Application Acknowledgement Type 16 ID 2 O [0..1] Fixed to ‘NE’ if used Country Code 17 ID 3 O [0..1] Character Set 18 ID 16 O [0..1] Principal Language Of Message 19 CE 841 O [0..1] Alternate Character Set Handling Scheme 20 ID 20 O [0..1] )
NK1 - / The NK1 segment contains information about the patient’s other related parties. Any associated parties may be identified. Utilizing NK1-1 - set ID, multiple NK1 segments can be sent. Table 5.2.3: Next of Kin / Associated Parties Segment (NK1) Field Name Seq DT Len Usage Cardinality Value Set Description/Comments Set ID – NK1 1 SI 4 R [1..1] This field contains the number that identifies this transaction. The sequence number shall start with ‘1’. Name 2 X Relationship 3 CE 841 RE [0..1] Description of the relationship between the next of kin/related party and the patient. It is of particular importance when documenting the parent or guardian of a child patient or the owner of an animal patient. Address 4 XAD 274 RE [0..1] Phone Number 5 X Business Phone Number 6 X Contact Role 7 CE 841 O [0..1] Start Date 8 DT 8 O [0..1] End Date 9 DT 8 O [0..1] NOK/Assoc Parties Job Title 10 ST O [0..1] NOK/Assoc Parties Job Code/Class 11 JCC 250 O [0..1] NOK/Assoc Parties Employee Number 12 CX 2646 O [0..1] Organization Name - NK1 13 XON 563 O [0..1] 63
Description structure attributes were constrained out/not supported. OBX segment to allow comments associated with Laboratory Observations to be in the message. 7 Segment Profile Attributes Throughout The message was very constrained to set many fields to “not supported.” In theory, this will kick out a lot of messages if the receiver profile is not relaxed. Many fields in used segments have been set to “optional” with the comment that if the field is optional, it is not defined in this document and not expected to be processed by the receiver. Fields that remained constrained as “not supported” are those that are no longer used for this HL7 version or ones that potentially contain PII data that should not be sent for this use case. 8 Message Structure ORU^R01 Message Syntax ORU^R01^ORU_R01 Message definition was a very simplified structure that only showed the required fields and segment groups. ORU^R01^ORU_R01 Message Syntax has been updated to align with the ELR version of the message syntax. 9 1.4 Summary of Changes Formerly described the use of the 6 categories of data. Reworked to clarify and correct the HL7 content change descriptions 10 6 Appendix A Technical Considerations Only contained a discussion about repeating groups Added a section to discuss repeating variables (that is, the use of the tilde in the field for a multi-select answer). 11 7 Appendix Messaging Examples Messages were conformant to specifications. Revised the messages 12 5.2 Segment and Field All CE fields Maximum length CE fields were not consistence. Maximum length increased to 841. This increase affected other datatypes that contain a CE datatype as a component, such as VID and XPN. 13 5.2 Segment and Field All CWE fields Maximum length CE fields were not consistence. Maximum length increased to 1063. This increase affected other datatypes that contain a CWE datatype as a component, such as XCN. 14 5.2.4 OBR Segment Detail OBR-22 Status Chg/Update Date/time The cardinality of OBR-22 was [1..1]. Technical correction to the cardinality of OBR-22 from [1..1] to [0..1]. This is not an HL7 required field so it is only required per Condition Predicate: If OBR-4 is populated with Information^LN’
APPENDIX E – REVISION LIST Location Field Name Justifications / Comments Version 3.0 1 Pages 1-4 Release 3.0 Publication History Copyright text Version 3.0 Release 1 October 18, 2016 Updated with correct LOINC information 2 Throughout A number of conformance statements have been added and detailed in the appendix to clarify any ambiguities in the use of the message fields. APPENDIX C – CONFORMANCE STATEMENTS has been added. 3 Actors, Goals and Messaging Transactions The Case Notification Use Case was not included in the document, it was previously described in a separate document posted on the PHIN web site. The Use Case for National Notifiable Condition Reporting has been incorporated into the document. 4 HL7 Batch Protocol HL7 Batch Protocol was previously described in a separate document posted on the PHIN web site. HL7 Batch Protocol has been incorporated into this document under the Messaging Infrastructure section. 5 Reviewers Comments Throughout Incorporated feedback and comments. Incorporated many suggestions for edits and improvements to wording, typo corrections, etc. 6 Table 2.1. Information Interchange Requirements State case investigation identifier Throughout Message needs to be structurally correct as well as have a minimum set of required observations answered to be accepted and processed. Added requirement for the state case investigation identifier. Case Report to Case Notification National Notifiable Case Notification containing data elements related to a nationally notifiable disease. Required patient data for all National Notifiable Case Notification: Sending system’s Internal case investigation identifier Case Class Status MMWR Week MMWR Year
14 5.2.6 SPM – Specimen Segment SPM-1 / Set ID – SPM The SPM segment usage and cardinality is incorrect with optional if sent with a related OBR, the SPM should indicate that it is required if sent. Changed usage to R, updated cardinality to [1..1]. 15 5.2.4 OBR – Observation Request Segment OBR-16 / Ordering Provider Previously not supported Updated to be supported, changed usage from X to RE and removed the highlighting for OBR-16 in the OBR table to indicate it is available for use. 16 Contact Information Contact information added for assistance with the artifact. Added with the following text: This artifact is considered to be a technical document. Please contact edx@cdc.gov for assistance with this artifact. 17 Section 1.2 Removal of unused acronyms and addition of used acronyms. Removed CSTE, IIS, NETSS, PHLIP, STD, STLT. Added ELR, MMG, OID. 18 Table 2.1 Corrected the required patient data list for “Reporting State OR National Reporting Jurisdiction,” replaced “OR” with “AND”. Reporting State AND National Reporting Jurisdiction 19 Tables 2.1, 2.2, 3.1 / Sections 3.10, 3.11, 4 Updated table numbering and section numbering due to table changes or for newly added tables and sections. Some tables used the ‘-’ notation and used the ‘.’ Notation. Example Table 2-1 or Table 2.1, replaced with the ‘.’ Notation. Table 2.1, Table 2.2, Table 3.1 Updated Usage Conformance Testing Recommendations section to 3.10. Various tables under 3.11 HL7 Batch Protocol. Various tables under section 4 Data Types. 20 Section Added sections for information on the use of standard codes, literal values, unknown values and MMG constraints. Sections 3.6 – 3.9 21 Section 4.3 & 4.11 Addition of CQ and FT data types, mentioned or used but not listed in the data type list. CQ (Composite Quantity with Units) FT (Formatted Text Data)
format requirement replacing the condition predicate. 34 Table 5.2.1 MSH-10 Additional wording was added to clarify the use of the Message Control ID to uniquely identify the message and updates to indicate appending a timestamp is an example to ensure uniqueness but not required. This field contains a string that uniquely identifies the message instance from the sending application. The unique record identifier for the notification as created by the sending surveillance system is a good candidate for this string. If the local record identifier is not unique (if the record is updated), as an example a timestamp can be appended to ensure a unique identifier. 35 Various Places Removal of the reference to “From Reference to a specific ELR guide may be misleading to requirements to how to provide the laboratory information. Various. 36 Table 5.2.1 MSH-21 Removal of the specific literals for indicating the profile and MMG to be used for a given message. The conformance statement was removed and added to each MMG instead of in this messaging specification, because each conformance is unique to each MMG. Conformance statement replaced with: “The conformance statements for NOT115 SHALL be obtained from the program specific MMG.” 37 Table 5.2.4 OBR-4 Updated the conformance statement to clearly state “one and only one” occurrence of the Information^LN‘ will be allowed, instead of “an occurrence”. CONFORMANCE STATEMENT There SHALL be one and only one occurrence of OBR-4 (Universal Identifier) valued Information^LN‘in all types of Case Notification Messages. 38 Table 5.2.4 OBR-4 Removal of the Treatment Information conformance statement because it is currently not used, replaced the reference to any other specific section header for OBR-4 to a more generic CONFORMANCE STATEMENT There MAY be zero to many additional and optional instances of Notification Sections from the value set () as indicated by an MMG where the OBR-4 Universal Service ID C
conformance statement to capture anything not listed in this messaging specification. This allows the MMG(s) to specify other headers sections without requiring additional changes to the messaging specification. SHOULD contain the literal value as specified in the MMG. 39 Table 5.2.4 OBR-4 Clarification for the Information^LN” conformance statement, corrected the wording of “one or more additional” to “zero to many” and added specific instructions for values not listed in value set and added a link to the value set. CONFORMANCE STATEMENT There SHALL be zero to many optional instances of associated laboratory report data sources that may be useful for CDC programs, the OBR-4 Universal Service ID SHOULD contain an value from the source laboratory report whose OBR-4 value is ’30954-2^Laboratory Information^LN’ or another value not in the value set () to identify the laboratory information. 40 Table 5.2.4 OBR-4 Added information regarding reference to condition specific MMG(s) for the use of other values used in OBR-4. For any other value used in OBR-4 refer to the condition specific MMG. 41 Various Updated wording “to allow ELR-like” to state “similar to ELR” to help with references to laboratory data elements. “similar to ELR” added where references are made for supporting the Laboratory Information Header. “Optionally supported to allow mapping similar to ELR.” 42 Various Added wording for intended data elements supported under the Laboratory Information Header. Supported to allow for the sending of optional laboratory data elements of interest under the Laboratory Information Header. 43 Table 5.2.4 OBR-25 Updated conformance statement for OBR-25 to include key words, added “SHALL be” to indicate the requirement for the listed OBR-25 values, added additional wording changes to clarify the usage of ‘X’. CONFORMANCE STATEMENT OBR-25 Result Status SHALL be limited to the following values when OBR-4 is valued Information^LN’: ‘F’ for Final, when the notification is first sent. ‘C’ for Correction, when an update/revision is sent. ‘X’ to indicate that the previously received notification has been deleted or rescinded. To update information on a previously