Integrating the Healthcare Enterprise Departmental Appointment Notification Option Eric Poiseau Laboratoire IDM Faculté de Médecine Université de Rennes 1

February 9th 2005IHE-EU Conference Workshop Scheduled Workflow Profile Registration Orders Placed Orders Filled Film Folder Image Manager & Archive Film Lightbox report Report Repository Diagnostic Workstation Modality acquisition in-progress acquisition completed images printed Acquisition Modality

February 9th 2005IHE-EU Conference Workshop NEW SWF Options Departmental Appointment Notification Departmental Appointment Notification –Gives the Department System Scheduler an option to notify Order Placer of date and time of scheduled examinations.

February 9th 2005IHE-EU Conference Workshop Value Proposition Provides a mechanism for the Order Placer to keep track of appointments scheduled for a patient within Radiology Department Provides a mechanism for the Order Placer to keep track of appointments scheduled for a patient within Radiology Department Includes notifications of scheduling, re- scheduling and cancellation events Includes notifications of scheduling, re- scheduling and cancellation events Helps synchronization of scheduling processes between enterprise and radiology Helps synchronization of scheduling processes between enterprise and radiology

February 9th 2005IHE-EU Conference Workshop Background Existing Placer Order Management Transaction allows Order Placer specify preferred date and time of an order fulfillment (i.e., radiological examination) Existing Placer Order Management Transaction allows Order Placer specify preferred date and time of an order fulfillment (i.e., radiological examination) Order Filler is ultimately responsible for scheduling of examination as a succession of Procedure Steps that may require one or more appointments to be created Order Filler is ultimately responsible for scheduling of examination as a succession of Procedure Steps that may require one or more appointments to be created Currently, Order Placer has no way to know when or where exactly the appointment will take place. Currently, Order Placer has no way to know when or where exactly the appointment will take place.

February 9th 2005IHE-EU Conference Workshop Departmental Appointment Booking Use Case

February 9th 2005IHE-EU Conference Workshop Appointment Notification Transaction Department System Scheduler/Order Filler generates Appointment Notification messages and sends them to the corresponding Order Placer actor. Order Placer receives Appointment Notification messages and internally processes them.

February 9th 2005IHE-EU Conference Workshop Interaction Diagram

February 9th 2005IHE-EU Conference Workshop Appointment Notification Transaction Three typical use cases Three typical use cases –New booking: initial scheduling of an examination –Re-schedule: change in date/time of examination –Cancellation: examination cancellation Mechanism Mechanism –HL7 SIU messages –One message may convey multiple appointments corresponding to a single order –One appointment corresponds to one or more Scheduled Procedure Steps

February 9th 2005IHE-EU Conference Workshop SIU Message Structure SIU^S12, SIU^S13, SIU^S15 Schedule Information Unsolicited Chapter in HL7 V2.4/2.5 MSHSCH { RGS { AIS { AIS [ { NTE } ] [ { NTE } ] }} Message Header Schedule Activity Information Resource Group Segment Appt Information – Service Notes and Comments

February 9th 2005IHE-EU Conference Workshop SCH Segment SEQLENDTOPTRP/#TBL#ITEM# ELEMENT NAME 175EIO00860 Placer Appointment ID 275EIR00861 Filler Appointment ID 422EIC00218 Placer Group Number 6250CER00883 Event Reason (^APT) 11200TQRY00884 Appointment Timing Quantity (1) 16250XCNRY00885 Filler Contact Person 20250XCNOY00878 Entered by Person 2622EIRY00216 Placer Order Number 2722EIRY00217 Filler Order Number Specifies identification information of particular set of appointments for given Order

February 9th 2005IHE-EU Conference Workshop SCH Segment Specifies common information for one or more appointments associated with single order Specifies common information for one or more appointments associated with single order –Placer Appointment ID is not used –Filler Appointment ID is required Appointment timing is defined on the Resource Group level, per Scheduled Procedure Step Appointment timing is defined on the Resource Group level, per Scheduled Procedure Step –SCH-6 has fixed value of 1 –One message can have multiple resource groups, thus multiple appointments (procedure steps) No patient identification information is required, thus Order Numbers are required No patient identification information is required, thus Order Numbers are required

February 9th 2005IHE-EU Conference Workshop SIU Message Structure SIU^S12, SIU^S13, SIU^S15 Schedule Information Unsolicited Chapter in HL7 V2.4/2.5 MSHSCH { RGS { AIS { AIS [ { NTE } ] [ { NTE } ] }} Message Header Schedule Activity Information Resource Group Segment Appt Information – Service Notes and Comments

February 9th 2005IHE-EU Conference Workshop RGS Segment Marks beginning of a resource group for a particular appointment. May contain only RGS-1. SEQLENDTOPTRP/#TBL#ITEM# ELEMENT NAME 14SIR01203 Set ID – RGS 23IDC Segment Action Code 3250CEO01204 Resource Group ID

February 9th 2005IHE-EU Conference Workshop SIU Message Structure SIU^S12, SIU^S13, SIU^S15 Schedule Information Unsolicited Chapter in HL7 V2.4/2.5 MSHSCH { RGS { AIS { AIS [ { NTE } ] [ { NTE } ] }} Message Header Schedule Activity Information Resource Group Segment Appt Information – Service Notes and Comments

February 9th 2005IHE-EU Conference Workshop AIS Segment Specifies date/time and service type for an appointment (set of Scheduled Procedure Steps) SEQLENDTOPTRP/#TBL#ITEM# ELEMENT NAME 14SIR00890 Set ID – AIS 23IDR Segment Action Code (A : Add/Insert) 3250CER00238 Universal Service Identifier 426TSR01202 Start Date/Time 520NMO00891 Start Date/Time Offset 6250CEO00892 Start Date/Time Offset Units 720NMO00893Duration 8250CEO00894 Duration Units 910ISC Allow Substitution Code 10250CEC Filler Status Code 11250CEOY Placer Supplemental Service Information 12250CEOY Filler Supplemental Service Information

February 9th 2005IHE-EU Conference Workshop AIS Segment Specifies Procedure Code and Description to for the Scheduled Procedure Step(s) included into this appointment Specifies Procedure Code and Description to for the Scheduled Procedure Step(s) included into this appointment –Procedure Code in components 1-3 –Not all steps of the procedure may be included –Those included are identified by a the text in component 5 Date/Time of an appointment is expected to be in UTC Date/Time of an appointment is expected to be in UTC –If local, UTC offset is required No specification of location or resources (one should use AIG, AIL, AIP segments within the same group, as appropriate) No specification of location or resources (one should use AIG, AIL, AIP segments within the same group, as appropriate)

February 9th 2005IHE-EU Conference Workshop SIU Message Structure SIU^S12, SIU^S13, SIU^S15 Schedule Information Unsolicited Chapter in HL7 V2.4/2.5 MSHSCH { RGS { AIS { AIS [ { NTE } ] [ { NTE } ] }} Message Header Schedule Activity Information Resource Group Segment Appt Information – Service Notes and Comments

February 9th 2005IHE-EU Conference Workshop NTE Segment Allows Order Filler to pass additional information, such as patient instructions, to Order Placer SEQLENDTOPTRP/#TBL#ITEM# ELEMENT NAME 14SIR00096 Set ID – NTE 28IDR00097 Source of Comment (L, O) FTR00098Comment 4250CER01318 Comment Type (PI : Patient Instruction, RE: Remark)

February 9th 2005IHE-EU Conference Workshop What is not in the option Departmental Appointment Notification Option does not allow Order Placer to request re-scheduling – it only can do it by cancel and re-order Departmental Appointment Notification Option does not allow Order Placer to request re-scheduling – it only can do it by cancel and re-order Transaction does not require AIL segment – thus notifications on re-scheduling of the service from one location to another may not be sent Transaction does not require AIL segment – thus notifications on re-scheduling of the service from one location to another may not be sent This option does not address needs of enterprise-wide scheduling This option does not address needs of enterprise-wide scheduling

February 9th 2005IHE-EU Conference Workshop References Profile Option - Volume 1, Section Profile Option - Volume 1, Section Transactions - Volume 3, Section 4.48 Transactions - Volume 3, Section 4.48

February 9th 2005IHE-EU Conference Workshop Questions, Comments, and/or Suggestions?