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Lifepoint 2014 Implementation Guide

Version 1.0

Confidential

Lifepoint 2014 Implementation Guide, Version 1.0

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Copyright Notice

LifePoint Informatics, Glen Rock, New Jersey 07452

Copyright 1999 - 2014 LifePoint Informatics. All rights reserved.

This document is protected by the copyright laws as an unpublished work.

Confidentiality and Proprietary Rights This document is the confidential property of LifePoint Informatics. It is furnished under an agreement with LifePoint Informatics and may only be used in accordance with the terms of that agreement. The use of this document is restricted to customers of LifePoint Informatics and their employees. The user of this document agrees to protect LifePoint Informatics’ proprietary rights as expressed herein. The user further agrees not to permit access to this document by any person for any purpose other than as an aid in the use of the associated system. In no case will this document be examined for the purpose of copying any portion of the system described herein or to design another system to accomplish similar results. This document or portions of it may not be copied without written permission from LifePoint Informatics Revision History June 16, 2014 Version 1.0 Creation of document for new web platform (PMB)


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Overview

This document contains a list of the items needed to complete implementation of the Lifepoint 2014 product.

Purpose

This document is to be referenced as a guide and checklist for gathering and disseminating information during the implementation process. Some items may not apply and are dependent upon what the laboratory has chosen to implement.

Introduction

This is Lifepoint’s general implementation guide for the Lifepoint 2014 platform. During your initial meetings, your Lifepoint project manager (PM) will customize your implementation plan based on your purchased options. The PM will also indicate which sections of this guide apply to your particular installation. Lifepoint employs a combination of agile and rapid development methods during the implementation phase. Lifepoint does not employ a more traditional waterfall model when making changes to the system. Instead of requiring formal specification and design documents, sign-offs, prototyping, etc., a general spec is done to let the Lifepoint programming team interpret and do informal specification calls. Often times clients are not 100% sure of what they want to have done and often requests overwrite other requests. Lifepoint also assigns multiple resources to projects and does not perform cross-function regression testing and pushes changes out to the test environment as soon as it passes a programmer unit test. In the end, weeks are saved of formal specification and individual feature test time for individual changes. Lifepoint performs full-system test scripts that are adjusted based on the final chosen configuration. The downside of this methodology is that functions will break as others are changed and therefore your test environment is unstable during this phase.


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Table of Contents

Chapter 1 | IMPLEMENTATION PLAN………………………………………………………………………………………………………………6

CHAPTER 2 | PATIENT MATCHING .......................................................................................................................... 8

About Patient Matching .................................................................................................................. 8 Patient Identification Criteria ......................................................................................................... 9 Sample HL7 Message ...................................................................................................................... 9 Patient Matching Options ............................................................................................................. 10

CHAPTER 3 | INTERFACES AND REQUIRED FIELDS ............................................................................................... 23

Interfaces ...................................................................................................................................... 23 Required Fields Overview ............................................................................................................. 23

CHAPTER 4 | INSURANCE COMPANY AND PHYSICIAN MASTER FILE SPECIFICATIONS ........................................ 25

Insurance Company Specifications ............................................................................................... 25 Physician Directory Specifications ................................................................................................ 29

CHAPTER 5 | TEST DIRECTORY SPECIFICATIONS ................................................................................................... 31

Test Directory Specifications ........................................................................................................ 31

CHAPTER 6 | WEB PORTAL OPTIONS .................................................................................................................... 39

CHAPTER 7 | REQUISITION AND LABEL OPTIONS ................................................................................................. 46

Order Requisition Specification .................................................................................................... 46 Label Options ................................................................................................................................ 48

CHAPTER 8 | RESULT REPORT OPTIONS ............................................................................................................... 49

Report Options .............................................................................................................................. 49

APPENDIX A | ADDITIONAL FUNCTIONS AND FEATURES (FEE FOR SERVICE) ...................................................... 53

Using a custom result report ........................................................................................................ 53 Abnormal Summary ...................................................................................................................... 53 Bold transform of HL7 of HTML Bolding ....................................................................................... 53 Merge of other PDF’s .................................................................................................................... 53 Lab Director Signature Image and Name ...................................................................................... 53


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APPENDIX B | LIFEPOINT INTERFACE SPECIFICATIONS ........................................................................................ 54

Inbound Results (ORU) Specifications .................................................................... ……………………54 OUTBOUND ADT SPECIFICATION………………………………………………………………………………………………………72 Inbound ADT Specification ............................................................................................................ 83 Outbound Orders (ORM) Specification ......................................................................................... 93 Inbound Orders (ORM) Specification .......................................................................................... 107 Inbound Demographics Delimited File Specification .................................................................. 123


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Chapter 1 | Implementation Plan

A. Kick off agenda

Contract Review—Lifepoint Sales

A PowerPoint presentation will be prepared for the project kick off call. This presentation will be sent to the client for future reference.

1. Contact Information and Roles

o Establish main contacts at the client site including their roles o Team Composition Form

Please use the following form to ensure that the client team has ‘all bases covered’.

Team Member Name

Team Member Title / Role

Phone #

LIS

HIS

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Secu

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o Escalation contacts

Name Phone E-mail Comments

o Lifepoint will inform the client of all necessary contacts and their roles o Establish a time for weekly conference calls o Main communication will be via email

2. Development/Implementation Process Summary

Lifepoint will provide: o VPN request form o Result Interface Questionnaire o Training o Interfaces and options


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o Customized project plan (in Excel format) o Password to the Secure Documents area of www.lifepoint.com o Sign off documentation for Go Live

3. Client Responsibilities o Participate in the development process o Perform QA of the website o Provide any data requested by Lifepoint (Test directory, logo, physician list) o Attend educational training sessions o Assign a project leader o Return sign off documentation for Go Live

4. Lifepoint Responsibilities o Report, Correct and Track issues timely o Prepare environment o Assist with feature decisions o Provide educational training sessions

5. Additional functions to follow initial implementation o Autoprint o EMR

B. Per Fee/Time and Materials Definition

Anticipated changes will be provided via a quote, including the scope of work to be done, the maximum number of hours to complete, and the hourly programming rate. Receipt of a signed quote will be required prior to any work being done. Please refer to the Appendices for the Additional Features available.

C. Prerequisites to Testing Test plans are not meant to be a complete guide to validation, but rather a starting point from which the client can define the specific steps to validate the web portal and interfaces for their site. Some of the steps noted here might not be applicable for every client, while additional steps may be necessary for others. This document contains the steps in doing the validation and worksheets to log the results. It is also highly recommended to use printer screens when doing validation. 1. VPN connectivity has been established. 2. Test Directory information has been loaded into Lifepoint and validated to be correct and complete

a. The CPT field must be populated for the generation of ABNs b. The Profile Components field must be populated to catch duplicates contained within a

profile. 3. Physician and Insurance master lists have been loaded into Lifepoint and validated. 4. Users have been built for at least two accounts that have unique client mnemonics. 5. Ask at order entry (AAOE) questions have been built. 6. Any necessary Order Code/Result Code translation tables have been built. 7. 2D barcode scripting has been completed and validated (if this is part of the project scope).

http://www.lifepoint.com/


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Chapter 2 | Patient Matching

About Patient Matching: It is assumed in all matching algorithms that the patient is available for the client mnemonic to which the result

is being loaded. So, while not specifically mentioned in any of the algorithms, a search is not done for patients across mnemonics. A patient must already exist in the mnemonic, otherwise there will be no match and a new patient will be created.

If more than one set of matching criteria exist in an option, patient matching is done sequentially (IE. If a match is found at A, the other options of B and C will not be used).

All algorithms will attach ‘NoPID’ to the incoming accession to form a PatientId if one is not sent in the incoming HL7.

Some algorithms have what’s called an ‘Ident’ patient functionality. o If ‘Ident Check’ is being performed as part of a matching algorithm, it means that if a patient already exists

for the PatientId, but something in the demographics is different (IE. a female’s last name has changed), a new patient will be created using the patientID with ‘Ident’ attached to the front and a flag indicating what has changed, to the back. For example, 12345 is a valid patient ID but the last name in the HL7 is different than the Last Name of the patient in the database. A new patient will be created identified as Ident12345L – the ‘L’ indicating that the last name is different. The ‘Ident’ flags are L=Last Name, F=First Name, D=DOB, G=Gender. See below:

Scenario Ident PatientId# Assigned

The Last Name doesn’t match. “IdentnnnnL”

The First Name doesn’t match. “IdentnnnnF”

The DOB doesn’t match. “IdentnnnnD”

The Gender doesn’t match. “IdentnnnnG”

Anytime ‘Ident Check’ is being performed, an attempt will also be made to look up any previously created ‘Ident’ patients and try to match on that.

o If ‘Ident Check’ is not being performed as part of a matching algorithm, Lifepoint will simply create a new patient if a complete match is not found.

A commonality between all algorithms is, after a match has been found, there is a choice of either: o Using the PatientID that’s being sent in the HL7 and updating the one in the database. o Disregarding the PatientID that was sent in the HL7 and continuing to use the PatientID as it currently

exists in the database.

In all algorithms, the obvious course of not finding a match is to create a ‘new’ patient for which to load the results.


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Patient Identification Criteria:

Different patient identification criteria may be used to accurately match the data that is being received in the HL7, to data that already exists in the Lifepoint database:

Sample HL7 Message:

MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LIFEPOINT|NJA|200307311001||ADTÂ08||T|2.3 PID|1||2519136||TEST^MARIE^J||19730628|F|||2101 MARK DR^^SHERWOOD^NJ^07432^||201-555-1111|212-555-2222||||2519136|666666666| GT1|1||TEST^MARIE^J||2101 MARK DR^^SHERWOOD^NJ^07432^|201-555-1111|212-555-2222||||SELF IN1|1||461|BLUE CROSS BLUE SHIELD OF NEBRASKA||||112|||MAPLE AUTO PARTS|||||TEST^MARIE^J|SELF|||||||||||||||||||9112 IN1|2||3608|COVENTRY HEALTH CARE||||333|||MAPLE AUTO PARTS|||||TEST^JOSEPHÊ|SPOUSE|||||||||||||||||||1011233333 DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER|||||| MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LIFEPOINT|NJA|200307311001||ADTÂ04||T|2.3 PID|1||2520658||TEST^MARK^||19280725|M|||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^|||||||2520658|777777777| GT1|1||TEST^MARK^||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^||||||SELF IN1|1||001|MEDICARE||||||||||||TEST^MARK^|SELF|||||||||||||||||||777777777A IN1|2||002|AETNA||||MEDIADD||||||||TEST^KATHY|SPOUSE|||||||||||||||||||777777777A DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER||||||

Criteria Description HL7

First name The patient’s first name PID:5^2

Last name The patient’s last name PID:5^1

DOB Date of Birth PID:7

Gender Male or female PID:8

Patient ID The laboratory or hospital medical record number or identifying alphanumeric value.

PID:2

PID:3, or

PID:18

Alternate Patient ID An external identifying alphanumeric value. Example: A physician office’s EMR patient record number.

PID:2

PID:3, or

PID:18

SSN Social Security Number PID:19

Requisition # A Lifepoint-generated order number that is returned in the HL7 to Lifepoint.

Insurance Policy # The patient’s primary insurance policy #

Patient Address The patient’s address

Third Patient ID An external identifying alphanumeric value


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Patient Matching Options: Option Matching Criteria Instructions

#1 A) Patient ID, Last Name,

First 3 characters of First Name, DOB

Since Patient ID is a required match, updating the PID is irrelevant.

IDENT checking is performed.

If... Then…

All of the values in A match…

Update the existing Patient Record.

Any of the values do not match…

Create a new Patient Record.

Option Matching Criteria Instructions

#2 A) Patient ID B) SSN C) Last Name, First

Name, DOB, Gender

Patient ID is updated from the incoming HL7.

IDENT checking is not performed.

If... Then…

All of the values in either A, B or C match…


Neither A, B nor C completely match …



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#3 A) Patient ID B) SSN, DOB C) Last Name, First

Name, DOB, Gender



If... Then…






#4 A) Patient ID B) SSN, Gender C) Last Name, First

Name, DOB, Gender



If... Then…






#5 Option #5 is no longer in use.


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#6 A) Patient ID B) SSN, Last Name C) Last Name, First

Name, DOB, Gender

Patient ID is not updated from the incoming HL7.


If... Then…






#7 A) Patient ID B) Alternate Patient ID



If... Then…

Either A or B match… Update the existing Patient Record.

Neither A nor B

match …



#8 Option #8 is no longer in use.


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#9 A) SSN, Last Name, First Name, DOB

B) Last Name, First Name, DOB, Gender



If... Then…

All of the values in either A or B match…


Neither A nor B completely match …



#10 A) Requisition #, Last Name, First Name, DOB, Gender

B) Patient ID, Last Name, First Name, DOB, Gender

C) SSN, Last Name, First Name, DOB, Gender



If... Then…



Neither A,B nor C completely match …



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#11 A) Last Name, First Name, DOB, Gender, Insurance Policy #, Patient Address.



If... Then…






#12 A) Accession # B) Last Name, First

Name, DOB, Gender C) Requisition #

(The requisition # match is independent of the client mnemonic)



If... Then…



Neither A, B nor C completely match…



#13 A) Patient ID B) SSN, Last Name, First

Name, DOB, Gender



If... Then…



Neither A nor B completely match…



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#14 A) SSN and at least 2 of the following; Last Name, First Name, DOB)




If... Then…

All of the required values in either A or B match…


Neither the required values in A nor B completely match …



#15 A) Patient ID

Since Patient ID is a required match, updating the PID is irrelevant.


If... Then…

The Patient ID does match…


The Patient ID does not match…



#16 A) Patient ID B) Last Name, First

Name, DOB, Gender



If... Then…






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#17 A) Patient ID B) Requisition # C) Last Name, First

Name, DOB, Gender




If... Then…






#18 A) Alternate Patient ID, Last Name, First Name, DOB, Gender, Requisition #



If... Then…



Any of the values in A do not match…



#19 A) Alternate Patient ID B) Last Name, First

Name, DOB, Gender



If... Then…






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#20 A) Patient ID B) Last Name, First

Name, DOB, Gender



If... Then…






#21 A) Patient ID B) SSN, DOB, Gender C) Last Name, First

Name, DOB, Gender



If... Then…






#22 A) Patient ID B) Alternate Patient ID,

Last Name C) Last Name, First

Name, DOB, Gender



If... Then…






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#23 A) Patient ID B) Requisition # C) SSN, Last Name, First

Name, DOB, Gender




If... Then…






#24 A) Patient ID B) Third Patient ID C) Last Name, First

Name, DOB, Gender



If... Then…






#25 A) Alternate Patient ID B) Patient ID



If... Then…


Neither A nor B match…



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#26 A) Alternate Patient ID



If... Then…

The Alternate Patient ID does match…


The Alternate Patient ID does not match…



#27 A) Alternate Patient ID B) Last Name, First

Name, DOB, Gender



If... Then…






#28 A) Patient ID B) Requisition #




If... Then…


Neither A nor B match…



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#29 A) Patient ID,

Alternate Patient ID,

Last Name, First Name,



If... Then…



A does not completely match …



#30 A) Patient ID B) Tertiary Patient ID



If... Then…



Neither A nor B completely match …



#31 A) Patient ID B) SSN, Gender, DOB C) Last Name, First

Name, DOB, Gender



If... Then…






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#32 A) Alternate Patient ID, Last Name, First Name, DOB, Gender



If... Then…

All of the values match…


Any of the values do not match …



#33 Option #33 not available for use.


#34 A) Patient ID, DOB B) Last Name, First

Name, DOB, Gender



If... Then…

All of the values in A or B match…





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#35 A) Patient ID, DOB




If... Then…

All of the values in A or B match…





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Chapter 3 | Interfaces and Required Fields

A. Interfaces

You will be provided with two questionnaires (VPN and Result Interface). Please follow your project manager’s instructions for filling out these questionnaires. The information in this chapter may be adjusted based on your installation needs.

Lifepoint will code the result and order interface(s) to your specifications. The client project manager will provide all specifications and answers to questionnaires requested by Lifepoint. To view the Lifepoint specifications for all interface types, please refer to Appendix B.

VPN Questionnaire o This will be sent by a member of the Lifepoint Network Team after the project kick off call.

Result Interface Questionnaire o This will be sent by the Lifepoint PM with the project kick off call minutes. Once this has

been filled out and returned to the project manager, a call will be scheduled with the Director of Infohub (or designee) to review the responses and answer any questions. Once the meeting is complete, both Lifepoint and the client will sign off on the document. At that time the result interface will be coded.

B. Required Fields Overview

This chapter contains the required and recommended fields for utilization of the Lifepoint products as well as maintaining feeds to and from downstream systems. This is a minimum set of data and can be added to by your project manager during your implementation depending upon requirements of other connected systems.

You are permitted two submissions of Required Field changes during the implementation process. These are normally submitted with the website changes.

1. Required Fields in the Interface File o Patient Identifying Number (MRN, Patient ID, etc). This is a single number that represents the

patient in the source system. Any messages sent for this patient would have this same number. o Patient First Name o Patient Last Name o Patient Date of Birth o Ordering Physician o Collection Date o Order ID (requisition number, order number, billing number or accession number) o Ordering Location (Client Mnemonic)

2. Highly Recommended Fields in the Interface File

o Patient Gender o Collection Time o Test Code o Result (Analyte Code) o Ordering Physician Code (UPIN, NPI or laboratory internal ID)


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o Common Order ID for multiple tests per order (example: if a CBC, UA, IgG are all ordered at once and it is desired to place them on a single report, a common order ID for each is needed)

3. Required Fields for Medical Necessity Checking o CPT Code o Price o Insurance Company Name o Insurance Company Code (from laboratory billing system)

4. Required Fields for Quest/LabCorp Insurance Re-Direction

o Quest/LabCorp Physician Code (for those utilizing) o Quest/LabCorp Test Codes matching laboratory tests (highly recommended o Insurance Company Name o Insurance Company Code (from laboratory billing system)

5. Required Fields for Non-HL7 Interfaces

PDF files that include a textual header, accompanying document of HL7 that includes the following as discrete or parse-able data fields: o Patient First Name o Patient Last Name o Patient Date of Birth o Patient ID/MRN o Accession/Report Number o Ordering Physician Name o Collection Date o Order ID (requisition number, order number, billing number or accession number) o Location (Client mnemonic)

6. Highly Recommended Fields for Non-HL7 Interfaces

o Gender o Collection Time o Ordering Physician Code


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Chapter 4 | Insurance Company and Physician Master File Specifications

This chapter provides the format acceptable for submitting the Insurance Company and Physician Master Files for loading to the website. These files can be sent via ftp in the same format, after the client is live. If you would like information on sending files via ftp, please ask your Lifepoint project manager.

A. Insurance Company Specifications

This specification can be used to provide Lifepoint with the laboratory billing insurance companies and codes. This same format may be used for full-replacement updates. Fields may be omitted, but the first line of your file must include the field names that are populated in the remainder of the file.

Insurance Company Format

The preferred way to submit the insurance company file is in Excel format where the column headers match the field names as shown below. Columns may be submitted in any order. Headers are case sensitive. Fields marked with an * are required entries.

Field Name Description Comment

*PracInsId LIS Code for the insurance company. If not provided, will assign name

*InsName Name of insurance company. Value must be unique

AltPracInsId Alternate Name of insurance company. Value does not have to be unique

InsAddr1 Insurance address number 1

InsAddr2 Insurance address number 2

InsCity Insurance city.

InsState Insurance state.

InsZip Insurance zip code.

InsPhone Insurance phone number

Inactive Inactive Flag 1/0. If inactive, will not display outside of admin screens

The following are control fields, typically modified through Admin tools

DisplayAltId1 Display the AltId1 field 1/0

LabelAltId1 Label for the AltId1 field 15 character text


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ErrMessAltId1 Error message to display for invalid AltId1 field

40 character text

PatternMatchAltId1 Pattern match for AltId1 Validation Caché Pattern Match code

RequiredAltId1 Require AltId1 field 1/0

DisplayAltId2 Display AltId2 field 1/0



40 character text






40 character text






40 character text




ErrMessAltId5 Label for the AltId5 field 15 character text

LabelAltId5 Error message to display for invalid AltId5 field

40 character text




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DisplayGroupNumber Display Group Number field 1/0

ErrMessGroupNumber Error message to display for invalid Group Number field

1/0

LabelGroupNumber Label for the Group Number field 15 character text

RequiredGroupNumber Require Group Number field 1/0

PatternMatchGroupNumber Pattern match for Group Number Validation Caché Pattern Match code

DisplayPolicyNumber Display Policy Number field 1/0

LabelPolicyNumber Label for the Policy Number field 15 character text

ErrMessPolicyNumber Error message to display for invalid Policy Number field

1/0

RequiredPolicyNumber Require Policy Number field 1/0

PatternMatchPolicyNumber Pattern match for Policy Number Validation Caché Pattern Match code

DisplaySubscriberEmployer Display SubscriberEmployer field 1/0

LabelSubscriberEmployer Label for the SubscriberEmployerfield 15 character text

RequiredSubscriberEmployer Require SubscriberEmployer field 1/0

RequiredGuarAddress Require GuarAddress field 1/0

DisplayGuarAddress Display GuarAddress field 1/0

RequiredGuarName Require GuarName field 1/0

DisplayGuarName Display GuarName field 1/0

RequiredGuarSSN Require GuarSSN field 1/0

DisplayGuarSSN Display GuarSSN field 1/0

RequiredInsCoAddress Require InsCoAddress field 1/0

DisplayInsCoAddress Display InsCoAddress field 1/0

RequiredPatAddress Require PatAddress field 1/0

DisplayPatAddress Display PatAddress field 1/0

RequiredPatDob Require PatDob field 1/0

DisplayPatDob Display PatDob field 1/0


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Separate fields by pipe (“|”)

Include field headers in the first line of the file

Start a new record on a new line Sample File: PMISCode|PMISName|LISCode|LISName AE1|Aetna (PA)|10012|Aetna Healthcare AMERI|Americare|10013|American Healthcare Headers for Excel File:

RequiredPatEmployer Require PatEmployer field 1/0

DisplayPatEmployer Display PatEmployer field 1/0

RequiredPatHPhone Require PatHPhone field 1/0

DisplayPatHPhone Display PatHPhone field 1/0

RequiredPatName Require PatName field 1/0

DisplayPatName Display PatName field 1/0

RequiredPatSSN Require PatSSN field 1/0

DisplayPatSSN Display PatSSN field 1/0

RequiredSubscriberAddress Require SubscriberAddress field 1/0

DisplaySubscriberAddress Display SubscriberAddress field 1/0

RequiredSubscriberDOB Require SubscriberDOB field 1/0

DisplaySubscriberDOB Display SubscriberDOB field 1/0

RequiredSubscriberGender Require SubscriberGender field 1/0

DisplaySubscriberGender Display SubscriberGender field 1/0

RequiredSubscriberName Require SubscriberName field 1/0

DisplaySubscriberName Display SubscriberName field 1/0

PracInsId* InsName* AltPracInsId InsAddr1 InsAddr2 InsCity InsState InsZip InsPhone BillDefault ContactPerson


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B. Physician Directory Specifications

This specification can be used to provide Lifepoint with the laboratory billing physician information. Lifepoint maps all physician ID’s based on values that you provide, so you can provide NPI information in the UPIN field if desired. This same format may be used for full-replacement updates. Fields may be omitted, but the first line of your file must include the field names that are populated in the remainder of the file.

Physician Directory Format

The preferred way to submit the physician directory file is in Excel format where the column headers match the field names as shown below. Fields marked with an * are required entries. Columns may be submitted in any order. Headers are case sensitive. Fields marked with an * are required entries.


Address1 Street Address

Address2 Other Address

AltPhone Alternate phone number (NNN) NNN-NNNN or NNN-NNNN or NNNNNNNNNNN

Cell Mobile phone number (NNN) NNN-NNNN or NNN-NNNN or NNNNNNNNNNN

City City

Fax Fax number (NNN) NNN-NNNN or NNN-NNNN or NNNNNNNNNNN

FirstName* Given Name

FullName** Family Name Given Name Middle Initial Title

Lab2UPIN**

LabUPIN**

LastName* Family Name

Pager Pager number

Phone Physicians Phone number (NNN) NNN-NNNN or NNN-NNNN or NNNNNNNNNNN

State State code

Suffix Suffix MD, DO, etc.

Title Physicians Title Dr., Mr., Mrs., Ms, Miss, etc.

UPIN* UPIN or any code LIS would like to use for The Physician’s ID

All of the screens involving ordering use the UPIN field, so if they give us only one physician ID, we load that into UPIN.

Zip Zip Code

email Physician’s email address

NPI Physician’s NPI number

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**These items may replace the other required items (FirstName, LastName and at least one code to be stored as UPIN are required.) FullName—may replace LastName and FirstName Lab2UPIN or LabUPIN—may replace UPIN

All fields are string value and can contain the following HTML tags: , , .

Separate fields by either tab or pipe (“|”).

Include field headers on first line of your file.

Start a new record on a new line

Sample File (required fields only): Code|FullName|UPIN O143|ABDOUCH, IVAN G (MD)|E07828 O145|ACKERMAN, STEPHEN J (MD)| F19708 O148|ADAM, GEORGE M (MD) |D05101 O149|ADAMS, CHARLES R (MD)| B67884 In this case, the FirstName, LastName and Suffix will be built from the FullName field. Headers for Excel File:

FullName* FirstName LastName Address1 Address2 City State Zip Phone Fax

UPIN* LabUPIN Lab2UPIN NPI Email


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Chapter 5 | Test Directory Specifications

This chapter provides the format acceptable for submitting to Lifepoint the laboratory test directory (compendium) for loading to the website. These files can be sent via ftp in the same format, after the client is live. If you would like information on sending files via ftp, please ask your Lifepoint project manager.

A. Test Directory Specifications

This specification can be used to provide Lifepoint with the laboratory test collection information and codes. This same format may be used for full-replacement updates. Fields may be omitted, but the first line of your file must include the field names that are populated in the remainder of the file.

Test Directory Format

The preferred way to submit the test directory file is in Excel format where the column headers match the field names as shown below. Columns may be submitted in any order. Headers are case sensitive. Fields marked with an * are required entries.

Description

Contains field name and, if applicable, its sub components.

Comment

Contains additional information about the field. If the comment has the text in quotation marks, then the corresponding field is expected to contain exactly this text, or, in case of multiple tests, one of them as it appears inside quotation marks. For example, “MSH” in the comment column means that this field will always contain the following value: MSH

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Comment

FHS 0 3 R ID Segment type ID “FHS”

FHS 1 1 R ID Field Separator “|”

FHS 2 4 R ST Encoding Characters “^~\&”

FHS 3 40 O ST File Sending Application Name of sending application

FHS 4 O ST File Sending Facility A unique identifier for the facility sending that particular message.

31 Name

31 ID

23 ID Type

FHS 5 20 O ST File Receiving Application “LABTEST”


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Segm

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Description

Comment

FHS 6 20 O ST File Receiving Facility “NJA”

FHS 7 26 O TS File Creation Date/Time of Message CCYYMMDDHHMM

FHS 8 12 O ST File Security

FHS 9 ST File Name / ID Submitting Laboratory’s Local File

FHS 10 12 O ST File Header Comment

FHS 11 20 R ST File Control Number Submitting Laboratory Identifying Number

FHS 12 20 C ST Reference File Control ID File Control ID when this file was originally transmitted. Not present if this file is being transmitted for the first time.

BHS 0 3 R ID Segment type ID “BHS”

BHS 1 1 R ID Batch Field Separator “|”

BHS 2 4 R ST Batch Encoding Characters “^~\&”

BHS 3 40 O ST Batch Sending Application Name of sending application

BHS 4 O ST Batch Sending Facility A unique identifier for the facility sending that particular message.

31 Name

31 ID

23 ID Type

BHS 5 20 O ST Batch Receiving Application “LABTEST”

BHS 6 20 O ST Batch Receiving Facility “NJA”

BHS 7 26 O TS Batch Date/Time of Message CCYYMMDDHHMM

BHS 8 12 O ST Batch Security

BHS 9 O ST Batch Message Type This field can be used by the application processing the batch.

BHS 10 12 O ST Batch Comment


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BHS 11 20 O ST Batch Control ID

BHS 12 5 O ID Reference Batch Control ID

MSH 0 3 R ID Segment type ID “MSH”

MSH 1 1 R ID Field Separator “|”

MSH 2 4 R ST Encoding Characters “^~\&”

MSH 3 40 O ST Sending Application Name of sending application

MSH 4 R ST Sending Facility A unique identifier for the facility sending that particular message.

31 Name

31 ID

23 ID Type

MSH 5 40 O ST Receiving Application “LABTEST”

MSH 6 40 O ST Receiving Facility A mutually agreed upon unique identifier for the facility to receive the particular message. “NJA”

MSH 7 26 O TS Date/Time of Message CCYYMMDDHHMM

MSH 8 12 O ST Security

MSH 9 ST Message Type

3 R Type “MFN”

3 O Trigger “M03”

MSH 10 12 O ST Message Control ID

MSH 11 20 R ST Processing ID “P” = “Production”

“T” = “Test”

MSH 12 5 R ID Version ID “2.3”

MSH 13 O ST Sequence Number


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MSH 14 O ST Continuation Pointer

MSH 15 O ST Accept Acknowledgment Type

MSH 16 O ST Application Acknowledgment Type

MSH 17 O ST Country Code

MSH 18 O ID Character Set

MSH 19 O ST Principle Language of Message

MFI 0 3 R ID Segment type ID “MFI”

MFI 1 60 R ST Master File Identifier “PRA”

MFI 2 6 O ST Master File Application Identifier “OC” = Order Codes

MFI 3 3 O ST File – Level Event Code “REP” = Replace current version of this Master File (Default)

“UPD” = Change file records as defined

MFI 4 26 O TS Entered Date / Time CCYYMMDDHHMM

MFI 5 26 O TS Effective Date / Time CCYYMMDDHHMM

MFI 6 2 O ST Response Level Code

MFE 0 3 R ID Segment type ID “MFE”

MFE 1 6 O ST Set ID – MFE Segment’s sequence number

MFE 2 3 O ST Record Level Event Code “MAC” = Reactivate Deactivated Record from Master File

“MAD” = Add Record to Master File

“MDC” = Deactivate from Master File

“MDL” = Delete Record from Master File

“MUP” = Update Record for Master File


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MFE 3 20 0 ST MFN Control ID

MFE 4 26 R TS Effective Date / Time CCYYMMDDHHMM

MFE 5 300 R ST Primary Key Value

10

Identifier = LOINC Number

5 Name of system = “LOINC”

20 Alternate Identifier = Local Laboratory’s order code"

100 Test Name

200 Alias list

OBR 0 3 R ID Segment type ID “OBR”

OBR 1 4 O ST Set ID – OBR Sequence number

OBR 2 30 O ST Placer Order Number

OBR 3 22 O ST Filler Order Number CPT Code

OBR 4 200 R ST Universal Service ID: The limit of the entire field is 200. The limit of the text field (second sub-component) is 100. The length of other sub-components is not specified.

10 Identifier = LOINC Number



100 Test Name

OBR 5 2 O ST Priority “R” = Routine

“S” = STAT testing allowed on this sample.

“T”= Timing Critical

OBR 9 O ST Collection Volume: Volume of a specimen (required for


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10 Quantity some tests)

10 Units

OBR 10 O ST Collector Identifier

OBR 13 80 O ST Relevant Clinical Info. Methodology

OBR 15 O ST Specimen Source Code

OBR 18 60 O ST Placer field 1


OBR 20 60 R ST Filler Field 1 Container Type

OBR 21 60 R ST Filler Field 2 Units of Measure

OBR 23 O MO Charge to Practice Standard Price

OBR 26 O ST Parent Result Used to identify OBR as alias (synonym), Should contain primary Local Laboratory’s order code

OBR 38 O 2 ST Quantity/Timing

OBR 39 20 O ST Transportation Mode “F” = Frozen

“R” = Room Temperature

OBR 21 60 O ST Transport Logistics of Collected Sample

OBR 22 200 O ST Collector’s Comment Use of test.

BTS 0 3 R ID Segment type ID “BTS”

BTS 1 1 R ST Batch Message Count Contains the individual messages contained within the batch.

BTS 2 80 0 ST Batch Comment

BTS 3 100 0 NM Batch Totals

FTS 0 3 R ID Segment type ID “FTS”

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FTS 1 10 R NM File Batch Counts

FTS 3 80 O ST File Trailer Comment

All fields are string value and can contain the following HTML tags: , , .

Separate fields by either tab or pipe (“|”).

Include field headers on first line of your file.

Start a new record on a new line

Sample File (required fields only)

OrderCode|TestName|Price|CPT

CBC|Complete Blood Count|45.00|85025

HBCT|Hemoglobin and Hematocrit|23.00|85014,85018

URNC|Urinalysis, Complete|45.00|81000

Sample Files

MSH|^~\&|LISCODE|LABNAME^LABCODE^LAB|LABTEST|NJA|200403251549||MFN^M03||T|2.3 MFE||MAD||200403251549|^^27045^COMPLETE BLOOD COUNT W/PLT^CBCWPLT (COMPLETE BLOOD COUNT W/PLT) OBR||||^^240416^SPECIMEN #||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200440^WBC||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200365^RBC||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200135^HGB||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200115^HCT||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200190^MCV||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200180^MCH||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200185^MCHC||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200362^RDW-SD||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200390^RDW-CV||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200310^PLT||||||||||||||||*|*||0|HM||27045||||R OBR||||^^206360^ABS LYMPH||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200255^NRBC/100 WBC||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200696^PERFORMED BY||||||||||||||||*|*||0|HM||27045||||R OBR||||^^200652^!COMMENT||||||||||||||||*|*||0|HM||27045||||R


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OBR||||^^200686^PATHOLOGIST COMMENT||||||||||||||||*|*||0|HM||27045||||R OBR|||85027|^^^CBC W/PLATELET||||||||||||||||*|*||21.57|HM||27045||||R MFE||MAD||200403251549|^^20116^HEMATOCRIT^HCT (HEMATOCRIT) OBR||||^^210116^SPECIMEN #||||||||||||||||*|*||0|HM||20116||||R OBR||||^^200116^HCT||||||||||||||||*|*||0|HM||20116||||R OBR||||^^220116^!COMMENT||||||||||||||||*|*||0|HM||20116||||R OBR||||^^230116^PATHOLOGIST COMMENT||||||||||||||||*|*||0|HM||20116||||R OBR||||^^240116^PERFORMED BY||||||||||||||||*|*||0|HM||20116||||R OBR|||85014|^^^HEMATOCRIT||||||||||||||||*|*||7.99|HM||20116||

Headers for Excel File:

CollectionInstructions TransportTemperature Price

TestName LabOc Cpt Synonyms Container Method Temperature Specimen


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Chapter 6 | Web Portal Options

Implementation Applications Options-Site Customizations

Using the Lifepoint2014.Web Application

As part of your implementation fee, Lifepoint will provide several product options. The lab/client will have the opportunity to make two revisions to their base system application by choosing from the available options included in this section. Additional changes are available on a time and materials basis. See Appendix A for additional options and modules.

A. Login Screen Options 1. Logo:

The lab will be responsible for providing a high resolution image in a standard graphics format. Lifepoint will resize provided logos as needed.

2. Splash Image: The lab will be responsible for providing a high resolution image in a standard graphics format. Lifepoint will resize the provided splash image as needed. If you do not have an image, Lifepoint

will provide one for you. 3. Notifications can be added to the login page.

These are specific messages set by you, to notify your clients of an alert or additional information.

The default Login Screen is shown below:

B. Menu Options 1. Any item on the menu can be removed 2. Order supplies-The order supplies function is an option offering and can be removed


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C. Inbox Options 1. Columns—The client may choose from any or all of the following fields:

a. Lab b. Practice c. Accession d. PID e. AltPtID f. Last Name g. First Name h. DOS (Date of Service) i. Coll Dt (Collection Date) j. Ordering Physician

2. Practice—This field name can be customized (common customizations are “Office” and “Location”) 3. Patient ID—this field name can be customized (common customizations are “MRN” and “Lab PID”). 4. Accession—this field name can be customized (common customizations are “Req/Accession” and

“Order Number”).

D. Patient Search Screen Options 1. The radio button defaults can be changed 2. The radio buttons for “Starts With” and “Exact” can be removed 3. Fields in the Patient Search Screen can be any of the following:

a. Last Name b. First Name c. Patient ID d. Alternate Patient ID e. Physician f. Accession g. Date of Birth h. Date search (collection date)

4. Patient ID—this field name can be customized (common customizations are “MRN” and “Lab PID”). 5. Alternate Patient ID—this field name can be customized (common customizations are “Office

MRN” and “Office PID”). 6. Accession—this field name can be customized (common customizations are “Req/Accession” and

“Order Number”).


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The default Patient Search screen is shown below:

E. Select a Patient Lookup Options

1. Patient ID—this field name can be customized (common customizations are “MRN” and “Lab PID”). 2. Alternate Patient ID—this field name can be customized (common customizations are “Office

MRN” and “Office PID”). 3. Practice—this field name can be customized (common customizations are “Office” and “Location”).

The default Select a Patient screen is shown below.

F. Patient History Options 1. Pending Orders Not Received—there are 4 options available for editing Pending Orders Not

Received: a. Remove From Pending—removes the order from the pending order report b. Delete Req—deletes the requisition entirely from the website c. Edit Order—returns the user to the order review screen to edit the order d. Print Labels—allows the user to reprint the labels


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NOTE: These options can be enabled, disabled, or only enabled for an Admin User. e. Requisition—this field can be customized (common customizations are “Encounter” and

“Order Number”). 2. Result History:

a. Accession—this field name can be customized (common customizations are “Req/Accession” and “Order Number”).

G. Accession View Option 1. Display an embedded PDF instead of the website view

H. Order Review Section

1. Additional Information Area—any or all of these fields can be made required. a. Collection Date and Time b. Priority c. Report delivery d. Fasting Status e. Requesting Physician f. Requesting Location g. Draw Location h. Bill To i. Copy-To j. ‘This order appears to require’ k. Duplicate test checking l. Copy To Physician Text Field

The default Additional Information screen is shown below:


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I. Add/Edit Patient 1. Patient Information screen—all fields are optional other than first name, last name and PID

a. The PID can be edited, locked from editing and/or autogenerated b. Generate PID link, can be removed c. One Patient ID wheel can be set for the entire site, or each mnemonic d. Alternate Patient ID, can be added and renamed e. A Third Patient ID can be added f. Middle Initial field can be changed to allow the full middle name g. SSN, all 9 numbers can be entered or only the last 4 digits h. Email address for the patient can be added i. Sex can be changed to Gender j. Ethnicity can be added and renamed as desired k. Marital Status can be added l. Patient Room/Bed can be added m. Relationship to Responsible Party field can be renamed as desired n. Any other field can be removed, unless stated in #1 above.

NOTE: Required fields should reflect the minimum needed for a client bill. Required fields can be determined by insurance company. The default Patient Information screen is shown below:

2. Responsible Party screen—all fields are optional and can be changed as needed a. Option available to have the patient’s address default when “Spouse” or “Child” is chosen

as the relationship b. Required fields can be determined by insurance company c. Any of the fields can be removed and/or set as required.


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The default Responsible Party screen is shown below:

3. Insurance screen—all fields are optional a. Add Insurance link after search can be removed

b. Primary, Secondary and Supplemental naming is optional c. Display of Secondary and Supplemental insurance is optional d. Required fields can be determined by insurance company e. Option available for editing a patient’s insurance. If this option is on, when the subscriber

relationship is changed the option to remove the previous subscriber information is presented.

f. Option available to display the insurance company address when searching as well as on the common insurance screen

The default insurance screen is shown below:


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J. Activity Logs 1. The user can optionally suppress the Add-On List and/or the Manifest List. 2. Manifest List options:

a. Enable retransmission of the HL7 message b. Optional fields:

i. Client MRN ii. Patient ID

iii. Patient Date of Birth The default Activity Logs list is shown below:


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Chapter 7 | Requisition and Label Options

Order Requisition Specification

As part of your implementation fee, Lifepoint will provide an Order Requisition (“base document”) and a list of options. The lab will have the opportunity to make two revisions to the base document by choosing from the available options in this section. Additional changes are available on a time and materials basis. See Appendix A for additional options.

A. Order Requisition Options 1. Requisition Header

Order Requisition—optional document label Logo—required laboratory logo. One logo for all reports is permitted. The lab will be responsible for providing a logo in jpg, bmp or png format, which must be sized at 435 pixel height x 801 pixel width (i.e. 1.45 inches height x 2.67 inches width) at 300 dpi resolution. Lifepoint will resize provided logo(s) as needed. Lab Address—required label. Up to 4 lines of address information for the laboratory is permitted. This can be changed based on specific test codes that are on the order for situations where Pathology tests are performed by a different internal organization. Priority—optional label and field. Label value can be changed. Data value will be either Stat or Normal. Option exists to put “Stat” in larger font and in red. Data value corresponds to document footer Stat indicator. Bill To—optional label and field. Label value can be changed. Data value will be based on Bill-To dropdown indicator in Order Review. Drop-down option values are: Insurance, Patient, Client. Req #—required label and field. Label value can be changed. Data value will be based on an incremented Lifepoint requisition number. Optional numbering sequences are:

Sequential (1, 2, 3, etc.)

Client-Sequential (SUN-0001, SUN-0002, etc.)

Date/Time stamp-Sequential (200612221301-001, 200612221305-001, etc) YYYYMMDDHHMM-NNN

Coll Dt—required label and field. Label value can be changed. Optional data values are Collection Date and Collection Date/Time.


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Coll Tm—required label and field. Label value can be changed. Optional data values are Collection Time and Collection Date/Time. Fasting—optional label and field. Label value can be changed. Data value will be based on Fasting checkbox indicator in Order Review. Optional values are: Yes, No, Unknown 2. Patient Information and Requesting Location

Patient Information—required label. Label value can be changed. Patient Name/Address/Phone—optional fields. Optional Data values are:

Patient Name (lastname, firstname, MiddleInitial)

Patient Home Address

Patient Home City/State/Zip code

Patient Home Phone

Patient Work Phone Patient Identifiers—optional labels and fields. Label values can be changed. Optional Data values are:

PtId—primary Lifepoint patient identifier

AltPtId—alternate Lifepoint patient identifier

Additional Patient Information

Optional labels and fields: Label values can be changed. Data value will be based on data fields displayed in Order Review or Add/Edit Patient. Up to six fields may be displayed.

1. SSN—Patient SSN from Add/Edit Patient. Can optionally suppress first 5 digits 2. DOB—Patient Date of Birth from Add/Edit Patient. 3. Gender—Patient gender as “Male” or “Female” from Add/Edit Patient 4. Room—Room from either Add/Edit Patient or Order Review 5. EMR#—EMR# from Order Review. Used to pass a specific EMR control number in the resulted

data. Requires EMR interface upgrades. 6. Employer—Patient Employer from Add/Edit Patient 7. Age—Age calculated from DOB on Add/Edit Patient 8. Marital Status—Marital Status from Add/Edit Patient 9. Race—Race from Add/Edit Patient


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Requesting Location—required label and fields. Up to 4 lines of address information for the ordering user. Primary client code can be included along with the name. Name, address, phone are entered from Admin Mode/Add User.

B. Specimen Label Options In accordance with the Clinical Laboratory Standards Institute document AUTO12-A—Specimen Labels: Content and Location, Fonts, and Label Orientation; Approved Standard Lifepoint will create a default specimen label for use, if requested. 1. There must be 5 main data elements on the specimen label.

Patient Name

Unique Patient Identifier

Date of Birth

Collection Date & Time

Collector Identification.

2. The orientation of the data elements will be as follows:

3. Any additional data that is present on the requisition may be included on the specimen label.

4. A linear barcode may also be added

5. The orientation of the label with additional data elements will be as follows:


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Chapter 8 | Result Report Options

Using the Lifepoint Result Report

As part of your implementation fee, Lifepoint will provide a result report (‘base document’) and a list of options. The lab will have the opportunity to make two revisions to the base document by choosing from the available options in this section. Additional changes are available on a time and materials basis. See Appendix A for additional options.

Report Options

Test Results- optional label. Can be changed based on Accession Number format or HL7 data key for AP, Radiology Results, etc. Example: “Pathology Report”

Final Report- optional label. Logical value based on report status (Partial/Final). Default values are “Partial Report” and “Final Report”. Logical values can be changed based on Partial/Final status to any other wording. Example: “Preliminary Report”.

Logo- required laboratory logo. One logo for all reports is permitted. Lab must provide logo in jpg, bmp, or png format, which must be sized at 109 pixel height x 200 pixel width (1.45 inches height x 2.67 inches width) at 300 dpi resolution. Lifepoint will resize provided logos as needed.

Lab Address- required label. Up to 4 lines of address information for the laboratory. Can be changed based on Accession Number format or HL7 data key for AP, Radiology Results, etc. for situations where Pathology tests are performed by a different internal organization.

Organization Information- required label. Wording change is permitted, but not dynamic.

Address- required label. Up to 5 lines of address and location identifying information for the requesting location. Variable based on data entered at user setup.


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Patient Information- required label. Wording change is permitted, but not dynamic.

Data Fields- optional labels and data fields. Up to 9 lines of patient identifying information. All data fields must be included in the PID segment of HL7 result messages, in a text header transformed to HL7, or available in the Add/Edit patient screen. Simple data transforms are available (example: “F” instead of “FEMALE”).

Order Information- required label. Wording change is permitted, but not dynamic.

Data Fields- optional labels and data fields. Up to 10 lines of report identifying information. All data fields must be included in the MSH, ORC, PV1, OBR or OBX segment of the HL7 result messages or in a text header transformed to HL7. Simple data transforms are available (example: “11-23-2006” instead of “11/23/2006”).

Comments- optional label. Wording change is permitted, by not dynamic.

Comment Data- optional data fields. Up to 2 lines, 80 characters max of report comment. Data must be sent as NTE’s following an ORC or PV1 segment, or in a text header transformed to HL7.

Column Headers- optional labels. Column order can be changed. Additional separate headers for Abnormal/Normal results can be added. Can be suppressed based on Accession Number format or HL7 data keys for AP, Radiology Results, etc. (example: Suppress for Pathology Report).

Test Name- optional label. Wording change is permitted but not dynamic. In the report this column will contain:

Test Code (optional)

Test Name (optional)

Result Analyte Code (optional, if different from test code)

Result Analyte Name (optional, if different from test name)

Test Comments (optional, conditional, up to 80 characters)

Result Comments (optional, conditional, up to 80 characters)

AP/Textual Result data (optional, conditional, up to 80 characters)

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Result- optional label. Wording change is permitted, but not dynamic. In the report this column will consist of two sub-columns. One for normal results, one for abnormal results. Options are:

Abnormal results can have row, cell or column highlighting based on the user’s preferences.

Sub-columns may be switched (Normal/Abnormal or Abnormal/Normal)

Abnormal Results can additionally be marked with <H>, *H, *, or H (bolded)

Longer textual results may be displayed in the Test Name column

Reference Range- optional label. Wording change is permitted, but not dynamic. In the report this column will contain the reference range sent in the HL7.

Units- optional label. Wording change is permitted, but not dynamic. In the report this column will contain the Units sent in the HL7.

Resulted- optional label. Wording change is permitted, but not dynamic. In the report this column will contain the resulted date sent in OBX segment of the HL7.

Site- optional label. Wording change is permitted, but not dynamic. In the report, this column will contain the performing test location or initials of the performing technician sent in OBX segment of the HL7. If performing test location is chosen, a “Site Codes” key will display below the last test.

Site Codes

Each entry in the SITE column can be referenced to a Site Codes table provided by the Laboratory. Contact your Implementation Project Manager for formatting information in submitting a Site Codes table.

Print Information/Page Numbering

User print information and page numbering can be included at the bottom of the report. Options are:

Date/Time printed

Username

“Page # of #” on each page

“End of Report” on final page


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Complete Report example:

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Appendix A | Additional Functions and Features (fee for service)

Lifepoint Result Report Options

1. Using a custom result report

Lifepoint will map data fields from their base documents to a lab-specific result report. In order to do this, the lab must provide the mapping of data fields between their report and the Lifepoint base document. Once this mapping is applied, this will become the “base document” for the Lab. The Lab will have the opportunity to make two revisions to the base document during the implementation phase.

2. Abnormal Summary

Abnormal results may be optionally summarized at the end of the report. Note that CAP and CLIA requirements dictate that they are shown in the main body of the report, so the abnormal summary is an optional additional display.

3. Bold transform of HL7 of HTML Bolding

Lifepoint supports HTML tags and HL7 bold indicators in comment (NTE) or OBX text (TX or FT) messages.

4. Merge of other PDF’s

Additional PDF’s may be sent and attached to the end of the report. These additional PDF’s will not be counted in the page counts and need to stand alone. The file name either needs to be Accession#.pdf or the file name needs to be submitted in the HL7.

5. Lab Director Signature Image and Name

Optionally, the Lab Director’s name and signature image can be printed in any location on the bottom of the report. The lab must provide the signature image in the appropriate size and resolution.


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Appendix B | Lifepoint Interface Specifications

1. Inbound Results (ORU) Specifications

Note: This specification is for LifePoint Informatics’ implementation guide only. For actual coding purposes, please refer to Health Level Seven’s document HL7 Standard Version 2.3.

Introduction

This specification provides a detailed description of LifePoint Informatics’ implementation of Health Level 7 (HL7) Version 2.3 for collection of managed care laboratory results. It is assumed that the user of this specification is knowledgeable of HL7.

LifePoint Informatics has identified the HL7 segments and fields required for collection of laboratory results.

LifePoint Informatics requirements presented in this specification conform to HL7 Version 2.3. Optional fields in the HL7 specification have been identified as required for collection of laboratory data by LifePoint Informatics.

HL7 ORU^R01 Unsolicited Transmission of Lab Observation Message

HL7 ORU^R01 messages will be received by LifePoint, Inc. Application either via TCP/IP communication or whenever a batch file containing lab results is placed in the input directory. LifePoint Informatics must be informed whether the lab intends to send lab results via TCP/IP or through batch files in order to properly receive.

Unsolicited Transmission of an Observation Message (ORU)

Segment Name LifePoint Repeat?

FHS File Header Segment O BHS Batch Header Segment O MSH Message Header R NTE Notes and Comments O Yes PID Patient Identification R Yes PV1 Patient Visit R OBR Observation Request R Yes OBX Results O Yes BTS Batch Trailer Segment O FTS File Trailer Segment O

Notation: R Required by LifePoint, Inc.

O Optional

N Received by LifePoint, Inc., but not processed. Always optional.

C Conditionally handled by LifePoint, Inc.

Grayed Not handled by LifePoint, Inc.


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Results Message Format

Unsolicited lab results:

FHS File Header Segment

BHS Batch Header Segment

MSH Message Header

[{NTE}] Notes and Comments (for Header) { PID Patient Identification [{NTE}] Comments (for Patient Identification) PV1 Patient Visit [{NTE}] Comments (for Patient Visit) { OBR Order Request [{NTE}] Notes and Comments (for Order Request) [{OBX}] Observation/Result [{NTE}] Notes and Comments (for Observation/Result) } } BTS Batch Trailer Segment FTS File Trailer Segment

Notation: [ ] Optional elements

{ } Repeating elements

Field Notations The following are the clarifications for the column use and notations for the fields in the tables that describe individual segments in the following pages. Only the segments that are actually processed by the LifePoint, Inc.’s Application are included in this document. The grayed fields are not processed by the LifePoint, Inc.’s Application.

Sequence Contains field sequence number.

Max Size Contains the maximum size of the corresponding column in LifePoint, Inc. database. This is the size that is guaranteed to be placed in LifePoint, Inc. records in its entirety. If there are sizes indicated for sub-components, it means that each sub-component is placed in the separate column in the database. If there is only one value for the maximum size for the composite field, it means that the entire composite field is placed in the single column in the LifePoint, Inc. database (the field is not parsed). If the maximum sizes are provided for certain sub-components of the composite field only, it means that only these sub-components are saved in LifePoint, Inc.’s database.


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Required

Notation Definition

R Required by LifePoint, Inc.

D Desired by LifePoint, Inc.

C Conditional

O Optional

Repeats Contains the maximum number of times the field can be repeated. If this field is left blank, there are no repeats.

Data type Contains data types accepted by LifePoint, Inc. The following table lists some of them.

Notation Definition

ID Value restricted to certain characters defined by the HL7 standard

IS Value restricted to certain characters defined by the user

NM Numeric

TS Time Stamp

ST String

More data types are defined by the HL7 standard. For more information please call Health Level Seven at 313/677-7777 or on the Internet at http://www.mcis.duke.edu/standards/HL7/hl7.htm .

Description Contains field name and, if applicable, its sub-components.

Comment Contains additional information about the field. If the comment has the text in quotation marks, then the corresponding field is expected to contain exactly this text, or, in case of multiple texts, one of them as it appears inside quotation marks. For example, “MSH” in the comment column means that this field will always contain the following value: MSH

http://www.mcis.duke.edu/standards/HL7/hl7.htm


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Description

Comment FHS 0 3 R ID Segment type ID “FHS”





31 Name

31 ID

23 ID Type

FHS 5 20 O ST File Receiving Application “LIFEPOINT”


FHS 7 26 O TS File Creation Date/Time of Message

CCYYMMDDHHMM


FHS 9 20 R ST File Name / ID Submitting Laboratory’s Local File









31 Name


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Comment 31 ID

23 ID Type

BHS 5 20 O ST Batch Receiving Application “LIFEPOINT”













31 Name

31 ID

23 ID Type

MSH 5 40 O ST Receiving Application “LIFEPOINT”

MSH 6 40 R ST Receiving Facility A mutually agreed upon unique identifier for the facility to receive the particular message. “NJA”




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Description

Comment MSH 9 ST Message Type

3 R Type “ORU”

3 O Trigger “R01”












PID 0 3 R ID Segment type ID “PID”

PID 1 4 O ST Set ID – Patient ID Segment’s sequence number

PID 2 30 O ST Patient Id (External Id) – uses first sub-component only (ID).

Requestor Id (LifePoint, Inc. ID returned by a lab)

PID 3 16 R ST Patient Id (Internal Id) – uses first sub-component only (ID).

Physician Practice ID

PID 4 16 O ST Alternate Patient ID – uses first sub-component only (ID).

Internal Submitting Laboratory ID

PID 5 ST Patient Name: Patient’s legal name

19 R Family Name

14 R Given Name


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Comment 2 O Middle initial

PID 7 8 R/O

ST Date/Time of Birth Patient’s date and time of birth

CCYYMMDDHHMM * If not used in matching, not required

PID 8 2 R/O

ST Patient’s sex “F” = Female

“M” = Male

“U” = Unknown * If not used in matching, not required

PID 11 O ST Patient’s Address:

31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country

PID 13 20 O ST Phone Number – Home. Uses first sub-component only.

Patient’s home phone number

PID 14 20 O ST Phone Number – Business. Uses first sub-component only.

Patient’s work phone number

PID 16 10 O IS Marital Status “M” = Married

“S” = Single

“D” = Divorced

“W” = Widowed

“U” = Unknown

PID 18 O ST Patient/Client Account Number This field can be filled with client id assigned by a lab for billing purposes.


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Description

Comment PID 19 9 R/

O ST SSN Number – Patient Patient’s Social Security number Format:

999999999

May be required for patient matching.

NTE 0 3 O ID Segment type ID “NTE”

NTE 1 6 O ST Set ID – NTE Segment’s sequence number

NTE 2 8 O IS Source of Comment “L” = Lab is the source of comment

“P” = Order placer (i.e. LifePoint, Inc.) is the source of comment

“O” = Other system is the source

NTE 3 200 O ST Comment Comment text (may include embedded HTML) or line break characters

PV1 0 3 R ID Segment type ID “PV1”

PV1 7 6 R ST Physician License Number Attending physician license number.

Not required if sent in OBR

UPIN

Family Name

Given Name

Middle initial

PV1 39 10 O ST Servicing Provider

PV1 50 20 O ST Alternate Visit ID



OBR 2 30 C ST Placer Order Number – uses first sub-component only.

Placer order number (requestor accession, i.e. LifePoint, Inc. Requisition Number)

OBR 3 22 R ST Filler Order Number – uses first sub-component only.

Laboratory Accession Number (internal lab number)

OBR 4 200 R ST Universal Service ID: The limit of the entire field is 200. The limit of


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Description

Comment 10 Identifier = LOINC Number the text field (second sub-component) is 100.

The length of other sub-components is not specified. 5 Name of system = “LOINC”


100 Test Name



“T” = Timing Critical

OBR 6 26 O TS Requested Date/time CCYYMMDDHHMM

OBR 7 26 O TS Observation Date/Time Collection start date and time CCYYMMDDHHMM

OBR 8 26 R TS Observation End Date/Time Collection end date time CCYYMMDDHHMM

OBR 9 O ST Collection Volume: Volume of a specimen (required for some tests)

10 Quantity

10 Units

OBR 10 O ST Collector Identifier Person who collected the specimen

5 Code

19 Last name

14 First name

2 Middle name

3 Suffix

5 Prefix

5 Degree

OBR 11 2 O ID Specimen Action Code

OBR 13 80 O ST Relevant Clinical Info. Suspected diagnosis or other clinical findings


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Comment OBR 14 26 O TS Specimen Received Date/Time Received date time CCYYMMDDHHMM


OBR 16 R ST Ordering Provider: Account Number Account Name

*Not required if sent in PV1

12 Id

19 Last name

14 First Name

2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type



OBR 20 60 O ST Filler Field 1


OBR 22 26 O TS Results Reported/Status Changed - Date/Time

CCYYMMDDHHMM

OBR 23 O ST Diagnostic Service Section ID “AU” = Audiology

“BG” = Blood Gases

“BLB” = Blood Bank

“CUS” = Cardiac Ultrasound

“CTH” = Cardiac Catheterization

“CT” = CAT Scan

“CH” = Chemistry

“CP” = Cytopathology


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Description

Comment “EC” = Electro cardiac (e.g., EKG, EEC, Holter)

“EN” = Electroneuro (EEG, EMG,EP,PSG)

“HM” = Hematology

“ICU” = Bedside ICU Monitoring

“IMM” = Immunology

“LAB” = Laboratory

“MB” = Microbiology

“MCB” = Mycobacteriology

“MYC” = Mycology

“NMS” = Nuclear Medicine Scan

“NMR” = Nuclear Magnetic Resonance

“NRS” = Nursing Service Measures

“OUS” = OB Ultrasound

“OT” = Occupational Therapy

“OTH” = Other

“OSL” = Outside Lab

“PHR” = Pharmacy

“PT” = Physical Therapy

“PHY” = Physician (Hx. Dx, admission note, etc.l)

“PF” = Pulmonary Function

“RAD” = Radiology

“RX” = Radiograph

“RUS” = Radiology Ultrasound

“RC” = Respiratory Care (therapy)


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Description

Comment “RT” = Radiation Therapy

“SR” = Serology

“SP” = Surgical Pathology

“TX” = Toxicology

“VUS” = Vascular Ultrasound

“VR” = Virology

“XRC” = Cineradiograph

OBR 25 2 O IS Result Status “P” = Preliminary: A verified early result is available, final results not yet obtained

“F” = Final

OBR 26

O ST Parent Result Link to parent result

OBR 28 O Y ST Result Copies To:

5 Id

19 Last name

14 First Name

2 Middle initial

5 Suffix

5 Prefix

10 Degree

10 Code Type

OBR 32 O ST Principal Result Interpreter:

7 Id

19 Last name

14 First Name


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Description

Comment 2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type

OBR 34 O ST Technician:

7 Id

19 Last name

14 First Name

2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type

OBX 0 3 O ID Segment type ID “OBX”

OBX 1 4 O ST Set ID – OBX Sequence number

OBX 2 3 O ST Value Type “ST” = String

”CE” = Coded Element

“TX” = Text Data

“FT” = Formatted Text (may include embedded HTML or line break)

“NM” = Numeric

Other Values – please specify

OBX 3 200 R ST Observation ID: The limit of the entire field is 200. The limit of the text field (second sub-component) is 100. The length of other sub-components is not Identifier = LOINC Number

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Description

Comment Name of system = “LOINC” specified.

100 Alternate Identifier = Local Laboratory’s order code”

Test Name

OBX 4 20 O ST Observation Sub-Id

OBX 5 255 C ST Observation Value (Result) Laboratory Result

OBX 6 C ST Units: Units of measure

20 Identifier

Text

Name of the coding system

Alternate Id

Alternate text

Alternate coding system

OBX 7 60 C ST Reference Range

10 Low Range

10 High Range

40 Alpha - Report Range

OBX 8 10 C ST Abnormal Flags “L” = Below low normal

“H” = Above high normal

“LL” = Below lower panic limits

“HH” = Above upper panic limits

“<” = Below absolute low-off instrument scale

“>” = Above absolute high-off instrument scale

“null” = No range defined, or normal ranges don't apply


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Comment OBX 10 2 O 5 ST Nature of Abnormal Test

OBX 11 2 R ST Observation Result Status “F” = Final result

“P” = Preliminary Result

OBX 14 26 O TS Date/Time of the Observation CCYYMMDDHHMM

OBX 15 255 O ST Producer’s Information

ID

Name

Identifying Code

Name of Producer – can be looked up if table provided. Sub-delimiters of semi-colon or tilde are supported for name, address, csz, or any line break needed on printed report








SAMPLE FILES MSH|^~\&|LAB||LIFEPOINT|CLIENTCODE|200407150900||ORU^R01||P|2.3| PID|1|1008 3036|3200067|AC450450|TEST^PATIENT^||19680510|M|||||||||||380-14-0114 PV1|O|||||ZZ43043655^TEST,DOCTOR OBR|1|1008 3036|AC450450|^LOINC^19147^URINALYSIS|R|||200407081216||||||200407080000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^106785^SPECIMEN #|1|DNR||||||F| OBX|2||^LOINC^100590^COLOR|1|YELLOW||||||F| OBX|3||^LOINC^100525^CLARITY|1|CLEAR||||||F| OBX|4||^LOINC^101080^GLUCOSE|1|negative||neg||||F| OBX|5||^LOINC^100400^BILIRUBIN|1|negative||neg||||F| OBX|6||^LOINC^101325^KETONES|1|negative||neg||||F|


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OBX|7||^LOINC^102075^SPECIFIC GRAVITY|1|1.030||1.005^1.030||||F| OBX|8||^LOINC^108400^BLOOD|1|negative||neg||||F| OBX|9||^LOINC^106672^PH|1|5.5||5.0^8.0||||F| OBX|10||^LOINC^101825^PROTEIN|1|negative||neg||||F| OBX|11||^LOINC^102825ÛROBI|1|0.2|EU/dL|0.2^1.0||||F| OBX|12||^LOINC^101575^NITRITE|1|negative||neg||||F| OBX|13||^LOINC^101375^LEUK ESTER|1|negative||neg||||F| OBX|14||^LOINC^106033^WBC (/hpf)|1|DNR|per hpf|||||F| OBX|15||^LOINC^106031^RBC (/hpf)|1|DNR|per hpf|||||F| OBX|16||^LOINC^109142^SQ EP (/lpf)|1|DNR||||||F| OBX|17||^LOINC^109143^HY CAST (/lpf)|1|DNR||||||F| OBX|18||^LOINC^100325^BACT (/hpf)|1|DNR||||||F| OBX|19||^LOINC^109144^PATH CASTS|1|DNR||||||F| OBX|20||^LOINC^100785ÊPITHELIA|1|DNR||||||F| OBX|21||^LOINC^100670^CRYST (/hpf)|1|DNR||||||F| OBX|22||^LOINC^109145ÔTHERS|1|DNR||||||F| OBX|23||^LOINC^101860^QL PROTEIN|1|DNR||||||F| OBX|24||^LOINC^102015^REDUCING SUBSTANCES|1|DNR||||||F| OBX|25||^LOINC^101280ÎCTOTEST|1|DNR||||||F| OBX|26||^LOINC^101510^MICRO ORD|1|DNR||||||F| OBX|27||^LOINC^106321^DONE?|1|DNR||||||F| OBX|28||^LOINC^106535^PERFORMED BY|1|DNR||||||F| OBX|29||^LOINC^106151^COMMENT|1|DNR||||||F| OBR|2|1008 3036|AC450450|^LOINC^60212^C TRACHOMATIS & N GONORRHOEAE - PCR|R|||200407081216||||||200407080000||CLIENTCODE||||Y||200407150816||MPRB|F|| OBX|1||^LOINC^610212^SPECIMEN #|1|DNR||||||F| OBX|2||^LOINC^620212^PROBE LAB #|1|L04-8114||||||F| OBX|3||^LOINC^630212^SPECIMEN TYPE|1|URETHRAL SWAB||||||F| OBX|4||^LOINC^640212^C. trachomatis RESULT|1|Negative||Negative||||F| OBX|5||^LOINC^650212^N. gonorrhoeae RESULT|1|Negative||Negative||||F| OBX|6||^LOINC^660212^NOTE|1|||||||F| NTE|1||This assay is approved by the FDA for diagnostic purposes using the following NTE|2||sample types from symptomatic and asymptomatic males and females: female NTE|3||endocervical swab, male urethral swab, and male urine. Other sample types have NTE|4||not been validated. The Chlamydia assay does not detect plasmid-free variants NTE|5||of Chlamydia trachomatis. OBX|7||^LOINC^670212^COMMENT|6|DNR||||||F| OBX|8||^LOINC^680212^METHODOLOGY|6|||||||F| NTE|1||Polymerase Chain Reaction OBX|9||^LOINC^690212^PERFORMED BY|7|DNR||||||F| NTE|1|| NTE|2|| NTE|3||PATH:I have reviewed the results and agree with the diagnosis. NTE|4||Pathologist NTE|5||Myname, Any, M.D. MSH|^~\&|LAB||LIFEPOINT|CLIENTCODE|200407150900||ORU^R01||P|2.3| PID|2|1008 3068|3205985|AC458573|TEST^PATIENT2^||19480127|M|||||||||||368-50-8405 PV1|O|||||ZZ43050762^TEST,DOCTOR

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OBR|1|1008 3068|AC458573|^LOINC^13480^LIPID PANEL|S|||200407131728||||||200407130000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^105966^SPECIMEN #|1|DNR||||||F| NTE|1||NOT INDICATED OBX|2||^LOINC^105967^FASTING SPECIMEN|2|NOT INDICATED||||||F| OBX|3||^LOINC^100475^CHOL|2|229|mg/dL|<=199|H|||F| NTE|1||Ref Range: NTE|2||200-239 mg/dL borderline high NTE|3|| >240 mg/dL high OBX|4||^LOINC^102270^TRIG|5|79|mg/dL|<=149||||F| NTE|1||Ref Range: NTE|2||150-199 mg/dL borderline high NTE|3||200-499 mg/dL high NTE|4|| >=500 mg/dL very high OBX|5||^LOINC^101370^LDL CHOL|9|152|mg/dL|<=129|H|||F| NTE|1||Ref Range: NTE|2|| <100 mg/dL optimal (if other risk factors) NTE|3||100-129 mg/dL near or above optimal NTE|4||130-159 mg/dL borderline high NTE|5||160-190 mg/dL high NTE|6|| >190 mg/dL very high OBX|6||^LOINC^101170^HDL CHOL|15|61|mg/dL|<40 increased risk of CHD||||F| OBX|7||^LOINC^100480^CHOL/HDL RATIO|15|3.8||<=4.9||||F| NTE|1||Ref Range: NTE|2|| <5.0: desirable NTE|3||5.0-6.0: borderline-high NTE|4|| >6.0: high OBX|8||^LOINC^100481^NOTE|19|||||||F| NTE|1||The appropriate LDL cholesterol level for an individual depends on overall NTE|2||risk factors for cardiovascular disease. Risk factors are CHD, other NTE|3||atherosclerotic disease, diabetes mellitus, cigarette smoking, hypertension, NTE|4||family history of premature CHD, age (male >=45y, female >=55y). An HDL NTE|5||cholesterol >=60 mg/dL is regarded as a negative risk factor. JAMA 285:2486-97 NTE|6||(2001). OBX|9||^LOINC^105968^COMMENT|25|DNR||||||F| OBX|10||^LOINC^104330^INTERFERENCE|25|DNR||||||F| OBR|2|1008 3068|AC458573|^LOINC^17050^FASTING GLUCOSE|S|||200407131728||||||200407130000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^105126^SPECIMEN #|25|DNR||||||F| NTE|1||%SUPP OBX|2||^LOINC^101135^GLUCOSE, FASTING|26|108|mg/dL|60^109||||F| OBX|3||^LOINC^104879^COMMENT|26|DNR||||||F| OBX|4||^LOINC^105004^PERFORMED BY|26|DNR||||||F| OBR|3|1008 3068|AC458573|^LOINC^17231^PROSTATE SPECIFIC ANTIGEN, SCREENING|S|||200407131728||||||200407130000||CLIENTCODE||||||200407140818|||F|| OBX|1||^LOINC^105549^SPECIMEN #|26|DNR||||||F| OBX|2||^LOINC^101810^PSA|26|2.3|ng/mL|<= 3.9||||F| OBX|3||^LOINC^105324^COMMENT|26|DNR||||||F| OBX|4||^LOINC^105435^PERFORMED BY|26|DNR||||||F|


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OBR|4|1008 3068|AC458573|^LOINC^27055^COMPLETE BLOOD COUNT W/DIFFERENTIAL AND PLT|S|||200407131728||||||200407130000||CLIENTCODE||||||200407140818|||F|| OBX|1||^LOINC^200721^SPECIMEN #|26|DNR||||||F| OBX|2||^LOINC^200440^WBC|26|5.6|bil/L|4.4^10.1||||F| OBX|3||^LOINC^200365^RBC|26|5.12|tril/L|4.31^5.48||||F| OBX|4||^LOINC^200135^HGB|26|15.6|g/dL|13.5^17.0||||F| OBX|5||^LOINC^200115^HCT|26|47.7|%|40.0^50.1||||F| OBX|6||^LOINC^200190^MCV|26|93.2|fl|80^100||||F| OBX|7||^LOINC^200180^MCH|26|30.5|pg|28^33||||F| OBX|8||^LOINC^200185^MCHC|26|32.7|%|32^36||||F| OBX|9||^LOINC^200362^RDW-SD|26|44|%|37^47||||F| OBX|10||^LOINC^200390^RDW-CV|26|13|%|12^15||||F| OBX|11||^LOINC^200310^PLT|26|181|bil/L|150^400||||F| OBX|12||^LOINC^200040^CBC COMMENT|26|DNR||||||F| OBX|13||^LOINC^200050^CELLS CTD|26|DNR||||||F| OBX|14||^LOINC^200080^DOWNTIME DIFF|26|DNR||||||F| OBX|15||^LOINC^200245^NEUT|26|2.8|bil/L|2.0^6.2||||F| OBX|16||^LOINC^200155^LYMPH|26|2.1|bil/L|1.1^4.0||||F| OBX|17||^LOINC^200215^MONO|26|0.5|bil/L|0.0^0.9||||F| OBX|18||^LOINC^200085ÊOS|26|0.2|bil/L|0.0^0.4||||F| OBX|19||^LOINC^200015^BASO|26|0.1|bil/L|0.0^0.1||||F| OBX|20||^LOINC^200361ÂBS IG|26|DNR|bil/L|||||F| OBX|21||^LOINC^200005ÂT LYM|26|DNR|bil/L|||||F| OBX|22||^LOINC^200010^BAND|26|DNR|bil/L|||||F| OBX|23||^LOINC^200205^META|26|DNR|bil/L|||||F| OBX|24||^LOINC^200230^MYELO|26|DNR|bil/L|||||F| OBX|25||^LOINC^200330^PROGRAN|26|DNR|bil/L|||||F| OBX|26||^LOINC^200025^BLAST|26|DNR|bil/L|||||F| OBX|27||^LOINC^200255^NRBC/100 WBC|26|DNR||||||F| OBX|28||^LOINC^200295^PLASMA|26|DNR|bil/L|||||F| OBX|29||^LOINC^200280^PELG|26|DNR|bil/L|||||F| OBX|30||^LOINC^200165^M MONO|26|DNR|bil/L|||||F| OBX|31||^LOINC^200100^HAIRY|26|DNR|bil/L|||||F| OBX|32||^LOINC^200270ÔTHER|26|DNR|bil/L|||||F| OBX|33||^LOINC^200385^RBC MORPH|26|DNR||||||F| OBX|34||^LOINC^200450^WBC MORPH|26|DNR||||||F| OBX|35||^LOINC^200315^PLT EST|26|DNR||||||F| OBX|36||^LOINC^200678ÔBSERVATIONS|26|DNR||||||F| OBX|37||^LOINC^200070^DIFF COMMENT|26|DNR||||||F| OBX|38||^LOINC^200682^PATH COMMENT|26|DNR||||||F| OBX|39||^LOINC^200698^PERFORMED BY|26|DNR||||||F|


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2. Outbound ADT Specification

Note: This specification is for LifePoint Informatics’ implementation guide only. For actual coding purposes, please refer to Health Level Seven’s document HL7 Standard Version 2.3.

Introduction

This specification provides a detailed description of LifePoint Informatics’ implementation of Health Level 7 (HL7) Version 2.3 for collection of managed care laboratory results. It is assumed that the user of this specification is knowledgeable of HL7.


LifePoint Informatics requirements presented in this specification conform to HL7 Version 2.3. Optional fields in the HL7 specification have been identified as required for collection of laboratory data by LifePoint Informatics.

HL7 ADTÂ08 and ADTÂ04 Transmission of Patient Demographics

HL7 ADTÂ08 and ADTÂ04 messages will be sent by LifePoint Informatics Application either via TCP/IP communication or whenever a batch file containing lab results is placed in the input directory. LifePoint Informatics must be informed whether to send patient demographics via TCP/IP or through batch files. Outbound messages are sent only when users release the manifest list (online) on Chart Sync (desktop).

Inbound Patient Data Message (ADT) Segment Name Labtest Repeat? FHS File Header

Segment O


O

MSH Message Header R PID Patient

Identification R

GT1 Guarantor Segment

O

IN1 Insurer Segment O Yes DG1 Diagnosis Segment O Yes BTS Batch Trailer

Segment O

FTS File Trailer Segment

O

Notation: R Required by LifePoint Informatics

O Optional

N Received by LifePoint Informatics, but not processed. Always optional.

C Conditionally handled by LifePoint Informatics

Grayed Not handled by LifePoint, Inc.


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Message Format

Inbound ADT:



MSH Message Header PID Patient Identification [GT1] Guarantor Segment [{IN1}] Insurer Segment [{DG1}] Diagnosis Segment BTS Batch Trailer Segment FTS File Trailer Segment



Field Notations The following are the clarifications for the column use and notations for the fields in the tables that describe individual segments in the following pages. Only the segments that are actually processed by the LifePoint Informatics’ Application are included in this document. The grayed fields are not processed by the LifePoint Informatics’ Application.


Max Size Contains the maximum size of the corresponding column in LifePoint Informatics database. This is the size that is guaranteed to be placed in LifePoint Informatics records in its entirety. If there are sizes indicated for sub-components, it means that each sub-component is placed in the separate column in the database. If there is only one value for the maximum size for the composite field, it means that the entire composite field is placed in the single column in the LifePoint Informatics database (the field is not parsed). If the maximum sizes are provided for certain sub-components of the composite field only, it means that only these sub-components are saved in LifePoint Informatics’ database.


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Required

Notation Definition

R Required by LifePoint Informatics

D Desired by LifePoint Informatics

C Conditional

O Optional


Data type Contains data types accepted by LifePoint Informatics The following table lists some of them.

Notation Definition



NM Numeric

TS Time Stamp

ST String

More data types are defined by the HL7 standard. For more information please call Health Level Seven at 313/677-7777 or on the Internet at http://www.mcis.duke.edu/standards/HL7/hl7.htm.





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31 Name

31 ID

23 ID Type


FHS 6 20 O ST File Receiving Facility












31 Name


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31 ID

23 ID Type


BHS 6 20 O ST Batch Receiving Facility












31 Name

31 ID

23 ID Type


MSH 6 40 R ST Receiving Facility A mutually agreed upon unique identifier for the facility to receive the particular message.




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3 R Type “ADT”

3 O Trigger “A08” , “A04”















Requestor Id (LifePoint Informatics ID returned by a lab)






19 R Family Name


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14 R Given Name

2 O Middle initial

PID 7 8 R/O


(Only if required for patient matching)

CCYYMMDDHHMM

PID 8 2 R/O

ST Patient’s sex “F” = Female (Only if required for patient matching)

“M” = Male

“U” = Unknown


31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country






PID 19 9 R/O

ST SSN Number – Patient Patient’s Social Security number Format: 999999999



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GT1 0 3 R ID Segment type ID “GT1”

GT1 3 ST Guarantor Name: Guarantor’ legal name

19 R Family Name

14 R Given Name

2 O Middle Initial

GT1 5 O ST Guarantor’s Address:

31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country

GT1 8 8 O ST Guarantor’s Date/Time of Birth Guarantor’s date and time of birth

CCYYMMDDHHMM

GT1 9 2 R ST Guarantor’s sex “F” = Female

“M” = Male

“U” = Unknown

GT1 11 10 O IS Relationship Patient’s relationship to Guarantor.

“SELF” = Self

“SPOUSE” = Spouse

“CHILD” = Child

“OTHER” = Other

GT1 12 9 O ST SSN Number – Guarantor Guarantor’s Social Security number Format: 999999999


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GT1 16 O ST Employer – Guarantor Guarantor’s employer

IN1 2 60 O ST Insurance Plan ID

IN1 3 59 R Y ST Insurance Company ID Either IN1:3 or IN1:4 is needed.

IN1 4 130 R Y ST Insurance Company Name

IN1 5 106 O Y ST Insurance Company Address

IN1 6 48 O Y ST Insurance Co. Contact Person

IN1 7 40 O Y ST Insurance Co Phone Number

IN1 8 12 O ST Group Number

IN1 9 130 O Y ST Group Name

IN1 10 12 O Y ST Insured’s Group Emp ID

IN1 11 130 O Y ST Insured’s Group Emp Name

IN1 16 48 R Y ST Name Of Insured Insured Party Name

First Name

Given Name

Middle Initial

IN1 17 2 O IS Patient Relationship to Insured Patient’s relationship to Insured

“SELF” = Self


“CHILD” = Child

“OTHER” = Other

IN1 18 26 O TS Insured’s Date Of Birth CCYYMMDDHHMM

IN1 19 106 O Y ST Insured’s Address Insured Party Address

30 Address Line 1


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30 Address Line 2

20 City

2 State

9 ZIP Code

IN1 36 15 R ST Policy Number

IN1 42 60 O ST Insured’s Employment Status

IN1 43 1 O IS Insured’s Sex

IN1 44 106 O Y ST Insured’s Employer Address

DG1 0 3 R Segment ID type “DG1”

DG1 1 4 O Set ID Segment’s sequence number

DG1 3 7 R ICD-9 Code

DG1 4 40 O ICD-9 Description If not provided, will look up in Labtest table




BTS 3 100 0 NM

Batch Totals


FTS 1 10 R NM

File Batch Counts

FTS 3 80 O File Trailer Comment


Page 82 of 126

SAMPLE FILES

MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LABTEST|NJA|200307311001||ADTÂ08||T|2.3 PID|1||2519136||TEST^MARIE^J||19730628|F|||2101 MARK DR^^SHERWOOD^NJ^07432^||201-555-1111|212-555-2222||||2519136|666666666| GT1|1||TEST^MARIE^J||2101 MARK DR^^SHERWOOD^NJ^07432^|201-555-1111|212-555-2222||||SELF IN1|1||461|BLUE CROSS BLUE SHIELD OF NEBRASKA||||112|||MAPLE AUTO PARTS|||||TEST^MARIE^J|SELF|||||||||||||||||||9112 IN1|2||3608|COVENTRY HEALTH CARE||||333|||MAPLE AUTO PARTS|||||TEST^JOSEPHÊ|SPOUSE|||||||||||||||||||1011233333 DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER|||||| MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LABTEST|NJA|200307311001||ADTÂ04||T|2.3 PID|1||2520658||TEST^MARK^||19280725|M|||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^|||||||2520658|777777777| GT1|1||TEST^MARK^||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^||||||SELF IN1|1||001|MEDICARE||||||||||||TEST^MARK^|SELF|||||||||||||||||||777777777A IN1|2||002|AETNA||||MEDIADD||||||||TEST^KATHY|SPOUSE|||||||||||||||||||777777777A DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER||||||


Page 83 of 126

3. Inbound ADT Specification

Note: This specification is LifePoint Informatics’ implementation guide only. For actual coding purposes, please refer to Health Level Seven’s document HL7 Standard Version 2.3. Please see page 5 for more information on obtaining this document.

Introduction

This specification provides a detailed description of LifePoint Informatics’ implementation of Health Level 7 (HL7) Version 2.3 for collection of patient demographics. It is assumed that the user of this document is knowledgeable of HL7.

LifePoint Informatics has identified the HL7 segments and fields required for collection of patient demographics.

LifePoint Informatics requirements presented in this document conform to HL7 Version 2.3. Optional fields in the HL7 specification have been identified as required for collection of laboratory data by LifePoint Informatics

HL7 ADTÂ08 and ADTÂ04 Transmission of Patient Demographics

HL7 ADTÂ08 and ADTÂ04 messages will be received by LifePoint Informatics Application either via TCP/IP communication or whenever a batch file containing lab results is placed in the input directory. LifePoint Informatics must be informed whether the lab intends to send lab results via TCP/IP or through batch files in order to properly receive.

Inbound Patient Data Message (ADT) Segment

Name Labtest Repeat?

FHS File Header Segment O BHS Batch Header Segment O MSH Message Header R PID Patient Identification R PV1 Patient Visit O GT1 Guarantor Segment O IN1 Insurer Segment O Yes DG1 Diagnosis Segment O Yes BTS Batch Trailer Segment O FTS File Trailer Segment O


O Optional



Grayed Not handled by LifePoint Informatics


Page 84 of 126

Message Format

Inbound ADT:



MSH Message Header PID Patient Identification [PV1] Patient Visit [GT1] Guarantor Segment [{IN1}] Insurer Segment [{DG1}] Diagnosis Segment BTS Batch Trailer Segment FTS File Trailer Segment







Page 85 of 126

Required

Notation Definition



C Conditional

O Optional

Repeats Contains the maximum number of times the field can be repeated. If this field is left blank, there are no repeats. Data type Contains data types accepted by LifePoint Informatics The following table lists some of them.

Notation Definition



NM Numeric

TS Time Stamp

ST String




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31 Name

31 ID

23 ID Type














31 Name

31 ID

23 ID Type







Page 87 of 126









31 Name

31 ID

23 ID Type


MSH 6 40 R ST Receiving Facility A mutually agreed upon unique identifier for the facility to receive the particular message.




3 R Type “ADT”

3 O Trigger “A08” , “A04”










Page 88 of 126













19 R Family Name

14 R Given Name

2 O Middle initial

PID 7 8 R/O


(Only if required for patient matching)

CCYYMMDDHHMM

PID 8 2 R/O

ST Patient’s sex “F” = Female (Only if required for patient matching)

“M” = Male

“U” = Unknown


31 Street Address

31 Other Address

21 City

4 State

10 Postal Code


Page 89 of 126

50 Country






PID 19 9 R/O

ST SSN Number – Patient Patient’s Social Security number Format: 999999999



PV1 7 6 R ST Physician Information Primary physician license number.

GT1 0 3 R ID Segment type ID “GT1”

GT1 3 ST Guarantor Name: Guarantor’ legal name

19 R Family Name

14 R Given Name

2 O Middle Initial

GT1 5 O ST Guarantor’s Address:

31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country

GT1 6 O ST Phone number Guarantor’s home phone number

GT1 7 O ST Phone number Guarantor’s work phone number

GT1 8 8 O ST Guarantor’s Date/Time of Birth Guarantor’s date and time of birth

CCYYMMDDHHMM


Page 90 of 126

GT1 9 2 O ST Guarantor’s sex “F” = Female

“M” = Male

“U” = Unknown

GT1 11 10 O IS Relationship Patient’s relationship to Guarantor.

“SELF” = Self


“CHILD” = Child

“OTHER” = Other

GT1 12 9 O ST SSN Number – Guarantor Guarantor’s Social Security number Format: 999999999

GT1 16 O ST Employer – Guarantor Guarantor’s employer

IN1 0 3 R ID Segment type ID “IN1”

IN1 1 4 O Set ID Segment’s sequence number. If not provided, first IN1 will be primary, second secondary, and third tertiary. Labtest supports up to three insurances per patient.

IN1 2 60 O ST Insurance Plan ID

IN1 3 59 R Y ST Insurance Company ID Either IN1:3 or IN1:4 is needed.

IN1 4 130 R Y ST Insurance Company Name

IN1 5 106 O Y ST Insurance Company Address

IN1 6 48 O Y ST Insurance Co. Contact Person

IN1 7 40 O Y ST Insurance Co Phone Number

IN1 8 12 O ST Group Number

IN1 9 130 O Y ST Group Name

IN1 10 12 O Y ST Insured’s Group Emp ID

IN1 11 130 O Y ST Insured’s Group Emp Name

IN1 16 48 R Y ST Name Of Insured Insured Party Name

First Name


Page 91 of 126

Given Name

Middle Initial

IN1 17 2 O IS Patient Relationship to Insured Patient’s relationship to Insured

“SELF” = Self


“CHILD” = Child

“OTHER” = Other

IN1 18 26 O TS Insured’s Date Of Birth CCYYMMDDHHMM

IN1 19 106 O Y ST Insured’s Address Insured Party Address

30 Address Line 1

30 Address Line 2

20 City

2 State

9 ZIP Code

IN1 36 15 R ST Policy Number

IN1 42 60 O ST Insured’s Employment Status

IN1 43 1 O IS Insured’s Sex

IN1 44 106 O Y ST Insured’s Employer Address

DG1 0 3 R Segment ID type “DG1”

DG1 1 4 O Set ID Segment’s sequence number

DG1 3 7 R ICD-9 Code

DG1 4 40 O ICD-9 Description If not provided, will look up in Labtest table






Page 92 of 126

SAMPLE FILES

MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LABTEST|NJA|200307311001||ADTÂ08||T|2.3 PID|1||2519136||TEST^MARIE^J||19730628|F|||2101 MARK DR^^SHERWOOD^NJ^07432^||201-555-1111|212-555-2222||||2519136|666666666| GT1|1||TEST^MARIE^J||2101 MARK DR^^SHERWOOD^NJ^07432^|201-555-1111|212-555-2222||||SELF IN1|1||461|BLUE CROSS BLUE SHIELD OF NEBRASKA||||112|||MAPLE AUTO PARTS|||||TEST^MARIE^J|SELF|||||||||||||||||||9112 IN1|2||3608|COVENTRY HEALTH CARE||||333|||MAPLE AUTO PARTS|||||TEST^JOSEPHÊ|SPOUSE|||||||||||||||||||1011233333 DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER|||||| MSH|^~\&|LISNAME|LABNAME^LABCODE^LAB|LABTEST|NJA|200307311001||ADTÂ04||T|2.3 PID|1||2520658||TEST^MARK^||19280725|M|||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^|||||||2520658|777777777| GT1|1||TEST^MARK^||7101 FREEDOM ROADÂPT 1234^LANCASTER^NJ^07432^||||||SELF IN1|1||001|MEDICARE||||||||||||TEST^MARK^|SELF|||||||||||||||||||777777777A IN1|2||002|AETNA||||MEDIADD||||||||TEST^KATHY|SPOUSE|||||||||||||||||||777777777A DG1|1||787.01|NAUSEA WITH VOMITING|||||| DG1|2||780.6|FEVER||||||



FTS 3 80 O File Trailer Comment


Page 93 of 126

4. Outbound Orders (ORM) Specification


Introduction

This specification provides a detailed description of LifePoint Informatics’ implementation of Health Level 7 (HL7) Version 2.3 for collection of managed care laboratory results. It is assumed that the user of this document is knowledgeable of HL7.


LifePoint Informatics requirements presented in this specification conform to HL7 Version 2.3. Optional fields in the HL7 specification have been identified as required for collection of laboratory data by LifePoint Informatics

HL7 ORM^O01 Unsolicited Transmission of Lab Observation Message

HL7 ORM^O01 messages will be sent by LifePoint Informatics Application either via TCP/IP communication or whenever a batch file containing laboratory orders is placed in the output directory. LifePoint Informatics must be informed whether the laboratory intends to receive laboratory orders via TCP/IP or through batch files in order to properly send. Outbound messages are sent only when users release the manifest list (online) on Chart Sync (desktop).

Unsolicited Transmission of an Observation Message (ORM) Segment

Name Labtest Repeat?

FHS File Header Segment O BHS Batch Header Segment O MSH Message Header R NTE Notes and Comments O Yes PID Patient Identification R Yes PV1 Patient Visit O ORC Common Order R Yes OBR Observation Request R Yes DG1 Diagnosis Segment OBX Results O Yes BTS Batch Trailer Segment O FTS File Trailer Segment O


O Optional



Page 94 of 126



Order Message Format

Unsolicited lab orders:



MSH Message Header

[{NTE}] Comments (for Message Header) { PID Patient Identification [{NTE}] Comments (for Patient Identification) [PV1] Patient Visit [{NTE}] Comments (for Insurer Segment) [{NTE}] Comments (for Staff Identification Segment) [{NTE}] Comments (for Diagnosis Segment)

{ ORC Common Order

[{OBR}] Order Request [{DG1}] Diagnosis Segment

[{OBX}] Results BTS Batch Trailer Segment FTS File Trailer Segment






Page 95 of 126


Required

Notation Definition



C Conditional

O Optional



Notation Definition



NM Numeric

TS Time Stamp

ST String






Page 96 of 126

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Comment FHS 0 3 R ID Segment type ID “FHS”



FHS 3 40 O ST File Sending Application “LABTEST”

FHS 4 O ST File Sending Facility “LABTEST”

FHS 5 20 O ST File Receiving Application A unique identifier for the facility receiving the particular message.

FHS 6 20 O ST File Receiving Facility A unique identifier for the facility receiving the particular message.



FHS 9 ST File Name / ID Labtest.com’s Local File







BHS 3 40 O ST Batch Sending Application “LABTEST”

BHS 4 O ST Batch Sending Facility “LABTEST”

BHS 5 20 O ST Batch Receiving Application A unique identifier for the facility receiving the particular message.

BHS 6 20 O ST Batch Receiving Facility A unique identifier for the facility receiving the particular message.


Page 97 of 126

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Comment BHS 7 26 O TS Batch Date/Time of Message CCYYMMDDHHMM









MSH 3 40 O ST Sending Application “LABTEST”

MSH 4 O ST Sending Facility

MSH 5 40 O ST Receiving Application A unique identifier for the facility receiving the particular message.

MSH 6 40 O ST Receiving Facility A unique identifier for the facility receiving the particular message.




3 R Type “ORM”

3 O Trigger “O01”






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Comment MSH 13 O ST Sequence Number










Requestor Id (Labtest.com ID returned by a lab)






19 R Family Name

14 R Given Name

2 O Middle initial

PID 7 8 O ST Date/Time of Birth Patient’s date and time of birth


PID 8 2 O ST Patient’s sex “F” = Female

“M” = Male



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Comment PID 11 O ST Patient’s Address:

31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country






“S” = Single

“D” = Divorced

“W” = Widowed

“U” = Unknown


PID 19 9 O ST SSN Number – Patient Patient’s Social Security number Format: 999999999





“P” = Order placer (i.e. LifePoint Informatics) is the source of comment


Page 100 of 126

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Comment “O” = Other system is the source

NTE 3 200 O ST Comment Comment text




UPIN

Family Name

Given Name

Middle initial



ORC 0 3 R ID Segment type ID “ORC”

ORC 1 4 R ST Order Control “NW” or “CA”

ORC 2 30 R ST Placer Order Number – uses first sub-component only.

Placer order number (requestor accession, i.e. LifePoint Informatics Requisition Number)

ORC 3 22 O ST Filler Order Number – uses first sub-component only.


ORC 4 75 O ST Placer Group Number

ORC 5 2 O ST Order Status

ORC 9 26 R TS Date / Time of Transaction CCYYMMDDHHMM

ORC 10 80 O ST Entered By

ORC 12 3 R ST Ordering Provider OR can be sent in PV1

ORC 13 80 O ST Enterer’s Location

ORC 15 26 O TS Order Effective Date / Time CCYYMMDDHHMM

ORC 17 60 O ST Entering Organization


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Comment ORC 19 80 O ST Action BY










20

Alternate Identifier = Local Laboratory’s order code"

100 Test Name

OBR

OBR

OBR

OBR

OBR

5

6

7

8

9

2 O

O

O

R

O

ST

TS

TS

TS

ST

Priority “R” = Routine



CCYYMMDDHHMM

Collection start date and time CCYYMMDDHHMM

Collection end date time CCYYMMDDHHMM

Volume of a specimen (required for some tests)

26 Requested Date/time

26 Observation Date/Time

26 Observation End Date/Time

10

10

Collection Volume:

Quantity

Units


5 Code

19 Last name


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Comment 14 First name

2 Middle name

OBR

OBR

OBR

OBR

OBR

11

13

14

15

16

3

O

O

O

O

R

ID

ST

TS

ST

ST

Suffix

Suspected diagnosis or other clinical findings

Received date time CCYYMMDDHHMM


5 Prefix

5 Degree

2 Specimen Action Code

80 Relevant Clinical Info.

26 Specimen Received Date/Time

Specimen Source Code

Ordering Provider:

12 Id Account Number

19 Last name Account Name

14 First Name

2 Middle initial

OBR

OBR

OBR

OBR

OBR

18

19

20

21

22

3

O

O

O

O

O

ST

ST

ST

ST

TS

Suffix

5 Prefix Account Number

5 Degree Account Name

5 Code Type

CCYYMMDDHHMM

60 Placer field 1

60 Placer field 2

60 Filler Field 1

60 Filler Field 2

26 Results Reported/Status Changed - Date/Time


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Comment OBR 23 O ST Diagnostic Service Section ID “AU” = Audiology

“BG” = Blood Gases

“BLB” = Blood Bank

“CUS” = Cardiac Ultrasound

“CTH” = Cardiac Catheterization

OBR

28

5

19

14

2

O

Y

ST

Result Copies To:

Id

Last name

First Name

Middle initial

“CT” = CAT Scan

“CH” = Chemistry

“CP” = Cytopathology

“EC” = Electrocardiac (e.g., EKG, EEC, Holter)

“EN” = Electroneuro (EEG, EMG,EP,PSG)

“HM” = Hematology

“ICU” = Bedside ICU Monitoring

“IMM” = Immunology

“LAB” = Laboratory

“MB” = Microbiology

“MCB” = Mycobacteriology

“MYC” = Mycology

“NMS” = Nuclear Medicine Scan

“NMR” = Nuclear Magnetic Resonance

“NRS” = Nursing Service Measures

“OUS” = OB Ultrasound

“OT” = Occupational Therapy

“OTH” = Other


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Comment “OSL” = Outside Lab

“PHR” = Pharmacy

“PT” = Physical Therapy

“PHY” = Physician (Hx. Dx, admission note, etc.l)

“PF” = Pulmonary Function

“RAD” = Radiology

“RX” = Radiograph

“RUS” = Radiology Ultrasound

“RC” = Respiratory Care (therapy)

“RT” = Radiation Therapy

“SR” = Serology

“SP” = Surgical Pathology



“VR” = Virology




“VR” = Virology


OBR

33

5

O

ST

Suffix

5 Prefix

10 Degree


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Comment 10 Code Type

Technician:

7 Id

19 Last name

14 First Name

2 Middle initial

DG1

DG1

DG1

DG1

DG1

0

1

2

3

4

3

O

R

O

O

O

ID

NM

ID

ST

ST

Suffix

“DG1”

“ICD9”

5 Prefix

5 Degree

5 Code Type

3 Segment type ID

4 Sequence Number

2 Diagnosis Coding Method

60

40

Diagnosis Code

5 Diagnosis Description

Text

OBX 4 20 O ST Observation Sub-Id “1”

OBX 5 255

20

235

C ST Observation Value (Result) AAOE Answer

If no code is assigned, text is in the first sub-piece

OBX

11

2

R

ST

Code

“F” Text

Observation Result Status


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Comment BTS 0 3 R ID Segment type ID “BTS”

BTS

BTS

BTS

1

2

3

1

80

100

R

0

0

ST

ST

NM

Batch Message Count Contains the individual messages contained within the batch.

Batch Comment

Batch Totals


FTS 1 10 R NM

File Batch Counts



Page 107 of 126

5. Inbound Orders (ORM) Specification


Introduction

This specification provides a detailed description of LifePoint Informatics’ implementation of Health Level 7 (HL7) Version 2.3 for collection of managed care laboratory results. It is assumed that the user of this document is knowledgeable of HL7.


LifePoint Informatics requirements presented in this specification conform to HL7 Version 2.3. Optional fields in the HL7 specification have been identified as required for collection of laboratory data by LifePoint Informatics

HL7 ORM^O01 Unsolicited Transmission of Lab Inbound Orders Message

HL7 ORM^O01 messages will be received by LifePoint Informatics Application either via TCP/IP communication or whenever a batch file containing lab results is placed in the input directory. LifePoint Informatics must be informed whether the lab intends to send lab results via TCP/IP or through batch files in order to properly receive.

Unsolicited Transmission of an Observation Message (ORU) Segment Name Labtest Repeat

? FHS File Header Segment O BHS Batch Header Segment O MSH Message Header R NTE Notes and Comments O Yes PID Patient Identification R Yes PV1 Patient Visit R ORC Order Control R OBR Observation Request R Yes BTS Batch Trailer Segment O FTS File Trailer Segment O


O Optional





Page 108 of 126

Message Format

Unsolicited lab results:

[FHS] File Header Segment

[BHS] Batch Header Segment

MSH Message Header

{ PID Patient Identification PV1 Patient Visit ORC Order Control [{NTE}] Comments (for Patient Visit) { OBR Order Request [{NTE}] Notes and Comments (for Order Request) } } [BTS] Batch Trailer Segment [FTS] File Trailer Segment







Page 109 of 126

Required

Notation Definition



C Conditional

O Optional



Notation Definition



NM Numeric

TS Time Stamp

ST String






Page 110 of 126

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31 Name

31 ID

23 ID Type













BHS 4 O ST Batch Sending Facility A unique identifier for the facility


Page 111 of 126

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31 Name sending that particular message.

31 ID

23 ID Type














31 Name

31 ID

23 ID Type


MSH 6 40 R ST Receiving Facility A mutually agreed upon unique identifier for the facility to receive the particular message. “NJA”



Page 112 of 126

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3 R Type “ORM”

3 O Trigger “O01”





















19 R Family Name


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14 R Given Name

2 O Middle initial

PID 7 8 R/O ST Date/Time of Birth Patient’s date and time of birth


PID 8 2 R/O ST Patient’s sex “F” = Female

“M” = Male



31 Street Address

31 Other Address

21 City

4 State

10 Postal Code

50 Country






“S” = Single

“D” = Divorced

“W” = Widowed

“U” = Unknown


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PID 19 9 R/O ST SSN Number – Patient Patient’s Social Security number Format: 999999999





“P” = Order placer (i.e. LifePoint Informatics) is the source of comment

“O” = Other system is the source

NTE 3 200 O ST Comment Comment text




UPIN

Family Name

Given Name

Middle initial



ORC 0 3 R ID Segment type ID “ORC”

ORC 1 4 R ST Order Control “NW” or “CA”

ORC 2 30 R ST Placer Order Number – uses first sub-component only.



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ORC 3 22 O ST Filler Order Number – uses first sub-component only.


ORC 4 75 O ST Placer Group Number

ORC 5 2 O ST Order Status

ORC 9 26 R TS Date / Time of Transaction CCYYMMDDHHMM

ORC 10 80 O ST Entered By

ORC 12 3 R ST Ordering Provider OR can be sent in PV1

ORC 13 80 O ST Enterer’s Location

ORC 15 26 O TS Order Effective Date / Time CCYYMMDDHHMM

ORC 17 60 O ST Entering Organization

ORC 19 80 O ST Action BY











100 Test Name


“S” = STAT testing allowed on this


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sample.


OBR 6 26 O TS Requested Date/time CCYYMMDDHHMM

OBR 7 26 O TS Observation Date/Time Collection start date and time CCYYMMDDHHMM

OBR 8 26 R TS Observation End Date/Time Collection end date time CCYYMMDDHHMM

OBR 9 O ST Collection Volume: Volume of a specimen (required for some tests)

10 Quantity

10 Units


5 Code

19 Last name

14 First name

2 Middle name

3 Suffix

5 Prefix

5 Degree

OBR 11 2 O ID Specimen Action Code

OBR 13 80 O ST Relevant Clinical Info. Suspected diagnosis or other clinical findings

OBR 14 26 O TS Specimen Received Date/Time Received date time CCYYMMDDHHMM


OBR 16 R ST Ordering Provider: Account Number

12 Id


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19 Last name Account Name


14 First Name

2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type





OBR 22 26 O TS Results Reported/Status Changed - Date/Time

CCYYMMDDHHMM

OBR 23 O ST Diagnostic Service Section ID

OBR 27 5 O Y ST Result Copies To:

Id

19 Last name

14 First Name

2 Middle initial

5 Suffix

5 Prefix

10 Degree

10 Code Type

OBR 31 O ST Principal Result Interpreter:


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7 Id

19 Last name

14 First Name

2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type

OBR 33 O ST Technician:

7 Id

19 Last name

14 First Name

2 Middle initial

3 Suffix

5 Prefix

5 Degree

5 Code Type








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SAMPLE FILES MSH|^~\&|LAB||LABTEST|CLIENTCODE|200407150900||ORU^R01||P|2.3| PID|1|1008 3036|3200067|AC450450|TEST^PATIENT^||19680510|M|||||||||||380-14-0114 PV1|O|||||ZZ43043655^TEST,DOCTOR OBR|1|1008 3036|AC450450|^LOINC^19147ÛRINALYSIS|R|||200407081216||||||200407080000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^106785^SPECIMEN #|1|DNR||||||F| OBX|2||^LOINC^100590^COLOR|1|YELLOW||||||F| OBX|3||^LOINC^100525^CLARITY|1|CLEAR||||||F| OBX|4||^LOINC^101080^GLUCOSE|1|negative||neg||||F| OBX|5||^LOINC^100400^BILIRUBIN|1|negative||neg||||F| OBX|6||^LOINC^101325^KETONES|1|negative||neg||||F| OBX|7||^LOINC^102075^SPECIFIC GRAVITY|1|1.030||1.005^1.030||||F| OBX|8||^LOINC^108400^BLOOD|1|negative||neg||||F| OBX|9||^LOINC^106672^PH|1|5.5||5.0^8.0||||F| OBX|10||^LOINC^101825^PROTEIN|1|negative||neg||||F| OBX|11||^LOINC^102825ÛROBI|1|0.2|EU/dL|0.2^1.0||||F| OBX|12||^LOINC^101575^NITRITE|1|negative||neg||||F| OBX|13||^LOINC^101375^LEUK ESTER|1|negative||neg||||F| OBX|14||^LOINC^106033^WBC (/hpf)|1|DNR|per hpf|||||F| OBX|15||^LOINC^106031^RBC (/hpf)|1|DNR|per hpf|||||F| OBX|16||^LOINC^109142^SQ EP (/lpf)|1|DNR||||||F| OBX|17||^LOINC^109143^HY CAST (/lpf)|1|DNR||||||F| OBX|18||^LOINC^100325^BACT (/hpf)|1|DNR||||||F| OBX|19||^LOINC^109144^PATH CASTS|1|DNR||||||F| OBX|20||^LOINC^100785ÊPITHELIA|1|DNR||||||F| OBX|21||^LOINC^100670^CRYST (/hpf)|1|DNR||||||F| OBX|22||^LOINC^109145ÔTHERS|1|DNR||||||F| OBX|23||^LOINC^101860^QL PROTEIN|1|DNR||||||F| OBX|24||^LOINC^102015^REDUCING SUBSTANCES|1|DNR||||||F| OBX|25||^LOINC^101280ÎCTOTEST|1|DNR||||||F| OBX|26||^LOINC^101510^MICRO ORD|1|DNR||||||F| OBX|27||^LOINC^106321^DONE?|1|DNR||||||F| OBX|28||^LOINC^106535^PERFORMED BY|1|DNR||||||F| OBX|29||^LOINC^106151^COMMENT|1|DNR||||||F|

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OBR|2|1008 3036|AC450450|^LOINC^60212^C TRACHOMATIS & N GONORRHOEAE - PCR|R|||200407081216||||||200407080000||CLIENTCODE||||Y||200407150816||MPRB|F|| OBX|1||^LOINC^610212^SPECIMEN #|1|DNR||||||F| OBX|2||^LOINC^620212^PROBE LAB #|1|L04-8114||||||F| OBX|3||^LOINC^630212^SPECIMEN TYPE|1|URETHRAL SWAB||||||F| OBX|4||^LOINC^640212^C. trachomatis RESULT|1|Negative||Negative||||F| OBX|5||^LOINC^650212^N. gonorrhoeae RESULT|1|Negative||Negative||||F| OBX|6||^LOINC^660212^NOTE|1|||||||F| NTE|1||This assay is approved by the FDA for diagnostic purposes using the following NTE|2||sample types from symptomatic and asymptomatic males and females: female NTE|3||endocervical swab, male urethral swab, and male urine. Other sample types have NTE|4||not been validated. The Chlamydia assay does not detect plasmid-free variants NTE|5||of Chlamydia trachomatis. OBX|7||^LOINC^670212^COMMENT|6|DNR||||||F| OBX|8||^LOINC^680212^METHODOLOGY|6|||||||F| NTE|1||Polymerase Chain Reaction OBX|9||^LOINC^690212^PERFORMED BY|7|DNR||||||F| NTE|1|| NTE|2|| NTE|3||PATH:I have reviewed the results and agree with the diagnosis. NTE|4||Pathologist NTE|5||Myname, Any, M.D. MSH|^~\&|LAB||LABTEST|CLIENTCODE|200407150900||ORU^R01||P|2.3| PID|2|1008 3068|3205985|AC458573|TEST^PATIENT2^||19480127|M|||||||||||368-50-8405 PV1|O|||||ZZ43050762^TEST,DOCTOR OBR|1|1008 3068|AC458573|^LOINC^13480^LIPID PANEL|S|||200407131728||||||200407130000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^105966^SPECIMEN #|1|DNR||||||F| NTE|1||NOT INDICATED OBX|2||^LOINC^105967^FASTING SPECIMEN|2|NOT INDICATED||||||F| OBX|3||^LOINC^100475^CHOL|2|229|mg/dL|<=199|H|||F| NTE|1||Ref Range: NTE|2||200-239 mg/dL borderline high NTE|3|| >240 mg/dL high OBX|4||^LOINC^102270^TRIG|5|79|mg/dL|<=149||||F| NTE|1||Ref Range: NTE|2||150-199 mg/dL borderline high NTE|3||200-499 mg/dL high NTE|4|| >=500 mg/dL very high OBX|5||^LOINC^101370^LDL CHOL|9|152|mg/dL|<=129|H|||F| NTE|1||Ref Range: NTE|2|| <100 mg/dL optimal (if other risk factors) NTE|3||100-129 mg/dL near or above optimal NTE|4||130-159 mg/dL borderline high

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NTE|5||160-190 mg/dL high NTE|6|| >190 mg/dL very high OBX|6||^LOINC^101170^HDL CHOL|15|61|mg/dL|<40 increased risk of CHD||||F| OBX|7||^LOINC^100480^CHOL/HDL RATIO|15|3.8||<=4.9||||F| NTE|1||Ref Range: NTE|2|| <5.0: desirable NTE|3||5.0-6.0: borderline-high NTE|4|| >6.0: high OBX|8||^LOINC^100481^NOTE|19|||||||F| NTE|1||The appropriate LDL cholesterol level for an individual depends on overall NTE|2||risk factors for cardiovascular disease. Risk factors are CHD, other NTE|3||atherosclerotic disease, diabetes mellitus, cigarette smoking, hypertension, NTE|4||family history of premature CHD, age (male >=45y, female >=55y). An HDL NTE|5||cholesterol >=60 mg/dL is regarded as a negative risk factor. JAMA 285:2486-97 NTE|6||(2001). OBX|9||^LOINC^105968^COMMENT|25|DNR||||||F| OBX|10||^LOINC^104330^INTERFERENCE|25|DNR||||||F| OBR|2|1008 3068|AC458573|^LOINC^17050^FASTING GLUCOSE|S|||200407131728||||||200407130000||CLIENTCODE||||||200407150816|||F|| OBX|1||^LOINC^105126^SPECIMEN #|25|DNR||||||F| NTE|1||%SUPP OBX|2||^LOINC^101135^GLUCOSE, FASTING|26|108|mg/dL|60^109||||F| OBX|3||^LOINC^104879^COMMENT|26|DNR||||||F| OBX|4||^LOINC^105004^PERFORMED BY|26|DNR||||||F| OBR|3|1008 3068|AC458573|^LOINC^17231^PROSTATE SPECIFIC ANTIGEN, SCREENING|S|||200407131728||||||200407130000||CLIENTCODE||||||200407140818|||F|| OBX|1||^LOINC^105549^SPECIMEN #|26|DNR||||||F| OBX|2||^LOINC^101810^PSA|26|2.3|ng/mL|<= 3.9||||F| OBX|3||^LOINC^105324^COMMENT|26|DNR||||||F| OBX|4||^LOINC^105435^PERFORMED BY|26|DNR||||||F| OBR|4|1008 3068|AC458573|^LOINC^27055^COMPLETE BLOOD COUNT W/DIFFERENTIAL AND PLT|S|||200407131728||||||200407130000||CLIENTCODE||||||200407140818|||F|| OBX|1||^LOINC^200721^SPECIMEN #|26|DNR||||||F| OBX|2||^LOINC^200440^WBC|26|5.6|bil/L|4.4^10.1||||F| OBX|3||^LOINC^200365^RBC|26|5.12|tril/L|4.31^5.48||||F| OBX|4||^LOINC^200135^HGB|26|15.6|g/dL|13.5^17.0||||F| OBX|5||^LOINC^200115^HCT|26|47.7|%|40.0^50.1||||F| OBX|6||^LOINC^200190^MCV|26|93.2|fl|80^100||||F| OBX|7||^LOINC^200180^MCH|26|30.5|pg|28^33||||F| OBX|8||^LOINC^200185^MCHC|26|32.7|%|32^36||||F| OBX|9||^LOINC^200362^RDW-SD|26|44|%|37^47||||F| OBX|10||^LOINC^200390^RDW-CV|26|13|%|12^15||||F| OBX|11||^LOINC^200310^PLT|26|181|bil/L|150^400||||F| OBX|12||^LOINC^200040^CBC COMMENT|26|DNR||||||F| OBX|13||^LOINC^200050^CELLS CTD|26|DNR||||||F| OBX|14||^LOINC^200080^DOWNTIME DIFF|26|DNR||||||F|


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OBX|15||^LOINC^200245^NEUT|26|2.8|bil/L|2.0^6.2||||F| OBX|16||^LOINC^200155^LYMPH|26|2.1|bil/L|1.1^4.0||||F| OBX|17||^LOINC^200215^MONO|26|0.5|bil/L|0.0^0.9||||F| OBX|18||^LOINC^200085ÊOS|26|0.2|bil/L|0.0^0.4||||F| OBX|19||^LOINC^200015^BASO|26|0.1|bil/L|0.0^0.1||||F| OBX|20||^LOINC^200361ÂBS IG|26|DNR|bil/L|||||F| OBX|21||^LOINC^200005ÂT LYM|26|DNR|bil/L|||||F| OBX|22||^LOINC^200010^BAND|26|DNR|bil/L|||||F| OBX|23||^LOINC^200205^META|26|DNR|bil/L|||||F| OBX|24||^LOINC^200230^MYELO|26|DNR|bil/L|||||F| OBX|25||^LOINC^200330^PROGRAN|26|DNR|bil/L|||||F| OBX|26||^LOINC^200025^BLAST|26|DNR|bil/L|||||F| OBX|27||^LOINC^200255^NRBC/100 WBC|26|DNR||||||F| OBX|28||^LOINC^200295^PLASMA|26|DNR|bil/L|||||F| OBX|29||^LOINC^200280^PELG|26|DNR|bil/L|||||F| OBX|30||^LOINC^200165^M MONO|26|DNR|bil/L|||||F| OBX|31||^LOINC^200100^HAIRY|26|DNR|bil/L|||||F| OBX|32||^LOINC^200270ÔTHER|26|DNR|bil/L|||||F| OBX|33||^LOINC^200385^RBC MORPH|26|DNR||||||F| OBX|34||^LOINC^200450^WBC MORPH|26|DNR||||||F| OBX|35||^LOINC^200315^PLT EST|26|DNR||||||F| OBX|36||^LOINC^200678ÔBSERVATIONS|26|DNR||||||F| OBX|37||^LOINC^200070^DIFF COMMENT|26|DNR||||||F| OBX|38||^LOINC^200682^PATH COMMENT|26|DNR||||||F| OBX|39||^LOINC^200698^PERFORMED BY|26|DNR||||||F|


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6. Inbound Demographics Delimited File Specification

Introduction This specification can be used for one-time loads into the Lifepoint database. It cannot be used for ongoing loads. Fields may be omitted, but the first line of your file must include the field names that are populated in the remainder of the file. Note: This specification is Lifepoint Informatics’ implementation guide only. *Please note that required fields vary per Lab Message Format


*PID Patient ID # PMIS/EMR Medical Record Number/Patient ID, Can be Auto-generated by Lifepoint

*Clmne Client Number/Mnemonic

*PatientLastName Last Name of Patient

*PatientFirstName First Name of Patient

PatientMiddleInitial Middle Initial of Patient

PatientSex Patient’s Gender M or F

PatientDOB Patient’s Date of Birth MMDDYYYY

PatientRoom/Bed Room/Bed # of Patient

PatientSS# Patient’s Social Security # 999999999 (no dashes or spaces)

PatientHomePhone Patient’s Home Phone # 1112223333 (no punctuation or spaces)

PatientWorkPhone Patient’s Work Phone # 1112223333 (no punctuation or spaces)

PatientWorkPhoneExt Extension # of Patient’s Work Phone

PatientAddress Patient’s Address

PatientCity Patient’s City

PatientState Patient’s State Two-letter abbreviation

PatientZip Patient’s Zip Code # 99999-9999

PatientEmployer Patient’s Employer

ResponsiblePartyRelationship Relationship to Patient SELF, SPOUSE, CHILD, OTHER

ResponsiblePartyLastName Last Name of Responsible Party

ResponsiblePartyFirstName First Name of Responsible Party

ResponsiblePartyMiddleInitial Middle Initial of Responsible Party

ResponsiblePartySS# Responsible Party’s Social Security # 999999999 (no dashes or spaces)

ResponsiblePartyAddress Responsible Party’s Address

ResponsiblePartyCity Responsible Party’s City

ResponsiblePartyState Responsible Party’s State Two-letter abbreviation

ResponsiblePartyZip Responsible Party’s Zip Code # 99999-9999


Page 124 of 126

InsuranceCompanyName(1) Name of Insurance Company #1

InsuranceCompanyCode(1) Code # of Insurance Company #1 If the Insurance Code # and a Table is provided the Address of the Insurance Company will not be necessary.

InsuranceCompanyAddress(1) Insurance Company #1’s Address “

InsuranceCompanyCity(1) Insurance Company #1’s City “

InsuranceCompanyState(1) Insurance Company #1’s State Two-letter abbreviation

InsuranceCompanyZip(1) Insurance Company #1’s Zip Code # 99999-9999

InsuranceCompanyPolicy#(1) Policy # of Insurance Company #1

InsuranceCompanyGroup#(1) Group # of Insurance Company #1

SubscriberRelationship(1) Relationship of Subscriber #1 SELF, SPOUSE, CHILD, OTHER

SubscriberName(1) Name of Subscriber #1 LNAME, FNAME MI

SubscriberSex(1) Subscriber #1’s Gender M or F

SubscriberDOB(1) Subscriber #1’s Date of Birth MMDDYYYY

SubscriberAddress(1) Subscriber #1’s Address

SubscriberCity(1) Subscriber #1’s City

SubscriberState(1) Subscriber #1’s State Two-letter abbreviation

SubscriberZip(1) Subscriber #1’s Zip Code # 99999-9999

SubscriberEmployer(1) Subscriber #1’s Employer


InsuranceCompanyCode(2) Code # of Insurance Company #2 If the Insurance Code # and a Table is provided the Address of the Insurance Company will not be necessary.



InsuranceCompanyState(2) Insurance Company #2’s State “















Page 126 of 126

10001|Mouse|Mickey|M|M|02231932|RM 222|999999999|2125551212|2125553333|311|123 Main Street|Orlando|FL|09090-2222|Disneyworld|Self|Mouse|Mickey|M|999999999|123 Main Street|Orlando|FL|09090-2222|Medicare|MEDI1|123 Medicare Blvd|Hartford|CT|09099|999-99-9999A||Self|Mouse, Mickey M|M|02231932|123 Main Street|Orlando|FL|09090-2222|Disneyworld|Aetna|AE1|123 Aetna Blvd|Hartford|CT|09099|AE99999999ABC|WDN001|Self|Mouse, MickeyM|M|02231932|123 Main Street|Orlando|FL|09090-2222|Disneyworld