MCSS
HL7 Implementation Guide for
E-path Reporting
 Minnesota Cancer Surveillance System
PO Box 64882
St Paul, MN 55164-0882
Chapter .................................................................................................................................................................................................................. 4
1 .............................................................................................................................................................................................................................. 4
Introduction to E-path ......................................................................................................................................................................................... 4
Required Data Items for E-path Reporting ........................................................................................................................................... 5
Refer to Appendix B: HL7 Structure and Required Data items for complete standards and description of the requirements for
submitting pathology reports as an HL7 message. ................................................................................................................................ 12
Refer to Appendix C: NAACCR Standards for Cancer Registries, Volume II, Chapter 6 ................................................................ 12
Pathology Laboratory Electronic Reporting: Items, Formatting, Recommendations. (Version 1.1; September, 2000) for
complete standards and description of the requirements for submitting pathology reports as an ascii file. .................................. 12
Chapter ................................................................................................................................................................................................................ 14
2 ............................................................................................................................................................................................................................ 14
Use Case #1: Submission of pathology reports to the MCSS ........................................................................................................................... 14
#1A. Pathology Laboratory completes the MCSS E-path Reporting: Laboratory Assessment. .......................................... 14
#1B. Pathology Laboratory creates an HL7 message of pathology reports. ............................................................................ 14
Responsible Party: Pathology Laboratory .............................................................................................................................................. 14
#1C. HL7 Message is encrypted and sent to MDH. ......................................................................................................................... 16
Responsible Party: Pathology Laboratory .............................................................................................................................................. 16
Chapter ................................................................................................................................................................................................................ 17
3 ............................................................................................................................................................................................................................ 17
Use Case #2: Transfer of files to the MCSS database ...................................................................................................................................... 17
#2A. Prepare file for loading into MCSS database. ......................................................................................................................... 17
Responsible Party: VisionShare ............................................................................................................... Error! Bookmark not defined.
#2B. Load ascii formatted file into the mcss pending database................................................... Error! Bookmark not defined.
Responsible Party: MCSS IT .................................................................................................................... Error! Bookmark not defined.
Chapter ................................................................................................................................................................................................................ 18
4 ............................................................................................................................................................................................................................ 18
Use Case #3: Processing of Electronic Pathology Reports at the MCSS .......................................................................................................... 18
#3A. Update Path-number log to ensure all reports are submitted. ........................................................................................... 18
#3B. Identify pathology reports that are potentially reportable to the MCSS. .......................................................................... 19
#3C. Notify MCSS staff of results of submission and pre-processing........................................ Error! Bookmark not defined.
#3D. Determine final reportability of pathology reports. ............................................................................................................... 19
Appendix A. MCSS Electronic Pathology Reporting: Laboratory Assessment ...................................................................... 21
1.
Type and version of Laboratory Information System (LIS) ................................................................................................ 21
2.
Method of submitting pathology reports electronically ...................................................................................................... 21
3.
Method of reporting Text information ..................................................................................................................................... 21
4.
Method of identifying and submitting late reports ............................................................................................................... 21
5.
Method of reporting amended/supplemental reports .......................................................................................................... 21
6.
Laboratory Pathology Report Types........................................................................................................................................ 22
Prefix ............................................................................................................................................................................................................ 22
Report Type: Definition/Comments ......................................................................................................................................................... 22
Recycle numbers annually? ...................................................................................................................................................................... 22
Comments: ................................................................................................................................................................................................ 22
Laboratory Assessment of Required Data Items.............................................................................................................................. 23
Appendix B. HL7 Structure and Required Data Items for E-path Reporting ............................................................................. 25
The following segments relate to the HL7 Batch Protocol: 1) BHS - Batch Header, 2) BTS -Batch Trailer, 3) FHS - File Header,
and 4) FTS - File Trailer. The BTS segment contains a field, BTS-3-batch totals, which may have one or more totals drawn
from fields within the individual messages. The method for computing such totals resides with the sending facility. ........... Error!
Bookmark not defined.
4.3.1
File Header (FHS) Segment .................................................................................................................................................... 26
4.3.2
File Trailer (FTS) ....................................................................................................................................................................... 26
4.3.3
Batch Header (BHS) Segment ............................................................................................................................................... 26
4.3.4
Batch Trailer (BTS) Segment ................................................................................................................................................. 26
3.1.1
Message Header (MSH) Segment ......................................................................................................................................... 26
3.2.1
Patient Identification (PID) Segment .................................................................................................................................... 27
3.2.1
Next of Kin/Associated Parties (NK1) Segment ................................................................. Error! Bookmark not defined.
3.3.1
Common Order (ORC) Segment............................................................................................................................................ 27
3.3.2
Observation Request Segment (OBR) ................................................................................................................................. 27
3.3.3
Observation/Result (OBX) Segment. ................................................................................................................................... 27
3.3.4
NOTES AND COMMENTS (NTE) SEGMENT ...................................................................................................................... 27
7 Data Types used in this Implementation..................................................................................................... Error! Bookmark not defined.
Appendix C: ASCII Record Layout and Required Data Items for E-path Reporting .............................................................. 28
NAACCR Standards for Cancer Registries, Volume II, Chapter 6 - Pathology Laboratory Electronic Reporting: Items,
Formatting, Recommendations. (Version 1.1; September, 2000) ...................................................................................................... 28
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Chapter IV. B.: Pathology Laboratory Data Table ........................................................................................................................... 28
Appendix D: Table Structures .............................................................................................................................................................. 29
Appendix D: Email Messages ...................................................................................................................................................................... 39
Incomplete ASCII Record (critical data item(s) missing from a record.) ....................................................................... 39
Bad ASCII Record (a non-standard ascii record is identified.) ......................................... Error! Bookmark not defined.
Appendix E. File structure for epr files ........................................................................................................................................................ 40
Version 5.0
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1
Chapter
Introduction to E-path
Purpose, Definitions, and Overview
Electronic submission of laboratory-based reports for cancer reporting, e-path, has become
a popular method for laboratories to meet their reporting requirements for cancer diagnoses.
E-path, using standard messaging and file structures, will “greatly increase the efficiency and
consistency with which laboratories and central registries can meet reporting and data
collection requirements”.1
The MCSS offers e-path reporting for laboratories that can send encrypted files through our
secure web page or using PhinMS transfer technology from the CDC. The files may be
either HL7 or ascii pipe-delimited files.
Required data items, standard message and file formats are discussed in detail within this
document.
1 “Pathology Laboratory Electronic Reporting Recommendations …: Version 2.0 February 2009. See
http://www.naaccr.org/filesystem/pdf/Standards_Volume_V_version_2.2_draftB_revised_February_2009.pdf
Version 5.0
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Required Data Items for E-path Reporting
The MCSS requires specific data items when cancer cases are being reported via a
pathology report. These data items are the same, whether submitting a printed copy of
the pathology report or an electronic version and include:
1. Pathology Facility ID Number (The laboratory submitting the report; it may be
different that #11, the facility that obtained the specimen.)
2. Laboratory Name
3. Patient Name
4. Patient Address
5. Date of Birth (or path-age at specimen)
6. Social Security Number
7. Sex
8. Medical Record Number
9. Path-Slide/Pathology Report Number
10. Physician (Attending)
11. Facility ID Number (The facility that obtained the specimen)
12. Pathologist
13. Date of Specimen Collection
14. Text of pathology report (including clinical history, nature of specimen, gross
pathology, microscopic pathology, final diagnosis, staging, parameters,
comments, addenda)
Specific data item requirements are described in Table 1, “MCSS Data Item
Requirements for Electronic Pathology Reporting”. The data items marked “R” in the
MCSS opt column are the required dataset. These data items must be included in the
submission if the data is available in the facility.
Additionally, Minnesota Rules Chapter 4606 requires that “as much as is known” of
additional patient information fields be submitted to the MCSS. These are marked as
“RE”. Data items marked “R” and “RE” is nearly always available in the medical records
or business office of the hospitals where the pathology laboratories are located or on the
pathology specimen requisition slip. The additional data items must be submitted if they
are available in the laboratory or in the hospital patient data system.
If the data item is not available within the facility, the MCSS will issue a waiver, indicating
that the data item does not need to be submitted.
Version 5.0
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Table 1: MCSS Data Item Requirements for Electronic Pathology (epath) Reporting
HL7 HL7 HL7 HL7 ELEMENT NAME NAAC MCS
Segm Seq Item #
CR
S
ent
OPT opt*
MSH
MSH
MSH
MSH
1
2
3
4
00001
00002
00003
00004
Field separator
Encoding characters
Sending application
Sending facility
R
R
O
R
R
R
O
R
MSH
MSH
MSH
MSH
MSH
MSH
MSH
MSH
MSH
MSH
MSH
5
6
7
8
9
10
11
12
13
14
15
00005
Receiving application
00006
Receiving facility
00007
Date/Time of message
00008
Security
00009
Message type
00010
Message control ID
00011
Processing ID
00012
Version ID
00013
Sequence number
00014
Continuation pointer
00015 Accept acknowledgment
type
00016
Application
acknowledgment type
00017
Country code
00692
Character set
00693
Principal language of
message
01317
Alternate character set
handling scheme
00104
Set ID - PID
00105
Patient ID (External)
00106
Patient identifier list
O
O
R
O
R
R
R
R
O
O
O
O
O
R
O
R
R
R
R
O
O
O
MSH
16
O
O
MSH
MSH
MSH
17
18
19
O
O
O
O
O
O
MSH
20
NA
NA
PID
PID
PID
1
2
3
O
B
R
O
B
R
PID
4 00107
B
B
PID
5 00108
R
R
Alternate patient ID PID
Patient name
NAACCR Item Name
old
Epath
item #
7020, 7030,
7040, 7050,
7060
Path Lab Name, Path Lab
Addr-No & St, Path Lab AddrCity, Path Lab Addr-State, and
Path Lab Addr-Postal Code
4-8
20, 2300,
2320
Patient ID Number, Social 22, 20
Security Number, and Medical
Record Number
2230, 2240,
2250
PID
PID
PID
PID
PID
PID
6
7
8
9
10
11
00109
00110
00111
00112
00113
00114
Mother's maiden name
Date/time of birth
Sex
Patient alias
Race
Patient address
O
RE
RE
O
RE
RE
RE
R
RE
RE
RE
RE
PID
PID
PID
12 00115
13 00116
14 00117
County code
Phone number - home
Phone number -
B
O
O
B
O
O
Version 5.0
NAACCR
Item #
240
220
2280
160
70, 80, 100,
2330
2360
6
Name-Last, Name-First, and
Name-Middle
10-12
Birth Date
18
Sex
21
Name-Alias
Race 1
Addr at DX-City, Addr at DX- 14-16,
State, Addr at DX Postal Code,
13
and Addr at DX-No & Street
Telephone
17
8/1/2012
PID
PID
PID
PID
PID
PID
15
16
17
18
19
20
00118
00119
00120
00121
00122
00123
PID
PID
PID
PID
PID
PID
PID
PID
PID
21
22
23
24
25
26
27
28
29
00124
00125
00126
00127
00128
00129
00130
00739
00740
PID
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
30
1
2
3
4
5
6
7
8
9
10
11
00741
00190
00191
00192
00193
00194
00195
00196
00197
00198
00199
00200
NK1
12 00201
NK1
13 00202
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
NK1
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
00119
00111
00110
00755
00145
00129
00118
00742
00743
00744
00745
00120
00746
00739
00125
00747
00748
Version 5.0
business
Primary language
Marital status
Religion
Patient account number
SSN number - patient
Driver's license number
- patient
Mother's identifier
Ethnic group
Birth place
Multiple birth indicator
Birth order
Citizenship
Veterans military status
Nationality
Patient death date and
time
Patient death indicator
Set ID - NK1
Name
Relationship
Address
Phone number
Business phone number
Contact role
Start date
End date
Next of kin/AP job title
Next of kin/AP job
code/class
Next of kin/AP employee
number
Organization name NK1
Marital status
Sex
Date/time of birth
Living dependency
Ambulatory status
Citizenship
Primary language
Living arrangement
Publicity code
Protection indicator
Student indicator
Religion
Mother's maiden name
Nationality
Ethnic group
Contact reason
Contact person's name
O
O
O
O
B
O
O
O
O
O
B
O
O
O
O
NA
NA
NA
NA
O
O
O
RE
O
NA
NA
NA
NA
RE
RE
O
R
O
O
O
O
NA
NA
NA
NA
NA
NA
RE
R
O
O
O
O
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
150
260
7
1760
Marital Status
Religion
Vital Status
8/1/2012
NK1
31 00749
NK1
32 00750
NK1
33 00751
NK1
NK1
NK1
NK1
34
35
36
37
PV1
PV1
PV1
00752
00113
00753
00754
1 00131
2 00132
3 00133
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
00134
00135
00136
00137
00138
00139
00140
00141
00142
00143
00144
00145
00146
00147
00148
00149
00150
00151
00152
00153
00154
00155
00156
00157
00158
00159
PV1
30 00160
PV1
PV1
31 00161
32 00162
PV1
33 00163
PV1
PV1
PV1
PV1
34
35
36
37
00164
00165
00166
00167
Version 5.0
Contact person's
telephone number
Contact person's
address
Next of kin/AP's
identifiers
Job status
Race
Handicap
Contact person social
security #
Set ID – PV1
Patient Class
Assigned Patient
Location
Admission Type
Preadmit Number
Prior Patient Location
Attending Doctor
Referring Doctor
Consulting Doctor
Hospital Service
Temporary Location
Preadmit Test Indicator
Re-admission Indicator
Admit Source
Ambulatory Status
VIP Indicator
Admitting Doctor
Patient Type
Visit Number
Financial Class
Charge Price Indicator
Courtesy Code
Credit Rating
Contract Code
Contract Effective Date
Contract Amount
Contract Period
Interest Code
Transfer to Bad Debt
Code
Transfer to Bad Debt
Date
Bad Debt Agency Code
Bad Debt Transfer
Amount
Bad Debt Recovery
Amount
Delete Account Indicator
Delete Account Date
Discharge Disposition
Discharged to Location
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
O
R
NA
O
RE
NA
O
NA
NA
RE
RE
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
O
NA
NA
RE
RE
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
8
2460
2470
Physician Managing
Physician Follow-up
8/1/2012
PV1
PV1
PV1
PV1
PV1
PV1
38
39
40
41
42
43
00168
00169
00170
00171
00172
00173
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
PV1
44
45
46
47
48
49
50
51
52
00174
00175
00176
00177
00178
00179
00180
01226
01274
Diet Type
Servicing Facility
Bed Status
Account Status
Pending Location
Prior Temporary
Location
Admit Date/Time
Discharge Date/Time
Current Patient Balance
Total Charges
Total Adjustments
Total Payments
Alternate Visit ID
Visit Indicator
Other Healthcare
Provider
Order Control
Placer Order Number
Filler Order Number
Placer Group Number
Order Status
Response Flag
Quantity/Timing
Parent
Date/Time of
Transaction
Entered By
Verified By
Ordering Provider
Enterer’s Location
Call Back Phone
Number
Order Effective
Date/Time
Order Control Code
Reason
Entering Organization
Entering Device
Action By
Advanced Beneficiary
Notice Code
Ordering Facility Name
Ordering Facility
Address
ORC
ORC
ORC
ORC
ORC
ORC
ORC
ORC
ORC
1
2
3
4
5
6
7
8
9
00215
00216
00217
00218
00219
00220
00221
00222
00223
ORC
ORC
ORC
ORC
ORC
10
11
12
13
14
00224
00225
00226
00227
00228
ORC
15
00229
ORC
16
00230
ORC
ORC
ORC
ORC
17
18
19
20
00231
00232
00233
01310
ORC
ORC
21
22
01311
01312
ORC
23
ORC
24
01313 Ordering Facility Phone
Number
01314 Ordering Provider
Address
Version 5.0
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
R
NA
NA
NA
NA
NA
NA
NA
NA
R
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
R
RE
R
RE
7200
7210, 7220,
7230, 7240
RE
RE
7250
RE
RE
7140, 7150,
7160, 7170
9
Work Facility Name
Work Fac Addr-No & St, Work
Fac Addr-City, Work Fac AddrState, and Work Fac-Postal
Code
Work Facility-Telephone
34
35-38
Order Client/Phys-Street,
Order Client/Phys-City, Order
Client/Phys-State, andOrder
Client/Phys-PostCod
28-31
39
8/1/2012
OBR
OBR
OBR
OBR
OBR
OBR
OBR
1
2
3
4
5
6
7
00237
00216
00217
00238
00239
00240
00241
R
O
R
R
NA
NA
R
R
O
R
R
NA
NA
R
NA
NA
NA
NA
NA
NA
NA
RE
NA
NA
NA
NA
NA
RE
RE
RE
O
RE
RE
O
NA
NA
NA
NA
RE
NA
NA
NA
NA
RE
23
24
25
26
27
28
29
30
31
32
00256
00257
00258
00259
00221
00260
00261
00262
00263
00264
Set ID – OBR
Placer Order Number
Filler Order Number+
Universal Service ID
Priority
Requested Date/Time
Observation Date/Time
#
Observation End
Date/Time #
Collection Volume *
Collector Identifier *
Specimen Action Code *
Danger Code
Relevant Clinical Info.
Specimen Received
Date/Time *
Specimen Source *
Ordering Provider
Order Callback Phone
Number
Placer Field 1
Placer Field 2
Filler Field 1 +
Filler Field 2 +
Results Rpt/Status
Chng-Date/Time +
Charge to Practice +
Diagnostic Serv Sect ID
Result Status +
Parent Result +
Quantity/Timing
Result Copies To
Parent *
Transportation Mode
Reason for Study
Principal Result
Interpreter +
OBR
8
00242
OBR
OBR
OBR
OBR
OBR
OBR
9
10
11
12
13
14
00243
00244
00245
00246
00247
00248
OBR
OBR
OBR
15
16
17
00249
00226
00250
OBR
OBR
OBR
OBR
OBR
18
19
20
21
22
00251
00252
00253
00254
00255
OBR
OBR
OBR
OBR
OBR
OBR
OBR
OBR
OBR
OBR
NA
NA
RE
O
NA
O
O
O
O
R
NA
NA
RE
O
NA
O
O
O
O
R
OBR
33
O
O
OBR
OBR
OBR
OBR
34
35
36
37
O
NA
NA
NA
O
NA
NA
NA
OBR
38
NA
NA
OBR
OBR
39
40
00265 Assistant Result
Interpreter +
00266 Technician +
00267 Transcriptionist +
00268 Scheduled Date/ Time +
01028 Number of Sample
Containers *
01029 Transport Logistics of
Collected Sample *
01030 Collector's Comment*
01031 Transport Arrangement
NA
NA
NA
NA
Version 5.0
10
7090
Slide Report Number
23
7320
Path-Date Spec Collection
46
2480
7180
Primary Surgeon
Order Client Phone
32
7260, 7270,
7280, 7290,
7300, 7310
Pathologist Last Name,
Pathologist First Name,
Pathologist Middle Name,
Pathologist Name Suffix,
Pathologist Lic Number, and
Pathologist Lic State
40-45
8/1/2012
OBR
OBR
OBR
41
42
43
OBR
OBR
44
45
Responsibility
01032 Transport Arranged
01033 Escort Required
01034 Planned Patient
Transport Comment
00393 Procedure Code
01316 Procedure Code
Modifier
00569
Set ID-OBX
00570
Value type
00571
Observation identifier*
00572
Observation sub-ID
00573
Observation value*
OBX
OBX
OBX
OBX
OBX
1
2
3
4
5
OBX
OBX
OBX
OBX
OBX
OBX
6
7
8
9
10
11
OBX
12 00580
OBX
13 00581
OBX
14 00582
OBX
OBX
OBX
NTE
NTE
NTE
NTE
FHS
FHS
FHS
FHS
FHS
FHS
FHS
15
16
17
1
2
3
4
1
2
3
4
5
6
7
00574
00575
00576
00577
00578
00579
00583
00584
00936
00096
00097
00098
01318
00067
00068
00069
00070
00071
00072
00073
Version 5.0
Units
Reference ranges
Abnormal flags
Probability
Nature of abnormal test
Observation result
status
Date last Obs normal
values
User defined access
checks
Date/time of the
observation
Producer's ID
Responsible observer
Observation method
Set ID – NTE
Source of Comment
Comment
Comment Type
File field separator
File encoding characters
File sending application
File sending facility
File receiving application
File receiving facility
File creation date/time
NA
NA
NA
NA
NA
NA
RE
RE
RE
RE
R
R
R
RE
R
R
R
R
RE
R
RE
O
O
O
O
RE
RE
O
O
O
O
RE
O
O
O
O
O
O
O
O
O
O
O
O
O
R
R
O
R
O
O
R
O
O
O
O
O
O
O
R
R
O
R
O
O
R
11
7340, 7350,
7360, 7370,
7380, 7390,
7400, 7410,
7420, 7430,
7440, 7450,
7460, 7470
7330
Path-SNOMED Code(s), PathSNOMED Version, Path-ICDCM codes, Path-ICD Version
Number, Path-CPT codes,
Path-CPT Code Version, PathText Diagnosis, Path-Clinical
History, Path-Nature of
Specimen, Path-Gross
Pathology, Path-Micro
Pathology, Path-Comment
Section, Path-Suppl Reports,
and Path-Final Diagnosis
Path—Result Status
48-61
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FHS
FHS
FHS
FHS
FHS
FTS
FTS
BHS
BHS
8
9
10
11
12
1
2
1
2
BHS
3
BHS
BHS
4
5
BHS
BHS
BHS
BHS
BHS
BHS
BHS
6
7
8
9
10
11
12
BTS
BTS
BTS
1
2
3
00074
File security
00075
File name/ID/type
00076
File comment
00077
File control ID
00078 Reference file control ID
00079
File batch count
00080
File trailer comment
00081
Batch field separator
00082
Batch encoding
characters
00083
Batch sending
application
00084
Batch sending facility
00085
Batch receiving
application
00086
Batch receiving facility
00087 Batch creation date/time
00088
Batch security
00089
Batch name/ID/type
00090
Batch comment
00091
Batch control ID
00092 Reference batch control
ID
00093
Batch message count
00094
Batch comment
00095
Batch totals
O
RE
O
O
O
R
O
R
R
O
RE
O
O
O
R
O
R
R
O
O
R
O
R
O
O
R
O
O
O
O
O
O
R
O
O
O
O
O
R
O
R
R
O
R
*MCSS Option Key:
R
Required
Laboratory must send this information or obtain a waiver from the MCSS.
RE
Required field but can be left Empty
Laboratory must send this information if it is in their laboratory information
system or the hospital/facility registration system, OR obtain a waiver from
the MCSS.
O
Optional
Laboratory does not need to send this information. It will be ignored if
sent.
NA
Not Applicable
This data item is not applicable for cancer registries.
B
Backwards Compatible
Data item location in previous HL7 versions. Laboratory may submit the
data in this location with approval from the MCSS.
Refer to Appendix B: HL7 Structure and Required Data items for complete standards and
description of the requirements for submitting pathology reports as an HL7 message.
Refer to Appendix C: NAACCR Standards for Cancer Registries, Volume V, appendix A for
Pathology Laboratory Electronic Reporting for complete standards and description of the
requirements for submitting pathology reports as an ascii file.
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http://www.naaccr.org/filesystem/pdf/Standards_Volume_V_version_2.2_draftB_revised_Fe
bruary_2009.pdf
All pathology reports must be submitted within 15 days of completion of the report,
regardless of the availability of required data items. Laboratories should make every
effort to obtain the required data items as they exist in their facility, but may not delay the
submission due to missing data.
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2
Chapter
Use Case #1: Submission of
pathology reports to the MCSS
Notes:
07/07/04: Added to #1C: statement that an empty message should be transmitted when there are no
reports to be submitted. This ensures that the MCSS receives a file every day. If a file is not sent for a
particular day it means that a part of the system is not working.. The MCSS will verify its systems and then
the lab will be contacted to verify that all of their systems are working.
#1A. Pathology Laboratory completes the MCSS E-path Reporting: Laboratory
Assessment.2
Responsible Party: Laboratory and MCSS staff
1.
2.
3.
4.
Laboratory notifies the MCSS of interest in e-path reporting.
MCSS email documentation and Assessment to laboratory.
Laboratory completes Assessment and submits it to the MCSS.
The MCSS and laboratory review the Assessment and begin planning for e-path
implementation.
#1B. Pathology Laboratory creates an HL7 message of pathology reports.
Responsible Party: Pathology Laboratory
4. Use NAACCR HL7 Record Layout Structure for reporting pathology reports. 3, 4
5. Include all final (completed) pathology reports.
2
Appendix A: MCSS Electronic Pathology Reporting Assessment
3 Appendix B: MCSS Excerpted HL7 Segment Attributes from NAACCR Implementation Guide for Transmission of LaboratoryBased Reporting to Cancer Registries Using Version 2.3.1 of the Health Level Seven (HL7) Standard Protocol (November 2003)
4 NAACCR Implementation Guide for Transmission of Laboratory-Based Reporting to Cancer Registries Using Version 2.3.1 of the
Health Level Seven (HL7) Standard Protocol (November 2003). Available via email upon request. [email protected]
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a. For laboratory not submitting non-MN residents’ pathology reports, a full
HL7 message must be submitted that includes only the following data
items:
i. the pathology report number;
ii. specimen collections date; and
iii. the statement “NON-MN RESIDENT in the first OBX segment
results segment [IS this the appropriate place?]
6. Include all report types. 5
7. Include all required data items. 6
a. If demographic data items are in the facility’s master patient index, they
must be included in the pathology report submission record. Otherwise,
demographic data items in the laboratory information system must be
submitted.
8. Provide documentation on how late pathology reports will be identified and
submitted to the MCSS. 7
9. Provide documentation on method of reporting amended pathology reports
(addenda, supplemental reports, etc.)8
10. Provide master list (or database table) of codes and definitions for each coded
data item. [pipe-delimited ascii text file.]
11. Test File creation.
a. All pathology reports are collected.
i. Create list of pathology report numbers in the laboratory for a
specific time period (one day).
ii. Create HL7 file/message
iii. Send both to the MCSS for comparison.
b. All required data items are complete.
i. Create a test file/message of 5 reports for each pathology report
type.
ii. Send to the MCSS for analysis.
12. Identify Laboratory Contact Person to coordinate routine submission activities and
respond to error message notices, questions, etc. Include:
a. Contact for file structure and transmission issues;
b. Contact for changes in report numbering systems, contents of the
pathology reports, required data items, etc.
5
Appendix A. MCSS Electronic Pathology Reporting Laboratory Assessment, Question 6.
6
Appendix B. MCSS Required Data items for Electronic Pathology Reporting (e-path).
7
Appendix A. MCSS Electronic Pathology Reporting Laboratory Assessment, Question 4.
8
Appendix A. MCSS Electronic Pathology Reporting Laboratory Assessment, Question 5.
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#1C. HL7 Message is encrypted and sent to MDH.
Responsible Party: Pathology Laboratory
1. [add: timeframe for reporting; frequency and lagtime]
2. [add: method of triggering file/message creation]
3. [add: method of encryption]
4. Create File/Message Submission Report
a. File/message creation date
b. File/message transfer date
c. Laboratory
d. Number of records within the message.
e. [add: other statistics?]
5. Send empty message if no reports are found.
6. [add: method of transmitting file to MDH.]
7. Transmit File/message and Submission Report to MDH PhinMS server.
8. [MDH] Send email to laboratory, MCSS-IT, FS representative, DM representative
regarding status of transfer.
9. Report errors
Notify laboratory, MDH IT, MCSS IT if number of records does not match with
number submitted. Responsible party: __________________ Include:
a. Information in the laboratory Status Report.
b. Number of records received
c. List of pathology report numbers received.
Fairview: HL7: OBR.3.1: specnum_formatted.
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3
Chapter
Use Case #2: Transfer of files to
the MCSS database and create
load file.
#2A. Decript HL7 file
#2B. Map HL7 data items to NAACCR pipe-delimited text structure.
1. Translate HL7 file/message to ascii pipe delimited file
a. Use NAACCR ascii Pipe Delimited Record Layout Structure for reporting
pathology reports. 9
b. Make hl7_err file and/or ascii_inc file.
i. Notify “epr” if record(s) cannot be translated.
2. Clean up directories on computer systems.
9
See http://www.naaccr.org/filesystem/pdf/Standards_Volume_V_version_2.2_draftB_revised_February_2009.pdf
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4
Chapter
Use Case #3: Processing of
Electronic Pathology Reports at
the MCSS
#3A. Load ascii formatted file into the mcss database.
Responsible Party: MCSS IT
1. Use MCSS standard module for loading ascii files into Sybase.
2. Load file into database 10.
#3B. Standardize data to the MCSS standard.
1. See epr-scrubber. (not included)
#3C. Convert pathology report number to standard format.
1. Convert pathology report number to MCSS’ convert_path.
a. use pathconvert:
b. structure: xxxxccyynnnnnnnnnnnn.
#3D. Update monitoring/status tables
1. insert record into epr_pathnumbers.
a. Create list of missing pathlogy numbers by report type for each laboratory.
i. Those missing for more than ____ days since the subsequent report
number’s submission.
2. insert record into epr_stats table
10
Appendix E. MCSS E-Path Table Structures
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#3E. Identify resubmits and addenda.
1. Record results in epr_stats
#3F. Identify pathology reports that are potentially reportable to the MCSS.
1. Apply Optimized NAACCR Search Term List to new records. 11 12
2. Insert reports that positively matched with the search term list into
mcss..epr_pend [db table] 13.
3. Record results in mcss..epr_stats [db table]
.
#3G. Determine final reportability of pathology reports.
1. Compare all text against the MCSS Reportability List.
2. Delete reports that are not related to cancer from the database (with no back-up)
a. On a regular schedule (i.e. twice a year, all submitted pathology reports will
be manually review to identify possible gaps in the Search Term List.
3. Code the pathology report using ICD-O-3.
a. Primary Site
b. Laterality
c. Histology/ behavior code
d. Grade
e. Specimen type
4. Insert demographic, facility and coded medical information into the MCSS patient
data tables (mcss..abstracts, mcss..abs_extra).
5. Add results to mcss..epr_stats [db table].
6. Add results to mcss..epr_batch [db table].
11 MCSS optimized the NAACCR Search Term List so that only the root word of a reportable diagnosis is included. (Example:
LEUKEMIA encompasses all of the lymphocytic, myeloid and other subtypes of leukemia.)
12
Appendix H. MCSS Optimized NAACCR Search Term List.
13
Appendix E. MCSS E-Path Table Structures
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Appendix A: MCSS Electronic Pathology Reporting: Laboratory
Assessment
1. Type and version of Laboratory Information System (LIS)
__________________________________________ version:__________
2. Method of submitting pathology reports electronically
____ HL7
____ ascii pipe delimited file
3. Method of reporting Text information
____ All Text in one obx segment (or pipe delimited field)
____ Text reported in separate obx segments (or pipe delimited fields)
4. Method of identifying and submitting late reports
___________________________________________________________
___________________________________________________________
___________________________________________________________
5. Method of reporting amended/supplemental reports
___________________________________________________________
___________________________________________________________
___________________________________________________________
6. Method of identifying canceled pathology numbers (or re-assigned
pathology numbers
___________________________________________________________
___________________________________________________________
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7. Laboratory Pathology Report Types
Prefix Report Type: Definition/Comments
Recycle
numbers
annually?
Comments:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
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Laboratory Assessment of Data Items
(Required data items are in bold; other data items must be submitted if they are available at
the facility.)
Data Item
Available Available Comments;
in Lab
in Hosp. Alternative data items
database database
Pathology Facility ID
Number
Laboratory Name
Street
City
State
Zip Code
Telephone
Patient Name
Last Name
First Name
Middle Name
Patient Address
Street
City/Town
State
Zip Code
Date of Birth (or pathage at specimen)
Social Security Number
Sex
Medical Record Number
Path-Slide/Pathology
Report Number
Path Ordering
Client/Physician
(Attending)
Last Name
First Name
Middle Name
Street
City
State
Zip Code
Work Facility ID
Number
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Data Item
Available Available Comments;
in Lab
in Hosp. Alternative data items
database database
Pathologist
Date of Specimen
Collection
Path-Text-Diagnosis
Clinical History
Nature of Specimen
Gross Pathology
Microscopic
Pathology
Final Diagnosis
MCSS Incidence
Status*
Comment Section
Supplemental
Reports
and/or
Addenda
Staging Parameters
Date Transmitted
* Pathologist’s determination of whether this is a newly diagnosed cancer (within 2
months) or prevalent (including a dxdate of when the cancers was diagnosed.)
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Appendix B: HL7 Structure for E-path Reporting
The MCSS requires that data items marked as R or RE be submitted, if available in the
facility. This includes data items available in the medical record and billing systems as
well as the laboratory information system.
A pathology report must be submitted when it has been marked complete, even if one or
more required data items are not available. The required data item location is left empty
if the data is not available.
Optional data items may be filled at the decision of the laboratory creating the message.
The MCSS will protect all data item submitted with the same level of protection as the
required information.
The following Segment Attribute Tables are excerpted directly from the NAACCR
Implementation Guide for Transmission of Laboratory-Based Reporting to Cancer
Registries using Version 2.3.1 of the Health Level Seven (HL7) Standard Protocol (Draft
Nov. 2003.
The only modifications are:
• Modifying the OPT column to be the requirements for the MCSS; and
• Placing the tables in a different order to match the standard hl7 message
transmission format.
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HL7 batch file structure and Segment Definitions
A batch of HL7 messages may be sent online using a common file transfer protocol or
offline via tape or diskette. If needed, a group of batches may be sent using the file
header and trailer segments. The FHS and FTS are optional and need not be sent if the
transaction is one batch of records. The file/batch syntax follows:
[FHS]
{ [BHS]
{ [MSH
PID
OBR
....
] }
[BTS]
}
[FTS]
(file header segment)
(batch header segment)
(zero or more HL7 messages)
(batch trailer segment)
(file trailer segment)
File Header (FHS) Segment
The FHS segment is used to head a file (group of batches). Ideally, a single sending
facility, for instance a regional laboratory for a hospital consortium, could send a group of
batches of reportable findings from separate laboratories within the consortium. In this
setting, each separate BHS would have a different CLIA identifier. The FHS would have
a different CLIA number as well, or would have the same CLIA number as the one batch
that was performed at the sending facility. This complexity of message processing is not
common yet, either at laboratories or public health agencies. The description of batch
reporting in this guide demonstrates reporting from a single facility and thus the CLIA
number is the same for MSH, BHS, and FHS.
File Trailer (FTS)
Used to define the end of a file.
Batch Header (BHS) Segment
Used to define the start of a batch.
Batch Trailer (BTS) Segment
Used to define the end of a batch.
Message Header (MSH) Segment
Used to define the intent, source, destination, and some specifics of the syntax of a
message.
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Patient Identification Segment (PID)
Used by all applications as the primary means of communicating patient identification
information. This segment contains permanent patient identifying and demographic
information that, for the most part, is not likely to change frequently.
Common Order Segment (ORC)
Used to transmit fields that are common to all orders (all types of services that are
requested).
Observation Request Segment (OBR)
The Observation Request (OBR) segment is used to transmit information specific to an
order for a diagnostic study or observation, physical exam, or assessment. The OBR
defines the attributes of a particular request for diagnostic services or clinical
observations. For laboratory-based reporting, the OBR defines the attributes of the
original request for laboratory testing. Essentially, the OBR describes a battery or panel
of tests that is being requested or reported. The OBR is somewhat analogous to a
generic lab slip that is filled out when physician requests a lab test. The individual test
names and results for the panel of tests performed are reported in OBX segments, which
are described below. As defined by the ORU syntax, there can be many OBX’s per
OBR, and there can be many OBR’s per PID.
Observation/Result Segment (OBX)
The OBX segment is used to transmit a single observation or observation fragment. It
represents the smallest indivisible unit of a report. Its principal mission is to carry
information about observations in report messages. While OBR gives general
information about the order for the test and ORC gives information on all services that
are requested, the OBX segment gives the specific, individual tests performed (OBX-3)
and the specific results for each test (OBX-5). Laboratory-based reporting to public
health agencies focuses on OBX-3 and OBX-5 as the most informative elements of
the message; thus, every effort should be made to make OBX-3 and OBX-5 as
informative and unambiguous as possible.
NOTES AND COMMENTS SEGMENT (NTE)
The NTE segment is a common format for sending notes and comments. This optional,
repeating segment may be inserted after any of the OBX segments in the ORU
message. The NTE segment applies to the information in the segment that immediately
precedes it, i.e., the observation reported in the preceding OBX segment. The NTE
segment is not further defined by HL7.
Note: This segment is not routinely completed, however, if this section is used it should
only include general comments, instructions, or results and not specific results.
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Appendix C: ASCII Record Layout Structure
The MCSS uses the record layout format developed by NAACCR for reporting pathology
reports electronically in an ascii text file layout, found in the “NAACCR Standards for Cancer
Registries, Volume V, Appendix B - Pathology Laboratory Electronic Reporting Pipe
Delimited Format (Version 2.0; July 2009)”
http://www.naaccr.org/filesystem/pdf/Standards_Volume_V_version_2.2_draftB_revised_Fe
bruary_2009.pdf
The NAACCR Standards document should be used only for the record layout format. All
other portions of the document have been replaced with more updated information and
should not be referenced or used. (Specifically, the data item requirements table in
NAACCR Standards document is no longer current. Use the “MCSS Data Item
Requirements for Electronic Pathology (epath) Reporting” (Table 1) already discussed in
Chapter 1.
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Appendix D: Data Item Mapping: HL7  NAACCR  MCSS
Table of data items required by the MCSS, identifying their location in an HL7 message,
the NAACCR data item number and the location of the data item in the MCSS patient
data tables.
HL7 Epath Mapping software data item name
position data
item #
n/a
Harcoded:
L
Hardcoded
:1
p
properties
file
""
""
""
""
""
PID-5-1
PID-5-2
PID-5-3
PID-11-1
PID-11-3
PID-11-4
PID-11-5
PID-11-13
PID-7
????
PID-3
PID-8
PID-3
OBR-3
OBR-16-1
OBR-16-2
OBR-16-4
OBR-16-5
0RC-24-1
ORC-24-3
ORC-24-4
ORC-24-5
5
6
7
8
9
10
11
12
13
14
15
16
17
18
*19
20
21
22
23
24
25
26
27
28
29
30
31
ORC-23
32
ORC-21-3
ORC-21-1
ORC-22-1
ORC-22-3
33
34
35
36
Version 5.0
n/a
1
Data
item
length
mcss..epath_pend
fieldname
naaccr
lay- out
num
n/a
Record_Type
1
1
recnum
rectype
2
Path_Version_Number
6
layout_vers
7000
3
4
Path_Facility_ID_Number
Lab_Name
25
50
submit_lab_num
submit_lab_name
7010
7020
Lab_Street
Lab_City
Lab_State_or_Province
Lab_Zipcode_or_Postalcode
Lab_Telephone_Number
Patient_Last_Name
Patient_First_Name
Patient_Middle_Name
Patient_Street
Patient_City
Patient_State_or_Province
Patient_Zipcode_or_Postalcode
Patient_Telephone_Number
Patient_Date_of_Birth
Patient_Age_at_Specimen
Patient_Social_Security_Number
Patient_Sex
Patient_Medical_Record_Number
Pathology_or_Slide_Report_Number
Path_Order_Person_License
Path_Order_Person_Last_Name
Path_Order_Person_First_Name
Path_Order_Person_Middle_Name
Path_Order_Person_Street
Path_Order_Person_City
Path_Order_Person_State_or_Province
Path_Order_Person_Zipcode_or_Postal
code
Path_Order_Person_Telephone_Numbe
r
Path_Work_Facility_ID_Number
Path_Work_Facility_Name
Path_Work_Facility_Street
Path_Work_Facility_City
25
20
2
9
10
25
14
14
25
20
2
9
10
8
10
9
1
11
20
8
25
14
14
25
20
2
9
submit_lab_street
submit_lab_city
submit_lab_state
submit_lab_zipcode
submit_lab_telephone
lastname
firstname
middlename
streetname
city
state
zipcode
telephone
date_of_birth
pathage
ssn
sex
medrecnum
pathnumber
doc1num
doc1lname
doc1fname
doc1mname
doc1_street
doc1_city
doc1_state
doc1_zipcode
7030
7040
7050
7060
7070
2230
2240
2250
2330
70
80
100
2360
240
7080
2320
220
2300
7090
7100
7110
7120
7130
7140
7150
7160
7170
10
doc1_telephone
7180
25
50
25
20
trtfacility_license
trtfacility_name
trtfacility_streetadd
trtfacility_city
7190
7200
7210
7220
29
n/a
10
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0RC-23-4
ORC-22-5
37
38
ORC-23
OBR-32
39
40
OBR-32
41
OBR-32
42
OBR-32
OBR-32
0BR-32
OBR-7
BOX-11
OBX-CE-5
????
""
""
""
""
OBX-5
""
""
""
""
""
""
""
""
MSH-7
OBR-24
n/a
n/a
n/a
n/a
43
44
45
46
47
48
*49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
n/a
n/a
n/a
n/a
Version 5.0
Path_Work_Facility_State_or_Province
Path_Work_Facility_Zipcode_or_Postalc
ode
Path_Work_Facility_Telephone_Number
Path_Reporting_
Pathologist_Last_Name
Path_Reporting_
Pathologist_First_Name
Path_Reporting_
Pathologist_Middle_Name
Path_Reporting_ Pathologist_Suffix
Path_Pathologist_License_Number
Path_Pathologist_State_Licensor
Path_Date_of_Specimen_Collection
Path_Status_Individual_Result
Path_SNOMED_Codes
Path_SNOMED_Version_Control
Path_ICD_Code
Path_ICD_Revision_Number_Code
Path_CPT_Code
Path_CPT_Code_Version
Path_Text_Diagnosis
Path_Clinical_History
Path_Nature_of_Specimen
Path_Gross_Pathology
Path_Microscopic_Pathology
Path_Final_Diagnosis
Path_Comment_Section
Path_Supplemental_Reports
Path_Staging_Parameters
Date_Transmitted
Path_Report_Type
n/a
n/a
n/a
n/a
30
2
9
trtfacility_state
trtfacility_zipcode
7230
7240
10
25
trtfacility_telphone
pathmd_lname
7250
7260
14
pathmd_firstname
7270
14
pathmd_middlename
7280
pathmd_suffix
pathmd_license
pathmd_state_license
specdate
path_report_status
snomed
snomed_version
icd_code
icd_version
cpt_code
cpt_version
path_text_diagnosis
path_text_clin_history
path_nature_of_specimen
path_gross
path_micro
path_final_dx
path_comments
path_supplemental
path_staging
date_transmitted
path_report_type
supplemental
convert_path
coder1
coder2
7290
7300
7310
7320
7330
7340
7350
7360
7370
7380
7390
7400
7410
7420
7430
7440
7450
7460
7470
2600
2110
7480
n/a
n/a
n/a
n/a
3
8
2
8
1
18
5
10
5
5
5
44800
1000
1000
1000
1000
1000
1000
1000
1000
8
2
1
20
1
1
8/1/2012
Appendix E: Table Structures
epr table list
mcss.epr.epr_data
# raw epr data (ascii file structure)
mcss.epr.epr_wrk
# data extract and transform (epr_pend structure)
mcss.epr.epr_recnum
# last used epr recnum
mcss.epr.epr_batchnum
# last used epr batchnum
mcss.epr.epr_testing_lab_locations
# lookup table for MCSS pathlab
mcss.epr.epr_trtfacility_clients
# lookup table for MCSS trtfacility
mcss.epr.epr_pend
# stl reportable epr: awaiting DM coding
mcss.epr.epr_first_code
# DM first code epr results
mcss.epr.epr_second_code
# DM second code epr results
mcss.epr.epr_batch_YYYY
# epr batch info for current year
mcss.epr.epr_stats_YYYY
# epr statistics for current year
mcss.epr.epr_batch_archive
# epr batch info archive for all previous years
mcss.epr.epr_stats_archive
# epr statistics archive for all previous years
mcss.epr.epr_pathnumbers
# all epr submitted pathnumbers
mcss.epr.epr_nr
# MCSS NON-reportable epr (stl reportable)
mcss.dbo.abs_epr
# MCSS reportable epr (stl reportable)
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Mcss.epr.epr_batch_2004
One record per batch of pathology reports.
Data Item
batch
Data Type
Int
create_date_lab
pathlab
filename_lab
filename_mcss
process_date_mcss
Num_rec_submitted
num_hl7_records
Datetime
Int
Text
Text
Datetime
Int
Int
num_hl7_bad
Int
num_hl7_good
Int
num_ascii_incomplete
Int
num_missing_path
num_missing_text
num_ascii_good
begin_recnum
Int
Int
end_recnum
Int
num_resubmits
num_positive
Int
Int
num_negative
Int
final_reportable
Int
coder1
Int
coder2
Int
Int
Comment
Sequential number for each file submitted,
regardless of laboratory
Date Laboratory created the file
MCSS pathology laboratory code
Name given to the file by the pathlab
Name given to the file by mcss
Date mcss began processing file
Number of records in the file
Number of records found by the mcss hl7
reader
Number of records that do not meet mcss hl7
structure
Number of records that meet the mcss hl7
structure
Number of records that have incomplete
information in the record
Number missing pathnumber
Number missing text
First of sequential record control numbers
assigned to path reports in the batch
Last of sequential record control numbers
assigned to path reports in the batch
Number of resubmitted reports
Number of reports that positively matched with
a term on the Search Term List
Number of reports that did not match with any
term on the Search Term List
Final number of reportable pathology reports
in the batch
MCSS abstractor code for the person first
processing the batch of reports
MCSS abstractor code for the person second
processing the batch of reports
mcss.epr.epr_stats_2004
One record for each pathology report submitted as a complete, good ascii record.
Data Item
Data Type
Comment
batch
int
recnum
int
Sequential record control number assigned
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date_created
pathlab
convert_path
Datetime
Int
Varchar(20)
pathnumber
Varchar(15)
stl_reportable
Char(1)
staff_reportable
Char(1)
reviewed_by
coder1
coder2
dm_consult
supplemental
completed
Supp_lognumber
Int
Int
Int
Char(1)
Char(1)
Datetime
Int
to each path report
Date Laboratory created the file
MCSS pathology laboratory code
MCSS’ Converted pathology report number
assigned to the path report
Pathology report number assigned by the
laboratory
search term list (stl) decision of whether
report is reportable (Y) or not-reportable (N)
Mcss staff decision of whether report is
reportable (Y) or not-reportable (N)
Abstracter/region code
Abstracter code for first coder
Abstracter code for second coder
Date a pathology report assigned to pending
Whether report is a supplemental report
Date final resolution of pathology report
Sequential number assigned to an abstract
inserted into the main database
(mcss..abstracts)
mcss.epr.epr_pathnumbers
One record per pathnumber submitted for each laboratory. Uses the MCSS converted
pathology report number so that numbering is standardized.
Data Item
pathlab
convert_path
tabledate
Version 5.0
Data Type
Int
Varchar(2)
Datetime
Comment
MCSS pathology laboratory code
Converted pathology report number
Date record inserted into the table
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mcss.epr.epr_pend
One record per pathnumber submitted for each laboratory. Data record from laboratory
that will be reviewed for reportability and coded (if reportable).
recnum
rectype
layout_vers
submit_lab_num
submit_lab_name
submit_lab_street
submit_lab_city
submit_lab_state
submit_lab_zipcode
submit_lab_telephone
lastname
firstname
middlename
streetname
city
state
zipcode
county
telephone
date_of_birth
pathage
race
ssn
sex
medrecnum
doc1num
doc1lname
doc1fname
doc1mname
doc1_street
doc1_city
doc1_state
doc1_zipcode
doc1_telephone
doc2num
doc2lname
doc2fname
doc2mname
trtfacility
trtfacility_license
trtfacility_name
Version 5.0
int
varchar
varchar
int
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
varchar
int
varchar
varchar
1
6
50
25
20
2
9
10
25
14
14
25
20
2
9
3
10
8
10
1
9
1
11
6
15
10
1
25
20
2
9
10
6
15
10
1
25
50
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trtfacility_streetadd
trtfacility_city
trtfacility_state
trtfacility_zipcode
trtfacility_telephone
pathlab
pathnumber
convert_path
specdate
pathmd_lname
pathmd_firstname
pathmd_middlename
pathmd_suffix
pathmd_license
pathmd_state_license
path_report_status
snomed
snomed_version
icd_code
icd_version
cpt_code
cpt_version
path_text_diagnosis
path_text_clin_history
path_nature_of_specimen
path_gross
path_micro
path_final_dx
path_comments
path_supplemental
path_staging
date_transmitted
path_report_type
Supplemental
tabledate
Version 5.0
varchar 25
varchar 20
varchar 2
varchar 9
varchar 10
int
4
varchar 20
varchar 20
varchar 8
varchar 25
varchar 14
varchar 14
varchar 3
varchar 8
varchar 6
varchar 1
varchar 18
varchar 5
varchar 10
varchar 5
varchar 5
varchar 5
text
text
text
text
text
text
text
text
text
varchar 8
varchar 1
varchar 1
datetime
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mcss.epr.epr_first_code
One record per pathnumber submitted for each laboratory that has been coded by a
Data Management Representative. Record remains in this table until the full batch of
reports has been first and second coded and the records dispersed to either
mcss..rawtable or mcss..epr_nr.
recnum
primarynum
coder
decision
nr_code
trtfacility
pathlab
specdate
pathnumber
sex
site
laterality
histo
grade
spectype
incident
dxdate
consultstatus
reviewlab
abs_notes
coder_notes
tabledate
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int
int
varchar (3)
char (1)
int
int
int
varchar (8)
varchar (15)
varchar (1)
varchar (4)
varchar (1)
varchar (5)
varchar (2)
varchar (2)
varchar (1)
varchar (8)
varchar (1)
int
varchar (255)
varchar (255)
datetime
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mcss.epr.epr_nr
One record per pathnumber submitted that has been determined to be nonreportable but
useful for administrative functions (ie. Case ascertainment, residency, diagnosis date,
etc.)
recnum
pathlab
lastname
firstname
pathnumber
dob
sex
medrecnum
accession_date
blurb
nr_code
nr_rationale
tabledate
int
int
varchar (15)
varchar (10)
varchar (12)
char (8)
char (1)
varchar (12)
char (8)
text
int
varchar (72)
datetime
epr log for each file
Data Item
Program + Version
Date
MCSS Filename
Date Lab Created File
Error Message: File not Found
Number of Records Submitted
Number of HL7 Records
Number of bad HL7 Records
Number of good HL7 Records
Number of bad ASCII Records
Number of Incomplete ASCII
Records
Number of good ASCII Records
Number Missing Pathnumber
Number Missing Treatment Facility
Number Missing Text
Num_missing_lastname
Debug/Notification Messages
Error Messages
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Appendix F: Email Messages
Header for ALL email messages:
Date:
Laboratoy
Laboratory File Creation Date
Laboratory File Name
MCSS File Name
To: fs-rep, nancy, chris, mila, sally, brenda (and LAB-IT when noted below)
Bad HL7 Record (a non-standard hl7 record is received.)
To: add: LAB-IT
“The following pathology report numbers could not be translated due to an unexpected
error in reading the HL7 message. Please review your original file to determine error in
HL7 structure.
Contact Ashley Harvieux: 651-201-5191 [email protected] with
questions and resolution of problem records.
Thank you very much.”
[List of record numbers + pathology report numbers, if possible ]
Incomplete ASCII Record (critical data item(s) missing from a record.)
To: add: LAB-IT
“The following pathology report numbers are rejected due to missing critical data items
(pathology report number, treatment facility, text, patient name). Please review the
review and re-submit a complete pathology report record.
Contact Ashley Harvieux: 651-201-5191 [email protected] with
questions and resolution of problem records.
Thank you very much.”
[List of record numbers + critical data item that was missing]
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Appendix G: File structure for epr files
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Appendix H: Ecode software
Ecode is used to review, first and second code pathology reports.
Table 1: Ecode action first to second code
1st
Code
Action
“1st code marked as delete”
R
2nd
Code
Action
Delete record
[no error messages, no discrepancies]
D
D
“1st code marked as delete”
N
Move the record to epr_nr.
[No error messages, no discrepancies.]
D
“1st code marked as delete”
C
Send Record To DM Consult
D
“1st code marked as delete”
R
Insert record into rawtable
Move record from epr_pend to abs_epr
Add to discrepancies list
N
“1st code marked as NR”
N
Move record to epr_nr
nd
[use the nr code from the 2 code]
[no error messages, no discrepancies.]
N
“1st code marked as NR”
D
Error msg:
st
“You can’t delete a record that the 1 code marked as
NR.
Use NR or DM Consult or Code it if it is reportable.”
N
“1st code marked as NR”
C
Send record to DM Consult
N
“1st code marked as NR”
R
Insert record into rawtable
Move record from epr_pend to abs_epr
Add to discrepancies list
R
Fields are coded
D
Error msg:
st
You can’t delete a record that the 1 coder made
Reportable.
Send to DM Consult or Code it if it is reportable.”
R
Fields are coded
N
Error msg:
st
You can’t make a record NR that the 1 coder made
reportable.
Send to DM Consult or Code it if it is reportable.”
R
Fields are coded
C
Record sent through DM Consult process
Fields are coded
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R
Insert record into rawtable
Move record from epr_pend to abs_epr
st
nd
Check for discrepancies between 1 code and 2 code
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st
1
Code
D
Action
“1st code marked as
delete”
nd
2
Code
D
Action
Delete record
[no error messages, no discrepancies]
N
“1st code marked as NR”
D
Error msg:
st
“You can’t delete a record that the 1 code marked as NR.
Use NR or DM Consult or Code it if it is reportable.”
R
Fields are coded
D
Error msg:
st
You can’t delete a record that the 1 coder made Reportable.
Send to DM Consult or Code it if it is reportable.”
C
Can’t mark C as first
coder
D
D
“1st code marked as
delete”
N
Move the record to epr_nr.
[No error messages, no discrepancies.]
N
“1st code marked as NR”
N
Move record to epr_nr
nd
[use the nr code from the 2 code]
[no error messages, no discrepancies.]
R
Fields are coded
N
Error msg:
st
You can’t make a record NR that the 1 coder made
reportable.
Send to DM Consult or Code it if it is reportable.”
C
Can’t mark C as first
coder
N
D
“1st code marked as
delete”
R
Insert record into rawtable
Move record from epr_pend to abs_epr
Add to discrepancies list
N
“1st code marked as NR”
R
Insert record into rawtable
Move record from epr_pend to abs_epr
Add to discrepancies list
Fields are coded
R
R
Insert record into rawtable
Move record from epr_pend to abs_epr
st
nd
Check for discrepancies between 1 code and 2 code
C
Can’t mark C as first
coder
R
D
“1st code marked as
delete”
C
Send Record To DM Consult
N
“1st code marked as NR”
C
Send record to DM Consult
R
Fields are coded
C
Send record DM Consult process
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