Integrating the Healthcare Enterprise

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IHE Radiology (RAD)Technical Framework

Volume 4
IHE RAD TF-4
National Extensions

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Revision 18.0 – Final Text
August 9, 201925

Please verify you have the most recent version of this document, which is published here.

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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________CONTENTS
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1 Introduction ................................................................................................................................ 5
1.1 Overview of Technical Framework ..................................................................................... 5
1.2 Overview of Volume 4 ......................................................................................................... 6
2 Overview of National Extensions to the Technical Framework ................................................ 7
2.1 Scope of National Extensions ............................................................................................. 7
2.2 Process for Developing National Extensions...................................................................... 7
2.3 Process for Proposing Revisions to the Technical Framework .......................................... 8
3 National Extensions for IHE France .......................................................................................... 9
3.1 Comments ........................................................................................................................... 9
3.2 IHE-F 2002 Scope............................................................................................................... 9
3.3 Extended DICOM® Character Sets ..................................................................................... 9
3.4 Extended HL7® Character set ........................................................................................... 10
3.5 Translation of Specific Fields of the PID Segment .......................................................... 10
3.6 Insurance Information ....................................................................................................... 10
3.7 Forbidden PID Fields ........................................................................................................ 11
3.8 Syntax Rules for PID-5 (Patient Name)............................................................................ 11
3.9 Syntax Rules for PID-11 (Patient Address) ...................................................................... 11
3.10 Extensions of PID-16 (Marital Status).............................................................................. 11
3.11 Translations of PID-16 (Marital Status) and Selection of Values .................................... 11
3.12 Translations of PV1-19, Visit Number ............................................................................. 12
3.13 Extensions of PV1-2 (Patient Class) ................................................................................. 12
3.14 Translations of PV1-2 (Patient Class) and Selection of Values ....................................... 12
3.15 Visit number usage and interpretation .............................................................................. 13
3.16 Patient Account Number ................................................................................................... 13
3.17 Translations of PV1-4 (Admission Type) and Selection of Values .................................. 13
3.18 Extension and Translations of Physician Types in PV1 ................................................... 14
3.19 Translation of PV1-51 Visit Indicator and Selection of Value ......................................... 15
3.20 Extension of PV2-3 (Admit Reason) ................................................................................ 15
3.21 Translation of PV2-3 (Admit Reason) and Selection of Value ........................................ 15
3.22 Management of Functional Units...................................................................................... 15
4 National Extensions for IHE Germany .................................................................................... 17
4.1 Comments ......................................................................................................................... 17
4.2 Scope ................................................................................................................................. 17
4.3 DICOM: Support for ISO Latin 1 ..................................................................................... 17
4.4 HL7: Support for ISO Latin 1 ........................................................................................... 17
4.5 HL7: German Semantics ................................................................................................... 17
4.6 HL7: PID-18 “Patient Account Number” and PV1-19 “Visit Number” .......................... 18
4.7 Change PV1-8 “Referring Doctor” to Type R2 in all PV1 Segments .............................. 18
4.8 HL7: ZBE Segment in ADT ............................................................................................. 18
5 National Extensions for IHE United States .............................................................................. 20
5.1 PID Segment ..................................................................................................................... 20__________________________________________________________________________
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6 National Extensions for IHE Italy ............................................................................................ 21
6.1 Comments ......................................................................................................................... 21
6.2 IHE-I Scope ...................................................................................................................... 21
6.3 Extended DICOM Character Sets ..................................................................................... 21
6.4 Extended HL7 Character Set ............................................................................................ 21
6.5 Translation of specific Fields of the PID Segment ........................................................... 21
6.6 Syntax Rules for PID-11 (Patient Address) ...................................................................... 22
6.7 Translations of PV1-19, Visit Number ............................................................................. 22
6.8 Extensions of PV1-2 (Patient Class) ................................................................................. 22
6.9 Patient Account Number ................................................................................................... 23
6.10 Extension and Translations of Physician Types in PV1 ................................................... 23
7 National Extensions for IHE United Kingdom ........................................................................ 24
7.1 Introduction ....................................................................................................................... 24
7.2 Scope ................................................................................................................................. 24
7.3 HL7: PID-18 “Patient Account Number” ......................................................................... 24
7.4 HL7: PV1-19 “Visit Number” .......................................................................................... 24
7.5 HL7: PV1-8 “Referring Doctor” ....................................................................................... 24
7.6 DICOM: Support for ISO Latin 1 ..................................................................................... 25
7.7 HL7: Support for ISO Latin 1 ........................................................................................... 25
8 National Extensions for IHE Canada ....................................................................................... 26
8.1 Comments ......................................................................................................................... 26
8.2 Extended DICOM Character Sets ..................................................................................... 26
8.3 Extended HL7 Character set ............................................................................................. 26
8.4 Translation of Specific Fields of the PID Segment .......................................................... 26
8.5 Syntax Rules for PID-5 (Patient Name)............................................................................ 27
8.6 Extensions of PID-16 (Marital Status).............................................................................. 27
8.7 Translations of PV1-2 (Patient Class) and Selection of Values ....................................... 27
8.8 Visit number usage and interpretation .............................................................................. 27
8.9 Extension and Translations of Physician Types in PV1 ................................................... 27
9 National Extensions for IHE Spain .......................................................................................... 29
9.1 Comments ......................................................................................................................... 29
9.2 IHE-E: Scope of National Extension ................................................................................ 29
9.3 1.3 IHE-E: Translation of IHE terms into Spanish ........................................................... 29
9.4 Support for ISO Latin 1 .................................................................................................... 29
9.4.1 HL7 ............................................................................................................................ 29
9.4.2 DICOM ...................................................................................................................... 29
9.5 Patient Identification Data ................................................................................................ 30
9.5.1 Spanish naming convention: the second family name ............................................... 30
9.5.2 HL7 ............................................................................................................................ 30
9.5.2.1 Second family name ........................................................................................... 31
9.5.2.2 Patient Identifiers................................................................................................ 32
9.5.2.3 Contact Data ....................................................................................................... 34
9.5.2.4 Address Data ...................................................................................................... 35
9.5.3 DICOM: Patient Identification Module ..................................................................... 36__________________________________________________________________________
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9.5.3.1 Second family name ........................................................................................... 36
9.5.3.2 Patient Identifiers................................................................................................ 37
9.6 Insurance Data .................................................................................................................. 37
9.6.1 HL7: Insurance Data Mapping .................................................................................. 37
9.7 Examples ........................................................................................................................... 38
9.7.1 HL7 Example 1 .......................................................................................................... 38
9.7.2 HL7 Example 2 .......................................................................................................... 41
9.7.3 DICOM Example 1 .................................................................................................... 43
9.7.4 DICOM Example 2 .................................................................................................... 43
9.8 References ......................................................................................................................... 44
10 National Extensions for IHE Japan .......................................................................................... 45
10.1 Comment Submission ....................................................................................................... 45
10.2 Referenced Standards........................................................................................................ 45
10.3 All Profiles ........................................................................................................................ 45
10.3.1
Character Set Codes ........................................................................................... 45
10.3.2PID Segment Usage ............................................................................................ 46
Message Control Codes (“0B”) .......................................................................... 47
10.3.310.4 Scheduled Workflow.b (SWF.b)....................................................................................... 47
10.4.1
SWF.b – OBX Segment Usage for Common Observations ............................... 47
10.4.2
SWF.b – PV1 Segment Usage ............................................................................ 49
10.4.3
SWF.b – TQ1 Segment Usage............................................................................ 51
SWF.b – Drug Coding with HOT & MR9P ....................................................... 52
10.4.410.4.5
SWF.b – Parent & Child Orders ......................................................................... 52
10.4.6
SWF.b – Procedure Coding with JJ1017............................................................ 53
10.4.7
SWF.b – Notification of Patient Presence .......................................................... 54
10.5 Examples for Japan National Extension ........................................................................... 54
10.5.1
Case: Radiography.............................................................................................. 54
10.5.1.1
Placing an Order (HIS to RIS) .................................................................. 54
10.5.1.2
Radiography Order Response (RIS to HIS) .............................................. 56
10.5.1.3
Conveying the Radiography Order (RIS to PACS) .................................. 56
10.5.1.4
Response to the Conveyed Radiography Order (PACS to RIS) ............... 58
Notification of Patient Presence (RIS to HIS) .......................................... 58
10.5.1.5
10.5.1.6
Response to Notification of Patient Presence (HIS to RIS) ...................... 58
10.5.2
Case: CT ............................................................................................................. 58
10.5.2.1
Placing an Order (HIS to RIS) .................................................................. 58
10.5.3
Case: Ultrasonography ....................................................................................... 60
10.5.3.1
Placing an Order (HIS to RIS) .................................................................. 60
10.5.4
Case: Nuclear Medicine ..................................................................................... 61
10.5.4.1
Placing an Order (HIS to RIS) .................................................................. 61
10.5.5
Case: Angiography ............................................................................................. 62
10.5.5.1
Placing an Order (HIS to RIS) .................................................................. 62
10.5.6
Case: Patient Information ................................................................................... 63
10.5.6.1
Patient Update (HIS to RIS) ..................................................................... 63__________________________________________________________________________
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1 Introduction
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Integrating the Healthcare Enterprise (IHE) is an initiative to promote the use of standards toachieve interoperability of health information technology (HIT) systems and effective use ofelectronic health records (EHRs). IHE provides a forum for volunteer committees of careproviders, HIT experts and other stakeholders in several clinical and operational domains toreach consensus on standards-based solutions to critical interoperability issues. IHE publishes theimplementation guides they produce (called IHE profiles), first to gather public comment andthen for trial implementation by HIT vendors and other system developers.
IHE provides a process for developers to test their implementations of IHE profiles, including
regular testing events called Connectathons. After a committee determines that a profile has
undergone sufficient successful testing and deployment in real-world care settings, it isincorporated in the appropriate IHE Technical Framework, of which the present document is a
volume. The Technical Frameworks provide a unique resource for developers and users of HIT
systems: a set of proven, standards-based solutions to address common interoperability issues
and support the convenient and secure use of EHRs.
Purchasers can specify conformance with appropriate IHE profiles as a requirement in requests
for proposal. Vendors who have successfully implemented IHE profiles in their products canpublish conformance statements (called IHE Integration Statements) in the IHE Product Registry(http://ihe.net/IHE_Product_Registry).
The current versions of this and all IHE Technical Framework documents are available at
http://ihe.net/Technical_Frameworks. Comments may be submitted at
http://www.ihe.net/Radiology_Public_Comments.
IHE domain committees are responsible for developing and publishing Technical Framework
documents. This document is published by the IHE Radiology committees. Information on theactivities of this domain, including its committee rosters and how to participate, is available at
http://wiki.ihe.net/index.php?title=Domains.

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General information about IHE, including its governance structure, sponsorship, member
organizations and work process, is available at www.ihe.net.

1.1 Overview of Technical Framework
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An IHE Technical Framework describes use cases requiring interoperability of HIT systems anddefines functional components (called IHE actors) of these systems. Using established standards,
they specify the actions and interactions of these actors, including the content objects they
produce and exchange. Volume 1 of the Radiology Technical Framework provides high-level
overviews of each profile, the use case it addresses and the actors involved. Volumes 2 and 3
provide detailed specifications of each transaction and other technical requirements. The current
document, Volume 4, describes national extensions to the IHE Radiology Technical Framework.

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1.2 Overview of Volume 4
Volume 4 contains information about the scope of national extensions to the transactions definedin the IHE Radiology Technical Framework. Section 2 describes the permitted scope of national
extensions and the process by which national IHE initiatives can propose such extensions forapproval by the IHE Radiology Technical Committee and documentation in the IHE Radiology
Technical Framework. Sections 3 through 10 provide the sets of national extensions that havethus far been approved by IHE: those from France, Germany, United States, Italy, United
Kingdom, Canada, Spain, and Japan.

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2 Overview of National Extensions to the Technical Framework
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The goal of IHE is to promote implementation of standards-based solutions to improve workflow
and access to information in support of optimal patient care. To that end, IHE encourages thedevelopment of IHE National Deployment Committees to address issues specific to local healthsystems, policies and traditions of care. The role of these organizations and information about
how they are formed is available at http://ihe.net/Governance/#National_Deployment.

2.1 Scope of National Extensions
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National extensions to the IHE Technical Framework are allowed in order to address specificlocal healthcare needs and promote the implementation of the IHE Technical Frameworks. They
may add (though not relax) requirements that apply to the Technical Framework generally or to
specific transactions, actors and integration profiles. Some examples of appropriate national
extensions are:• Require support of character sets and national languages• Provide translation of IHE concepts or data fields from English into other national
languages• Extensions of patient or provider information to reflect policies regarding privacy andconfidentiality• Changes to institutional information and financial transactions to conform to national
health system payment structures and support specific local care practices
All national extensions shall include concise descriptions of the local need they are intended toaddress. They shall identify the precise transactions, actors, integration profiles and sections of
the Technical Framework to which they apply. And they must provide technical detail equivalent
to that contained in the Technical Framework in describing the nature of the extension.

2.2 Process for Developing National Extensions

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National extension documents are to be developed, approved and incorporated in the Technical
Framework in coordination with the IHE Technical Committee and its annual cycle of activities
in publishing and maintaining the Technical Framework. The first prerequisite for developing anational extension document is to establish a national IHE initiative and make information
regarding its composition and activities available to other IHE initiatives.
Established IHE national initiatives may draft a document describing potential national
extensions containing the general information outlined above and similar in form to those foundin sections 4-6 of the current document. They submit this draft document to the IHE TechnicalCommittee for review and comment. Based on discussion with the Technical Committee, they
prepare and submit finalized version of the document in appropriate format for incorporation into
the Technical Framework. The publication of National Extensions is to be coordinated with theannual publication cycle of other Technical Framework documents in the relevant domain. The
annual cycle for Radiology is available at http://wiki.ihe.net/index.php?title=Radiology.
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2.3 Process for Proposing Revisions to the Technical Framework245

In addition to developing national extension documents to be incorporated in the Technical
Framework, national IHE initiatives may also propose revisions to the global Technical
Framework. These may take the form of changes to existing transactions, actors or integration
profiles or the addition of new ones. Such general changes would be subject to approval by the
IHE Technical and Planning Committees.
Changes that are minor in scope, such as suggestions for clarifications or corrections to
documentation, may be submitted throughout the year via the ongoing errata tracking process.
Comments on this document may be submitted at
http://www.ihe.net/Radiology_Public_Comments.

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More substantial revision proposals, such as proposals to add new integration profiles, should besubmitted directly to the IHE Technical and Planning Committees. The initial submission of suchproposed revisions to the global Technical Framework should be a 1-2 page white paper
containing:• A description of the clinical need addressed by the proposed revision with appropriately
detailed use cases• An overview of the proposed technical approach for meeting this clinical need, including
the established standards to be used
• Any known constraints to the proposed solution (e.g., maturity of standards or necessityof regulatory compliance)• An estimate of the level of effort for developing and implementing the proposed solution
The IHE Planning and Technical Committees will give due consideration to all such revision
proposals received from national IHE initiatives and will notify their originators of theirdisposition. Revisions or additions that are accepted as work items for the Technical Committee
will be completed in its annual revision cycle of the Technical Framework.

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3 National Extensions for IHE France

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The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical Framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in France. It also translates a number of English terms
to ensure correct interpretation of requirements of the Technical Framework.

3.1 Comments
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This national extension document was authored under the sponsorship and supervision of
GMSIH and JFR, who welcome comments on this document and the IHE France initiative.
Comments should be directed to:
Karima Bourquard
IHE-France project manager
Email: kbourquard@yahoo.fr

3.2 Scope
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The extensions, restrictions and translations specified apply to the following IHE integration
profiles:• Scheduled Workflow• Patient Reconciliation• Consistent Presentation of Images• Key Image Notes• Simple Image and Numerical Report• Access to Radiology Information

3.3 Extended DICOM®1 Character Sets
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The support of accented characters is required for all actors with DICOM-based transactions.
The Specific Character Set (0008,0005) Attribute shall contain the value “ISO_IR 100” in order
to select ISO 8859/1 Latin-1 characters.

DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards
publications relating to digital communications of medical information.

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3.4 Extended HL7®2 Character set
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The support of accented characters is required for all actors with HL7 based transactions. The
Field MSH 18 shall contain the value “8859/1” in order to select the ISO 8859 Latin-1
characters.

3.5 Translation of Specific Fields of the PID Segment
The table below provides the translation of specific fields of the PID Segment:
La table ci-dessous fournit la traduction de champs specific du segment PID.
Table 3.5-1: Translation of PID Segment Fields
Champ (Field)

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Interprétation/Traduction

Patient Identifier List (PID – 3)

IPP (Identifiant Permanent du Patient)

Legal Name (PID – 5)

Nom patronymique

Maiden Name (PID – 5)

Nom de jeune filleDisplay Name (PID – 5)

Nom usuel

SSN Number Patient (PID – 19) This is the
personal social security number of the patientwhich may not be the social security number used
for the insurance billing payment.

Numéro de Sécurité Social du patient.

Patient Account Number (PID – 18) Unique
identifier for collecting and grouping all elements
necessary for charging AND / OR the transmission
to the insurance company for charging.

Numéro de compte patient Numéro unique qui permet decollecter et de grouper tous les éléments nécessaires à lafacturation ET / OU à la transmission vers les organismesd'assurances et mutuelles, pour prise en charge

3.6 Insurance Information
The IHE Radiology Technical Framework includes the IN1 and IN2 segments as an option forthe purpose of communicating the insurance information of the patient.

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IHE-France supports the optional use of the segments IN1 and IN2 in order to convey the social
security number when used as an insurance number for the patient care. It is used when patientcharge posting is made by the clinical / radiology department. It is conveyed through A01, A04
or A08.
Table 3.6-1: IHE profile – IN1 Segment

2

SEQ

LEN

DT

OPT

TBL#

ITEM#

ELEMENT NAME

1

4

SI

R

Set ID – IN1

2

60

CE

R

Insurance Plan ID

3

59

CX

R

Insurance Company ID

HL7 is the registered trademark of Health Level Seven International.

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Adapted from the HL7 Standard, version 2.3.1
Table 3.6-2: IHE profile – IN2 Segment
SEQ

LEN

DT

OPT

TBL#

1

60

XON

O

Insured Employee ID

2

60

XON

O

Insured Social Security Number

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ITEM#

ELEMENT NAME

Adapted from the HL7 Standard, version 2.3.1

3.7 Forbidden PID Fields
In France, it is illegal to transmit the Fields PID-10 (Race) and PID-22 (Ethnic Group).
En France, il est interdit de transmettre les champs PID-10 (Race) et PID-22 (Groupe éthnique).

3.8 Syntax Rules for PID-5 (Patient Name)
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Last name prefix (<family name (ST) & <last_name_prefix (ST)>) will be used for names with «particule ». Prefix sera utilisé pour la particule des noms à particules.

3.9 Syntax Rules for PID-11 (Patient Address)
The ZIP or Postal Code will contain the “code postal”.
Le “ZIP or Postal Code” devra contenir le Code Postal.
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3.10 Extensions of PID-16 (Marital Status)
Two values, G for Living Together and P for Domestic Partner shall be added to The Marital
Status table 002 of HL7 v2.3.1 (User defined table). No IHE-F implementation shall extend thistable.
Note: These G and P values have been obtained from HL7 2.4.

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3.11 Translations of PID-16 (Marital Status) and Selection of Values
The table below includes the translations of the PID-16, Marital Status:
La table ci-dessous fournit la traduction de champs specific du segment PID-16, Marital Status:
Table 3.11-1: Translation of PID-16, Marital Status
ValeurDescription

Interprétation/Traduction

A

Separated

Séparé

D

Divorced

DivorcéM

MarriedMarié

SSingleCélibataireW

Widowed

Veuf/Veuve__________________________________________________________________________
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ValeurDescription

Interprétation/Traduction

G

Living together

ConcubinP

Domestic Partner

Pacte Civil de Solidarité (PACS)

3.12 Translations of PV1-19, Visit Number
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This number corresponds to physical visit of the patient into the hospital. The patient accountnumber may group one or more visit number (PV1-19)
Ce numéro correspond à un passage physique dans l'établissement. Le patient account number(PID-18) regroupe un ou plusieurs «Visit number» (PV1-19).
The table below provides the translation of specific fields of the PV1 Segment:

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La Table ci-dessous donne la traduction de champs specifiques du segment PV1:
Table 3.12-1: Translation of Specific Fields of PV-1 Segment
Champ

Interprétation/Traduction

Visit Number (PV1 – 19)

Numéro de séjour / numéro de passage ou mouvement

3.13 Extensions of PV1-2 (Patient Class)340

Two values, W for Week in Hospital, S for Psychiatric, K for Newborn, shall be added to The
Patient Class Table 004 of HL7 v2.3.1 (User defined table). No IHE-F implementation shallextend this table.
Note: The Addition of the W, S and K values will be submitted to the HL7 French Chapter whencreated.

3.14 Translations of PV1-2 (Patient Class) and Selection of Values
345

The table below includes the translations of the PV1-2, Patient Class and shall not be extended:La table ci-dessous fournit la traduction de champs specifiques du segment PV1-2, Patient Classet ne doit pas être étendue:
Table 3.14-1: PV1-2 Values and Translations
ValeurDescription

Interprétation/Traduction

E

Emergency

Urgence

I

Inpatient

HospitaliséO

Outpatient

ExterneP

Preadmit

Peut comprendre les catégories
nationale : Hospitalisation
programmées, Consultants
externes programmés, Psychiatrie
programmées, Résidents__________________________________________________________________________
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Valeur350

Description

Interprétation/Traduction
programmésR

Recuring Patient

Résident

B

Obstetrics

ObstétriqueD

Day hospital

Hopital du jourW

Week hospital

Hopital de semaine

S

Psychiatric

Psychiatrie

K

NewbornNouveau néNote: For S=Psychiatry, in the context of patient admission in this class, the type of admission
will be refined in the field PV2-3 Admit Reason (See Section A.4.15).
Note : Pour S= Psychiatrie, dans le cadre de l’admission d’un patient dans cette catégorie, letype d’admission sera précisé dans le champ PV2-3 Admit Reason (voir Section A.4.15).

3.15 Visit number usage and interpretation
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Field PV1-2 Visit Number is a required field in IHE France.
If Field PV1-2 is « I » then PV1-19 is interpreted as n° de séjour.
If Field PV1-2 is « D or W » then PV1-19 is interpreted as n° de séjour.
If Field PV1-2 is « O » Outpatient then PV1-19 is interpreted as n° de consultation.
If Field PV1-2 is « R » Inpatient then PV1-19 is interpreted as n° de séance.

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3.16 Patient Account Number
Field PID-18 Patient Account Number is an optional field in IHE France.
The field PID-18 may be used in cases when a patient may have multiple visits (each visit having
independent transfer and discharge), but where all the visits need to be linked under one
Case/Episode number (either for billing or clinical tracking reasons).

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3.17 Translations of PV1-4 (Admission Type) and Selection of Values
The table below includes the translations of the PV1-4, Admission Type and shall not be
extended:
La table ci-dessous fournit la traduction de champs specifiques du segment PV1-4, Admission
Type et ne doit pas être étendu:

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ValeurDescription

Interprétation/Traduction

A

Accident

Accident de travail

CElective

Confort (chirurgie esthétique…)

E

Emergency

Urgence__________________________________________________________________________
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ValeurDescription

Interprétation/Traduction

L

Labor and Delivery

Accouchement

N

Newborn (Birth in Healthcare
facility)

Nouveau NéR

RoutineRoutineU

UrgentUrgent3.18 Extension and Translations of Physician Types in PV1
The optionality status of PV1-7, PV1-8, PV1-9 and PV1-17 is R2 for French implementation.
The table below includes the translations of the PV1 Physician Types:
La table ci-dessous fournit la traduction de champs relatif aux types de doctuers dans PV1:
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Table 3.18-1: Translation of PV1 Physician Types
Field

Description

Interprétation/Traduction

PV1-7Attending doctor:

The person primarily responsible
for the care of the patient during aparticular health care visit(generally used for inpatient
events, but could be extended to an
outpatient visit as well.)

Médecin responsable pendant ladurée de l’admission.

PV1-8Referring doctor

Is any physician who referred thepatient to the care of anotherphysician (generally a specialist)
for a particular visit. The referring
physician might be noted in an
HL7 event so that she/he receives
a copy of any test results or
documentation of care.

Médecin (en général extérieur àl'établissement) qui a adressé lepatient.

PV1-9Consulting doctor

Is generally a specialist who sees apatient as the result of a referral ora consultation order. She/he is not
the attending physician for thecase, although that status could betransferred to a consulting
physician at some point.

Le médecin qui est consulté pourun deuxième avis.

PV1-17 Admitting doctor

Is the physician who decides that apatient meets the criteria for an
inpatient admission to a hospitalduring a specific visit. The
admitting physician is responsible
for evaluating the patient so that
their acuity satisfies admission
criteria.

Médecin de l'établissement qui
décide d’hospitaliser un patient.
(ex. En cas d’urgence)__________________________________________________________________________
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3.19 Translation of PV1-51 Visit Indicator and Selection of ValueIHE France will only use the visit indicator at the visit level, there is no accounting information
issued.
Table 3.19-1: Translation of PV1-51 Visit Indicator
ValeurDescription

V

380

Interprétation/Traduction

Visit

Venue

3.20 Extension of PV2-3 (Admit Reason)
Two values listed in Table A.4-1 shall be added to the Table 004 of HL72.3.1 (User definedtable). No IHE-F implementation shall extend this table.

3.21 Translation of PV2-3 (Admit Reason) and Selection of Value
385

In the case of the hospitalization of a patient in psychiatry, one shall use the field PV2-3 Admit
Reason as defined below:
Dans le cadre d’une hospitalisation d’un patient en psychiatrie alors on devra utiliser le champ
PV2-3 Admit Reason afin de préciser le mode de placement.
Table 3.21-1: PV2-3 Interpretation of Values
CodeMode de placement

HL

Hospitalisation Libre

HO

Placement d’office

HDT

Hospitalisation à la demande d’un tiers

LV

Levée d’hospitalisation

SE

Sortie à l’essai

3.22 Management of Functional Units
390

395

A major difference between the management of responsibilities between the USA and France isthat the responsibility for a patient is often managed at the level of a functional unit rather than at
the level of an attending doctor. For this purpose the Z Segment ZFU has been created.
Il y une différence entre la manière dont les responsabilités sont gérées aux USA et en France.
Alors qu’aux USA la responsabilité du patient est très souvent liée au médecin (Attending
Doctor), en France, celle-ci est rattachée à l’unité fonctionnelle. C’est pourquoi le champ privé
ZFU a été crée.
For IHE-F, the ZFU segment is required for messages A01, A02, A04, A05, A06, A07, and A08.

400

Pour IHE-F ce segment est obligatoire pour les messages: A01, A02, A04, A05, A06, A07, andA08.
__________________________________________________________________________
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Field ZFU-1 Nursing Functional Unit is responsible for the care of the patient.
C’est l’unité fonctionnelle responsable des soins donnés au patient.
Field ZFU-2 Housing Functional Unit is responsible for housing the patient.
C’est l’unité fonctionnelle d’hébergement.
405

Field ZFU-3 Medical Functional Unit is the unit for which the attending doctor is operating.
C’est l’unité fonctionnelle qui a la responsabilité Médicale du patient.
Table 3.22-1: IHE profile - ZFU Segment

410

415

SEQ

LEN

DT

OPT

TBL#

ITEM#

ELEMENT NAME

1

60

XO
N

C

Nursing Functional Unit: UF
soin

2

60

TS

C

Nursing Functional Unit Start
date/time

3

60

XO
N

C

Housing Functional Unit: UF
hébergement

4

60

TS

C

Housing Functional Unit Start
date/time

5

60

XO
N

C

Medical Functional Unit: UF
médicale

6

60

TS

C

Medical Functional Unit Start
date/time

Conditions: At least one of these three functional units is required (name and date/time that thepatient has “entered” the functional unit). Two or three of them can have the same value.
Conditions : Au moins une des ces unités fonctionelles est obligatoire (nom et la date/heure lepatient est « entré » sous l’unité fonctionnelle). Deux ou trois d’entre eux peuvent avoir la mêmevaleur.

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4 National Extensions for IHE Germany420

The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical Framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in Germany.

4.1 Comments
425

The IHE-D Initiative welcomes comments on this document and the IHE Germany initiative.
Comments should be directed to the IHE-D Working Group <ihe-d@rad.rwth-aachen.de> or to
Marco Eichelberg <eichelberg@offis.de>, IHE-D Technical Project Manager.

4.2 Scope

430

The extensions, restrictions and translations specified apply to the following IHE integration
profiles:• Scheduled Workflow• Patient Reconciliation• Consistent Presentation of Images

4.3 DICOM: Support for ISO Latin 1
435

All actors with DICOM based transactions shall support the value “ISO_IR 100” for the attribute(0008,0005) “Specific Character Set” if this attribute is defined in the DICOM SOP class used by
the IHE transaction. This attribute value specifies the ISO 8859-1 (Latin 1) character set.

4.4 HL7: Support for ISO Latin 1
All actors with HL7 based transactions shall support the value “8859/1” for the field “MSH-18
Character Set” in the MSH segment. This value specifies the printable characters from the ISO
8859-1 (Latin 1) character set (see Table 0211 in HL7 Appendix A).
440

4.5 HL7: German Semantics
The semantics (i.e., names) of the HL7 fields shall be used as defined in the German HL7 edition
2.3.1d published by the German HL7 Chapter (HL7-Benutzergruppe in Deutschland e. V.,
http://www.hl7.de/). In particular, the use of the following field deviates from the U.S. HL7
specification:

445

Table 4.5-1: Differences in HL7 Semantics in USA and Germany
Field
PID-27HL7 USA Semantics
Veteran Military Status

HL7 Germany Semantics
Beruf/Tätigkeit des Patienten(Patient’s Profession/Occupation)__________________________________________________________________________
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4.6 HL7: PID-18 “Patient Account Number” and PV1-19 “Visit
Number”
450

Field PV1-19 “Visit Number” is required and shall be used to transmit the patient admission
identifier (“Fallnummer”). Field PID-18 “Patient Account Number” is used to consolidate
information relative to several visits and is generally not used in Germany.

4.7 Change PV1-8 “Referring Doctor” to Type R2 in all PV1 Segments
Volume 2, Sections 4.1.4.1.2.4, 4.2.4.1.2.3, 4.4.4.1.2.3 and 4.12.4.2.2.4

455

In RAD TF-2: 4.1.4.1.2.4, 4.2.4.1.2.3, 4.4.4.1.2.3 and 4.12.4.2.2.4, the optionality of field PV1-8,
Referring Doctor, is C: Conditional. Clinical situations have been identified in which an ORM
message is sent for an outpatient, but the Referring Doctor is unknown and, therefore, field PV18 cannot be valued. In particular this affects the treatment of emergency outpatients in theGerman healthcare system.

460

Therefore, the optionality of field PV1-8, Referring Doctor shall be changed to R2, meaning thatfield PV1-8 “Referring Doctor” shall always be sent when a message contains the PV1 segment
and the sending application has data for the field. It may be present otherwise. This change
affects the following IHE transactions: Patient Registration, Placer and Filler OrderManagement, Procedure Scheduled and Patient Update.
Tables 4.1-3, 4.2-2, 4.4-2 and 4.12-4 and explanations following shall be modified as shown:
Table 4.7-1: Modifications to PV1-8
SEQ

LEN

DT

OPT

TBL#

ITEM#

0010

00138

ELEMENT NAME

. . .
8

60

XCN

R2

Referring Doctor

. . .

465

Field PV1-8 Referring Doctor shall be valued when a procedure is scheduled for an outpatient,and the sending application has data for the field. It may be present otherwise.

4.8 HL7: ZBE Segment in ADT
470

The ZBE segment is an HL7 extension defined by the German Chapter of HL7. It introduces afield called “Movement ID” which allows, upon the reception of a change message (e. g.
ADT^A08), to exactly determine the original message (ADT^A01, ADT^A02) to which thechange is related. The following table contains an English translation of the original ZBE
definition table which is part of the German HL7, edition 2.3.1d and available online at
http://www.hl7.de/zregister/zbeweg.html.

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475

Table 4.8-1: Translation of IHE-Germany ZBE Table
LE
N

DT

OPT

RP/#

1

EI

R

Y

2

TS

3
4

SEQ

TBL
#

ITEM#

ELEMENT NAME

49071

Movement ID

O

49072

Start of Movement Date/Time

TS

O

49073

End of Movement Date/Time

ST

O

49074

Reason for Triggering the Movement /Processing Identifier (“INSERT”,“UPDATE”, “DELETE”)

The use of this Z-segment is optional, but allowed and recommended in IHE-D for all ADT
messages.
480

Note: It is the intention of the IHE-D working group to declare support of the ZBE segment
mandatory for all ADT messages sent by an ADT actor in a future version of the German
Technical Framework Addendum. Implementations of an ADT actor according to this Technical
Framework Addendum are strongly recommended to support the ZBE segment.

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5 National Extensions for IHE United States
485

The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical Framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in the U.S.A.

5.1 PID Segment
490

In the US, PID-18 Patient Account Number must be valued and PV1-19 Visit Number is required
when PID-18 identifies an account that spans more than one encounter or visit.

__________________________________________________________________________
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6 National Extensions for IHE Italy495

The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in Italy. It also translates a number of English terms toensure correct interpretation of requirements of the Technical Framework.

6.1 Comments
500

This national extension document was authored under the sponsorship and supervision of SIRM,
welcome comments on this document and the IHE Italy initiative. They should be directed to the
National Project Manager:
Claudio Saccavini
IHE-Italy project manager
Email: csaccavini@rad.unipd.it

505

6.2 Scope
The extensions, restrictions and translations specified apply to the following IHE Integration

510

515

profiles:• Scheduled Workflow• Patient Reconciliation• Consistent Presentation of Images• Key Image Notes• Simple Image and Numerical Report• Access to Radiology Information

6.3 Extended DICOM Character Sets
The support of accented characters is required for all actors with DICOM-based transactions.
The Specific Character Set (0008,0005) Attribute shall contain the value "ISO_IR 100" in order
to select ISO 8859/1 Latin-1 characters.

6.4 Extended HL7 Character Set
520

The support of accented characters is required for all actors with HL7 based transactions. The
Field MSH-18 shall contain the value "8859/1" in order to select the ISO 8859 Latin-1
characters.

6.5 Translation of specific Fields of the PID Segment
The table below provides the translation of specific fields of the PID Segment:__________________________________________________________________________
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525

La tabella sotto riporta la traduzione di alcunicampi specfici del segmento PID:
Table 6.5-1: Translation of PID Segment Fields
Campo (Field)

Traduzione/Traduction

Patient Identifier List
(PID 3)

Identificativivo univoco del paziente all'interno della singola struttura sanitaria.
Normalmente può essere il codice sanitario

Legal Name (PID 5)

Cognome e Nome del paziente. Nel caso delle donne sposate non si utilizza ma il
cognome del marito.

Maiden Name (PID 5)

Campo non utilizzato in Italia

SSN Number Patient(PID 19)

Numero della tessera sanitaria del Servizio Sanitario Nazionale della Regione di
Residenza del paziente.

Patient Account Number(PID 18)

Codice Fiscale del Paziente

Campo (Field)

Traduzione/Traduction

6.6 Syntax Rules for PID-11 (Patient Address)
The ZIP or Postal Code will contain the "code postal".
Il "ZIP or Postal Code" dovrà contenere il Codice di Avviamento Postale.
530

6.7 Translations of PV1-19, Visit NumberThis number corresponds to physical visit of the patient into the hospital.
Questo numero corrisponde al numero di ricovero per i pazienti interni, o al numero di richiesta
nel caso di pazienti esterni.

6.8 Extensions of PV1-2 (Patient Class)535

We introduce three new types of Patient Class, the Day Hospital, the After Dismission and theProtected Dismission.
Sono stati introdotte tre nuove classi di paziente: il Day Hospital, il Post-Ricovero e laDimissione Protetta.
Table 6.8-1: Translation of PV1-2 Segment Fields Patient Class
Value

Description

Translation/Traduzione

E

Emergency

Paziente proveniente dal Pronto Soccorso

I

Inpatient

Paziente in Ricovero OrdinarioO

Outpatient

Paziente Esterno o Ambulatoriale

P

Preadmit

Paziente in Ricovero Programmato

R

Recurring Patient

Paziente con ricovero che prevede cicli di cura

B

Obstetrics

Valore non utilizzato in Italia

D

Day Hospital

Paziente in regime di ricovero giornalieroC

After Dismission

Paziente in regime di prestazioni di post-ricovero__________________________________________________________________________
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Value
X

540

Description
Protected Dismission

Translation/Traduzione
Paziente in regime di Dimissione Protetta

6.9 Patient Account Number
Field PID-18 Patient Account Number is a required field in IHE Italy.
Il Campo PID-18 Patient Account Number è obbligatorio per IHE-Italy

6.10 Extension and Translations of Physician Types in PV1
545

The table below includes the translations of the PV1 Physician Types:
La tabella sotto riportata fornisce l'interpretazione dei Tipi Medici:Table 6.10-1: Translation of Physician Types in PV1
Campo (Field)

Translation/Traduzione

PV1-7Attending
doctorMedico responsabile della cura del paziente durante il ricovero, il medico di medicina
generale nel caso di un paziente esterno o ambulatoriale

PV1-8Referring
doctorIl medico che richiede la consulenza e che è indicato come il destinatario della rispostadello specialista.

PV1-9Consulting
doctorIl medico che esegue la consulenza richiesta dal Referring Doctor

PV1-17 Admitting
doctorIl medico che decide il ricovero del paziente__________________________________________________________________________
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7 National Extensions for IHE United Kingdom
7.1 Introduction
550

This appendix to the IHE Radiology Technical Framework document shall be used inconjunction with the integration profiles defined in the IHE Radiology Technical Framework.
This document includes provisions that must be implemented by UK participants in theEuropean Connectathon to be held from 2003 onward.

7.2 Scope
555

The extensions, restrictions and translations specified apply to the following IHE Integration
Profiles:• Scheduled Workflow• Patient Reconciliation• Consistent Presentation of Images

7.3 HL7: PID-18 “Patient Account Number”
560

Field PID-18 “Patient Account Number “is not supported in the UK (i.e., ignored).

7.4 HL7: PV1-19 “Visit Number”
Field PV1-19 “Visit Number” shall contain a locally unique patient admission identifier(Enterprise Visit Identifier).

7.5 HL7: PV1-8 “Referring Doctor”
565

Field PV1-8 “Referring Doctor” shall always be sent when a message contains the PV1 segment.
Note: In the Technical Framework, rev. 5.5, PV1-8 is only required for ADT^A04 messages.
Note: In HL7 UK standard this field is optional
The table below shows PV1 Field Physician Types as given in IHE France specifics:
Field

Description

PV1-7
Attending
doctor:

The person primarily responsible for the care of the patient during a particular healthcare visit(generally used for inpatient events, but could be extended to an outpatient visit as well.)

PV1-8Referring
doctor:Is any physician who referred the patient to the care of another physician (generally a
specialist) for a particular visit. The referring physician might be noted in an HL7 event sothat she/he receives a copy of any test results or documentation of care.

PV1-9Consulting
doctor:Is generally a specialist who sees a patient as the result of a referral or a consultation order.
She/he is not the attending physician for the case, although that status could be transferred to a
consulting physician at some point.

__________________________________________________________________________
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Field
PV1-17AdmittingdoctorDescription
Is the physician who decides that a patient meets the criteria for an inpatient admission to a
hospital during a specific visit. The admitting physician is responsible for evaluating thepatient so that their acuity satisfies admission criteria.

570

7.6 DICOM: Support for ISO Latin 1
All actors with DICOM based transactions shall support the value “ISO_IR 100” for the attribute(0008,0005) “Specific Character Set” if this attribute is defined in the DICOM SOP class used by
the IHE transaction. This attribute value specifies the ISO 8859-1 (Latin 1) character set.
575

Note: this character set supports the Welsh language

7.7 HL7: Support for ISO Latin 1
All actors with HL7 based transactions shall support the value “8859/1” for the field “MSH-18
Character Set” in the MSH segment. This value specifies the printable characters from the ISO
8859-1 (Latin 1) character set (see Table 0211 in HL7 Appendix A).
580

Note: this character set supports the Welsh language__________________________________________________________________________
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8 National Extensions for IHE Canada585

The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical Framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in Canada. It also translates a number of English terms
to French to ensure correct interpretation of requirements of the Technical Framework.

8.1 Comments
This national extension document was authored by the Radiology committee of IHE Canada.
Comments and suggestions should be sent to infocentral@infoway-inforoute.ca
590

The extensions, restrictions and translations specified apply to the IHE Radiology Technical
Framework.

8.2 Extended DICOM Character Sets
595

The support of accented characters is required for all actors with DICOM-based transactions.
The Specific Character Set (0008,0005) Attribute shall contain the value “ISO_IR 100” in order
to select ISO 8859/1 Latin-1 characters.

8.3 Extended HL7 Character set
The support of accented characters is required for all actors with HL7 based transactions. The
Field MSH 18 shall contain the value “8859/1” in order to select the ISO 8859 Latin-1
characters.
600

8.4 Translation of Specific Fields of the PID Segment
The table below provides the translation of specific fields of the PID Segment:
La table ci-dessous fournit la traduction de champs spécifiques du segment PID.
Table 8.4-1: Translation of PID Segment Fields or component values
Champ (Field)

Interprétation/Traduction

Patient Identifier List (PID – 3)

Numéro de dossier

Legal Name (in table 0200 for name type in PID – 5)

Nom de famille

Maiden Name (in table 0200 for name type in PID – 5)

Nom de filleDisplay Name (in table 0200 for name type in PID – 5)

Nom usuel

SSN Number Patient (PID – 19) This is the personalsocial security number of the patient which may not be
the social security number used for the insurance billing
payment.

Numéro de Sécurité Social du patient.

Patient Account Number (PID – 18) Unique identifier
for collecting and grouping all elements necessary for

Numéro de compte patient Numéro unique qui permetde collecter et de grouper tous les éléments__________________________________________________________________________
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Champ (Field)
charging AND / OR the transmission to the insurancecompany for charging.

Interprétation/Traduction
nécessaires à la facturation ET / OU à la transmission
vers les organismes d'assurances et mutuelles, pourprise en charge

8.5 Syntax Rules for PID-5 (Patient Name)
605

Last name prefix (<family name (ST) & <last_name_prefix (ST)>) will be used for names with «particule ». Prefix sera utilisé pour la particule des noms à particules.

8.6 Extensions of PID-16 (Marital Status)
One value, G for Living Together shall be added to The Marital Status table 002 of HL7 v2.3.1(User defined table).
610

Note: The value G has been obtained from HL7 v2.4.
Table 8.6-1: Translation of PID-16, Marital Status
ValeurDescription

Interprétation/Traduction

A

Separated

Séparé

D

Divorced

DivorcéM

MarriedMarié

SSingleCélibataireW

Widowed

Veuf/Veuve

G

Living together

Concubin

8.7 Translations of PV1-2 (Patient Class) and Selection of Values
The value ‘D’, for ‘Day hospital’ or ‘Hospitalisation d’un jour’ shall be added to the table 0004.

8.8 Visit number usage and interpretation
615

PV1-19 (Visit Number) is an identifier for the visit or consult episode.
If Field PV1-2 is « I » Inpatient then PV1-19 is interpreted as visit number, or n° de séjour.
If Field PV1-2 is « D » Day Patient then PV1-19 is interpreted as visit number, or n° de séjour.
If Field PV1-2 is « O » Outpatient then PV1-19 is interpreted as consult number, or n° deconsultation.

620

If Field PV1-2 is « R » Recurring Inpatient then PV1-19 is interpreted as session number, or n°de séance.

8.9 Extension and Translations of Physician Types in PV1
The optionality status of PV1-8 is R for the Canadian implementation.
__________________________________________________________________________
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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________The table below includes the translations of the PV1 Physician Types:625

La table ci-dessous fournit la traduction de champs relatif aux types de médecins dans PV1:
Table 8.9-1: Translation of PV1 Physician Types
Field

Description

Interprétation/Traduction

PV1-7 Attending doctor:

The person primarily responsible
for the care of the patient during aparticular health care visit(generally used for inpatient
events, but could be extended to an
outpatient visit as well.)

Médecin traitant.

PV1-8 Referring doctor

Is any physician who referred thepatient to the care of anotherphysician (generally a specialist)
for a particular visit. The referring
physician might be noted in an
HL7 event so that she/he receives
a copy of any test results or
documentation of care.

Médecin référant.

PV1-9Consulting doctor

Is generally a specialist who sees apatient as the result of a referral ora consultation order. She/he is not
the attending physician for thecase, although that status could betransferred to a consulting
physician at some point.

Le médecin qui est consulté pourun deuxième avis.

PV1-17 Admitting doctor

Is the physician who decides that apatient meets the criteria for an
inpatient admission to a hospitalduring a specific visit. The
admitting physician is responsible
for evaluating the patient so that
their acuity satisfies admission
criteria.

Médecin responsable del’admission.

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9 National Extensions for IHE Spain
630

The national extensions documented in this section shall be used in conjunction with thedefinitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE
Radiology Technical Framework. This section includes extensions and restrictions to effectively
support the regional practice of healthcare in Spain. IHE Spain provides a translation tool toensure correct interpretation of requirements of the Technical Framework (see www.ihe-e.org).

9.1 Comments
635

IHE-Spain (from now on IHE-E) welcomes comments on this document and the IHE Spain
initiative. Comments can be directed to the IHE-E technical manager, following the links of the
IHE-E web site: www.ihe-e.org.

9.2 Scope
The extensions, restrictions and translations specified apply to HL7 and DICOM requirements as
used in IHE integration profiles: such as Scheduled Workflow.
640

9.3 Translation of IHE terms into Spanish
A JAVA tool has been developed to support the translation of the main IHE terms into Spanish.
This tool provides a dictionary that contains integration profiles, actors and transactions, and foreach one, the domain/TF document where they are referenced (if applicable), acronym, thetranslation of the term into Spanish, and a short description.

645

The last version of this JAVA tool can be downloaded from the web site of the Spanish IHE
initiative (www.ihe-e.org).

9.4 Support for ISO Latin 1
9.4.1 HL7
650

All actors with HL7 based transactions shall support the value “8859/1” for the field “MSH-18
Character Set” in the MSH segment. This value specifies the printable characters from the ISO
8859 (Latin 1) character set.
Note: this character set supports all languages which are official in Spain.
9.4.2 DICOM

655

All actors with DICOM based transactions shall support the value “ISO_IR_100” for theattribute (0008, 0005) “Specific Character Set” if this attribute is defined in the DICOM SOP
class used by the IHE transaction. This attribute specifies the ISO 8859-1 (Latin 1) character set.
Note: this character set supports all languages which are official in Spain.

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9.5 Patient Identification Data
660

This section is intended to give an orientation in the use of the main attributes related to thepatient entity and which can be subject to an ambiguous interpretation. Likewise, we will focus
in the use or adoption or codifications that allow a higher interoperability between systems.
9.5.1 Spanish naming convention: the second family name665

In Spain, people use two family names. In this document they will be referred to as the first
family name and the second family name. The first family name is the father’s first family nameand the second family name is the mother’s first family name.
For instance, Picasso is known for his second family name. His real name was Pablo Ruiz
Picasso, son of José Ruiz Blasco, and Maria Picasso Lopez.
Another example useful for non-Spanish readers: The daughter of the actors Antonio Banderas
and Melanie Griffith is named Estela Banderas Griffith.

670

Note that, as women in Spain don’t change names when they get married, a person’s second
family name is as well his/her mother’s maiden name.
The patient’s second family name is an essential attribute for a person’s identification in Spain.
However, if a person is not of Spanish descent, it is possible that he or she does not have asecond family name675

Handling particles

680

It is quite common in Spain that names have particles. Some examples of this are Felipe deBorbon y Grecia or Teresa Garcia de la Vega. These particles are not handled consistently acrosshospitals (or other information systems) and its codification is beyond the scope of this national
extension. Common solutions are either adding de particle at the end of the name (|BORBON>YGRECIA^FELIPE DE|) or before the surname (|DE BORBON>Y GRECIA^FELIPE)|
9.5.2 HL7
Most of the identification data of a patient are specified in the PID segment as described in thetable below (Table 1. PID attributes, HL7 version 2.3.1. Chapter 3, Section 3.4.2)
Table 9.5.2-1: IHE profile –PID Segment
RP/#

TBL#

ITEM
#

SEQ

LEN

DT

OPT

ELEMENT NAME

1

4

SI

O

00104

Set ID – PID

2

20

CX

B

00105

Patient ID

3

20

CX

R

Y

00106

Patient Identifier List

4

20

CX

B

Y

00107

Alternate Patient ID – PID

5

48

XPN

R

Y

00108

Patient Name

6

48

XPN

O

Y

00109

Mother’s Maiden Name__________________________________________________________________________
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SEQ

LEN

DT

OPT

RP/#

7

26

TS

O

8

1

IS

O

9

48

XPN

O

Y

10

80

CE

O

Y

11

106

XAD

O

Y

12

4

IS

B

13

40

XTN

O

14

40

XTN

O

15

60

CE

O

16

80

CE

17

80

18

TBL#

ITEM
#

ELEMENT NAME

00110

Date/Time of Birth

00111

Sex

00112

Patient Alias

00113

Race

00114

Patient Address

00115

County Code

Y

00116

Phone Number – Home

Y

00117

Phone Number – Business

0296

00118

Primary Language

O

0002

00119

Marital Status

CE

O

0006

00120

Religion

20

CX

O

00121

Patient Account Number

19

16

ST

B

00122

SSN Number – Patient

20

25

DLN

O

00123

Driver’s License Number - Patient

21

20

CX

O

Y

00124

Mother’s Identifier

22

80

CE

O

Y

00125

Ethnic Group

23

60

ST

O

00126

Birth Place

24

1

ID

O

00127

Multiple Birth Indicator

25

2

NM

O

00128

Birth Order

26

80

CE

O

0171

00129

Citizenship

27

60

CE

O

0172

00130

Veterans Military Status

28

80

CE

O

0212

00739

Nationality

29

26

TS

O

00740

Patient Death Date and Time

30

1

ID

O

00741

Patient Death Indicator

0001
0005
0289

0189
0136

Y

0136

685

Adapted from the HL7 Standard, version 2.3.1
9.5.2.1 Second family name
Patient’s second family name

690

695

Amongst the fields defined for the PID segment, there is no specific location for the second
family name. In most current implementations, the field selected to convey this information is
PID-6 Mother’s Maiden Name (XPN). This is a composed data type, whose description
according to HL7 v2.3.1 is the following:
XPN Components: <family name (ST)> & <last_name_prefix (ST)> ^ <given name (ST)> ^ <middle initial orname (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name typecode (ID) > ^ <name representation code (ID)>__________________________________________________________________________
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PID-6 Mother’s maiden name  Family Name

700

However, this solution can’t be extended to reporting other second family names, i.e., attending
doctor. To achieve a rule that is consistent for reporting second family names of all person’s
involved, it is suggested that the second family name is coded as a subcomponent of the patient’s
family name as well.
Therefore the component <family name (ST)> can have two parts the first family name and thesecond family name, separated by a >, as shown in the following example:|BANDERAS>GRIFFITH^ESTELA|705

As people who are not Spanish descendants may not have second family name this field PID-6 is
not required to be filled.
Professional’s second family name710

The second family name is used for any persons, including patients. An example can be the nameof the physician visiting a patient (i.e., PV1 9, Consulting Doctor XCN).
In HL7 v2.3.1 a subcomponent of the family name component can be used in the same way isdone for the patient name.
In v2.5 the definition for XCN data type is changed, and it is recommended to place both patientand professional names of XCN fields such as “Consulting Doctor”, in the following XCN route:

715“Field x” Second and Further Given Names or Initials Thereof
9.5.2.2 Patient Identifiers
The identifier associated to a patient shall be located in the PID-3 Patient Identifier List field.
According to HL7 v2.3.1 the patient identifier list is defined as follows.

720

725

PID-3 Patient identifier list (CX)

00106

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the checkdigit scheme employed (ID)> ^ <assigning authority (HD)> ^<identifier type code (IS)> ^ <assigning facility (HD)>Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID(ST)> & <universal ID type (ID)>
Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID(ST)> & <universal ID type (ID)>This is a mixed type that allows great flexibility of use due to its subcomponents. With the goalof simplifying the patient identifier’s management, the use of the components shown in Table 2
is required.

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730

Table 9.5.2-2: HL7 v2.3.1 PID-3
PID-3 Patient identifier list (CX)
Identifier code (i.e.
43678234V or
DAAS223446778999)

id number (ST)check digit (ST)check digit Scheme –(ID)Assigning authority (i.e. ministerio interior,servicio de salud de la comunidad xx,
Clinica privada yy

assigning authority (HD)namespace ID (IS)universal ID (ST)universal ID type (ID)Type of identifier (i.e identificador internodel paciente, documento nacional
identidad, numero seguridad social)

identifier type code (IS)assigning facility (HD)namespace ID (IS>universal ID (ST)universal ID type (ID)>735

There are many approaches for the management of these identifiers (for more details in otherpossible strategies see [1]). The technical subcommittee has decided to use specific values for
assigning authorities and identifier type codes. These are summarized in Table 3. The lastcolumn, assigning jurisdiction is a field added in HL7 v2.5, and is shown here only as arecommendation for future HL7 v2.5 implementations.
Table 9.5.2-3: Spain’s local codes for HL7 v2.3.1 PID-3, assigning authority fields
Description
Identifier(Spanish
name)
DNI

Identifier(Englishdescription)
National identify card

Codes to be used
Assigning
Authority

Identifier
Type
Code

Assigning
Jurisdiction(recommendation for
HL7 v2.5)

NamespaceID: MI

NNESP3

Identifier ESP4 Name of
Coding System: ISO3166(3 char)

The last 3 characters correspond to the ISO3166 code (3 characters) of the country that issues the document. Seereference [6].

34This applies only for Spain. For other countries, their ISO codification should be taken into.

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Description
Identifier(Spanish
name)Identifier(Englishdescription)

Codes to be used
Assigning
Authority

Identifier
Type
Code

Assigning
Jurisdiction(recommendation for
HL7 v2.5)

Pasaporte

Passport

NamespaceID: MI

PPN

Identifier ESP2 Name of
Coding System: ISO3166(3 char)Trajetaresidencia

Spanish identity cardfor foreigners resident
in SpainNamespaceID: MI

PRC

Identifier: ESP2 Name of
Coding System: ISO3166(3 char)Númeroafiliación
Seguridad
SocialSocial Security id

NamespaceID: SS

SS

Identifier: ESP Name of
Coding System: ISO3166(3 char)

CIP
autonómico

Regional authority
unique patient
identifierNamespaceID:CAXX5

JHN

Identifier: AN, AR, ..
Name of Coding System:
ISO3166-26

CIP del SNS

National healthauthority uniquepatient identifierNamespace ID: MS

HC

Identifier: ESP Name of
Coding System: ISO3166(3 char)

CIP europeo

European patient
identifierNamespaceID: TSE

HC

Identifier: EU Name of
Coding System: ISO3166

ID interno

Internal patient
identifier

Definition pending

PI

Definition pending

9.5.2.3 Contact Data
740

For the contact data (mail, telephone, etc.) the use of PID-13 Phone Number – Home shall be
used. This field is of the type XTN (extended telecommunication number data type)The following fields shall be used:745•

phone number (NM): this field contains the telephone number (without country code)•telecommunication use code: in this field the values suggested in the HL7 0201 tableshall be used.

•

telecommunication equipment type: in this field, the values suggested in the HL7 0202
shall be used.

5

The ISO code should be replaced with the regional authority (“Comunidad autonoma” - CA) ISO (see following note). Seereference [5] for autonomous regions codification.

6

ISO regional authority (CCAA) Codification. See reference [5].

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750

country code: the international code for Spain, +34, is optional. Foreign international
codes shall be filled in.

9.5.2.4 Address Data
The field used in the PID segment to store the possible addresses of the patient is PID-11 Patient
Address.
Components: <street address (ST)> ^ <other designation (ST)> ^ <city(ST)> ^ <state or province (ST)> ^ <zip or postal code(ST)> ^<country (ID)> ^ < address type (ID)> ^ <other geographic
designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)>^ <address representation code (ID)>755

To identify the type of address, it is recommended that the values from the HL7 table 0190 beused in the following way:
760

Table 9.5.2-4: Spain’s recommended local codes for address typeType of address“Address Type” Field

Fiscal (tax)L

Empadronamiento (city register)H

Contacto (contact)

M

Empresa (company)

B

Desplazado (temporal)C

In the event that the “address type” is not filled in, the address is considered to be the city
register’s postal address (H).
The components of the address field are recommended to be used as follows:
765

Table 9.5.2-5: Spain’s recommended interpretation for HL7 v.2.3.1 PID-11 components.
Recommended
interpretation

PID-11 component

Recommended coding
scheme“Street Address”

Tipo de vía, nombre de la vía ynúmero de la vía

n/a“City”:

Municipio

INE code7“State or Province”:

Provincia

INE code5“Zip or postal code”

Código Postal“Country”

País

ISO3166 (3 characters)“Other geographic designation”

Población8n/a7

Spain’s recommended interpretation for HL7 v.2.3.1 PID-11 components.

8

Only used in case that the name of the city does not match the name of the INE codified district.

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recommendation for future HL7 v2.5 implementations is:
770

Table 9.5.2-6: Spain’s recommended interpretation for HL7 v.2.5 PID-11 Street address
subfields.
Subfields of “Street Address”
component

Recommended interpretation“Street or mailing address”

Tipo de vía“Street name”

Nombre de la vía“Dwelling number”

Número de la vía

9.5.3 DICOM: Patient Identification Module

775

The DICOM Standard provides definitions for the information objects [9]. Most of theidentification data of a patient are specified in the Patient Modules. (DICOM PS 3.3. Patient
Identification Module). Patient Identification Attributes are summarized in DICOM PS 3.3.
Table C.2-2.
9.5.3.1 Second family name780

Attribute Patient’s Name (0010, 0010) has a value representation ([10] 6.2. Value
Representation, VR) of person name (PN), which does not allow to distinguish [11] between thefirst and the second family name.
Amongst the patient’s personal data fields available in the Patient Identification Modules, thereis as well no specific location for the second family name.

785

Therefore, it is recommended that the first and second family names are placed in the firstcomponent of PN, family name, in the above mentioned order, using the character “>” (ANSI
003E hex) as delimiter.
Other Patient Name (0010,1001) attribute was not chosen to specify second family name because
there are other Names in the system such as the Referring Physician which can be encoded in thesame way.

790

795

Other examples besides the Referring Physician’s Name (0008, 0090), are Performing
Physician’s Name (0008, 1050), Name of Physician’s Reading Study (0008, 1060), Operator’sName (0008, 1070), Names of Intended Recipients of Results (0040,1010), Order Entered By(0040,2008), Human Performer’s Name (0040,4037), Verifying Observer Name (0040,A075),
Content Creator’s Name (0070,0084), Reviewer Name (300E,0008), Interpretation Recorder(4008,0102), and Interpretation Transcriber (4008,010A).
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9.5.3.2 Patient Identifiers
The main patient identifier shall be reported in:
800

805

(0010, 0020)“Patient ID”(0010, 0021)“Issuer of Patient ID” (Corresponds to HL7 “Assigning authority”,
see Table 3 for recommended codes)

In some cases the Assigning authority alone is not enough to ensure a unique interpretation of thepatient id (see Table 3), and additional information regarding the “Identifier Type Code” isneeded. This is supported in HL7 v2.3, but not in the current DICOM specification. Please notethat this issue may lead to errors if an assigning authority uses only the identifier type code to
distinguish between the patient identifiers.
To code more than one patient identifier, the attribute (0010,1002) "Other Patient IDs Sequence”(DICOM PS 3.3 - 2007 Page 242) can be used.

810

9.6 Insurance Data
This section recommends a representation for insurance data. It focuses on the identification of
the Insurance Company and does not cover the specific conditions of the insurance. This last
aspect depends mainly on implementation and it goes beyond the aim of this national extension.

815

The proposal for the identification of the patient’s main insurance data can be found in document[8].
9.6.1 HL7: Insurance Data Mapping
Table 9.6.1-1 describes the elements of the HL7 v2.3.1 IN1 segment (chapter 6, section 6.4.6)
that shall be used and their recommended interpretation. Fields 1,2 and 3 are required according
to HL7 v2.3.1 definition.

820

IN1 segment should not be sent if the information in IN1-3 (Insurance company ID) is not
relevant.
Table 9.6.1-1: Spain’s recommended interpretation for HL7 v.2.3.1 IN1
IN1 Field

Recommended interpretation

Optionality

In1-1 Set id IN1

Number that identifies the transaction. If the patient has
more than one insurance company, the message shall be
repeated for each company, using a different transaction
ID.

RequiredIn1-2 Insurance
Plan ID

Coverage Plan identifier.

RequiredIn1-3 Insurance
Company ID

Unique company identifier.

Required__________________________________________________________________________
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IN1 Field

Recommended interpretation

Optionality

In1-4 Insurance
Company Name

Name of the company. We suggest repeated use of thisfield to identify the name of the company’s delegation.

Optional

In1-12 Plan
effective date

The date the Coverage Plan comes into force.

Optional

In1-13 Plan
expiration date

The date the Coverage Plan finishes.

Optional

In1-36 Policy
NumberPolicy number.

Optional

9.7 Examples
825

9.7.1 HL7 Example 1
The first example provided is the PID information of a patient living in the Extremadura region.
Only information addressed within this document is shown.
Datos del paciente

Patient data

NombreName

ManuelPrimer Apellido

First family name

Fernández

Segundo Apellido

Second family name

FerrerIdentificadores

Identifiers

DNI

National identity card

37456765V

CIP autonómico

Regional authority uniquepatient identifier

CAEX123456789088(extremadura =EX)

Número afiliación Seguridad
SocialSocial Security id

061081880847

Identificador interno del HIS

Internal patient id at the HIS

9987765

Datos de contacto

Contact information

Teléfono de casa

Home phone

924678564

Móvil

Cell phone

659877877

Correo electrónico

e-mailmfernandez@hl7spain.org

Direcciones

Adresses

Dirección deempadronamiento

Address for the city register

Tipo de vía

Street type (avenue, square,..)AvenidaNombre de la vía

Street nameAlangeNúmeroStreet number

8

Piso

Floor

4ª-3ª

Escalera

Stair

B__________________________________________________________________________
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Datos del paciente

830

Patient data

Código Postal

Zip code

06800

Municipio

City

MéridaPoblaciónCity

MéridaProvincia

Province

Badajoz

País

Country

EspañaDirección de contacto

Contact address

Tipo de vía

Street type

Calle

Nombre de la vía

Street nameConstitución

NúmeroStreet number

34

Piso

Floor

1º-C

Escalera

Stair

Código Postal

Zip code

06800

Municipio

City

MéridaPoblaciónCity

MéridaProvincia

Province

Badajoz

País

Country

EspañaThe location of these data in an HL7 message would be the following:
PID-3 Patient
identifier List

ID Number

37456765V

Assigning Authority
Namespace
ID

MI

Identifier Type CodeNNESP

ID Number

CAEX123456789088

Assigning Authority
Namespace
ID

CAEX

Identifier Type CodeJHN

ID Number

61081880847

Assigning Authority
Namespace
ID

SS

Identifier Type CodeSS

ID Number

9987765

Assigning Authority
NamespaceHC__________________________________________________________________________
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ID
Identifier Type CodePID-5 Patient
Name

PI

Family Name
SurnameGiven Name

PID-6 Mother's
Maiden Name

Fernández
ManuelFamily Name
SurnameFerrerGiven Name
PID-11 Patient
Address

Avenida Alange 8 4º-3ª
Escalera B

Street Address
Other Designation
City

06083

State or Province06

Zip or Postal Code

06800

Country

ESP

Address TypeH

Other Geographic
Designation
Street Address

Calle Constitución 34 1ª - C

Other Designation
City

06083

State or Province06

Zip or Postal Code

06800

Country

ESP

Address TypeM

Other Geographic
Designation
PID-13 Phone
Number - Home

Telecommunication Use
Code

PRN

Telecomm. Equipment TypePHCountry code

+34

Phone Number

924678564

Telecommunication Use
Code

WPN

Telecomm. Equipment TypeCPCountry code

+34

Phone Number

659877877

Telecommunication Use
Code

NET

Telecomm. Equipment TypeInternet__________________________________________________________________________
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Email Addressmfernandez_f@ihe-e.org

And the corresponding PID segment in a message would be:

835

840

845

PID|
1|
37456765V^^^MI&&^NNESP^~CAEX123456789088^^^CAEX&&^JHN^~
61081880847^^^SS&&^SS^~
9987765^^^HC&&^PI^~||FERNANDEZ>FERRER^MANUEL|FERRER||F|||
Avenida Alange 8 4º-3ª Escalera B^^06083^06^06800^ESP^H^^^^~
Calle Constitución 34 1ª - C^^06083^06^06800^ESP^M^^^^||^PRN^PH^^^924678564~^WPN^CP^^^659877877~^NET Internet^^^mfernandez_f@ihe-e.org
9.7.2 HL7 Example 2

850

This example shows the data of a patient admitted in the Emergency Room of the “Hospital
Virgen de la Salud” at Toledo (Castilla La Mancha Region).
Datos del paciente

Patient data

NombreName

EstelaPrimer Apellido

First family nameBanderas

Segundo Apellido

Second family name

GriffithFecha de nacimiento

Date of birthJune 1st, 1970

Identificadores

Identifiers

DNI

National identity card

00000001R

CIP autonómico

Regional authority unique patient
identifier

HOPN700641916019

Número afiliación Seguridad
SocialSocial Security id

2803800541502

Identificador interno del HIS

Internal patient id at the HIS

40004

Datos de contacto

Contact information

Teléfono de casa

Home phone

925 123 456

Otro teléfono de contacto

Secondary contact telephone

925 654 321

Móvil

Cell phone

660 445 566

Correo electrónico

e-mailDirecciones

Adresses__________________________________________________________________________
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Datos del paciente

Patient data

Dirección de contacto

Contact address

Nombre de la vía

Street name

Plaza de Alfares 2 , Apt. 2º“A”

Código Postal

Zip code

45002

Municipio

City

ToledoPoblación

City

Provincia

Province

País

Country

ToledoThe patient identifiers are coded as follows:855

CIP autonomico

HOPN700641916019^^^CACM&&^JHN^

DNI

00000001R^^^MI&&^NNESP^

Identificador interno del HIS (Número de historia
clínica)

40004^^^PI&&^

Número afiliación Seguridad Social

2803800541502^^^SS&&^SS^

The address is coded taking into account that the code for the city of TOLEDO is (45 1685) andthe province of is TOLEDO(45) 45002 ESP M
Plaza de Alfares 2, Apt. 2º A^451685^45^45002^ ESP^M
The resulting patient identification segment (PID) is as follows:

860

865

870

PID|1|HOPN700641916019^^CACM&&^JHN^~
00000001R^^MI&&^NNESP^~
40004^^^PI&&^^^~
2803800541502^^SS&&^SS^^^~||BANDERAS>GRIFFITH^ESTELA|GRIFFITH|
19700601|
F|||
Plaza de Alfares 2 , Apt. 2º A^451685^45^45002^ ESP^M||^PRN^PH^^^925123456~^ORN^PH^^^925654321~^ORN^CP^^^660445566__________________________________________________________________________
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9.7.3 DICOM Example 1
875

The patient information described in Section 9.7.1 HL7 example 1 would be codified as follows
in DICOM.
TAG

Value

(0010,0010)

FERNANDEZ>FERRER^MANUEL(0010,0020)

9987765(0010,0021)

PEND(0010,1002)(0010,0020)

CAEX123456789088(0010,0021)

CAEX(0010,0022)

TEXT(0010,0020)

61081880847(0010,0021)

SS(0010,0022)

TEXT(0010,0020)

37456765V(0010,0021)

MI(0010,0022)

TEXT(0010,1040)

Avenida Alange 8 4º-3ª Escalera B(0010,1060)

FERRER>(0010,2150)

ESP(0010,2152)

06083(0010,2154)+34924678564 / +34659877877

9.7.4 DICOM Example 2
880

The patient information described in Section 9.7.2 HL7 example 2 would be codified as follows
in DICOM.
TAG

Value -according to option 1(0010,0010)

BANDERAS>GRIFFITH^ESTELA(0010,0020)

40004(0010,0021)

PEND(0010,0022)

TEXT>(0010,1002)>(0010,0020)

2803800541502>(0010,0021)

SS>(0010,0022)

TEXT__________________________________________________________________________
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TAG

Value -according to option 1>(0010,0020)

00000001R>(0010,0021)

MI(0010,0022)

TEXT(0010,1040)

Plaza de Alfares 2, Apt. 2º A

(0010,1060)

GRIFFITH(0010,2150)

ESP(0010,2152)

451685(0010,2154)+34925123456 / +34925654321 / +34660445566

9.8 References
885[1] Proposal for Identifiers Management(Technical Subcommittee HL7 Spain, http://www.hl7spain.org/)[2] Minutes of Meeting – Technical Subcommittee ADT 03-02-2005(Technical Subcommittee HL7 Spain, http://www.hl7spain.org/)[3] Minutes of Conference Call Technical Subcommittee ADT 14-02-2005

890(Technical Subcommittee HL7 Spain, http://www.hl7spain.org/)[4] Minutes of Meeting Technical Subcommittee ADT 10-03-2005(Technical Subcommittee HL7 Spain, http://www.hl7spain.org/)[5] ISO Codification for Regions (autonomous regions) in Spain(ISO, http://www.iso.org/iso/en/prods-services/iso3166ma/03updates-on-iso-3166/nli-4.pdf)

895[6] ISO Codification for Countries(ISO, http://www.iso.org/iso/en/prods-services/iso3166ma/02iso-3166-code-lists/iso_31661_decoding_table.html#EU)[7] INE Codification for Districts and Provinces(http://www.ine.es/inebase/cgi/um?M=%2Ft20%2Fe245%2Fcodmun&O=inebase&N=&L=0)900[8] Proposal for Insurance data associated with the patient(Technical Subcommittee HL7 Spain, http://www.hl7spain.org/)[9] DICOM Part 3: IOD, information Object Definitions[10] DICOM Part 5, Data Structures and Encoding

905[11] ANSI HISPP MSDS: COMMON DATA TYPES for Harmonization of Communications
Standards in Medical Informatics__________________________________________________________________________
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10 National Extensions for IHE JapanSee Section 10.5 for examples of messages illustrating the requirements specified here.

10.1 Comment Submission
910

This national extension document was authored under the sponsorship and supervision of JRS,
JAMI, MEDIS, JIRA, JSRT and JAHIS by the IHE Japan initiative, who welcome comments on
this document and the IHE Japan initiative.
Comments should be directed to:
Shirou Endou, IHE-J Secretary, endou@ihe-j.org

10.2 Referenced Standards
915

920

This National Extension depends on the following standards (which are approved by the
Ministry of Health, Welfare and Labour of Japan):•

The JAHIS Protocol for Radiology Data Communication v.3.0C (JRDC), issued by
Japanese Association of Healthcare Information System Industry (JAHIS), which isfound at http://www.jahis.jp/•

Radiology Procedure Codes Standard (JJ1017 V3.3), issued by Japanese Society ofRadiological Technology (JSRT), which is found at http://www.jsrt.or.jp/.

•

Standard Master for Pharmaceutical (known as “HOT code”, which lists government
approved drugs and provides codes to use for ordering, charging and record keeping),
issued by Medical Information System Development Center (MEDIS), which is found at
http://www.medis.or.jp/master/hcode•Standard codes for pharmaceutical units (MR9P) are included as part of the MERIT9(Medical Record Image Text - Information Exchange) data exchange standard issued by
Japan Association for Medical Informatics (JAMI), which is found at
http://www.mi.hama-med.ac.jp/emr/medic/merit9_051220.pdf

925

930

10.3 All Profiles
The following requirements apply to HL7 messages across all Radiology profiles.
10.3.1 Character Set Codes
All senders and receivers of HL7 transactions:935•

shall support the use of two-byte characters in any character field•shall use the ASCII character set code (ISO IR6) for single-byte characters__________________________________________________________________________
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940

945

•

shall use Japan Industrial Standard Kanji code (ISO IR87) for two-byte characters. MSH18 shall be "ISO IR87". Characters not defined in ISO IR87 shall be replaced by phonetic
characters, i.e., Kana (Hiragana or Katakana).

•

shall use ISO 2022-1994 (JIS-X0202) for switching between single- and two-bytecharacters, e.g., Kanji, Hiragana, Katakana and alphabet. MSH-20 shall be "ISO 20221994".

•

shall not use ISO IR13.

•

should not use ISO IR159.

Note: The backslash character “\”, which is used as the Escape character, appears in Japanese fonts as a “\” character whenviewing the raw byte stream.

10.3.2 PID Segment Usage

950

955

960

965

All senders and receivers of HL7 transactions:• should put the legal name in PID-5• shall include the name written in Katakana.
• shall support the name written also in Kanji• should support the name written also in Roman Alphabet• shall support the Katakana, Kanji, and alphabet appearing in any order.
• shall not use PID-9 (Patient Alias)• shall represent Japanese addresses by populating component 8 of PID-11 <Other
Geographic Designation> with Japanese characters organized as described in
https://en.wikipedia.org/wiki/Japanese_addressing_system• shall structure component 8 as a single string without delimiting the subcomponents
using a subcomponent delimiter• should not use components 1, 2, 3 or 4 of PID-11 for Japanese addresses (they do nothave appropriate structure/semantics for Japanese addresses), although it is appropriate touse them for non-Japanese addresses.
• shall use component 12 of PID-13 and PID-14 <Unformatted Telephone Number> forphone numbers• should not use components 4, 5 or 6 of PID-13 and PID-14 for phone numbers (they do
not have appropriate structure/semantics for Japanese phone numbers)
Example value of PID-5:
Yamada^ Taro^^^^^L^A~山田^太郎^^^^^L^I~ヤマダ^タロウ^^^^^L^P
In this example, the order is Alphabet, Kanji and Katakana.

970

Example value of PID-11:^^^^105-0004^^H^^東京都港区新橋２－５－５__________________________________________________________________________
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Example of value of PID-13 and 14:^PRN^PH^^^^^^^^^03-3506-8010
10.3.3 Message Control Codes (“0B”)
975

The IHE Radiology Technical Framework requires that "0B" be present at the beginning of all
HL7 messages as part of the Minimal Lower Layer Protocol mandated in RAD TF-2: 2.4.1.1.
JRDC v3.0C (a national standard of Japan, proposed by JAHIS and approved by Ministry of
Health, Labour and Welfare of Japan) requires omission of "0B" at the initial part of a message.

980

All senders and receivers of HL7 transactions shall be configurable to operate successfully withand without the beginning "0B" character.

10.4 Scheduled Workflow.b (SWF.b)
The Japanese National Extension adds requirements to SWF.b. The same requirements apply to
implementations of SWF with the HL7 v2.5.1 Option (see the IHE Radiology Technical
Framework, Revision 11 (July 24, 2012) or later).
985

10.4.1 SWF.b – OBX Segment Usage for Common Observations
The observations and observation values in this section are commonly used in Japan.
ADT, Order Placer and Order Filler Actors are recommended to support sending theobservations in Table 10.4.1-1 in one or more OBX segments in [RAD-1], [RAD-2], [RAD-4],[RAD-12], and [RAD-13].

990

The Observation Code will appear in OBX-3, the Data Type in OBX-2, and the result value in
OBX-5.
Note: Allergy information is communicated in an AL1 segment according to HL7 V2.5.

995

Note: Fields for "History of …" may contain a Yes/No, a date, a statement that such information was not requested or is notavailable or may contain a text description of the history itself such as the specific procedure performed. As a result
this field is mostly for human viewing (e.g., by the technologist or the radiologist), not for any kind of automatedprocessing or decision support.

Table 10.4.1-1: Common Observation Identifiers in Japan
Observation
Code(OBX-3)Meaning

English Translation

Data
Type
(OBX-2)

Observation
Value(OBX-5)01-01

身長Body height

NM

-

01-02

体重

Body weight

NM

-

01-03

ABO式血液型

ABO blood type

CWE

Table 10.4.1-402-01

造影剤副作用Side effect of contrast
media

TX

-

02-02

気管支喘息

AsthmaTX-__________________________________________________________________________
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Observation
Code(OBX-3)Meaning

English Translation

Data
Type
(OBX-2)

Observation
Value(OBX-5)

02-03

腎機能障害

Renal dysfunction

TX

-

02-04

胃の手術

History of gastric surgery

TX

-

02-05

大腸の手術

History of colon surgery

TX

-

02-06

胆嚢の手術

History of gall bladdersurgery

TX

-

02-07

その他腹部の手術
歴

History of abdominal
surgery

TX

-

02-08

体内ペースメーカ

Implanted pacemaker

TX

-

02-09

体内金属

Metal in body

TX

-

03-01

HBs抗原

Hepatitis B surface antigen

CWE

Table 10.4.1-2

03-02

HCV抗体

Anti-Hepatitis C Virus
antibody

CWE

Table 10.4.1-2

03-03

TPHA法

Treponema PHA

CWE

Table 10.4.1-2

03-04

STS法

Serological Test for
Syphilis

CWE

Table 10.4.1-2

03-05

ツ反

PPD skin test

CWE

Table 10.4.1-2

03-06

TB塗抹

TB smear

CWE

Table 10.4.1-2

03-07

TB培養

TB culture

CWE

Table 10.4.1-2

03-08

HIV抗体

HIV antibody

CWE

Table 10.4.1-2

03-09

HTLV-I抗体

HTLV-I antibody

CWE

Table 10.4.1-2

03-10

MRSA

MRSA

CWE

Table 10.4.1-2

03-11

クレアチニン値

Serum creatinine

NM

-

03-12

BUN値

Blood urea nitrogen

NM

-

04-01

聴覚障害

Hearing impairment

CWE

Table 10.4.1-3

04-02

言語障害

Speech disturbance

CWE

Table 10.4.1-3

04-03

視覚障害

Impairment in vision

CWE

Table 10.4.1-3

04-04

運動障害

Motor dysfunction

CWE

Table 10.4.1-3

04-05

意識障害

Disturbance of
consciousness

CWE

Table 10.4.1-3

Source: JRDC v3.0C, JHSR 001
1000

ADT, Order Placer and Order Filler Actors are recommended to support sending the observation
values in Table 10.4.1-2, Table 10.4.1-3 and Table 10.4.1-4 for the observations indicated inTable 10.4.1-1 in [RAD-1], [RAD-2], [RAD-4], [RAD-12], and [RAD-13].
__________________________________________________________________________
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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________The Code Value (left column) will appear in the "Code Value" of OBX-5, the Meaning (middle
column) in the “Code Meaning” of OBX-5. The English Translation does not typically appear inmessages in Japan. The coding system name shall be “JHSR002”
1005

Note: Observation value of "not tested" is represented by "Unknown" if needed.

Table 10.4.1-2: Common Observation Values for Test Result
Code Value

Meaning

English Translation

0-

Negative1

擬陽性

Equivocal

2＋

Positive

3＋＋

Moderately positive

4＋＋＋

Strongly positive

Source: JRDC v3.0C, JHSR 002
Table 10.4.1-3: Common Observation Values for Evaluation Level
Code Value

Meaning

English Translation

SV

重度

SevereMO

中等度

Moderate

MI

軽度

Mild

U

不明

Unknown

Source: JRDC v3.0C, JHSR 002
1010

Table 10.4.1-4: Common Observation Values for Blood Type
Code Value

Meaning

English Translation

A

A

Blood type A

B

B

Blood type BOO

Blood type O

AB

AB

Blood type AB

Source: JRDC v3.0C, JHSR 002
10.4.2 SWF.b – PV1 Segment Usage
1015

ADT, Order Placer and Order Filler Actors shall support sending the values in Table 10.4.2-1,
Table 10.4.2-2 and Table 10.4.2-3 in PV1-2, PV1-3 and PV1-4 in [RAD-1], [RAD-2], [RAD-3],[RAD-4], [RAD-12], and [RAD-13].

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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________The Code Value (left column) will appear in the "Code Value" and the Meaning (middle column)
may be used when presenting the information to a human. The English Translation does not
typically appear in messages in Japan.
1020

Table 10.4.2-1: PV1-2 Patient Class (HL7 Table 0004)
Code Value

Meaning

English Translation

E

救急

Emergency

I

入院患者

Inpatient

O

外来患者

Outpatient

P

事前登録

Preadmit

R

通院患者

Recurring Patient

B

産科来院

Obstetrics

C

商用アカウント

Commercial Account

N

摘応なし

Not ApplicableU不明

Unknown

Source: JRDC v3.0C
Table 10.4.2-2: PV1-3 Assigned Patient Location, Component 6 Person Location Type(HL7 Table 0305)
Code Value

Meaning

English Translation

C

診察室

Clinic

D

部門

Department

H

在宅

Home

N

病棟

Nursing Unit

O

依頼医の部
屋

Provider's Office

P

電話

Phone

S

高度看護施
設

Skilled Nursing Facility

Source: JRDC v3.0C
1025

For Patient Class Inpatient, Component 6 shall be N and PV1-3 may be formatted as follows:<Ward>^<Room>^<Bed>^^^N
For Patient Class Outpatient, Component 6 shall be C and PV1-3 may be formatted as follows:<Clinic>^^^^^C__________________________________________________________________________
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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________For other Patient Class values, the PV1-3 format and values are not further constrained in Japan.
1030

Table 10.4.2-3: PV1-4 Admission Type (HL7 Table 03065)
Code Value

Meaning

English Translation

A

事故

Accident

E

救急

Emergency

L

陣痛と出産

Labor and DeliveryR

通常

RoutineN

新生児（院内で誕生）

Newborn (Birthed in
Healthcare Facility)

U

緊急

UrgentC

選択的Elective

Source: JRDC v3.0C
10.4.3 SWF.b – TQ1 Segment Usage
Order Placer and Order Filler Actors shall support sending the values in Table 10.4.3-1 in TQ1-9
in [RAD-2], [RAD-3], [RAD-4], and [RAD-13].
1035

The Code Value (left column) will appear in the "Code Value" and the Meaning (middle column)
may be used when presenting the information to a human. The English Translation does not
typically appear in messages in Japan.
Table 10.4.3-1: TQ1-9 Extended Priority Codes (HL7 Table 0485)
Code Value

Meaning

English Translation

S

緊急

Urgent, with the highest priority

A

Ｓオーダの後As soon as possible

R

ルーチン

Routine

P

術前Preoperative patient, fulfill an order before the planned
date of surgery

C

返信(呼び戻し)Callback

T

時期厳守

Timing is critical. Fulfill order at the specified timing.

必要に応じてAs needed. Fulfill order when condition is met. The
condition must be defined by an ordering provider
beforehand.

PRN

Source: JRDC v3.0C__________________________________________________________________________
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1040

10.4.4 SWF.b – Drug Coding with HOT & MR9P
Order Placer and Order Filler Actors shall support using HOT coding for any drugs and MR9P
coding (see Table 10.4.4-1) for any drug amounts encoded in [RAD-2], [RAD-3], [RAD-4], and[RAD-13]. For example contrast in an OBX segment in an order, or consumed drugs in the ZE1
segment.

1045

The coding system name for HOT shall be “HOT9”.
The coding system name for MR9P shall be “MR9P”.
Table 10.4.4-1: Units of Drug Dose (MR9P)
Code Value

Meaning

English Translation

TAB

錠

TabletCAP

カプセル

Capsule

G

グラム

Gram

MG

ミリグラム

Milligram

MCG

マイクログラム

Microgram

L

リットル

Liter

ML

ミリリットルMilliliter

UNT

単位

Unit

AMP

管、アンプル

Ampule

BAG

袋

Bag

BTL

瓶

BottleHON

本

Hon (a unit for counting drugs or drug
containers with a stick-like shape)

KO個

Ko (a unit for counting drugs or drug
containers whose unit is not otherwise
specified)

PCK

包

Pack

SHT

枚

Sheet

VIL

バイアル

Vial

Source: JRDC v3.0C
10.4.5 SWF.b – Parent & Child Orders
1050

Order Placers shall be able to generate compound orders containing both parent (PA) and child(CH) order components and send them in Placer Order Management [RAD-2].
Order Fillers shall include any compound orders received from the Order Placer into Procedure
Scheduled [RAD-4] and Procedure Update [RAD-13].
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1055

1060

A parent order transmits information common to both the parent order and its child orders. Eachchild order transmits information specific to that child order. For example the parent order might
specify a digital radiography (DR) exam, and child order(s) specify that it is a DR exam of theAbdomen with AP & Lateral views. The parent order sometimes serves as a coarse order, usefulfor scheduling the modality resource (since the anatomy and views might not be relevant toscheduling) and for showing in the GUI of the EMR as a summary description of the study (it's a
DR study). The child order is a refined order that is complete for the tech to perform since thechild order also contains all the information in the parent order.
A parent order is indicated by the value "PA" in ORC-1 of an ORC segment. A parent ordersegment is followed by one or more child order segments.

1065

A child order is indicated by the value "CH" in ORC-1 of an ORC segment. An NW ORC
segment is placed before the PA ORC segment.
When child orders are generated by the Order Placer, the Placer Order Number is assigned by theOrder Placer. The Order Placer might be configured to use a certain pattern, such as prefixing"999" to the beginning of child order numbers.
In child orders, ORC-8 and OBR-29 shall contain the Placer Order Number of the parent order.

1070

Table 10.4.5-1 shows an example of a single compound order with one parent and two childorders to demonstrate the sequence in which the segments appear and show example values in
relevant "linking fields".
Table 10.4.5-1: Parent and Child Order Example
Comment

Placer Order
Number(ORC-2)

Parent(ORC-8)NW

New Order

"A00"

blank

ORC

PA

1st Parent

"A00"

blank

ORC

CH

1st Child

"A01"

"A00"

Seg

Order
Control(ORC-1)

ORC

OBR
ORC
OBR

1st ChildCH

2nd Child"A02"

Placer Order
Number(OBR-2)

Parent(OBR-29)

"A01"

"A00"

"A02"

"A00"

"A00"

2nd Child

10.4.6 SWF.b – Procedure Coding with JJ1017
1075

Order Placers, Order Fillers and Image Manager/Archives shall support using JJ1017 codes to
describe the procedures ordered, procedures scheduled and procedures performed in OBR-4
fields in [RAD-2], [RAD-3], [RAD-4], and [RAD-13].
JJ1017-16P codes are used for “parent orders”. They are strings of 16 characters where the last
13 characters are zeros.

1080

Other JJ1017 codes are made by combining a 16-character JJ1017-16M code and a 16-character
JJ1017-16S code.
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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________The OBR-4 field of a parent order shall contain one JJ1017-16P code.

1085

The OBR-4 field of each of child order shall contain one JJ1017 code (JJ1017-16M + JJ101716S, 32 characters) corresponding to a single procedure from the set of procedures included in
the parent order.
See Appendix A for examples of JJ1017 usage.
10.4.7 SWF.b – Notification of Patient Presence
Order Fillers shall be able to send a Status Update [RAD-3] with a status of IP (In Progress),when triggered by arrival of the patient.

1090

When a patient presents for a study, an operator of the Order Filler (RIS) logs this fact and a[RAD-3] message is sent to notify the Order Placer that they can no longer change or cancel the
study electronically. Communication with a radiology technician or other relevant personnel incharge of the study may be required for any "last minute" discontinuation.

10.5 Examples for Japan National Extension
1095This appendix provides example messages that illustrate features and requirements of the IHE
Japan National Extension as specified in RAD TF-4: 10. The examples were translated from theRadiology Data Exchange Standard (JRDC), ver3.0C © JAHIS 2014.
Some message segments are preceded by explanatory comments which would not appear in themessage.

1100

In these examples person names are written with the family name first and given name second inaccordance with the customs in Japan. In the explanatory text English information is often
followed by the corresponding Japanese words in the same order in parentheses in blue text, forexample Tokyo Taro (東京太郎).
10.5.1 Case: Radiography1105

10.5.1.1 Placing an Order (HIS to RIS)HIS_ALPHA sends a message for an imaging service request with the message number 100001
to RIS_BETA on the 20th of January, 2005.
MSH|^~\&|HIS_ALPHA||RIS_BETA||20050120||OMG^O19^OMG_O19|100001|P|2.5|||||JPN|ASCII~ISO IR87|| ISO 2022-1994<cr>

1110

1115

The Patient is Tokyo Taro (東京太郎), male, born 14th of December, 1950. The Patient ID is12345678; the patient's address, preceded by postal code, is 105-0004 Shinbashi 2-5-5, Minatoku, Tokyo-to (東京都港区新橋２－５－５); and the patient's home telephone number is 033506-8010.
PID|||12345678^^^^PI||東京^太郎^^^^^L^I~トウキョウ^タロウ^^^^^L^P||19501214|M|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>__________________________________________________________________________
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IHE Radiology Technical Framework, Volume 4: National Extensions______________________________________________________________________________The patient is seen by Dr. Nakada Takashi (中田隆) in the out-patient clinic of the Internal
Medicine (内科) department.
PV1||O|01^^^^^C||||112233^中田^隆^^^^^^^L^^^^^I|||01<cr>1120

Dr. Nakada orders radiography of the chest in two projections (AP and LR lateral) andradiography of the abdomen in two projections (AP and LR lateral) at 10:10 AM in 20th ofJanuary, 2005. The assigned placer order number is 2005012000100. The blood type (血液型) of
the patient is A. The patient has severe (重度) impairment in vision (視力障害).
ORC|NW|2005012000100|||SC||||20050120101000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>1125

TQ1|||||||200501201010||R<cr>
OBR||2005012000100||1000000000000000^Ｘ線単純撮影^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I|||||||||O|||||WALK<cr>
ORC|PA|2005012000100|||SC||||20050120101000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>1130

TQ1|||||||200501201010||R<cr>
OBR||2005012000100||1000000000000000^Ｘ線単純撮影^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I||||||||||||||WALK<cr>
OBX|1|CWE|01-03^血液型-ABO式^JHSR001|1|A^A^JHSR002||||||F<cr>
OBX|2|CWE|04-03^視覚障害^JHSR001||SV^重度^JHSR002||||||F<cr>1135

ORC|CH|2005012000101|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1140

OBR||2005012000101||
10000002000002000000010000000000^胸部.Ｘ線単純撮影.正面(A→P)^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK<cr>
ORC|CH|2005012000102|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>1145

TQ1|||||||200501201010||R<cr>
OBR||2005012000102||
10000002000006000000010000000000^胸部.Ｘ線単純撮影.側面(L→R)^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK<cr>1150

ORC|CH|2005012000103|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>__________________________________________________________________________
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1155

OBR||2005012000103||
10000002510002000000010000000000^腹部(KUB).Ｘ線単純撮影.正面(A→P)^JJ1017||||||||||||112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK<cr>
ORC|CH|2005012000104|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1160

OBR||2005012000104||
10000002510006000000010000000000^腹部(KUB).Ｘ線単純撮影.側面(L→R)^JJ1017||||||||||||112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK<cr>

10.5.1.2 Radiography Order Response (RIS to HIS)
1165

In response to the message in A.1.1, RIS_BETA sends a message to HIS_ALPHA on the 20th ofJanuary, 2005.
MSH|^~\&|RIS_BETA||HIS_ALPHA||20050120||ORG^O20^ORG_O20|100002|P|2.5|||||JPN|ASCII~ISO IR87||ISO 2022-1994<cr>
MSA|AA|100001<cr>

10.5.1.3 Conveying the Radiography Order (RIS to PACS)
1170

1175

Following receipt of the message A.1.1, RIS_BETA sends message number 110001 to
PACS_GAMMA on the 20th of January, 2005 informing it of the order contents. The Accession
Number is A2005012000100 and the Study Instance UID is 1.2.392.1114.2004.543233.1. The
Modality is CR.
MSH|^~\&|RIS_BETA||PACS_GAMMA||20050120||OMI^O23^OMI_O23|110001|P|2.5|||||JPN|ASCII~ISO IR87||ISO 2022-1994<cr>
PID|||12345678^^^^PI||
東京^太郎^^^^^L^I~トウキョウ^タロウ^^^^^L^P~TOKYOU^TAROU^^^^^L^A||19501214|M|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>
PV1||O|01^^^^^C||||112233^中田^隆^^^^^^^L^^^^^I|||01<cr>

1180

ORC|NW|2005012000100|||SC||||20050120101000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1185

OBR||2005012000100||1000000000000000^Ｘ線単純撮影^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I||||||||||||||WALK||||||||||||||
1000000000000000^Ｘ線単純撮影^JJ1017<cr>
IPC|A2005012000100||1.2.392.1114.2004.543233.1||CR<cr>
ORC|PA|2005012000100|||SC||||20050120101000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>__________________________________________________________________________
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1190

OBR||2005012000100||1000000000000000^Ｘ線単純撮影^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I||||||||||||||WALK ||||||||||||||
1000000000000000^Ｘ線単純撮影^JJ1017<cr>
OBX|1|CWE|01-03^血液型-ABO式^JHSR001|1|A^A^JHSR002||||||F<cr>
OBX|2|CWE|04-03^視覚障害^JHSR001||SV^重度^JHSR002||||||F<cr>

1195

IPC|A2005012000100||1.2.392.1114.2004.543233.1||CR<cr>
ORC|CH|2005012000101|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>

1200

OBR||2005012000101||
10000002000002000000010000000000^胸部.Ｘ線単純撮影.正面(A→P)^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK||||||||||||||
10000002000002000000010000000000^胸部.Ｘ線単純撮影.正面(A→P)^JJ1017<cr>
IPC|A2005012000100||1.2.392.1114.2004.543233.1||CR<cr>

1205

ORC|CH|2005012000102|||SC|||2005012000100|20050120101000|112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1210

OBR||2005012000102||
10000002000006000000010000000000^胸部.Ｘ線単純撮影.側面(L→R)^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK||||||||||||||
10000002000006000000010000000000^胸部.Ｘ線単純撮影.側面(L→R)^JJ1017<cr>
IPC|A2005012000100||1.2.392.1114.2004.543233.1||CR<cr>

1215

ORC|CH|2005012000103|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1220

OBR||2005012000103||
10000002510002000000010000000000^腹部(KUB).Ｘ線単純撮影.正面(A→P)^JJ1017||||||||||||112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000100|WALK||||||||||||||
10000002510002000000010000000000^腹部(KUB).Ｘ線単純撮影.正面(A→P)^JJ1017<cr>
ORC|CH|2005012000104|||SC|||2005012000100|20050120101000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1225

OBR||2005012000104||
10000002510006000000010000000000^腹部(KUB).Ｘ線単純撮影.側面(L→R)^JJ1017__________________________________________________________________________
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10000002510006000000010000000000^腹部(KUB).Ｘ線単純撮影.側面(L→R)^JJ1017<cr>10.5.1.4 Response to the Conveyed Radiography Order (PACS to RIS)
1230

In response to the message in A.1.3, PACS_GAMMA sends message number 110002 to
RIS_BETA on the 20th January, 2005.
MSH|^~\&||PACS_GAMMA||RIS_BETA|20050120||ORI^O24^ORI_O24|110002|P|2.5||||||~ISO
IR87||ISO 2022-1994<cr>
MSA|AA|110001 <cr>1235

10.5.1.5 Notification of Patient Presence (RIS to HIS)
The patient arrives at the Department of Radiology after RIS_BETA receives the message in
A.1.1. RIS_BETA sends message number 120001 acknowledging the presence of the patient to
HIS_ALPHA at the time of the patient encounter at the Department of Radiology, which is
10:30:45 AM in 20th of January, 2005.

1240

MSH|^~\&|RIS_BETA||HIS_ALPHA||20050120133035||OMG^O19^OMG_O19|120001|P|2.5|||||JPN|ASCII~ISO IR87||ISO 2022-1994<cr>
PID|||12345678^^^^PI||
東京^太郎^^^^^L^I~トウキョウ^タロウ^^^^^L^P~TOKYOU^TAROU^^^^^L^A||19501214|M|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>1245

PV1||O|01^^^^^C||||112233^中田^隆^^^^^^^L^^^^^I|||01<cr>
ORC|SC|2005012000100|||IP||||20050120132918|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||O<cr>
TQ1|||||||200501201010||R<cr>1250

OBR||2005012000100||1000000000000000^Ｘ線単純撮影^JJ1017||||||||||||112233^中田^隆^^^^^^^L^^^^^I||||||||||I||||WALK<cr>

10.5.1.6 Response to Notification of Patient Presence (HIS to RIS)In response to the message in A.1.5, HIS_ALPHA sends a message number 120002 to
RIS_BETA in the 20th of January, 2005.
1255

MSH|^~\&|HIS_ALPHA||RIS_BETA||20050120133103||ORG^O20^ORG_O20|120002|P|2.5|||||
JPN|
ASCII~ISO IR87||ISO 2022-1994<cr>
MSA|AA|120001<cr>

10.5.2 Case: CT
10.5.2.1 Placing an Order (HIS to RIS)
1260

HIS_ALPHA sends a message for an imaging service request with the message number 200001
to RIS_BETA on the 20th of January, 2005.
__________________________________________________________________________
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MSH|^~\&|HIS_ALPHA||RIS_BETA||20050120||OMG^O19^OMG_O19|200001|P|2.5|||||JPN|ASCII~ISO IR87||ISO 2022-1994<cr>1265

The Patient is Toranomonn Ichiro (虎ノ門一郎), male, born 11th of April, 1960. The Patient ID
is 22333444; The patient's address preceded by postal code is 105-004 Shinbashi 2-2-5, Minatoku, Tokyo-to (東京都港区新橋２－２－５); and the patient's home telephone number is 033406-8010．
PID|||22333444^^^^PI||虎ノ門^一郎^^^^^L^I~とらのもん^いちろう^^^^^L^P||19600411|M|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>1270

His attending doctor is Dr. Nakata Takashi (中田隆) of Internal Medicine and the patient is
assigned a bed in Room 30 on the 3rd floor of the South Ward (南病棟).
PV1||I|3S^30^^^^N||||112233^中田^隆^^^^^^^L^^^^^I|||01<cr>

The patient has an allergy including past history of mild adverse reaction to contrast medium (造影剤副作用) and moderate asthma (気管支喘息).
1275

AL1|1|DA^薬物アレルギー^HL70127|02-01^造影剤副作用^JHSR001|MI^Mild^HL70128<cr>
AL1|2|EA^環境アレルギー^HL70127|02-02^気管支喘息^JHSR001|
MO^Moderate^HL70128<cr>

1280

After considering the risk-benefit of the patient's allergy, Dr. Nakada places an order requesting
contrast-enhanced CT of the abdomen (上腹部Ｘ線ＣＴ検査) at 9:30AM on the 20th ofJanuary, 2005. The placer order number is 2005012000300. The patient has severe hearing
impairment and his blood type (血液型) is AB.
ORC|NW|2005012000300|||SC||||20050120093000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501200930||R<cr>1285

OBR||2005012000300||600000000000000^Ｘ線ＣＴ検査^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I||||||||||||||WALK<cr>
ORC|PA|2005012000300|||SC||||20050120093000|112233^中田^隆^^^^^^^L^^^^^I||
112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501200930||R<cr>1290

OBR||2005012000300||600000000000000^Ｘ線ＣＴ検査^JJ1017||||||||||||
112233^中田^隆^^^^^^^L^^^^^I||||||||||||||WALK<cr>
OBX|1|CWE|01-03^血液型-ABO 式^JHSR001|1|AB^AB^JHSR002||||||F<cr>
OBX|2|CWE|04-01^聴覚障害^JHSR001||SV^重度^JHSR002||||||F<cr>1295

ORC|CH|2005012000301|||SC|||2005012000300|20050120093000|
112233^中田^隆^^^^^^^L^^^^^I||112233^中田^隆^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501200930||R<cr>__________________________________________________________________________
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OBR||2005012000301||60001002550000000000000000000000^上腹部Ｘ線ＣＴ検査^JJ1017||||||||||||112233^中田^隆^^^^^^^L^^^^^I|||||||||||||2005012000300|WALK<cr>

1300
Contrast medium is determined to be Iopamiron 300 61.24% 100 ml (HOT9 code: 111836001)
by Dr. Nakada.
NOTE: The ordering doctor may determine details of the imaging study, particularly in ahealthcare facility where radiologists are unavailable.
1305

OBX|1|ZRD|DE-02^薬品^JHSR006||111836001^イオパミロン３００６１．２４％１００ｍＬ^HOT9^1^HON&本&MR9P||||||O<cr>

10.5.3 Case: Ultrasonography
10.5.3.1 Placing an Order (HIS to RIS)
1310

HIS_ALPHA sends a message for an imaging service request with the message number
3000001, to RIS_BETA at 12:50:25 on the first of August, 2005.
MSH|^~\&|HIS_ALPHA||RIS_BETA||20100801125025||OMG^O19^OMG_O19|300001|P|2.5|||||JPN|ASII~ISO IR87||ISO 2022-1994<cr>1315

The Patient is Tokushima Naomi (徳島尚美), female, born 11th of September, 1982. The Patient
ID is 3330000333; the patient's address, preceded by postal code, is 105-0004 Shinbashi 2-2-5,
Minato-ku, Tokyo-to (東京都港区新橋２－５－５); and the patient's home telephone number
is 03-3506-8010.
PID|||3330000333^^^^PI||徳島^尚美L^I~トクシマ^ナオミ^^^^^L^P||9820911|F|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^HP^^^03-3506-8010<cr>

1320

The patient visits an out-patient clinic of Obstetrics (産科) and is seen by Dr. Noriko Akita (秋田典子).
PV1||O|||||5559999555^秋田^典子^^^^^^^L^^^^^I|||24<cr>

Dr. Akita orders an obstetric ultrasonography of the fetus at 11:25 in the 1st of August, 2010.
The Placer order number is 201081100300. The Patient blood type (血液型) is B, body height (身長) of 158 cm, and body weight (体重) is 65 kg.
1325

ORC|NW|20100800100300|||SC||||20100801112555|5559999555^秋田^典子^^^^^^^L^^^^^I||
5559999555^秋田^典子^^^^^^^L^^^^^I|24^^^^^C||||24^産科^MML028||||||||||||O<cr>
TQ1|||||||201008011125||R<cr>
OBR||2010080100300||99A000000000000^経皮的超音波検査^JJ1017||||||||||||
5559999555^秋田^典子^^^^^^^L^^^^^I||||||||||||||WALK<cr>1330

ORC|PA|2010080100300|||SC||||20100801112555|5559999555^秋田^典子^^^^^^^L^^^^^I||
5559999555^秋田^典子^^^^^^^L^^^^^I|24^^^^^C||||24^産科^MML028||||||||||||O<cr>
TQ1|||||||201008011125||R<cr>__________________________________________________________________________
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OBR||2010080100300||99A000000000000^経皮的超音波検査^JJ1017||||||||||||
5559999555^秋田^典子^^^^^^^L^^^^^I||||||||||||||WALK<cr>1335

OBX|1|CWE|01-03^血液型-ABO 式^JHSR001|1|B^B^JHSR002||||||F<cr>
OBX|2|NM|01-01^身長^JHSR001||158|cm|||||F<cr>
OBX|3|NM|01-02^体重^JHSR001||65|kg|||||F<cr>1340

ORC|CH|2010080100301|||SC|||2010080100300|20100801112555|
5559999555^秋田^典子^^^^^^^L^^^^^I||5559999555^秋田^典子^^^^^^^L^^^^^I|24^^^^^C||||24^産科^MML028||||||||||||O<cr>
TQ1|||||||201008011125||R<cr>
OBR||2010080100301||
99A00005550000000000000000000000^胎児.超音波検査^JJ1017||||||||||||
5559999555^秋田^典子^^^^^^^L^^^^^I|||||||||||||2010080100300|WALK<cr>1345

10.5.4 Case: Nuclear Medicine
10.5.4.1 Placing an Order (HIS to RIS)HIS_ALPHA sends a message requesting a nuclear medicine study with the message number
4000001 to RIS_BETA at 10:20:15 AM on the 18th of January, 2005.

1350

MSH|^~\&|HIS_ALPHA||RIS_BETA||20050118102015||OMG^O19^OMG_O19|400001|P|2.5|||||JPN|ASCII~ISO IR87||ISO 2022-1994<cr>

The Patient is Nasuno Hajime (那須野一), male, born 10th of August, 1970. The Patient ID is98765432; the patient's address, preceded by postal code, is 105-0004 Shinbashi 2-2-5, Minatoku, Tokyo-to (東京都港区新橋２－２－５); and the home telephone number is 03-3506-8010.
1355

PID|||98765432^^^^PI||那須野^一^^^^^L^I~なすの^はじめ^^^^^L^P||19700810|M|||^^^^105-0004^^H^^東京都港区新橋２－２－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>

The patient is seen by Dr. Sasaki Jirou (佐々木治朗) of the Internal Medicine department and isassigned a bed in room 35 on the third floor of the south ward (南病棟).
PV1||I|3S^35^^^^N||||112255^佐々木^治朗^^^^^^^L^^^^^I|||01<cr>

1360

Dr. Sasaki places an order for a brain perfusion SPECT with 99mTc at 10:20:00 on the 18th ofJanuary, 2005. The order is scheduled at 15:30 in the 20th of January, 2005 with the placer ordernumber of 20050120004. The Patient blood type is O.
ORC|NW|2005011800400|||SC||||20050118102000|112255^佐々木^治朗^^^^^^^L^^^^^I||
112255^佐々木^治朗^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501201530||R<cr>1365

OBR||2005011800400||84J0000000000000^シンチグラム^JJ1017||||||||||||
112255^佐々木^治朗^^^^^^^L^^^^^I||||||||||||||WALK<cr>__________________________________________________________________________
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ORC|PA|2005011800400|||SC||||20050118102000|112255^佐々木^治朗^^^^^^^L^^^^^I||
112255^佐々木^治朗^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501201530||R<cr>1370

OBR||2005011800400||84J0000000000000^シンチグラム^JJ1017||||||||||||
112255^佐々木^治朗^^^^^^^L^^^^^I||||||||||||||WALK<cr>
OBX|1|CWE|01-03^血液型-ABO 式^JHSR001||O^O^JHSR002||||||F<cr>1375

ORC|CH|2005011800401|||SC|||2005011800400|20050118102000|
112255^佐々木^治朗^^^^^^^L^^^^^I||112255^佐々木^治朗^^^^^^^L^^^^^I|01^^^^^C||||01^内科^MML028||||||||||||I<cr>
TQ1|||||||200501201530||R<cr>
OBR||2005011800401||
84J44006010000000000410000000000^シンチグラム.血流.脳.99mTc^JJ1017||||||||||||
112255^佐々木^治朗^^^^^^^L^^^^^I|||||||||||||2005011800400|WALK<cr>1380

10.5.5 Case: Angiography
10.5.5.1 Placing an Order (HIS to RIS)HIS_ALPHA sends a message requesting coronary angiography with the message number
500001 to RIS_BETA at 10:11 in the 20th of January, 2005.

1385

MSH|^~\&|HIS_ALPHA||RIS_BETA||20050120101100||OMG^O19^OMG_O19|500001|P|2.5|||||JPN|ASCII~ISO IR87||ISO2022-1994<cr>

The Patient is Hukuoka Chihiro (福岡千尋), female, born 21st of October, 1980. The Patient ID
is 97531111; the patient's address, preceded by postal code, is 105-0004 Shinbashi 2-2-5,
Minato-ku, Tokyo-to (東京都港区新橋２－５－５); and the patient's home telephone number
is 03-3506-8010.
1390

PID|||97531111^^^^PI||フクオカ^チヒロ^^^^^L^P~福岡^千尋^^^^^L^I||19801021|F|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>

The patient is seen by Dr. Tanaka Ichiro (田中一郎) of Cardiology (循環器科) and is assigned a
bed in room 21 of the E02 ward.
PV1||I|E02^21^^^^N||||112235^田中^一郎^^^^^^^L^^^^^I|||08<cr>

1395

1400

Dr. Takahashi Kazushi (高橋和志) orders a coronary angiography and embolization (forcoronary arterio-venous fistula) at 10:10 in the 20th of January, 2005. The order is scheduled at
16:50 in the 20th of January, 2005 with the placer order number of 2005012000300. The Patient
blood type is O. The patient has severe impairment in vision.
ORC|NW|2005012000300|||SC||||20050120101000|112234^高橋^和志^^^^^^^L^^^^^I||
112234^高橋^和志^^^^^^^L^^^^^I|08^^^^^C||||08^循環器科^MML028||||||||||||I<cr>
TQ1|||||||200501201650||R<cr>__________________________________________________________________________
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OBR||2005012000300||3000000000000000^Ｘ線血管撮影^JJ1017||||||||||||
112234^高橋^和志^^^^^^^L^^^^^I||||||||||||||WALK<cr>1405

ORC|PA|2005012000300|||SC||||20050120101000|112234^高橋^和志^^^^^^^L^^^^^I||
112234^高橋^和志^^^^^^^L^^^^^I|08^^^^^C||||08^循環器科^MML028||||||||||||I<cr>
TQ1|||||||200501201650||R<cr>
OBR|1|2005012000300||3000000000000000^Ｘ線血管撮影^JJ1017||||||||||||
112234^高橋^和志^^^^^^^L^^^^^I||||||||||||||WALK<cr>
OBX|1|CWE|01-03^血液型-ABO式^JHSR001|1|A^A^JHSR002||||||F<cr>1410

OBX|2|CWE|04-05^意識障害^JHSR001||SV^重度^JHSR002||||||F<cr>
ORC|CH|2005012000301|||SC|||2005012000300|20050120101000|
112234^高橋^和志^^^^^^^L^^^^^I||112234^高橋^和志^^^^^^^L^^^^^I|08^^^^^C||||08^循環器科^MML028||||||||||||I<cr>
TQ1|||||||200501201650||R<cr>1415

OBR||2005012000301||
30031004740200000000010000000000^Ｘ線血管撮影.血管塞栓術冠動脈仰臥位^JJ1017||||||||||||112234^高橋^和^^^^^^^L^^^^^I|||||||||||||2005012000300|WALK<cr>

10.5.6 Case: Patient Information
10.5.6.1 Patient Update (HIS to RIS)
1420

HIS_ALPHA sends message number 720001 to RIS_BETA acknowledging the change in thepatient demographics at 10:30:20 in the 25th of October.
MSH|^~\&|HIS_ALPHA||RIS_BETA||20081025103020||ADT^A08^ADT_A01|820001|P|2.5|||||J
PN|ASCII~ISO IR87||ISO 2022-1994<cr>1425

The Patient is Kagoshima Taro (鹿児島太郎), male, born 14th of February, 1959. The Patient ID
is not changed and is 4012345678. The patient's address, preceded by postal code, is 105-0004
Shinbashi 2-2-5, Minato-ku, Tokyo-to; and the patient's phone number is 03-3506-8010.
EVN||20081025103020<cr>
PID|||4012345678^^^^PI||鹿児島^太郎^^^^^L^I~カゴシマ^タロウ^^^^^L^P||19590214|M|||^^^^105-0004^^H^^東京都港区新橋２－５－５||^PRN^PH^^^^^^^^^03-3506-8010<cr>

1430

The patient is seen by Dr. Shibuya Takashi (渋谷隆) at the outpatient clinic of Internal Medicine(内科).
PV1||O|||||11225533^渋谷^隆^^^^^^^L^^^^^I|||01<cr>

The blood type (血液型) of the patient is A. The patient's body height (身長) and weight (体重)are 168 cm and 55 kg. The patient has severe (重度) impairment in vision (視覚障害).
1435

OBX|1|CWE|01-03^血液型-ABO 式^JHSR001|1|A^A^JHSR002||||||F<cr>
OBX|2|NM|01-01^身長^JHSR001||168|cm|||||F<cr>__________________________________________________________________________
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OBX|3|NM|01-02^体重^JHSR001||55|kg|||||F<cr>
OBX|4|CWE|04-03^視覚障害^JHSR001||SV^重度^JHSR002||||||F<cr>1440

The patient has a severe adverse reaction to contrast media (造影剤副作用) and has moderateasthma (気管支喘息).
AL1|1|DA^薬物アレルギー^HL70127|02-01^造影剤副作用^JHSR001|SV^Severe^HL70128
AL1|2|EA^環境アレルギー^HL70127|02-02^気管支喘息^JHSR001|MO^Moderate^HL70128__________________________________________________________________________
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