Friday, December 17, 2010

Radiology Orders and Results Interface

Here is another interesting interface project.

We want to send Radiology Orders from our EHR system to our trading partner and want the Radiology Results document to be returned electronically and placed into the patient's chart in the EHR.

Simple. Right.

Except, the scheduling system at our trading partner will not receive the order. I suggested that we send them an order message (ORM), a scheduled appointment (SIU), and a registration message for a future encounter (ADT). They told us that they could not process any of those HL7 messages into their scheduling system. So, we settled on this kluge. I will convert the order message into an email that I will send securely to the scheduling department. They will then manually key the appointment into their system. Hopefully, they will remember to key our Order Number so that I can match the result to a patient. Securely? Well, yes. The appointment will contain PHI, so I will utilize the secure email function of our email system. They wanted some data that the EHR could not place into the order, so I had to look that data up from the database and place it into the email.

So much for the outbound "order." Now, for the returned results.

A Radiology Result is just a special type of Clinical Document.

We have an existing document interface which we use to receive clinical documents from this trading partner as ORU^R01 messages. They will place these radiology documents into that stream and I will have to select those messages, process them a little bit differently and send them to the EHR. I will need to look up our patient identifier and put it into the message in place of their patient identifier. I will also look up the NPI for each of the incoming providers and place that into the message. The sending system gives us their internal identifier for each provider, and the EHR would like to see the NPI instead.

We are still developing this interface. The outbound orders seem to be working fine. I have built the results processing route and am waiting to get a test result to see if I have built that correctly.

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