Automated ADT Interface Version .02 As of December 7, 2016 by Lee J. Hirz (and the VA Interface Development Team)

Overview Process enables ADT HL7 messaging Infrastructure for ADT Messaging is implemented by setting up an HL7 Application, an HL Logical link and protocols. Protocols are subscribed to Event Protocols that have been nationally released in the VA as part of standard patches. HL7 messages will be received by an External server which will create and/or update patient records in its database. Interface is uni-directional. Results are not automatically returned. A separate, ancillary set up can be done to facilitate reception of results.

Summary of Steps Preparation: In order HL7 messages to be sent from the VistA TaskMan node to the external server Set up ACL. Test the ACL with an HL7 Logical from VistA TaskMan node. On Implementation Day Run option ATYMUSE-PRECHECK (HL7 ADT IMPLEMENTATION PRECHECK) Run option ATYMUSE-INSTALL HL7 ADT INSTALL Add IP Address and Port to HL Logical Link Enable Link to start sending.

Important set up information ACL – needs to be set up and confirmed – important information is correct IP addresses and ports of both the external system service and the VistA TaskMan node. External server – needs to be able to receive VistA-style HL7 messages and transmit them to the carts properly. Sometimes the technical support will need to do some work.

How it Works in VistA HL7 Messages are generated for ADT transactions Because the ADT Clients are subscribers to the ADT protocols the messages generated for them go into the HL7 transmission queue The HL7 queue is transmitted to the external server(by establishing a TCP/IP channel to it’s IP address/port. As each message is transmitted (and acknowledged), the number of items transmitted is increased until it matches the number of items to transmit.

How it works on the External System A service on the server “sits” on a port waiting for a TCP/IP connection request. The VistA HL7 module requests a channel to that port. The port “wakes up” the HL7 receiver (service) and accepts the transmission and acknowledges it. The accepted/acknowledged messages are: processed into the server application database and patient information is transmitted to the appropriate carts. After the patient information is received users can look them up.

VistA HL7 APPLICATION PARAMETER NAME: XXXXX-ADT ACTIVE/INACTIVE: ACTIVE FACILITY NAME: 688 MAIL GROUP: XXXX4 INTERFACE GROUP COUNTRY CODE: USA HL7 FIELD SEPARATOR: |

HL LOGICAL LINK FileMan Inquire NODE: XXXX4 LLP TYPE: TCP DEVICE TYPE: Non-Persistent Client STATE: Retention TIME STARTED: DEC 28, 2015@08:39:32 TASK NUMBER: 5348152 SHUTDOWN LLP ?: NO QUEUE SIZE: 10 RE-TRANSMISSION ATTEMPTS: 5 READ TIMEOUT: 60 ACK TIMEOUT: 300 EXCEED RE-TRANSMIT ACTION: restart TCP/IP ADDRESS: 10.26.69.202 TCP/IP PORT: 6020 TCP/IP SERVICE TYPE: CLIENT (SENDER) PERSISTENT: NO IN QUEUE BACK POINTER: 15386 IN QUEUE FRONT POINTER: 15386 OUT QUEUE BACK POINTER: 15608 OUT QUEUE FRONT POINTER: 15608

Example Transmission Protocol (File 101) NAME: XXXX4-ADT-A01-CLIENT ITEM TEXT: XXXX4-ADT-A01-Client TYPE: subscriber CREATOR: HIRZ,LEE J DESCRIPTION: Sends ADT data TIMESTAMP: 63929,39364 RECEIVING APPLICATION: XXXX4-ADT TRANSACTION MESSAGE TYPE: ADT EVENT TYPE: A01 MESSAGE STRUCTURE: ADT_A01 LOGICAL LINK: XXXX4-ADT

Example Event Protocol (File 101) NAME: VAFH A01 TYPE: event driver CREATOR: USER,VISTA PACKAGE: REGISTRATION ITEM: VAFH CLIENT A01 TIMESTAMP: 57366,56491 SENDING APPLICATION: VAFH PIMS TRANSACTION MESSAGE TYPE: ADT EVENT TYPE: A01 MESSAGE STRUCTURE: i PROCESSING ID: P LOGICAL LINK: VAFH ADT APPLICATION ACK TYPE: AL VERSION ID: 2.2 RESPONSE MESSAGE TYPE: ADT PROCESSING ROUTINE: Q RESPONSE PROCESSING ROUTINE: Q SUBSCRIBERS: VAFH CLIENT A01

Prerequisites VistA patches released many Event Protocols that are necessary as well as routines… The entry point CHEKPTCH tests the destination VistA system to make sure the prerequisites are there

CHEKPTCH - #1 12:30 PM Confirming precursors that are necessary to implement the interface exist. For problems the report will say 'Not found.####' or a longer error message. Checking for Patches Patch HL*1.6*93 is installed. Patch DG*5.3*91 is installed. Checking for Protocols 1. Protocol:DGPM MOVEMENT EVENTS: (IEN=1532) exists. 2. Protocol:SDAM APPOINTMENT EVENTS: (IEN=2087) exists. 3. Protocol:VAFC ADT-A01 SERVER: (IEN=5322) exists. 4. Protocol:VAFC ADT-A02 SERVER: (IEN=5323) exists. 5. Protocol:VAFC ADT-A03 SERVER: (IEN=5324) exists. 6. Protocol:VAFC ADT-A04 SERVER: (IEN=5298) exists. 7. Protocol:VAFC ADT-A08 SERVER: (IEN=5299) exists. 8. Protocol:VAFC ADT-A08-SCHED SERVER: (IEN=5344) exists. 9. Protocol:VAFC ADT-A08-SDAM SERVER: (IEN=5342) exists.

CHEKPTCH (Continued) 10. Protocol:VAFC ADT-A11 SERVER: (IEN=5325) exists. 11. Protocol:VAFC ADT-A12 SERVER: (IEN=5326) exists. 12. Protocol:VAFC ADT-A13 SERVER: (IEN=5327) exists. 13. Protocol:VAFC HL7 INPATIENT CAPTURE: (IEN=5338) exists. 14. Protocol:VAFC HL7 OUTPATIENT CAPTURE: (IEN=5339) exists. 15. Protocol:VAFH A01: (IEN=5302) exists. 16. Protocol:VAFH A02: (IEN=5304) exists. 17. Protocol:VAFH A03: (IEN=5308) exists. 18. Protocol:VAFH A04: (IEN=5309) exists. 19. Protocol:VAFH A08: (IEN=5310) exists. 20. Protocol:VAFH A11: (IEN=5305) exists. 21. Protocol:VAFH A12: (IEN=5306) exists. 22. Protocol:VAFH A13: (IEN=5307) exists. 23. Protocol:VAFH A19: (IEN=5321) exists. 24. Protocol:VAFH A34: (IEN=5311) exists. 25. Protocol:VAFH HL7 INPATIENT CAPTURE: (IEN=5300) exists. 26. Protocol:VAFH HL7 OUTPATIENT CAPTURE: (IEN=5301) exists. This site currently allows HL7 2.3 messages to be sent. <<< END of Check >>>

Install The install sets up all the necessary new records in the following files. HL7 APPLICATION PARAMETERS HL LOGICAL LINK PROTOCOL And connects it all together with the already installed HL7 infrastructure.

Install Initial Prompts #1 D INSTALL^ATYMUSE 12:36 PM This is the beginning of the implementation. New records will be created. In order to conform to site conventions please specify the string that will be used to prefix all new records. Using the default, 'BOS-DEVX', will mean all will begin with 'BOS-DEVX'. For the Logical Link the default would be 'BOS-DEVX-ADT'. Enter a prefix for all the objects to be created: DEVX// XXXX4 XXXX4 will prefix all new entities. For instance, the HL Logical Link will be named XXXX4-ADT.

Install Initial Prompts #2 Please review the below list of names (to be used for this implementation). This site currently allows HL7 2.3 messages to be sent. XXXX4-ADT-A01-Client - will be set up. XXXX4-ADT-A02-Client - will be set up. XXXX4-ADT-A03-Client - will be set up. XXXX4-ADT-A04-Client - will be set up. XXXX4-ADT-A08-Client - will be set up. XXXX4-ADT-A11-Client - will be set up. XXXX4-ADT-A12-Client - will be set up. XXXX4-ADT-A13-Client - will be set up. OK to continue? NO// YES

Install (Continued) Add ITEM: HL7 PROTOCOL 'VAFH HL7 INPATIENT CAPTURE ' to EVENT DRIVER 'DGPM MOVEMENT EVENTS': EXISTS. HL7 PROTOCOL 'VAFC HL7 INPATIENT CAPTURE HL7 PROTOCOL 'VAFH HL7 OUTPATIENT CAPTURE ' to EVENT DRIVER 'SDAM APPOINTMENT EVENTS': EXISTS. HL7 PROTOCOL 'VAFC HL7 OUTPATIENT CAPTURE Adding Mail Group XXXX4-ADT - DONE. <<< ADDING HL7 Application Parameter XXXX4-ADT: -- Success !!?? XXXX4-ADT updated in file 771 (HL7 Application Parameter). <<< ADDING HL LOGICAL LINK XXXX4-ADT into file #870: - Done. >>>

Install (Continued 2) Adding Protocols to the PROTOCOL file (101): Protocol XXXX4-ADT-A01-Client: CREATED and updated. Protocol XXXX4-ADT-A02-Client: CREATED and updated. Protocol XXXX4-ADT-A03-Client: CREATED and updated. Protocol XXXX4-ADT-A04-Client: CREATED and updated. Protocol XXXX4-ADT-A08-Client: CREATED and updated. Protocol XXXX4-ADT-A11-Client: CREATED and updated. Protocol XXXX4-ADT-A12-Client: CREATED and updated. Protocol XXXX4-ADT-A13-Client: CREATED and updated. Registering created protocols with HL7 Version 2.3 EVENT protocols. VAFC EVENT DRIVERS are for HL7 version 2.3. VAFH EVENT DRIVERS are for HL7 version 2.2.

Install (Continued 3) XXXX4-ADT-A01-Client For XXXX4-ADT-A01-Client (VAFC ADT-A01 SERVER/VAFH A01) Add SUBSCRIBER HL7 PROTOCOL 'XXXX4-ADT-A01-Client ' to EVENT DRIVER 'VAFC ADT-A01 SERVER' - OK. XXXX4-ADT-A01-Client (V2.3) NOT registered to VAFH A01 (V2.2). . 12:38 PM << Processing Complete; review output; follow instructions. >>

Install (Continued 4) Edit HL7 APPLICATION PARAMETER FILE Please review the HL7 Application Parameters and make changes if they are not correct. Enter XXXX4-ADT for the name. HL7 APPLICATION EDIT -------------------------------------------------------------------------------- NAME: XXXX4-ADT ACTIVE/INACTIVE: ACTIVE FACILITY NAME: TEST.WASHINGTON.MED. COUNTRY CODE: USA HL7 FIELD SEPARATOR: HL7 ENCODING CHARACTERS: MAIL GROUP: _______________________________________________________________________________ Exit Save Refresh Quit Enter a COMMAND, or "^" followed by the CAPTION of a FIELD to jump to. COMMAND: E Press <P

Install (Continued 5) <<< Please EDIT HL LOGICAL LINK XXXX4-ADT. >>> <<< The IP address and port of the receiving >>> <<< system needs to be added. >>> <<< (OPTION: Link Edit - HL EDIT LOGICAL LINKS >>>

THE END QUESTIONS?