Dear All,

For Sites Sending HL7 data and using AllTalk Tracking.

I am updating the Tracking record default settings to match HB262-2008 and I would appreciate a few examples from each of you so I can see where I can make improvements.  In particular where the the results are requested a copy-to (ie requested by DR A, this copy to Dr B).

In our work from about 18 months ago on Victorian Cytology's Medipath System, we spent a great deal of time generating HL7 messages that were "Generic" ie worked for pretty much every practice software package.  Alas all our previous work making it HB262 compliant had to be undone!  So we understand the reason why there is non-conformance.

Most significant variance is with the managment of Addressee Doctors and Copy-to Doctors.
HB262 says for Unsolicited Results (ie ones without an electronic order) MSH5 should contain the Addresee Doctors details in AUSHIC format eg

MSH|^-&\|QMLPTX|QML^2184^AUSNATA|Dr Harry Green^012345XY.GREEN.HARRY^DR^AUSHICPR|GX32615492^GOLD^L|199710291523+1000||

Most HL7 generators tend to put its Original Intention which is Receiving Application (eg Medical Director etc).

MSH|^~\&|ABC123|ABC PATHOLOGY - NATA/RCPA laboratory #0001|Medical Director||20081115131000||

For copy-to information, HB262 (and AS4700) says to use OBR 28 with repeating fields to Identify the doctors that also received a copy (but it is not clear if you are supposed to put the Addressee doctor in this list too...)

Most packages still use a combination of OBR 17 and 18 to manage this.  Most use

OBR16 - Requesting Doctor

OBR17 - Addressee (if not same as OBR16)

occasionally OBR18  for Copy to Doctors  (HL7 Placer field 1)

occasionally OBR20 using value pair format eg  DR=1234567F, CP=Y (indicating the intended doctor's prov num is 1234567F and they are a COPY doctor, not requestor)

If you could send me some de-referenced results for comparison, that would be greatly helpful.

Thanks

Glen.