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– Second level
• Third level
– Fourth level
» Fifth level
Introduction to
Health Level Seven Standard Version 2.8.2
National Resource Centre for EHR Standards(NRCeS)
C-DAC, Pune

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Click to edit Master title style
Agenda
• Why
Click Medical Standard?
to edit Master text styles
• – Second
What level Level Seven (HL7)?
is Health
• • Third level
Purpose
– Fourth level
• Timeline of» HL7 Standards
Fifth level
• HL7 in Communication
• Scope of HL7
• HL7 Systems
• HL7 Message
• Understanding HL7 Message Structure

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Click Medical
Why to edit Master
Standard?
title style
• Click to edit
In order to Master
reduce text styles
disconnects between all health care systems, there
– Second
must some standard to achieve interoperability.
level
• Third level
• Standards are vital for interoperability.
– Fourth level
• Provide quality
» Fifth improvement
level and greater value.
• Improve information access.
• Helps to identify the mechanisms for protecting the privacy &
confidentiality of individual’s health data.
• Allows industry to move forward without having each individual having to
the ground implementation.

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What is edit
Click to Health Leveltitle
Master Seven (HL7)?
style
Version 2.8.2

• Click
An Application
to edit Master Protocol for Electronic Data Exchange in Healthcare
text styles
Environments
– Second level
• Health
• Third level or HL7 refers to a set of international standards for transfer
Level-7
– Fourth
of clinical and level
administrative data
» Fifth level
• Language that describes you, and your medical information, to all the
Hospital information systems
• Produced by the Health Level Seven International
• A not-for-profit, international standards developing organization
• ANSI-accredited
• Founded in 1987

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Click-to
HL7 What
editDoes
Master
it Mean?
title style
• Click to edit Master text styles
– Second level7 Application Layer HL7 – Health Level 7

• Third level
6 Presentation Layer
– Fourth level
» Fifth level
5 Session Layer

4 Transport Layer
OSI Model
3 Network Layer

2 Data Link Layer

1 Physical Layer

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Purpose
• Click
To provide
to edit aMaster
comprehensive
text styles framework and related standards for the
exchange, integration, sharing and retrieval of electronic health
– Second level
information that supports clinical practice and the management, delivery
• Third level
and evaluation of health services
– Fourth level

• HL7 Vision» -Fifth

A level
world in which everyone can securely access and use the
right health data when and where they need it
• HL7 Mission - To provide standards that empower global health data
interoperability

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Purpose
• HL7
Clickprovides standards
to edit Master textfor interoperability that improves –
styles
– Care delivery
Second level
– Reduce
• Thirdambiguity
level
– Fourth
– Enhance level
knowledge transfer
» Fifth level
among healthcare providers, government agencies, vendor community and patient

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Click to edit
Timeline of HL7
Master
Standards
title style
• 1987
Click to edit Master textFounded
styles and Version 1.0
• – Second level
1988 Version 2.0
• • Third level
1990-2000 Version 2.1 to 2.4
– Fourth level
• 2000-2007» Fifth level Version 2.5
• 2007-2014 Version 2.6 to Version 2.7
• 2014 Version 2.8 to version 2.8.2
• 2015 Version 2.8.2

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ClickintoCommunication
HL7 edit Master title style
• Click to edit Master text styles
Patient Registration
– Second level
• Third level
– Fourth level Clinical Laboratory
Information System
» Fifth level

Financial Management
Health Information System Information System

Radiology Information
System

…….. and more

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ClickintoCommunication
HL7 edit Master title style
• Click to edit Master text styles
Patient Registration
– Second level Patient Arrives
• Third level
– Fourth level
» Fifth level

Clinical Laboratory
Information System Patient goes for Lab test

Financial Management
Information System Patient Discharge

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ClickintoCommunication
HL7 edit Master title style
• Patient
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Registration text styles
Scenario
– Second level
• Third level
– Fourth level
Patient Admit
» Fifth level

Sends information to Finance

department (ADT_A01)

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HL7 edit Master title style
• Patient
Click to
Labedit
TestMaster
Scenariotext styles
– Second level
• Third level
Goes for lab test
– Fourth level
» Fifth level
Query Patient Admin (QBP_Q21)

Retrieves Info (RSP_K21)

Sends info to finance (ORU_R01)

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ClickintoCommunication
HL7 edit Master title style
• Patient
Click to edit Master
Discharge text styles
Scenario
– Second level
• Third level
– Fourth level Sends discharge
» Fifth level notification (ADT_A03)

Generates Bill

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Scope HL7Master title style
• Click
HL7 Version 2.8.2Master
to edit provide text
a considerable
styles service in everyday use, in thousands of locations
and–inSecond
many level
different countries, However, there are certainly many areas of healthcare
system integration that HL7 does not address or addresses with what may prove to be an
• Third
inadequate level
or incomplete solution.
– Fourth level
• A Complete Solution
» Fifth level
- HL7 Version 2.8.2 is not, in itself, a complete systems integration solution. There are several barriers in
today’s healthcare delivery environment that makes it difficult for HL7 to create a complete “plug-
and-play” solution.
• Protection of Healthcare Information
• HL7 Version 2.8.2 is largely silent about the issues of privacy authentication and confidentiality of data
that pass through HL7 messages. HL7 makes no assumption about the ultimate use of data but rather
assumes that both source and destination applications provide for these requirements.
• Enforcement of Organizational Security and Access Control Policies
- HL7 Version 2.8.2, itself, does not provide for the enforcement of a provider organization’s security
and access control policies. 14
Click toofedit
Scope HL7Master title style
•• Roles
Click and Relationships
to edit Master text styles
- HL7 Version 2.8.2 does not, in itself, attempt to define or even support the implicit and explicit
– Second level
relationships between persons such as patients, physicians, providers, etc.
• Third level
• Accountability, Audit Trails and Assigned Responsibility
– Fourth level
- HL7 Version 2.8 does not attempt to define typical transaction processing features such as audit
trails. » Fifth level

• Tracking of Corrections, Amendments or Refusals to Correct or Amend Protected

Health Information
- HL7 Version 2.8 does not provide messages to support the tracking of corrections, amendments or
refusals to correct or amend protected health information.
• Tracking Input Validation
- HL7 Version 2.8 does not provide messages for tracking the validation (or lack of validation) of data
from its source (human or machine).

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ClickSystems
HL7 to edit Master title style
• Click
Theretoare large
edit Masternumber of Messages present for different departments in
text styles
Health
– Secondinformation
level system.
• HL7 • standard
Third level categories these messages according to their purpose in
different– Fourth level
HL7 Systems.
» Fifth level
• In HL7 v2.8.2, total 15 Systems are stated.
• Patient Administration, Observation Reporting, Medical Records, Order
entry, Application Management, Scheduling, Patient Referral, Financial
Management, Master Files, Patient Care, Clinical Laboratory Automation,
Personnel Management, Claims and Reimbursement, Materials
Management.

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ClickMessage
HL7 to edit Master title style
• Atomic
Click to unit
edit of data transferred
Master text styles between systems
• – Second
Group level
of segments in a defined sequence
• Each• message
Third levelhas a message type that defines its purpose
– Fourth level
• Message Code» Fifth level
- A three-character code contained within each message identifies its
type.

For example: the ADT Message type is used to transmit portions of a

patient’s Patient Administration (ADT) data from one system to another.

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Click to edit Master title style
Message
• Click to Event
Trigger edit Master text styles
–
- Second level event that initiates an exchange of messages.
The real-world
• Third
- Event level
type
– Fourth level
» Fifth level

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Segment
• A segment
Click to editisMaster
a logical grouping
text styles of data fields.
• – Second level
Segments of a message may be required or optional.
• • Third level
A segment may occur only once in a message or they may be allowed to
– Fourth level
repeat.
» Fifth level
• Each segment contains a unique three-character code which defines
nature of Segment.
• All segment ID codes beginning with the letter Z are reserved for locally
defined segments.

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Click to edit
Segment Group
Master title style
• Click
Two orto more segments
edit Master textmay be organized as a logical unit called a segment
styles
group.
– Second level
• A segment
• Third level
group may be required or optional and might or might not
repeat.– Fourth level
» Fifth level
• A segment group is assigned a name that represents a permanent
identifier that may not be changed.

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Field
• A fieldtoisedit
Click a string
Master of characters.
text styles
• – Second
Fields for level
use within HL7 segments are defined by HL7.
• HL7 •does
Third not
levelcare how systems actually store data within an application.
– Fourth level
When fields are transmitted, they are sent as character strings.
» Fifth level
• A field SHALL exist in one of three population states in an HL7 message:
- Populated (Synonyms: valued, non-blank, not empty.)
- Not populated (Synonyms: unpopulated, not valued, unvalued, blank, empty, not present,
missing.)
- Null

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Click to
Data Type
edit Master title style
• Click
The basic building
to edit Masterblock used to construct or restrict the contents of a data
text styles
field.
– Second level
• Each• Third
field level
is assigned a data type that defines the value domain of the
field. – Fourth level
» Fifth level
• In the segment attribute tables this information is provided in the column
labeled DT.
• If the data type of the field is variable, the notation "varies" will be
displayed.

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Click to
Data Type
edit
Types
Master title style
• Primitive
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PDT Primitive Data Type
-– Second
Series oflevel
characters
• Third
- E.g. DT, DTM,
level ID, ST etc.
– Fourth level
• Composite
» Fifth level
- Series of components that are themselves assigned to a data type, which may again
be either primitive or composite data types
- The components of a component are called sub-components, and they SHALL only
be assigned primitive data types.
- E.g. AD, CNE, CWE, XCN, XPN etc.

PDT PDT CDT CDT PDT Composite Data Type

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Message Delimiters
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– Second level
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– Fourth level
» Fifth level

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Understanding HL7 Message
title styleStructure
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– Second level
• Third level
– Fourth level
» Fifth level

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Click to edit Master
Understanding HL7 Message
title styleStructure
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– Second level
• Third level
– Fourth level
» Fifth level

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Click to edit Master
Understanding HL7 Message
title styleStructure
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– Second level
• Third level
– Fourth level
» Fifth level

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Understanding HL7 Message
title styleStructure
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– Second level
• Third level
– Fourth level
» Fifth level

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Understanding HL7 Message
title styleStructure
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– Second level
• Third level
– Fourth level
» Fifth level

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Understanding HL7 Message
title styleStructure
• Click to edit Master text styles
– Second level
• Third level Patient Identification
– Fourth level
» Fifth level
PID Field Field Field Field Field <cr>

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Click to edit Master
Understanding HL7 Message
title styleStructure
• Click to edit Master text styles
– Second
PID level
Name DOB Address
<cr>

• Third level
– Fourth level
» Fifth level

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Click to edit Master
Understanding HL7 Message
title styleStructure
• Click to edit Master text styles
– Second level
• Third level
– Fourth level
» Fifth level

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ClickSpecial
HL7 to edit Protocols
Master title style
• Sequence Number
Click to edit MasterProtocol
text styles
• – Second and
Message level Segments Continuation (Fragmentation/Defragmentation)
• • Third level
Publish-Subscribe Protocol
– Fourth level
• Interactive»Continuation
Fifth level Protocol
• Query Cancellation
• Batch Protocol
• Local Extension Protocol

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References
• Click
http://www.hl7.org/
to edit Master text styles
– Second
• HL7 level Standard Version 2.8.2 -
Messaging
• Third level
http://www.hl7.org/implement/standards/product_brief.cfm?product_id=
185 – Fourth level
» Fifth level

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Click to edit Master title style
• Click to edit Master text styles
– Second level
• Third level
– Fourth level
» Fifth level
Thank You
nrc-help@cdac.in

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