IHE-JコネクタソンPAM,PDQ仕様書

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IHE International Integrating the Healthcare Enterprise IHE-J コネクタソン PAM,PDQ

2 はじめに本書は Integrating the Healthcare Enterprise Japan( 以下 IHE-J) が実施するコネクタソン 2010 の Patient Administration Management および Patient Demographics Query の電文仕様について記したものである前提資料 IT Infrastructure Technical Framework Volume 1,2 Revision 4.0 Final Text August 22, 2007 Health Level Seven, Version 2.5 IHE-J 用語集 ( 来歴 Ver 更新者日付内容千葉新規作成千葉 XTN 型の注釈を変更千葉クエリパラメータの記述の変更

3 1. PAM (Patient Administration Management ) の概要基本的には Radiology の PIR Laboratory の LIR と同じ Patient Identity Feed と Patient Encounter Management がある Patient Demographics Supplier? Patient Identity Feed [ITI-030] Patient Demographics Consumer Patient Encounter Supplier? Patient Encounter Management [ITI-031] Patient Encounter Consumer Figure Patient Administration Management Actor Diagram Figure Patient Encounter Supplier Grouping Requirements

4 1.1 Patient Identity Feed のイベント一覧 Required message subset with option Merge Event Trigger Message Static definition Create new patient A28 ADT^A28^ADT_A05 Update patient information A31 ADT^A31^ADT_A05 Change Patient Identifier List A47 ADT^A47^ADT_A30 Merge two patients A40 ADT^A40^ADT_A39 Required message subset with option Link/Unlink Event Trigger Message Static definition Create new patient A28 ADT^A28^ADT_A05 Update patient information A31 ADT^A31^ADT_A05 Change Patient Identifier List A47 ADT^A47^ADT_A30 Link Patient Information A24 ADT^A24^ADT_A24 Unlink Patient Information A37 ADT^A37^ADT_A37

5 1.2 Patient Encounter Management のイベント一覧 Trigger / Action Category of event insert cancel Admit inpatient A01 ADT^A01^ADT_A01 Register outpatient A04 ADT^A04^ADT_A01 A11 ADT^A11^ADT_A09 Discharge patient A03 ADT^A03^ADT_A03 A13 ADT^A13^ADT_A01 Update patient A08 information ADT^A08^ADT_A01 Merge patient A40 ADT^A40^ADT_A39 identifier list コネクタソン 2010 での実施範囲コネクタソン 2010 では個人情報患者情報の更新のみを実施するものとする Patient Identity Feed Update patient information A31 ADT^A31^ADT_A05 Patient Encounter Management Update patient information A08 ADT^A08^ADT_A01 PR1 と ROL の関係と PDA 以外は同一の電文構造である

6 2. 使用するメッセージ 2.1 Patient Identity Feed Table : Static definition of ADT^A31^ADT_A05 Segment Meaning Usage Card. HL7 chapter MSH Message Header R [1..1] 2 SFT Software Segment O [0..*] 2 EVN Event Type R [1..1] 2 PID Patient Identification R [1..1] 3 PD1 Additional Demographics O [0..1] 3 ROL Role O [0..*] 15 NK1 Next of Kin / Associated Parties O [0..*] 3 PV1 Patient Visit R [1..1] 3 PV2 Patient Visit Additional Info X [0..0] 3 ROL Role O [0..*] 15 DB1 Disability Information O [0..*] 3 OBX Observation/Result O [0..*] 7 AL1 Allergy Information O [0..*] 3 DG1 Diagnosis Information O [0..*] 6 DRG Diagnosis Related Group O [0..1] PROCEDURE begin O [0..*] PR1 Procedures R [1..1] 6 ROL Role O [0..*] PROCEDURE end GT1 Guarantor O [0..*] INSURANCE begin O [0..1] IN1 Insurance R [1..1] 6 IN2 Insurance Additional Info. O [0..1] 6 IN3 Insurance Additional Info - Cert. O [0..1] 6 ROL Role O [0..*] 15

7 INSURANCE end ACC Accident Information O [0..1] 6 UB1 Universal Bill Information O [0..1] 6 UB2 Universal Bill 92 Information O [0..1] 6 注 1)PR1 と IN1 セグメントは PROCEDURE ブロック及び INSURANCE ブロックがオプションになっているので今回は使用しない注 2)EVN セグメントについてはコネクタソン 2010 では必須とする 2.2 Patient Encounter Management Table : Static definition of message ADT^A08^ADT_A01 Segment Meaning Usage Card. HL7 chapter MSH Message Header R [1..1] 2 SFT Software Segment O [0..*] 2 EVN Event Type R [1..1] 2 PID Patient Identification R [1..1] 3 PD1 Additional Demographics O [0..1] 3 ROL Role O [0..*] 15 NK1 Next of Kin / Associated Parties O [0..*] 3 PV1 Patient Visit R [1..1] 3 PV2 Patient Visit Additional Info O [0..1] 3 ROL Role O [0..*] 15 DB1 Disability Information O [0..*] 3 OBX Observation/Result O [0..*] 7 AL1 Allergy Information O [0..*] 3 DG1 Diagnosis Information O [0..*] 6 DRG Diagnosis Related Group O [0..1] PROCEDURE begin O [0..*]

8 Segment Meaning Usage Card. HL7 chapter PR1 Procedures R [1..1] 6 ROL Role O [0..*] PROCEDURE end GT1 Guarantor O [0..*] INSURANCE begin O [0..1] IN1 Insurance R [1..1] 6 IN2 Insurance Additional Info. O [0..1] 6 IN3 Insurance Additional Info - Cert. O [0..1] 6 ROL Role O [0..*] INSURANCE end ACC Accident Information O [0..1] 6 UB1 Universal Bill Information O [0..1] 6 UB2 Universal Bill 92 Information O [0..1] 6 PDA Patient Death and Autopsy O [0..1] 3 注 1)PR1 と IN1 セグメントは PROCEDURE ブロック及び INSURANCE ブロックがオプションになっているので今回は使用しない注 2)EVN セグメントについてはコネクタソン 2010 では必須とする必須項目は EVN-2 (Recorded Date Time) であるが EVN-7 (Event Facility) が管理できれば送信してもかまわない

9 3. 使用するセグメント Table : MSH - Message Header SEQ LEN DT Usage Card. TBL# ITEM# Element name 1 1 SI R [1..1] Field Separator 2 4 ST R [1..1] Encoding Characters HD R [1..1] Sending Application HD R [1..1] Sending Facility HD R [1..1] Receiving Application HD R [1..1] Receiving Facility 7 26 TS R [1..1] Date/Time of Message 8 40 ST X [0..0] Security 9 15 MSG R [1..1] Message Type ST R [1..1] Message Control Id 11 3 PT R [1..1] Processing Id VID R [1..1] Version ID NM O [0..1] Sequence Number ST X [0..0] Continuation Pointer 15 2 ID X [0..0] Accept Acknowledgement Type 16 2 ID X [0..0] Application Acknowledgement Type 17 3 ID RE [1..1] Country Code ID C [0..1] Character Set CE RE [1..1] Principal Language of Message ID X [0..0] Alternate Character Set Handling Scheme EI RE [0..*] Message Profile Identifier

10 Table : EVN Event Type segment SEQ LEN DT Usage Card. TBL# ITEM# Element name 1 3 ID X [0..0] Event Type Code 2 26 TS R [1..1] Recorded Date Time 3 26 TS C [0..1] Date/Time Planned Event 4 3 IS O [0..1] Event Reason Code XCN O [0..*] Operator ID 6 26 TS C [0..1] Event Occurred HD RE [0..1] Event Facility Table : PID - Patient Identification segment SEQ LEN DT Usage Card. TBL# ITEM# Element name 1 4 SI O [0..1] Set ID - PID 2 20 CX X [0..0] Patient ID CX R [1..*] Patient Identifier List 4 20 CX X [0..0] Alternate Patient ID - PID XPN R [1..*] Patient Name XPN O [0..1] Mother s Maiden Name 7 26 TS CE [0..1] Date/Time of Birth 8 1 IS CE [1..1] Administrative Sex XPN X [0..1] Patient Alias CE O [0..1] Race XAD CE [0..*] Patient Address 12 4 IS X [0..1] County Code XTN O [0..*] Phone Number - Home XTN O [0..*] Phone Number - Business CE O [0..1] Primary Language CE O [0..1] Marital Status CE O [0..1] Religion

11 SEQ LEN DT Usage Card. TBL# ITEM# Element name CX O [0..1] Patient Account Number ST X [0..1] SSN Number - Patient DLN X [0..1] Driver's License Number - Patient CX O [0..*] Mother's Identifier CE O [0..1] Ethnic Group ST O [0..1] Birth Place 24 1 ID O [0..1] Multiple Birth Indicator 25 2 NM O [0..1] Birth Order CE O [0..1] Citizenship CE O [0..1] Veterans Military Status CE X [0..0] Nationality TS C [0..1] Patient Death Date and Time 30 1 ID C [0..1] Patient Death Indicator 31 1 ID CE [0..1] Identity Unknown Indicator IS CE [0..*] Identity Reliability Code TS CE [0..1] Last Update Date/Time HD O [0..1] Last Update Facility CE CE [0..1] Species Code CE C [0..1] Breed Code ST O [0..1] Strain CE O [0..2] Production Class Code CWE O [0..*] Tribal Citizenship 注 )PID-13( 電話番号 )XTN の第 1 要素は B になっているので注意従来 ^PRN^PH のような書き方であったが

12 <DEPRECATED-Telephone Number (ST)> ^ <Telecommunication Use Code (ID)> ^ <Telecommunication Equipment Type (ID)> ^ < Address (ST)> ^ <Country Code (NM)> ^ <Area/City Code (NM)> ^ <Local Number (NM)> ^ <Extension (NM)> ^ <Any Text (ST)> ^ <Extension Prefix (ST)> ^ <Speed Dial Code (ST)> ^ <Unformatted Telephone number (ST)> (HL OM1-17より引用 PID-13には 'DEPRECATED' の記述は無い ) となっているので ^PRN^PH^^81^33506^8010 ^PRN^PH^^^03^ ^PRN^PH^^^033506^8010 ^PRN^PH^^^^ のような書き方あるいは最終要素 <Unformatted Telephone number (ST)> にのような非定型文字列を表現するのが正しいと思われる ^PRN^PH^^^^^^^^^ 接続検証委員会としてはコネクタソン2010では過去互換性を考慮して従来型表記 ^PRN^PH とするが実運用においては充分考慮されたい

13 Table : PV1 - Patient Visit segmentsit segment SEQ LEN DT Usage Card. TBL# ITEM# ELEMENT NAME 1 4 SI O [0..1] Set ID - PV1 2 1 IS R [1..1] Patient Class 3 80 PL C [0..1] Assigned Patient Location 4 2 IS O [0..1] Admission Type CX O [0..1] Preadmit Number 6 80 PL C [0..1] Prior Patient Location XCN O [0..*] Attending Doctor XCN O [0..*] Referring Doctor XCN X [0..0] Consulting Doctor 10 3 IS O [0..1] Hospital Service PL C [0..1] Temporary Location 12 2 IS O [0..1] Preadmit Test Indicator 13 2 IS O [0..1] Re-admission Indicator 14 6 IS O [0..1] Admit Supplier 15 2 IS O [0..*] Ambulatory Status 16 2 IS O [0..1] VIP Indicator XCN O [0..*] Admitting Doctor 18 2 IS O [0..1] Patient Type CX O [0..1] Visit Number FC O [0..*] Financial Class 21 2 IS O [0..1] Charge Price Indicator 22 2 IS O [0..1] Courtesy Code 23 2 IS O [0..1] Credit Rating 24 2 IS O [0..*] Contract Code 25 8 DT O [0..*] Contract Effective Date NM O [0..*] Contract Amount 27 3 NM O [0..*] Contract Period

14 SEQ LEN DT Usage Card. TBL# ITEM# ELEMENT NAME 28 2 IS O [0..1] Interest Code 29 4 IS O [0..1] Transfer to Bad Debt Code 30 8 DT O [0..1] Transfer to Bad Debt Date IS O [0..1] Bad Debt Agency Code NM O [0..1] Bad Debt Transfer Amount NM O [0..1] Bad Debt Recovery Amount 34 1 IS O [0..1] Delete Account Indicator 35 8 DT O [0..1] Delete Account Date 36 3 IS O [0..1] Discharge Disposition DLD O [0..1] Discharged to Location CE O [0..1] Diet Type 39 2 IS O [0..1] Servicing Facility 40 1 IS X [0..1] Bed Status 41 2 IS O [0..1] Account Status PL C [0..1] Pending Location PL O [0..1] Prior Temporary Location TS RE [0..1] Admit Date/Time TS RE [0..1] Discharge Date/Time NM O [0..1] Current Patient Balance NM O [0..1] Total Charges NM O [0..1] Total Adjustments NM O [0..1] Total Payments CX O [0..1] Alternate Visit ID 51 1 IS O [0..1] Visit Indicator XCN X [0..*] Other Healthcare Provider

15 4. PDQ(Patient Demographics Query) の概要経産省相互運用性実証実験で行っている患者基本情報のクエリとほぼ同じ Patient Demographics Supplier Patient Demographics Query [ITI-21] Patient Demographics and Visit Query [ITI-22] Patient Demographics Consumer Patient Demographics Query Patient Demographics and Visit Query の 2 種類のクエリがある前者は応答として PID セグメントのみ後者は応答として PID PV1 セグメントが要求される

16 4.1 Patient Demographics Query QPD-1(Query Name) は IHE PDQ Query QPD-3 (Demographics Fields ) no>.<component no>.<subcomponent no> PID3-1( 患者 ID) Patient Demographics Consumer Patient Demographics Supplier Patient Demographics Query: QBP^Q22 Patient Demographics Response: RSP^K Patient Demographics and Visit Query QPD-1(Query Name) は IHE PDVQ Query QPD-3 (Demographics and Visit-Related Fields) no>.<component no>.<subcomponent no> PID3-1( 患者 ID) Patient Demographics Consumer Patient Demographics Supplier Patient Demographics and Visit Query: QBP^ZV1 Patient Demographics and Visit Response: RSP^ZV2

17 5. 使用するメッセージとセグメント 5.1 Patient Demographics Query Table QBP Query by Parameter QBP Query by Parameter Chapter in HL7 2.5 MSH Message Header 2 QPD Query Parameter Definition 5 RCP Response Control Parameter 5 [DSC] Continuation Pointer 2 MSH-9 は QBP^Q22^QBP_Q21 Table IHE Profile - QPD segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME CE R Message Query Name 2 32 ST R Query Tag 3 QIP R Demographics Fields 8 CX O What Domains Returned QPD-1(Query Name) は IHE PDQ Query QPD-2(Query Tag) は現在時刻 (YYYYMMDDHHMMSS) QPD-3 (Demographics Fields ) no>.<component no>.<subcomponent no> PID3-1( 患者 ID) QPD-8 は今回使用しない ( 参考 ITI TF で要求されているクエリパラメータ ) Table PDQ Profile QPD-3 fields required to be supported FLD PID.3 PID.5 PID.7 PID.8 PID.11 PID.18 ELEMENT NAME Patient Identifier List Patient Name Date/Time of Birth Administrative Sex Patient Address Patient Account Number An example of parameter expressions in

18 ( 参考終わり ) Table IHE Profile - RCP segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME 1 1 ID R Query Priority 2 10 CQ O Quantity Limited Request RCP-1( 問い合わせ優先度 ) は I (Immediate) RCP-2( 量限定要求 ) は 1^RD (1レコード) Table RSP Segment Pattern Response RSP Segment Pattern Response Chapter in HL7 2.5 MSH Message Header 2 MSA Message Acknowledgement 2 [ {ERR} ] Error 2 QAK Query Acknowledgement 5 QPD Query Parameter Definition 5 [ { PID Patient Identification 3 [ PD1 ] Query Response Instance 5 [ QRI ] } ] [ DSC ] Continuation Pointer 2 MSH-9 は RSP^K22^RSP_K22 QPD セグメントの内容は QBP メッセージ中の QPD セグメントと同一 PD1,QRI,DSC セグメントは使用しない Table PDQ Profile - QAK segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME 1 32 ST R Query Tag 2 2 ID R Query Response Status QAK-1 は QPD-2 と同じ値とする QAK-2 は OK: 該当データあり NF: 該当データなし AE: アプリケーションエラー AR: アプリケーション破棄省略時は OK とみなすが OK を詰めることを推奨する

19 Table PDQ Profile - PID segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME CX R Patient Identifier List XPN R Patient Name 7 26 TS R Date/Time of Birth 8 1 IS R Administrative Sex XAD R Patient Address CX R Patient Account Number

20 5.2 Patient Demographics and Visit Query Table QBP Query by Parameter QBP Query by Parameter Chapter in HL7 2.5 MSH Message Header 2 QPD Query Parameter Definition 5 RCP Response Control Parameter 5 [DSC] Continuation Pointer 2 MSH-9 は QBP^ZV1^QBP_Q21 Table PDQ Profile - QPD segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME CE R Message Query Name 2 32 ST R Query Tag 3 QIP R Demographics and Visit Fields 8 CX O What Domains Returned QPD-1(Query Name) は IHE PDVQ Query QPD-2(Query Tag) は現在時刻 (YYYYMMDDHHMMSS) QPD-3 (Demographics Fields ) no>.<component no>.<subcomponent no> 今回は PID3-1( 患者 ID) QPD-8 は今回使用しない

21 ( 参考 ITI TF で要求されているクエリパラメータ ) Table PDQ Profile QPD-3 fields required to be supported FLD ELEMENT NAME PID.3 Patient Identifier List PID.5 Patient Name PID.7 Date/Time of Birth PID.8 Administrative Sex PID.11 Patient Address PID.18 Patient Account Number In addition, it is recommended that the Patient Demographics Supplier support the fields in the following table. Some fields may not be relevant to particular care settings (e.g., inpatient, day patient) and will thus not be supportable by domains in those care settings. Table PDQ Profile QPD-3 fields recommended to be supported FLD PV1.2 PV1.3 PV1.7 PV1.8 PV1.9 PV1.10 PV1.17 PV1.19 ELEMENT NAME Patient Class Assigned Patient Location Attending Doctor Referring Doctor Consulting Doctor Hospital Service Admitting Doctor Visit Number Examples of parameter expressions in requests all patients whose family name (first subcomponent (data type ST) of the first component (data type FN) of PID-5-Patient Name (data type XPN)) matches the value SMITH and whose sex (PID-8-Sex (data type IS)) matches the value requests all patients whose room number (second component (data type IS) of PV1-3-Assigned Patient Location (data type PL)) matches the value 389 and whose bed number (third component (data type IS) of PV1-3-Assigned Patient Location (data type PL)) matches the value 2. ( 参考終わり )

22 Table IHE Profile - RCP segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME 1 1 ID R Query Priority 2 10 CQ O Quantity Limited Request RCP-1( 問い合わせ優先度 ) は I (Immediate) RCP-2( 量限定要求 ) は 1^RD (1レコード) Table RSP Segment Pattern Response RSP Segment Pattern Response Chapter in HL7 2.5 MSH Message Header 2 MSA Message Acknowledgement 2 [ {ERR} ] Error 2 QAK Query Acknowledgement 5 QPD Query Parameter Definition 5 [ { PID Patient Identification 3 [ PD1 ] Additional Patient Demographics 3 PV1 Patient Visit 3 [ PV2 ] Patient Visit Additional Information 3 Query Response Instance 5 [ QRI ] } ] [ DSC ] Continuation Pointer 2 MSH-9 は RSP^ZV2^RSP_ZV2 QPD セグメントの内容は QBP メッセージ中の QPD セグメントと同一 PD1,QRI,DSC セグメントは使用しない Table IHE Profile - QAK segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME 1 32 ST R Query Tag 2 2 ID R Query Response Status QAK-1 は QPD-2 と同じ値とする QAK-2 は OK: 該当データあり NF: 該当データなし AE: アプリケーションエラー AR: アプリケーション破棄省略時は OK とみなすが OK を詰めることを推奨する

23 Table PDQ Profile - PID segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME CX R Patient Identifier List XPN R Patient Name 7 26 TS R Date/Time of Birth 8 1 IS R Administrative Sex XAD R Patient Address CX R Patient Account Number Table PDQ Profile PV1 segment SEQ LEN DT OPT TBL# ITEM# ELEMENT NAME 2 1 IS R Patient Class 3 80 PL R Assigned Patient Location XCN R Attending Doctor XCN R Referring Doctor XCN R Consulting Doctor 10 3 IS R Hospital Service XCN R Admitting Doctor CX R Visit Number

ＨＬ７Ｖ2.4における患者管理　～患者移動通知を中心として～

ＨＬ７Ｖ2.4における患者管理　～患者移動通知を中心として～ ( ) 2 18 etc ( ) 3 18 ( ) 4 18 ( ) 5 18 ( ) 6 18 HL7 ( ) 7 18 HL7 ( ) 8 18 ( ) 9 18 ( ) 10 18 HL7 etc ( ) 11 18 ( ) 12 18 ( ) 13 18 ( ) 14 18 ( ) 15 18 ( ) 16 18 - - - - - - ( ) 17 18 ( ) 18 18 1 / 3 HL7V2.4