ADT Message Details

17 min

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 SegmentsADT Message Segments 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^^^[email protected]
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.	[email protected]
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.