Ralph Stamerjohn

1
A Review of HL7 and Normal Workflow Processes

• Ralph Stamerjohn
• Mitra
• IHE Technical Committee

2
HL7 Actors in IHE Year 3

• HL7 Actors
• ltMPIgt
• ADT/Patient Registration
• Order Placer
• DSS / Order Filler
• Image Manager

3
ADT Actor

4
ADT Actor

• 6.1 - Patient Registration transaction
• Send
• Admit A01 (In Patient), A04 (Out Patient), A05
  (Pre-Admission)
• Cancel A11 (Cancel Admit), A38 (Cancel Preadmit)

5
ADT Actor (cont.)

• 6.12 - ADT Patient Update transaction
• Send
• Transfer A02 (Patient Transfer)
• Update Patient Class A03 (Discharge),
  A06(Outpatient becomes Inpatient), A07 (Inpatient
  becomes Outpatient)
• Update Patient Information A08 (Update)
• Merge Patients A40 (Merge)
• Cancel A12 (Cancel Transfer), A13 (Cancel
  Discharge)

6
Order Placer Actor

7
Order Placer Actor

• 6.2 - Placer Order Management transaction
• Send
• New Order ORM/NW (New Order)
• Cancel ORM/CA (Cancel Order), ORM/DC
  (Discontinue)

8
Order Placer Actor (cont.)

• 6.1 - Patient Registration transaction
• Receive
• A01 (In Patient), A04 (Out Patient), A05
  (Pre-Admission), A11 (Cancel Admit), A38 (Cancel
  Preadmit)
• 6.12 - Patient Update transaction
• Receive
• A02 (Patient Transfer), A03 (Discharge),
  A06(Outpatient becomes Inpatient), A07 (Inpatient
  becomes Outpatient), A08 (Update), A12 (Cancel
  Transfer), A13 (Cancel Discharge), A40 (Merge)
• 6.3 - Filler Order Management transaction
• Receive
• ORM/SN (New Order), ORM/SC (Status Update),
  ORM/OC (Cancel Order)

9
DSS / Order Filler Actor

10
Department System Scheduler/Order Filler Actor

• 6.3 - Placer Filler Management transaction
• Send
• New Order ORM/SN (New Order)
• Order Status ORM/SC (Status Change)
• Cancel ORM/OC (Cancel Order)
• 6.4 - Procedure Scheduled transaction
• Send
• ORM (procedure scheduled)
• 6.13 - Procedure Updated transaction
• Send
• ORM (procedure updated)

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DSS/Order Filler Actor (Cont.)

• 6.1 - Patient Registration transaction
• Receive
• A01 (In Patient), A04 (Out Patient), A05
  (Pre-Admission), A11 (Cancel Admit), A38 (Cancel
  Preadmit)
• 6.12 - Patient Update transaction
• Receive
• A02 (Patient Transfer), A03 (Discharge),
  A06(Outpatient becomes Inpatient), A07 (Inpatient
  becomes Outpatient), A08 (Update), A12 (Cancel
  Transfer), A13 (Cancel Discharge), A40 (Merge)
• 6.2 - Placer Order Management transaction
• Receive
• ORM/NW (New Order), ORM/CA (Cancel Order), ORM/DC
  (Discontinue)

12
Next Step

• Explore first the normal message flow
• Explore the exception handling message flow
• All diagrams are in IHE Technical Framework Year
  3

13
Administrative Normal Process Flow
14
Procedure PerformanceNormal Process Flow
15
Patient UpdateBefore Order Entry
16
Patient UpdateAfter Order Entry
17
Patient UpdateAfter Procedure Scheduling
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Order ReplacementBy the Order Placer
19
Order ReplacementBy the DSS/Order Filler