.PatientMRN
[1.3].
ID ID R Patient.PatientIdentification
1.1
Patient.PatientSSN
[1.3].
ID identifier type code R
1.5
Prior Patient Account
3 250 CX O 00213 Y Used for A49
Number
3.1 ID ID Y Patient.PatientAccountNr
5 250 CX O 01279 Prior Visit Number Y Used for A50
5.1 ID ID Y PatVisitNo.VisitNo
5.9.11 AL1- Allergy Segment

Element
TVS IN
Name
RP/#
OPT
LEN
SEQ
DT
1 250 CE R Set ID - AL1 Ignored

2 250 CE O Allergen Type Code Y
Allergen Code/Mnemonic/
3 250 CE R Y
Description
4 250 CE O Allergy Severity Code Y
1
5 15 ST O Y Allergy Reaction Code Y
6 8 DT B Identification Date Y
1. 15 per component, with a maximum of 50.

5.9.12 IAM- Allergy Segment
Element
TVS IN
Name
RP/#
OPT
LEN
SEQ
DT
1 4 SI R Set ID - IAM Ignored
2 250 CE O Allergen Type Code Y
3 250 CE R Allergen Code/Mnemonic/Description Y
4 250 CE O Allergy Severity Code Y
5 15 ST O Y Allergy Reaction Code Y
6 250 CNE R Allergy Action Code Y
7 80 EI R Allergy Unique Identifier
8 60 ST O Action Reason
9 250 CE O Sensitivity to Causative Agent Code
Allergen Group Code/Mnemonic/
10 250 CE O
Description
11 8 DT O Onset Date
12 60 ST O Onset Date Text
13 8 TS O Reported Date/Time Y
14 250 XPN O Reported By
15 250 CE O Relationship to Patient Code
16 250 CE O Alarm Device Code
17 250 CE O Allergy Clinical Status Code
18 250 XCN O Statused by Person
19 250 XON O Statused by Organization
20 8 TS O Statused at Date/Time

5.9.13 Medical Document Management (MDM)

TXA attributes (outbound only)
Element
MDM
Name
RP/#
OPT
LEN
SEQ
TVS
Out
DT
1 4 SI R Set ID - TXA Y
2 30 IS R Document type Y
3 2 ID C Document Content Presentation
4 26 TS O Activity Date/Time
5 250 XCN C Y Primary Activity Provider Code/Name
6 26 TS O Origination Date/Time Y
7 26 TS C Transcription Date/Time
8 26 TS O Y Edit Date/Time
9 250 XCN O Y Origination Code/Name
10 250 XCN O Y Assigned Document Authenticator
11 250 XCN C Y Transcriptionist Code/Name
12 30 EI R Unique Document Number Y
13 30 EI C Parent Document Number
14 22 EI O Y Placer Order Number
15 22 EI O Filler Order Number
16 30 ST O Unique Document File Name Y
17 2 ID R Document Completion Status Y
18 2 ID O Document Confidentiality Status
19 2 ID O Document Availability Status
20 2 ID O Document Storage Status
21 30 ST C Document Change Reason
22 250 PPN C Y Authentication Person, Time Stamp
Distributed Copies (Code and Name of
23 250 XCN O Y
Recipients)

5.9.14 OBR - Observation Request Segment (ORU Out)

The outgoing OBR segment is made up of the following elements:
OBR - Observation Request Segment (ORU Out)
Sequence Type Field Name Remarks

number
Sequence number for the OBR segment within one PV1 seg-
1 SI Set ID
ment. Starts with 1, and increments by 1.
Contains the subcase ID and the note handle, used as a speci-
men ID to identify a note. Also contains the application name
Placer order (from HL7 configuration).
2 EI
number Format:
<subcaseID>-<note handle>^<application
name>
Contains the subcase ID and the note handle, used as a speci-
men ID to identify a note. Also contains the application name
(from HL7 configuration) and the EUI-64 code for
Filler order IntelliSpace Perinatal (ISP).
3 EI
number
Format:
<subcaseID>-<note handle>^<application
name>^<EUI-64 code for ISP>ÊUI-64
Coded note type. Format:
NTE<note id>^<note description>^99POB
<note id> is the internal Note ID defined for IntelliSpace Peri-
natal.
All notes having a relation to a fetus will get an appendix to the
Universal Service note type. The appendix format is:
4 CE NTE<note id>_FX[Fetus Index]
ID
Example: NTE123_FX2 (where 123 is the note ID and 2 is
the fetus index)
Index is n-1 (if n is the fetus number, as described in “Fetus In-
dex” on page 69).
If the configuration option “Fetus identifier as OBX segment”
is enabled, no appendix is sent. An extra OBX with fetus index
is sent instead.
Time zone of the system at message creation time,
Note Display if configured.
7 TS
Time Format: TS (time stamp)
Accuracy: seconds
Collector Identi-
10 XCN Same as OBX-18 if EPIC Device Interface is configured
fier
This field can have one of the following values:
Observation Autocharting notes: P (preliminary)
25 ID
Result Status Deleted notes: X (deleted)
Otherwise: F (final)"

Attributes:
ORU Out
Element
ORU In
ITEM#
TBL#
Name
RP/#
OPT
LEN
SEQ
TVS
TVS
DT
1 4 SI O 00237 Set ID - OBR Y
2 22 EI C 00216 Place Order Number Y
3 22 EI C 00217 Filler Order Number Y Y
4 250 CE R 00238 Universal Service Identifier Y Y
7 26 TS C 00241 Observation Date/Time # Y Y
10 22 XCN O Y 00244 Collector Identifier Y
25 1 ID C 0123 00258 Result Status + Y Y

5.9.15 OBX - Observation Result Segment - (ORU Out)
OBX - Observation / Result Segment (ORU Out)
Seque Type Field Name Remarks

nce #
This is the sequence number for individual OBX segment with-
1 SI Set ID
in one OBR segment. Starts with 1, and increments by 1.
Type of value sent in OBX-5.
For notes with attributes:
ST: string
NM: numeric
2 ID Value Type
DT: date/time
TS: time stamp
CE: Coded Element
For notes without attributes the value type is left empty.
Coded note element. Format:
NTE<note id>-<seq.#>^<description>^99POB
<note id>: internal note ID defined for IntelliSpace Perinatal
<seq-#>: sequence number of the note element.
Assessment Notes content is structured into OBX segments.
All notes having a relation to a fetus will get an appendix to the
3 CE Note Element note type. The appendix format is:
NTE<note id>-<seq.#>.FX[Fetus Index]
Example: NTE123-2.FX2 (where 123 is the note type ID and
2 is the fetus index)
Index is n-1 (if n is the fetus number, as described in “Fetus In-
dex” on page 69).
If the configuration option “Fetus identifier as OBX segment”
is enabled, no appendix is sent. An extra OBX with fetus index
is sent instead.
Value of observation (type according to OBX-2).
For notes with attributes:
5 n/a Value
Observation value depends on the value type in OBX-2
For notes without attributes the observation value is left empty.
Unit of observation (optional, depends on note type)
Pre-Defined Notes and Custom Charting Elements
6 CE Units For notes with attributes:
Appropriate units value depends on the note type
For notes without attributes the units value is not included.

OBX - Observation / Result Segment (ORU Out)
Seque Type Field Name Remarks

nce #
This can have one of the following values:
11 ID Result Status New notes: F (final)

Autocharting notes: P (preliminary)
Deleted notes: D (deleted)
Format: TS (time stamp).
Note Display
14 TS Accuracy: seconds.
Time
Time zone of the system at message creation time if configured.
Responsible Ob-
16 XCN This is the full name of the user who entered the note.
server
Equipment In- Contains the Device ID of the note (could be serial number of
18 ST
stance Identifier the fetal monitor, etc).
Attributes:
ORU Out
Element
ORU In
ITEM#
Name
TBL#
RP/#
OPT
LEN
SEQ
TVS
TVS
DT
1 4 SI O 00569 Set ID - OBX Y

1
2 2 ID C 0125 00570 Value Type Y Y
3 250 CE R 00571 Observation Identifier Y Y
4 20 ST R 00572 Observation Sub-ID Y Y
2 3
5 65536 * C Y 00573 Observation Value Y Y
6 250 CE C 00574 Units Y Y
7 60 ST O 00575 Reference Range Y
8 5 IS O Y/5 0078 00576 Abnormal Flags Y
11 1 ID R 0085 00579 Observation Result Status Y Y
14 26 TS O 00582 Date/Time of the Observation Y Y
16 250 XCN O Y 00584 Responsible Observer Y
18 22 EI O Y 01479 Equipment Instance Identifier Y Y
1. [OBTV]: Used to convert OBX-5 field
2. The length of the observation field is variable, depending upon value type
3. May repeat for multipart, single answer results with appropriate data types, e.g., CE, TX, and FT data types

5.9.16 OBR - Observation Request Segment (ORU Incoming)

See the description of OBX-11, in the section “Field Description” on page 116, for details about
updates and changes to results.
OBR identifies the test battery (that is, the category of test).
If IntelliSpace Perinatal systems are linked together, updates of observation results occur only for
observation results originally received on that system.
OBR Field New Observation Result Value Update Message

value supplied value null value supplied null omitted
omitted
OBR-3 identifier sup- no update
Filled Order Number applied empty value applied plied, but no (identifier, empty identi-
(note handle) update fier is valid)
OBR-4
no update
Universal Service Identifier applied ignored1 n/a
(identifier)
(Category ID)
applied uses MSH-7 value if applied uses MSH-7 value if
OBR-7
(if OBX-14 is both OBX-14 and (if OBX-14 is both OBX-14 and OBR-
Observation Date/Time
omitted OBR-7 are missing2 omitted 7 are missing1
OBR-25 Does not apply Does not apply
Result Status overridden by OBX-11 overridden by OBX-11
1. Ignore entire result (identifier)
2. If MSH-7 is not present, it uses the current time.
5.9.16.1 Field Description

OBR-3 is an HL7 type “EI” (entity identifier). All components, if given, are used to identify
observation results. It is made up of three elements, the code, the label, and the coding system. For
example 101^lab-ca^Snomed.

5.9.17 OBX - Observation Result Segment (ORU Incoming)

OBX identifies individual tests and results.
OBX Field New Observation Result Value Update Message

value supplied value null value supplied null omitted
omitted
OBX-3 no update
applied ignored1 n/a
Observation Identifier (identifier)
update no update
empty value applied (apply emp- Ignore the
(Forms only) ty value) observation
OBX-5 result
applied Ignore the observation re- update Deletes whole
Observation Value (CCE)
sult (Flowchart Lab-in and observation in
CCE) Lab and CCE
(Flowchart)
OBX-6
Units
update no update
OBX-7
applied empty value applied update (apply emp-
Reference Range
ty value)
OBX-8
Abnormal Flags
OBX-11
applied n/a applied ignored n/a
Observation Result Status
identifier sup-
OBX-14 Take OBR-7 value as
applied apply OBR-7 value plied, but no
Date/Time of Observation identifier
update
OBX-16 “HL7” applied “HL7” applied
applied applied
Observation Identifier as display name as display name
update value
NTE-3
applied Ignore update (apply emp- no update
Comment (note)
ty value
1. Ignore entire result (identifier)
5.9.17.1 Field Description

OBX-2: Value type. The following types are supported:
– ST (String)
– TX (Text)
– NM (Numeric)
– SN (Structured Numeric). These are stored without content evaluation. The single components
are concatenated, separated by a single space character.
– FT (Formatted Text)
– CE (Coded Element)
– CWE (Coded Element with Exception)
– CNE (Coded Element with No Exception)

Other Value Types are not supported by IntelliSpace Perinatal. OBX segments having an unsupported
Value Type are considered invalid.
OBX-5: Value conversion. See OBX-2 for accepted types.The value of the OBX-5 observation result is
converted to a string, truncated at 32,000 characters if necessary.
OBX-6: Unit conversion. OBX-6 CE.2 (Label) is converted to a string without any interpretation. If
OBX-6 CE.2 (Label) is empty, CE.1 (Code) of the same field is copied to CD2. There is a length
limitation of 250 characters.
OBX-7: Range conversion. The range string is used direction from the OBX-7 field, if available. There
is a length limitation of 60 characters.
OBX-8: Abnormal Flag Mapping: If the OBX-8 field is <empty> or “N” this is not considered
abnormal and it appears normally in IntelliSpace Perinatal. <all others> are considered abnormal and
highlighted in IntelliSpace Perinatal.
OBX-11: State determination/transition. The OBR-25 (Result Status) contains the status for the entire
test battery (a test battery contains multiple results for a test category). Each individual result has its
own status indicator which is sent in the mandatory OBX-11 field. The result status of OBX-11
overrides the test battery status in the OBR-25 field. The result status for OBR-25 is, consequently,
not processed by IntelliSpace Perinatal.
Possible states for OBX-11 are contained in the HL7 standard. IntelliSpace Perinatal recognizes them,
converting them to either:
– P: Preliminary result
– F: Final result
– D: Deleted result
OBX-11 Status ID Action on Preliminary (P) Observation Item
P, R, S Update value but keep preliminary status
C, F
U - when value not available set state Update value and change state to final
to final only
D, W Delete lab result
I, N, O, X Do not change anything
OBX-11 Status ID Action on Final (F) Observation Item

C (change), F Update value
D, W Delete lab result
I, N, O, P, R, S, U, X, others not list-
Do not change anything
ed above
OBX-14: Date/Time of the Observation. If this is not available, the observation time stamp is taken
from OBR-7. If neither OBR-7 not OBX-14 are available, MSH-7 (Date/Time of message) is used. If
MSH-7 is unavailable, the current time of the IntelliSpace Perinatal computer is used.
– OBX-3 / CE.1 and 3 (Observation Identifier)
– OBR-4 / CE.1 and 3 (Universal Service Identifier)
A maximum of 1000 mappings, including auto mappings can be created.
Limit for Lab results in Forms:

– no implicit import limit

– a system message is displayed if a patient has more than 2000 lab results, but imports still
proceed.
Limit for Lab results in flow chart:
– total number (cumulative sum) of flow chart notes of categories Alarm, Assessment, Vag. Exam,
and LAB: 30000 per episode
OBX-16: Responsible Observer. This is used to identify the user who entered the observation and will
be applied to the note added in IntelliSpace Perinatal according to the following table:
OBX-16 (Observation Identifier) User found Action

in System
OBX-16.1 OBX-16.2
Yes2 ISP user information is applied to observation
1
value supplied non-empty Account Name: OBX-16.1
No
Display Name: HL7: OBX-16.2
1
value supplied empty Account Name: empty
No
empty value supplied Account Name: empty
No
Account Name: empty
empty empty No
Display Name: HL7
1. For lookup: OBX-16.1 is used as account and display name
2. If the found user has credentials, they are applied as configured in the system
NTE - comments:
If these are at an OBX level, they apply to individual lab tests; if at an OBR level, they apply to all
OBX. Multiple NTEs are concatenated. The content of the NTE segments is used to fill the
"Comment" field of a Lab result in IntelliSpace Perinatal. This field is filled for all types of Lab results
(both for flow chart notes and IntelliSpace Perinatal Forms entries). The maximum length of the
concatenated strings are 2000 characters and are truncated.

5.9.18 Query/Report for Results of Observation

QRD attributes:
Element
ITEM/#
TBL/#
Name
RP/#
OPT
QRY
LEN
SEQ
TVS
DT
In
1 26 TS R 00025 Query Date/Time
2 1 ID R 103 00026 Query Format Code R
3 1 ID R 091 00027 Query Priority
4 10 ST R 00028 Query ID R
5 1 ID O 0107 00029 Deferred Response Type
6 26 TS O 00030 Deferred Response Date/Time
7 10 CQ R 126 00031 Quantity Limited Request
8 60 XCN R Y 00032 Who Subject Filter R
8.1 ST R ID Number R
8.13 ID O Identifier Type Code Y
9 60 CE R Y 48 00033 What Subject Filter
10 60 CE R Y 00034 What Department Data Code
11 20 VR O Y 00035 What Data Code Value Qual.
12 1 ID O 0108 00036 Query Results Level
QRF attributes:
Element
ITEM/#
TBL/#
Name
RP/#
OPT
QRY
LEN
SEQ
TVS
DT
In
1 20 ST R Y 00037 Where Subject Filter
2 26 TS B 00038 When Data Start Date/Time Y
3 26 TS B 00039 When Data End Date/Time Y
4 60 ST O Y 00040 What User Qualifier
5 60 ST O Y 00041 Other QRY Subject Filter
6 12 ID O Y 0156 00042 Which Date/Time Qualifier
7 12 ID O Y 0157 00043 Which Date/Time Status Qualifier
8 12 ID O Y 0158 00044 Date/Time Selection Qualifier
QAK attributes:
Element
ITEM/#
TBL/#
Name
RP/#
OPT
QRY
LEN
SEQ
TVS
Out
DT
1 32 ST C 00696 Query Tag Y

2 2 ID O 0208 00708 Query Response Status Y
3 250 CE O 0471 01375 Message Query Name
4 10 NM O 01434 Hit Count
5 10 NM O 01622 This payload
8 10 NM O 01623 Hits remaining

5.9.19 MSA - Message Acknowledgement Segment
MSA Message Acknowledgement Segment
Comment
Element
ITEM
TBL#
Name
RP/#
OPT
LEN
SEQ
TVS
DT
Acknowledgement
1 2 ID R 0008 00018 R
Code
2 20 ST R 00010 Message Control ID R
3 80 ST O 00020 Text Message Y Error message text

Example Messages 5 HL7 Interface
5.10 Example Messages

5.10.1 ADT inbound
5.10.1.1 Admission / Pre-Admission (A01, A04, A05)
Minimal:
MSH|^~\&|HIS|REC01|NHApp|NHFac|||ADTÂ01|ID00000001|P|2.4|||AL|AL|
EVN|A01|20140613083055|
PID|1||MRN_HIS1||HIS1^Pat1|
PV1|1|E|Unit 1^^B1.1
Full demographics:
MSH|^~\&|HIS|MTGH|RECAPP|RECFAC|201602030839||ADTÂ01|35205|D|2.4|||NE|AL
EVN|1
PID|1||123^^^^MR~E51201^^ÊPIC^MRN~546879654^^ÛSSSA^SS~NHSNumber123^^^
NHS^NH||Brown&&Maiden^Melissa^MI^^^^L~AliasNew^^^^^Â||19700201|F|AliasO
ld|W~A|Hannover Street 1^^New York^NYC^32112||123003-HOME|123003-
BUS|fr|S|JEW|ACCOUNT1|SSNalternative|||Hispanic or Latino|New Mexico
NK1|1|EmergencyLastÊmergencyFirstÊMI|||01234567
PV1|1|I|NUR^NUR^9|NB|||||||||||||||Visit231
IN1|1|1|1|CompanyName1|||||||||||||RelationToPatient1||||||||||||||||||||
|||||||||||InsurdsIDNumber1
IN1|2|1|1|CompanyName2|||||||||||||RelationToPatient2|||||||||||||||||||||

5 HL7 Interface Example Messages
5.10.1.2 Transfer (A02)
Transfer (Care Unit + Bed):
EVN|A02|19980102081000|
PV1|1|E|---^^BED05
Transfer (full patient location):
EVN|A01|20140623131502|
PV1|1|E|Unit 1^R1^Bed1^Fac 1^^^B1^F1||||||||||||||||008|
5.10.1.3 Discharge (A03)
EVN|A03|20140613092517|
PV1|1|E|
5.10.1.4 Change Outpatient / Inpatient (A06, A07)
MSH|^~\&|HIS|REC01|TRACEVUE|YAT|19980101121200||ADTÂ06|ID00000001|P|2.4||
|AL|AL|
EVN|A06|19980102081000|19980102081000|01||19980102
PID|1||MRN876||PatientLastName^PatientFirstName||19900505|F||||||||||
AccountNumberUnknown|
PV1|1|E
AL1|1|Type1|Code1ÂllergenCode1^99POB|MO|Reaction11~Reaction12|20091001|
AL1|2|Type2|Code2ÂllergenCode2^99POB|MO|Reaction21~Reaction22|20091002|
MSH|^~\&|HIS|REC01|TRACEVUE|YAT|19980101121200||ADTÂ07|ID00000001|P|2.4||
|AL|AL|
EVN|A07|19980102081000|19980102081000|01||19980102
PID|1||MRN876||PatientLastName^PatientFirstName||19900505|F||||||||||
AccountNumberPending|
PV1|1|E

5.10.1.5 Update patient information with allergies (A08)
MSH|^~\&|HIS|MTGH|RECAPP|RECFAC|201602030839||ADTÂ08|35205|D|2.4|||NE|AL
EVN|1
PID|1||123^^^^MR~E51201^^ÊPIC^MRN~546879654^^ÛSSSA^SS~NHSNumber123^^^NHS
^NH||Brown&&Maiden^Melissa^MI^^^^L~AliasNew^^^^^Â||19700201|F|AliasOld|
W~A|Hannover Street 1^^New York^NYC^32112||123003-HOME|123003-
BUS|fr|S|JEW|ACCOUNT1|SSNalternative|||Hispanic or Latino|New Mexico
NK1|1|EmergencyLastÊmergencyFirstÊMI|||01234567
PV1|1|I|NUR^NUR^9|NB|||||||||||||||Visit231
IN1|1|1|1|CompanyName|||||||||||||RelationToPatient1||||||||||||||||||||||
||||||||||InsurdsIDNumber1
AL1|1|Type1|SNOMED Code XXX^Citrus1^99POB1|MO1|Angioedema1|
AL1|2|Type2|SNOMED Code XXX^Citrus2^99POB2|MO2|Angioedema2|
5.10.1.6 Swap Patients (A17)

MSH|^~\&|HIS|REC01|APPLICATION|FACILITY|20200101000000||ADTÂ17|ID_adt17|P
|2.5|||AL|AL|
EVN|A17|20200101000000|
PID|1||W23^^^^MR||Doe^Jane|||F|
PV1|1|E|Antepartum^^Bed1|
PID|2||AB23C^^^^MR||Black^Kim|||F|
5.10.1.7 Merge a Patient (A18, A24, A40)

MSH|^~\&|HIS|REC01|TRACEVUE|YAT|20161206153304||ADTÂ18|ID04_3|P|2.5|||AL|
AL|
EVN|A18|20161206153304|20161206153304|01||19980102
PID|1||56AB||Doe^Jane
MRG|56Ab|
PV1|1|E|
AL|
EVN|A24|20161206153304|20161206153304|01||19980102
PID|1||56AB||Doe^Jane|||||||||||||AN34|
PID|1||56ab||Doe^Jane|||||||||||||AN unknown|
AL|
EVN|A40|20161206153304|20161206153304|01||19980102
PID|1||56AB||Doe^Jane
MRG|56Ab|
PV1|1|E|

5.10.1.8 Unlink a Patient (A37)

AL|
EVN|A37|20161206153304|20161206153304|01||19980102
PID|1||56AB||Doe^Jane|||||||||||||AN34|
PID|1||56ab||Doe^Jane|||||||||||||AN35|
5.10.1.9 Cancel Pre-Admit (A38)

MSH|^~\&|HIS|REC01|TRACEVUE|YAT|||ADTÂ38|ID00005|P|2.4|||AL|AL||||
EVN|A01|20161104113332||Philips|
PID|1||56789||Brown&&Maiden^Melissa^HIS>
PV1|1||EDMG^^^GMC1^^^^^^^DEPID|||||||Emergency||||||||||||||||||||||||||||
||||||||||||||
5.10.1.10 Change Patient Identification (A47)

MSH|^~\&|HIS|REC01|OBTraceVue|FACILITY1|20070612152800||ADTÂ47|ID00000001
|P|2.3.1|00001|00001|AL|AL|USA|ASCII||ISO 2022-1994
EVN|A47|20070612152800
PID|1||MRN34^^^^MR~1234-56-789^^^^SS||Brown^Melissa||19701224|||||||
|German|||
MRG|MRN34^^^^MR~0123-45-678^^^^SS||
5.10.1.11 Change Account Number (A48)

MSH|^~\&|HIS|REC01|OBTraceVue|FACILITY1|20070612152800||ADTÂ48|ID00000001
|P|2.3.1|00001|00001|AL|AL|USA|ASCII||ISO 2022-1994
EVN|A48|20070612152800
PID|1||MRN34^^^^MR||Brown^Melissa||19701224|
MRG|Mrn34^^^^MR|
5.10.1.12 Change Visit Number (A50)

MSH|^~\&|HIS|REC01|APPLICATION|FACILITY|19980101121200||ADTÂ50|ID00000001
|P|2.3.1|||AL|AL|
EVN|A50|19980102081000|19980102081000|01||19980102
PID|1||ID_02||PATNAMELAST_02^PATNAMEFIRST||19700201|F|||||||||||||||||1|
MRG|ID_02||||VisitPending
PV1|1|E|||||||||||||||||Visit123|

5.10.1.13 Update Adverse Reaction (A60)

MSH|^~\&|HIS|REC01|APPLICATION|FACILITY|19980101121200||ADTÂ60|ID00000001
|P|2.4|||AL|AL|
EVN|A60|19980102081000|19980102081000|01||19980102
PID|1||PatMRN_03||Doe^Jane
PV1|1|E
IAM|1|Type1|Code1ÂllergenCode1^99POB|MO|Reaction11~Reaction12|U||||||
|20100105|
5.10.2 Observation Inbound
5.10.2.1 Incoming ORU (R01)

Configured custom charting elements:
• Code: "2.228", Name: "BP", Coding system "EICUFDC"
• Code: "2.265", Name: " Temp ", Coding system "EICUFDC"
• Code: "2. 212", Name: "Pulse", Coding system "EICUFDC"
• Code: "2. 253", Name: "Resp", Coding system "EICUFDC"
MSH|^~\&|||||20140521133128|EDTECH|ORU^R01|1245|T|2.3|
EVN|R01|20140521133128|||Model UserÊMERGENCY^TECHNICIAN^^^^^ÔHSA^^^^^GMC1
PID|1||E51201^^ÊPIC^MRN~546879654^^ÛSSSA^SS||TECH^NEGTEST||19700604|M||
PV1|1||EDMG^^^GMC1^^^^^^^DEPID|||||||Emergency|||||||||6100069836||||||||
OBR|1||Filler1|T10^Vital SignsÊICUFDC|||20140521133100|
OBX|1|ST|2.228^BPÊICUFDC||140/60||||||F|||20140521133100||Model User
OBX|2|NM|2.265^TempÊICUFDC||37.2|C|||||F|||20140521133100||Model User
OBX|3|NM|2.212^PulseÊICUFDC||60||||||F|||20140521133100||Model User
OBX|4|NM|2.253^RespÊICUFDC||15||||||F|||20140521133100||Model User

5.10.2.2 Incoming Labs (R01)
Minimal example
MSH|^~\&|HIS|REC01|HL7App|HL7Fac|||ORU^R01|ID00000001|P|2.3.1|||AL|AL|
OBR|1||28040|ALBU_22^^|||20130109151754||||||||||||||||||P|
OBX|1|ST|ALBU_2^^||116|mg/dl|||||P|||20130109151754|
Blood test for patient "M002"

MSH|^~\&|HIS|REC01|OBTV1|F1|||ORU^R01|ID00000001|P|2.5|||AL|AL|
PID|1||M102^^^^MR||LabPat2|
OBR|1||28042|lab-El^^Snomed|||20080507145522||||||||||||||||||P|
OBX|1|ST|lab-Bil^^Snomed||150|mg/dl|||||P|||20080507145522|
NTE|||device broke down; could only test Bilirubin|
Electrolyte tests for patient "M001", with preliminary results

MSH|^~\&|HIS|REC01|OBTV1|F1|||ORU^R01|ID00000001|P|2.3.1|||AL|AL|
PID|1||P005^^^^MR||AMTestpatientÂM|
OBR|1||28042|004^lab-El^Snomed|||20080912132522||||||||||||||||||P|
OBX|1|ST|123^lab-Ca^Snomed||150|mg/dl|||||P|||20081002102522|
OBX|1|ST|456^lab-Na^Snomed||150|mg/dl|||||P|||20081002102522|
OBX|1|ST|^lab-Ka^Snomed||150|mg/dl|||||P|||20081002102522|
OBX|1|ST|^lab-Mg^Snomed||150|mg/dl|||||P|||20081002102522|
OBX|1|ST|^lab-Pt^Snomed||150|mg/dl|||||P|||20081002102522|
NTE|||device not yet calibrated|
Remember:
In the above messages, the first sub-component is a code. The second sub-component is a label. If both
are received, IntelliSpace Perinatal drops the label for storage and display, but uses the components to
check the mapping. If no code is received, the label is used for mapping, display, and storage.

5.10.3 ADT Outbound
5.10.3.1 Create / Admission (A01)

MSH|^~\&|||||20161207090141||ADTÂ01ÂDT_A01|C120709014192611b928|T|2.5|||
AL|AL
EVN|A01|20161207090139
PID|||MRN3892^^^^MR~280-50-7124^^^^SS~NHS37847^^^^NH||Brown&&Yellow^
Melissa^JJ^^^^L||19800605|F||||||||||Enc2321|280-50-7124
PV1||B|Unit 1^^B1.9|||---|||||||||||||||||||||||||||||||||||||||||||
|b58226d2-a530-4179-856d-2d5822ee7d15^^ÔBTVÊID
5.10.3.2 Transfer (A02)

MSH|^~\&|||||20161207090221||ADTÂ02ÂDT_A02|C1207090221884f5912a|T|2.5|||
AL|AL
EVN|A02|20161207090213
Melissa^JJ^^^^L||19800605|F||||||||||Enc2321
PV1||B|Unit 2^R2^B2.2^Fac2^^^B1^F1|||Unit1^^B1.9|||||||||||||||||||||||
|||||||||||||||||||||b58226d2-a530-4179-856d-2d5822ee7d15^^ÔBTVÊID
5.10.3.3 Close / Discharge (A03)

MSH|^~\&|||||20161207090301||ADTÂ03ÂDT_A03|C1207090301890f31b20|T|2.5|||
AL|AL
EVN|A03|20161207090300
Melissa^JJ^^^^L||19800605|F||||||||||Enc2321
PV1||B|Unit 2^^HOME^Fac 2|||Unit 2^R2^B2.2^Fac 2^^^B1^F1|||||||||||||
|||||||||||||||||||||||||||||||b58226d2-a530-4179-856d-
2d5822ee7d15^^ÔBTVÊID

5.10.4 Observation Outbound
5.10.4.1 Query for results of observation (R02, R04)
Not configured HL7 batch protocol:
Query
MSH|^~`&|APP|FAC|AppName|FacName|20160201150344||QRY^R02|CCUALPHA11140201|
P|2.3|
QRD|20160201150344|R|I|01||||PATID|RES
QRF|MON|20160215113000|20160215144500
Response
MSH|^~\&|AppName|FacName|APP|FAC|20160224134138||ORF^R04ÔRF_R04|C02241341
38923f516c3|T|2.5|||NE|NE
MSA|AA|CCUALPHA11140201|Message accepted.
QRD|20160201150344|R|I|01||||PATID123|RES
QRF|MON|20160215113000|20160215144500
PID|||PATID123^^^^MR~987-61-4321^^^^SS||PatNameLast^PatNameFirst|||F
NTE|1
OBR|1||2ÔBTV|NTE108^Contraction Frequency^99POB|||20160215113334
||||||||||||||||||F
OBX|1|NM|NTE108-1^Frequency^99POB||0|/(10.Min)^ÎSO|||||F|||
20160215113334||Dr. Woo
OBX|2|NM|NTE108-2^ChartingInterval^99POB||3|Min^ÎSO|||||
F|||20160215113334||Dr. Woo
OBR|2||591ÔBTV|NTE215^Maternal Blood Pressure^99POB|||20160215143920|
|||||||||||||||||F
OBX|1|NM|NTE215-1^Systolic^99POB||115|mm(hg)^ÎSO|||||F|||
20160215143920||Dr. Woo
OBX|2|NM|NTE215-2^Diastolic^99POB||77|mm(hg)^ÎSO|||||F||
|20160215143920||Dr. Woo
OBX|3|NM|NTE215-3^Mean^99POB||90|mm(hg)^ÎSO|||||F|||20160215143920|
|Dr. Woo
OBX|4|ST|NTE215-4^Source^99POB||Right upper arm||||||F|||20160215143920|
|Dr. Woo
QAK|CCUALPHA11140201|OK

Configured HL7 batch protocol:
Query
MSH|^~`&|APP|FAC|AppName|FacName|20160201150344||QRY^R02|CCUALPHA11140201|
P|2.3|
QRD|20160201150344|R|I|01||||PATID123|RES
QRF|MON|20160215113000|20160215144500
Response
MSH|^~\&|AppName|FacName|APP|FAC|20160225074946||ORF^R04ÔRF_R04
|C022507494665867cd5|T|2.5|||NE|NE
MSA|AA|CCUALPHA11140201|Message accepted.
QRD|20160201150344|R|I|01||||PATID123|RES
QRF|MON|20160215113000|20160215144500
NTE|1||//share/temp/OBTV_PATID123_0_20160225074946.txt
QAK|CCUALPHA11140201|OK
File
FHS|^~\&|AppName|FacName|APP|FAC|20160225074946||//share/temp/
OBTV_PATID123_0_20160225074946.txt
BHS|^~\&|AppName|FacName|APP|FAC|20160225074946||//share/temp/
OBTV_PATID123_0_20160225074946.txt
MSH|^~\&|AppName|FacName|||20160225074946||ORU^R01ÔRU_R01|C0225074946365a
59838|T|2.5|||AL|AL
PV1||B|^^---|
OBR|1||2ÔBTV|NTE108^Contraction Frequency^99POB|||20160215113334
||||||||||||||||||F
OBX|1|NM|NTE108-1^Frequency^99POB||0|/(10.Min)^ÎSO|||||F|||
20160215113334||Dr. Woo
OBX|2|NM|NTE108-2^ChartingInterval^99POB||3|Min^ÎSO|||||F|||
20160215113334||Dr. Woo
OBR|2||591ÔBTV|NTE215^Maternal Blood Pressure^99POB|||20160215143920||||||
||||||||||||F
OBX|1|NM|NTE215-1^Systolic^99POB||115|mm(hg)^ÎSO|||||F|||
20160215143920||Dr. Woo
OBX|2|NM|NTE215-2^Diastolic^99POB||77|mm(hg)^ÎSO|||||F|||
20160215143920||Dr. Woo
OBX|3|NM|NTE215-3^Mean^99POB||90|mm(hg)^ÎSO|||||F|||20160215143920||
Dr. Woo
OBX|4|ST|NTE215-4^Source^99POB||Right upper arm||||||F|||20160215143920||
Dr. Woo
BTS|1
FTS|1

5.10.4.2 Unsolicited Observations (R01)
Vital signs (Create/Change/Delete):

Create (SpO2 99; BP 120/80; RR 44)
MSH|^~\&|||||20161207145041||ORU^R01ÔRU_R01|C1207145041700e9e48b|T|2.5|||
AL|AL
PID|||YATADTPERFE9^^^^MR~SSNE9^^^^SS||Brown^Melissa^^^^^L||19800101|F
PV1||B|---^^BED04||||||||||||||||E9|||||||||||||||||||||||||||||||
8effc3ec-4908-42ad-9233-f9761c65d471^^ÔBTVÊID
OBR|1|8effc3ec-4908-42ad-9233-f9761c65d471.2^ÊUI-64-OBTVÊUI-64|8effc3ec-
4908-42ad-9233-f9761c65d471.2|NTE217^Maternal
SpO2^99POB|||20161207145029||||||||||||||||||F
OBX|1|NM|NTE217-1^SpO2^99POB||99|%^ÎSO|||||F|||20161207145029||Hombeuel,
Nils AR
OBX|2|ST|NTE217-2^Source^99POB||||||||F|||20161207145029||Hombeuel, Nils AR
OBR|2|8effc3ec-4908-42ad-9233-f9761c65d471.93^ÊUI-64-OBTVÊUI-
64|8effc3ec-4908-42ad-9233-f9761c65d471.93|NTE215^Maternal Blood
Pressure^99POB|||20161207145043||||||||||||||||||F
OBX|1|NM|NTE215-1^Systolic^99POB||120|mm(hg)^ÎSO|||||F
|||20161207145043||Hombeuel, Nils AR
OBX|2|NM|NTE215-2^Diastolic^99POB||80|mm(hg)^ÎSO|||||F
|||20161207145043||Hombeuel, Nils AR
OBX|3|NM|NTE215-
3^Mean^99POB|||mm(hg)^ÎSO|||||F|||20161207145043||Hombeuel, Nils AR
64|8effc3ec-4908-42ad-9233-f9761c65d471.189|NTE081^Maternal
Respiration^99POB|||20161207145050||||||||||||||||||F
OBX|1|NM|NTE081-1^RespirationRate^99POB||44|/
Min^ÎSO|||||F|||20161207145050||Hombeuel, Nils AR

Change (BP 120/80 ' 127/79; RR 44'38)

MSH|^~\&|||||20161207145111||ORU^R01ÔRU_R01|C1207145111702299d1c|T|2.5|||
AL|AL
PV1||B|---^^BED04||||||||||||||||E9|||||||||||||||||||||||||||||||
Respiration^99POB|||20161207145050||||||||||||||||||X
OBX|1|NM|NTE081-1^RespirationRate^99POB||||||||D|||20161207145050|
|Hombeuel, Nils AR
Respiration^99POB|||20161207145050||||||||||||||||||F
OBX|1|NM|NTE081-1^RespirationRate^99POB||38|/
Pressure^99POB|||20161207145043||||||||||||||||||X
OBX|1|NM|NTE215-1^Systolic^99POB||||||||D|||20161207145043||
Hombeuel, Nils AR
OBX|2|NM|NTE215-2^Diastolic^99POB||||||||D|||20161207145043||
Hombeuel, Nils AR
OBX|3|NM|NTE215-3^Mean^99POB||||||||D|||20161207145043||Hombeuel, Nils AR
OBX|4|ST|NTE215-4^Source^99POB||||||||D|||20161207145043||Hombeuel, Nils AR
Pressure^99POB|||20161207145043||||||||||||||||||F
OBX|1|NM|NTE215-1^Systolic^99POB||127|mm(hg)^ÎSO|||||F|||20161207145043||
Hombeuel, Nils AR
OBX|2|NM|NTE215-2^Diastolic^99POB||79|mm(hg)^ÎSO|||||F|||20161207145043||
Hombeuel, Nils AR
OBX|3|NM|NTE215-3^Mean^99POB|||mm(hg)^ÎSO|||||F|||20161207145043||
Hombeuel, Nils AR

Delete (SpO2 99; BP 127/79)

MSH|^~\&|||||20161207145141||ORU^R01ÔRU_R01|C1207145141695f49cd5|T|2.5|||
AL|AL
PV1||B|---^^BED04||||||||||||||||E9|||||||||||||||||||||||||||||||
Pressure^99POB|||20161207145043||||||||||||||||||X
OBX|1|NM|NTE215-1^Systolic^99POB||||||||D|||20161207145043||
Hombeuel, Nils AR
OBX|2|NM|NTE215-2^Diastolic^99POB||||||||D|||20161207145043||
Hombeuel, Nils AR
OBX|3|NM|NTE215-3^Mean^99POB||||||||D|||20161207145043||Hombeuel, Nils AR
OBR|2|8effc3ec-4908-42ad-9233-f9761c65d471.2^ÊUI-64-OBTVÊUI-64|8effc3ec-
4908-42ad-9233-f9761c65d471.2|NTE217^Maternal
SpO2^99POB|||20161207145029||||||||||||||||||X
OBX|1|NM|NTE217-1^SpO2^99POB||||||||D|||20161207145029||Hombeuel, Nils AR
Transfer and remarks:

The following example shows a cumulative message which includes:
1 system note for transfer from home to bed04
2 system note for transfer from bed04 to bed08
3 flowchart note 'remark' with value 'remark note test'
4 flowchart note 'contraction' with values '55' and charting interval '12 min'
5 flowchart note 'contraction' with values '66' and charting interval '12 min

MSH|^~\&|OBTV1â01-pc^DNS|F1|||20051129131223||ORU^R01|
C11291312229513fb725|P|2.5|||NE|AL
PID|||M001^^^^MR~M001^^^^SS~M001^^^^PT~ded12757-3b47-4034-926e-
75d5f665b127^^^^PI||Merlot^Marie^M||19710101000000
PV1||B|bed08|||||||||||||||||||||||||||||||||||||||||||||||
bdb7a11c-77f5-47af-ae78-45a4c333d613^^ÔBTVÊID
OBR|1||-1ÔBTV|NTE100^System:
Transfer^99POB|||20051129125530||||||||||||||||||
OBX|1|ST|NTE100-1^SrcLocation^99POB||HOME||||||F|||20051129125530|
|Dr.Daniel DeSoto^Dr.Daniel DeSoto
OBX|2|ST|NTE100-2^DestLocation^99POB||bed04||||||F|||20051129125530|
|Dr.Daniel DeSoto^Dr.Daniel DeSoto
OBX|3|ST|NTE100-3^Reason^99POB||||||||F|||20051129125530||Dr.Daniel
DeSoto^Dr.Daniel DeSoto
OBX|4|ST|NTE100-4^TransferType^99POB||Patient admitted||||||F|||
20051129125530||Dr.Daniel DeSoto^Dr.Daniel DeSoto
OBR|2||-2ÔBTV|NTE100^System:
Transfer^99POB|||20051129125541||||||||||||||||||
OBX|1|ST|NTE100-1^SrcLocation^99POB||bed04||||||F|||
OBX|2|ST|NTE100-2^DestLocation^99POB||bed08||||||F|||
OBX|3|ST|NTE100-3^Reason^99POB||||||||F|||
OBX|4|ST|NTE100-4^TransferType^99POB||Patient transferred.||||||F|||
OBR|3||2ÔBTV|NTE047^Remark^99POB|||20051129125642||||||||||||||||||
OBX|1|ST|NTE047-1^Remark^99POB||Remarks: remark note
test||||||F|||20051129125642||Dr.Daniel DeSoto^Dr.Daniel DeSoto
OBR|4||95ÔBTV|NTE044^Contraction^99POB|||20051129131204||||||||||||||||||
OBX|1|NM|NTE044-1^Contractions^99POB||55||||||F|||
OBR|5||166ÔBTV|NTE044^Contraction^99POB|||
20051129131212||||||||||||||||||
OBX|1|NM|NTE044-1^Contractions^99POB||66||||||F|||20051129131212||
Dr.Daniel DeSoto^Dr.Daniel DeSoto

Vag. examination:
The following example shows a cumulative message which includes four individual notes:
1 Flowchart note 'membranes' (only AmnioticFluidStatus has a data value, but associated
'AmnioticFluidQuantity') is also transmitted.
2 Flowchart note 'dilation'.
3 Flowchart note 'effacement'.
4 Flowchart note 'contraction'.
5 Flowchart note 'remark'.

MSH|^~\&|OBTV1â01-pc^DNS|F1|HIS1|H1|20051223130202||ORU^R01|
C1223130201828b16d1|P|2.5|||NE|AL
PID|||ADT01_2^^^^MR~ssn02^^^^SS~^^^^PT~dfaa261c-6eb7-41dc-84d7-
2b85044e94e0^^^^PI||Mercure^Marie||19760811000000
PV1||B|bed03|||||||||||||||||||||||||||||||||||||||||||||||11609e78-e607-
4fd9-bc0bbccb12d4a297^^ÔBTVÊID
OBR|1||-5ÔBTV|NTE106^Membranes^99POB|||20051223130023||||||||||||||||||
OBX|1|NM|NTE106-1^FetusIndex^99POB||||||||F|||20051223130023||
DeSoto^DeSoto
OBX|2|ST|NTE106-2^MembranesStatus^99POB||||||||F|||
20051223130023||DeSoto^DeSoto
OBX|3|ST|NTE106-3ÂmnioticFluidStatus^99POB||heavily
bloodstained||||||F|||20051223130023||DeSoto^DeSoto
OBX|4|ST|NTE106-4ÂmnioticFluidQuantity^99POB||||||||F|||20051223130023||
DeSoto^DeSoto
OBR|2||-6ÔBTV|NTE106^Membranes^99POB|||20051223130028||||||||||||||||||
OBX|1|NM|NTE106-1^FetusIndex^99POB||||||||F|||20051223130028||
DeSoto^DeSoto
OBX|2|ST|NTE106-2^MembranesStatus^99POB||Intact||||||F|||20051223130028||
DeSoto^DeSoto
OBX|3|ST|NTE106-3ÂmnioticFluidStatus^99POB||||||||F|||20051223130028||
DeSoto^DeSoto
OBX|4|ST|NTE106-4ÂmnioticFluidQuantity^99POB||||||||F|||20051223130028||
DeSoto^DeSoto
OBR|3||-2ÔBTV|NTE104^Dilation^99POB|||20051223130003||||||||||||||||||
OBX|1|NM|NTE104-1^Dilation^99POB||8||||||F|||20051223130003||DeSoto^DeSoto
OBR|4||-3ÔBTV|NTE105Êffacement^99POB|||20051223130003||||||||||||||||||
OBX|1|NM|NTE105-1Êffacement^99POB||80||||||F|||20051223130003||
DeSoto^DeSoto
OBR|5||2ÔBTV|NTE044^Contraction^99POB|||20051223125811||||||||||||||||||
OBX|1|NM|NTE044-1^Contractions^99POB||55||||||F|||20051223125811||
DeSoto^DeSoto
OBX|2|NM|NTE044-
2^ChartingInterval^99POB||13|Min^ÎSO|||||F|||20051223125811||
DeSoto^DeSoto
OBX|1|ST|NTE047-1^Remark^99POB||Remarks:
[jo||||||F|||20051223125838||DeSoto^DeSoto
OBX|1|ST|NTE047-1^Remark^99POB||Remarks:wwwwwwwwwwwwwwww||||||F|||
20051223130000||DeSoto^DeSoto

Fetal Monitor Data Un-validated (Auto-chart, preliminary):

MSH|^~\&|||||20160826110014||ORU^R01ÔRU_R01|C08261100143976419d5|T|2.5|||
AL|AL
PID|||as390e^^^^VN~YATADTPERFG5^^^^MR~SSNG5^^^^SS||Brown^Melissa^^^^^L||
19830524|F
PV1||B|---^^BED02||||||||||||||||G5|||||||||||||||||||||||||||||||
85ece1c7-528b-4264-a945-177a00aed2a0^^ÔBTVÊID
OBR|1|85ece1c7-528b-4264-a945-177a00aed2a0.1369^ÊUI-64-OBTVÊUI-
64|85ece1c7-528b-4264-a945-177a00aed2a0.1369|NTE295^Maternal Blood
Pressure (Auto-chart)^99POB|||20160826110000||||||||||||||||||P
OBX|1|NM|NTE295-1^Systolic^99POB||112|mm(hg)^ÎSO|||||P|||20160826110000
||||SIM-COM1
OBX|2|NM|NTE295-2^Diastolic^99POB||76|mm(hg)^ÎSO|||||P|||20160826110000
||||SIM-COM1
OBX|3|NM|NTE295-3^Mean^99POB||88|mm(hg)^ÎSO|||||P|||20160826110000
||||SIM-COM1
OBX|4|ST|NTE295-4^Source^99POB||||||||P|||20160826110000||||SIM-COM1
64|85ece1c7-528b-4264-a945-177a00aed2a0.1478|NTE296^Maternal Heart Rate
(Auto-chart)^99POB|||20160826110000||||||||||||||||||P
OBX|1|NM|NTE296-1^Rate^99POB||89|/Min^ÎSO|||||P|||20160826110000
||||SIM-COM1
OBX|2|ST|NTE296-2^Source^99POB||NBP||||||P|||20160826110000||||SIM-COM1
64|85ece1c7-528b-4264-a945-177a00aed2a0.1586|NTE297^Maternal SpO2 (Auto-
chart)^99POB|||20160826110000||||||||||||||||||P
OBX|1|NM|NTE297-1^SpO2^99POB||99|%^ÎSO|||||P|||20160826110000||||SIM-COM1
OBX|2|ST|NTE297-2^Source^99POB||||||||P|||20160826110000||||SIM-COM1
64|85ece1c7-528b-4264-a945-177a00aed2a0.1690|NTE298^Maternal Temperature
(Auto-chart)^99POB|||20160826110000||||||||||||||||||P
OBX|1|NM|NTE298-1^Temperature^99POB||36,9|Cel^ÎSO|||||P|||20160826110000
||||SIM-COM1
OBX|2|ST|NTE298-2^Source^99POB||iTtymp||||||P|||20160826110000||||SIM-COM1

Fetal Monitor Data validated maternal heart rate (delete preliminary, add final):
MSH|^~\&|||||20160826110414||ORU^R01ÔRU_R01|C0826110414419173f36|T|2.5|||
AL|AL
PID|||as390e^^^^VN~YATADTPERFG5^^^^MR~SSNG5^^^^SS||Brown^Melissa^^^^^L||
19830524|F
PV1||B|---^^BED02||||||||||||||||G5|||||||||||||||||||||||||||||||
85ece1c7-528b-4264-a945-177a00aed2a0^^ÔBTVÊID
64|85ece1c7-528b-4264-a945-177a00aed2a0.1478|NTE296^Maternal Heart Rate
(Auto-chart)^99POB|||20160826110000||||||||||||||||||X
OBX|1|NM|NTE296-1^Rate^99POB||||||||D|||20160826110000||Hombeuel, Nils AR
64|85ece1c7-528b-4264-a945-177a00aed2a0.1801|NTE216^Maternal Heart
Rate^99POB|||20160826110000||||||||||||||||||F
OBX|1|NM|NTE216-1^Rate^99POB||89|/
OBX|2|ST|NTE216-2^Source^99POB||NBP||||||F|||20160826110000||
Hombeuel, Nils AR
Fetus related observations - Observation identifier appendix:

Example Single fetus pregnancy
MSH|^~\&|App|Fac|||20161017133318+0200||ORU^R01ÔRU_R01|
C10171333180137f2ef|T|2.5|||AL|AL
PID|||A01_Test^^ÔBTV^MR~987-61-8888^^^NSSA^SS~PT_TEST^^^BRG^BC|
|LNameÂnabell^^^^^L~AAAA
PV1||B|Unit 2^R3^Bed05^^^^B2^F2||||||||||||||||TVisit^^ÂssAcc
|||||||||||||||||||||||||||
OBR|1|188286a0-4846-4113-af40-a650dcaac322.101ÂppÊUI-64-OBTVÊUI-
64|188286a0-4846-4113-
OBX|1|NM|NTE053-2.FX0^pH^99POB||7,00||||||F|||20161012133500+0200||XXX
Witt, Sebastian
Example 1st fetus

C10171333180137f2ef|T|2.5|||AL|AL
PID|||A01_Test^^ÔBTV^MR~987-61-8888^^^NSSA^SS~PT_TEST^^^BRG^BC||
LNameÂnabell^^^^^L~AAAA
|||||||||||||||||||||||||||
64|188286a0-4846-4113-
OBX|1|NM|NTE053-2.FX0^pH^99POB||7,00||||||F|||20161012133500+0200||XXX
Witt, Sebastian

Example 2nd fetus

C10171333180137f2ef|T|2.5|||AL|AL
|||||||||||||||||||||||||||
64|188286a0-4846-4113-
OBX|1|NM|NTE053-2.FX1^pH^99POB||7,00||||||F|||20161012133500+0200||
XXX Witt, Sebastian
Fetus related observations - Fetus index as separate OBX (configuration option):

C10171333180137f2ef|T|2.5|||AL|AL
|||||||||||||||||||||||||||
64|188286a0-4846-4113-
OBX|1|NM|NTE053-1^FetusIndex^99POB||0||||||F|||20161012133500+0200||XXX
Witt, Sebastian
OBX|2|NM|NTE053-2^pH^99POB||7,00||||||F|||20161012133500+0200||XXX
Witt, Sebastian

Assessment note categories (Code configured in VTE):

MSH|^~\&|SW1|SW1|||20150907174533||ORU^R01ÔRU_R01|C09071745336588b99c2|P|
2.5|||AL|AL
PID|||XXXXXY^^^^MR||XXXXXY^XXXXXY|||F
PV1||B|---^^BED04||||||||||||||||||||||||||
OBR|1||-9ÔBTV|NTE204^Psychosocial Assessment^99POB|||20150907174432
||||||||||||||||||F
OBX|1|ST|NTE204-1^Status^99POB||T||||||F|||20150907174432||Witt, Sebastian
OBX|2|ST|NTE204-2^Summary^99POB||(Reassessment: No changes, See below;
General Symptoms: Coping well with circumstances, Appropriate
interactions; Interventions: Questions answered, Supported to
grieve)||||||F|||20150907174328||Witt, Sebastian
OBX|3|ST|NTE204-3^Comment^99POB||Comment||||||F|||20150907174432||
Witt, Sebastian
OBX|4|ST|<Code FROM VTE>*^Reassessment^99POB||No changes~
See below||||||F|||20150907174432||Witt, Sebastian
OBX|5|ST|<Code FROM VTE>*^General Symptoms^99POB||Coping well with
circumstances~Appropriate interactions||||||F|||20150907174432||Witt,
Sebastian
OBX|6|ST|<Code FROM VTE>*^Bereavement^99POB||||||||F|||20150907174432||
Witt, Sebastian
OBX|7|ST|<Code FROM VTE>*Înterventions^99POB||Questions answered~
Supported to grieve||||||F|||20150907174432||Witt, Sebastian
All Alarm notes:

MSH|^~\&|||||20160909071515||ORU^R01ÔRU_R01|C09090715158713bd74|T|2.5||
|AL|AL
PID|||XSS482^^^^VN~YATADTPERFB9^^^^MR~SSNB9^^^^SS||Brown^Melissa^^^^^L||
19800101|F
PV1||B|---^^BED02||||||||||||||||B9|||||||||||||||||||||||||||||||
5ec7e245-02f1-4336-ab1b-83d63e2cac28^^ÔBTVÊID
OBR|31|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-31^ÊUI-64-OBTVÊUI-
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
31|NTE039Âlarm^99POB|||20160909070842||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||ALARM SETTINGS FOR PATIENT||||||F|||
20160909070842
OBX|2|ST|NTE039-2^Reason^99POB||FHR Alarm Mode: Basic Alarming (K.00.10)
Severe Tachycardia: 180 bpm for 300 sec Tachycardia: 160 bpm for 300
sec Bradycardia: 110 bpm for 240 sec Severe Bradycardia: 100 bpm for

120 sec Signal Loss: 25 % within 5 min Alarm Reactivation: after 10

min NST On No NBP Alarming||||||F|||20160909070842
OBX|3|NM|NTE039-3^DiagnosisLevel^99POB||0||||||F|||20160909070842
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
32|NTE039Âlarm^99POB|||20160909070839||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: BASELINE
UNKNOWN||||||F|||20160909070839
OBX|2|ST|NTE039-2^Reason^99POB||Unable to determine baseline FHR because of
increased FHR variability.||||||F|||20160909070839
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
33|NTE039Âlarm^99POB|||20160909070849||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: BASELINE
SHIFT||||||F|||20160909070849
OBX|2|ST|NTE039-2^Reason^99POB||Change in baseline
FHR.||||||F|||20160909070849
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
34|NTE039Âlarm^99POB|||20160909070859||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: LOW
VARIABILITY||||||F|||20160909070859
OBX|2|ST|NTE039-2^Reason^99POB||Absent FHR variability for 10
minutes.||||||F|||20160909070859
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
35|NTE039Âlarm^99POB|||20160909070909||||||||||||||||||F
VARIABILITY||||||F|||20160909070909
OBX|2|ST|NTE039-2^Reason^99POB||Absent FHR variability for 20
minutes.||||||F|||20160909070909
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
36|NTE039Âlarm^99POB|||20160909070919||||||||||||||||||F
VARIABILITY||||||F|||20160909070919
OBX|2|ST|NTE039-2^Reason^99POB||Minimal FHR variability for 30
minutes.||||||F|||20160909070919
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
37|NTE039Âlarm^99POB|||20160909070929||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: TACHYCARDIA WITH NO

VARIABILITY||||||F|||20160909070929
OBX|2|ST|NTE039-2^Reason^99POB||Tachycardia with absent variability for 10
minutes.||||||F|||20160909070929
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
38|NTE039Âlarm^99POB|||20160909070930||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: HIGH FHR WITH NO
VARIABILITY||||||F|||20160909070930
OBX|2|ST|NTE039-2^Reason^99POB||High fetal heart rate with absent
variability for 10 minutes.||||||F|||20160909070930
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
39|NTE039Âlarm^99POB|||20160909070939||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: PROLONGED
DECELERATION||||||F|||20160909070939
OBX|2|ST|NTE039-2^Reason^99POB||Prolonged deceleration
detected.||||||F|||20160909070939
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
40|NTE039Âlarm^99POB|||20160909070949||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: RECURRENT VARIABLE
DECELERATIONS||||||F|||20160909070949
OBX|2|ST|NTE039-2^Reason^99POB||Most contractions are associated with
variable decelerations.||||||F|||20160909070949
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
41|NTE039Âlarm^99POB|||20160909070959||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: RECURRENT VARIABLE
DECELERATIONS||||||F|||20160909070959
OBX|2|ST|NTE039-2^Reason^99POB||Most contractions are associated with
variable decelerations during a period of minimal
variability.||||||F|||20160909070959
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
42|NTE039Âlarm^99POB|||20160909071009||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: DECELERATIONS||||||F|||20160909071009
OBX|2|ST|NTE039-2^Reason^99POB||Detected 2 decelerations within 10
minutes.||||||F|||20160909071009
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
43|NTE039Âlarm^99POB|||20160909071019||||||||||||||||||F

OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: DECELERATIONS||||||F|||20160909071019

OBX|2|ST|NTE039-2^Reason^99POB||Detected 2 decelerations within 10 minutes
during a period of minimal variability.||||||F|||20160909071019
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
44|NTE039Âlarm^99POB|||20160909071029||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: LATE
DECELERATIONS||||||F|||20160909071029
OBX|2|ST|NTE039-2^Reason^99POB||Detected 3 late decelerations within 20
minutes.||||||F|||20160909071029
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
45|NTE039Âlarm^99POB|||20160909071039||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: LATE
DECELERATIONS||||||F|||20160909071039
OBX|2|ST|NTE039-2^Reason^99POB||Detected 3 late decelerations within 20
minutes during a period of minimal variability.||||||F|||20160909071039
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
46|NTE039Âlarm^99POB|||20160909071049||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: TACHYCARDIA WITH
DECELERATIONS||||||F|||20160909071049
OBX|2|ST|NTE039-2^Reason^99POB||Tachycardia with decelerations for 10
minutes.||||||F|||20160909071049
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
47|NTE039Âlarm^99POB|||20160909071050||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: HIGH FHR WITH
DECELERATIONS||||||F|||20160909071050
OBX|2|ST|NTE039-2^Reason^99POB||High fetal heart rate with decelerations
for 10 minutes.||||||F|||20160909071050
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
48|NTE039Âlarm^99POB|||20160909071059||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: LOW VARIABILITY WITH
DECELERATIONS||||||F|||20160909071059
OBX|2|ST|NTE039-2^Reason^99POB||Undetectable variability with decelerations
for 10 minutes.||||||F|||20160909071059
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
49|NTE039Âlarm^99POB|||20160909071109||||||||||||||||||F

OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: NO
ACCELERATIONS||||||F|||20160909071109
OBX|2|ST|NTE039-2^Reason^99POB||No accelerations detected within 40
minutes.||||||F|||20160909071109
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
50|NTE039Âlarm^99POB|||20160909071119||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: DECELERATIONS||||||F|||
20160909071119
OBX|2|ST|NTE039-2^Reason^99POB||Deceleration
detected.||||||F|||20160909071119
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
51|NTE039Âlarm^99POB|||20160909071129||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: SINUSOIDAL
PATTERN||||||F|||20160909071129
OBX|2|ST|NTE039-2^Reason^99POB||Sinusoidal pattern
detected.||||||F|||20160909071129
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
52|NTE039Âlarm^99POB|||20160909071139||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: SINUSOIDAL
PATTERN||||||F|||20160909071139
OBX|2|ST|NTE039-2^Reason^99POB||Sinusoidal pattern
detected.||||||F|||20160909071139
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
53|NTE039Âlarm^99POB|||20160909071149||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: TACHYSYSTOLE||||||F|||20160909071149
OBX|2|ST|NTE039-2^Reason^99POB||Detected more than 5 contractions within 10
minutes without associated decelerations averaged over 30
minutes.||||||F|||20160909071149
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
54|NTE039Âlarm^99POB|||20160909071159||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: TACHYSYSTOLE WITH
DECELERATIONS||||||F|||20160909071159
OBX|2|ST|NTE039-2^Reason^99POB||Detected more than 5 contractions within 10
minutes with associated decelerations averaged over 30
minutes.||||||F|||20160909071159

64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
55|NTE039Âlarm^99POB|||20160909071209||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: SIGNAL LOSS||||||F|||20160909071209
OBX|2|ST|NTE039-2^Reason^99POB||Bad FHR signal. Please adjust FHR
sensor.||||||F|||20160909071209
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
56|NTE039Âlarm^99POB|||20160909071219||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||** FHR1: SIGNAL LOSS||||||F|||20160909071219
OBX|2|ST|NTE039-2^Reason^99POB||Critical FHR. Please check patient and FHR
sensor.||||||F|||20160909071219
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
57|NTE039Âlarm^99POB|||20160909071229||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: TACHYCARDIA||||||F|||20160909071229
OBX|2|ST|NTE039-2^Reason^99POB||Tachycardia
detected.||||||F|||20160909071229
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
58|NTE039Âlarm^99POB|||20160909071239||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||** FHR1: TACHYCARDIA||||||F|||20160909071239
OBX|2|ST|NTE039-2^Reason^99POB||Severe tachycardia
detected.||||||F|||20160909071239
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
59|NTE039Âlarm^99POB|||20160909071249||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: BRADYCARDIA||||||F|||20160909071249
OBX|2|ST|NTE039-2^Reason^99POB||Bradycardia
detected.||||||F|||20160909071249
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
60|NTE039Âlarm^99POB|||20160909071259||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||** FHR1: BRADYCARDIA||||||F|||20160909071259
OBX|2|ST|NTE039-2^Reason^99POB||Severe bradycardia
detected.||||||F|||20160909071259
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
61|NTE039Âlarm^99POB|||20160909071309||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: HIGH FHR||||||F|||20160909071309
OBX|2|ST|NTE039-2^Reason^99POB||High fetal heart rate
detected.||||||F|||20160909071309

64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
62|NTE039Âlarm^99POB|||20160909071319||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||** FHR1: HIGH FHR||||||F|||20160909071319
OBX|2|ST|NTE039-2^Reason^99POB||Very high fetal heart rate
detected.||||||F|||20160909071319
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
63|NTE039Âlarm^99POB|||20160909071329||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* FHR1: LOW FHR||||||F|||20160909071329
OBX|2|ST|NTE039-2^Reason^99POB||Low fetal heart rate
detected.||||||F|||20160909071329
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
64|NTE039Âlarm^99POB|||20160909071339||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||** FHR1: LOW FHR||||||F|||20160909071339
OBX|2|ST|NTE039-2^Reason^99POB||Very low fetal heart rate
detected.||||||F|||20160909071339
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
65|NTE039Âlarm^99POB|||20160909071349||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* INCREASED IUP||||||F|||20160909071349
OBX|2|ST|NTE039-2^Reason^99POB||Increased intrauterine
pressure.||||||F|||20160909071349
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
66|NTE039Âlarm^99POB|||20160909071359||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* COINCIDENCE||||||F|||20160909071359
OBX|2|ST|NTE039-2^Reason^99POB||Coincidence detected by fetal monitor.
Please verify the source of the displayed fetal heart
rate.||||||F|||20160909071359
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
67|NTE039Âlarm^99POB|||20160909071409||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* PAPER END||||||F|||20160909071409
OBX|2|ST|NTE039-2^Reason^99POB||Paper end detected by fetal
monitor.||||||F|||20160909071409
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
69|NTE039Âlarm^99POB|||20160909071429||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP SYSTOLE HIGH||||||F|||20160909071429
OBX|2|ST|NTE039-2^Reason^99POB||NBP is above high alarm limit for systolic

pressure||||||F|||20160909071429
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
70|NTE039Âlarm^99POB|||20160909071439||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP SYSTOLE LOW||||||F|||20160909071439
OBX|2|ST|NTE039-2^Reason^99POB||NBP is below low alarm limit for systolic
pressure||||||F|||20160909071439
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
71|NTE039Âlarm^99POB|||20160909071449||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP DIASTOLE HIGH||||||F|||20160909071449
OBX|2|ST|NTE039-2^Reason^99POB||NBP is above high alarm limit for diastolic
pressure||||||F|||20160909071449
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
72|NTE039Âlarm^99POB|||20160909071459||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP DIASTOLE LOW||||||F|||20160909071459
OBX|2|ST|NTE039-2^Reason^99POB||NBP is below low alarm limit for diastolic
pressure||||||F|||20160909071459
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
73|NTE039Âlarm^99POB|||20160909071509||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP MEAN HIGH||||||F|||20160909071509
OBX|2|ST|NTE039-2^Reason^99POB||NBP is above high alarm limit for mean
pressure||||||F|||20160909071509
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
74|NTE039Âlarm^99POB|||20160909071519||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP MEAN LOW||||||F|||20160909071519
OBX|2|ST|NTE039-2^Reason^99POB||NBP is below low alarm limit for mean
pressure||||||F|||20160909071519
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
75|NTE039Âlarm^99POB|||20160909071529||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* NBP INOP||||||F|||20160909071529
OBX|2|ST|NTE039-2^Reason^99POB||NBP measurement failed or not
possible||||||F|||20160909071529
64|5ec7e245-02f1-4336-ab1b-83d63e2cac28.-
76|NTE039Âlarm^99POB|||20160909071539||||||||||||||||||F
OBX|1|ST|NTE039-1^Rule^99POB||* MISSING NBP

MEASUREMENT||||||F|||20160909071539
OBX|2|ST|NTE039-2^Reason^99POB||No NBP measurement result received from
fetal monitor within expected time frame.||||||F|||20160909071539
Medications:
The following example shows an outgoing message representing medication notes.
The notes type, represented in OBR, is "medication start".
The following notes data is represented in OBX:
• medication: Pitocin
• route: topical
• dose: 2mu/min
• rate: 27.27mu/min
• in.amount: 2200mu
• in.volume: 500cc
• patient weight is empty
Medication Start
MSH|^~\&|ISP1â01.rsdom.local^DNS|F1|HIS-A1|HISA2|20070727133554||ORU^R01|
C07271335544884036a2|P|2.5|||NE|AL
PID|||C0002^^^^MR~000-00-0002^^^^SS~C0002^^^^PT||Cohiba&&CC^Connie^C|
|19710101000000
PV1||B|bed01|||||||||||||||||||||||||||||||||||||||||||||||
ba07b22a-d978-45a3-bc4d-d5e0fdfffcb5^^ÔBTVÊID
OBR|1||133ÔBTV|NTE288^Medication Start^99POB|||20070727133200|
|||||||||||||||||F
OBX|1|ST|NTE288-1^Name^99POB||Pitocin||||||F|||20070727133200||
Rainer H. Schmidt^Rainer H. Schmidt
OBX|2|ST|NTE288-2^Route^99POB||topical||||||F|||20070727133200||
OBX|3|NM|NTE288-3^Dose^99POB||2|mu/min^^99POB|||||F|||20070727133200||
OBX|4|NM|NTE288-4^Rate^99POB||27.2727|cc/h^^99POB|||||F|||20070727133200||
OBX|5|NM|NTE288-5ÎnitialAmount^99POB||2200|mu^^99POB|||||F|||
20070727133200||Rainer H. Schmidt^Rainer H. Schmidt
OBX|6|NM|NTE288-6ÎnitialVolume^99POB||500|cc^^99POB|||||F|||
OBX|7|NM|NTE288-7^PatWeight^99POB||-1|kg^ÎSO|||||F|||20070727133200||
OBX|8|ST|NTE288-8^Code^99POB||||||||F|||20070727133200||

Medication Stop
MSH|^~\&|ISP1â01.rsdom.local^DNS|F1|HIS-A1|HIS-A2|20070727141554||
ORU^R01|C0727141554541f3e00|P|2.5|||NE|AL
PID|||C0002^^^^MR~000-00-0002^^^^SS~C0002^^^^PT||Cohiba&&CC^Connie^C|
|19710101000000
PV1||B|bed01|||||||||||||||||||||||||||||||||||||||||||||||
OBR|1||672ÔBTV|NTE086^Medication Stop^99POB|||20070727141326|
|||||||||||||||||F
OBX|1|NM|NTE086-1^PrevNoteHandle^99POB||133||||||F|||20070727141326||
OBX|2|ST|NTE086-2^Name^99POB||Pitocin||||||F|||20070727141326||
OBX|3|ST|NTE086-3^Route^99POB||topical||||||F|||20070727141326||

Medication Start and Stop

MSH|^~\&|OBTV1^cie.rsdom.local^DNS|F1|HIS-A1|HISA2|20070727142054|
|ORU^R01|C0727142054549e72894|P|2.5|||NE|AL
PID|||C0002^^^^MR~000-00-0002^^^^SS~C0002^^^^PT||
Cohiba&&CC^Connie^C||19710101000000
PV1||B|bed01|||||||||||||||||||||||||||||||||||||||||||||||
OBR|1||883ÔBTV|NTE288^Medication Start^99POB|||20070727141900|
|||||||||||||||||F
OBX|1|ST|NTE288-1^Name^99POB||AZT||||||F|||20070727141900||
OBX|2|ST|NTE288-2^Route^99POB||right eye||||||F|||20070727141900||
OBX|3|NM|NTE288-3^Dose^99POB||-1|mcg^^99POB|||||F|||20070727141900||
OBX|4|NM|NTE288-4^Rate^99POB||66|mL/min^^99POB|||||F|||20070727141900||
OBX|5|NM|NTE288-5ÎnitialAmount^99POB||77|mcg^^99POB|||||F|||
OBX|6|NM|NTE288-6ÎnitialVolume^99POB||88|mL^^99POB|||||F|||
OBX|7|NM|NTE288-7^PatWeight^99POB||-1|kg^ÎSO|||||F|||20070727141900||
OBX|8|ST|NTE288-8^Code^99POB||||||||F|||20070727141900||
OBR|2||1026ÔBTV|NTE086^Medication Stop^99POB|||20070727142020|
|||||||||||||||||F
OBX|1|NM|NTE086-1^PrevNoteHandle^99POB||883||||||F|||20070727142020||
OBX|2|ST|NTE086-2^Name^99POB||AZT||||||F|||20070727142020||
OBX|3|ST|NTE086-3^Route^99POB||right eye||||||F|||20070727142020||
Multi-selection notes as repeated values:

MSH|^~\&|SW1|SW1|||20150907174533||ORU^R01ÔRU_R01|C09071745336588b99c2|P|
2.5|||AL|AL
PID|||XXXXXY^^^^MR||XXXXXY^XXXXXY|||F
PV1||B|---^^BED04||||||||||||||||||||||||||
OBR|1||172ÔBTV|NTE158^Postpartum Lochia^99POB|||20161031170049|
|||||||||||||||||F\r
OBX|1|ST|NTE158-1Âmount^99POB||heavy with clots~pad count
initiated||||||F|||20161031170049||Philips\r
OBX|2|ST|NTE158-2^Type^99POB||||||||F|||20161031170049||Philips\r

5.10.5 MDM outbound

Note list (document map)
MSH|^~\&|OBTV1^delivery.hospital.com^DNS|F1|A1|F1|20110704144635||MDM^T01|
C070414463555229f0b9|P|2.5
EVN||20110704144635
PID|||B301^^^^MR||Bayley^B^B||19710101000000
PV1||B||||||||||||||||||||||||||||||||||||||||||||||||
40a74160-31e8-4d6a-8029-7de267f0625c^^^ÔBTV
TXA|1|Note List||||20110704144628||||||8829772d-825a-49ef-949e-
677ebeb7c7d4^Philips.OBTV.DocExportÔBTV1||||//./C:/RS/8829772d-825a-
49ef-949e-677ebeb7c7d4.xps|DO
Trace (document map)

C07041446355522e4cf8|P|2.5
EVN||20110704144635
PID|||B301^^^^MR||Bayley^B^B||19710101000000
PV1||B||||||||||||||||||||||||||||||||||||||||||||||||40a74160-31e8-4d6a-
8029-7de267f0625c^^^ÔBTV
TXA|1|Trace||||20110704144620||||||68834168-1a36-47b8-93ac-
7e53367a41e4^Philips.OBTV.DocExportÔBTV1||||//./C:/RS/68834168-1a36-
47b8-93ac-7e53367a41e4.xps|DO
Flowchart (document map)

C070414463553734a72b|P|2.5
EVN||20110704144635
PID|||B301^^^^MR||Bayley^B^B||19710101000000
PV1||B||||||||||||||||||||||||||||||||||||||||||||||||40a74160-31e8-4d6a-
8029-7de267f0625c^^^ÔBTV
TXA|1|Partogram (AP/IP): OVW||||20110704144627||||||33366e14-b7b1-46b2-
950c-2d92678d44e9^Philips.OBTV.DocExportÔBTV1||||//./C:/RS/33366e14-
b7b1-46b2-950c-2d92678d44e9.xps|DO
5.10.6 Acknowledgment
5.10.6.1 Original Mode
Application Accept
MSH|^~\&|||HIS|REC01|20161207084325||ACKÂ01ÂCK|C1207084325873d16050|T|
2.5|||NE|NE
MSA|AA|ID00000001|Message accepted.

Application Reject
MSH|^~\&|||HIS|REC01|20161207084641||ACKÂ23ÂCK|C120708464186522dcdd|T|
2.5|||NE|NE
MSA|AR|ID00000001|Message not accepted.
ERR|^^^201&Message event type not supported
5.10.6.2 Enhanced Mode
Commit Accept
MSH|^~\&|||HIS|REC01|20161207084325||ACKÂ01ÂCK|C1207084325869bf52f9|T|
2.5|||NE|NE
MSA|CA|ID00000001|Message accepted.
Commit Error
MSH|^~\&|||HIS|REC01|20161207084604||ACKÂ01ÂCK|C1207084604394b295d2|T|
2.5|||NE|NE
MSA|CE|ID00000001|Message not accepted.
ERR|^^^102&Invalid message. Missing mandatory field. The following field is
mandatory: PID-3-1

5 HL7 Interface Additional Information
5.11 Additional Information

• An audit trail is created for HL7 supplied data.
• ADT and ORU Outbound behavior when a configured route is changed and the service is restarted:
HL7 Route ADT-out ORU-out
Pending ADT-Out messages are ORU outbound stops on this
Delete the HL7 Route
deleted route
ADT messages created since the Notes created since the system
Change an existing HL7 Route system disconnected are sent to disconnected are sent to the
the new route new route
All notes – including past notes
New ADT messages created af-
– belonging to currently open
Configure a new HL7 Route ter the configuration was ap-
episodes are sent to the new
plied are sent to the new route
route
• ORU and ADT require separate routes.

• IntelliSpace Perinatal System Console monitors and traces HL7 messages (see system Console On-
line Help for further information).
• Network Card Priority for the HL7 Interface Connection:
HL7 communication always uses the network interface card with the highest priority.
To check network card priority, go to Start menu and type cmd in the search box and open cmd.exe
from the programs list to open the command prompt. Then type: netstat –rn
You will now see the Interface List, as below:
The numbers in the first column of the Interface List represent the Network Card Priority. The
lower the number, the higher the priority. In the sample above, the “Software Loopback Interface 1”
(representing the Microsoft Loopback adapter) is assigned the highest priority (lowest number is
#1), followed by the Broadcom NetXtreme Adapter (number #11).
Change the priority of your network card in the operating system settings as required.

6
6IntelliSpace Perinatal Link

You can link multiple IntelliSpace Perinatal systems to allow patient transfers from one system to
another, for example from an antepartum system to an intrapartum system. This multi-directional data
transfer uses the hospital’s LAN cabling and domain administration. See also the IntelliSpace Perinatal
Site Preparation and IT Specification Guide’s Networking section for additional details.
6.1 System Requirements

The following are prerequisites for implementing an IntelliSpace Perinatal to IntelliSpace Perinatal
Link.
All IntelliSpace Perinatal systems must:
• be installed with the same version of IntelliSpace Perinatal. When one system is upgraded, others
must be too.
• have the archiving option installed
• be configured with the IntelliSpace Perinatal Link option.
• be configured with the same language option.
• have a network connection between all computers of one system to the internal server of the linked
systems
• the destination location of a configured IntelliSpace Perinatal Link must match the system name of
the destination system.
• have the same time. See “Time Information for Linked IntelliSpace Perinatal Systems” on page 154.
• have no connection to public networks, as the data is not encrypted.
• In order to transfer newborn patients, both systems must have the newborn option enabled. If this is
set up on only one of the linked systems, only maternal patients can be transferred.
• All linked IntelliSpace Perinatal systems must be configured to receive the same ADT and ORU
messages from the HIS to guarantee data consistency among the connected systems. EHR systems
may not always be aware of the current IntelliSpace Perinatal patient location.

6 IntelliSpace Perinatal Link Time Information for Linked IntelliSpace Perinatal Systems
6.2 Time Information for Linked IntelliSpace

Perinatal Systems
If an external time service is used, each internal server must be synchronized by the same, or by an
equivalent, external time source. There is no synchronization mechanism between the internal servers
of a linked system.
Operation of linked systems across different time zones is NOT permitted as there is no timezone
information stored in the patient record/episode.
6.3 Setting Up and Using Linked Systems

Refer to the current IntelliSpace Perinatal System Administration and Configuration Guide for details.

7
7Context Synchronization
7.1 Startup Patient Context

The IntelliSpace Perinatal application can be started with a predefined patient in focus. A simple
patient context can thus be established if another patient-oriented software is in use at the same time.
To set the startup patient, a parameterized switch is used when running the application .exe file from a
command line. In combination with single-sign-on of integrated users, this can be used to start
IntelliSpace Perinatal on a computer with a logged-in user and a special patient in focus.
Command line:
\TV2\prog\IntelliSpacePerinatal.exe [-Focus=<FocusHISID>]
<FocusHISID>: This parameter is the currently configured HIS identification for patients. The HIS
identification is a system setting and can be configured in the Setup program on the Internal Server.
Available options are: MRN, SSN, and Patient ID. The configured setting can be viewed in the
Installation Record in the Windows Start menu via IntelliSpace Perinatal Support.
If the <FocusHISID> variable is provided on startup, the application takes the last episode of the
matching patient in focus, regardless of whether the episode is open or closed. If no matching patient is
found, the focus is left empty on startup.
WARNING This feature does not establish an automatic synchronization of the patient context with any other
software. It is in the responsibility of the operator to make sure that every running application has the
correct patient context at all times.
Startup with patient context is also possible when working via Remote Desktop Session. For details
refer to the IntelliSpace Perinatal Site Preparation and IT Specification Guide, chapter Dynamic RDP File
Generation.
NOTE If the option Minimize upon close is enabled in the system configuration (see the IntelliSpace Perinatal
System Administration and Configuration Guide for details), the application is always running in the
background and is maximized when context synchronization takes effect. For the user this will look as
if Intellispace Perinatal is opened and closed via context synchronization.

7 Context Synchronization XML Context Synchronization
7.2 XML Context Synchronization

The XML file based context synchronization integrates interfaces to external applications to allow
switching the application context (patient or user) without user interaction in IntelliSpace Perinatal. If
a patient or user is selected in the external application, the same patient/user is selected automatically as
current patient/user in IntelliSpace Perinatal, and the default screen opens.
To set up IntelliSpace Perinatal for this feature, select Configuration - PCs:
Select the Care Unit (if configured), then select the Context Synchronization radio button. In the list of
PC names, select the PC where you want to enable context synchronization, and mark the Synchronize
Users and /or the Synchronize Patients checkbox.
Setting a checkmark in the column activates the patient-in-focus lock function. This prevents the
manual selection of the patient in focus by the IntelliSpace Perinatal user.
In the Read Path and Write Path fields, enter the respective paths where the context XML files will be
placed. The path may contain the tag <PCInternalName>, which is replaced by the PC's internal name
(hostname). Example: host\share\sharedcontexts\<PCInternalName>.
The directory defined in the Read path will contain the XML file from the external application with
the context information about patient / user focus. This path is monitored by IntelliSpace Perinatal,
and the context information from the XML file is taken over into IntelliSpace Perinatal. IntelliSpace
Perinatal deletes the XML file after processing the context information.
Correspondingly, IntelliSpace Perinatal writes context information to the Write path, where it is read
and taken over by the external application. Read and Write access to the directories needs to be granted
to the Windows user who started the application.
The Read and Write directories defined here should not be used for any other purpose than for XML-
based context synchronization. Different clients must not use the same directory. This is especially
important for RD clients which run on the same Remote Desktop Server.
Configure RD clients to keep settings on exit. To do this, select the Remote Desktop radio button,
select the RD client from the list and mark the checkbox:
Otherwise, the RD client will lose the context synchronization configuration settings with every
disconnect.
Patient context identifier:
Patient context is based on the configured HL7 patient identifier. This can be medical record number,
social security number or generic patient identifier.

XML Context Synchronization 7 Context Synchronization
7.2.1 Vendor-neutral XML Integration
7.2.1.1 Patient Context

When IntelliSpace Perinatal sends patient information to the external application, the following rules
apply:
IntelliSpace Perinatal user action <Action> type sent to external application
Take patient into focus PatientChange
(with PatientLifetimeId of patient)
Clear focus PatientChange
(with empty PatientLifetimeId)
7.2.1.2 User Context

When IntelliSpace Perinatal sends user information to the external application, the following rules
apply:
IntelliSpace Perinatal Action <Action> type sent to external application
Lock application (click on lock icon) Logout
(with user data and empty user name)
Login Login (with account name)

7.2.1.3 Vendor-Neutral XML File Definition
File Format:
– Patient Change Example:

<?xml version="1.0" encoding="utf-8"?>
<IntelliSpacePerinatal>
<DateTimeUTC>20150924093325</DateTimeUTC>
<Action>PatientChange</Action>
<PatientLifetimeId>23452342</PatientLifetimeId>
</IntelliSpacePerinatal>
– User Change Example:

<?xml version="1.0" encoding="utf-8"?>
<DateTimeUTC>20150924093325</DateTimeUTC>
<Action>UserChange</Action>
<User>ISnn9UnvC9PO+2BVMgQI2TABLQkuk42UjjbgoN2ppO5L/
FQuYGAHzNLqS+Q==</User>
User Data Encryption:

The <User> data string is the encrypted user account name.
Unencrypted string encoding: UTF-8
algorithm: AES256
salt: DateTimeUTC string in XML as UTF-8 encoded byte array
key derivation: derived from customer-provided password according to RFC2898
string encoding: Base64
File Name:
IntelliSpace expects the file name of the received file to contain a time stamp (in the format
YYYYMMDDHHMMSS or YYYYMMDDHHMMSSFFF with milliseconds) to uniquely name each file.
Example: XYApp-20151009154705.xml
The file name created by IntelliSpace Perinatal follows the same format:
Example: IntelliSpacePerinatal-20140218171659123.xml

7.2.2 EPIC XML-based PACS Integration
7.2.2.1 Patient Context

When IntelliSpace Perinatal sends patient information to the external application, the following rules
apply:
IntelliSpace Perinatal Action <Action> type sent to external application
Take patient into focus PatientSwitch
(with PatientId of patient)
Clear focus PatientChange
(with empty PatientId)
7.2.2.2 User Context

When IntelliSpace Perinatal sends user information to the external application, the following rules
apply:
IntelliSpace Perinatal Action <Eventn> type sent to external application
Lock application (click on lock icon) Logout
(with AuthenticationData and empty user name)
Login Login (with account name)

7.2.3 XML Integration Simulator Tool

The XML Context Synchronization Simulator Tool is an application that may be used by field service
and support for integration testing with 3rd party partner applications.
The tool is completely separate from the IntelliSpace Perinatal application and does not use any of its
data or configuration.
Usage:
• Start the tool from the Windows Start menu
• Select the type of context synchronization according to the IntelliSpace Perinatal installation
• Enter the read and write paths and the context encryption key exactly as configured in the
IntelliSpace Perinatal application.
• Press the Start button to start using the context synchronization
• Select an event, provide event data like patient identifier or user account name
• Press the Publish button to write an XML file to the according folder.
• Observe the Received window for any received synchronization events.
• Use the IntelliSpace Perinatal LogFile Viewer to examine the "ContextSyncSimulator.log" file in the
logdata folder of the local PC.

Item Description
Type Type of context synchronization. Available options are:
- Vendor-Neutral XML integration
- Epic® XML-Based PACS integration
Start button starts the required functionality to set/get the patient or user context.
starts looking for new XML files
Stop button stops looking for new XML files
Read Path the Read Path as configured in IntelliSpace Perinatal.
Write Path the Write Path as configured in IntelliSpace Perinatal.
Context Encryption the Context Encryption as configured in IntelliSpace Perinatal.
Context Encryption Key the key/passcode to encrypt and decrypt user authentication data.
User data is always encrypted when it is exchanged between
applications. Note that Vendor-Neutral XML integration uses other
encryption mechanisms than the Epic® XML-Based PACS
integration.
When the checkbox next to eye symbol is selected, the encryption key
is visible for a short time.
Encoding the Encoding as configured in IntelliSpace Perinatal.
Mode A) Simulate an IntelliSpace Perinatal client communicating with
Partner System:
When selecting this mode, shut down the IntelliSpace Perinatal
application.
The simulator tool behaves like IntelliSpace Perinatal and reads XML
files from the Read Path and drops XML files to the Write Path for
the Partner System.
B) Simulate the Partner System communicating with an IntelliSpace
Perinatal client:
In this mode, shut down the partner application.
The simulator tool behaves like a partner system and can synchronize
contexts with IntelliSpace Perinatal. It writes XML files to the
configured Read Path and listens to the Write Path of the IntelliSpace
Perinatal client.
Action/Event The synchronization event to publish to a participating application.
Available events are:
- PatientChange (corresponds to "PatientSwitch" in Epic® mode)
- Login (User)
- Logoff (User)
Patient Identifier the patient's lifetime identifier, e.g. medical record number
this field is not available for user specific events.
User Account the user account name
this field is not available for patient-specific events and "Logoff"

7.2.4 Context Synchronization Configuration

The context synchronization type can be set during IntelliSpace Perinatal Setup. To change the context
synchronization configuration, the System Manager role is required.
The context synchronization settings can be configured in Configuration - Context Synchronization
Configuration. For further details see the IntelliSpace Perinatal System Administration and Configuration
Guide, chapter System Configuration.

8
8Diagnostics and Repair
8.1 Co-residency
If it is not possible to identify whether a co-residency problem is IntelliSpace Perinatal or third-party
specific:
1 the customer must backup his third party application and data files
2 Philips must re-install the IntelliSpace Perinatal client computer completely (including operating
system) and verify the system functionality.
If problem still exists, then it is IntelliSpace Perinatal-related. Troubleshoot/fix the IntelliSpace
Perinatal problem. Then the customer can re-install the third-party application. If the problem is gone,
it is considered that the third party application caused the problem. It is the customer’s responsibility
to fix the problem and then perform a new integration test.
If the integration does not comply with IntelliSpace Perinatal support strategy, IntelliSpace Perinatal
must be reinstalled completely (including the operating system). The third-party application must not
be re-installed.
8.2 Network
The purpose of troubleshooting extended network integrations is to determine whether the problem is
caused by the hospital network or by the IntelliSpace Perinatal system. The purpose is not to fix the
problems in the hospital network infrastructure. This is the customer’s responsibility. If there is
evidence indicating problems in integrated network infrastructure, Philips support is not responsible
for any further troubleshooting or repair.
The Philips Response Center has customer-specific integration information on file (from installation).
1 Run 'net-test' utility (included with getlog-package) from remote IntelliSpace Perinatal computers
to check server connection performance and compare new results to the report which was
generated at installation time to check if IntelliSpace Perinatal network requirements are still
fulfilled; if not OK, then customer must bring the network into compliant status; no further
diagnostic by Philips support
2 If problems are not yet identified: check line speed and duplex setting for all IntelliSpace Perinatal
components
3 If problems are not yet identified: run Windows performance monitor to measure critical
parameters like throughput and others.

8 Diagnostics and Repair Domain Integration
4 If problems are not yet identified: temporarily disable DNS name resolution for IntelliSpace
Perinatal computers to identify if DNS could cause the problems (use local host file for name
resolution)
5 If problems are not yet identified: contract network specialist for further diagnostic, re-do network
certification for IntelliSpace Perinatal network segment.
6 If problems cannot be identified: bring system into isolated IntelliSpace Perinatal network
environment for troubleshooting and replace customer switches by IntelliSpace Perinatal switches
(temporarily)
Labor for this diagnostic (including network specialist) is covered by IntelliSpace Perinatal within
warranty period only if diagnostic shows that problem is caused by IntelliSpace Perinatal system;
otherwise all labor will be charged to the customer.
8.3 Domain Integration

To test an existing domain integration, you can use the Active Directory Test Tool described in the
IntelliSpace Perinatal Installation and Service Guide.
Diagnostic/repair procedure for domain integration problems:
1 Temporarily disable group policy deployment for all IntelliSpace Perinatal computers and
IntelliSpace Perinatal users to identify if group policies could cause the problems. This must be
done by the customer's IT department.
2 If the problem remains, temporarily remove IntelliSpace Perinatal computers from the domain to
identify if ADS environment could cause the problems
3 If the problem remains, and cannot be identified, completely reinstall IntelliSpace Perinatal
including the operating system without domain integration.
8.4 HL7 Link

Diagnostic/repair procedure for HL7 Link problems:
1 Simulate HIS sending message to IntelliSpace Perinatal to identify if HIS message format could
cause the problems.
2 Analyze IntelliSpace Perinatal application acknowledge message.
3 Trigger IntelliSpace Perinatal sending message and analyze accept-acknowledge.
4 Check IntelliSpace Perinatal logfiles.

9
9Third Party Co-residency and

Network Integration
The IntelliSpace Perinatal application software covers the following areas:
• Surveillance and alarming
• Flow sheet-based charting
• Forms based charting
• Administration and statistical reporting/archiving
In order to reduce the amount of equipment, IntelliSpace Perinatal can be integrated with third-party
software applications to address other applications and local legal documentation requirements.
Additionally, software sharing hardware, and accessing multiple applications from a single client are
also possible.
9.1 Integration Responsibility

The responsibility for integrating third-party components divides between Philips, the customer, and
any third-party integrator.
Philips tolerates the implementation of some third-party hardware with limited support.
CAUTION In all instances, it is the customer’s responsibility to ensure that integration or use of third-party
hardware does not affect the IntelliSpace Perinatal installation.
Additional or alternative hardware components may be used with IntelliSpace Perinatal, but these
components and their functionality are not subject to IntelliSpace Perinatal support and warranty, and
they are in the responsibility of the customer for servicing and replacement. Warranty and support for
IntelliSpace Perinatal is still valid.

9 Third Party Co-residency and Network Integration Integration Responsibility
9.1.1 Third Party Co-residency

The customer is responsible to:
• ensure that third-party software is compatible with the operating system on the installed computer.
• install third-party application
• perform integration test
9.1.2 Network Integration

• setup IP addresses and gateways
• configure DNS name resolution for IntelliSpace Perinatal computers
• join IntelliSpace Perinatal computers to the domain
• authorize or deactivate IntelliSpace Perinatal DHCP server
• setup domain users as IntelliSpace Perinatal users
• include customer confirmation about network compliance, especially bandwidth availability, into
the statement of work
• perform integration test.
9.1.3 Non-Production System

• ensure that the operating system is correctly installed
• configure VM per the requirements documented
• enable Remote Desktop Session host functionality if required
• install IntelliSpace Perinatal application software
9.1.4 HL7 Link

• install IntelliSpace Perinatal HL7 interface (IntelliSpace Perinatal setup) running on a client without
data acquisition
• set communication routes in IntelliSpace Perinatal configuration
• select IntelliSpace Perinatal note types to be transferred for ORU outgoing communication
• perform integration test if installed on extra computer, or if linked into hospital network via
IntelliSpace Perinatal switch
• provide lab test information for Lab interface

System Support Strategy 9 Third Party Co-residency and Network Integration
9.2 System Support Strategy

This section describes the levels of Philips system support.
9.2.1 Full Support

Full system support (FS) covers division provided components if not modified. The complete system
(including hardware, operating system and IntelliSpace Perinatal system) is not covered by FS because
hardware and operating system are customer provided.
9.2.2 Limited Support

Limited support covers customer provided components, integrated solutions, and customizations. It
also covers the IntelliSpace Perinatal core system without customer provided components, as this is the
customer’s responsibility.
9.2.2.1 Limited Support / Division-Validated (LS/D)

Philips division has validated integration for a certain use model. Other use models are not validated.
An integration test is not required. No disclaimers apply. LS/D applies for customer provided
hardware, if the same model and same firmware (if applicable) is as was validated in division. It also
applies for upgraded systems from an earlier revision where hardware was originally shipped from
division because the operating system is customer provided.
9.2.2.2 Limited Support / Customer-Validated Implementation (LS/C)

Philips division has not validated the integration but has no objections. Validation is customer
responsibility. An integration test is required. Disclaimers and warnings apply. LS/C also applies for all
customer provided components if a different model firmware other than what was division validated
has been used.

9 Third Party Co-residency and Network Integration System Support Strategy
9.2.3 No Support
Integrations which are not listed as limited support have no support.
An integration that fails the integration tests has no support.
An integration that does not fulfill the requirements stated in this guide has no support.
From a technical point, unsupported implementations might work but to minimize the risk of
uncontrolled side effect, and to guarantee the integrity of the IntelliSpace Perinatal database, it is
essential to limit the system support to those configurations that can be tested and verified by Philips
division personnel.
Using an unsupported system means:
• The system’s functionality and IntelliSpace Perinatal database integrity is the customer’s
responsibility.
• The Philips service organization/division is not responsible for problem solution.
• If a Philips customer engineer is called on site to solve the problem, the customer will be charged for
it.
• Philips Technical Support Engineering will not troubleshoot, investigate or solve these problems.
The following are examples of hardware and software that must not be integrated:
• Wireless LAN
• Installing any version of the operating system, other than that shipped with the system
• Using any installation process other than the procedures described in the IntelliSpace Perinatal
Installation and Service Guide
• Installing any additional hardware accessories other than those listed as limited support
• Installing additional PC boards (such as fiber optic cards and so forth) into any IntelliSpace Perinatal
computer
• Network cabling other than that specified in the Site Preparation and IT Specification Guide, and
the Installation and Service Guide
• PDF driver installed at the Internal Server
• Installing any additional components into IntelliSpace Perinatal computers is not supported, except
the redundant power-supply for high-end servers
9.2.4 Customer Responsibility

Tasks that are the customer’s responsibility cannot be billed to warranty. Customers can purchase value
added services (based on time and material) if technical assistance is needed.
Customer responsibilities include:
• installation of operating system and the .NET environment for new installation
• all customer-provided hardware
• required changes to hardware and operating system, as required by the System Check Tool
• installation of the Microsoft Office package
• all Microsoft licenses and activation of Windows operating system and MS Office

System Support Strategy 9 Third Party Co-residency and Network Integration
• assigning a dedicated System Administrator who is able to restart the complete system and who will
act as contact person for communication with the Philips Response Center, if necessary.
• making backups:
– create regular IntelliSpace Perinatal Backups of Internal and External Server.
– create regular backups of the entire ‘Network Based Storage’ share.
– store all backups in a confidential and safe location and have procedures in place to make them
available for IntelliSpace Perinatal for recovery.
See the IntelliSpace Perinatal Installation and Service Guide for details of how to make IntelliSpace
Perinatal Backups.
• fulfilling environmental and electrical requirements (see specifications in the Site Preparation and IT
Specification Guide.)
• wall cabling and cable termination
• backup (streamer tape) and maintenance of external database
• cleaning and correct storage of optical media
• storage of IntelliSpace Perinatal SW kit and documentation, including the cleanup of target folders
used in document export, except for when the Delete on Acknowledge Feature feature is used.
IntelliSpace Perinatal assumes that target directories have enough capacity to accept documents, and
performs no general cleanup of any target directory.
• supply of consumables (e.g. printer paper, toner cartridge, optical media ....)
• shutdown/restart of system after power-fail or other problem
• replacement of old batteries (UPS, RAID system)
• verifying cabling and connections in case of problems
• providing detailed error description when reporting problems
• providing access to system for repair and troubleshooting
• installation and setup of RD clients used for remote IntelliSpace Perinatal access, including
registration of Microsoft RDS Client Access Licenses, also for upgrades
• compliance of HIS system to HL7 standard and IntelliSpace Perinatal requirements
• installation, integration, maintenance and backup of third-party applications, also for division-
validated applications
• re-installation of third-party-applications after IntelliSpace Perinatal revision upgrade, including
third-party upgrade to current Windows compatibility and new integration test
• co-residency of customer-validated third-party applications (IntelliSpace Perinatal support only
covers co-residency for division-validated applications) integration test
• The customer is responsible for the complete network, including network integration and any
additional software components not required for IntelliSpace Perinatal operation. Co-residency is
not permitted on the Internal Server (except for diagnostic agents, tools and utilities), or RDSH
server, unless explicitly permitted. DAC clients and the DAC server may not have the HL7
interface. IntelliSpace Perinatal support covers only the IntelliSpace Perinatal core system, not HIS
components or applications.

9 Third Party Co-residency and Network Integration System Support Strategy
• Office package and Office licenses for Office installation on RDSH server and on IntelliSpace
Perinatal clients including installation and license activation
• all items which are subject to limited support
• network infrastructure including programming of switches and routers and network security
• providing network info to configure gateway NIC
• providing detailed network drawing which includes all IntelliSpace Perinatal connections and
a. all addresses, gateways and access-control lists
b. speed and duplex settings for all NICs and all switch ports
c. firewall settings and any traffic control implementation
• bringing non-compliant network into compliant status
• analyzing sniffer recordings if such a device is used for diagnostic.
• installation, configuration, troubleshooting, and repair of VMs and related problems
• ensuring compliance of virtualized system with requirements and restrictions described in
IntelliSpace Perinatal documentation.
For Integration Testing, see “Integration Tests” on page 177 for details.
9.2.5 System Status Indicator

Even after successful integration of a third-party software application, the integrator, customer
and users should always be aware of the train icon. This is the system status indicator. When
the wheels on the engine are turning and smoke puffs from the smokestack, IntelliSpace
Perinatal is functioning correctly. However, if the background color flashes yellow, or the train stops
entirely, this indicates a problem with the system. It may not be gathering data, and the on-screen
display may not have been updated recently. Use the system status indicator as a measure of the
“health” of the integration as well as that of IntelliSpace Perinatal generally.
A Remote Desktop client has no system status indicator engine, although the background to the system
name flashes yellow, in the same way as the engine, to indicate problems and urgent messages.
An IntelliSpace Perinatal RD session can run a session window. If this session window is minimized, or
concealed by another window, no part of IntelliSpace Perinatal is visible, not even the system status
indicator. This could result in alarms, system messages and so forth being unnoticed.

Integration Support 9 Third Party Co-residency and Network Integration
9.3 Integration Support

Solutions that have failed the validation test are unsupported. Also, if the implementation model of a
solution contradicts the requirements of IntelliSpace Perinatal, that solution is unsupported.
WARNING Installation of IntelliSpace Perinatal in the healthcare facility network on customer-provided hardware,
and installation of third-party hardware and/or software can severely compromise the system
performance and the alarm handling of the IntelliSpace Perinatal system. For third-party hardware
and/or software components that are not Philips factory-validated, there is a risk that alarming could be
delayed, or the IntelliSpace Perinatal system performance could be compromised, even if an integration
test was successful. Installing third-party applications onto client computers with data acquisition or
servers increases these risks.
9.3.1 Hardware
Division-validated (LS/D):
• Servers and desktop computers as shipped with the IntelliSpace Perinatal Surveillance and Archiving
product. For details refer to the IntelliSpace Perinatal Site Preparation and IT Specification Guide.
Customer-validated (LS/C):
• SPS Moxa, pre-qualified, still needs integration test,
routing only with new Moxa model 6610, requires latest driver from ISP software media, requires
0% packet-loss; also supported: 6610 model without use of routing, also different number of ports
• scanner at client without DAC, only single-page
• different PC model, specification-compliant, alternative peripherals
• barcode reader at client without DAC
• RS232 opto-coupler, RS232 adapter
• LAN cable for RS232
• fiber-optic LAN cable
• Fibre Channel card, also on Internal Server
• Additional partitions on hard drives
• 3rd party fetal monitors. For further details refer to the IntelliSpace Perinatal Installation and Service
Guide, Chapter "Fetal Monitor Connections".
Unsupported (NoS): (including, but not limited to the following items)

• any computer failing System Check Tool
• SPS from another company than MOXA
• scanner, barcode at DAC computer
• document attachment via multipage scanner

9 Third Party Co-residency and Network Integration Integration Support
9.3.2 Software
• MS Office 2016 and 2013 as specified
• Adobe PDF driver for document export as described in the IntelliSpace Perinatal Site Preparation and
IT Specification Guide
• 3rd party software, revision-controlled, on clients and External Server
• diagnostic and deployment agents
• Microsoft updates, also on Internal Server, service packs require Philips pre-qualification.
For details refer to the IntelliSpace Perinatal Site Preparation and IT Specification Guide
• Anti-virus software: scan only local hard disks, network drives must be excluded.
For details refer to the IntelliSpace Perinatal Site Preparation and IT Specification Guide.
• remote assistance
• HP diagnostics on high-end server
• BGInfo, incl. wallpaper
• alternate driver for document export, RDS client for mobile device

• Software not revision-controlled
• 3rd party software other than anti-virus or diagnostics or deployment agents on Internal Server,
Remote Desktop Session Host Server, Data Acquisition Server
• UltraVNC remote access
• online backup programs
• Microsoft Office on Internal Server, Data Acquisition Server
• Recover IntelliSpace Perinatal system from 3rd-party backup image

9.3.3 Network
• DHCP service on Internal Server, External Server
• Windows Firewall with IntelliSpace Perinatal ports open
• LAN FM in different network segment than hosting machine
• domain integration
• VLAN integration, only port-based
• VPN implementation
• HIS DHCP server
• RD clients for mobile devices
• Software for remote support, RealVNC, TightVNC, are pre-qualified, still need integration test for
up-to-date versions
• RDSH: HIS license server
• RDSH gateway with encryption via RDP, changing RDP settings
• RDSH: balancers NLB, SessionBroker, others
• RDSH: 'remoteApp', gateway with encryption via RDP
• RDSH: changing certain RDP settings, for details refer to the IntelliSpace Perinatal Site Preparation
and IT Specification Guide
• RDSH: WiFi RD clients, with and without real time alerting (requires Microsoft RD clients).
• Citrix on RDS host/client, no real time alerting
• time synch with time server
• dynamic IP address for client, RDSH, External Server, Data Warehouse Server
• RSN via HIS network
• linked IntelliSpace Perinatal systems on the same network
• SNMP activation
• iSCSI directly into SAN
• additional network protocols, changing NIC settings
• NIC teaming
• ILO remote HP utility
• WAN for: Internal Server -> client,
min.1Mbps line-speed /BW, no NAT
• WAN for SPS -> Host computer, requires new Moxa model and driver
• iPv6


• Microsoft cluster integration
• WiFi for IntelliSpace Perinatal computers
• video-streaming, VoIP
• WAN for LAN FM -> host computer because UDP cannot recover lost packets (but routing is ok)
• WAN for External Server / Remote Desktop Session Host Server -> Internal Server

9.3.4 Virtualization
• ESX/ESXi 3.5, 4.1, ESXi 5.0/5.1/5.5/6.0. Other revisions and update levels are also LS/C.
• vMotion, clone
• snapshot only temporary for backup, must delete after backup
• VMware High Availability system at VM level
• DRS, DPM, SRM, vSphere appliances
• Operation below recommended resources
• Operating system recovery via snapshot, but IntelliSpace Perinatal recovery only based on
IntelliSpace Perinatal backups
• VMware ConsolidatedGuidance on physical system before virtualization
• VMwareView only if all View computers have alerting de-activated
• other VM (not IntelliSpace Perinatal) on same ESX Server
• Additional partitions on hard drives

• HyperV, Xen, any hypervisor other than ESX
• VMware High Availability at application level
• Fault Tolerance
• Convert physical >VM
• Hardware hot-plugging
• NBS same SAN + same LUN as Server VM
• VM as cloud service
• Permanent snapshot
• Throughput / latency not complying with specification
(bad latency could be a result of thin-provisioning depending on data-store implementation)
• VMware View clients with alerting activated

9.3.5 Other Features

• linked IntelliSpace Perinatal systems
• Windows fax, only sending
• multiple Data Warehouse Servers
• additional Windows utilities
• customized external database, customized Data Warehouse Server database
• IPsec data encryption
• hard disk encryption
• NBS on local hard disk of computer without IntelliSpace Perinatal system or on a dedicated RAID
array
• change regional setting to different language
• Citrix: only without alarming, disable alarms for this computer in ISP configuration
• customized PS/ISE commandlets for Automation Interface
• multiple partitions on hard disk.
Note: System Check Tool will report on one partition only, the reported performance data apply to
the complete drive, not only to this particular partition.

• DWS inside SAN
• distributed file system DFS
• remove FORMS option retrospectively
• NBS on local hard disk of IntelliSpace Perinatal computer (possible for Non-Production System)
• connecting clinical system and non-production system (NPS, test system) to same NBS
• use :\TV2 as destination for TVbackup

10
10 Integration Tests
Perform the integration tests detailed in this chapter to verify the functionality after IntelliSpace
Perinatal installation, integrating any third-party application or component or when integrating
IntelliSpace Perinatal into the HIS network. Systems that are not connected to the Hospital IT
network and receive no modification from factory default installation do not need to be integration
tested.
The integrator may ask Philips to perform these integration tests. The cost for this is billed to the
integrator based on labor, time and material required. These tests do not verify the functionality of the
third-party integration in any way. It is the integrator’s responsibility to ensure that the third-party
applications/components function satisfactorily.
These tests are in addition to, not instead of, the T&I tests described in the Test and Inspection matrix
of the Installation and Service Guide.
Perform the tests on a live IntelliSpace Perinatal system. Performing them on a training or test system is
no guarantee that the same results will occur on a fully deployed system. Before testing changes on a
production system you may use the training system to perform a dry run to prevent adverse effects on
the production system.
Integration tests are the customer’s responsibility.
Integration includes connecting hardware components, installing third-party software, installing
Microsoft updates, and modifying the external database.
If the same application/hardware is installed on multiple computers of the same type and model, only
one integration test per computer type and model is required.
There are two different test scenarios:
• Basic Functionality Test
for non-critical hardware, see “Basic Functionality Test (Test Scenario 1)” on page 181, which consists
of one test module.
• Full Integrations Test
See “Full Integration Test (Test Scenario 2)” on page 181, which consists of several test modules.

WARNING Installation of IntelliSpace Perinatal in the healthcare facility network on customer-provided hardware,
and installation of third-party hardware and/or software can severely compromise the system
performance and the alarm handling of the IntelliSpace Perinatal system.
For third-party hardware and/or software components that are not Philips factory-validated, there is a
risk that alarming could be delayed, or the IntelliSpace Perinatal system performance could be
compromised, even if an integration test was successful. Installing third-party applications onto client
computers with data acquisition or servers increases these risks.
If integration proves incompatible with the IntelliSpace Perinatal system, the integration must be
removed. You must perform the required integration tests to ensure that IntelliSpace Perinatal
performance is not adversely affected by the integration. These tests indicate a “snapshot” of the system
functionality at the time of testing. They do not guarantee that this functionality will be maintained.
The tests indicate that there is no evidence of incompatibility at the time of testing. For each
integration, an integration test protocol, signed with date and name of person performing the test must
be stored with the system documentation before using the installed system.
10.0.1 Mandatory Integration Testing

Integration testing is required:
• after new installation of an IntelliSpace Perinatal Advanced System
• for all non-approved third-party applications
• for approved third-party applications if installed on client computer with data-acquisition
• for all network integrations
• for hardware integration (e.g. connecting scanner, installing tape drive for external high-end server);
here, a reduced integration test applies, focusing on the functionality of the new hardware
component
• for implementation of virus protection programs
• for system updates with Microsoft updates
• for configuration changes within system environment (for example, Remote Desktop Session Host
configuration)
• for customization of external DB
• for integration into virtualized environments
• for all items described as “limited support/customer-validated (LS/C)”
10.0.2 Integration Re-testing

In addition to the testing that is performed at initial integration, re-testing is required when:
• updating operating system drivers
• changing a PC BIOS revision or disk controller firmware
• changing the network infrastructure
• upgrading the third-party software revision, or adding new third-party software

• adding “limited support/customer validated (LS/C)” hardware components

• installing MS software updates
• installing virus protection programs
• there is a change in the IntelliSpace Perinatal / OB TraceVue software revision with a version (V)
change, or update (UU) in the revision coding. For example G.00.20 -> H.00.00.
V.UU.FF
version update defect fix /minor enhancement
10.0.3 When Integration Testing is Not Required

• RD Client (for alarming-enabled RD clients the user, however, must execute the procedure from the
Instructions for Use, “Testing the Alarm Sounds”)
• When installing mounting hardware (as there is no connection to the system network)
10.0.4 When Integration Re-testing is Not Required

Integration retesting is not required when:
• applying a fix upgrade (“FF” according to the “V.UU.FF” revision codes) to an existing IntelliSpace
Perinatal system (e.g. upgrade from G.00.00 to G.00.20)
• applying an IntelliSpace Perinatal Service Pack or other IntelliSpace Perinatal fix to an existing
IntelliSpace Perinatal system
• updating virus definitions for virus protection programs

10 Integration Tests What if the Integration Test Fails?
10.1 What if the Integration Test Fails?

If the integration test fails, even if the system continues to run, the system is unsupported (including
the IntelliSpace Perinatal application). The customer should remove the integration, or change the
application environment to allow compliance, and then re-do the test. Philips does not support
IntelliSpace Perinatal on any system until all integration tests are passed successfully.
If the integration tests cannot be passed successfully, at the customer’s cost either:
• the integration must be removed
• the computer must be completely reinstalled; including the operating system
No matter which decision is made, the integration test execution must be finally passed.

Integration Test Scenarios 10 Integration Tests
10.2 Integration Test Scenarios

10.2.1 Basic Functionality Test (Test Scenario 1)
Use the following test module (“Basic”) when installing non-critical hardware accessories without
software (drivers), such as a video splitter, KVM, etc. The module offers a brief test of IntelliSpace
Perinatal and is required for thick clients only.
Est. Duration Test Module Test Required

5 minutes Basic [_]
Model and Serial Number of computer _____________________________________

Location of computer ___________________________________________________ Test Passed
1 Test and Inspection matrix is done (refer to testing and maintenance chapter in ISG). [_]
2 Start the IntelliSpace Perinatal session. [_]
3 Iconize the IntelliSpace Perinatal application, and verify that the locomotive engine is on [_]
top and the wheels on the engine are turning and smoke puffs from the smokestack.
Test passed successfully: [_] Yes [_] No Duration: _______
10.2.2 Full Integration Test (Test Scenario 2)

This test module is to be done with every integration test and consists of two sections:
• System Essential Test, which is mandatory with every full integration and ensures the products
essential performance is not negatively affected by integration
• Individual integration Tests, which are optional and only required for specific integrations that may
have impact on system performance if improperly installed

10 Integration Tests Integration Test Scenarios
10.2.2.1 System Essential Test

This test must be executed with every full integration.
Est. Duration Test Module Test always

24 hours System Essential Test Required
Model and Serial Number of computer _____________________________________

Location of computer ___________________________________________________ Test Passed
1 Test and Inspection matrix is done (refer to the Testing and Maintenance chapter in the [_]
Installation and Service Guide).
2 Provided network meets network requirements (refer to the Site Preparation and IT [_]
Specification Guide)
3 Test modules that apply from individual integration test sections below are performed. [_]
Tests already done as part of Test and Inspection matrix do not need to be re-executed,
unless implementation-changed after go-live.
4 The system must be operated with the regular user operations until a 24 hour evaluation [_]
period is completed. On the server roles (including Internal Server, External Server, Data
Acquisition Server, Remote Desktop Session Host server and Data Warehouse Server if
applicable) verify through the 24-hour period, that no flashing train occurs, and at the end
of the integration test, no flashing train remains. Flashing train conditions can be
considered “passed” if the reason and system impact is understood and documented with
the conclusion that there is no risk to system operation. (e.g. flashing train due to shutdown
of a client by power off or trace capacity limit reached for a specific patient that no longer
needs to be monitored).
5 Automatic Backup process is implemented by the customer for Internal, External and
Data Warehouse server (refer to the Maintenance chapter IntelliSpace Perinatal Backup in
ISG). Verify a TVBackup with the current date stamp has been created during the 24-hour
testing period.
6 Check the IntelliSpace Perinatal Internal Server, External Server, DAC Server, DOX [_]
Server, HL7 Server, Data Warehouse Server, NetMsgService and DBWatch log files to
verify that there are no errors related to this test. Error log entries can be considered
“passed” if the reason and system impact is understood and documented with the
conclusion that there is no risk to system operation.
7 Check the Windows system and application event log to verify that there are no errors [_]
related to this test. Error log entries can be considered “passed” if the reason and system
impact is understood and documented with the conclusion that there is no risk to system
operation.

8 This test applies to VMware environment only. It is recommended to have the VMware [_]
default vCenter alarms enabled. VMware Alarms in the vCenter should include these basic
parameters:
Typical Parameter Warning Level Alarm Level

vCenter Alarms Condition length Condition length
VMware Host cpu usage > 75% > 90%
vCenter 4.1 5min (default) 5min (default)
Host memory usage Memory > 90% Memory > 95%
5min (default) 5min (default)
Virtual machine CPU > 85% CPU > 95%
cpu usage 1min (modified)* 1min (modified)*
Virtual machine Memory > 85% Memory > 95%
memory usage 1min (modified)* 1min (modified)*
* IntelliSpace Perinatal has a safeguard implemented that triggers a restart after 5 minute
timeouts. This VMware alarm setting proactively notifies of potential constrained resources
Check the vCenter console and verify if VMware Warnings or Alarms were triggered during
the 24-hour timeframe for the Hosts and VMs that are used by IntelliSpace Perinatal.
VMware alarms from the typical alarms listed above must be considered "failed".
Other VMware Warnings and Alarms can be considered "passed" if the reason and system
impact is understood and documented with the conclusion that there is no risk to system
operation.

10.2.2.2 Individual Integration Test

Select the tests required matching your level of integration.
Integration Test Module

3rd party software on external database server External Database
Modification to the external database
HIS Interface: ADT messages HL7 – ADT
HIS Interface: Inbound ORU messages HL7 – Lab Interface
HIS Interface: Outbound ORU messages HL7 – Notes Interface
Systems linked together (via IntelliSpace Perinatal to IntelliSpace Perinatal link) Link
Fax printing Modem for fax printing
Server/Client Computer NBS Setup Network based storage
Integration with ICCA NICU Interface NICU Interface
Locally sourced Printer Printer
Scanner Scanner
TWAIN interface software update
UPS UPS
VMware storage vMotion VM - Storage vMotion
VMware Temporary snapshots for backups VM - Temp Snapshots
Migrate VM automatically during IntelliSpace Perinatal full load phase: VM - Auto Full vMotion
vMotion can be started automatically under these full load conditions.
DRS and DPM are supported
Migrate VM during reduced IntelliSpace Perinatal load phase: VM - Reduced vMotion
This scenario may be used as a fallback when the VM environment does not have
sufficient resources to handle the scenario "VM Auto Full vMotion".
vMotion can only be started manually under these reduced conditions as tested.
DRS and DPM are not supported.
LAN FM connection Installation and Service Guide
(ISG), Test and Inspection
Matrix:
Performance LAN Fetal
Monitor
Locally sourced Moxa serial port server with different firmware from factory provided ISG, Test and Inspection
Moxa serial port server Matrix: Performance Serial
Port Server
Non HP/Philips fetal monitor connection ISG, Test and Inspection
integration of a RS232 opto coupler Matrix: Performance RS-232
RDSH server RDP Session configuration changes (incl. all variations of RDP ISG, Test and Inspection
connections e.g. RDS Load Balancing) Matrix: Performance
Web Server CITRIX Metaframe (aka Citrix Metaframe XP, Citrix Presentation Server, SoftWare, Step 3. Remote
Citrix XenApp) Desktop Session Host server

For all other integrations, the System Essential Test is sufficient (for instance software installation on
client or server, software installation on virtual machines, domain integration, document export,
allergy HL7 import, new mainboard BIOS revision, new Raid BIOS, locally sourced MOXA serial
port server, and virus protection software).
Test patients that need to be created during the course of any test module should be done in such a way
that the test patient is easily identifiable and cannot be confused with any real patient.


30 minutes External Database [_]
Model and Serial Number of Computer _____________________________________ Test Passed

Location of Computer ___________________________________________________
1 Start IntelliSpace Perinatal on the Internal Server. [_]

2 Start IntelliSpace Perinatal on the External Server. [_]
3 Create a maternal test patient. [_]
4 Fill up the IntelliSpace Perinatal forms and charts for this patient with typical data usually [_]
created by this customer. If applicable, the data entered must be appropriate to validate the
modifications made to the external database within the regular use model of the customer.
5 Print out Word reports and Excel statistics reports of this open episode of this patient. [_]
Verify the printouts show the expected data, including modifications to the external
database if applicable.
6 Close the episode for this patient, leaving the pregnancy open. [_]
7 Create a new episode for this same patient. [_]
8 Enter typical data. If applicable, the data entered must be appropriate to validate the [_]
modifications made to the external database within the regular use model of the customer.
9 Close the episode, including closing the pregnancy. [_]
Verify the printouts show the expected data, including modifications to the external
11 Retrieve the first episode for this patient. [_]
Verify that printouts show the expected data, including modifications to the external
13 Create at least one newborn patient for this “mother” (newborn systems only). [_]
14 Enter some newborn data (newborn systems only). [_]
15 Print out Word reports and Excel statistics reports of this open episode of this newborn. [_]
Verify that printouts show the expected data, including modifications to the external
database if applicable (newborn systems only).

10 minutes HL7 - ADT [_]

1 Admit a test patient on the central hospital information system. [_]

2 Verify the test patient is available on the IntelliSpace Perinatal Patient received from HIS [_]
list.


60 minutes HL7 – Lab Interface [_]

1 Precondition: Make sure the HL7 interface with routing type "Clinical LAB Inbound [_]
ORU" is installed and the IntelliSpace Perinatal mapping is configured to communicate
with the providing LAB interface. The flowchart categories must be configured. Activate
auto-mapping.
2 In IntelliSpace Perinatal: Create a test patient. From the customers LAB interface, send [_]
ORU test messages containing the customer utilized ORU fields.
Send some mapped messages.
Send some unmapped messages.
Keep the ORU messages sent for later reference.
3 Now, review one of the notes received for the test patient in forms or flowchart. [_]
Verify the following fields for the different ORU messages:
– OBX-5 Observation Value (optional)
– OBX-6 Units (optional)
– OBX-7 Range (optional)
– OBX-8 Abnormal flag (optional)
– OBX-11 Result status (optional)
– OBX-14 Date/Time of the observation (optional)
The lab results must appear in IntelliSpace Perinatal as the customer expects them.
Mark this integration test passed if all ORU messages appear with their corresponding
attributes in the expected category of forms or flowchart.
4 Verify that unmapped messages create a new auto-mapping line appended to the mapping [_]
table.
5 Check the IntelliSpace Perinatal HL7 log file of the HL7 interface computer to verify that [_]
there are no errors related to this test.
6 Check the IntelliSpace Perinatal System Console (HL7 node) to verify that [_]
there are no errors/rejects related to this test.


30 minutes HL7 – Notes Interface [_]

1 Review the HL7 route for Outgoing ORU messages and customer related configuration [_]
of outgoing notes (ORU) messages.
2 Admit a test patient, go to the Flowchart and enter the test data for configured notes. [_]
3 Test data is sent via HL7 to the receiving application and verify the result data is meeting [_]
customer expectations (HL7 notes export may take up to 30 seconds).

20 minutes Link [_]

Systems linked _________________________________________________________
1 Admit a test patient, generate/collect some data and then transfer the test patient to the [_]
destination IntelliSpace Perinatal system.
2 Verify the last episode of the test to see that the patient is available on the destination [_]
system.

20 minutes Fax Printer [_]

Modem Model and Serial Number _________________________________________
1 Print patient notes and traces to fax printer. [_]
2 Print the same data to the usual printer and verify that the printout is identical. [_]


20 minutes Network Based Storage [_]

NBS Share ____________________________________________________________
NBS User _____________________________________________________________
1 At the IntelliSpace Perinatal configuration/archive screen, verify that the NBS location is [_]
available.
2 Create a patient test episode. [_]
3 Add test data. [_]
4 Close the episode. [_]
5 Retrieve the episode. [_]

30 minutes NICU Interface [_]

CareVue Chart Revision _________________________________________________
CareVue Chart SP level __________________________________________________
1 In ICCA, the NICU interface is installed and configured to communicate with this [_]
IntelliSpace Perinatal installation.
2 In IntelliSpace Perinatal: Create a test patient with three fetuses; create one newborn test [_]
patient from the maternal patient.
Enter all the relevant data for the maternal patient and enter three different delivery types
for the three fetuses in the maternal delivery form.
Only forms data that the customer wants to transfer into the ICCA system needs to be
entered.
Note the forms the customer wants to transfer to ICCA below.
3 ICCA: Create the same test patient as created in IntelliSpace Perinatal and search for the [_]
maternal and newborn patient using the ICCA IntelliSpace Perinatal Patient Data transfer
tool and transfer the data from IntelliSpace Perinatal.
Verify that the forms appear in ICCA as expected by the customer; for reference,
check the verification table below.
This integration test has passed if IntelliSpace Perinatal data comes up in the associated
CareVue ICCA form.
4 Check the external server log file to verify that there are no errors related to this test. [_]

Forms Data Transfer Verification Table

CareVue Chart Form Section CareVue Chart Form Name
(Example) Labor/Delivery (Example) Maternal

10 minutes Printer [_]
Model and Serial Number of Computer _____________________________________

Location of Computer ___________________________________________________ Test Passed
Model and Serial Number of Printer________________________________________
Location of Printer _____________________________________________________
1 Print multiple pages of traces, and a labor chart. [_]
2 Compare the trace printout to the trace display. Verify the printout matches the display [_]
and printout quality is acceptable for customer.
3 Share the printer and connect from another computer. Verify the print operation. [_]


20 minutes Scanner [_]
Model and Serial Number of Computer _______________________________

Location of Computer _____________________________________________ Test Passed
Scanner Manufacturer:_____________________________________________
Model: _________________________________________________________
Serial number:___________________________________________________
Order number:___________________________________________________
TWAIN driver name and version:____________________________________
1 Open the Attachment form of any test patient. [_]

2 Insert a paper FM strip onto the scanner lid having at least three pages [_]
3 Start scanning with a 150 dpi resolution by clicking on the gray scale scan [_]
4 Verify the paper strip is visible in the image area and the disk space consumed by this one [_]
trace is acceptable to customer (remember the 10MB limit per episode).
Verify with customer that the quality of the scanned file is acceptable.
5 Start scanning with a 150 dpi resolution by clicking on the color scan [_]
6 Verify the paper strip is visible in the image area, and the disk space consumed by this one [_]
trace is acceptable to customer (remember the 10MB limit per episode).
Verify with customer that the quality of the scanned file is acceptable.

10 minutes UPS [_]
Model and Serial Number of Computer ________________________________

Location of Computer _____________________________________________ Test Passed
UPS Manufacturer ________________________________________________
UPS Model ______________________________________________________
1 Verify UPS is supplying power to the computer. [_]



2-20 minutes VM - Storage vMotion [_]
VM Name _____________________________________ Test Passed
1 Wait until the system is fully operational. [_]

2 In vCenter, initiate a storage migration for the internal server. [_]
3 Verify in vCenter that the storage migration has successfully ended. [_]
4 Verify that the train is still running on the internal server, and that there is no system [_]
message in relation to the VMware activity.

20 minutes VM - Temp Snapshots [_]
VM Name ___________________________________________________ Test Passed
1 In vCenter, initiate the temporary snapshot creation, backup of the internal server VM [_]
and deletion of the temporary snapshot (using, for instance, the hot clone feature to create a
backup).
2 Verify in vCenter that the operation has finished and that there is no permanent snapshot [_]
afterwards in the snapshot manager:
message in relation to the VMware activity

30 minutes VM - Auto Full vMotion [_]
1 Wait until the system is under full load [_]

(for instance during standard operation time 10AM)

2 In vCenter, initiate a live migration for all the different servers. If resources are [_]
constrained, we recommend to migrate one after the other. Resources permitting, the
migration may be done simultaneously.
3 Verify in vCenter that the migration has successfully ended for all VMs [_]

60 minutes VM - Reduced vMotion [_]
1 Wait until the limited system usage level is reached. [_]

2 Take a note of the systems load level that the live migration is tested with: [_]
System activity:
Load Index Actual value

System activity Pending Episodes (max of all modules)
(See IntelliSpace Perinatal System
Console -> Patient Processes-> Episode
close process)
Internal Server Currently connected clients
(See IntelliSpace Perinatal System
Console -> Limits -> System)
DAC Host Number of DACs
(LAN: IntelliSpace Perinatal System
Console -> Data Acquisition ->
Number of currently connected fetal
monitors
Serial: See Chalkboard -> Number of
currently connected fetal monitors)
RDSH Server Current active sessions
(Windows Remote Desktop Service
manager -> Users in state active)
3 In vCenter, initiate a live migration for all the different servers. If resources are [_]
constrained, we recommend to migrate one after the other. Resources permitting, the
migration may be done simultaneously.
4 Verify in vCenter that the migration has successfully ended for all VMs. [_]

10 Integration Tests Recording the Results
10.3 Recording the Results

Use the check box in the test modules to record progress for each test. When all required tests are
finished, complete the Integration Test Summary below.
The integrator and customer should both sign the test forms and each should keep a copy. The
integrator (customer, Philips or third-party) must archive the results in the system documentation
binder for transition to support, including following documents:
• IntelliSpace Perinatal installation record
• System diagram, showing both IntelliSpace Perinatal and all other applications
• Full contact details of third party integrator (name of representative, name of company, address,
telephone number, email. etc.)
• Checked of Tests executed during this integration test (including T&I tests)
Additionally, a summary description of the integrated system must be communicated to the local
response center. This must include the information shown above.
When testing a VMware environment, document the VMware version, the memory size and the CPU
count. Optionally, also document the virtual disk file location.

Recording the Results 10 Integration Tests
Integration Test Summary
Facility Name and Address

______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
IntelliSpace Perinatal Software Revision

______________________________________________________________
Test Result
Integration test has
[_] passed [_] failed
Test performed by
(Integrator)
Signature
Date
Customer Representative
Signature
Date
Document the integrated equipment or software that was part of the integration:

10 Integration Tests Recording the Results

11
11Glossary
The following is a list of terms that are commonly used.
AD(S) Active Directory (Service)
AFR Annual Failure Rate
AV Anti Virus SW
BW Band Width
CBT Computer based training
CS Clinical Specialist, clinical education specialist, application specialist
CSA Customer Service Agreement
CSPP Customer Service Product Plan
DAC Data acquisition from fetal monitor
DC Domain Controller
DPSP Discontinuance Product Support Plan
DRS, DPS Distributed Resource Sharing, Distributed Power Sharing
FCO Field change order (service note)
FM Fetal Monitor
FS Full Support
HIS Hospital information system
ISP IntelliSpace Perinatal
NAT Network Address Translation
NBS Network Based Storage
NIC Network interface card

11 Glossary
NLB Network Load Balancing
OBR Observation Request
OBX Observation Result
OU Organizational unit, relates to ADS
PSA Philips Service Agent
RC Response center
RD Remote desktop
RDC Remote desktop connection
RDS CAL Remote Desktop Session Client Access License
RDSH Remote Desktop Session Host
RSN Remote service network
RTAC/RCE Remote Technical Assistance Center / Response Center Engineer
SPS Serial port server (RS232 to LAN conversion)
T&I Test & Inspection

1Index
A NotesDocumentation.xls 66
administrative episodes 40 O
ADT
ORU outgoing, export cycle time 63
admission, discharge and transfer 37
ORU routes 72, 75, 78
ADT data fields 47
ORU routes (incoming) 87
ADT Operating Modes 47
ORU routes (outgoing) 72, 75, 78
ADT routes 56
audit trail 152 P
Avalon FM2030/40/50 25
patient context 155
C patient identifier 45
character set handling 152 R

classic RS232 connection 25
readership 1
communications
single port mode 38 S
Context Synchronization 156
single port mode communications 38
D SQL queries
NICU 23
data fields, ADT 47
startup patient context 155
date and time values 152
strong identification 48
direct LAN connection 25
system status indicator 170
E
T
export cycle time, ORU outgoing 63
third party
F hardware integration 165
triplet monitoring 25
fast upload 25
field for NICU 23
H
HL7 installation 38
I
ICCA, NICU interface 23
identifier list 45
M
mobile fetal monitors 33
N
NICU
fields 23
SQL queries 23
NICU interface with ICCA 23
4535 648 45721 - IntelliSpace Perinatal Integration Guide - i

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I nt e g r a ti o n G ui de

4535 648 45721

Who This Book is For 1

2 Document Export (DOX) 11

4535 648 45721 - IntelliSpace Perinatal Integration Guide - i

4 Fetal Monitor LAN Connection 25

ii - IntelliSpace Perinatal Integration Guide - 4535 648 45721

4535 648 45721 - IntelliSpace Perinatal Integration Guide - iii

iv - IntelliSpace Perinatal Integration Guide - 4535 648 45721

6 IntelliSpace Perinatal Link 153

System Requirements 153

7 Context Synchronization 155

Startup Patient Context 155

4535 647 97241 - IntelliSpace Perinatal Integration Guide - v

8 Diagnostics and Repair 163

9 Third Party Co-residency and Network Integration 165

Integration Responsibility 165

10 Integration Tests 177

Mandatory Integration Testing 178

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1.1 Who This Book is For

4535 648 45721 - IntelliSpace Perinatal Integration Guide - 1

1.2 Interface Overview and Integration Points

Clients Other Vendor Systems Philips Systems

ADT System EHR System LIS System

1.3 What’s New in Rev. K.00?

2 - IntelliSpace Perinatal Integration Guide - 4535 648 45721

• Allows to configure a patient identifier with label and type code

1.3.1.2 IHE Profiles (HL7)

1.3.1.3 Patient and User Context Synchronization (Single Sign-On)

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1.3.1.4 DOX Signature Events

1.3.2 Enhancements and Fixed Issues

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1.4 What’s New in Rev. J.00?

1.4.1.1 Patient and User Context Synchronization (Single Sign-On)

1.4.1.2 Built-In HL7 Support

1.4.1.3 Automated ADT Workflow Option (ADT Inbound)

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1.4.1.4 EPIC Device Data Interface (ORU Outbound)

1.4.1.5 Incoming Custom Charting Notes (ORU inbound)

1.4.2 Enhancements and Fixed Issues

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– Fetal Monitor Marker Pressed NTE062

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• ORU outbound: Changed identifier in deceleration note from NTE177-6^SevereDecel^99POB to

1.4.3 Specific CIE functionality no longer available

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2Document Export (DOX)

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2.1 Process Overview

2.2 General Setup

2.2.1 Requirements for Optional HL7 Notifications

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2.3 Document Export Module

2.4 IntelliSpace Perinatal Events

Transfer from departmental location

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Grid Row Signature - Grid row signed. Yes Yes No

Transfer out of care unit Care unit n/a

Transfer out of location Location n/a

Transfer into care unit Care unit n/a