---
title: ADT Messages Overview
slug: record-locator-exchange-adt/guide/adt-messages-overview
docTags: 
createdAt: 2026-06-02T15:11:18.087Z
---

## ADT Messages Overview

The healthcare facility (ADT system) may send Surescripts an ADT HL7 message when any of the following events occur at their facility:

1. ADT^A01 - Hospital Admission/Check-in
2. ADT^A03 - Patient Discharge/End Visit
3. ADT^A04 - Register a Patient
4. ADT^A08 - Update Patient Information
5. ADT^A28 - Add Person Information
6. ADT^A31 - Update Person Information
7. ADT^A37 - Unlink Patient Information
8. ADT^A40 - Merge Patient

See the [ADT Message Flow Use Cases](docId\:zpgygQnsZ_LcRAog8Et51) section for details on how these messages could be processed depending on the use case.

## ADT Message Flow Use Cases

### RLE MPI Load ADT Message Flow

This message flow is used when a vendor system sends an ADT message to load patients to the RLE MPI to make them available for record locator services.

:::hint{type="info"}
**Note: **The ADT^A01, ADT^A04, ADT^A08, ADT^A28, ADT^A31, and ADT^A40 message types can be used for this use case.
:::

![](https://api.archbee.com/api/optimize/fNEeV2bO-J-V0NK1eH_VR/1bBuZajQp1S9coVN-GcbZ_rle-adt-mpi-2023-06-061948x785.png)

1. The vendor initiates a request to load the patient to the Surescripts RLE MPI by sending an ADT message via their vendor system.

:::hint{type="info"}
**Note: **The ADT^A01, ADT^A04, ADT^A08, ADT^A28, ADT^A31, and ADT^A40 message types can be used for this use case.
:::

2. Surescripts creates an entry into the RLE MPI that links the requesting location with the patient demographics.
3. Surescripts responds with an ACK if the update was successful or a NACK if the message contained errors.

### RLE Unlink Patient ADT Message Flow

This message flow is used when a vendor system sends an ADT message to unlink the patient in the Surescripts MPI.

:::hint{type="info"}
- This can be used to remove a patient from the RLE MPI or the CEN MPI.
- The ADT^A37 message type can be used for this use case, or any of the accepted ADT events can be used by setting PD1.11 to "N" to indicate the patient data should not be shared.
:::

![](https://api.archbee.com/api/optimize/fNEeV2bO-J-V0NK1eH_VR/5voG3DzFHnN0Xy-5BVuQ__rle-unlink-patient-adt1695x1178.png)

1\. The vendor initiates a request to unlink the patient from the Surescripts RLE MPI or CEN MPI by sending an ADT message via their vendor system.

- **To unlink from RLE Notifications MP**I: the MSH.5 field should be populated with "S00000000000004" when the portal is configured for both the RLE and CEN MPI.
- **To unlink from the RLE MPI**: the MSH.5 field should be populated with "S00000000000004".

2\. Surescripts updates the RLE MPI and/or CEN MPI to remove the patient link. Links are removed by setting an expiration date on the record in the MPI. Once a record is deactivated, it is no longer shared with any requesting system.

3\. Surescripts responds with an ACK if the patient removal was successful or a NACK if the message contained errors.

## Update Surescripts MPI Based on ADT Message

Depending on the ADT message type sent, the Surescripts MPI will be updated in the following manner:

- **Add/Update Patient Information**: ADT^A01, ADT^A04, ADT^A08, ADT^A28, and ADT^A31: The home community id from MSH-4, assigning authority, and patient id from the message will be used to search for the patient in the MPI.
  - If the patient sent in the message does not already exist in the MPI, Surescripts will add the patient to the MPI.
  - If the patient does exist, demographic information will be updated from the incoming message.
- **Unlink Patient**: ADT^A37: When Surescripts receives this message type and matches the patient information to the MPI, Surescripts will then deactivate the patient record so that the record is no longer returned in MPI searches.
- **Merging Patient IDs**: ADT^A40: Surescripts will update the MPI with the patient information found in segment PID-3. The patient information found in the MRG segment will be deactivated so that the record is no longer returned in MPI searches.

:::hint{type="info"}
**Note: **If an ADT^03 is sent for a patient discharge, Surescripts will audit, but not process the message. In this instance, the message will not be used to load or update the Surescripts MPI.
:::

## ADT Message Error Processing

In instances where Surescripts receives a message that has errors or is unrecognizable, Surescripts will respond with an HL7 ACK that indicates an error (aka a NACK or negative acknowledgment).