mock hl7 api

Tackle HL7 With Our Mock API and Extensive Documentation

The Catalyze HL7 Docs are a series of files describing and documenting the HL7 messages - it's models, the Catalyze interpretation into APIs and examples of the raw HL7 and translated JSON. The Mock API provides developers with a prototyping tool that acts and functions as a JSON API for all things HL7. This is a living document and will continue to evolve as we add more details for each of the multitude of HL7 messages.

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An introduction to HL7

HL7 (Health Language 7) is a “standard” utilized by the healthcare industry to enable messaging between applications. A good example is the exchange of scheduling data between an EHR and an appointment scheduling system. It is managed and maintained by Health Level Seven International (HL7) which is a not-for-profit, ANSI-accredited standards developing organization. The HL7 standard is often jokingly referred to as the “non-standard standard.” This is not very fair but it does reflect the fact that almost every hospital, clinic, imaging center, lab, and care facility is “special” in terms of how it implements HL7. This is because there is no such thing as a standard business or clinical process for interacting with patients, clinical data, or related personnel.

The HL7 messaging protocol was designed to facilitate high volumes of pre-defined data to be shared across many applications reliably. The protocol selected to make this happen was a traditional file transfer or a TCP/IP socket in both a real-time and batched fashion (HTTP didn’t exist as we know it in 1991). HL7 v2.x message structure is complex, flat, and delimited. HL7 has obviously evolved over time. The current version of HL7 is v3.0. However, older versions exist and make up the bulk of the standard used today primarily because of the large number customizations that have been done to each HL7 message type.

The key differences between a v2.x and v3 message are as follows:

  1. v2.x was primarily meant for clinical communications - medical orders, patient registration etc. whereas v3.x has additional features for use by informaticists and for government reporting requirements.
  2. v2.x was a custom format (barebones text - all coded and separated by a pipe with headers and multiple segments etc.) v2.x looks like this:

HL7 v2.x format

whereas an HL7 v3.0 message is an XML format - very verbose and detailed - like this:

HL7 v3.x format

  1. All v2.x formats are backward compatible. v3.x is a wholly separate format and not backwards compatible with v2.x implementations.

Any technology solution in healthcare has to support at least v2.x. Open source parsing solutions exist to help with processing HL7 (see section below on Parsing HL7 messages). In 2015, under development FHIR standards are more likely to be implemented rather than the v3.0 standards. For more details on FHIR, check out our FHIR docs here

Customization

Every conversation that you’ve ever overheard about HL7 usually talks about customizations to be accounted for and associated implementation costs. Customizations are not uncommon, but the devil is really in the details. Let’s talk about an HL7 ADT feed, which every hospital needs to have. Customization came about when certain message types, like ADT, could not support sending all the data elements that needed to be sent. HL7 was initially developed in the 1980s and 1990s when things like NPI (National Provider Identifier), email addresses, mobile phone numbers etc. did not exist. This data was shoved somewhere “custom”. Likewise, a message might be able to handle only 50 data elements but an EKG reading might need to send over 200. The extra data elements were then sent over using the notorious Z segment - a miscellaneous segment into which pretty much any data object could be jammed in. This custom blob of data in the Z segment would then need to be parsed and mapped etc. for automated processing and use, creating impressive levels of customization in data exchange.

Ultimately, the true customization comes in the form of the content of the HL7 message. The HL7 organization has defined code sets to be used to translate the terse codes sent over within the HL7 message. See here for a listing of some v2.3 code sets or here for a more comprehensive listing. The purpose of the code sets is to codify the content to reduce the size of the message. For example, ANT stands for Anterior in the context of body sites. These code sets for HL7 have also evolved / been added to / modified with each version of HL7. However, these code sets, which are released and maintained as part of the standard, aren’t often adhered to. EHRs and hospitals have also defined their own code sets. So the content sent through the HL7 message needs to be “looked up” against that specific code set before it can be made useful. An Epic code set is unique (although common across Epic deployments) and different from an Allscripts code set. This is the uniqueness that must be addressed by any solution in this space and the reason why HL7 implementations can sometimes be expensive - they need to take into account not only the Z segments and map them to the appropriate data models but the code sets have to be taken into account as well.

So in practice, HL7 can be perhaps best described as a messaging protocol and format standard in most implementations rather than as a comprehensive messaging standard.

Common HL7 Message Types

There are over 80 message types, a whole host of segments and codes for pretty much anything you can think of. See this document for a pretty comprehensive listing. But the following are the most common HL7 message types:

Message Name Description
ACK General acknowledgement message. This is the ack sent when a message is received by the destination system. ACKs are automated responses. However, you could use ACKs as a way to modulate the speed at which messages come through as the sending system will not send the next message until the ACK is received
ADT Admission, Discharge and Transfer message. Created whenever a patient goes through any of those states. Also handles “Registration” and demographics updates. There are a whole list of these possible states. See below for a sampling of a few more
ORM Pharmacy/treatment order message
ORU Observation message. Usually this is in the form of a “result”, like from that of a lab system. This can be tied to an ORM message or can also be what is referred to as an “unsolicited result”. The term unsolicited is used because the destination systems are not asking for a result; it is fired off and the source systems will take it in and process it if possible.
BAR Add or change the billing account.
SIU Scheduling information, usually patient specific. This is used to create, modify and delete patient appointments.
MDM Medical document management. This often acts as a workhorse. It is meant to handle documents like clinician notes and patient-specific or encounter-specific documentation. This is often used to capture a whole host of other data for which there is no easy mapping.
DFT Detailed financial transactions. This data is used to capture the details of procedures etc. so that claims can be generated.
MFN Master files notification - changes to core data elements are sent through this. For example, Epic can broadcast changes to the facility structure to downstream systems through MFN messages.
QRY Query - as the name implies is used to query source systems for data on things like patient demographics etc.
RAS Pharmacy/treatment administration message
RDE Pharmacy/treatment encoded order message
RGV Pharmacy/treatment give message

​It should also be noted that each of these message types have different types (sub-types) as well. For example, there are 51 (yep, that’s right) different types of ADT messages that are used for various trigger events. Some of the most commonly used ADT messages include:

  • ADT-A01 – patient admit

  • ADT-A02 – patient transfer

  • ADT-A03 – patient discharge

  • ADT-A04 – patient registration

  • ADT-A05 – patient pre-admission

  • ADT-A08 – patient information update

  • ADT-A11 – cancel patient admit

  • ADT-A12 – cancel patient transfer

  • ADT-A13 – cancel patient discharge

The important thing to remember is that the content of the message doesn’t change all that much between all these sub-types. The message is still about the specific patient; the various message types modify what is being communicated about that patient.

HL7 message structure

HL7 is a near real-time messaging prototcol, When a trigger event happens, an HL7 message will get fired off and any system which is programmed to receive the event are “pushed” the message. The HL7 standard defines trigger event as “an event in the real world of health care (that) creates the need for data to flow among systems”. Each trigger event is associated with a specific message type. Each message is a collection of segments, and includes the rules of repetition and inclusion for those segments. The following table shows an example of an ADT message triggered by the event of placing a lab order (ORM).

A couple of quick notes:

  • No brackets around it - Required
  • [] - Optional
  • { } - Repeating
  • [{ }] - Optional Repeating

The ORM message structure is as follows.

ORM     General Order Message
MSH     Message Header
 [{NTE}]    Notes and Comments (for Header)
[
   PID     Patient Identification
   [PD1]    Additional Patient Identification
      [{NTE}]  Notes and Comments (for Patient ID)
   [PV1    Patient Visit
    [PV2|]   Patient Visit Additional Information
    [{IN1   Insurance
      [IN2]   Insurance Additional Info
   [IN3]   Insurance Additional Info
    }]
    [GT1]   Guarantor
    [{AL1}]   Allergy
  ]
]
 {
   ORC    Common Order
  [
   Order Detail Segment OBR, etc.
       [{NTE}]  Notes and Comments (for Detail)
       [{DG1}]  Diagnosis
       [
        {
         OBX   Observation/Result
              [{NTE}] Notes and Comments (for Results)
         }
       ]
  ]
  {[CTI]}   Clinical Trial Identification
 [BLG]    Billing segment
 }

Parts of the HL7 message

An HL7 message contains the following parts: segments, data fields, components, and optionally subcomponents. HL7 messages have a hierarchical structure in a specific order:

  • Segment
  • Data Field
  • Component
  • Subcomponent (optional)

HL7 Segments

A segment is a group of fields that then contain different types of data. Each segment exists independently and can be utilized in multiple messages in different sequences. Segments may be required for a particular message or in other cases they may be optional.

A unique three-character code called the “Segment ID” identifies each segment. Segment ID codes beginning with the letter Z are reserved for custom segments that are not part of the HL7 standard.

You can remove one or more segments from a message if desired. But, because HL7 rules state that unexpected or unused segments should be ignored, most systems will ignore the unexpected segments without issue. Segments should be removed only if one of the receiving systems will have problems when unexpected segments are received.

These are the most common segment types that will be used across multiple message types.

Segment Name Description
DG1 Diagnosis
EVN Event type
GT1 Guarantor
IN1 >Insurance
MSH Message header
NTE Notes and comments
OBR Observation Request
OBX Observation Result
ORC Common Order
PID Patient Identification
FT1 For DFT messages - Financial transactions

All HL7 messages have a message header and body. The MSH segment is the header of the message and all other types of segments form the body of the message.

HL7 Data Fields & Components

These basically refer to the elements and sub-elements in the specific segment. Data types define data fields: Simple and Complex. So an MSH.1 would be a data field under the MSH segment and EVN.1 would be under the EVN segment.

Within data fields, Components and subcomponents contain further data and can be repeated within the same field.

The intent of this HL7 documentation

The intent of this documentation is to provide you an in-depth view into HL7 and additionally a view into the APIs that Catalyze provides so that you do not have to deal with the pain of managing and maintaining various HL7 mappings and understanding HL7 versions. Our intention is to offer you a turnkey solution so that all you ever have to deal with is JSON. We deal with the pain of managing the mappings and versions of HL7, connecting to health systems, monitoring the interface status, ensuring messages do not get dropped, and re-processing messages in case issues crop up.

Note that this documentation should always be considered as an accompaniment to the authoritative source of all things related to HL7 - namely, the HL7 website. This documentation is by no means a replacement for the extremely comprehensive documentation available there. Any errors are completely our fault. Please do let us know immediately if you find any errors and we’ll correct them ASAP.

You can also use this documentation as a guide to help you get going on development using the Catalyze HL7 JSON models so that you can get started on development while the business folks deal with the relationships at the health systems and get the necessary approvals to enable you to receive the data. As soon as the feed is turned on, you already will have a head start on development.

The design of HL7

The overall structure of an HL7 message

Think of an HL7 message as an envelope. It contains various segments (pieces of data) which are (usually) patient oriented and triggered based on specific events (admits, lab results, procedures, discharge etc.) and communicate relevant information about that triggered event.

There are a lot of message types - 76 in v2.3 and 85 in v2.3.1 and even more now. An HL7 message is constructed with:

  • One or more segments: Segments are re-usable sub-parts of a message which contain the pertinent information related to that message type. So for example, an Admit message would contain information on the patient and her demographics, the reason for admission, the attending physician who signed off on the admit etc. And as you can imagine, patient demographics is reused in a lot of places and is a segment. There are a lot of segments (101 in v2.3 and 111 in v2.3.1) to cover almost any use case you can think of - from financial transactions (DFT) to Bed Status Updates (NPU).

  • Fields & Code sets: Each segment consists of one or more fields of data. Since the message needs to be as short as possible, the fields are encoded using standardized codes (provided by HL7 or other bodies) or user defined (ideally only if HL7 doesn’t recommend any or you need to communicate more than permitted). Message Header becomes MSH, patient demographics becomes PD1 and Male becomes M. There are lot of additional codes to cover all the various kinds of information that need to be communicated - 1691 codes in v2.3 not including any user defined codes and

  • Control characters: These are the ASCII characters used to separate data elements (|), indicate spaces or new lines (^) and the beginning of the next segment (the CR or carriage return). These are a subset of the control characters but some of the more important ones.

In order to ensure that the receiving system knows how to parse the incoming message, some rules are laid down in that define

  • For each message, the required or optional segments and the number of times a segment could be repeated within.

  • For each segment, the sequence (SEQ) in which fields are expected, their length (LEN), the data types (DT), if the fields are required or optional (R/O), if they are repeatable or not and how many times can they be repeated (RP/#) and the table in which the code sets are defined (mapping guide)

Both of these rules are used for validation of any inbound message but the code sets are not. You can now see how the HL7 standard could be bastardized:

  • Code set doesn’t cover all my needs: So you add one more to the list that HL7 provides. Now your HL7 standard is not quite a standard and cannot be shared with another entity unless they implement your code set as well

  • Field repetitions allowed is insufficient: I want to send an EKG reading but the standard only allows for 50 repetitions of key value pairs. So I dump the rest into the Z segment and shoot it over that way. Now your HL7 message can be processed by any engine but the content inside the Z segment now has to be parsed and managed separately.

A quick note on reading HL7 message examples which seem to contain a bunch of [],{} etc. The general rule is as follows:

  • No brackets around it - Required
  • [] - Optional
  • { } - Repeating
  • [{ }] - Optional Repeating

The ORM message structure is as follows.

ORM     General Order Message
MSH     Message Header
 [{NTE}]    Notes and Comments (for Header)
[
   PID     Patient Identification
   [PD1]    Additional Patient Identification
      [{NTE}]  Notes and Comments (for Patient ID)
   [PV1    Patient Visit
    [PV2|]   Patient Visit Additional Information
    [{IN1   Insurance
      [IN2]   Insurance Additional Info
   [IN3]   Insurance Additional Info
    }]
    [GT1]   Guarantor
    [{AL1}]   Allergy
  ]
]
 {
   ORC    Common Order
  [
   Order Detail Segment OBR, etc.
       [{NTE}]  Notes and Comments (for Detail)
       [{DG1}]  Diagnosis
       [
        {
         OBX   Observation/Result
              [{NTE}] Notes and Comments (for Results)
         }
       ]
  ]
  {[CTI]}   Clinical Trial Identification
 [BLG]    Billing segment
 }

Parts of the HL7 message

An HL7 message contains the following parts: segments, data fields, components, and optionally subcomponents. HL7 messages have a hierarchical structure in a specific order:

  • Segment
  • Data Field
  • Component
  • Subcomponent (optional)

HL7 Segments

A segment is a group of fields that then contain different types of data. Each segment exists independently and can be utilized in multiple messages, in different sequences. Segments may be required for a particular message or in other cases, they may be optional.

A unique three-character code called the “Segment ID” identifies each segment. Segment ID codes beginning with the letter Z are reserved for the “custom” Z-segments (key value pairs) that are not part of the HL7 standard.

You can remove one or more segments from a message if desired. But because HL7 rules state that unexpected or unused segments should be ignored, most systems will ignore the unexpected segments without issue (therefore, manually removing these segments is unnecessary). Segments should be removed only if one of the receiving systems will not have problems when unexpected segments are received.

These are the most common segment types that will be used across multiple message types.

Segment Name Description
DG1 Diagnosis
EVN Event type
GT1 Guarantor
IN1 >Insurance
MSH Message header
NTE Notes and comments
OBRI Observation Request
OBXI Observation Result
ORCI Common Order
PID Patient Identification
FT1 For DFT messages - Financial transactions

All HL7 messages have a message header and body. The MSH segment is the header of the message and all other types of segments form the body of the message.

Z Segments

It is worth calling out the Z segment. HL7 messages are customizable. Customization came about when certain message types did not support sending all the data elements that a particular workflow needed. For example, a message might be able to handle only 50 data elements but an EKG reading might need to send over 200. The extra data elements were then sent over using the notorious Z segment - a miscellaneous segment into which pretty much any key value pair could be jammed in. This custom blob of data in the Z segment would then need to be parsed and mapped etc. for automated processing and use, creating impressive levels of customization in data exchange.

HL7 Data Fields & Components

These basically refer to the elements and sub-elements in the specific segment. Data types define data fields: Simple and Complex. So an MSH.1 would be a data field under the MSH segment and EVN.1 would be under the EVN segment.

Within data fields, Components and subcomponents contain further data and can be repeated within the same field.

Vocabularies

While vocabularies are not part of the structure, it is again worth calling out as it is a critical part of deciphering any HL7 message. The HL7 organization has defined code sets to be used to translate the terse codes sent over within the HL7 message. See here for a listing of some v2.3 code sets or here for a more comprehensive listing from HL7. The purpose of the code sets is to codify the content to reduce the size of the message. ANT, as an example, stands for Anterior in the context of body sites. These code sets for HL7 have also evolved / been added to / modified with each version of HL7. However, these code sets, which are released and maintained as part of the standard, aren’t often adhered to. EHRs (usually) and hospitals have defined their own code sets. So the content sent over within the HL7 message needs to be “looked up” against that specific code set before it can be made useful. An Epic code set is unique (although common across Epic deployments) and different from an AllScripts code set. This is the uniqueness that must be addressed by any solution in this space and the reason why HL7 implementations can sometimes be expensive - they need to take into account not only the Z segments and map them to the appropriate data models but the code sets have to be taken into account as well.

The ADT (Admission, Discharge, Transfer) message

The ADT message is one of the most common messages in HL7. It covers a lot of use cases such as admissions, cancellation of admits, merging of patient data etc. This is the reason why there is such a long list of possible events / message types that could be sent. The full list for the HL7 v2.3.1 is shown below.

Segment ID Description
A01 Admit/visit notification
A02 Transfer a patient
A03 Discharge/end visit
A04 Register a patient
A05 Pre-admit a patient
A06 Change an outpatient to an inpatient
A07 Change an inpatient to an outpatient
A08 Update patient information
A09 Patient departing - tracking
A10 Patient arriving - tracking
A11 Cancel admit/visit notification
A12 Cancel transfer
A13 Cancel discharge/end visit
A14 Pending admit
A15 Pending transfer
A16 Pending discharge
A17 Swap patients
A18 Merge patient information
A19 QRY/ADR - Patient query
A20 Bed status update
A21 Patient goes on a “leave of absence”
A22 Patient returns from a “leave of absence”
A23 Delete a patient record
A24 Link patient information
A25 Cancel pending discharge
A26 Cancel pending transfer
A27 Cancel pending admit
A28 Add person information
A29 Delete person information
A30 Merge person information
A31 Update person information
A32 Cancel patient arriving - tracking
A33 Cancel patient departing - tracking
A34 Merge patient information - patient I
A35 Merge patient information - account only
A36 Merge patient information - patient ID and account number
A37 Unlink patient information
A38 Cancel pre-admit
A39 Merge person - patient ID
A40 Merge patient - patient identifier list
A41 Merge account - patient account num
A42 Merge visit - visit number
A43 Move patient information - patient identifier list
A44 Move account information - patient account number
A45 Move visit information - visit number
A46 Change patient ID
A47 Change patient identifier list
A48 Change alternate patient ID
A49 Change patient account number
A50 Change visit number
A51 Change alternate visit ID

The mandated structure of the ADT-A01 message

As we discussed earlier, HL7 recommends / mandates that messages follow a specific structure. The segments we will need are:

  • MSH: the message header (required everywhere)
  • EVN: indicating the event that happened (in this case the admission of the patient)
  • PID: the patient identification segment. Note that demographics can be included within the PID segment itself
  • NK1: next of kin (which is always good to know in a hospital context in case something goes wrong)
  • PV1: information about the patient “visit” - this is where you would include the physician info and the current location of the patient.

One quick tip - in most HL7 messages the pipe character “|” is called the BAR and it is the field separator and in the case of this message, we’re going to use the “^” as a space. So if you see a bunch of pipes together like this “||||||||||” - all that means is that the fields at that point in the sequence were optional or not available. Also remember that segments are separated by a carriage return - which cannot be displayed as any and all viewers will interpret that for display.

The HL7 v2.x specifies the following format for an ADT A01 message. For additional examples and specific structure, you can view the Patient Admin related PDF on the HL7 site. Note also that EHRs often have created their own variants of this standard for example Epic has a slightly different format that it specifies that also adheres to the 2.3 standard with some additions as well.

Segment Description
MSH Message Header
[{ SFT }] Software Segment
[ UAC ] User Authentication Credential
EVN Event Type
PID Patient Identification
[ PD1 ] Additional Demographics
[{ ARV }] Access Restrictions
[{ ROL }] Role
[{ NK1 }] Next of Kin / Associated Parties
PV1 Patient Visit
[ PV2 ] Patient Visit - Additional Info.
[{ ARV }] Access Restrictions
[{ ROL }] Role
[{ DB1 }] Disability Information
[{ OBX }] Observation/Result
[{ AL1 }] Allergy Information
[{ DG1 }] Diagnosis Information
[ DRG ] Diagnosis Related Group
[{ — PROCEDURE begin
PR1 Procedures
[{ ROL }] Role
}] — PROCEDURE end
[{ GT1 }] Guarantor
[{ — INSURANCE begin
IN1 Insurance
[ IN2 ] Insurance Additional Info
[{ IN3 }] Insurance Additional Info - Cert
[{ ROL }] Role
}] — INSURANCE end
[ ACC ] Accident Information
[ UB1 ] Universal Bill Information
[ UB2 ] Universal Bill 92 Information
[ PDA ] Patient Death and Autopsy

We’ll take some of the key segments listed above and provide examples for each below and finally show an fully composed HL7 message. Additionally, a few more HL7 sample messages of each will be listed below.

The MSH (message header) segment

MSH|^~\&|EPICADT|DH|LABADT|DH|201301011226||ADT^A01|HL7MSG00001|P|2.3|

The EVN (event) segment

EVN|A01|201301011223||

The PID (patient identifier) segment

PID|||MRN12345^5^M11||APPLESEED^JOHN^A^III||19710101|M||C|1^CATALYZE STREET^^MADISON^WI^53005-1020|GL|(414)379-1212|(414)271-3434||S||MRN12345001^2^M10|123456789|987654^NC|

The NK1 (next of kin) segment

NK1|1|APPLESEED^BARBARA^J|WIFE||||||NK^NEXT OF KIN

The PV1 (patient visit) segment

PV1|1|I|2000^2012^01||||004777^GOOD^SIDNEY^J.|||SUR||||ADM|A0|

Putting it all together

he full HL7 ADT-A01 message (without the carriage returns)

MSH|^~\&|EPICADT|DH|LABADT|DH|201301011226||ADT^A01|HL7MSG00001|P|2.3|
EVN|A01|201301011223||
PID|||MRN12345^5^M11||APPLESEED^JOHN^A^III||19710101|M||C|1 CATALYZE STREET^^MADISON^WI^53005-1020|GL|(414)379-1212|(414)271-3434||S||MRN12345001^2^M10|123456789|987654^NC|
NK1|1|APPLESEED^BARBARA^J|WIFE||||||NK^NEXT OF KIN
PV1|1|I|2000^2012^01||||004777^GOOD^SIDNEY^J.|||SUR||||ADM|A0|

Additional ADT examples

Here a few more samples of ADT messages for some of the key message and event types (without the carriage returns <cr> fields.

Admission / visit notification (patient has been admitted) - ADT^A01

MSH|^~\&|AccMgr|1|||20120123495123||ADT^A01|599102|P|2.3|||
EVN|A01|20050110045502||||| 
PID|1||10006579^^^1^MRN^1||DOE^JOHN^Q||19241234|M||1|123 MAIN ST^^SOMEWHERE^CT^999990000^^M|1|8885551212|8885551212|1|2||40007716^^^AccMgr^VN^1|123121234|||||||||||NO NK1|1|DUCK^HUEY|SO|3583 DUCK RD^^SOMEWHERE^CT^999990000|8885552222||Y|||||||||||||| 
PV1|1|I|PREOP^101^1^1^^^S|3|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|||01||||1|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|2|40007716^^^AccMgr^VN|4|||||||||||||||||||1||G|||20050110045253||||||
GT1|1|8291|DOE^JOHN^Q||111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||19241234|M||1|123121234||||#MyCompany LLC|111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||PT|
DG1|1|I9|71596^OSTEOARTHROS NOS-L/LEG ^I9|OSTEOARTHROS NOS-L/LEG ||A|
IN1|1|MEDICARE|3|MEDICARE|||||||MyCompany LLC|19891001|||4|DOE^JOHN^Q|1|19241234|111^MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||123121234A||||||PT|M|123 MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|1||123121234|MyCompany LLC|||123121234A|||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|2|NON-PRIMARY|9|MEDICAL MUTUAL CALIF.|PO BOX 94776^^SMALLVILLE^KS^441414776||8003621279|PUBSUMB|||MyCompany LLC||||7|DOE^JOHN^Q|1|19241234|123 MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||056269770||||||PT|M|111^MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|2||123121234|MyCompany LLC||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|3|SELF PAY|1|SELF PAY|||||||||||5||1

Transfer patient - ADT^A02

MSH|^~\&|AccMgr|1|||20120101121234||ADT^A02|99991234|P|2.3|||
EVN|A02|20120101121234|||||
PID|1||12341234^^^1^MRN^1||DOE^JOHN^D||43214321|M||1|111^MAIN ST^^SMALLVILLE^KS^999991234^^M|1|8005551212|8005551212|1|2||40007716^^^AccMgr^VN^1|123121234|||||||||||NO
PV1|1|I|IN1^123^1^1^^^S|3||PREOP^101^|37^DOE^JOHN^^^^^^AccMgr^^^^CI|||01||||1|||37^DOE^JOHN^^^^^^AccMgr^^^^CI|2|12341234^^^AccMgr^VN|4|||||||||||||||||||1||I|||20120101121234||||||

Discharge patient - ADT^A03

MSH|^~\&|XX|YY||ZZ|20051223000530||ADT^A03|161949|D|2.4
EVN|A03|20051223000530|||891701|20051223000530
PID|||50521935^^^^XX||ZZTEST^BILL^""^^||19721221|F|ZZTEST^BILL^~|UN-6|9200 W STATE ST^""^MADISON^WI^53226^||(414)887-6453|(414)444-3333||XX-S||66000757630|
PV1||I|UNH1^123^A||||006080^GILLIS^TROY^^^^^^^^^^XXPROV|||INC|||||||006080^GILLIS^TROY^^^^^^^^^^XX
PROV|||||||||||||||||||XX-01||||||||20051222132214|20051222235959
PV2|||||||||
DG1|||^Hx Palpitations|||

Patient registration (patient yet to be admitted) - ADT^A04


MSH|^~\&|XX|YY||ZZ|20051222132306||ADT^A04|161935|D|2.4
EVN|A01|20051222132306|||891701|20051222132306
PID|||50521935^^^^XX||ZZTEST^BILL^""^^||19721221|F|ZZTEST^BILL^~|XX-6|9200 W STATE ST^""^MADISON^WI^53226^||(414)887-6453|(414)444-3333||UN-S||66000757630|
NK1|1|ZZTEST^DAUGHTER^|XX-O|4422 S LOOMIS BLVD^""^WEST ALLIS^WI^53214|(414)222-8888|(262)333-5555|EC1
PV1||O|XXINCO||||006080^GILLIS^TROY^^^^^^^^^^XXPROV|||INCO|||||||006080^GILLIS^TROY^^^^^^^^^^XXPROV|||||||||||||||||||||||||||20051222132214
PV2|||||||||
DG1|||^Colonoscopy|||
GT1|1|50521935X|AA^CARLA^||9200 W STATE ST^^MADISON^WI^53226^^|(414)259-3000|||||XX-X|125-41-2000
IN1|0|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M149849^""^||555-555-3015|90||||||50 OK|
IN1|2|""|""

Pre-admit notification (patient yet to be admitted) - ADT^A05

 MSH|^~\&|REGADT|GOOD HEALTH HOSPITAL|GHH LAB||200701061000||ADT^A05^ADT_A05|000001|P|2.7|||
EVN|A05|200701061000|200701101400|01||200701061000
PID|1|| PATID1234^^^GOOD HEALTH HOSPITAL^MR^GOOD HEALTH
HOSPITAL~123456789^^^USSSA^SS|253763|EVERYMAN^ADAM^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||(555) 555-2004|(555)555-2004||S|C|99999^^^GOOD HEALTH HOSPITAL^AN|444-33-3333||
NK1|1|NUCLEAR^NELDA^W|SPO^SPOUSE|6666 HOME STREET ^^ISHPEMING^MI^49849^""^|555- 555-5001|555-555-5001555-555-5001|EC^EMERGENCY CONTACT
NK1|2|MUM^MARTHA^M|MOTHER|4444 HOME STREET ^^ISHPEMING^MI^49849^""^|555-555- 2006|555-555-2006~555-555-2006|EC^EMERGENCY CONTACT
NK1|3
NK1|4|||6666 WORKER LOOP^^ISHPEMING^MI^49849|555-555-3003|EM^EMPLOYER|19940605||PROGRAMMER|||WORK IS FUN, INC. PV1||O|||||0148^ATTEND^AARON^A|0148^SENDER^SAM||AMB|||||||0148^ATTEND^AARON^A|S|1
400|A|||||||||||||||||||GOOD HEALTH HOSPITAL||||||
PV2||||||||200301101400||||||||||||||||||||||||||200301101400
OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F
OBX||ST|1010.1^HEIGHT||190|cm|||||F
DG1|1|19||BIOPSY||00
GT1|1||EVERYMAN^ADAM^A^""^""^""^""^||2222 HOME STREET^ISHPEMING^MI^49849^""^|(555) 555-2004|555 555-2004||||SE^SELF|444-33 3333|||| |2222 HOME STREET^^ISHPEMING^MI^49849^""|555-555-2004 |||||||||||||||||||||||||||||||||AUTO CLINIC
IN1|1|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M1^49849^^||555- 555-3015|90||||||50 OK
IN1|2|""|""

Patient status changed from outpatient to inpatient - ADT^A06

MSH|^~\&|AccMgr|1|||20120123495123||ADT^A06|599102|P|2.3|||
EVN|A06|20050110045502||||| 
PID|1||10006579^^^1^MRN^1||DOE^JOHN^Q||19241234|M||1|123 MAIN ST^^SOMEWHERE^CT^999990000^^M|1|8885551212|8885551212|1|2||40007716^^^AccMgr^VN^1|123121234|||||||||||NO NK1|1|DUCK^HUEY|SO|3583 DUCK RD^^SOMEWHERE^CT^999990000|8885552222||Y|||||||||||||| 
PV1|1|I|PREOP^101^1^1^^^S|3|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|||01||||1|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|2|40007716^^^AccMgr^VN|4|||||||||||||||||||1||G|||20050110045253||||||
GT1|1|8291|DOE^JOHN^Q||111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||19241234|M||1|123121234||||#MyCompany LLC|111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||PT|
DG1|1|I9|71596^OSTEOARTHROS NOS-L/LEG ^I9|OSTEOARTHROS NOS-L/LEG ||A|
IN1|1|MEDICARE|3|MEDICARE|||||||MyCompany LLC|19891001|||4|DOE^JOHN^Q|1|19241234|111^MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||123121234A||||||PT|M|123 MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|1||123121234|MyCompany LLC|||123121234A|||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|2|NON-PRIMARY|9|MEDICAL MUTUAL CALIF.|PO BOX 94776^^SMALLVILLE^KS^441414776||8003621279|PUBSUMB|||MyCompany LLC||||7|DOE^JOHN^Q|1|19241234|123 MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||056269770||||||PT|M|111^MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|2||123121234|MyCompany LLC||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|3|SELF PAY|1|SELF PAY|||||||||||5||1

Patient status changed from inpatient to outpatient - ADT^A07

MSH|^~\&|AccMgr|1|||20120123495123||ADT^A07|599102|P|2.3|||
EVN|A07|20120101041234||||| 
PID|1||10006579^^^1^MRN^1||DOE^JOHN^Q||19241234|M||1|123 MAIN ST^^SOMEWHERE^CT^999991234^^M|1|8885551212|8885551212|1|2||40007716^^^AccMgr^VN^1|123121234|||||||||||NO NK1|1|DUCK^HUEY|SO|3583 DUCK RD^^SOMEWHERE^CT^999990000|8885552222||Y|||||||||||||| 
PV1|1|I|PREOP^101^1^1^^^S|3|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|||01||||1|||37^SMITH^JOE^Q^^^^^^AccMgr^^^^CI|2|40007716^^^AccMgr^VN|4|||||||||||||||||||1||G|||20050110045253||||||
GT1|1|8291|DOE^JOHN^Q||111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||19241234|M||1|123121234||||#MyCompany LLC|111^MAIN ST^^SOMEWHERE^CT^999990000|8885551212||PT|
DG1|1|I9|71596^OSTEOARTHROS NOS-L/LEG ^I9|OSTEOARTHROS NOS-L/LEG ||A|
IN1|1|MEDICARE|3|MEDICARE|||||||MyCompany LLC|19891001|||4|DOE^JOHN^Q|1|19241234|111^MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||123121234A||||||PT|M|123 MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|1||123121234|MyCompany LLC|||123121234A|||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|2|NON-PRIMARY|9|MEDICAL MUTUAL CALIF.|PO BOX 94776^^SMALLVILLE^KS^441414776||8003621279|PUBSUMB|||MyCompany LLC||||7|DOE^JOHN^Q|1|19241234|123 MAIN ST^^SOMEWHERE^CT^999990000|||||||||||||||||056269770||||||PT|M|111^MAIN ST^^SOMEWHERE^CT^999990000|||||8291
IN2|2||123121234|MyCompany LLC||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||8885551212
IN1|3|SELF PAY|1|SELF PAY|||||||||||5||1

Update the patient’s information - ADT^A08

MSH|^~\&||Testlab^00D0000000^CLIA|ELR|DOH|20061101102000||ADT^A08^ADT^A01|2006280000002|T|2.3|
EVN|A08|20061101102100|
PID|1|^^^^^City Hospital Center&00D0000000&CLIA|2320023^^^^^City Hospital&00D0000000&CLIA||Test^Patient 2||19940910|M|||100 Main Street^City^State^ZIP^^M||^^^^^123^5551212|^^^^^123^5551213|||||234567890|||U|
PV1||I

The JSON object model

To ensure maximum coverage, we have mapped all the data elements in the HL7 standard to a corresponding JSON data element. Additionally, JSON doesn’t have the concept of sequence or order (as opposed to XML). Order can be important in HL7 messages. The inital DG1 segment is usually the primary diagnosis for billing purposes and the initial IN1 segment is the primary insurance to bill for the visit. To overcome issues in ordering, we introduced specific numbering into our arrays.

Below is a sample JSON object for the HL7 ADT message. Note that this is the same object you will receive for all ADT message types. Certain or whole sets of fields can be empty depending on the message type. As you can also notice, there is a lot going on in this object. There are a large number of fields and most of our customers rarely use more than 5-10% of them. That is an additional value add that is included in our service; we’ll trim down your data models as required.

If the following HL7 ADT message is received by Catalyze, then the JSON object immediately following is the response you can expect to be POST-ed to your API endpoint.

HL7 ADT^A01 message received

MSH|^~\&|XX|YY||ZZ|20160502172306-0800||ADT^A01|203495|D|2.4
EVN|A01|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^PHD|||MED|||||A0||123456||E4003692|||||||||||||||||||||||||20151222132306-0800

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-05-02T21:23:06-0400",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A01",
            "messageControlId":"203495",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A01"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"50521935",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"ZZTEST",
                "firstName":"BILL",
                "middleInitOrName":"C"
            },
            "mothersMaidenName":"AATEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"M",
            "alias":"RONALD",
            "race":"",
            "address":{  
                "streetAddress":"640 W BARFORD AVE",
                "otherDesignation":"",
                "city":"MILWAUKEE",
                "state":"WI",
                "postalCode":"53211",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(414)888-5588",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"bzztest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"ronnymcdonny@realsite.net",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(414)444-3333",
            "primaryLanguage":"ENG",
            "maritalStatus":"M",
            "religion":"MOT",
            "patientAccountNumber":{  
                "id":"6600075763",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"333772222",
            "driversLicenseNumber":"Y5529583110042",
            "mothersId":"",
            "ethnicGroup":"U",
            "birthPlace":"",
            "multipleBirthIndicator":"N",
            "birthOrder":"",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"PHD",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"123456",
                "lastName":"",
                "firstName":"",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        }
    }
}

HL7 ADT^A02 message received

MSH|^~\&|XX|YY||ZZ|20161222132306-0800||ADT^A02|115547|D|2.4
EVN|A02|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|QQTEST|19910310080910-0800|O|BIANCA||9200 W STATE ST^3^MADISON^WI^53226^USA||(414)888-5588^^^bzztest@gmail.com|(414)444-3333|ENG|M|MOT|66000757630|333772222|||U||N||USA||||N
PV1|1|I|XXPOC^206^^XXFAC^XXSTATUS^OR^XXBUILDING|U||XXPOC^204^^XXFAC^XXSTATUS^NURSING^XXBUILDING|123456^DUCK^DAFFY^P^JR^DR^PHD|||MED|||||A0||123456||E4003692|||||||||||||||||||||||||20151222132306-0800
OBX|1|CWE|271649006^Systolic blood pressure^SNOMED-CT||120|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
OBX|2|CWE|271650006^Diastolic blood pressure^SNOMED-CT||80|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A02",
            "messageControlId":"115547",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A02"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"50521935",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"ZZTEST",
                "firstName":"BILL",
                "middleInitOrName":"C"
            },
            "mothersMaidenName":"QQTEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"O",
            "alias":"BIANCA",
            "race":"",
            "address":{  
                "streetAddress":"9200 W STATE ST",
                "otherDesignation":"3",
                "city":"MADISON",
                "state":"WI",
                "postalCode":"53226",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(414)888-5588",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"bzztest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(414)444-3333",
            "primaryLanguage":"ENG",
            "maritalStatus":"M",
            "religion":"MOT",
            "patientAccountNumber":{  
                "id":"66000757630",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"333772222",
            "driversLicenseNumber":"",
            "mothersId":"",
            "ethnicGroup":"U",
            "birthPlace":"",
            "multipleBirthIndicator":"N",
            "birthOrder":"",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"206",
                "bed":"",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"OR",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPOC",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"PHD",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"123456",
                "lastName":"",
                "firstName":"",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "OBX":[  
            {  
                "setId":"1",
                "valueType":"CWE",
                "identifer":{  
                    "id":"271649006",
                    "text":"Systolic blood pressure",
                    "codingSystem":"SNOMED-CT",
                    "alternateId":"",
                    "alternateText":"",
                    "alternateCodingSystem":""
                },
                "subId":"",
                "observationValue":"120",
                "units":"mmHg",
                "referenceRange":"",
                "abnormalFlag":"",
                "probability":"",
                "natureOfAbnormal":"",
                "observeResultStatus":"F",
                "effectiveDateLastNormalValue":"",
                "definedAccessChecks":"",
                "observationDateTime":"2015-12-22T16:35:00-0500",
                "producerId":{  
                    "identifier":"",
                    "text":""
                },
                "responsibleObserver":{  
                    "id":"52936881",
                    "lastName":"DUCK",
                    "firstName":"DAFFY"
                },
                "method":""
            },
            {  
                "setId":"2",
                "valueType":"CWE",
                "identifer":{  
                    "id":"271650006",
                    "text":"Diastolic blood pressure",
                    "codingSystem":"SNOMED-CT",
                    "alternateId":"",
                    "alternateText":"",
                    "alternateCodingSystem":""
                },
                "subId":"",
                "observationValue":"80",
                "units":"mmHg",
                "referenceRange":"",
                "abnormalFlag":"",
                "probability":"",
                "natureOfAbnormal":"",
                "observeResultStatus":"F",
                "effectiveDateLastNormalValue":"",
                "definedAccessChecks":"",
                "observationDateTime":"2015-12-22T16:35:00-0500",
                "producerId":{  
                    "identifier":"",
                    "text":""
                },
                "responsibleObserver":{  
                    "id":"52936881",
                    "lastName":"DUCK",
                    "firstName":"DAFFY"
                },
                "method":""
            }
        ]
    }
}

HL7 ADT^A03 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||ADT^A03|657657|D|2.4
EVN|A03|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||22490753^^^^MRN||XXTEST^TIMOTHY^R|CCTEST|19910310080910-0800|O|BIANCA||123 SESAME STREET^MADISON^WI^53713^USA||(608)444-5678^^^txxtest@gmail.com~^^^xxbianca@yahoo.com|(608)221-5555|ENG|P|AGN|8845620749|555883456|Q8820033123469||H||Y|2|USA|||20160120103000-0800|Y
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^Ph.D.|||MED|XXTEMP||||A0||782200^PIG^PORKY||E4003692|||||||||||||||||||||||||20151222132306-0800
PV2|XXPRIORPENDING||400999005^Procedure requested^SNOMED-CT||Gold watch, cell phone, keys.|XXVALLOC||20151222133000-0800|20151224133000-0800|2||Elective surgery.|||N|||ES||1|F|Y|XXCLINIC|AI|3|||20151220|||||20151222134500-0800|N||N||P|K|IM|P|S|F|Y

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A03",
            "messageControlId":"657657",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A03"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"22490753",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"XXTEST",
                "firstName":"TIMOTHY",
                "middleInitOrName":"R"
            },
            "mothersMaidenName":"CCTEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"O",
            "alias":"BIANCA",
            "race":"",
            "address":{  
                "streetAddress":"123 SESAME STREET",
                "otherDesignation":"MADISON",
                "city":"WI",
                "state":"53713",
                "postalCode":"USA",
                "country":"",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)444-5678",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"txxtest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"xxbianca@yahoo.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)221-5555",
            "primaryLanguage":"ENG",
            "maritalStatus":"P",
            "religion":"AGN",
            "patientAccountNumber":{  
                "id":"8845620749",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"555883456",
            "driversLicenseNumber":"Q8820033123469",
            "mothersId":"",
            "ethnicGroup":"H",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"2",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"2016-01-20T13:30:00-0500",
            "deathIndicator":"Y"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"Ph.D.",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"XXTEMP",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"782200",
                "lastName":"PIG",
                "firstName":"PORKY",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "PV2":{  
            "priorPendingLocation":"XXPRIORPENDING",
            "accommodationCode":"",
            "admitReason":"400999005",
            "transferReason":"",
            "patientValuables":"Gold watch, cell phone, keys.",
            "patientValuablesLocation":"XXVALLOC",
            "visitUserCode":"",
            "expectedAdmitDateTime":"2015-12-22T16:30:00-0500",
            "expectedDischargeDateTime":"2015-12-24T16:30:00-0500",
            "estimatedLengthInpatientStay":"2",
            "actualLengthInpatientStay":"",
            "visitDescription":"Elective surgery.",
            "referralSourceCode":"",
            "previousServiceDate":"",
            "employmentIllnessRelatedIndicator":"N",
            "purgeStatusCode":"",
            "purgeStatusDate":"",
            "specialProgramCode":"ES",
            "retentionIndicator":"",
            "expectedNumInsurancePlans":"1",
            "visitPublicityCode":"F",
            "visitProtectionIndicator":"Y",
            "clinicOrganizationName":"XXCLINIC",
            "patientStatusCode":"AI",
            "visitPriorityCode":"3",
            "previousTreatmentDate":"",
            "expectedDischargeDisposition":"",
            "signatureOnFileDate":"2015-12-20T00:00:00-0500",
            "firstSimilarIllnessDate":"",
            "patientChargeAdjustmentCode":"",
            "recurringServiceCode":"",
            "billingMediaCode":"",
            "expectedSurgeryDateTime":"2015-12-22T16:45:00-0500",
            "militaryPartnershipCode":"N",
            "militaryNonAvailabilityCode":"",
            "newbornBabyIndicator":"N",
            "babyDetainedIndicator":"",
            "modeOfArrivalCode":"P",
            "recreationalDrugUseCode":"K",
            "admissionLevelOfCareCode":"IM",
            "precautionCode":"P",
            "patientConditionCode":"S",
            "livingWillCode":"F",
            "organDonorCode":"Y",
            "advanceDirectiveCode":"",
            "patientStatusAffectiveDate":"",
            "expectedLOAReturnDateTime":"",
            "expectedPreAdmissionTestingDateTime":"",
            "notifyClergyCode":""
        }
    }
}

HL7 ADT^A04 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||ADT^A04|293873|D|2.4
EVN|A04|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||73902171^^^^MRN||YYTEST^ERIN^M|BBTEST|19840722141856-0800|F|SHIRLEY||9200 W STATE ST^3^MADISON^WI^53715^USA||(608)344-8800^^^eyytest@hotmail.com~^^^yytest84@gmail.com|(608)222-9999|ESP|S|ATH|8302741992|999772222|B2408664777790||N||Y|1|USA||||N
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^Ph.D.|||MED|XXTEMP||||A0||782200^PIG^PORKY||E4003692|||||||||||||||||||||||||20151222132306-0800
DG1|1||527.7^Dry mouth^ICD 9||20151222170000-0800|W
DG1|2||784.99^Halitosis^ICD 9||20151222170000-0800|F

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A04",
            "messageControlId":"293873",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A04"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"73902171",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"YYTEST",
                "firstName":"ERIN",
                "middleInitOrName":"M"
            },
            "mothersMaidenName":"BBTEST",
            "dateTimeBirth":"1984-07-22T18:18:56-0400",
            "sex":"F",
            "alias":"SHIRLEY",
            "race":"",
            "address":{  
                "streetAddress":"9200 W STATE ST",
                "otherDesignation":"3",
                "city":"MADISON",
                "state":"WI",
                "postalCode":"53715",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)344-8800",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"eyytest@hotmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"yytest84@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)222-9999",
            "primaryLanguage":"ESP",
            "maritalStatus":"S",
            "religion":"ATH",
            "patientAccountNumber":{  
                "id":"8302741992",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"999772222",
            "driversLicenseNumber":"B2408664777790",
            "mothersId":"",
            "ethnicGroup":"N",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"1",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"Ph.D.",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"XXTEMP",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"782200",
                "lastName":"PIG",
                "firstName":"PORKY",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "DG1":[  
            {  
                "id":"1",
                "codingMethod":"",
                "code":{  
                    "identifier":"527.7",
                    "text":"Dry mouth",
                    "codingSystem":"ICD 9"
                },
                "description":"",
                "dateTime":"2015-12-22T20:00:00-0500",
                "type":"W",
                "diagnosticCategory":""
            },
            {  
                "id":"2",
                "codingMethod":"",
                "code":{  
                    "identifier":"784.99",
                    "text":"Halitosis",
                    "codingSystem":"ICD 9"
                },
                "description":"",
                "dateTime":"2015-12-22T20:00:00-0500",
                "type":"F",
                "diagnosticCategory":""
            }
        ]
    }
}

HL7 ADT^A05 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||ADT^A05|999789|D|2.4
EVN|A05|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^Ph.D.|||MED|XXTEMP||||A0||782200^PIG^PORKY||E4003692|||||||||||||||||||||||||20151222132306-0800
PV2|YYPRIORPENDING||829^Bone fracture^ICD-9||Pocket knife, thumb drive, tablet, wallet.|YYVALLOC||20160113193000-0800|20160114004200-0800|||Urgent,urgent, emergency.|||Y|||U||1|N|N|YYCLINIC||2|||20130813||||||Y|Y|N||H|AT|CR|C|C|N|F
DG1|1||784.99^Halitosis^ICD 9||20151222170000-0800|F
DG1|2||E927.1^Overexertion from prolonged static position^ICD 9||20151222170000-0800|F

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A05",
            "messageControlId":"999789",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A05"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"50521935",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"ZZTEST",
                "firstName":"BILL",
                "middleInitOrName":"C"
            },
            "mothersMaidenName":"AATEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"M",
            "alias":"RONALD",
            "race":"",
            "address":{  
                "streetAddress":"640 W BARFORD AVE",
                "otherDesignation":"",
                "city":"MILWAUKEE",
                "state":"WI",
                "postalCode":"53211",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(414)888-5588",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"bzztest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"ronnymcdonny@realsite.net",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(414)444-3333",
            "primaryLanguage":"ENG",
            "maritalStatus":"M",
            "religion":"MOT",
            "patientAccountNumber":{  
                "id":"6600075763",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"333772222",
            "driversLicenseNumber":"Y5529583110042",
            "mothersId":"",
            "ethnicGroup":"U",
            "birthPlace":"",
            "multipleBirthIndicator":"N",
            "birthOrder":"",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"Ph.D.",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"XXTEMP",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"782200",
                "lastName":"PIG",
                "firstName":"PORKY",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
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            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
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            "pendingLocation":"",
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            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "PV2":{  
            "priorPendingLocation":"YYPRIORPENDING",
            "accommodationCode":"",
            "admitReason":"829",
            "transferReason":"",
            "patientValuables":"Pocket knife, thumb drive, tablet, wallet.",
            "patientValuablesLocation":"YYVALLOC",
            "visitUserCode":"",
            "expectedAdmitDateTime":"2016-01-13T22:30:00-0500",
            "expectedDischargeDateTime":"2016-01-14T03:42:00-0500",
            "estimatedLengthInpatientStay":"",
            "actualLengthInpatientStay":"",
            "visitDescription":"Urgent,urgent, emergency.",
            "referralSourceCode":"",
            "previousServiceDate":"",
            "employmentIllnessRelatedIndicator":"Y",
            "purgeStatusCode":"",
            "purgeStatusDate":"",
            "specialProgramCode":"U",
            "retentionIndicator":"",
            "expectedNumInsurancePlans":"1",
            "visitPublicityCode":"N",
            "visitProtectionIndicator":"N",
            "clinicOrganizationName":"YYCLINIC",
            "patientStatusCode":"",
            "visitPriorityCode":"2",
            "previousTreatmentDate":"",
            "expectedDischargeDisposition":"",
            "signatureOnFileDate":"2013-08-13T00:00:00-0400",
            "firstSimilarIllnessDate":"",
            "patientChargeAdjustmentCode":"",
            "recurringServiceCode":"",
            "billingMediaCode":"",
            "expectedSurgeryDateTime":"",
            "militaryPartnershipCode":"Y",
            "militaryNonAvailabilityCode":"Y",
            "newbornBabyIndicator":"N",
            "babyDetainedIndicator":"",
            "modeOfArrivalCode":"H",
            "recreationalDrugUseCode":"AT",
            "admissionLevelOfCareCode":"CR",
            "precautionCode":"C",
            "patientConditionCode":"C",
            "livingWillCode":"N",
            "organDonorCode":"F",
            "advanceDirectiveCode":"",
            "patientStatusAffectiveDate":"",
            "expectedLOAReturnDateTime":"",
            "expectedPreAdmissionTestingDateTime":"",
            "notifyClergyCode":""
        },
        "DG1":[  
            {  
                "id":"1",
                "codingMethod":"",
                "code":{  
                    "identifier":"784.99",
                    "text":"Halitosis",
                    "codingSystem":"ICD 9"
                },
                "description":"",
                "dateTime":"2015-12-22T20:00:00-0500",
                "type":"F",
                "diagnosticCategory":""
            },
            {  
                "id":"2",
                "codingMethod":"",
                "code":{  
                    "identifier":"E927.1",
                    "text":"Overexertion from prolonged static position",
                    "codingSystem":"ICD 9"
                },
                "description":"",
                "dateTime":"2015-12-22T20:00:00-0500",
                "type":"F",
                "diagnosticCategory":""
            }
        ]
    }
}

HL7 ADT^A06 message received

MSH|^~\&|XX|YY||ZZ|20160114142000-0800||ADT^A06|656599|D|2.4
EVN|A06|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||22490753^^^^MRN||XXTEST^TIMOTHY^R|CCTEST|19910310080910-0800|O|BIANCA||123 SESAME STREET^MADISON^WI^53713^USA||(608)444-5678^^^txxtest@gmail.com~^^^xxbianca@yahoo.com|(608)221-5555|ENG|P|AGN|8845620749|555883456|Q8820033123469||H||Y|2|USA|||20160120103000-0800|Y
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^Ph.D.|||MED|XXTEMP||||A0||782200^PIG^PORKY||E4003692|||||||||||||||||||||||||20151222132306-0800
PV2|ZZPRIORPENDING||267168001^Blood in urine^SNOMED-CT||Wallet, keys, cell phone, fitbit.|ZZVALLOC||20160421111545-0800|20160421174500-0800|||Typical lab stuff. You know, like blood draws. That sort of thing.||20160321|N|P|20170421|O|N|1|U|Y|ZZCLINIC|||20160210||20140101|20150230||RECUR|||N||N||C|MO|AC|D|A|Y|N
PR1|1||84.11^Amputation of toe^ICD 9||20151222133000-0800
PR1|2||21.85^Augmentation rhinoplasty^ICD 9||20151222134000-0800

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-01-14T17:20:00-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A06",
            "messageControlId":"656599",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A06"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"22490753",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"XXTEST",
                "firstName":"TIMOTHY",
                "middleInitOrName":"R"
            },
            "mothersMaidenName":"CCTEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"O",
            "alias":"BIANCA",
            "race":"",
            "address":{  
                "streetAddress":"123 SESAME STREET",
                "otherDesignation":"MADISON",
                "city":"WI",
                "state":"53713",
                "postalCode":"USA",
                "country":"",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)444-5678",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"txxtest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"xxbianca@yahoo.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)221-5555",
            "primaryLanguage":"ENG",
            "maritalStatus":"P",
            "religion":"AGN",
            "patientAccountNumber":{  
                "id":"8845620749",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"555883456",
            "driversLicenseNumber":"Q8820033123469",
            "mothersId":"",
            "ethnicGroup":"H",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"2",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"2016-01-20T13:30:00-0500",
            "deathIndicator":"Y"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"Ph.D.",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"XXTEMP",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"782200",
                "lastName":"PIG",
                "firstName":"PORKY",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "PV2":{  
            "priorPendingLocation":"ZZPRIORPENDING",
            "accommodationCode":"",
            "admitReason":"267168001",
            "transferReason":"",
            "patientValuables":"Wallet, keys, cell phone, fitbit.",
            "patientValuablesLocation":"ZZVALLOC",
            "visitUserCode":"",
            "expectedAdmitDateTime":"2016-04-21T15:15:45-0400",
            "expectedDischargeDateTime":"2016-04-21T21:45:00-0400",
            "estimatedLengthInpatientStay":"",
            "actualLengthInpatientStay":"",
            "visitDescription":"Typical lab stuff. You know, like blood draws. That sort of thing.",
            "referralSourceCode":"",
            "previousServiceDate":"2016-03-21T00:00:00-0400",
            "employmentIllnessRelatedIndicator":"N",
            "purgeStatusCode":"P",
            "purgeStatusDate":"2017-04-21T00:00:00-0400",
            "specialProgramCode":"O",
            "retentionIndicator":"N",
            "expectedNumInsurancePlans":"1",
            "visitPublicityCode":"U",
            "visitProtectionIndicator":"Y",
            "clinicOrganizationName":"ZZCLINIC",
            "patientStatusCode":"",
            "visitPriorityCode":"",
            "previousTreatmentDate":"2016-02-10T00:00:00-0500",
            "expectedDischargeDisposition":"",
            "signatureOnFileDate":"2014-01-01T00:00:00-0500",
            "firstSimilarIllnessDate":"2015-03-02T00:00:00-0500",
            "patientChargeAdjustmentCode":"",
            "recurringServiceCode":"RECUR",
            "billingMediaCode":"",
            "expectedSurgeryDateTime":"",
            "militaryPartnershipCode":"N",
            "militaryNonAvailabilityCode":"",
            "newbornBabyIndicator":"N",
            "babyDetainedIndicator":"",
            "modeOfArrivalCode":"C",
            "recreationalDrugUseCode":"MO",
            "admissionLevelOfCareCode":"AC",
            "precautionCode":"D",
            "patientConditionCode":"A",
            "livingWillCode":"Y",
            "organDonorCode":"N",
            "advanceDirectiveCode":"",
            "patientStatusAffectiveDate":"",
            "expectedLOAReturnDateTime":"",
            "expectedPreAdmissionTestingDateTime":"",
            "notifyClergyCode":""
        },
        "PR1":[  
            {  
                "id":"1",
                "codingMethod":"",
                "procedureCode":"84.11",
                "procedureDescription":"",
                "procedureTimestamp":"2015-12-22T16:30:00-0500"
            },
            {  
                "id":"2",
                "codingMethod":"",
                "procedureCode":"21.85",
                "procedureDescription":"",
                "procedureTimestamp":"2015-12-22T16:30:00-0500"
            }
        ]
    }
}

HL7 ADT^A07 message received

MSH|^~\&|XX|YY||ZZ|20140303000000-0800||ADT^A07|007123|D|2.4
EVN|A07|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||22490753^^^^MRN||XXTEST^TIMOTHY^R|CCTEST|19910310080910-0800|O|BIANCA||123 SESAME STREET^MADISON^WI^53713^USA||(608)444-5678^^^txxtest@gmail.com~^^^xxbianca@yahoo.com|(608)221-5555|ENG|P|AGN|8845620749|555883456|Q8820033123469||H||Y|2|USA|||20160120103000-0800|Y
PV1|1|I|XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|U||XXPRIOR|123456^DUCK^DAFFY^P^JR^DR^Ph.D.|||MED|XXTEMP||||A0||782200^PIG^PORKY||E4003692|||||||||||||||||||||||||20151222132306-0800
PV2|YYPRIORPENDING||829^Bone fracture^ICD-9||Pocket knife, thumb drive, tablet, wallet.|YYVALLOC||20160113193000-0800|20160114004200-0800|||Urgent,urgent, emergency.|||Y|||U||1|N|N|YYCLINIC||2|||20130813||||||Y|Y|N||H|AT|CR|C|C|N|F
GT1|1|50521935X|QQTEST^CARLA^M||421 S BURR OAK DR^^MADISON^WI^53713^USA|(608)222-3000|(608)444-9999|19641107121314-0800|F|IND|MTH|111-88-2000|||||444 W WASHINGTON AVE^699^MADISON^WI^53726^USA|(608)555-5555|11112233445|1|BIGCORP FINANCIAL, INC

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2014-03-03T03:00:00-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A07",
            "messageControlId":"007123",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A07"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"22490753",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"XXTEST",
                "firstName":"TIMOTHY",
                "middleInitOrName":"R"
            },
            "mothersMaidenName":"CCTEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"O",
            "alias":"BIANCA",
            "race":"",
            "address":{  
                "streetAddress":"123 SESAME STREET",
                "otherDesignation":"MADISON",
                "city":"WI",
                "state":"53713",
                "postalCode":"USA",
                "country":"",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)444-5678",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"txxtest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"xxbianca@yahoo.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)221-5555",
            "primaryLanguage":"ENG",
            "maritalStatus":"P",
            "religion":"AGN",
            "patientAccountNumber":{  
                "id":"8845620749",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"555883456",
            "driversLicenseNumber":"Q8820033123469",
            "mothersId":"",
            "ethnicGroup":"H",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"2",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"2016-01-20T13:30:00-0500",
            "deathIndicator":"Y"
        },
        "PV1":{  
            "id":"1",
            "patientClass":"I",
            "patientLocation":{  
                "pointOfCare":"XXPOC",
                "room":"204",
                "bed":"1",
                "facility":"XXFAC",
                "locationStatus":"XXSTATUS",
                "personLocationType":"NURSING",
                "building":"XXBUILDING"
            },
            "admissionType":"U",
            "priorPatientLocation":"XXPRIOR",
            "attendingProvider":{  
                "id":"123456",
                "lastName":"DUCK",
                "firstName":"DAFFY",
                "middleInitOrName":"P",
                "suffix":"JR",
                "prefix":"DR",
                "degree":"Ph.D.",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "referringProvider":"",
            "consultingDoctor":"",
            "hospitalService":"MED",
            "pointOfCare":"XXTEMP",
            "preadmitTestIndicator":"",
            "readmissionIndicator":"",
            "admitSource":"",
            "ambulatoryStatus":"A0",
            "vipIndicator":"",
            "admittingProvider":{  
                "id":"782200",
                "lastName":"PIG",
                "firstName":"PORKY",
                "middleInitOrName":"",
                "suffix":"",
                "prefix":"",
                "degree":"",
                "sourceTable":"",
                "assigningAuthority":"",
                "nameTypeCode":"",
                "identifierCheckDigit":"",
                "codeIdCheck":"",
                "identifierTypeCode":"",
                "assigningFacility":""
            },
            "patientType":"",
            "visitNumber":{  
                "id":"E4003692",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuthority":"",
                "idTypeCode":""
            },
            "financialClass":"",
            "chargePriceIndicator":"",
            "courtesyCode":"",
            "creditRating":"",
            "contractCode":"",
            "contractEffectiveDate":"",
            "contractAmmount":"",
            "contractPeriod":"",
            "interestCode":"",
            "transferToBadDebtCode":"",
            "transferToBadDebtDate":"",
            "badDebtAgencyCode":"",
            "badDebtRecoveryAmount":"",
            "deleteAccountIndicator":"",
            "deleteAccountDate":"",
            "dischargeDisposition":"",
            "dischargedToLocation":"",
            "dietType":"",
            "servicingFacility":"",
            "bedStatus":"",
            "accountStatus":"",
            "pendingLocation":"",
            "priorTemporaryLocation":"",
            "admitDateTime":"2015-12-22T16:23:06-0500",
            "dischargeDateTime":"",
            "currentPatientBalance":"",
            "totalCharges":"",
            "totalAdjustments":"",
            "totalPayments":"",
            "alternateVisitId":""
        },
        "PV2":{  
            "priorPendingLocation":"YYPRIORPENDING",
            "accommodationCode":"",
            "admitReason":"829",
            "transferReason":"",
            "patientValuables":"Pocket knife, thumb drive, tablet, wallet.",
            "patientValuablesLocation":"YYVALLOC",
            "visitUserCode":"",
            "expectedAdmitDateTime":"2016-01-13T22:30:00-0500",
            "expectedDischargeDateTime":"2016-01-14T03:42:00-0500",
            "estimatedLengthInpatientStay":"",
            "actualLengthInpatientStay":"",
            "visitDescription":"Urgent,urgent, emergency.",
            "referralSourceCode":"",
            "previousServiceDate":"",
            "employmentIllnessRelatedIndicator":"Y",
            "purgeStatusCode":"",
            "purgeStatusDate":"",
            "specialProgramCode":"U",
            "retentionIndicator":"",
            "expectedNumInsurancePlans":"1",
            "visitPublicityCode":"N",
            "visitProtectionIndicator":"N",
            "clinicOrganizationName":"YYCLINIC",
            "patientStatusCode":"",
            "visitPriorityCode":"2",
            "previousTreatmentDate":"",
            "expectedDischargeDisposition":"",
            "signatureOnFileDate":"2013-08-13T00:00:00-0400",
            "firstSimilarIllnessDate":"",
            "patientChargeAdjustmentCode":"",
            "recurringServiceCode":"",
            "billingMediaCode":"",
            "expectedSurgeryDateTime":"",
            "militaryPartnershipCode":"Y",
            "militaryNonAvailabilityCode":"Y",
            "newbornBabyIndicator":"N",
            "babyDetainedIndicator":"",
            "modeOfArrivalCode":"H",
            "recreationalDrugUseCode":"AT",
            "admissionLevelOfCareCode":"CR",
            "precautionCode":"C",
            "patientConditionCode":"C",
            "livingWillCode":"N",
            "organDonorCode":"F",
            "advanceDirectiveCode":"",
            "patientStatusAffectiveDate":"",
            "expectedLOAReturnDateTime":"",
            "expectedPreAdmissionTestingDateTime":"",
            "notifyClergyCode":""
        },
        "GT1":[  
            {  
                "id":"1",
                "guarantorNumber":"50521935X",
                "guarantorName":{  
                    "familyName":"QQTEST",
                    "givenName":"CARLA",
                    "middleInitOrName":"M"
                },
                "guarantorSpouseName":{  
                    "familyName":"",
                    "givenName":"",
                    "middleInitOrName":""
                },
                "guarantorAddress":{  
                    "streetAddress":"421 S BURR OAK DR",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53713",
                    "country":"USA"
                },
                "guarantorHomePhone":"(608)222-3000",
                "guarantorBusinessPhone":"(608)444-9999",
                "guarantorDateTimeBirth":"1964-11-07T15:13:14-0500",
                "guarantorSex":"F",
                "guarantorType":"IND",
                "guarantorRelationship":"MTH",
                "guarantorSSN":"111-88-2000",
                "guarantorBeginDate":"",
                "guarantorEndDate":"",
                "guarantorPriority":"",
                "guarantorEmployer":{  
                    "name":"",
                    "address":{  
                        "streetAddress":"444 W WASHINGTON AVE",
                        "otherDesignation":"699",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53726",
                        "country":"USA"
                    },
                    "phone":"(608)555-5555"
                },
                "guarantorEmployeeIdNumber":"11112233445",
                "guarantorEmploymentStatus":"1",
                "guarantorOrganizationName":"BIGCORP FINANCIAL, INC"
            }
        ]
    }
}

HL7 ADT^A08 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||ADT^A08|161935|D|2.4
EVN|A08|20151222132306-0800|20151222132500-0800|01|123456||
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|QQTEST|19910310080910-0800|O|BIANCA||9200 W STATE ST^3^MADISON^WI^53226^USA||(414)888-5588^^^bzztest@gmail.com|(414)444-3333|ENG|M|MOT|66000757630|333772222|||U||N||USA||||N
GT1|1|50521935X|QQTEST^CARLA^M||932 W SANDWOOD LN^^MADISON^WI^53713^USA|(608)222-3000|(608)444-9999|19641107121314-0800|F|IND|MTH|111-88-2000|||||555 W WASHINGTON AVE^^MADISON^WI^53726^USA|(608)434-1212|876901|1|MR MAGORIUM'S MATTRESS EMPORIUM

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ADT",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ADT",
            "messageEvent":"A08",
            "messageControlId":"161935",
            "processingID":"D",
            "versionID":"2.4"
        },
        "EVN":{  
            "eventType":"A08"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"50521935",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"ZZTEST",
                "firstName":"BILL",
                "middleInitOrName":"C"
            },
            "mothersMaidenName":"QQTEST",
            "dateTimeBirth":"1991-03-10T11:09:10-0500",
            "sex":"O",
            "alias":"BIANCA",
            "race":"",
            "address":{  
                "streetAddress":"9200 W STATE ST",
                "otherDesignation":"3",
                "city":"MADISON",
                "state":"WI",
                "postalCode":"53226",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(414)888-5588",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"bzztest@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(414)444-3333",
            "primaryLanguage":"ENG",
            "maritalStatus":"M",
            "religion":"MOT",
            "patientAccountNumber":{  
                "id":"66000757630",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"333772222",
            "driversLicenseNumber":"",
            "mothersId":"",
            "ethnicGroup":"U",
            "birthPlace":"",
            "multipleBirthIndicator":"N",
            "birthOrder":"",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N"
        },
        "GT1":[  
            {  
                "id":"1",
                "guarantorNumber":"50521935X",
                "guarantorName":{  
                    "familyName":"QQTEST",
                    "givenName":"CARLA",
                    "middleInitOrName":"M"
                },
                "guarantorSpouseName":{  
                    "familyName":"",
                    "givenName":"",
                    "middleInitOrName":""
                },
                "guarantorAddress":{  
                    "streetAddress":"932 W SANDWOOD LN",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53713",
                    "country":"USA"
                },
                "guarantorHomePhone":"(608)222-3000",
                "guarantorBusinessPhone":"(608)444-9999",
                "guarantorDateTimeBirth":"1964-11-07T15:13:14-0500",
                "guarantorSex":"F",
                "guarantorType":"IND",
                "guarantorRelationship":"MTH",
                "guarantorSSN":"111-88-2000",
                "guarantorBeginDate":"",
                "guarantorEndDate":"",
                "guarantorPriority":"",
                "guarantorEmployer":{  
                    "name":"",
                    "address":{  
                        "streetAddress":"555 W WASHINGTON AVE",
                        "otherDesignation":"",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53726",
                        "country":"USA"
                    },
                    "phone":"(608)434-1212"
                },
                "guarantorEmployeeIdNumber":"876901",
                "guarantorEmploymentStatus":"1",
                "guarantorOrganizationName":"MR MAGORIUM'S MATTRESS EMPORIUM"
            }
        ]
    }
}

The ORM (Patient Lab / Order ) message

ORM messages contain information about an order. The trigger event for theses messages are the original “signing” of that order and whenever the order is modified or cancelled. An order is a patient-specific request for material or services. These could be anything ranging from medication orders, nursing orders (take vitals q4h), lab tests, specific food / dietary orders and radiology films. If something needs to happen in a hospital or clinic, orders (ORM messages)distribute pertinent data from system to system. The only real exceptions to this rule involve NCPDP for e-prescribing and other HL7 message types for medication orders for pharmacy systems. We go into more detail about these HL7 message types in another segment.

The mandated structure of an ORM message

As we discussed earlier, HL7 recommends / mandates that messages follow a specific structure. The segments we will need are:

  • MSH: the message header (required everywhere)
  • NTE: Notes and comments. This will be repeated at the header level and then at the line level as well to provide context and result descriptions
  • PID: the patient identification segment. Note that demographics can be included within the PID segment itself
  • PV1: information about the patient “visit” - this is where you would include the physician info
  • IN1: this contains all the pertinent insurance information provided by the patient
  • GT1: guarantor of the patient in case of minor or similar situation
  • AL1: Any allergy information about the patient
  • ORC: Order section which could contain multiple orders
  • DG1: Diagnosis information based upon which the orders have been placed
  • OBX: Observations provided by the provider to provide context for the orders
  • BLG: The billing section containing specific information about the ordered service such as the charge type (professional, contract etc.)

One quick tip - in most HL7 messages the pipe character “|” is called the BAR and it is the field separator and in the case of this message, we’re going to use the “^” as a space. So if you see a bunch of pipes together like this “||||||||||” - all that means is that the fields at that point in the sequence were optional or not available. Also remember that segments are separated by a carriage return - which cannot be displayed as any and all viewers will interpret that for display.

The HL7 v2.7.x specifies the following format for an ORM message. For additional examples and specific structure, you can view the Patient Admin related PDF on the HL7 site. Note also that EHRs often have created their own variants of this standard for example Epic has a slightly different format that it specifies as it also adheres to the 2.3 standard with some additions as well. We intend to cover EHR specific variants soon.

Segment Description
MSH Message Header
[{NTE}] Notes and Comments (for Header)
[ – Begin Patient section
PID Patient Identification
[PD1] Additional Patient Identification
[{NTE}] Notes and Comments (for Patient ID)
[ – Begin Patient visit section
PV1 Patient Visit
[PV2] Patient Visit Additional Information
[{ – Begin Patient insurance section
IN1 Insurance
[IN2] Insurance Additional Info
[IN3] Insurance Additional Info
}] – End Patient insurance section
[GT1] Guarantor
[{AL1}] Allergy
] – End Patient visit section
] – End Patient section
{ – Begin Order section
ORC Common Order
[ – Begin Order details section
[{NTE}] Notes and Comments (for Detail)
[{DG1}] Diagnosis
[{ – Begin observation section
OBX Observation/Result
[{NTE}] Notes and Comments (for Results)
}] – End observation section
] – End Order details section
{[CTI]} Clinical Trial Identification
[BLG] Billing segment
} – End Order section

We’ll take some of the key segments listed above and provide examples for each below and finally show an fully composed HL7 message. Additionally, a few more HL7 sample messages of each will be listed below.

The MSH (message header) segment

MSH|^~\&|EPIC|EPIC|||20140418173314|1148|ORM^O01|497|D|2.3||

The PID (patient identification) segment

PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^

The PV1 (patient visit) segment

PV1|||^^^CARE HEALTH SYSTEMS^^^^^||| |1173^MATTHEWS^JAMES^A^^^||||||||||||610613||||||||||||||||||||||||||||||||V

The ORC (Order details) segment

ORC|NW|987654^EPIC|76543^EPC||Final||^^^20140418170014^^^^||20140418173314|1148^PATTERSON^JAMES^^^^||1173^MATTHEWS^JAMES^A^^^|1133^^^222^^^^^|(618)222-1122||

The DG1 (patient diagnosis) segment

DG1||I10|S82^ANKLE FRACTURE^I10|ANKLE FRACTURE||

The OBX (observations) segment

OBR|1|363463^EPC|1858^EPC|73610^X-RAY ANKLE 3+ VW^^^X-RAY ANKLE ||||||||||||1173^MATTHEWS^JAMES^A^^^|(608)258-8866||||||||Final||^^^20140418170014^^^^|||||6064^MANSFIELD^JEREMY^^^^||1148010^1A^EAST^X-RAY^^^|^|

Putting it all together

MSH|^~\&|EPIC|EPIC|||20140418173314|1148|ORM^O01|497|D|2.3||
PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^
PD1|||FACILITY(EAST)^^12345|1173^MATTHEWS^JAMES^A^^^
PV1|||^^^CARE HEALTH SYSTEMS^^^^^||| |1173^MATTHEWS^JAMES^A^^^||||||||||||610613||||||||||||||||||||||||||||||||V
ORC|NW|987654^EPIC|76543^EPC||Final||^^^20140418170014^^^^||20140418173314|1148^PATTERSON^JAMES^^^^||1173^MATTHEWS^JAMES^A^^^|1133^^^222^^^^^|(618)222-1122||
OBR|1|363463^EPC|1858^EPC|73610^X-RAY ANKLE 3+ VW^^^X-RAY ANKLE ||||||||||||1173^MATTHEWS^JAMES^A^^^|(608)258-
8866||||||||Final||^^^20140418170014^^^^|||||6064^MANSFIELD^JEREMY^^^^||1148010^1A^EAST^X-RAY^^^|^|
DG1||I10|S82^ANKLE FRACTURE^I10|ANKLE FRACTURE||

Additional ORM examples

Example 1 - Simple Urinalysis Order

MSH|^~\&|HIS|MedCenter|LIS|MedCenter|20060307110114||ORM^O01|MSGID20060307110114|P|2.3
PID|||12001||Jones^John^^^Mr.||19670824|M|||123 West St.^^Denver^CO^80020^USA|||||||
PV1||O|OP^PAREG^||||2342^Jones^Bob|||OP|||||||||2|||||||||||||||||||||||||20060307110111|
ORC|NW|20060307110114
OBR|1|20060307110114||003038^Urinalysis^L|||20060307110114

Example 2 - Image Order

MSH|^~\&|MESA_OF|XYZ_RADIOLOGY|MESA_IM|XYZ_IMAGE_MANAGER|||ORM^O01|100112|P|2.3.1|||||| ||
PID|||M4000^^^ADT1||KING^MARTIN||19450804|M||WH|820^JORIE BLVD^^CHICAGO^IL^60523|||||||20-98-4000|||||||||||||||||||||
PV1||E|ED||||1234^WEAVER^TIMOTHY^P^^DR|5101^NELL^FREDERICK^P^^DR|||||||||||V100^^^ADT1|||||||||||||| |||||||||||200008201100|||||||V|
ORC|NW|A100Z^MESA_ORDPLC|B100Z^MESA_ORDFIL||SC||1^ once^^^^S||200008161510|^ROSEWOOD^RANDOLPH||7101^E.^STRADA^JAIME^P^^DR||(314)555-1212|200008161510||922229-10^IHE-RAD^IHE-CODE-231||
OBR|1|A100Z^MESA_ORDPLC|B100Z^MESA_ORDFIL|P1^Procedure1^ERL_MESA^X1_A1^SP Action Item X1_A1^DSS_MESA|||||||||xxx||Radiology^^^^R|7101^ES TRADA^JAIME^P^^DR||XR999999|RP123456|SPS123456|||| MR|||1^once^^^^S|||WALK|||||||||||A|||RP_X1^RP Action Item RP_X1^DSS_MESA
ZDS|1.2.1^100^Application^DICOM

Example 3 - Another imaging order

MSH|^~\&|RAD.PRO|RAD|||200405100944||ORM^O01|PACS-OR/RR.1.38||2.3||||AL|
PID|1||Z000000360||DOE^JOHN^A^^^||19790228|M|||123 ANY STREET^APT
3^BOSTON^MA^12345||617-222-1111|781-444-5555||||V1234567|123-45-6789
PV1|1|I|E.MS3^E.2308^A|||||765^JONES^JAMES^J^^MD||||||||||||||||||||||||||||||||||||200405100941|
ORC|NW
OBR|1|000004529||CHE2V^CHEST PA/LAT|||20040629073000||||||ALERGIC TO
CONTRAST||^^^^B^|921^BROWN^STANLEY^S^^MD|||||CR2|||CR|||^^^^^R|||^AUTO ACCIDENT 

The JSON object model

To ensure maximum coverage, we have mapped all the data elements in the HL7 standard to a corresponding JSON data element. Additionally, JSON doesn’t have the concept of sequence or order (as opposed to XML). This can cause issues as for example, the first diagnosis in the DG1 segment is supposed to be interpreted as the primary diagnosis. To overcome issues such as that, specific numbering has also been introduced into such arrays.

Below is a sample JSON object for the HL7 ORM message. Note that this is the same object you will receive for all ORM message types. Certain or whole sets of fields can be empty depending on the message type. As you can also notice, there is a lot going on in this object i.e. there are a ridiculous number of fields and most of our customers rarely use more than 10-20% of them. That is an additional value add that is included in our service as we will trim or chop out the data fields that you do not need.

If the following HL7 ORM message is received by Catalyze, then the JSON object immediately following is the response you can expect to be POST-ed to your API end point (or whatever other way you choose to receive it).

HL7 ORM^O01 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||ORM^O01|161935|D|2.4
PID|1||73902171^^^^MRN||YYTEST^ERIN^M|BBTEST|19840722141856-0800|F|SHIRLEY||9200 W STATE ST^3^MADISON^WI^53715^USA||(608)344-8800^^^eyytest@hotmail.com~^^^yytest84@gmail.com|(608)222-9999|ESP|S|ATH|8302741992|999772222|B2408664777790||N||Y|1|USA||||N
PV1|1|P|ZZPOC^333^3^ZZFAC^ZZSTATUS^LAB^ZZBUILDING|R|13579246|ZZPRIOR|102938^SANCHEZ^RICK^L^SR^DR^D.Sc|069420^SMITH^JERRY^B|345765^SQUANCH^SQUANCHY|PUL|ZZTEMP||||B2||586032^MASON^TEDDY||H0094113|||||||||||||||||||||||||20160414083000-0800
PV2|ZZPRIORPENDING||267168001^Blood in urine^SNOMED-CT||Wallet, keys, cell phone, fitbit.|ZZVALLOC||20160421111545-0800|20160421174500-0800|||Typical lab stuff. You know, like blood draws. That sort of thing.||20160321|N|P|20170421|O|N|1|U|Y|ZZCLINIC|||20160210||20140101|20150230||RECUR|||N||N||C|MO|AC|D|A|Y|N
IN1|1|71492622|8624493|VVINSURANCE|8833 N OAKLAND AVE^^MILWAUKEE^WI^53211^USA|VVCONTACT^PAUL^Q|(800)336-2292|GN456789|||BIGCORP FINANCIAL, INC|20151031000000-0800|20201031000000-0800|AUTHNUM||QQTEST^CARLA^M|MTH|19641107121314-0800|421 S BURR OAK DR^^MADISON^WI^53713^USA|Y|IN||N||N||||||||||ABC123LMNOP|056269770||||||1|F|444 W WASHINGTON AVE^699^MADISON^WI^53726^USA|||H||8291
IN2|11112233445|111-88-2000|||P|||||||||||||||||||||||Private^Percentage^90||||USA|ENG||||N|MOT|||M|||Account Manager|accountant|1|BCCONTACT^ALLEN^B|(608)555-5555||||||||(800)336-2292|family||110003456|MTH|(608)222-3000|(608)444-9999
IN1|2|74829475|1930473|WWINSURANCE|4000 REGENT ST^3^MADISON^WI^53211^USA|WWCONTACT^GERALD^P|(608)444-1212|FZ428965|||HUEY, DEWEY AND LOUIE LAW OFFICES|20130614000000-0800|20180614000000-0800|AUTHNUM||QQTEST^BIFF^L|FTH|19620522212055-0800|421 S BURR OAK DR^^MADISON^WI^53713^USA|Y|CO||N||N||||||||||FZ58X293V|67893452||||||1|M|6732 MINERAL POINT RD^^MADISON^WI^53719^USA|||H||7113
IN2|114207783|122-33-4455|||P|||||||||||||||||||||||Private^Percentage^90||||USA|ENG||||N|MOT|||M|||Defense Attorney|lawyer|1|HDLCONTACT^Huey^D|(608)666-6969||||||||(608)444-1212|family||110093452|FTH|(608)222-3000|(608)777-2243
GT1|1|50521935X|QQTEST^CARLA^M||421 S BURR OAK DR^^MADISON^WI^53713^USA|(608)222-3000|(608)444-9999|19641107121314-0800|F|IND|MTH|111-88-2000|||||444 W WASHINGTON AVE^699^MADISON^WI^53726^USA|(608)555-5555|11112233445|1|BIGCORP FINANCIAL, INC
GT1|2|02846299Y|QQTEST^BIFF^L||421 S BURR OAK DR^^MADISON^WI^53713^USA|(608)222-3000|(608)777-2243|19620522212055-0800|M|IND|FTH|122-33-4455|||||6732 MINERAL POINT RD^^MADISON^WI^53719^USA|(608)666-6969|114207783|1|HUEY, DEWEY AND LOUIE LAW OFFICES
ORC|NW|01290|37334|1|CM|||01278^37215|20151222144500-0800|654321|711711|123456^DUCK^DAFFY^P|XXPOC|(608)777-1234
OBR|1|01290|37334|127800008^Microscopic urinalysis^SNOMED-CT|||20151222144500-0800|20151222151500-0800||500^ml|765098^SIMPSON^HOMER^J|L|||20151222160000-0800||123456^DUCK^DAFFY^P|(608)777-1234|||||20151222161230-0800||LAB|P|||||||549364^MARIO^MARIO^T|549365^MARIO^LUIGI^T|771952^TROOPA^KOOPA^
NTE|1||Here is where custom notes about the order would go.
NTE|2||A snail can sleep for more than three years at a time.
DG1|1||527.7^Dry mouth^ICD 9||20151222170000-0800|W
DG1|2||784.99^Halitosis^ICD 9||20151222170000-0800|F
OBX|1|CWE|386725007^Body temperature^SNOMED-CT||98.6|Fahrenheit|||||F|||20151222133200-0800||52936881^DUCK^DAFFY
OBX|2|CWE|271649006^Systolic blood pressure^SNOMED-CT||120|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
NTE|1||In Utah, it is illegal to fish from the back of a horse.
OBX|3|CWE|271650006^Diastolic blood pressure^SNOMED-CT||80|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
NTE|1||If you put a can of Diet Coke in water, it floats. Regular Coca-Cola sinks.

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ORM",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"ORM",
            "messageEvent":"O01",
            "messageControlId":"161935",
            "processingID":"D",
            "versionID":"2.4"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"73902171",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"YYTEST",
                "firstName":"ERIN",
                "middleInitOrName":"M"
            },
            "mothersMaidenName":"BBTEST",
            "dateTimeBirth":"1984-07-22T18:18:56-0400",
            "sex":"F",
            "alias":"SHIRLEY",
            "race":"",
            "address":{  
                "streetAddress":"9200 W STATE ST",
                "otherDesignation":"3",
                "city":"MADISON",
                "state":"WI",
                "postalCode":"53715",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)344-8800",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"eyytest@hotmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"yytest84@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)222-9999",
            "primaryLanguage":"ESP",
            "maritalStatus":"S",
            "religion":"ATH",
            "patientAccountNumber":{  
                "id":"8302741992",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"999772222",
            "driversLicenseNumber":"B2408664777790",
            "mothersId":"",
            "ethnicGroup":"N",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"1",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N",
            "PV1":{  
                "id":"1",
                "patientClass":"P",
                "patientLocation":{  
                    "pointOfCare":"ZZPOC",
                    "room":"333",
                    "bed":"3",
                    "facility":"ZZFAC",
                    "locationStatus":"ZZSTATUS",
                    "personLocationType":"LAB",
                    "building":"ZZBUILDING"
                },
                "admissionType":"R",
                "priorPatientLocation":"ZZPRIOR",
                "attendingProvider":{  
                    "id":"102938",
                    "lastName":"SANCHEZ",
                    "firstName":"RICK",
                    "middleInitOrName":"L",
                    "suffix":"SR",
                    "prefix":"DR",
                    "degree":"D.Sc",
                    "sourceTable":"",
                    "assigningAuthority":"",
                    "nameTypeCode":"",
                    "identifierCheckDigit":"",
                    "codeIdCheck":"",
                    "identifierTypeCode":"",
                    "assigningFacility":""
                },
                "referringProvider":"069420",
                "consultingDoctor":"345765",
                "hospitalService":"PUL",
                "pointOfCare":"ZZTEMP",
                "preadmitTestIndicator":"",
                "readmissionIndicator":"",
                "admitSource":"",
                "ambulatoryStatus":"B2",
                "vipIndicator":"",
                "admittingProvider":{  
                    "id":"102938",
                    "lastName":"MASON",
                    "firstName":"TEDDY",
                    "middleInitOrName":"",
                    "suffix":"",
                    "prefix":"",
                    "degree":"",
                    "sourceTable":"",
                    "assigningAuthority":"",
                    "nameTypeCode":"",
                    "identifierCheckDigit":"",
                    "codeIdCheck":"",
                    "identifierTypeCode":"",
                    "assigningFacility":""
                },
                "patientType":"",
                "visitNumber":{  
                    "id":"H0094113",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuthority":"",
                    "idTypeCode":""
                },
                "financialClass":"",
                "chargePriceIndicator":"",
                "courtesyCode":"",
                "creditRating":"",
                "contractCode":"",
                "contractEffectiveDate":"",
                "contractAmmount":"",
                "contractPeriod":"",
                "interestCode":"",
                "transferToBadDebtCode":"",
                "transferToBadDebtDate":"",
                "badDebtAgencyCode":"",
                "badDebtRecoveryAmount":"",
                "deleteAccountIndicator":"",
                "deleteAccountDate":"",
                "dischargeDisposition":"",
                "dischargedToLocation":"",
                "dietType":"",
                "servicingFacility":"",
                "bedStatus":"",
                "accountStatus":"",
                "pendingLocation":"",
                "priorTemporaryLocation":"",
                "admitDateTime":"2016-04-14T12:30:00-0400",
                "dischargeDateTime":"",
                "currentPatientBalance":"",
                "totalCharges":"",
                "totalAdjustments":"",
                "totalPayments":"",
                "alternateVisitId":""
            },
            "PV2":{  
                "priorPendingLocation":"ZZPRIORPENDING",
                "accommodationCode":"",
                "admitReason":"267168001",
                "transferReason":"",
                "patientValuables":"Wallet, keys, cell phone, fitbit.",
                "patientValuablesLocation":"ZZVALLOC",
                "visitUserCode":"",
                "expectedAdmitDateTime":"2016-04-21T15:15:45-0400",
                "expectedDischargeDateTime":"2016-04-21T21:45:00-0400",
                "estimatedLengthInpatientStay":"",
                "actualLengthInpatientStay":"",
                "visitDescription":"Typical lab stuff. You know, like blood draws. That sort of thing.",
                "referralSourceCode":"",
                "previousServiceDate":"2016-03-21T00:00:00-0400",
                "employmentIllnessRelatedIndicator":"N",
                "purgeStatusCode":"P",
                "purgeStatusDate":"2017-04-21T00:00:00-0400",
                "specialProgramCode":"O",
                "retentionIndicator":"N",
                "expectedNumInsurancePlans":"1",
                "visitPublicityCode":"U",
                "visitProtectionIndicator":"Y",
                "clinicOrganizationName":"ZZCLINIC",
                "patientStatusCode":"",
                "visitPriorityCode":"",
                "previousTreatmentDate":"2016-02-10T00:00:00-0500",
                "expectedDischargeDisposition":"",
                "signatureOnFileDate":"2014-01-01T00:00:00-0500",
                "firstSimilarIllnessDate":"2015-03-02T00:00:00-0500",
                "patientChargeAdjustmentCode":"",
                "recurringServiceCode":"RECUR",
                "billingMediaCode":"",
                "expectedSurgeryDateTime":"",
                "militaryPartnershipCode":"N",
                "militaryNonAvailabilityCode":"",
                "newbornBabyIndicator":"N",
                "babyDetainedIndicator":"",
                "modeOfArrivalCode":"C",
                "recreationalDrugUseCode":"MO",
                "admissionLevelOfCareCode":"AC",
                "precautionCode":"D",
                "patientConditionCode":"A",
                "livingWillCode":"Y",
                "organDonorCode":"N",
                "advanceDirectiveCode":"",
                "patientStatusAffectiveDate":"",
                "expectedLOAReturnDateTime":"",
                "expectedPreAdmissionTestingDateTime":"",
                "notifyClergyCode":""
            },
            "IN1":[  
                {  
                    "id":"1",
                    "planId":"71492622",
                    "companyId":"8624493",
                    "companyName":"VVINSURANCE",
                    "companyAddress":{  
                        "streetAddress":"8833 N OAKLAND AVE",
                        "otherDesignation":"",
                        "city":"MILWAUKEE",
                        "state":"WI",
                        "postalCode":"53211",
                        "country":"USA"
                    },
                    "companyContactPerson":{  
                        "lastName":"VVCONTACT",
                        "firstName":"PAUL",
                        "middleInitOrName":"Q"
                    },
                    "companyContactNumber":"(800)336-2292",
                    "groupNumber":"GN456789",
                    "groupName":"",
                    "groupEmpId":"",
                    "groupEmpName":"BIGCORP FINANCIAL, INC",
                    "planEffectiveDate":"2015-10-31T04:00:00-0400",
                    "planExpirationDate":"2020-10-31T04:00:00-0400",
                    "authorizationInformation":"AUTHNUM",
                    "planType":"",
                    "insuredName":{  
                        "lastName":"QQTEST",
                        "firstName":"CARLA",
                        "middleInitOrName":"M"
                    },
                    "insuredRelationshipToPatient":"MTH",
                    "insuredDob":"19641107121314-0800",
                    "insuredAddress":{  
                        "streetAddress":"421 S BURR OAK DR",
                        "otherDesignation":"",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53713",
                        "country":"USA"
                    },
                    "assignmentOfBenefits":"IN",
                    "coordinationOfBenefits":"",
                    "noticeOfAdmissionFlag":"N",
                    "noticeOfAdmissionDate":"",
                    "reportofEligibility":"N",
                    "reportofEligibilityDate":"",
                    "releaseInformationCode":"",
                    "preAdmitCert":"",
                    "verificationDateTime":"",
                    "verificationBy":"",
                    "typeOfAgreementCode":"",
                    "billingStatus":"",
                    "lifetimeReserveDays":"",
                    "delayBeforeLrDay":"",
                    "companyPlanCode":"ABC123LMNOP",
                    "policyNumber":"056269770",
                    "policyDeductible":"",
                    "policyLimitAmount":"",
                    "policyLimitDays":"",
                    "roomRateSemiPrivate":"",
                    "roomRatePrivate":"",
                    "insuredEmploymentStatus":"1",
                    "insuredSex":"F",
                    "insuredEmployerAddress":{  
                        "streetAddress":"444 W WASHINGTON AVE",
                        "otherDesignation":"699",
                        "city":"MADISON",
                        "state":"",
                        "postalCode":"53726"
                    },
                    "verificationStatus":"",
                    "priorInsurancePlanId":"",
                    "coverageType":"H",
                    "handicap":"",
                    "insuredIdNumber":"8291",
                    "IN2":{  
                        "insuredEmployeeId":"11112233445",
                        "insuredSSN":"111-88-2000",
                        "insuredEmployerName":{  
                            "id":"",
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "employerInfoData":"",
                        "mailClaimParty":"P",
                        "medicareHealthInsCardNumber":"",
                        "medicaidCaseName":{  
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "medicaidCaseNumber":"",
                        "champus":{  
                            "sponsorName":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "idNumber":"",
                            "dependentOfRecipient":"",
                            "organization":"",
                            "station":"",
                            "service":"",
                            "rankGrade":"",
                            "status":"",
                            "retireDate":"",
                            "nonAvailCertOnFile":""
                        },
                        "babyCoverage":"",
                        "combineBabyBill":"",
                        "bloodDeductible":"",
                        "specialCoverageApprovalName":{  
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "specialCoverageApprovalTitle":"",
                        "nonCoveredInsuranceCode":"",
                        "payorId":"",
                        "payorSubscriberId":"",
                        "eligibilitySource":"",
                        "roomCoverageTypeAmount":{  
                            "roomType":"Private",
                            "amountType":"Percentage",
                            "coverageAmount":"90"
                        },
                        "policyTypeAmount":{  
                            "policyType":"",
                            "amountClass":"",
                            "amount":""
                        },
                        "dailyDeductible":{  
                            "delayDays":"",
                            "amount":"",
                            "numberOfDays":""
                        },
                        "livingDependency":"",
                        "ambulatoryStatus":"USA",
                        "citizenship":"ENG",
                        "primaryLanguage":"",
                        "livingArrangement":"",
                        "publicityIndicator":"",
                        "protectionIndicator":"N",
                        "studentIndicator":"MOT",
                        "religion":"",
                        "motherMaidenName":"",
                        "nationality":"M",
                        "ethnicGroup":"",
                        "maritalStatus":"",
                        "insuredEmploymentStartDate":"Account Manager",
                        "insuredEmloymentStopDate":"accountant",
                        "job":{  
                            "title":"1",
                            "codeClass":"BCCONTACT",
                            "status":"(608)555-5555"
                        },
                        "employerContactPerson":{  
                            "name":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "phone":"",
                            "reason":""
                        },
                        "insuredContactPerson":{  
                            "name":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "phone":"",
                            "reason":""
                        },
                        "relationshipToPersonStartDate":"",
                        "relationshipToPersonStopDate":"(800)336-2292",
                        "insuranceCoContactReason":"family",
                        "insuranceCoContactPhone":"",
                        "policyScope":"110003456",
                        "policySource":"MTH",
                        "patientMemberNumber":"(608)222-3000",
                        "guarantorRelationshipToInsured":"(608)444-9999",
                        "insuredHomePhone":"",
                        "insuredEmployerPhone":""
                    }
                },
                {  
                    "id":"2",
                    "planId":"74829475",
                    "companyId":"1930473",
                    "companyName":"WWINSURANCE",
                    "companyAddress":{  
                        "streetAddress":"4000 REGENT ST",
                        "otherDesignation":"3",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53211",
                        "country":"USA"
                    },
                    "companyContactPerson":{  
                        "lastName":"WWCONTACT",
                        "firstName":"GERALD",
                        "middleInitOrName":"P"
                    },
                    "companyContactNumber":"(608)444-1212",
                    "groupNumber":"FZ428965",
                    "groupName":"",
                    "groupEmpId":"",
                    "groupEmpName":"HUEY, DEWEY AND LOUIE LAW OFFICES",
                    "planEffectiveDate":"2013-06-14T04:00:00-0400",
                    "planExpirationDate":"2018-06-14T04:00:00-0400",
                    "authorizationInformation":"AUTHNUM",
                    "planType":"",
                    "insuredName":{  
                        "lastName":"QQTEST",
                        "firstName":"BIFF",
                        "middleInitOrName":"L"
                    },
                    "insuredRelationshipToPatient":"FTH",
                    "insuredDob":"19620522212055-0800",
                    "insuredAddress":{  
                        "streetAddress":"421 S BURR OAK DR",
                        "otherDesignation":"",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53713",
                        "country":"USA"
                    },
                    "assignmentOfBenefits":"CO",
                    "coordinationOfBenefits":"",
                    "noticeOfAdmissionFlag":"N",
                    "noticeOfAdmissionDate":"",
                    "reportofEligibility":"N",
                    "reportofEligibilityDate":"",
                    "releaseInformationCode":"",
                    "preAdmitCert":"",
                    "verificationDateTime":"",
                    "verificationBy":"",
                    "typeOfAgreementCode":"",
                    "billingStatus":"",
                    "lifetimeReserveDays":"",
                    "delayBeforeLrDay":"",
                    "companyPlanCode":"FZ58X293V",
                    "policyNumber":"67893452",
                    "policyDeductible":"",
                    "policyLimitAmount":"",
                    "policyLimitDays":"",
                    "roomRateSemiPrivate":"",
                    "roomRatePrivate":"",
                    "insuredEmploymentStatus":"1",
                    "insuredSex":"M",
                    "insuredEmployerAddress":{  
                        "streetAddress":"6732 MINERAL POINT RD",
                        "otherDesignation":"",
                        "city":"MADISON",
                        "state":"",
                        "postalCode":"53719"
                    },
                    "verificationStatus":"",
                    "priorInsurancePlanId":"",
                    "coverageType":"H",
                    "handicap":"",
                    "insuredIdNumber":"7113",
                    "IN2":{  
                        "insuredEmployeeId":"114207783",
                        "insuredSSN":"122-33-4455",
                        "insuredEmployerName":{  
                            "id":"",
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "employerInfoData":"",
                        "mailClaimParty":"P",
                        "medicareHealthInsCardNumber":"",
                        "medicaidCaseName":{  
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "medicaidCaseNumber":"",
                        "champus":{  
                            "sponsorName":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "idNumber":"",
                            "dependentOfRecipient":"",
                            "organization":"",
                            "station":"",
                            "service":"",
                            "rankGrade":"",
                            "status":"",
                            "retireDate":"",
                            "nonAvailCertOnFile":""
                        },
                        "babyCoverage":"",
                        "combineBabyBill":"",
                        "bloodDeductible":"",
                        "specialCoverageApprovalName":{  
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        },
                        "specialCoverageApprovalTitle":"",
                        "nonCoveredInsuranceCode":"",
                        "payorId":"",
                        "payorSubscriberId":"",
                        "eligibilitySource":"",
                        "roomCoverageTypeAmount":{  
                            "roomType":"Private",
                            "amountType":"Percentage",
                            "coverageAmount":"90"
                        },
                        "policyTypeAmount":{  
                            "policyType":"",
                            "amountClass":"",
                            "amount":""
                        },
                        "dailyDeductible":{  
                            "delayDays":"",
                            "amount":"",
                            "numberOfDays":""
                        },
                        "livingDependency":"",
                        "ambulatoryStatus":"USA",
                        "citizenship":"ENG",
                        "primaryLanguage":"",
                        "livingArrangement":"",
                        "publicityIndicator":"",
                        "protectionIndicator":"N",
                        "studentIndicator":"MOT",
                        "religion":"",
                        "motherMaidenName":"",
                        "nationality":"M",
                        "ethnicGroup":"",
                        "maritalStatus":"",
                        "insuredEmploymentStartDate":"Defense Attorney",
                        "insuredEmloymentStopDate":"lawyer",
                        "job":{  
                            "title":"1",
                            "codeClass":"HDLCONTACT",
                            "status":"(608)666-6969"
                        },
                        "employerContactPerson":{  
                            "name":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "phone":"",
                            "reason":""
                        },
                        "insuredContactPerson":{  
                            "name":{  
                                "lastName":"",
                                "firstName":"",
                                "middleInitOrName":""
                            },
                            "phone":"",
                            "reason":""
                        },
                        "relationshipToPersonStartDate":"",
                        "relationshipToPersonStopDate":"(608)444-1212",
                        "insuranceCoContactReason":"family",
                        "insuranceCoContactPhone":"",
                        "policyScope":"110093452",
                        "policySource":"FTH",
                        "patientMemberNumber":"(608)222-3000",
                        "guarantorRelationshipToInsured":"(608)777-2243",
                        "insuredHomePhone":"",
                        "insuredEmployerPhone":""
                    }
                }
            ],
            "GT1":{  
                "id":"1",
                "guarantorNumber":"50521935X",
                "guarantorName":{  
                    "familyName":"QQTEST",
                    "givenName":"CARLA",
                    "middleInitOrName":"M"
                },
                "guarantorSpouseName":{  
                    "familyName":"",
                    "givenName":"",
                    "middleInitOrName":""
                },
                "guarantorAddress":{  
                    "streetAddress":"421 S BURR OAK DR",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53713",
                    "country":"USA"
                },
                "guarantorHomePhone":"(608)222-3000",
                "guarantorBusinessPhone":"(608)444-9999",
                "guarantorDateTimeBirth":"1964-11-07T15:13:14-0500",
                "guarantorSex":"F",
                "guarantorType":"IND",
                "guarantorRelationship":"MTH",
                "guarantorSSN":"111-88-2000",
                "guarantorBeginDate":"",
                "guarantorEndDate":"",
                "guarantorPriority":"",
                "guarantorEmployer":{  
                    "name":"",
                    "address":{  
                        "streetAddress":"444 W WASHINGTON AVE",
                        "otherDesignation":"699",
                        "city":"MADISON",
                        "state":"WI",
                        "postalCode":"53726",
                        "country":"USA"
                    },
                    "phone":"(608)555-5555"
                },
                "guarantorEmployeeIdNumber":"11112233445",
                "guarantorEmploymentStatus":"1",
                "guarantorOrganizationName":"BIGCORP FINANCIAL, INC"
            }
        },
        "ORC":[  
            {  
                "orderControl":"NW",
                "placerOrderNumber":"01290",
                "fillerOrderNumber":"37334",
                "placerGroupNumber":"1",
                "orderStatus":"CM",
                "responseFlag":"",
                "timingQuantity":"",
                "parentOrder":{  
                    "placerOrderNumber":"01278",
                    "fillerOrderNumber":"37215"
                },
                "transactionDateTime":"2015-12-22T17:45:00-0500",
                "enteredBy":"654321",
                "verifiedBy":"711711",
                "orderingProvider":{  
                    "id":"123456",
                    "lastName":"DUCK",
                    "firstName":"DAFFY",
                    "middleInitOrName":"P"
                },
                "enterersLocation":"XXPOC",
                "callBackPhoneNumber":"(608)777-1234",
                "OBR":{  
                    "setId":"1",
                    "placerOrderNumber":"01290",
                    "fillerOrderNumber":"37334",
                    "universalServiceId":{  
                        "id":"127800008",
                        "text":"Microscopic urinalysis",
                        "codingSystem":"SNOMED-CT",
                        "alternateId":"",
                        "alternateText":"",
                        "alternateCodingSystem":""
                    },
                    "priority":"",
                    "requestedDateTime":"",
                    "observationDateTime":"2015-12-22T17:45:00-0500",
                    "observationEndDateTime":"2015-12-22T18:15:00-0500",
                    "collectionVolume":{  
                        "quantity":"",
                        "units":""
                    },
                    "collectorIdentifier":"500",
                    "specimenActionCode":"765098",
                    "dangerCode":"L",
                    "relevantClinicalInfo":"20151222160000-0800",
                    "specimenReceivedDateTime":"",
                    "specimenSource":"20151222160000-0800",
                    "orderingProvider":{  
                        "id":"",
                        "lastName":"",
                        "firstName":"",
                        "middleInitOrName":""
                    },
                    "orderCallBackNumber":"123456",
                    "placerField1":"(608)777-1234",
                    "placerField2":"",
                    "fillerField1":"",
                    "fillerField2":"",
                    "rptStatusChangeDate":"",
                    "chargeToPractice":"20151222161230-0800",
                    "diagnosticServiceSectId":"",
                    "diagnosticServiceSectId2":"",
                    "resultStatus":"LAB",
                    "linkedResults":"P",
                    "quantityTiming":{  
                        "quantity":"",
                        "interval":"",
                        "duration":"",
                        "startDateTime":"",
                        "endDateTime":"",
                        "priority":""
                    },
                    "resultCopiesTo":[  
                        {  
                            "id":"",
                            "lastName":"",
                            "firstName":"",
                            "middleInitOrName":""
                        }
                    ],
                    "parent":{  
                        "placerOrderNumber":"",
                        "fillerOrderNumber":""
                    },
                    "transportationMode":"",
                    "reasonForStudy":"",
                    "principalResultInterpreter":"",
                    "assistantResultInterpreter":"549364",
                    "technician":"549365",
                    "transcriptionist":"771952",
                    "notes":[  
                        {  
                            "id":"1",
                            "source":"",
                            "body":"Here is where custom notes about the order would go."
                        },
                        {  
                            "id":"2",
                            "source":"",
                            "body":"A snail can sleep for more than three years at a time."
                        }
                    ]
                },
                "DG1":[  
                    {  
                        "id":"1",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"527.7",
                            "text":"Dry mouth",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"W",
                        "diagnosticCategory":""
                    },
                    {  
                        "id":"2",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"784.99",
                            "text":"Halitosis",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"F",
                        "diagnosticCategory":""
                    }
                ],
                "OBX":[  
                    {  
                        "setId":"1",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"386725007",
                            "text":"Body temperature",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"98.6",
                        "units":"Fahrenheit",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:32:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    },
                    {  
                        "setId":"2",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271649006",
                            "text":"Systolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"120",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":"",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"In Utah, it is illegal to fish from the back of a horse."
                            }
                        ]
                    },
                    {  
                        "setId":"3",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271650006",
                            "text":"Diastolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"80",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":"",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"If you put a can of Diet Coke in water, it floats. Regular Coca-Cola sinks."
                            }
                        ]
                    }
                ]
            }
        ]
    }
}

The ORU (Patient Order / Lab Results) message

The ORU message is used to communicate the results of the (non-pharmacy) order. Results are usually specific to a patient. Technically however, multiple patient results can be incorporated into a single ORU message. This is unusual.

The ORU is primarily intended to communicate structured patient specific clinical data back into the EHR such as observations and results of diagnostic studies from the “filling” system e.g., clinical laboratory system, EKG systems etc. to the “ordering” or “placing” system e.g., the EHR’s CPOE (order entry) etc. It is important to note that any HL7 message can be sent to any system - internal or external. So in this case, observations can be sent from these filling systems to any other system that needs this data e.g. referring physician, external vendor systems, clinical trial systems (CTMS) etc.

This set of messages allow for the communication of structured data such as:

  • Clinical laboratory results e.g. blood test results with associated details and units of measure.
  • Vital signs e.g. heart rate, blood pressure etc. = Severity and/or frequency of symptoms
  • Reactions to drugs or adverse events e.g. in the context of clinical trials

Usually only one of these types of data will be sent over in a single ORU message. HL7 does say that if more than one of these data types need to be sent over, the MDM message (covered later) might be a better option. However, with the advent of passive data collection devices such as Fitbit and apps such as Ginger.io, multiple of these data types are being collected over time for each patient and these will increasingly need to delivered in a structured manner into the EHR. The current way to look at whether the MDM or the ORU message is the best choice is to think of the data that needs to be put back into the EHR:

  • Is it structured or unstructured? If it is unstructured e.g. a PDF document, the best bet is to use the MDM.
  • Does the required discrete fields exist in the EHR? If the specific data elements that are needed to be delivered to the EHR don’t have a corresponding data element implemented in the EHR, then the ORU will not work. Unless the health system is willing to update the EHR to include those data elements. This does happen often enough. If not, then the MDM is the best choice again.

The mandated structure of an ORU message

As we discussed earlier, HL7 recommends / mandates that messages follow a specific structure. The segments we will need are:

  • MSH: the message header (required everywhere)
  • PID: the patient identification segment. Note that demographics can be included within the PID segment itself
  • PV1: information about the patient “visit” - this is where you would include the physician info and the current location of the patient.
  • ORC: Order section which could contain multiple orders
  • OBR: Results of the tests.
  • OBX: Observations provided by the lab or other performing entity to provide context for the orders or results
  • NTE: Notes and comments. This will be repeated at the header level and then at the line level as well to provide context and result descriptions

One quick tip - in most HL7 messages the pipe character “|” is called the BAR and it is the field separator and in the case of this message, we’re going to use the “^” as a space. So if you see a bunch of pipes together like this “||||||||||” - all that means is that the fields at that point in the sequence were optional or not available. Also remember that segments are separated by a carriage return - which cannot be displayed as any and all viewers will interpret that for display.

The HL7 v2.x specifies the following format for an ORU message. For additional examples and specific structure, you can view the Patient Admin related PDF on the HL7 site. Note also that EHRs often have created their own variants of this standard for example Epic has a slightly different format that it specifies as it also adheres to the 2.3 standard with some additions as well. We intend to cover EHR specific variants soon.

Segment Description
[ —- Begin Patient
PID Patient Identification
[PD1] Additional Demographics
[{NTE}] Notes and Comments
[{NK1}] Next of kin
{ — Begin Order related observations
ORC Common order
OBR Observation request
{[NTE]} Request related Notes and comments
OBX Observation (for Patient ID)
{[NTE]} Observation related Notes and comments
} — End Order related observations
] — End Patient

There are additional segments in the core HL7 definition but we’ve dropped those as those seem rarely used in practice. We’ll take some of the key segments listed above and provide examples for each below and finally show an fully composed HL7 message. Additionally, a few more HL7 sample messages of each will be listed below.

The MSH (message header) segment

MSH|^~\`|674|GHC|SISRL|PAML|20060922162830|L674-200609221628310220|ORU^R01|ORU000016168|P|2.3|||AL |AL

The PID (patient identification) segment

PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^

The ORC (order) segment

ORC|RE|F4334|51013174200601|||||^||||||||||||||||

The OBR (observation request) segment

OBR|1|F4334|51013174200601|80048^BASIC METABOLIC PANEL|||20060922152300||||||||^^^^^|023901^PACLAB| ||||||^|CH|F|^^|^^^20060922162659^^GHA||^|||^^^^^^ ^^^^|^^^^^^^^^^|^^^^^^^^^^|^^^^^^^^^^||||||||||

The OBX (observations) segment

OBX|1|NM|84295^SODIUM^GH|1|145|mmol/L|||||F|||20060922152300|GH
OBX|2|NM|84132^POTASSIUM^GH|2|5.2|mmol/L|||||F|||20060922152300|GH
OBX|3|NM|82435^CHLORIDE^GH|3|108|mmol/L|||||F|||20060922152300|GH
OBX|4|NM|82374^CARBON DIOXIDE^GH|4|31|mmol/L|||||F|||20060922152300|GH
OBX|5|NM|82947^GLUCOSE^GH|5|76|MG/DL|||||F|||20060922152300|GH
OBX|6|NM|84520^BUN^GH|6|22|MG/DL|||||F|||20060922152300|GH
OBX|7|NM|82565^CREATININE^GH^2160-0^CREATININE:MCNC:PT:SER/PLAS:QN:^LN|7|1.3|MG/DL|||||F|||20060922152300|GH
OBX|8|NM|82310^CALCIUM^GH|8|10.1|MG/DL|||||F|||20060922152300|GH
OBX|9|NM|GFR-AA*H^GFR--AFRICAN AMERICAN^GH|9|46|ML/MIN|||||F|||20060922152300|GH
OBX|10|NM|GFR*H^GFR--NON-AFRICAN AMERICAN^GH|10|46|ML/MIN|||||F|||20060922152300|GH
OBX|11|ST|84999.Z159||DNR||||||F||||GH
OBX|12|NM|84999.Z174^Anion Gap||6|mmol/L|||F

Putting it all together

MSH|^~\`|674|GHC|SISRL|PAML|20060922162830|L674-200609221628310220|ORU^R01|ORU000016168|P|2.3|||AL |AL
PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^
ORC|RE|F4334|51013174200601|||||^||||||||||||||||
OBR|1|F4334|51013174200601|80048^BASIC METABOLIC PANEL|||20060922152300||||||||^^^^^|023901^PACLAB| ||||||^|CH|F|^^|^^^20060922162659^^GHA||^|||^^^^^^ ^^^^|^^^^^^^^^^|^^^^^^^^^^|^^^^^^^^^^||||||||||
OBX|1|NM|84295^SODIUM^GH|1|145|mmol/L|||||F|||20060922152300|GH
OBX|2|NM|84132^POTASSIUM^GH|2|5.2|mmol/L|||||F|||20060922152300|GH
OBX|3|NM|82435^CHLORIDE^GH|3|108|mmol/L|||||F|||20060922152300|GH
OBX|4|NM|82374^CARBON DIOXIDE^GH|4|31|mmol/L|||||F|||20060922152300|GH
OBX|5|NM|82947^GLUCOSE^GH|5|76|MG/DL|||||F|||20060922152300|GH
OBX|6|NM|84520^BUN^GH|6|22|MG/DL|||||F|||20060922152300|GH
OBX|7|NM|82565^CREATININE^GH^2160-0^CREATININE:MCNC:PT:SER/PLAS:QN:^LN|7|1.3|MG/DL|||||F|||20060922152300|GH
OBX|8|NM|82310^CALCIUM^GH|8|10.1|MG/DL|||||F|||20060922152300|GH
OBX|9|NM|GFR-AA*H^GFR--AFRICAN AMERICAN^GH|9|46|ML/MIN|||||F|||20060922152300|GH
OBX|10|NM|GFR*H^GFR--NON-AFRICAN AMERICAN^GH|10|46|ML/MIN|||||F|||20060922152300|GH
OBX|11|ST|84999.Z159||DNR||||||F||||GH
OBX|12|NM|84999.Z174^Anion Gap||6|mmol/L|||F

Additional ORU examples

Generic ORU with field names

MSH|^~\&||||madhatterpracti|20090826163020||ORU^R01|MessageControlID|P|2.3
PID|||||Smith^John^Pete
PV1|||||||AttendingPhysicianID^AttendingPhysicianLastName^AttendingPhysicianFirstName
OBR|1|Placer1234|Filler56789|TestID^TestName^IDSystem|||ObservationDate/Time|||||||SpecimenReceivedDate/Time||||||||ResultChangeDate/Time|||ResultStatus(From HL7
table 0123)
OBX|1|OBX5-DataType|ObservationID^ObservationName^IDSystem||ResultValue||||||20090831145055 

Generic ORU with a PDF attachment

MSH|^~\&||SendingApplication|SendingFacility|PracticeAccount#|||ORU^R01|MessageControlID|P|2.3
PID|||||PatientLastName^PatientFirstName^PatientMiddleName
PV1|||||||AttendingPhysicianID^AttendingPhysicianLastName^AttendingPhysicianFirstName
OBR|1|Placer1234|Filler56789|TestID^TestName^IDSystem|||ObservationDate/Time|||||||SpecimenReceivedDate/Time||||||||ResultChangeDate/Time|||ResultStatus(From HL7table 0123)
OBX|1|OBX5-DataType|ObservationID^ObservationName^IDSystem||ResultValue|||||||LastObservationDate/Time
NTE|1|TX|A note on the order
NTE|2|TX|Another line in the note
OBX|2|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|3|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|4|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|5|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|6|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|7|ED|PDF^PDF
BASE64|1|^PDFReport^PDF^Base64^RTlENTUxOTFDMTIwQzQ3OUE0MDU2NzZDNkM4ODI1Mz5dL0luZGV4WzE4IDI4
OBX|2|ED|PDF^PDF 

Example ORU with Blood glucose results

MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01|CNTRL-3456|P|2.4
PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES|19620320|F|||153 FERNWOOD DR.^^STATESVILLE^OH^35292||(206)3345232|(206)752-121||||AC555444444||67-A4335^OH^20030520
OBR|1|845439^GHH OE|1045813^GHH LAB|15545^GLUCOSE|||200202150730|||||||||555-55-5555^PRIMARY^PATRICIA P^^^^MD^^|||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD
OBX|1|SN|1554-5^GLUCOSE^POST 12H CFST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F

Example ORU for CDC vaccine submissions

MSH|^~\&||GA0000||VAERS PROCESSOR|20010331605||ORU^RO1|20010422GA03|T|2.3. 1|||AL|
PID|||1234^^^^SR~1234-12^^^^LR~00725^^^^MR||Doe^John^Fitzgerald^JR^^^L|| 20001007|M||2106-3^White^HL70005|123 Peachtree St^APT 3B^Atlanta^GA^30210^^M^^GA067||(678) 555-1212^^PRN|
NK1|1|Jones^Jane^Lee^^RN|VAB^Vaccine administered by (Name)^HL70063|
NK1|2|Jones^Jane^Lee^^RN|FVP^Form completed by (Name)-Vaccine provider^HL70063|101 Main Street^^Atlanta^GA^38765^^O^^GA121||(404) 554-9097^^WPN|
ORC|CN|||||||||||1234567^Welby^Marcus^J^Jr^Dr.^MD^ L|||||||||Peachtree Clinic|101 Main Street^^Atlanta^GA^38765^^O^^GA121|(404) 554-9097^^WPN|101 Main Street^^Atlanta^GA^38765^^O^^GA121|
OBR|1|||^CDC VAERS-1 (FDA) Report|||20010316|
OBX|1|NM|21612-7^Reported Patient Age^LN||05|mo^month^ANSI|
OBX|1|TS|30947-6^Date form completed^LN||20010316|
OBX|2|FT|30948-4^Vaccination adverse events and treatment, if any^LN|1|fever of 106F, with vomiting, seizures, persistent crying lasting over 3 hours, loss of appetite|
OBX|3|CE|30949-2^Vaccination adverse event outcome^LN|1|E^required emergency room/doctor visit^NIP005|
OBX|4|CE|30949-2^Vaccination adverse event outcome^LN|1|H^required hospitalization^NIP005|
OBX|5|NM|30950-0^Number of days hospitalized due to vaccination adverse event^LN|1|02|d^day^ANSI|
OBX|6|CE|30951-8^Patient recovered^LN||Y^Yes^ HL70239|
OBX|7|TS|30952-6^Date of vaccination^LN||20010216|
OBX|8|TS|30953-4^Adverse event onset date and time^LN||200102180900|
OBX|9|FT|30954-2^Relevant diagnostic tests/lab data^LN||Electrolytes, CBC, Blood culture|
OBR|2|||30955-9^All vaccines given on date listed in #10^LN|
OBX|1|CE30955-9&30956-7^Vaccine type^LN|1|08^HepB-Adolescent/pediatric^CVX|
OBX|2|CE|30955-9&30957-5^Manufacturer^LN|1|MSD^Merck^MVX|
OBX|3|ST|30955-9&30959-1^Lot number^LN|1|MRK12345|
OBX|4|CE|30955-9&30958-3^ Route^LN|1|IM^Intramuscular ^HL70162|
OBX|5|CE|30955-9&31034-2^Site^LN|1|LA^Left arm^ HL70163|
OBX|6|NM|30955-9&30960-9^Number of previous doses^LN|1|01I
OBX|7|CE|CE|30955-9&30956-7^Vaccine type^LN|2|50^DTaP-Hib^CVX|
OBX|8|CE|30955-9&30957-5^ Manufacturer^LN|2|WAL^Wyeth_Ayerst^MVX|
OBX|9|ST|30955-9&30959-1^Lot number^LN|2|W46932777|
OBX|10|CE|30955-9&30958-3^ Route^LN|2|IM^Intramuscular^HL70162|

The JSON object model

To ensure maximum coverage, we have mapped all the data elements in the HL7 standard to a corresponding JSON data element. Additionally, JSON doesn’t have the concept of sequence or order (as opposed to XML). This can cause issues as for example, the first diagnosis in the DG1 segment is supposed to be interpreted as the primary diagnosis. To overcome issues such as that, specific numbering has also been introduced into such arrays.

Below is a sample JSON object for the HL7 ORU message. Note that this is the same object you will receive for all ORU message types. Certain or whole sets of fields can be empty depending on the message type. As you can also notice, there is a lot going on in this object i.e. there are a ridiculous number of fields and most of our customers rarely use more than 10-20% of them. That is an additional value add that is included in our service as we will trim or chop out the data fields that you do not need.

If the following HL7 ORU message is received by Catalyze, then the JSON object immediately following is the response you can expect to be POST-ed to your API end point (or whatever other way you choose to receive it).

HL7 ORU^R01 message received

MSH|^~\&|XX|YY||ZZ|201610150011656-0800||ORU^R01|733791|D|2.4
PID|1||73902171^^^^MRN||YYTEST^ERIN^M|BBTEST|19840722141856-0800|F|SHIRLEY||9200 W STATE ST^3^MADISON^WI^53715^USA||(608)344-8800^^^eyytest@hotmail.com~^^^yytest84@gmail.com|(608)222-9999|ESP|S|ATH|8302741992|999772222|B2408664777790||N||Y|1|USA||||N
NTE|1||Some notes about the patient go here.
NTE|2||Nothing notable about the patient, really. Except his last name. "ZZTEST", is that Swedish?
PV1|1|P|ZZPOC^333^3^ZZFAC^ZZSTATUS^LAB^ZZBUILDING|R|13579246|ZZPRIOR|102938^SANCHEZ^RICK^L^SR^DR^D.Sc|069420^SMITH^JERRY^B|345765^SQUANCH^SQUANCHY|PUL|ZZTEMP||||B2||586032^MASON^TEDDY||H0094113|||||||||||||||||||||||||20160414083000-0800
OBR|1|01290|37334|127800008^Microscopic urinalysis^SNOMED-CT|||20151222144500-0800|20151222151500-0800||500^ml|765098^SIMPSON^HOMER^J|L|||20151222160000-0800||123456^DUCK^DAFFY^P|(608)777-1234|||||20151222161230-0800||LAB|P|||||||549364^MARIO^MARIO^T|549365^MARIO^LUIGI^T|771952^TROOPA^KOOPA^
NTE|1||Results are good. No, GREAT. 
NTE|2||They're just terrific.
OBX|1|CWE|271649006^Systolic blood pressure^SNOMED-CT||120|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
OBX|2|CWE|271650006^Diastolic blood pressure^SNOMED-CT||80|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
OBX|3|CWE|386725007^Body temperature^SNOMED-CT||98.6|Fahrenheit|||||F|||20151222133200-0800||52936881^DUCK^DAFFY

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"ORU",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"201610150011656-0800",
            "security":"",
            "messageType":"ORU",
            "messageEvent":"R01",
            "messageControlId":"733791",
            "processingID":"D",
            "versionID":"2.4"
        },
        "PID":{  
            "externalId":"",
            "internalId":{  
                "id":"73902171",
                "type":"MRN"
            },
            "alternateId":"",
            "patientName":{  
                "lastName":"YYTEST",
                "firstName":"ERIN",
                "middleInitOrName":"M"
            },
            "mothersMaidenName":"BBTEST",
            "dateTimeBirth":"1984-07-22T18:18:56-0400",
            "sex":"F",
            "alias":"SHIRLEY",
            "race":"",
            "address":{  
                "streetAddress":"9200 W STATE ST",
                "otherDesignation":"3",
                "city":"MADISON",
                "state":"WI",
                "postalCode":"53715",
                "country":"USA",
                "addressType":""
            },
            "countyCode":"",
            "homePhone":[  
                {  
                    "number":"(608)344-8800",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"eyytest@hotmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                },
                {  
                    "number":"",
                    "useCode":"",
                    "equipmentType":"",
                    "email":"yytest84@gmail.com",
                    "countryCode":"",
                    "areaCode":"",
                    "phoneNumber":""
                }
            ],
            "businessPhone":"(608)222-9999",
            "primaryLanguage":"ESP",
            "maritalStatus":"S",
            "religion":"ATH",
            "patientAccountNumber":{  
                "id":"8302741992",
                "checkDigit":"",
                "codeIdCheck":"",
                "assigningAuth":"",
                "idTypeCode":"",
                "assigningFacility":""
            },
            "ssn":"999772222",
            "driversLicenseNumber":"B2408664777790",
            "mothersId":"",
            "ethnicGroup":"N",
            "birthPlace":"",
            "multipleBirthIndicator":"Y",
            "birthOrder":"1",
            "citizenship":"USA",
            "veteranStatus":"",
            "nationality":"",
            "deathDateTime":"",
            "deathIndicator":"N",
            "notes":[  
                {  
                    "id":"1",
                    "source":"",
                    "body":"Some notes about the patient go here."
                },
                {  
                    "id":"2",
                    "source":"",
                    "body":"Nothing notable about the patient, really. Except his last name. \"ZZTEST\", is that Swedish?"
                }
            ],
            "PV1":{  
                "id":"1",
                "patientClass":"P",
                "patientLocation":{  
                    "pointOfCare":"ZZPOC",
                    "room":"333",
                    "bed":"3",
                    "facility":"ZZFAC",
                    "locationStatus":"ZZSTATUS",
                    "personLocationType":"LAB",
                    "building":"ZZBUILDING"
                },
                "admissionType":"R",
                "priorPatientLocation":"ZZPRIOR",
                "attendingProvider":{  
                    "id":"102938",
                    "lastName":"SANCHEZ",
                    "firstName":"RICK",
                    "middleInitOrName":"L",
                    "suffix":"SR",
                    "prefix":"DR",
                    "degree":"D.Sc",
                    "sourceTable":"",
                    "assigningAuthority":"",
                    "nameTypeCode":"",
                    "identifierCheckDigit":"",
                    "codeIdCheck":"",
                    "identifierTypeCode":"",
                    "assigningFacility":""
                },
                "referringProvider":"069420",
                "consultingDoctor":"345765",
                "hospitalService":"PUL",
                "pointOfCare":"ZZTEMP",
                "preadmitTestIndicator":"",
                "readmissionIndicator":"",
                "admitSource":"",
                "ambulatoryStatus":"B2",
                "vipIndicator":"",
                "admittingProvider":{  
                    "id":"102938",
                    "lastName":"MASON",
                    "firstName":"TEDDY",
                    "middleInitOrName":"",
                    "suffix":"",
                    "prefix":"",
                    "degree":"",
                    "sourceTable":"",
                    "assigningAuthority":"",
                    "nameTypeCode":"",
                    "identifierCheckDigit":"",
                    "codeIdCheck":"",
                    "identifierTypeCode":"",
                    "assigningFacility":""
                },
                "patientType":"",
                "visitNumber":{  
                    "id":"H0094113",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuthority":"",
                    "idTypeCode":""
                },
                "financialClass":"",
                "chargePriceIndicator":"",
                "courtesyCode":"",
                "creditRating":"",
                "contractCode":"",
                "contractEffectiveDate":"",
                "contractAmount":"",
                "contractPeriod":"",
                "interestCode":"",
                "transferToBadDebtCode":"",
                "transferToBadDebtDate":"",
                "badDebtAgencyCode":"",
                "badDebtRecoveryAmount":"",
                "deleteAccountIndicator":"",
                "deleteAccountDate":"",
                "dischargeDisposition":"",
                "dischargedToLocation":"",
                "dietType":"",
                "servicingFacility":"",
                "bedStatus":"",
                "accountStatus":"",
                "pendingLocation":"",
                "priorTemporaryLocation":"",
                "admitDateTime":"2016-04-14T12:30:00-0400",
                "dischargeDateTime":"",
                "currentPatientBalance":"",
                "totalCharges":"",
                "totalAdjustments":"",
                "totalPayments":"",
                "alternateVisitId":""
            }
        },
        "OBR":[  
            {  
                "setId":"1",
                "placerOrderNumber":"01290",
                "fillerOrderNumber":"37334",
                "universalServiceId":{  
                    "id":"127800008",
                    "text":"Microscopic urinalysis",
                    "codingSystem":"SNOMED-CT",
                    "alternateId":"",
                    "alternateText":"",
                    "alternateCodingSystem":""
                },
                "priority":"",
                "requestedDateTime":"",
                "observationDateTime":"2015-12-22T17:45:00-0500",
                "observationEndDateTime":"2015-12-22T18:15:00-0500",
                "collectionVolume":{  
                    "quantity":"",
                    "units":""
                },
                "collectorIdentifier":"500",
                "specimenActionCode":"765098",
                "dangerCode":"L",
                "relevantClinicalInfo":"20151222160000-0800",
                "specimenReceivedDateTime":"",
                "specimenSource":"20151222160000-0800",
                "orderingProvider":{  
                    "id":"",
                    "lastName":"",
                    "firstName":"",
                    "middleInitOrName":""
                },
                "orderCallBackNumber":"123456",
                "placerField1":"(608)777-1234",
                "placerField2":"",
                "fillerField1":"",
                "fillerField2":"",
                "rptStatusChangeDate":"",
                "chargeToPractice":"20151222161230-0800",
                "diagnosticServiceSectId":"",
                "diagnosticServiceSectId2":"",
                "resultStatus":"LAB",
                "linkedResults":"P",
                "quantityTiming":{  
                    "quantity":"",
                    "interval":"",
                    "duration":"",
                    "startDateTime":"",
                    "endDateTime":"",
                    "priority":""
                },
                "resultCopiesTo":[  
                    {  
                        "id":"",
                        "lastName":"",
                        "firstName":"",
                        "middleInitOrName":""
                    }
                ],
                "parent":{  
                    "placerOrderNumber":"",
                    "fillerOrderNumber":""
                },
                "transportationMode":"",
                "reasonForStudy":"",
                "principalResultInterpreter":"",
                "assistantResultInterpreter":"549364",
                "technician":"549365",
                "transcriptionist":"771952",
                "notes":[  
                    {  
                        "id":"1",
                        "source":"",
                        "body":"Results are good. No, GREAT. "
                    },
                    {  
                        "id":"2",
                        "source":"",
                        "body":"They're just terrific."
                    }
                ],
                "OBX":[  
                    {  
                        "setId":"1",
                        "valueType":"CWE",
                        "identifier":{  
                            "id":"271649006",
                            "text":"Systolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"120",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    },
                    {  
                        "setId":"2",
                        "valueType":"CWE",
                        "identifier":{  
                            "id":"271650006",
                            "text":"Diastolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"80",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    },
                    {  
                        "setId":"3",
                        "valueType":"CWE",
                        "identifier":{  
                            "id":"386725007",
                            "text":"Body temperature",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"98.6",
                        "units":"Fahrenheit",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:32:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    }
                ]
            }
        ]
    }
}

The SIU / SRM (Resource or Services Scheduling) message

The SIU or scheduling message pertains to booking resources (physicians, rooms etc.) and services (appointments, procedures etc.) in the context of a patient (usually). The SIU has been renamed / replaced with the SRM message in HL7 v2.7+. However, there is a pretty clear mapping between the two message types even though they are called different things. An EHR (such as Epic) is capable of sending you both message formats especially since downstream applications might not have evolved to accept the “newer” standard. We’ll use SIU throughout this document for simplicity. There are multiple events that can trigger specific message types. Here is how they map to each other between the SIU and SRM standards:

Event SIU message SRM message
Request new appt. SIU^S12: Notification of new appt. booking SRM^S01: Request new appt. booking
Reschedule an appt. SIU^S13: Notification of appt. rescheduling SRM^S02: Request appt. rescheduling
Modify an appt. SIU^S14: Notification of appt. modification SRM^S03: Request appt. modification
Cancel an appt. SIU^S15: Notification of appt. cancellation SRM^S04: Request appt. cancellation
Delete an appt. SIU^S17: Notification of appt. deletion SRM^S06: Request appt. deletion

The mandated structure of an SIU message

As we discussed earlier, HL7 recommends / mandates that messages follow a specific structure. The segments we will need are:

  • MSH: the message header (required everywhere)
  • SCH / ARQ: Schedule activity information such as request
  • NTE: Notes and comments
  • PID: the patient identification segment. Note that demographics can be included within the PID segment itself
  • PV1: information about the patient “visit” - this is where you would include the physician info and the current location of the patient.
  • OBX: Observation / result and associated comments and notes
  • DG1: Diagnosis information
  • AIS: Appointment information pertaining to the service
  • AIG: Appointment information pertaining to the resource
  • AIL: Appointment information pertaining to the location
  • AIP: Appointment information pertaining to the personnel

One quick tip - in most HL7 messages the pipe character “|” is called the BAR and it is the field separator and in the case of this message, we’re going to use the “^” as a space. So if you see a bunch of pipes together like this “||||||||||” - all that means is that the fields at that point in the sequence were optional or not available. Also remember that segments are separated by a carriage return - which cannot be displayed as any and all viewers will interpret that for display.

The HL7 v2.7.x specifies the following format for an ADT A01 message. For additional examples and specific structure, you can view the Scheduling related PDF on the HL7 site. Note also that EHRs often have created their own variants of this standard for example Epic has a slightly different format that it specifies as it also adheres to the 2.3 standard with some additions as well. We intend to cover EHR specific variants soon.

SIU Message Format for Event Types S12, S13, S14, S15, S17, and S26

Segment Description
MSH Message header
SCH Schedule Activity Information
[ { NTE } ] Notes and Comments
PID Patient Identification
[ PD1 ] Patient Additional Demographics
[ ROL ] Role
[ PV1 ] Patient Visit Information
[ PV2 ] Patient Visit – Additional Info
[ { OBX } ] Notes and Comments
[ { DG1 } ] Diagnosis
{ —- Begin General resource section
RGS Resource Section
{ — Begin Appt. service section
AIS Appointment Info. - Service
[ { NTE } ] Notes and Comments
} — End Appt. service section
[ { — Begin Appt. resource section
AIG Appt. Info. - General Resource
[ { NTE } ] Notes and Comments
} ] — End Appt. resource section
[ { — Begin Appt. personnel section
AIP Appointment Info. - Personnel
[ { NTE } ] Notes and Comments
} ] — End Appt. personnel section
} —- End General resource section

SRM Message Format for Event Types S01, S02, S03, S04, and S06

Segment Description
MSH Message Header
ARQ Schedule Activity Information
[ { NTE } ] Notes and Comments
{ [ — Begin Patient section
PID Patient Identification
[ PD1 ] Patient Additional Demographics
[ ROL ] Role
[ PV1 ] Patient Visit Information
[ { OBX } ] Notes and Comments
[ { DG1 } ] Diagnosis
{ —- Begin General resource section
RGS Resource Section
{ — Begin Appt. service section
AIS Appointment Info. - Service
[ { NTE } ] Notes and Comments
} — End Appt. service section
[ { — Begin Appt. resource section
AIG Appt. Info. - General Resource
[ { NTE } ] Notes and Comments
}] — End Appt. resource section
[ { — Begin Appt. personnel section
AIP Appointment Info. - Personnel
[ { NTE } ] Notes and Comments
}] — End Appt. personnel section
} — End General resource section



We’ll take some of the key segments listed above and provide examples for each below and finally show an fully composed HL7 message. Additionally, a few more HL7 sample messages of each will be listed below. (note that this is based on the SIU format).

The MSH (message header) segment

MSH|^~\&|SENDING APP|SENDING FAC|RECEIVING|RECEIVING FAC|2015052711090000||SIU^S12|1055|P|2.3||

The PID (patient identification) segment

PID|||3378772^^^^MRN1||LASSETER^CARL^^^^||19711001|M|||310 DOWNTOWN AVE^^MINONA^WI^53302^||608-123-4556||||||333-44-4433|||||||||||N

The NTE (notes and comments) segment

This is repeated in different segments and used appropriately.

A general note

NTE|1||This is a Display Note.

A specific note related to the appointment.

NTE|1||These are patient instructions for visit type 001
NTE|2||Fast 24 hours before the appointment

The SCH (schedule activity) segment

SCH|1|688688|||||||45|MIN|^^^201505271115||||||||||||||1^SCH

The OBX (observations) segment

OBX|1|TX|||The patient gets a very high fever spiking at 103 at night.
OBX|2|TX|||The patient is a smoker. 

The DG1 (patient diagnosis) segment

DG1|1||002.0^TYPHOID FEVER^I9

The RGS (general resource ) segment

RGS|1||1^INTERNAL MEDICINE

The AIS (service ) segment

AIS|1||1^OFFICE VISIT

The AIG / AIL (resource or location ) segment

AIL|001|^NORTH OFFICE|002^CLINIC|||||||YES|<cr>

AIG|1||39^YELLOW ROAD^ROOM^^^|||||201510141500|0|MIN|15|MIN

The AIP ( personnel ) segment

AIP|1||400^JONSSON^JEREMY^^^^|||201505271115|0|MIN|15|MIN 

Putting it all together (SIU^S12)

MSH|^~\&|SENDING APP|SENDING FAC|RECEIVING APP|RECEIVING FAC|2015052711090000||SIU^S12|1055|P|2.3||
SCH|1|688688|||||||45|MIN|^^^201505271115||||||||||||||1^SCH
NTE|1||This is a Display Note.
PID|||3378772^^^^MRN1||LASSETER^CARL^^^^||19711001|M|||310 DOWNTOWN AVE^^MINONA^WI^53302^||608-123-4556||||||333-44-4433|||||||||||N
RGS|1||1^INTERNAL MEDICINE
AIS|1||001^OFFICE VISIT
NTE|1||These are patient instructions for visit type 001 
NTE|2||Fast 24 hours before the appointment 
AIG|1||399^SOME^RESOURCE^^^^|||||201505271130|15|MIN|30|MIN 
NTE|1||Resource Specific Notes 
AIP|1||400^JONSSON^JEREMY^^^^|||201505271115|0|MIN|15|MIN 
NTE|1||Appointment notes pertaining to a provider

Putting it all together (SRM^S01)

MSH|^~\&|SENDING APP|SENDING FAC|RECEIVING APP|RECEIVING FAC|2015080710350000||SRM^S01|1919|P|2.3|| 
ARQ|1|223350||||1^SCH|||60|MIN|200510141500||||||||593^JONSSON^JONA^^^^|608-123-4556|||
NTE|1||This is a Display Note. 
PID|||3378772^^^^MRN1||LASSETER^CARL^^^^||19711001|M|||310 DOWNTOWN AVE^^MINONA^WI^53302^||608-123-4556||||||333-44-4433|||||||||||N
OBX|1|TX|||The patient gets a very high fever spiking at 103 at night.
OBX|2|TX|||The patient is a smoker. 
DG1|1||002.0^TYPHOID FEVER^I9
RGS|1||1^INTERNAL MEDICINE
AIS|1||1^OFFICE VISIT
NTE|1||This is a patient specific note
AIG|1||101^YELLOW ROAD^ROOM^^^|||||201510141500|0|MIN|15|MIN
NTE|1||This is a note specific to the Yellow Road room
NTE|2||More details about the room if necessary
AIG|2||102^BABYBLUE^ROOM^^^|||||201510141515|0|MIN|15|MIN
NTE|1||This is a note specific to the Baby Blue room  
NTE|2||More details about the room if necessary
AIP|1||201^GUSTER^BURT^^^|||201510141515|0|MIN|15|MIN
NTE|1||This is a note specific to the resource i.e. Dr. Burt Guster
NTE|2||More details about the resource if necessary
RGS|2||5^RADIOLOGY
AIS|1||1^OFFICE VISIT 
AIG|1||301^XRAY^ROOM201^^^|||||201510141530|0|MIN|30|MIN
NTE|1||This is a note specific to the XRAY room 201
AIP|1||42^SPENCER,JEREMY^^^|||201510141545|0|MIN|15|MIN
NTE|1||This is a note specific to the resource i.e. Dr. Jeremy Spencer

Additional SIU examples

Coming soon.

The JSON object model

To ensure maximum coverage, we have mapped all the data elements in the HL7 standard to a corresponding JSON data element. Additionally, JSON doesn’t have the concept of sequence or order (as opposed to XML). This can cause issues as for example, the first diagnosis in the DG1 segment is supposed to be interpreted as the primary diagnosis. To overcome issues such as that, specific numbering has also been introduced into such arrays.

Below is a sample JSON object for the HL7 SIU message. Note that this is the same object you will receive for all SIU message types. Certain or whole sets of fields can be empty depending on the message type. As you can also notice, there is a lot going on in this object i.e. there are a ridiculous number of fields and most of our customers rarely use more than 10-20% of them. That is an additional value add that is included in our service as we will trim or chop out the data fields that you do not need.

If the following HL7 SIU message is received by Catalyze, then the JSON object immediately following is the response you can expect to be POST-ed to your API end point (or whatever other way you choose to receive it).

HL7 SRM^S01 message received

MSH|^~\&|XX|YY||ZZ|20161109132306-0800||SRM^S01|161135|D|2.4
ARQ|01928374|57483920|||||||1|hr|20151222132500-0800^20151222143000-0800||||123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|543210|(608)432-1098|XXPOC|01928350|57483875
RGS|1||1111111
AIS|1||84.11^Amputation of toe^ICD 9|20151222134000-0800|15|min|1|hr||Booked
AIG|1||A6219^Gauze <= 16 sq in with border^HCPCS|||||20151222134000-0800|15|min|1|hr||Booked
AIL|1||XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|||20151222132500-0800|0|min|15|min||Booked
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151222134000-0800|15|min|1|hr||Booked

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SRM",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-11-09T16:23:06-0500",
            "security":"",
            "messageType":"SRM",
            "messageEvent":"S01",
            "messageControlId":"161135",
            "processingID":"D",
            "versionID":"2.4"
        },
        "ARQ":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "requestEventReason":{  
                "id":"",
                "text":""
            },
            "appointmentReason":"",
            "appointmentType":"",
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "requestedStartDateTimeRange":{  
                "rangeStart":"2015-12-22T16:25:00-0500",
                "rangeEnd":"2015-12-22T17:30:00-0500"
            },
            "priority":"",
            "repeatingInterval":"",
            "repeatingIntervalDuration":"",
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"",
                    "otherDesignation":"",
                    "city":"",
                    "state":"",
                    "postalCode":"",
                    "country":""
                },
                "location":"XXPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerAppointmentId":"01928350",
            "parentFillerAppointmentId":"57483875"
        },
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"84.11",
                            "text":"Amputation of toe"
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A6219",
                            "text":"Gauze <= 16 sq in with border"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIL":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "locationResourceId":{  
                            "pointOfCare":"XXPOC",
                            "room":"204"
                        },
                        "locationType":"",
                        "locationGroup":"",
                        "startDateTime":"2015-12-22T16:25:00-0500",
                        "startDateTimeOffset":{  
                            "value":"0",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"15",
                            "units":"min"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIP":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "personnelResourceId":{  
                            "id":"123456",
                            "lastName":"DUCK",
                            "firstName":"DAFFY",
                            "middleInitOrName":"P"
                        },
                        "resourceRole":"Surgeon",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ]
            }
        ]
    }
}

HL7 SRM^S02 message received

MSH|^~\&|XX|YY||ZZ|20141018132306-0800||SRM^S02|168743|D|2.4
ARQ|01928374|57483920|||||||1|hr|20151229100000-0800^20151229113000-0800||||123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|543210|(608)432-1098|XXPOC|01928350|57483875
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
RGS|1||1111111
AIS|1||21.85^Augmentation rhinoplasty^ICD 9|20151229101500-0800|15|min|1|hr||Pending
AIG|1||A4657^Syringe, with or without needle, each^CPT|||5||20151229101500-0800|15|min|1|hr||Pending
AIL|1||XXPOC^232^1^XXFAC^XXSTATUS^SURGERY^XXBUILDING|||20151229101500-0800|15|min|1|hr||Pending
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151229101500-0800|15|min|1|hr||Pending
AIP|2||711711^DOG^DROOPY^D^SR^DR^MD|Anesthesiologist||20151229101500-0800|15|min|1|hr||Pending

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SRM",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2014-10-18T17:23:06-0400",
            "security":"",
            "messageType":"SRM",
            "messageEvent":"S02",
            "messageControlId":"168743",
            "processingID":"D",
            "versionID":"2.4"
        },
        "ARQ":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "requestEventReason":{  
                "id":"",
                "text":""
            },
            "appointmentReason":"",
            "appointmentType":"",
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "requestedStartDateTimeRange":{  
                "rangeStart":"2015-12-29T13:00:00-0500",
                "rangeEnd":"2015-12-29T14:30:00-0500"
            },
            "priority":"",
            "repeatingInterval":"",
            "repeatingIntervalDuration":"",
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"",
                    "otherDesignation":"",
                    "city":"",
                    "state":"",
                    "postalCode":"",
                    "country":""
                },
                "location":"XXPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerAppointmentId":"01928350",
            "parentFillerAppointmentId":"57483875"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"50521935",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"ZZTEST",
                    "firstName":"BILL",
                    "middleInitOrName":"C"
                },
                "mothersMaidenName":"AATEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"M",
                "alias":"RONALD",
                "race":"",
                "address":{  
                    "streetAddress":"640 W BARFORD AVE",
                    "otherDesignation":"",
                    "city":"MILWAUKEE",
                    "state":"WI",
                    "postalCode":"53211",
                    "country":"USA",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(414)888-5588",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"bzztest@gmail.com",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    },
                    {  
                        "number":"",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"ronnymcdonny@realsite.net",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    }
                ],
                "businessPhone":"(414)444-3333",
                "primaryLanguage":"ENG",
                "maritalStatus":"M",
                "religion":"MOT",
                "patientAccountNumber":{  
                    "id":"6600075763",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuth":"",
                    "idTypeCode":"",
                    "assigningFacility":""
                },
                "ssn":"333772222",
                "driversLicenseNumber":"Y5529583110042",
                "mothersId":"",
                "ethnicGroup":"U",
                "birthPlace":"",
                "multipleBirthIndicator":"N",
                "birthOrder":"",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"",
                "deathIndicator":"N"
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"21.85",
                            "text":"Augmentation rhinoplasty"
                        },
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A4657",
                            "text":"Syringe, with or without needle, each"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"5",
                            "units":""
                        },
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ],
                "AIL":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "locationResourceId":{  
                            "pointOfCare":"XXPOC",
                            "room":"232"
                        },
                        "locationType":"",
                        "locationGroup":"",
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ],
                "AIP":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "personnelResourceId":{  
                            "id":"123456",
                            "lastName":"DUCK",
                            "firstName":"DAFFY",
                            "middleInitOrName":"P"
                        },
                        "resourceRole":"Surgeon",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    },
                    {  
                        "setId":"2",
                        "segmentActionCode":"",
                        "personnelResourceId":{  
                            "id":"711711",
                            "lastName":"DOG",
                            "firstName":"DROOPY",
                            "middleInitOrName":"D"
                        },
                        "resourceRole":"Anesthesiologist",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ]
            }
        ]
    }
}

HL7 SRM^S03 message received

MSH|^~\&|XX|YY||ZZ|20150525132306-0800||SRM^S03|160925|D|2.4
ARQ|01928374|57483920|||||||1|hr|20151222132500-0800^20151222143000-0800||||123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|543210|(608)432-1098|XXPOC|01928350|57483875
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
RGS|1|A|1111111
AIG|1||A6219^Gauze <= 16 sq in with border^HCPCS|||||20151222134000-0800|15|min|1|hr||Pending
RGS|2|D|1111111
AIS|1||85.54^Bilateral breast implant^ICD 9|20151222140000-0800|35|min|1|hr||Pending
NTE|1||Patient backed out at the last minute.
NTE|2||The nurse owes me $20.
AIG|1||L8030^Breast prosthesis, silicone or equal, without integral adhesive^CPT|||2||20151222140000-0800|35|min|1|hr||Pending

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SRM",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-05-25T17:23:06-0400",
            "security":"",
            "messageType":"SRM",
            "messageEvent":"S03",
            "messageControlId":"160925",
            "processingID":"D",
            "versionID":"2.4"
        },
        "ARQ":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "requestEventReason":{  
                "id":"",
                "text":""
            },
            "appointmentReason":"",
            "appointmentType":"",
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "requestedStartDateTimeRange":{  
                "rangeStart":"2015-12-22T16:25:00-0500",
                "rangeEnd":"2015-12-22T17:30:00-0500"
            },
            "priority":"",
            "repeatingInterval":"",
            "repeatingIntervalDuration":"",
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"",
                    "otherDesignation":"",
                    "city":"",
                    "state":"",
                    "postalCode":"",
                    "country":""
                },
                "location":"XXPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerAppointmentId":"01928350",
            "parentFillerAppointmentId":"57483875"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"50521935",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"ZZTEST",
                    "firstName":"BILL",
                    "middleInitOrName":"C"
                },
                "mothersMaidenName":"AATEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"M",
                "alias":"RONALD",
                "race":"",
                "address":{  
                    "streetAddress":"640 W BARFORD AVE",
                    "otherDesignation":"",
                    "city":"MILWAUKEE",
                    "state":"WI",
                    "postalCode":"53211",
                    "country":"USA",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(414)888-5588",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"bzztest@gmail.com",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    },
                    {  
                        "number":"",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"ronnymcdonny@realsite.net",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    }
                ],
                "businessPhone":"(414)444-3333",
                "primaryLanguage":"ENG",
                "maritalStatus":"M",
                "religion":"MOT",
                "patientAccountNumber":{  
                    "id":"6600075763",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuth":"",
                    "idTypeCode":"",
                    "assigningFacility":""
                },
                "ssn":"333772222",
                "driversLicenseNumber":"Y5529583110042",
                "mothersId":"",
                "ethnicGroup":"U",
                "birthPlace":"",
                "multipleBirthIndicator":"N",
                "birthOrder":"",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"",
                "deathIndicator":"N"
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"A",
                "resourceGroupId":"1111111",
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A6219",
                            "text":"Gauze <= 16 sq in with border"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ]
            },
            {  
                "id":"2",
                "segmentActionCode":"D",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"85.54",
                            "text":"Bilateral breast implant"
                        },
                        "startDateTime":"2015-12-22T17:00:00-0500",
                        "startDateTimeOffset":{  
                            "value":"35",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"Patient backed out at the last minute."
                            },
                            {  
                                "id":"2",
                                "source":"",
                                "body":"The nurse owes me $20."
                            }
                        ]
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"L8030",
                            "text":"Breast prosthesis, silicone or equal, without integral adhesive"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"2",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T17:00:00-0500",
                        "startDateTimeOffset":{  
                            "value":"35",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ]
            }
        ]
    }
}

HL7 SRM^S04 message received

MSH|^~\&|XX|YY||ZZ|20160513132306-0800||SRM^S04|181220|D|2.4
ARQ|01928374|57483920|||||||1|hr|20151222132500-0800^20151222143000-0800||||123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|543210|(608)432-1098|XXPOC|01928350|57483875
PID|1||22490753^^^^MRN||XXTEST^TIMOTHY^R|CCTEST|19910310080910-0800|O|BIANCA||123 SESAME STREET^MADISON^WI^53713^USA||(608)444-5678^^^txxtest@gmail.com~^^^xxbianca@yahoo.com|(608)221-5555|ENG|P|AGN|8845620749|555883456|Q8820033123469||H||Y|2|USA|||20160120103000-0800|Y
OBX|1|CWE|271649006^Systolic blood pressure^SNOMED-CT||120|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
OBX|2|CWE|271650006^Diastolic blood pressure^SNOMED-CT||80|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
DG1|1||333.94^Restless legs syndrome^ICD 9||20151222133000-0800|A
DG1|2||527.7^Dry mouth^ICD 9||20151222170000-0800|W
DG1|3||784.99^Halitosis^ICD 9||20151222170000-0800|F
RGS|1||1111111
AIS|1||84.11^Amputation of toe^ICD 9|20151222134000-0800|15|min|1|hr||Booked
AIG|1||A6219^Gauze <= 16 sq in with border^HCPCS|||||20151222134000-0800|15|min|1|hr||Booked
AIL|1||XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|||20151222132500-0800|0|min|15|min||Booked
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151222134000-0800|15|min|1|hr||Booked

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SRM",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-05-13T17:23:06-0400",
            "security":"",
            "messageType":"SRM",
            "messageEvent":"S04",
            "messageControlId":"181220",
            "processingID":"D",
            "versionID":"2.4"
        },
        "ARQ":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "requestEventReason":{  
                "id":"",
                "text":""
            },
            "appointmentReason":"",
            "appointmentType":"",
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "requestedStartDateTimeRange":{  
                "rangeStart":"2015-12-22T16:25:00-0500",
                "rangeEnd":"2015-12-22T17:30:00-0500"
            },
            "priority":"",
            "repeatingInterval":"",
            "repeatingIntervalDuration":"",
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"",
                    "otherDesignation":"",
                    "city":"",
                    "state":"",
                    "postalCode":"",
                    "country":""
                },
                "location":"XXPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerAppointmentId":"01928350",
            "parentFillerAppointmentId":"57483875"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"22490753",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"XXTEST",
                    "firstName":"TIMOTHY",
                    "middleInitOrName":"R"
                },
                "mothersMaidenName":"CCTEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"O",
                "alias":"BIANCA",
                "race":"",
                "address":{  
                    "streetAddress":"123 SESAME STREET",
                    "otherDesignation":"MADISON",
                    "city":"WI",
                    "state":"53713",
                    "postalCode":"USA",
                    "country":"",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(608)444-5678",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"txxtest@gmail.com",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    },
                    {  
                        "number":"",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"xxbianca@yahoo.com",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    }
                ],
                "businessPhone":"(608)221-5555",
                "primaryLanguage":"ENG",
                "maritalStatus":"P",
                "religion":"AGN",
                "patientAccountNumber":{  
                    "id":"8845620749",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuth":"",
                    "idTypeCode":"",
                    "assigningFacility":""
                },
                "ssn":"555883456",
                "driversLicenseNumber":"Q8820033123469",
                "mothersId":"",
                "ethnicGroup":"H",
                "birthPlace":"",
                "multipleBirthIndicator":"Y",
                "birthOrder":"2",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"2016-01-20T13:30:00-0500",
                "deathIndicator":"Y",
                "OBX":[  
                    {  
                        "setId":"1",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271649006",
                            "text":"Systolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"120",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    },
                    {  
                        "setId":"2",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271650006",
                            "text":"Diastolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"80",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    }
                ],
                "DG1":[  
                    {  
                        "id":"1",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"333.94",
                            "text":"Restless legs syndrome",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T16:30:00-0500",
                        "type":"A",
                        "diagnosticCategory":""
                    },
                    {  
                        "id":"2",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"527.7",
                            "text":"Dry mouth",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"W",
                        "diagnosticCategory":""
                    },
                    {  
                        "id":"3",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"784.99",
                            "text":"Halitosis",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"F",
                        "diagnosticCategory":""
                    }
                ]
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"84.11",
                            "text":"Amputation of toe"
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A6219",
                            "text":"Gauze <= 16 sq in with border"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIL":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "locationResourceId":{  
                            "pointOfCare":"XXPOC",
                            "room":"204"
                        },
                        "locationType":"",
                        "locationGroup":"",
                        "startDateTime":"2015-12-22T16:25:00-0500",
                        "startDateTimeOffset":{  
                            "value":"0",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"15",
                            "units":"min"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ],
                "AIP":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "personnelResourceId":{  
                            "id":"123456",
                            "lastName":"DUCK",
                            "firstName":"DAFFY",
                            "middleInitOrName":"P"
                        },
                        "resourceRole":"Surgeon",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ]
            }
        ]
    }
}

HL7 SIU^S12 message received

MSH|^~\&|XX|YY||ZZ|20161209132300-0800||SIU^S12|122234|D|2.4
SCH|01928374|57483920|||||||1|hr|1^^^20151222132500-0800|123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|654321^RABBIT^JESSICA|(608)666-7777|888 MAIN ST^MADISON^WI^53726^USA|YYPOC|543210|(608)432-1098|XXPOC|01928350|57483875|Booked
PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
RGS|1||1111111
AIS|1||21.85^Augmentation rhinoplasty^ICD 9|20151222134000-0800|15|min|1|hr||Booked
NTE|1||Elective surgery.
AIS|2||85.54^Bilateral breast implant^ICD 9|20151222140000-0800|35|min|1|hr||Booked
NTE|1||Banging your head against a wall burns 150 Calories an hour.
AIG|1||L8030^Breast prosthesis, silicone or equal, without integral adhesive^CPT|||2||20151222140000-0800|35|min|1|hr||Booked
NTE|1||My favorite power ranger is the red one.
NTE|2||The average woman uses her height in lipstick every 5 years.

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SIU",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2016-12-09T16:23:00-0500",
            "security":"",
            "messageType":"SIU",
            "messageEvent":"S12",
            "messageControlId":"122234",
            "processingID":"D",
            "versionID":"2.4"
        },
        "SCH":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber:":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "eventReason":"",
            "appointmentReason":"",
            "appointmentType":{  
                "id":"",
                "text":""
            },
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "appointmentTimingQuantity":{  
                "quantity":"1",
                "interval":"",
                "duration":"",
                "startDateTime":"2015-12-22T16:25:00-0500"
            },
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"777 W DRURY LN",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53715",
                    "country":"USA"
                },
                "location":"XXPOC"
            },
            "fillerContactInfo":{  
                "person":"654321",
                "phone":"(608)666-7777",
                "address":{  
                    "streetAddress":"888 MAIN ST",
                    "otherDesignation":"MADISON",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53726",
                    "country":"USA"
                },
                "location":"YYPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerId":"01928350",
            "parentFillerId":"57483875",
            "fillerStatusCode":"Booked"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"50521935",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"ZZTEST",
                    "firstName":"BILL",
                    "middleInitOrName":"C"
                },
                "mothersMaidenName":"AATEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"M",
                "alias":"RONALD",
                "race":"",
                "address":{  
                    "streetAddress":"640 W BARFORD AVE",
                    "otherDesignation":"",
                    "city":"MILWAUKEE",
                    "state":"WI",
                    "postalCode":"53211",
                    "country":"USA",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(414)888-5588",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"bzztest@gmail.com",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    },
                    {  
                        "number":"",
                        "useCode":"",
                        "equipmentType":"",
                        "email":"ronnymcdonny@realsite.net",
                        "countryCode":"",
                        "areaCode":"",
                        "phoneNumber":""
                    }
                ],
                "businessPhone":"(414)444-3333",
                "primaryLanguage":"ENG",
                "maritalStatus":"M",
                "religion":"MOT",
                "patientAccountNumber":{  
                    "id":"6600075763",
                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuth":"",
                    "idTypeCode":"",
                    "assigningFacility":""
                },
                "ssn":"333772222",
                "driversLicenseNumber":"Y5529583110042",
                "mothersId":"",
                "ethnicGroup":"U",
                "birthPlace":"",
                "multipleBirthIndicator":"N",
                "birthOrder":"",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"",
                "deathIndicator":"N"
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"21.85",
                            "text":"Augmentation rhinoplasty"
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"Elective surgery."
                            }
                        ]
                    },
                    {  
                        "setId":"2",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"85.54",
                            "text":"Bilateral breast implant"
                        },
                        "startDateTime":"2015-12-22T17:00:00-0500",
                        "startDateTimeOffset":{  
                            "value":"35",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"Banging your head against a wall burns 150 Calories an hour."
                            }
                        ]
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"L8030",
                            "text":"Breast prosthesis, silicone or equal, without integral adhesive"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"2",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T17:00:00-0500",
                        "startDateTimeOffset":{  
                            "value":"35",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"My favorite power ranger is the red one."
                            },
                            {  
                                "id":"2",
                                "source":"",
                                "body":"The average woman uses her height in lipstick every 5 years."
                            }
                        ]
                    }
                ]
            }
        ]
    }
}

HL7 SIU^S13 message received

MSH|^~\&|XX|YY||ZZ|20151222132306-0800||SIU^S13|161935|D|2.4
SCH|01928374|57483920|||||||1|hr|1^^^20151229100000-0800^20151229113000-0800|123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|654321^RABBIT^JESSICA|(608)666-7777|888 MAIN ST^MADISON^WI^53726^USA|YYPOC|543210|(608)432-1098|XXPOC|01928350|57483875|Booked
PID|1||73902171^^^^MRN||YYTEST^ERIN^M|BBTEST|19840722141856-0800|F|SHIRLEY||9200 W STATE ST^3^MADISON^WI^53715^USA||(608)344-8800^^^eyytest@hotmail.com~^^^yytest84@gmail.com|(608)222-9999|ESP|S|ATH|8302741992|999772222|B2408664777790||N||Y|1|USA||||N
PV1|1|P|ZZPOC^333^3^ZZFAC^ZZSTATUS^LAB^ZZBUILDING|R|13579246|ZZPRIOR|102938^SANCHEZ^RICK^L^SR^DR^D.Sc|069420^SMITH^JERRY^B|345765^SQUANCH^SQUANCHY|PUL|ZZTEMP||||B2||586032^MASON^TEDDY||H0094113|||||||||||||||||||||||||20160414083000-0800
RGS|1||1111111
AIS|1||21.85^Augmentation rhinoplasty^ICD 9|20151229101500-0800|15|min|1|hr||Pending
AIG|1||A4657^Syringe, with or without needle, each^CPT|||5||20151229101500-0800|15|min|1|hr||Pending
NTE|1||Syringes suck.
RGS|2||2222222
AIL|1||XXPOC^232^1^XXFAC^XXSTATUS^SURGERY^XXBUILDING|||20151229101500-0800|15|min|1|hr||Pending
NTE|1||Needs to be cleared out immediately after surgery for staff party.
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151229101500-0800|15|min|1|hr||Pending
AIP|2||711711^DOG^DROOPY^D^SR^DR^MD|Anesthesiologist||20151229101500-0800|15|min|1|hr||Pending
NTE|1||Currently taking depression medication.
NTE|2||Jowels affect speech.

Catalyze JSON delivered

{  
    "content":{  
        "message_type":"SIU",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2015-12-22T16:23:06-0500",
            "security":"",
            "messageType":"SIU",
            "messageEvent":"S13",
            "messageControlId":"161935",
            "processingID":"D",
            "versionID":"2.4"
        },
        "SCH":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber:":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "eventReason":"",
            "appointmentReason":"",
            "appointmentType":{  
                "id":"",
                "text":""
            },
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "appointmentTimingQuantity":{  
                "quantity":"1",
                "interval":"",
                "duration":"",
                "startDateTime":"2015-12-29T13:00:00-0500"
            },
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"777 W DRURY LN",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53715",
                    "country":"USA"
                },
                "location":"XXPOC"
            },
            "fillerContactInfo":{  
                "person":"654321",
                "phone":"(608)666-7777",
                "address":{  
                    "streetAddress":"888 MAIN ST",
                    "otherDesignation":"MADISON",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53726",
                    "country":"USA"
                },
                "location":"YYPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerId":"01928350",
            "parentFillerId":"57483875",
            "fillerStatusCode":"Booked"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"73902171",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"YYTEST",
                    "firstName":"ERIN",
                    "middleInitOrName":"M"
                },
                "mothersMaidenName":"BBTEST",
                "dateTimeBirth":"1984-07-22T18:18:56-0400",
                "sex":"F",
                "alias":"SHIRLEY",
                "race":"",
                "address":{  
                    "streetAddress":"9200 W STATE ST",
                    "otherDesignation":"3",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53715",
                    "country":"USA",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(608)344-8800",
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                        "phoneNumber":""
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                    {  
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                "businessPhone":"(608)222-9999",
                "primaryLanguage":"ESP",
                "maritalStatus":"S",
                "religion":"ATH",
                "patientAccountNumber":{  
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                    "checkDigit":"",
                    "codeIdCheck":"",
                    "assigningAuth":"",
                    "idTypeCode":"",
                    "assigningFacility":""
                },
                "ssn":"999772222",
                "driversLicenseNumber":"B2408664777790",
                "mothersId":"",
                "ethnicGroup":"N",
                "birthPlace":"",
                "multipleBirthIndicator":"Y",
                "birthOrder":"1",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"",
                "deathIndicator":"N",
                "PV1":{  
                    "id":"1",
                    "patientClass":"P",
                    "patientLocation":{  
                        "pointOfCare":"ZZPOC",
                        "room":"333",
                        "bed":"3",
                        "facility":"ZZFAC",
                        "locationStatus":"ZZSTATUS",
                        "personLocationType":"LAB",
                        "building":"ZZBUILDING"
                    },
                    "admissionType":"R",
                    "priorPatientLocation":"ZZPRIOR",
                    "attendingProvider":{  
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                        "lastName":"SANCHEZ",
                        "firstName":"RICK",
                        "middleInitOrName":"L",
                        "suffix":"SR",
                        "prefix":"DR",
                        "degree":"D.Sc",
                        "sourceTable":"",
                        "assigningAuthority":"",
                        "nameTypeCode":"",
                        "identifierCheckDigit":"",
                        "codeIdCheck":"",
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                    },
                    "referringProvider":"069420",
                    "consultingDoctor":"345765",
                    "hospitalService":"PUL",
                    "pointOfCare":"ZZTEMP",
                    "preadmitTestIndicator":"",
                    "readmissionIndicator":"",
                    "admitSource":"",
                    "ambulatoryStatus":"B2",
                    "vipIndicator":"",
                    "admittingProvider":{  
                        "id":"102938",
                        "lastName":"MASON",
                        "firstName":"TEDDY",
                        "middleInitOrName":"",
                        "suffix":"",
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                        "degree":"",
                        "sourceTable":"",
                        "assigningAuthority":"",
                        "nameTypeCode":"",
                        "identifierCheckDigit":"",
                        "codeIdCheck":"",
                        "identifierTypeCode":"",
                        "assigningFacility":""
                    },
                    "patientType":"",
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                        "checkDigit":"",
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                    "financialClass":"",
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                    "courtesyCode":"",
                    "creditRating":"",
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                    "interestCode":"",
                    "transferToBadDebtCode":"",
                    "transferToBadDebtDate":"",
                    "badDebtAgencyCode":"",
                    "badDebtRecoveryAmount":"",
                    "deleteAccountIndicator":"",
                    "deleteAccountDate":"",
                    "dischargeDisposition":"",
                    "dischargedToLocation":"",
                    "dietType":"",
                    "servicingFacility":"",
                    "bedStatus":"",
                    "accountStatus":"",
                    "pendingLocation":"",
                    "priorTemporaryLocation":"",
                    "admitDateTime":"2016-04-14T12:30:00-0400",
                    "dischargeDateTime":"",
                    "currentPatientBalance":"",
                    "totalCharges":"",
                    "totalAdjustments":"",
                    "totalPayments":"",
                    "alternateVisitId":""
                }
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"21.85",
                            "text":"Augmentation rhinoplasty"
                        },
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending"
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A4657",
                            "text":"Syringe, with or without needle, each"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"5",
                            "units":""
                        },
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
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                            "units":"min"
                        },
                        "duration":{  
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                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
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                        "notes":[  
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                                "source":"",
                                "body":"Syringes suck."
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            {  
                "id":"2",
                "segmentActionCode":"",
                "resourceGroupId":"2222222",
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
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                            "id":"A4657",
                            "text":"Syringe, with or without needle, each"
                        },
                        "resourceType":"",
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                        "resourceQuantity":{  
                            "value":"5",
                            "units":""
                        },
                        "startDateTime":"2015-12-29T13:15:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
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                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Pending",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"Syringes suck."
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                ],
                "AIL":[  
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                        "segmentActionCode":"",
                        "locationResourceId":{  
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                            "room":"232"
                        },
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                        "allowSubstitutionCode":"",
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                                "id":"1",
                                "source":"",
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                "AIP":[  
                    {  
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                        "segmentActionCode":"",
                        "personnelResourceId":{  
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                                "source":"",
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HL7 SIU^S14 message received

MSH|^~\&|XX|YY||ZZ|20170102034500-0800||SIU^S14|193598|D|2.4
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PID|1||50521935^^^^MRN||ZZTEST^BILL^C|AATEST|19910310080910-0800|M|RONALD||640 W BARFORD AVE^^MILWAUKEE^WI^53211^USA||(414)888-5588^^^bzztest@gmail.com~^^^ronnymcdonny@realsite.net|(414)444-3333|ENG|M|MOT|6600075763|333772222|Y5529583110042||U||N||USA||||N
RGS|1|X|1111111
AIS|1||84.11^Amputation of toe^ICD 9|20151222134000-0800|15|min|1|hr||Pending
RGS|2|X|2222222
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151222134000-0800|15|min|1|hr||Booked
AIP|2||711711^DOG^DROOPY^D^SR^DR^MD|Anesthesiologist||20151222134000-0800|15|min|1|hr||Booked
RGS|3|U|1111111
AIS|1||84.11^Amputation of toe^ICD 9|20151222134000-0800|15|min|1|hr||Booked
NTE|1||Removal of only toes 2 and 4.
RGS|4|A|2222222
AIG|1||A4657^Syringe, with or without needle, each^CPT|||5||20151222134000-0800|15|min|1|hr||Booked
NTE|1||Because we need it. For stuff.

Catalyze JSON delivered

{  
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        "message_type":"SIU",
        "MSH":{  
            "sendingApplication":"XX",
            "sendingFacility":"YY",
            "receivingApplication":"",
            "receivingFacility":"ZZ",
            "dateTime":"2017-01-02T06:45:00-0500",
            "security":"",
            "messageType":"SIU",
            "messageEvent":"S14",
            "messageControlId":"193598",
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        "SCH":{  
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            "appointmentReason":"",
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            "appointmentDuration":{  
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                "units":"hr"
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            "appointmentTimingQuantity":{  
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                "interval":"",
                "duration":"",
                "startDateTime":"2015-12-22T16:25:00-0500"
            },
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"777 W DRURY LN",
                    "otherDesignation":"",
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                    "postalCode":"53715",
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                "location":"XXPOC"
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            "fillerContactInfo":{  
                "person":"654321",
                "phone":"(608)666-7777",
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                "location":"YYPOC"
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            "enteredBy":{  
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                "phone":"(608)432-1098",
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            },
            "parentPlacerId":"01928350",
            "parentFillerId":"57483875",
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        },
        "PID":[  
            {  
                "externalId":"",
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                    "id":"50521935",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"ZZTEST",
                    "firstName":"BILL",
                    "middleInitOrName":"C"
                },
                "mothersMaidenName":"AATEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"M",
                "alias":"RONALD",
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                    "otherDesignation":"",
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                "businessPhone":"(414)444-3333",
                "primaryLanguage":"ENG",
                "maritalStatus":"M",
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                "patientAccountNumber":{  
                    "id":"6600075763",
                    "checkDigit":"",
                    "codeIdCheck":"",
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                "ssn":"333772222",
                "driversLicenseNumber":"Y5529583110042",
                "mothersId":"",
                "ethnicGroup":"U",
                "birthPlace":"",
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                "birthOrder":"",
                "citizenship":"USA",
                "veteranStatus":"",
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                "deathDateTime":"",
                "deathIndicator":"N"
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        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"X",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
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                            "units":"min"
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                "segmentActionCode":"X",
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                            "id":"123456",
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                            "firstName":"DAFFY",
                            "middleInitOrName":"P"
                        },
                        "resourceRole":"Surgeon",
                        "resourceGroup":"",
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                    {  
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                            "firstName":"DROOPY",
                            "middleInitOrName":"D"
                        },
                        "resourceRole":"Anesthesiologist",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked"
                    }
                ]
            },
            {  
                "id":"3",
                "segmentActionCode":"U",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
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                            "id":"84.11",
                            "text":"Amputation of toe"
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                            "units":"min"
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                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Booked",
                        "notes":[  
                            {  
                                "id":"1",
                                "source":"",
                                "body":"Removal of only toes 2 and 4."
                            }
                        ]
                    }
                ]
            },
            {  
                "id":"4",
                "segmentActionCode":"A",
                "resourceGroupId":"2222222",
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A4657",
                            "text":"Syringe, with or without needle, each"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"5",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
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                        "allowSubstitutionCode":"",
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                            {  
                                "id":"1",
                                "source":"",
                                "body":"Because we need it. For stuff."
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                ]
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        ]
    }
}

HL7 SIU^S15 message received

MSH|^~\&|XX|YY||ZZ|20150622132306-0800||SIU^S15|061835|D|2.4
SCH|01928374|57483920|||||||1|hr|1^^^20151222132500-0800|123456^DUCK^DAFFY^P|(608)553-7722|777 W DRURY LN^^MADISON^WI^53715^USA|XXPOC|654321^RABBIT^JESSICA|(608)666-7777|888 MAIN ST^MADISON^WI^53726^USA|YYPOC|543210|(608)432-1098|XXPOC|01928350|57483875|Cancelled
PID|1||22490753^^^^MRN||XXTEST^TIMOTHY^R|CCTEST|19910310080910-0800|O|BIANCA||123 SESAME STREET^MADISON^WI^53713^USA||(608)444-5678^^^txxtest@gmail.com~^^^xxbianca@yahoo.com|(608)221-5555|ENG|P|AGN|8845620749|555883456|Q8820033123469||H||Y|2|USA|||20160120103000-0800|Y
OBX|1|CWE|271649006^Systolic blood pressure^SNOMED-CT||120|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
OBX|2|CWE|271650006^Diastolic blood pressure^SNOMED-CT||80|mmHg|||||F|||20151222133500-0800||52936881^DUCK^DAFFY
DG1|1||333.94^Restless legs syndrome^ICD 9||20151222133000-0800|A
DG1|2||527.7^Dry mouth^ICD 9||20151222170000-0800|W
DG1|3||784.99^Halitosis^ICD 9||20151222170000-0800|F
RGS|1||1111111
AIS|1||84.11^Amputation of toe^ICD 9|20151222134000-0800|15|min|1|hr||Cancelled
AIG|1||A6219^Gauze <= 16 sq in with border^HCPCS|||||20151222134000-0800|15|min|1|hr||Cancelled
AIL|1||XXPOC^204^1^XXFAC^XXSTATUS^NURSING^XXBUILDING|||20151222132500-0800|0|min|15|min||Cancelled
AIP|1||123456^DUCK^DAFFY^P^JR^DR^PHD|Surgeon||20151222134000-0800|15|min|1|hr||Cancelled

Catalyze JSON delivered

{  
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        "message_type":"SIU",
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            "sendingApplication":"XX",
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            "receivingApplication":"",
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            "dateTime":"2015-06-22T17:23:06-0400",
            "security":"",
            "messageType":"SIU",
            "messageEvent":"S15",
            "messageControlId":"061835",
            "processingID":"D",
            "versionID":"2.4"
        },
        "SCH":{  
            "placerAppointmentId":"01928374",
            "fillerAppointmentId":"57483920",
            "occurrenceNumber:":"",
            "placerGroupNumber":"",
            "scheduleId":"",
            "eventReason":"",
            "appointmentReason":"",
            "appointmentType":{  
                "id":"",
                "text":""
            },
            "appointmentDuration":{  
                "value":"1",
                "units":"hr"
            },
            "appointmentTimingQuantity":{  
                "quantity":"1",
                "interval":"",
                "duration":"",
                "startDateTime":"2015-12-22T16:25:00-0500"
            },
            "placerContactInfo":{  
                "person":"123456",
                "phone":"(608)553-7722",
                "address":{  
                    "streetAddress":"777 W DRURY LN",
                    "otherDesignation":"",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53715",
                    "country":"USA"
                },
                "location":"XXPOC"
            },
            "fillerContactInfo":{  
                "person":"654321",
                "phone":"(608)666-7777",
                "address":{  
                    "streetAddress":"888 MAIN ST",
                    "otherDesignation":"MADISON",
                    "city":"MADISON",
                    "state":"WI",
                    "postalCode":"53726",
                    "country":"USA"
                },
                "location":"YYPOC"
            },
            "enteredBy":{  
                "person":"543210",
                "phone":"(608)432-1098",
                "location":"XXPOC"
            },
            "parentPlacerId":"01928350",
            "parentFillerId":"57483875",
            "fillerStatusCode":"Cancelled"
        },
        "PID":[  
            {  
                "externalId":"",
                "internalId":{  
                    "id":"22490753",
                    "type":"MRN"
                },
                "alternateId":"",
                "patientName":{  
                    "lastName":"XXTEST",
                    "firstName":"TIMOTHY",
                    "middleInitOrName":"R"
                },
                "mothersMaidenName":"CCTEST",
                "dateTimeBirth":"1991-03-10T11:09:10-0500",
                "sex":"O",
                "alias":"BIANCA",
                "race":"",
                "address":{  
                    "streetAddress":"123 SESAME STREET",
                    "otherDesignation":"MADISON",
                    "city":"WI",
                    "state":"53713",
                    "postalCode":"USA",
                    "country":"",
                    "addressType":""
                },
                "countyCode":"",
                "homePhone":[  
                    {  
                        "number":"(608)444-5678",
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                        "countryCode":"",
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                    },
                    {  
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                ],
                "businessPhone":"(608)221-5555",
                "primaryLanguage":"ENG",
                "maritalStatus":"P",
                "religion":"AGN",
                "patientAccountNumber":{  
                    "id":"8845620749",
                    "checkDigit":"",
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                    "assigningAuth":"",
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                },
                "ssn":"555883456",
                "driversLicenseNumber":"Q8820033123469",
                "mothersId":"",
                "ethnicGroup":"H",
                "birthPlace":"",
                "multipleBirthIndicator":"Y",
                "birthOrder":"2",
                "citizenship":"USA",
                "veteranStatus":"",
                "nationality":"",
                "deathDateTime":"2016-01-20T13:30:00-0500",
                "deathIndicator":"Y",
                "OBX":[  
                    {  
                        "setId":"1",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271649006",
                            "text":"Systolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"120",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    },
                    {  
                        "setId":"2",
                        "valueType":"CWE",
                        "identifer":{  
                            "id":"271650006",
                            "text":"Diastolic blood pressure",
                            "codingSystem":"SNOMED-CT",
                            "alternateId":"",
                            "alternateText":"",
                            "alternateCodingSystem":""
                        },
                        "subId":"",
                        "observationValue":"80",
                        "units":"mmHg",
                        "referenceRange":"",
                        "abnormalFlag":"",
                        "probability":"",
                        "natureOfAbnormal":"",
                        "observeResultStatus":"F",
                        "effectiveDateLastNormalValue":"",
                        "definedAccessChecks":"",
                        "observationDateTime":"2015-12-22T16:35:00-0500",
                        "producerId":{  
                            "identifier":"",
                            "text":""
                        },
                        "responsibleObserver":{  
                            "id":"52936881",
                            "lastName":"DUCK",
                            "firstName":"DAFFY"
                        },
                        "method":""
                    }
                ],
                "DG1":[  
                    {  
                        "id":"1",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"333.94",
                            "text":"Restless legs syndrome",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T16:30:00-0500",
                        "type":"A",
                        "diagnosticCategory":""
                    },
                    {  
                        "id":"2",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"527.7",
                            "text":"Dry mouth",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"W",
                        "diagnosticCategory":""
                    },
                    {  
                        "id":"3",
                        "codingMethod":"",
                        "code":{  
                            "identifier":"784.99",
                            "text":"Halitosis",
                            "codingSystem":"ICD 9"
                        },
                        "description":"",
                        "dateTime":"2015-12-22T20:00:00-0500",
                        "type":"F",
                        "diagnosticCategory":""
                    }
                ]
            }
        ],
        "RGS":[  
            {  
                "id":"1",
                "segmentActionCode":"",
                "resourceGroupId":"1111111",
                "AIS":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "universalServiceId":{  
                            "id":"84.11",
                            "text":"Amputation of toe"
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Cancelled"
                    }
                ],
                "AIG":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "resourceId":{  
                            "id":"A6219",
                            "text":"Gauze <= 16 sq in with border"
                        },
                        "resourceType":"",
                        "resourceGroup":"",
                        "resourceQuantity":{  
                            "value":"",
                            "units":""
                        },
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Cancelled"
                    }
                ],
                "AIL":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "locationResourceId":{  
                            "pointOfCare":"XXPOC",
                            "room":"204"
                        },
                        "locationType":"",
                        "locationGroup":"",
                        "startDateTime":"2015-12-22T16:25:00-0500",
                        "startDateTimeOffset":{  
                            "value":"0",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"15",
                            "units":"min"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Cancelled"
                    }
                ],
                "AIP":[  
                    {  
                        "setId":"1",
                        "segmentActionCode":"",
                        "personnelResourceId":{  
                            "id":"123456",
                            "lastName":"DUCK",
                            "firstName":"DAFFY",
                            "middleInitOrName":"P"
                        },
                        "resourceRole":"Surgeon",
                        "resourceGroup":"",
                        "startDateTime":"2015-12-22T16:40:00-0500",
                        "startDateTimeOffset":{  
                            "value":"15",
                            "units":"min"
                        },
                        "duration":{  
                            "value":"1",
                            "units":"hr"
                        },
                        "allowSubstitutionCode":"",
                        "fillerStatusCode":"Cancelled"
                    }
                ]
            }
        ]
    }
}

The MDM (Medical Document Management) message

The MDM (medical document management) message was initially intended to provide a store of transcriptions created by the physician during the course of providing care to the patient i.e. progress notes. This over time has been expanded to pretty much cover almost any document or non-discrete data specific to a patient. Examples of these include, but are not limited to the following:

  • Patient consent
  • Transcriptions
  • Progress notes
  • Hospital discharge summaries
  • HPI (history and physical information including family histories)
  • Operative reports
  • Radiology and surgical pathology reports etc.

There are various events as well that trigger these messages, each of which is a specific type of MDM message. For example, the creation of a new document event will trigger a MDM^T02 message. Other event types includes updates (MDM^T08) and replacements (MDM^T10). You’ll usually want to replace a note with a new version so that the EHR can maintain a comprehensive history of addenda to that note.

The mandated structure of an MDM message

As we discussed earlier, HL7 recommends / mandates that messages follow a specific structure. Depending on the event type, a slightly different message type will be sent out. We’ll focus on the superset message. Smaller message types will not include specific segments of the message. The overall set of segments we will need are:

  • MSH: the message header (required everywhere)
  • PID: the patient identification segment. Note that demographics can be included within the PID segment itself
  • PV1: information about the patient “visit” - this is where you would include the physician info and the current location of the patient.
  • ORC: Order section which could contain multiple orders. Only relevant on notes related to results.
  • OBR: Results of the tests. Only relevant on notes related to results.
  • OBX: The content of the transcription split by HL7 max line length. Can be plain text, rich text or an item like a PDF.
  • NTE: Notes and comments. This will be repeated at the header level and then at the line level as well to provide additional context to the note that is not part of the note.
  • TXA: Transcription header. This defines the type and other info about the transcription but not the content itself.

One quick tip - in most HL7 messages the pipe character “|” is called the BAR and it is the field separator and in the case of this message, we’re going to use the “^” as a space. So if you see a bunch of pipes together like this “||||||||||” - all that means is that the fields at that point in the sequence were optional or not available. Also remember that segments are separated by a carriage return - which cannot be displayed as any and all viewers will interpret that for display.

The HL7 v2.x specifies the following format for an MDM message. For additional examples and specific structure, you can view the Medical Records related PDF on the HL7 site. Note also that EHRs often have created their own variants of this standard for example Epic has a slightly different format that it specifies as it also adheres to the 2.3 standard with some additions as well. We intend to cover EHR specific variants soon.

Segment Description
MSH   Message Header
EVN   Event Type
PID   Patient Identification
[{NTE}]   Notes and Comments
PV1   Patient Visit Information
[{ — Begin order section
ORC   Common Order
OBR   Observation Request
[{NTE}]   Notes and Comments
}] — End order section
TXA   Document Notification
[NTE]   Notes and Comments
{ — Begin Observation section
OBX   Observation notes
[{NTE}]   Notes and Comments
} — End Observation section

The MSH (message header) segment

MSH|^~\&|SENDING APP|SENDING FAC|RECEIVING|RECEIVING FAC|2015052711090000||SIU^S12|1055|P|2.3||

The EVN (event) segment

EVN|T02|20150215154405||04|1998690^LASSTER^CARL^J^ ^Dr^MD^|

The PID (patient identification) segment

PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^

The PV1 (patient visist) segment

PV1|||^^^CARE HEALTH SYSTEMS^^^^^||| |1173^MATTHEWS^JAMES^A^^^||||||||||||610613||||||||||||||||||||||||||||||||V

The ORC (Order details) segment


The OBR (observation request) segment

The TXA (transcription header) segment

Example 1: HPI

TXA|0001|HP^history & physical|TX^text|19960213213000|099919^Everyman^Adam^A^ ^Mr^MS^|
19960213153000|19960215134500||099919^Everyman^Adam^A^III^Mr^MS^|097220^Seven ^Henry^L^ ^Dr^MD^|01234567^Contact^Carrie^C^Ms|1996021500001^transA|||example.doc|LA|UC |AV||AC|||||097220^Seven^Henry^L^ ^Dr^MD^|

Example 2: Psych report including a PDF

TXA|1|Psychiatric Disabilities Report|PDF|||||20081126100756 ||||570531^SENDFAC||||1081007_2874942_570531_26100756.PDF|DO|||||||PSY^psychi atric document^^1.2.4481222~WEB^web document^^1.2.4481223

The OBX (observations) segment

OBX|2|ST|2000.01^SOURCE||PATIENT
OBX|3|TX|2000.02^PRESENT ILLNESS||SUDDEN ONSET OF CHEST PAIN. 2 DAYS, PTA ASSOCIATED WITH NAUSEA, VOMITING & SOB. NO RELIEF WITH ANTACIDS OR NTG. NO OTHER SX. NOT PREVIOUSLY ILL.

Putting it all together

MSH|^~\&|SENDING APP|SENDING FAC|RECEIVING|RECEIVING FAC|2015052711090000||SIU^S12|1055|P|2.3||
EVN|T02|20150215154405||04|1998690^LASSTER^CARL^J^ ^Dr^MD^|
PID|1||20891312^^^^EPI||APPLESEED^JOHN^A^^MR.^||19661201|M||AfrAm|505 S. HAMILTON AVE^^MADISON^WI^53505^US^^^DN |DN|(608)123-4567|(608)123-5678||S|| 11480003|123-45-7890||||^^^WI^^
PV1|||^^^CARE HEALTH SYSTEMS^^^^^||| |1173^MATTHEWS^JAMES^A^^^||||||||||||610613||||||||||||||||||||||||||||||||V
TXA|0001|HP^history & physical|TX^text|19960213213000|099919^Everyman^Adam^A^ ^Mr^MS^|
19960213153000|19960215134500||099919^Everyman^Adam^A^III^Mr^MS^|097220^Seven ^Henry^L^ ^Dr^MD^|01234567^Contact^Carrie^C^Ms|1996021500001^transA|||example.doc|LA|UC |AV||AC|||||097220^Seven^Henry^L^ ^Dr^MD^|
OBX|2|ST|2000.01^SOURCE||PATIENT
OBX|3|TX|2000.02^PRESENT ILLNESS||SUDDEN ONSET OF CHEST PAIN. 2 DAYS, PTA ASSOCIATED WITH NAUSEA, VOMITING & SOB. NO RELIEF WITH ANTACIDS OR NTG. NO OTHER SX. NOT PREVIOUSLY ILL.

Additional MDM examples

The JSON object model

To ensure maximum coverage, we have mapped all the data elements in the HL7 standard to a corresponding JSON data element. Additionally, JSON doesn’t have the concept of sequence or order (as opposed to XML). Order can be important in HL7 messages. The inital DG1 segment is usually the primary diagnosis for billing purposes and the initial IN1 segment is the primary insurance to bill for the visit. To overcome issues in ordering, we introduced specific numbering into our arrays.

Below is a sample JSON object for the HL7 ADT message. Note that this is the same object you will receive for all ADT message types. Certain or whole sets of fields can be empty depending on the message type. As you can also notice, there is a lot going on in this object. There are a large number of fields and most of our customers rarely use more than 5-10% of them. That is an additional value add that is included in our service; we’ll trim down your data models as required.

If the following HL7 ADT message is received by Catalyze, then the JSON object immediately following is the response you can expect to be POST-ed to your API endpoint.

HL7 MDM message received

Catalyze JSON delivered

The HL7 Mock API

You can make GET requests to our mock HL7 API by using the syntax /hl7/{messageType} where messageType is a valid HL7 message type code. You will receive a response back containing example JSON corresponding to the HL7 message type specified in the request. Before submitting requests, please use the form at the top of this page to receive an API key which you’ll need to include in the header of your request.

Routes

GET /hl7/{message_type}

Returns a list of all HL7 JSON of the given message_type (ADT, SIU, ORM, etc.). Note that you have to use the message type in lower case i.e. use adt instead of ADT. If you want a list of HL7 JSON with a particular event type code, simply append the lowercase event type code to the message type. For instance, GET /hl7/adt^a01 would return a list of ADT^A01 messages.

GET /hl7/{message_type}?[fields=a,b,c]

Returns a list of all HL7 JSON of the given message_type and in each object omits any fields that are not listed. For instance, GET /hl7/adt?fields=MSH,PID would return a list of ADT objects containing only the segments MSH and PID. GET /hl7/adt^a01?fields=messageEvent would return a list of ADT^A01 objects, each containing an MSH segment with one field: messageEvent.

GET /hl7/{message_type}?[fields=a,b,c]&{field1}=x&{field2}=y&{fieldN}=z

Returns a list of all HL7 JSON of message_type, omitting any fields not included in the fields parameter, and including only objects containing fields with the specified values. For example, GET /hl7/adt?fields=PID&PID.alias=RONALD would return only ADT objects with a patient whose alias is “RONALD” and would omit every segment except the PID segment.

Examples

Below are some example curl requests for the different message types available in our mock API. Give them a try!

ADT

Message Type GET Request
ADT^A01 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a01" -H "X-Api-Key: Your API Key Here"
ADT^A02 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a02" -H "X-Api-Key: Your API Key Here"
ADT^A03 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a03" -H "X-Api-Key: Your API Key Here"
ADT^A04 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a04" -H "X-Api-Key: Your API Key Here"
ADT^A05 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a05" -H "X-Api-Key: Your API Key Here"
ADT^A06 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a06" -H "X-Api-Key: Your API Key Here"
ADT^A07 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a07" -H "X-Api-Key: Your API Key Here"
ADT^A08 curl "http://hl7-api-mock.catalyze.io/hl7/adt^a08" -H "X-Api-Key: Your API Key Here"

ORM

Message Type GET Request
ORM^O01 curl "http://hl7-api-mock.catalyze.io/hl7/orm^o01" -H "X-Api-Key: Your API Key Here"

ORU

Message Type GET Request
ORU^R01 curl "http://hl7-api-mock.catalyze.io/hl7/oru^r01" -H "X-Api-Key: Your API Key Here"

SIU

Message Type GET Request
SIU^S12 curl "http://hl7-api-mock.catalyze.io/hl7/siu^s12" -H "X-Api-Key: Your API Key Here"
SIU^S13 curl "http://hl7-api-mock.catalyze.io/hl7/siu^s13" -H "X-Api-Key: Your API Key Here"
SIU^S14 curl "http://hl7-api-mock.catalyze.io/hl7/siu^s14" -H "X-Api-Key: Your API Key Here"
SIU^S15 curl "http://hl7-api-mock.catalyze.io/hl7/siu^s15" -H "X-Api-Key: Your API Key Here"

SRM

Message Type GET Request
SRM^S01 curl "http://hl7-api-mock.catalyze.io/hl7/srm^s01" -H "X-Api-Key: Your API Key Here"
SRM^S02 curl "http://hl7-api-mock.catalyze.io/hl7/srm^s02" -H "X-Api-Key: Your API Key Here"
SRM^S03 curl "http://hl7-api-mock.catalyze.io/hl7/srm^s03" -H "X-Api-Key: Your API Key Here"
SRM^S04 curl "http://hl7-api-mock.catalyze.io/hl7/srm^s04" -H "X-Api-Key: Your API Key Here"