ADT Message Details

adt message requirements the below minimum data points are needed for an adt message to be actionable event type home community id of the sending location assigning authority receiving application patient administrative sex patient date of birth patient id patient first name patient last name patient city patient street address 1 patient state patient zip code by filling out as many fields as possible it will help downstream users to perform the correct actions to improve the patient care plan many systems use a full set of patient demographics, including phone numbers and email addresses to match a patient within their system message segment usage the below message segment tables use the following codes to designate if a segment is required or not refer to adt message segments docid\ kpea89r6jg1chdafi5rs8 for the required and optional elements within each of these segments required description y yes – the segment is required n no – the segment is not required c conditional the segment must be used if conditions are met some fields may not have specific conditions data should be sent if available adt message segments the following segments are used to process an adt^a01, adt^a04, adt^a08, adt^a28, adt^a31, and adt^a37 messages segment required description msh y message header evn n event type pid y current patient identification pd1 n additional patient demographics used for local opt out pv2 c contains the reason for visit this is recommended for an rle notifications adt the following segments are used to process an adt^a03 message segment required description msh y message header evn n event type pid y current patient identification pd1 n additional patient demographics used for local opt out pv2 n contains the reason for visit dg1 y contains patient diagnosis information the following segments are used to process an adt^a40 message segment required description msh y message header pid y current patient identification pd1 n additional patient demographics used for local opt out mrg y previous patient identification the following segments are used to process a general acknowledgment (ack) message segment required description msh y message header msa y message acknowledgment requirement designation the best practice is to send fully populated adt messages receiving systems will accept all valid adt messages opt code description r required – the element must be included and must comply with the formatting standards listed below o optional – data should be sent if available c conditional the element must be used if conditions are met some fields may not have specific conditions data should be sent if available b backwards compatible – left in for backward compatibility with previous versions of hl7 the field definitions following the segment attribute table should denote the optionality of the field with prior versions msh message header segment the message header segment defines the intent, source, destination, and some specifics of the syntax of a message the table below outlines the surescripts usage of the msh segment seq hl7 opt surescripts opt element name description example 1 r r field separator this field contains the separator between the segment id and the first real field recommended value is | | 2 r r encoding characters this field contains four characters in the following order the component separator, repetition separator, escape character, and subcomponent separator recommended values are ^ \\& ^ \\& 3 o r sending application this field uniquely identifies the sending application among all other applications within the network enterprise the network enterprise consists of all those applications that participate in the exchange of hl7 messages within the enterprise this field is used for the sending system’s surescripts participant id assigned by surescripts p00000000000000 4 o r sending facility this field contains the home community id for the facility where the patient is being seen note home community id is required to be an oid the format must contain urn\ oid followed by the appropriate oid value urn\ oid 2 11 222 3 444444 5 6666 7 88888 5 o r receiving application this field uniquely identifies the receiving application it represents the surescripts application id populate this field based on the appropriate use case for loading the rle mpi use "s00000000000004" adt messages must contain the correct contents in msh 5 for the endpoint that is being targeted, otherwise they will be ignored without auditing reach out to your surescripts customer success resource, or reference the surescripts connectivity guide, for the endpoint information that correlates to the type of adt message(s) that will be sent to surescripts 6 o o receiving facility contains the home community id of the receiving system populate this field based on the appropriate use case for the adt sent to surescripts, this is the surescripts home community id use "2 16 840 1 113883 3 2054 2 1" for the adt sent out from surescripts, this is the receiving system’s home community id 7 r r date/time of message date/time of the patient activity format yyyymmddhhmmss stored by surescripts for audit 20090206132847 8 o o security not used by rle 9 r r message type this field contains the message type, trigger event, and the message structure id for the message for loading the rle mpi or enrolling patients to the rle notifications mpi adt^a01, adt^a04, adt^a08, adt^a28, adt^a31, adt^a37, adt^a40 adt messages must contain event types in msh 9 that are supported for the endpoint that is being targeted, otherwise they will be ignored without auditing reach out to your surescripts customer success resource, or reference the surescripts connectivity guide, for the endpoint information that correlates to the type of adt message(s) that will be sent to surescripts 10 r r message control id this field contains a number or other identifier that uniquely identifies the message a guid with or without dashes is recommended stored by surescripts for audit cfcc6a2a aa67 1d95 4914 163bb0e37a20 11 r r processing id this field is used to determine where the message was intended to be sent t must be used for surescripts staging messages p must be used for production messages p 12 r r version id this field is matched by the receiving system to its own version to be sure the message will be interpreted correctly 2 5 1 evn event type segment seq hl7 opt surescripts opt element name description example data 1 r r event type code adt event type a01 a03 a04 2 r o recorded date/time when the event occurred 3 o o date/time planned event 4 o o event reason code 5 o o operator id 6 o o event occurred 7 o o event facility location of event msa message acknowledgment segment seq hl7 opt surescripts opt element name description example data 1 r r acknowledgment code tells you if the message was accepted or if there was an error in processing aa ae 2 r r message control id message id urn\ uuid 2393540104d7bcfcca1507146146146 3 o o text message if there was an error, a description would be found here improperly formatted message 4 o o expected sequence number 5 o o delayed acknowledgment type 6 o o error condition pid patient identification segment the patient identification segment contains the patient demographic information that surescripts will use seq hl7 opt surescripts opt element name description example data 3 r r patient identifier list this field contains the list of identifiers (one or more) used by the originating healthcare facility to uniquely identify a patient this is the originating patient id pid 3 components \<id number (st)> ^ \<check digit (st)> ^ \<check digit scheme (id)> ^ \<assigning authority (hd)> ^ \<identifier type code (id)> ^ \<assigning facility (hd)> ^ \<effective date (dt)> ^\<expiration date (dt)> ^ \<assigning jurisdiction (cwe)>^\<assigning agency or department (cwe)> inbound notification 987654321^^^2 16 840 1 55555 3 5555 4 3333 2 outbound notification 1400001^^^2 16 999 7 1111 1 987654321^^^2 16 840 1 55555 3 5555 4 3333 2 note for the outbound notification there will be 2 or more patient identifiers the first will be the patient id and assigning authority at the enrolled location the second is the patient id and assigning authority at the location where the patient event has occurred if there are more patient identifiers for the sending system, they will be included here 3 1 r r patient identifier list id number this is the patient id that corresponds with the assigning authority in pid 3 4 this field contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient pid 3 components \<id number (st)> ^ \<check digit (st)> ^ \<check digit scheme (id)> ^ \<assigning authority (hd)> ^ \<identifier type code (id)> ^ \<assigning facility (hd)> ^ \<effective date (dt)> ^ \<expiration date (dt)> ^ \<assigning jurisdiction (cwe)> ^ \<assigning agency or department (cwe)> 123456789 3 4 r r patient identifier list assigning authority this field contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient this is the assigning authority pid 3 components \<id number (st)> ^ \<check digit (st)> ^ \<check digit scheme (id)> ^ \<assigning authority (hd)> ^ \<identifier type code (id)> ^ \<assigning facility (hd)> ^ \<effective date (dt)> ^ \<expiration date (dt)> ^ \<assigning jurisdiction (cwe)> ^ \<assigning agency or department (cwe)> 12345678^^^&2 11 222 3 444444 5 666^^^& 2 11 222 3 444444 5 666 77 5 r r patient name this field contains one or more of the names of the patient used for searching smith^john^r 5 1 r family name last name smith 5 2 r given first name john 5 3 c middle initial middle name highly recommended to send to aid in patient matching r 5 4 c suffix highly recommended to send to aid in patient matching 5 5 c prefix highly recommended to send to aid in patient matching 7 o r date/time of birth this field contains the patient's birth date used for searching format is yyyymmdd 19520318 8 o r administrative sex patient sex m male, f female, u unknown used for searching highly recommended to send to aid in patient matching m 11 o r patient address this field contains the mailing address of the patient this component may repeat the primary address is the first sequence and that will be used in the search used for searching highly recommended to send to aid in patient matching 406 w dandridge st^^anywhere^ar^77777 11 1 o r street address 1 highly recommended to send to aid in patient matching 406 w dandridge st 11 2 o o street address 2 apt 203 11 3 o r city highly recommended to send to aid in patient matching anywhere 11 4 o r state must be in two character format highly recommended to send to aid in patient matching ar 11 5 o r zip field length of 5 or 9 is accepted by surescripts hyphens are not permitted 77777 777771234 12 o o country code 13 o o home phone number home patient's home contact information highly recommended to send to aid in patient matching 5551112222^^^name\@domain com 13 1 o o home phone home phone number highly recommended to send to aid in patient matching 5556666777 13 4 o o email address patient’s email address highly recommended to send to aid in patient matching name\@domain com 14 o o phone number business patient's business number 5553334444 pd1 patient demographics segment surescripts will look at the pd1 segment for locally opting out a patient if the publicity indicator (pd1 11) is set to "n", then the patient information for the location that sent the adt will not be returned for a patient search if that patient was seen and enrolled at another location, patient information for that location would be returned this is not equivalent to the national opt out procedure if the segment is not present or it is, and the publicity indicator has a value of "y" or "y" then the patient information for that location will be shared seq hl7 opt surescripts opt element name description example data 1 o o living dependency 2 o o living arrangement 3 o o patient primary facility 4 o o patient primary care provider name & id no 5 o o student indicator 6 o o handicap 7 o o living will 8 o o organ donor 9 o o separate bill 10 o o duplicate patient 11 o o publicity indicator if "n" then the patient is locally opted out of document exchange with the sending location n = no consent to share 12 o o protection indicator pv1 patient visit segment contains basic inpatient or outpatient encounter information seq hl7 opt ss opt name example data 1 o o set id pv1 1 2 r c patient class i note populate, if possible highly recommended to send to aid in patient matching 3 o c assigned patient location 420^4201^01^dmh1^d^^^^^^depid note populate, if possible highly recommended to send to aid in patient matching 4 o c admission type e note populate, if possible highly recommended to send to aid in patient matching 5 o o preadmit number 6 o o prior patient location 99999^inc^central^ohio primary care 7 o c attending doctor note populate, if possible highly recommended to send to aid in patient matching 8 o o referring doctor 9 o o consulting doctor 10 o o hospital service 11 o o temporary location 12 o o preadmit test indicator 13 o o re admission indicator 14 o o admit source 15 o o ambulatory status 16 o o vip indicator 17 o o admitting doctor 18 o o patient type 19 o o visit number 20 o o financial class 21 o o charge price indicator 22 o o courtesy code 23 o o credit rating 24 o o contract code 25 o o contract effective date 26 o o contract amount 27 o o contract period 28 o o interest code 29 o o transfer to bad debt code 30 o o transfer to bad debt date 31 o o bad debt agency code 32 o o bad debt transfer amount 33 o o bad debt recovery amount 34 o o delete account indicator 35 o o delete account date 36 o o discharge disposition 37 o o discharged to location 38 o o diet type 39 o o servicing facility 40 o o bed status 41 o o account status 42 o o pending location 43 o o prior temporary location 44 o o admit date/time 45 o o discharge date/time 46 o o current patient balance 47 o o total charges 48 o o total adjustments 49 o o total payments 50 o o alternate visit id 51 o o visit indicator 52 o o other healthcare provide pv2 patient visit additional information segment when sending an adt for rle notifications the pv2 3 segment will be used to contain the reason for visit seq hl7 opt ss opt name example data 1 c o prior pending location 2 o o accommodation code 3 o c admit reason reason for visit non coded admit reason shortness of breath coded admit reason 535 61^duodenitis w/hemorrhage^i9c note populate, if possible highly recommended to send to aid in patient matching 4 o o transfer reason 5 o o patient valuables 6 o o patient valuables location 7 o o visit user code 8 o o expected admit date/time 9 o o expected discharge date/time 10 o o estimated length of inpatient stay 11 o o actual length of inpatient stay 12 o o visit description 13 o o referral source code 14 o o previous service date 15 o o employment illness related indicator 16 o o purge status code 17 o o purge status date 18 o o special program code 19 o o retention indicator 20 o o expected number of insurance plans 21 o o visit publicity code 22 o o visit protection indicator 23 o o clinic organization name 24 o o patient status code 25 o o visit priority code 26 o o previous treatment date 27 o o expected discharge disposition 28 o o signature on file date 29 o o first similar illness date 30 o o patient charge adjustment code 31 o o recurring service code 32 o o billing media code 33 o o expected surgery date and time 34 o o military partnership code 35 o o military non availability code 36 o o newborn baby indicator 37 o o baby detained indicator 38 o o mode of arrival code 39 o o recreational drug use code 40 o o admission level of care code 41 o o precaution code 42 o o patient condition code 43 o o living will code 44 o o organ donor code 45 o o advance directive code 46 o o patient status effective date 47 c c expected loa return date/time 48 o o expected pre admission testing date/time 49 o o notify clergy code dg1 diagnosis segment contains patient diagnosis information seq hl7 opt ss opt element name example 1 r r set id dg1 1 2 b o diagnosis coding method icd10 3 o r diagnosis code dg1 b69^cysticercosis^ 4 b r diagnosis description cysticercosis 5 o h diagnosis date/time 20150325000000 6 r r diagnosis type f 7 b o major diagnostic category 8 b o diagnostic related group 9 b o drg approval indicator 10 b o drg grouper review code 11 b o outlier type 12 b o outlier days 13 b o outlier cost 14 b o grouper version and type 15 o o diagnosis priority 16 o o diagnosing clinician 17 o o diagnosis classification 18 o o confidential indicator 19 o o attestation date/time mrg merge segment the merge segment contains the patient's demographic information that surescripts will deactivate seq hl7 opt surescripts opt element name description example data 1 r r prior patient id internal the previous patient identifier 41180600^^^&2 11 222 3 444444 5 666&^ 2 o o prior alternate patient id 3 o o prior patient account number 4 o o prior patient id external 5 o o prior visit number 6 o o prior alternate visit id 7 o o prior patient name remaining optional segments the adt message set contains many other optional segments surescripts does not require or utilize them at this time these segments will not be loaded, viewed, or returned by surescripts surescripts will only validate that the structure is syntactically sound for all segments received handling of additional/unexpected fields additional fields beyond those that are included in the preceding segment specific tables will not impact surescripts’ processing of adt messages and will be ignored