TEP/HL7 Transform Status
Latest Update: 2/5/2015
BACKGROUND ....................................................................................................................................................... 1
USE CASES ....................................................................................................................................................................2
TRANSFORM SPREADSHEET ................................................................................................................................... 5
3/2014 BALLOT VERSION OF THE SPREADSHEET ..................................................................................................................5
CURRENT WORKING VERSION OF THE SPREADSHEET .............................................................................................................6
TRANSFORMATION SPECIFICATION ....................................................................................................................... 7
3/2014 BALLOT VERSION OF THE SPECIFICATION .................................................................................................................7
CURRENT WORKING VERSION OF THE SPECIFICATION ............................................................................................................7
ACTION ITEMS ....................................................................................................................................................... 7
Background
Hospitals use the HL7 standard internally and in information exchange with other hospitals.
The EDXL-TEP/HL7 transform is being developed to bridge the electronic gap between the
Emergency Management and EMS communities and the hospital community.
The OASIS Emergency Management Technical Committee (EM-TC) Tracking of Emergency
Patients (TEP) subcommittee (SC) has been working with the HL7 Public Health and
Emergency Response (PHER) Working Group (WG) on the EDXL-TEP/HL7 transform. The HL7
Project Scope Statement was approved 1/13/2013 with Patient Care (PC) as a co-sponsoring
WG.
An initial, but incomplete, transform was balloted by HL7 PHER in March of 2014. This ballot
should probably have been postponed until the transform was more complete, but we did
get some good feedback from the HL7 WGs. This initial transform work was prepared by
Tim Grapes, Werner Joerg, Lizzie DeYoung, and Brian Wilkins. All of these EM-TC members
became unavailable right when the transform was balloted.
Patti Aymond attended the May 2014 HL7 WG meeting to work through the ballot
comments with the HL7 WG members. She has been working, almost completely singularly,
in folding in the feedback gathered at the May 2014 and subsequent September 2014 HL7
WG Meetings in revising and completing the transforms. She became almost completely
unavailable to work further on the transformation as of 1/15/2015.
1 TEP/HL7 Transform Status
The transformation remains incomplete to this date. The current goal is to have the
transformation complete and ready to ballot in March of 2015. This living document is
intended to act as a status snapshot of the transform effort under development.
Use Cases
In working with HL7, we have identified 5 messaging use cases for patient tracking. In all use
cases where an HL7 → TEP transform is required, the HL7 message type A03 is used. In all
use cases where a TEP → HL7 transform is required, the HL7 A14 is used. Note: the
pharmaceutical fields have not yet been mapped between the two standards. It is expected
that additional HL7 message type(s) will be required to complete the transformation.
1. The first one is hospital to hospital communication. This is strictly within the HL7
domain and is considered out-of-scope for the TEP/HL7 transform.
2 TEP/HL7 Transform Status
2. A second use case is patients arriving to the hospital ED via EMS. The EMS system
uses EDXL-TEP and the hospital uses HL7. The incoming TEP message is transformed
into an HL7 A14 message type for ingest by the hospital system.
3. A third use case is patients transferring from one hospital to another via EMS. An
HL7 A03 message type is transformed into a TEP message to provide information to
EMS, and the TEP message is again transformed into an HL7 A14 message type for
ingest by the receiving hospital system. This is the situation of day-to-day transfers,
so the complete electronic health record can be exchanged directly between
hospitals via HL7.
3 TEP/HL7 Transform Status
4. In an emergency, the evacuation, transfer and transport may be coordinated
through Emergency Management or regional healthcare coalition coordination. In
this situation, an HL7 A03 message type is transformed into a TEP message to
provide information to the transport coordinator, and the TEP message is again
transformed into an HL7 A14 message type for ingest by the receiving hospital
system. Since the sending hospital may not know where the patient will be received,
the complete electronic health record can be bundled with the TEP message in an
EDXL-DE wrapper.
4 TEP/HL7 Transform Status
5. Similar to the regional transfer and evacuation, long distance evacuation
coordination can be facilitated via HL7/TEP and TEP/HL7 transforms using JPATS
support. Now, Tim is going to show us some examples of how TEP can and is being
used.
Transform Spreadsheet
During the initial mapping effort, an Excel spreadsheet was created to facilitate the capture of the
transformations. The format of this spreadsheet has changed over time, and is expected to continue to
change until the transformation is complete.
3/2014 Ballot Version of the Spreadsheet
The version of the spreadsheet that was used for the 3/2014 ballot contains 9 worksheets:
1. Introduction
a. Provides the color legend and key for the spreadsheet.
2. TEP to HL7 V2.7.1
a. Worksheet structure:
i. The left most columns provide the details of the TEP messaging structure
ii. The right most columns provide the details of the HL7 messaging elements
that the TEP messaging elements are mapped to
iii. Between these sets of columns are two columns that capture the TEP →
HL7 transformation and the HL7 → TEP transformation. Note: The
anticipation is that most of the transformations will used the same fields in
both directions, but this is not always the case. Once a HL7 V2.7.1 to TEP
worksheet is added to the spreadsheet, the HL7 → TEP transformation
column should probably be deleted to minimize data integrity issues.
5 TEP/HL7 Transform Status
3.
4.
5.
6.
7.
8.
9.
b. There are several complex data structures that are not expanded in this worksheet.
Instead, these complex structures are mapped in separate worksheets.
c. At the time of the 3/2014 balloting, this worksheet was 47% complete. 100/189
entries contained a designation of “TBD”.
ct-PersonDetails to HL7 V2.7.1
a. This worksheet is expected to contain the mapping between the HL7 ADT and EDXL
PersonDetails common type.
b. At the time of the 3/2014 balloting, this worksheet was 0% complete.
ct-EDXLLocation to HL7 V2.7.1
a. This worksheet is expected to contain the mapping between the HL7 ADT and EDXL
Location common type.
b. At the time of the 3/2014 balloting, this worksheet was 0% complete.
ct-EDXLAddress to HL7 V2.7.1
a. This worksheet is expected to contain the mapping between the HL7 ADT and EDXL
Location common type.
b. At the time of the 3/2014 balloting, this worksheet was 0% complete.
CWE
a. This worksheet contains a few of the details of the HL7 Coded With Exception
(CWE) data type.
EI
a. This worksheet contains the details of the HL7 Entity Identifier (EI) data type.
OBX
a. This worksheet contains a note about the HL7 Observation/Result (OBX) segment.
Notes
a. This worksheets contains notes from those working on the transformation.
Current Working Version of the Spreadsheet
A new worksheet has been added to the spreadsheet:
1. EDXL-DE to HL7 V2.7.1
a. This worksheet, yet to be completed, contains the mapping of the EDXL-DE, the EDXLTEP message wrapper to the HL7 A14 message.
Two temporary working worksheets have been added to the spreadsheet to expedite the mapping
process:
1. tmpHL7MessageTypes
a. This worksheet contains a side-by-side expansion of the datatypes contained in the A03
and A14 ADT message types. These two message types are almost identical, so the
mapping from TEP to A14 is expected to be very similar to the mapping from A03 to TEP.
b. Grey fields are required. Bold fields are complex structures.
2. tmpTEPMessageType
6 TEP/HL7 Transform Status
3.
4.
5.
6.
a. This worksheet contains the expanded TEP message structure along with the HL7 A14
message mapping.
b. Grey elements are required. Grey sub-elements are required if parent elements are
present. Bold elements denote complex elements. Blue rows indicate complex elements
that have not yet been mapped to a complex HL7 datatype.
tmpPersonDetails
a. Contains the TEP complex structure of the ct-PersonDetails data type.
tmpLocationType
a. Contains the TEP complex structure of the ct-EDXLLocation data type.
tmpAddressType
a. Contains the TEP complex structure of the xal-Address data type.
tmpAddressMapping
a. Contains the mapping from xal-Address to the HL7 XAD data type.
Transformation Specification
3/2014 Ballot Version of the Specification
Werner Joerg created a version of the transform specification for inclusion in the 3/2014 HL7 ballot. It
isn’t clear where the breakdown occurred, but an early draft version with comments and revision
markings was used in the balloting. Very few comments were received on the specification – primarily,
that it needs to be finished.
Current Working Version of the Specification
The current working version of the specification is the one that Werner created for the HL7 ballot. A
member of PHER (Rob Savage?) provided a copy of the January 2007 “HL7-NCPDP Electronic Prescribing
Coordination Mapping Document, Release 1” HL7 Informative Ballot as an example and guide for
revision and completion of the Transformation Specification
Action Items
Status
√
Action Item
TEP → HL7 Mapping
1. Complete mapping of
“simple” TEP elements
to A14
Assignment
Patti
Aymond
7 TEP/HL7 Transform Status
Target
Completion
Notes
The following complex TEP
elements have not been
mapped with this action
item:
1. EDXL-DE
2. PersonDetailsType
3. AddressType
4. EDXLLocationType
5. MedicationType
Status
Action Item
In progress
2. Transfer mapping
information from the
tmpTEPMessageType
worksheet to the “TEP
to HL7 V2.7.1”
worksheet
3. Complete the EDXL-DE
to A14 mapping
4. Complete the
PersonDetailsType to
A14 mapping
6. Complete the
AddressType to A14
mapping
7. Complete the
EDXLLocationType to
A14 mapping
Unassigned
Unassigned
Unassigned
Unassigned
Assignment
Patti
Aymond
8 TEP/HL7 Transform Status
Target
Completion
Notes
2/19/2015
This transform is expected
to require the definition of a
profile.
This transform is expected
to require the definition of a
profile.
This transform is expected
to require the definition of a
profile.
Status
Action Item
Assignment
Unassigned 8. Complete the
MedicationType to
A14 mapping
Target
Completion
Notes
This transform is expect to
require the use of a
subsequent RXA message.
Email from Riki Merrick, OO:
“What is the best way to
connect an ADT message to a
subsequent RXA message example is ADT message sends
patient info from ambulance to
hospital, then ambulance sends
RXA message to notify what
medication has been given en
route to the hospital?
During the session we
suggested based on PID-3 (and
possibly PID-5 and PID-7 in
addition) but wanted to check
with Hans - and here is his
answer:
PID-3 makes sense and should
be the primary linkage. PID-5
and PID-7 start to get
challenging.
The other piece could be the
PV1 data, but only if it is
relevant to link at a visit level
as well. Most important is the
patient level.”
Unassigned 9. Crosswalk A14
required fields with
those population by
the transform to make
sure all required fields
are mapped
Hold
10. Apply for all necessary
new LOINC codes
HL7 → TEP Mapping
Hold
Pending completion of
previous action items
Pending completions of the
TEP → HL7 mapping
Transform Specification
Hold
9 TEP/HL7 Transform Status
Pending completions of the
TEP → HL7 and HL7 → TEP
mappings