HL7 Version 3 Standard |
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HL7® Version 3 Standard, © 2003 Health Level Seven®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off |
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Table of Contents1 Foreword1.1 Copyright Notice 1.2 HL7 Special Acknowledgments 2 V3 Packages 2.1 Domain Documents in the V3 Package 2.2 Foundation Documents in the V3 Package 3 Backbone Welcome 4 HL7 Organizational Overview 4.1 Mission 4.2 What is HL7? 4.3 Background 5 HL7 Version 3 Overview 5.1 V3 Principles 5.2 What's New with HL7 V3? 5.3 Managing HL7 V3 Message Development 5.3.1 Project Scope Definition 5.3.2 HL7 V3 Methodology 5.3.3 Quality Assurance Process 6 HL7 V3 Ballot Instructions 6.1 What do the Colors on the Menu Items Mean 7 Getting Started 7.1 New Implementer 7.1.1 Learn the Basics 7.2 Management 7.2.1 Manager 7.2.2 Project Manager 7.2.3 Marketer 7.2.4 Construct Site Agreement 7.2.5 Sign a Deal 7.3 Interface Developer 7.3.1 Interface Analyst 7.3.2 Interface Programmer 7.3.3 Develop Interface 7.4 HL7 Standard Developer 7.4.1 Develop the Standard |
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1 |
Foreword |
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1.1 |
Copyright Notice |
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The 2003 Health Level Seven V3 Publication is copyrighted by Health Level Seven, Inc. (HL7) and is therefore protected by the Copyright Law of the United States and copyright provisions of various international treaties. The effect of such laws and treaties is that you may not, without a license from Health Level Seven, Inc., copy or distribute HL7's publication Product. HL7 Organizational members are authorized to reproduce the publication for internal use in their organization. This authorization use does not include reproduction of any part of this publication for inclusion in products for direct commercial resale. HL7 Individual members may not reproduce any part of this publication. |
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1.2 |
HL7 Special Acknowledgments |
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In addition to acknowledging the Committee Co-chairs and Facilitators, special credit is due a number of contributors: |
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Special thanks go to George Beeler for serving as the V3 project leader and tools developer, Lloyd McKenzie with Alberta Wellnet for developing the Visio tool set for development of CMETs and Austin Kreisler with McKesson Informatioln Solutions for development of the Publication Database. Helen Stevens with McKesson Information Solutions is acknowledged for her leadership of the Publishing Committee. The following individuals are also acknowledged for their intellectual contributions: Wes Rishel with Gartner Group, Jim Case with University of California, Ken McCaslin with Quest Diagnostics, and Dale Nelson with Oracle Corporation. The following individuals are acknowledged for their technical support in the production of this publication: Rikki Holland with Double Click, Ltd, Alan Little with Holotech Enterprises, Charlie McCay with Ramsey Systems, Ltd, Mike Craig with HL7, Matthew Stephens with Ramsey Systems, Ltd, and Karen Van Hentenryck with HL7. |
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2 |
V3 Packages |
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Welcome to the fourth ballot of the Version 3 (V3) messaging standard. This package is the result of many years of work within the HL7 community and an increasingly focused effort over the last several months. We believe it is a major step forward for global health information standards. |
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2.1 |
Domain Documents in the V3 Package |
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The following material contains the content for the distinct ballot groups in different stages of committee and membership ballot: |
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(The user identified specification ../../foundationdocuments/helpfiles/datatypes.htm is not available) |
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(The user identified specification ../../foundationdocuments/itsxml/datatypes-its-xml.htm is not available) |
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Two ballot documents are contained here: |
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HL7 Version 3 Standard: XML Implementation Technology Specification-Data Types, Release 1 (5th committee level ballot) - This document defines the V3 data types that will be used by all of HL7 V3 and onwards. It also defines the representation of HL7 V3 data types in XML, including the schema necessary to derive XML schemas for HL7 V3 Hierarchical Message Descriptions (HMD). |
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HL7 Version 3 Standard: XML Implementation Technology SPecification-Messaging, Release 1 (4th committee level ballot) - This document defines the representation of HL7 V3 messages in XML, including the method to derive XML schemas and additional processing rules from HL7 V3 Hierarchical Message Descriptions (HMD). |
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V3 Infrastructure Management, Release 1 (3rd committee-level ballot)(The user identified specification ../../sectioncontent/ai/immcai.htm is not available)(The user identified specification ../../sectioncontent/ci/immcci.htm is not available)(The user identified specification ../../sectioncontent/qi/imquqi.htm is not available)(The user identified specification ../../sectioncontent/mi/immfmi.htm is not available) |
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This document focuses on the development and management of the infrastructure of the V3 standard. It includes information from the Message Control Infrastructure, Control Act Infrastructure, Master File Infrastructure and the Query Infrastructure domains. |
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(The user identified specification ../../foundationdocuments/helpfiles/conformance.htm is not available) |
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This document describes the processes whereby HL7 Version 3 Message Specifications may be refined, constrained and extended to support implementation designs, conformance profiles, and realm-specific standards. It also details the rules that underlie the development of Version 3 Messages based on the RIM and Vocabulary Domain. This document incorporates and replaces the Conformance document in the previous Version 3 ballot cycles.. |
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2.2 |
Foundation Documents in the V3 Package |
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In addition to the above ballot sections the following documents are included in this publication to assist in the comprehension and application of Version 3: |
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This document is the introduction or ‘home page’ of the HL7 V3 publication and includes introductory information relevant to the entire V3 publication. This includes an HL7 Overview, and Introduction to V3, Ballot Instructions, and Getting Started sections. |
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(The user identified specification ../../foundationdocuments/referencefiles/rim.htm is not available) |
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This document defines all the information from which the data content of HL7 messages are drawn. It forms a shared view of the information domain used across all HL7 messages independent of message structure and provides a means for discovering and reconciling differences in data definition. |
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(The user identified specification ../../foundationdocuments/helpfiles/v3guide.htm is not available) |
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This document is a primer of the concepts and artifacts found in V3. This document is recommended reading for all V3 voters. |
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(The user identified specification ../../foundationdocuments/referencefiles/vocabulary.htm is not available) |
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This document includes listing of all vocabularies used in the HL7 standard. This includes structured vocabulary that defines the valid (or invalid) relationships between classes in the RIM and Code Set Vocabularies used to define attribute code sets. |
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(The user identified specification ../../foundationdocuments/helpfiles/glossary.htm is not available) |
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The Glossary contains a comprehensive list of terms and acronyms used throughout V3. |
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3 |
Backbone Welcome |
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Welcome to the HL7 V3 Standard! V3 is comprised of many separate documents. The document you are currently reading is the Backbone document, which contains the following sections: |
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The HL7 Introduction section provides a brief overview of the HL7 Organization, its mission and philosophy. |
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Review this section to understand what HL7 V3 is, why we developed HL7 V3, and the principles underlying the V3 Standard. |
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The V3 Publication is composed of two types of documents: Foundation and Domain. The Foundation documents are those documents that are broader in scope and tend to apply to all domain documents. THe V3 Guide, the HL7 Vocabulary Domain and Reference Information Model, for example, are Foundation documents. Domain documents are produced for a specific domain such as pharmacy or scheduling and contain the messages relevant to that domain. |
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Below is a graphical representation of the Foundation documents. |
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4 |
HL7 Organizational Overview |
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4.1 |
Mission |
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HL7's mission is to provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services. Specifically, to create flexible, cost effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems. |
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4.2 |
What is HL7? |
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HL7 is one of several ANSI-accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as clinical data, pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven's domain is clinical and administrative data. |
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HL7 is a not-for-profit volunteer organization. Its members - providers, vendors, payers, consultants, government groups, pharmaceutical and others who have an interest in the development and advancement of clinical and administrative standards for healthcare - develop the standards. Like all ANSI-accredited SDOs, HL7 adheres to a strict and well-defined set of operating procedures that ensure consensus, openness and balance of interest. A frequent misconception about HL7 (and presumably about the other SDOs) is that it develops software. In reality, Health Level Seven develops specifications, the most widely used being a messaging standard that enables disparate healthcare applications to exchange key sets of clinical and administrative data. |
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The HL7 Working Group is composed of volunteers who give their time on a personal basis or under sponsorship of their employers. Membership in the HL7 Working Group has been, and continues to be, open to anyone wishing to contribute to the development and refinement of the HL7 standards. |
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4.3 |
Background |
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The term "Level 7" refers to the highest level of the Open System Interconnection (OSI) model of the International Organization for Standardization (ISO). This is not to say that HL7 conforms to ISO defined elements of the OSI's seventh level. Also, HL7 does not specify a set of ISO approved specifications to occupy layers 1 to 6 under HL7's abstract message specifications. HL7 does, however, correspond to the conceptual definition of an application-to-application interface placed in the seventh layer of the OSI model. |
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In the OSI conceptual model, the functions of both communications software and hardware are separated into seven layers, or levels. The HL7 Messaging Standard is primarily focused on the issues that occur within the seventh, or application, level. These are the definitions of the data to be exchanged, the timing of the exchanges, and the communication of certain application-specific errors between the applications. However, of necessity, protocols that refer to the lower layers of the OSI model are sometimes mentioned to help implementers understand the context of the standard. They are also sometimes specified to assist implementers in establishing working HL7-based systems. |
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It does not try to assume a particular architecture with respect to the placement of data within applications but is designed to support a central patient care system as well as a more distributed environment where data resides in departmental systems. Instead, HL7 serves as a way for inherently disparate applications and data architectures operating in a heterogeneous system environment to communicate with each other. |
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If we consider the multitude of healthcare information systems applications as well as the variety of environments in which healthcare is delivered, it is evident that there are many more interfaces which could benefit from standardization. The interfaces chosen were considered to be of high priority by the members participating in the standards writing process. HL7's intent is to prepare a complete standard for these interfaces, built on a generic framework that is sufficiently robust to support many other interfaces. |
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5 |
HL7 Version 3 Overview |
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5.1 |
V3 Principles |
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The HL7 V3 standard development methodology is based on a set of principles providing a common philosophy for all HL7 V3 standard developers. |
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5.2 |
What's New with HL7 V3? |
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5.3 |
Managing HL7 V3 Message Development |
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This section outlines the procedures used to develop the HL7 V3 messages. These procedures are based on the V3 Methodology and the HL7 Bylaws. The goal is to assure that the standard is developed expediently, appropriately documented, consistent with the requirements for an approval by a balanced consensus, and that it complies with the requirements for certification by the American National Standards Institute (ANSI). |
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5.3.1 |
Project Scope Definition |
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When a functional Technical Committee undertakes a project to develop new normative material in V3 it creates a brief description of the project for approval by the TSC. The project scope statement contains a concise description of the needs to be met by the transactions. This project scope statement is also be used for coordination of projects with other standards organizations. In fact, project scope statements must be reported to the ANSI so that ANSI can fulfill its standards coordination role.1 |
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Project scope statements are reviewed by the Architectural Review Board (ARB) and must be approved by the HL7 Technical Steering Committee. |
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5.3.2 |
HL7 V3 Methodology |
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The development of V3 messages follows the methodology specified by the HL7 Modeling and Methodology Committee. HL7 may amend the methodology from time to time. The methodology includes a definition of work products delivered by the Technical Committees. Portions of these work products are be designated for three different treatments: |
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The methodology specifies the following requirements. These are annotated to indicate the work products described in the V3 Guide that meet the requirements. The annotations further state whether the work product is normative or informative. |
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The Modeling and Methodology Committee does not have the right to determine the contents of work products created by the Technical Committees. It serves to facilitate their development, and to negotiate changes among the functional Technical Committees to ensure standard-wide consistency. If disputes cannot be resolved by the Technical Committees and/or the Modeling and Methodology Committee, they shall be resolved by the TSC. |
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5.3.3 |
Quality Assurance Process |
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In order to ensure the highest quality of the work products produced during the course of V3 message development, the HL7 Board of Directors has created the ARB. |
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The ARB works with the Technical Committees and Modeling and Methodology Committee to define quality measures for the HL7 work products, measure the work products again them, and that adherence to the defined message development process is documented in a manner consistent with HL7 bylaws and procedures. The ARB does not have the right to amend work products or disallow their distribution. It does have the right to include with any work product a statement describing areas where it has determined that the work product has not met established measures of quality. |
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As a general matter, the ARB is expected to include a statement of its findings in an HL7 general ballot package. However, in order to assist Technical Committees, and to avoid delaying the balloting process, the ARB attempts to make any significant comments as early in the ballot cycle as possible. |
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Disputes with the findings of the ARB are resolved through the TSC and, if necessary, the Board of Directors. |
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6 |
HL7 V3 Ballot Instructions |
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The HL7 V3 ballot is available for download from the HL7 website. Due to the size of the V3 ballot and the availability of extensive supporting materials, it is not necessary to download the entire package. You can choose the parts that are most important to you. |
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6.1 |
What do the Colors on the Menu Items Mean |
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If you look at menus that appear on the online ballot, you will notice that four colors are used. The colors determine the type of ballot document. The different types are enumerated below: |
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7 |
Getting Started |
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The Getting Started section provides guidelines and recommendation for how you should approach the HL7 V3 Publication. Each section below depicts a type of HL7 customer based on his or her relationship to the HL7 standard/organization. Locate the type of user that most closely reflects your experience level. The documentation includes recommended reading that will help you build the HL7 V3 knowledge base you desire. |
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7.1 |
New Implementer |
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A New Implementer is unfamiliar with HL7 terminology, methodology, and organization. A New Implementer may or may not be a member of the HL7 organization. |
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7.1.1 |
Learn the Basics |
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Learning the basics means becoming familiar with the basic terminology and methodology behind HL7. You would expect to learn the basic principles upon which HL7 V3 was constructed. Upon completion of this use case, you would be prepared to learn more detailed information about V3. |
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While learning the basics, refer to: |
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7.2 |
Management |
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7.2.1 |
Manager |
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Managers are responsible for hiring qualified HL7 analysts and programmers. They must supervise interface development and implementation efforts. They do not need to understand all of the details of creating an HL7 message, but they need to understand the concepts enough to review contacts, conformance statements, and assess the skills of their team. |
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7.2.2 |
Project Manager |
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The Project Manager is responsible for ensuring the project is completed within budget, on time, and within scope. Project Managers are not interested in all the details of creating an HL7 V3 message, but he needs to understand the concepts enough to review contacts, conformance statements, and assess the skills of his team. |
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7.2.3 |
Marketer |
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A Marketer is responsible for selling HL7 interfaces. He does not need to know the details, but must understand the major concepts and terminology. |
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7.2.4 |
Construct Site Agreement |
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Constructing a site agreement involves creating a specification for two or more parties to communicate using HL7 messages and documents. |
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When constructing a site agreement, refer to: |
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7.2.5 |
Sign a Deal |
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The deal requires HL7 interfaces, so in order to sign it a basic understanding of trigger events and message types, but not a detailed understanding of message fields, is required. |
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When signing a deal, refer to: |
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7.3 |
Interface Developer |
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7.3.1 |
Interface Analyst |
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Interface Analysts review the interface requirements and write detailed interface specifications. |
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7.3.2 |
Interface Programmer |
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Interface Programmers code and test interface based on the interface specifications. |
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7.3.3 |
Develop Interface |
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Developing an interface requires gathering the interface requirements, analyzing those requirements, developing detailed interface specifications, coding, and testing the interface against the interface specifications and defining the conformance statement. |
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When developing an interface, you must identify the application section you are working within: |
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Health & Clinical Management Section - This includes the Laboratory, Pharmacy, and Medical Records domain documents. |
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Administrative Management Section - This includes the Patient Administration, Scheduling, Personnel Management, Claims and Reimbursement, and Accounting and Billing domain documents. |
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Infrastructure Management Section - This includes the Infrastructment Management document (Message control Infrastructure, Control Act Infrastructure, Master File Infrastructure and Query Infrastructure) as well as the Common Message Elements and Common Message Content documents. |
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Once you identify the section you can drill down through to the domain messages. |
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To complete your message development analysis, you will also need to fully understand: |
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XML Implementation Technology Specification - The Implementation Technology Specification describes how HL7 messages are sent using a specific method of encoding. |
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HL7 Vocabulary Domains - HL7 Vocabulary Domains are concepts you are most likely already familiar with. HL7 Vocabulary Domains are the sets of allowable values for a coded field. For example, if a message contains a marital status field, then the vocabulary domain for that field would consist of the allowed values for that field, such as, single, married, divorced, and separated. Each coded attribute in the RIM will be associated with one and only one vocabulary domain. |
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For additional reference, be sure to review: |
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7.4 |
HL7 Standard Developer |
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Standard Developers attend HL7 Working Group Meetings and participate in the creation of the HL7 V3 Standard Specification. |
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7.4.1 |
Develop the Standard |
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Developing the HL7 Standards involves an understanding of the HL7 Organization and its development methods. |
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Before committing to HL7 Standards development, review: |
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Identify the section in which you are most interested. |
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Once you identify the section you can drill down to the domain messages. |
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XML Implementation Technology Specification - The XML Implementation Technology Specification defines the representation of HL7 V3 data types and messages in XML, including the method to derive XML DTDs plus additional processing rules from HL7 V3 Hierarchical Message Descriptions (HMDs). |
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Endnotes
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