HL7 ADT

The Discovery Data Service (DDS) takes HL7 ADT messages from a number of suppliers, transforms the data into FHIR, and makes this available for subscriber use. This page explains the HL7 ADT message types, structure, transform process, and the ADT -> FHIR -> Compass2 mappings.

Message Types

Message Type	Message Name	Publisher use
ADT^A01	Admit / visit notification	Barts Health
ADT^A02	Transfer a patient	Barts Health
ADT^A03	Discharge/end visit	Barts Health
ADT^A04	Register a patient	Barts Health
ADT^A05	Pre-admit a patient
ADT^A06	Change an outpatient to an inpatient
ADT^A07	Change an inpatient to an outpatient
ADT^A08	Update patient information	Barts Health
ADT^A11	Cancel admit/visit notification	Barts Health
ADT^A12	Cancel transfer	Barts Health
ADT^A13	Cancel discharge/end visit	Barts Health
ADT^A14	Pending admit
ADT^A17	Swap patients
ADT^A23	Delete a patient record	Barts Health
ADT^A27	Cancel pending admit
ADT^A28	Add person information	Barts Health
ADT^A31	Update person information	Barts Health
ADT^A34	Merge patient information - patient ID only	Barts Health
ADT^A35	Merge patient information - account number only	Barts Health
ADT^A44	Move account information - patient account number	Barts Health

Message Structures

The messages types are grouped by their structure for transformation to FHIR, since this avoids a large amount of code repetition.

When saving FHIR to the Discovery store there are variations in handling of message types within the message structure groups.

The structures are as follows:

Structure A – Patient level messages

Applies to:

• ADT^A01 (Admit/visit notification)
• ADT^A02 (Transfer a patient)
• ADT^A03 (Discharge/end visit)
• ADT^A04 (Register a patient)
• ADT^A08 (Update patient information)
• ADT^A11 (Cancel admit/visit notification)
• ADT^A12 (Cancel transfer)
• ADT^A13 (Cancel discharge/end visit)
• ADT^A23 (Delete a patient record)

Segments used:

• MSH [1..1] Message header
• EVN [1..1]  Event information
• PID [1..1] Patient information
• PD1 [0..1] Additional demographics
• PV1 [1..1] Patient visit information
• PV2 [0..1] Patient visit additional

Structure B – Person level messages (without encounter information)

Applies to:

• ADT^A28 (Add person information)
• ADT^A31 (Update person information)

Standard segments:

• MSH [1..1] Message header
• EVN [1..1] Event information
• PID [1..1] Patient information
• PD1 [0..1] Additional demographics

Structure C – Merge patient information

Applies to:

• A34 (Merge patient information)
• A44 (Move account information)

Standard segments:

• MSH [1..1] Message header
• EVN [1..1] Event information
• PID [1..1] Patient information
• PD1 [0..1] Additional demographics
• MRG [1..1] Merge information

Structure D – Merge account number

Applies to:

• A35 (Merge account number)

Standard segments:

• MSH [1..1] Message header
• EVN [1..1] Event information
• PID [1..1] Patient information
• PD1 [0..1] Additional demographics
• PV1 [1..1] Patient visit information
• MRG [1..1] Merge information

Segment - PID - Patient Identification

FHIR Resource: Patient

Field#	FieldName	FHIR Mapping	Extension
PID.2	Patient ID	Patient.identifier
PID.3	Patient Identifier List	Patient.identifier
PID.4	Alternate PatientIidentifier	Patient.identifier
PID.5	Patient Name	Patient.name
PID.7	Date/Time Of Birth	Patient.birthDate & Patient.extension	primarycare-contact-birth-time-extension
PID.8	Sex	Patient.gender
PID.9	Patient Alias	Patient.name
PID.11	Patient Address	Patient.address
PID.13	Phone Number - Home	Patient.telecom
PID.14	Phone Number - Business	Patient.telecom
PID.15	Primary Language	Patient.communication.language
PID.16	Marital Status	Patient.maritalStatus
PID.17	Religion	Patient.extension	primarycare-religion-category-extension
PID.18	Patient Account Number	Patient.identifier
PID.22	Ethnic Group	Patient.extension	primarycare-ethnic-category-extension
PID.29	Patient Death Date and Time	Patient.deceased
PID.30	Patient Death Indicator	Patient.deceased

Segment - PD1 - Patient Additional Demographic

FHIR Resource: Patient

Field#	FieldName	FHIR Mapping	Extension
PD1.3	Patient primary facility	Patient.careProvider& Organization
PD1.4	Patient primary care provider	Patient.careProvider& Practitioner

Segment - NK1 - Next of Kin / Associated Parties

FHIR Resource: Patient

Field#	FieldName	FHIR Mapping	Extension
NK1.2	Name	Patient.contact.name
NK1.3	Relationship	Patient.contact.relationship
NK1.4	Address	Patient.contact.address
NK1.5	Phone number	Patient.contact.telecom.value
NK1.6	Business phone number	Patient.contact.telecom.value
NK1.7	Contact role	Patient.contact.extension	primarycare-contact-role-category-extension
NK1.20	Primary language	Patient.contact.extension	primarycare-contact-main-language-category-extension

Segment - PV1 - Patient Visit

FHIR Resource: Encounter

Field#	FieldName	FHIR Mapping	Extension
PV1.2	Patient class	Encounter.class
PV1.4	Admission type	Encounter.extension	encounter-admission-type
PV1.6	Prior patient location	Encounter.location& Location
PV1.7	Attending doctor	Encounter.participant & Practitioner
PV1.8	Referring doctor	Encounter.participant & Practitioner
PV1.9	Consulting doctor	Encounter.participant& Practitioner
PV1.10	Hospital service	Encounter.serviceProvider& Organization
PV1.14	Admit source	Encounter.hospitalization.origin
PV1.17	Admitting doctor	Encounter.participant & Practitioner
PV1.18	Patient type	Encounter.type
PV1.19	Visit number	EpisodeOfCare.identifier
PV1.36	Discharge disposition	Encounter.hospitalization.dischargeDisposition
PV1.37	Discharged to location	Encounter.hospitalization.destination
PV1.39	Servicing facility	Encounter.managingOrganization
PV1.41	Account status	Encounter.status
PV1.44	Admit date/time	Encounter.statusHistory.start
PV1.45	Discharge date/time	Encounter.statusHistory.end
PV1.50	Alternate visit ID	Encounter.identifier
PV1.52	Other healthcare provider	Encounter.participant& Practitioner

Segment - PV2 - Patient Visit - Additional Information

FHIR Resource: Encounter

Field#	FieldName	FHIR Mapping	Extension
PV2.3	Admit reason	Encounter.reason
PV2.4	Transfer reason	Encounter.reason
PV2.8	Expected admit date/time	Encounter.statusHistory.start

Segment - EVN - Event Type

Field#	FieldName	FHIR Mapping	Extension
EVN.2	Recorded date/time	Encounter.extension	primarycare-recorded-date-extension
EVN.5	Operator ID	MessageHeader.enterer & Practitioner.identifier & Practitioner.name

Segment - MSH - Message Header

FHIR Resource:

Field#	FieldName	FHIR Mapping	Extension
MSH.3	Sending application	MessageHeader.source.software
MSH.4	Sending facility	MessageHeader.source.name
MSH.5	Receiving application	MessageHeader.destination.extension	message-header-destination-software-extension
MSH.6	Receiving facility	MessageHeader.destination.name & MessageHeader.responsible
MSH.7	Message date/time	MessageHeader.timestamp
MSH.9	Message type	MessageHeader.event.code
MSH.10	Message control id	MessageHeader.extension	message-header-message-control-id-extension
MSH.12	Version ID	MessageHeader.event.version
MSH.13	Sequence number	MessageHeader.extension	message-header-sequence-number-extension