HL7 REF Specifications

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Introduction VPN and Communication Protocol Patient Matching Incoming Integration (to Artera)Outgoing Integration (from Artera)

Introduction

This document defines the specifications for full integration with the Artera application using HL7 interface standards. Please note that Artera supports a wide range of integration methodologies depending on your Practice Management (PM) and Electronic Medical Record (EMR) system. For more information on HL7, please refer to the Health Level Seven website: http://www.hl7.org

Integration Checklist

Phase I: Patient Referral Data to Artera

Establish VPN Tunnel
- Connect Interface Engines

Live Data Feeds to Artera from Customer
- One-Way Referrals (HL7-REF)

Phase II: Data Writeback to External System (Optional and PM/EMR System Dependent)

Live data feeds from Artera to customer
- One-Way Referral Scheduling Status updates Confirmation Status - available via flat file, API, or custom webservice

VPN & Communication Protocol

Artera will provide all prospective clients with the Artera VPN Template. Please fill this out as soon as possible. A completed form is required before moving forward with any significant integration discussions.

Patient Matching

Due to the variability of patient spellings and risk of mistyping, Artera performs patient mapping based on the external application’s patient identifier sent over the interface. Artera will not update patient demographic data from this interface feed.

Incoming Integration (to Artera)

REF - Referral Messages

REF messages keep Artera synchronized when important referral information is changed in your system.

Artera is typically configured to use the following REF messages. Unless otherwise specified by an Artera Integration Engineer, any other message transactions might be filtered and ignored.

REF^I12 - Add a Referral Record
REF^I13 - Update a Referral Record (Note: this can also add a Referral Record if received instead of an I12)
REF^I14 - Cancel a Referral Record

REF Field Breakdown

Legend
Field	Requirement	Notes	HL7 Field
RF1 Segment
Authorization Decision Code	Required		RF1-1
Referral Priority	Required		RF1-2
Referral Type	Required		RF1-3
Referral Scheduling Status	Required		RF1-4
Referral Classification	Required	Expected: INT INC OUT	RF1-5
Referral ID	Required		RF1-6
Referral Effective Date	Optional		RF1-7
Referral Expiration Date	Optional		RF1-8
Authorization Reason	Optional		RF1-10
ZF1 Segment
Referred To Specialty ID or Name	Required	Can be defaulted but must be populated	ZF1-3
Referral Linked Appointment ID	Conditional		ZF1-8
AUT Segment
Coverage Plan ID	Optional		AUT-1.1
Coverage Plan Name	Optional		AUT-1.2
Coverage Payor ID	Optional		AUT-2.1
Coverage Payor Name	Optional		AUT-3.1
Authorization Effective Date	Optional		AUT-4
Authorization Expiration Date	Optional		AUT-5
Referral Authorization ID	Optional		AUT-6
Authorization Decision Date	Optional		AUT-10
PRD Segment (repeating)
PRD Designation	Required	RP = Referred By RT = Referred To	PRD-1
Referred By Provider last name	Required		PRD-2.1
Referred By Provider first name	Required		PRD-2.2
Referred By Location/department ID	Optional		PRD-4.1
Referred by Provider ID	Required		PRD-7.1
Referred by Provider ID Type	Required		PRD-7.2
Referred to Provider last name	Conditional (on PRD-7.1)		PRD-2.1
Referred to Provider first name	Conditional (on PRD-7.1)		PRD-2.2
Referred to Location/department ID	Optional		PRD-4.1
Referred to Provider ID	Optional		PRD-7.1
Referred by Provider ID Type	Conditional (on PRD-7.1)		PRD-7.2
PID Segment
Patient ID	Required	Used to uniquely identify patient	PID.3
First Name	Required		PID-5.2
Last Name	Required		PID-5.1
Middle Name	Optional		PID-5.3
Patient Phone Number(s)	Optional	PID-13 format should match ADT and SIU, if those are also being sent, including PID-13.3 phone type tags	PID-13
IN1 Segment
Patient Coverage ID Plan ID	Optional		IN1-2.1
Patient Coverage ID Plan Name	Optional		IN1-2.2
Patient Coverage Payor ID	Optional		IN1-3.1
Patient Coverage ID Payor Name	Optional		IN1-4.1
Patient Coverage ID	Optional		IN1-35
DG1 Segment
Referral Diagnosis Code	Optional		DG1-2
Referral Diagnosis ID	Optional		DG1-3
Referral Diagnosis Name	Optional		DG1-3
PR1 Segment
Referral Procedure Code	Optional		PR1-2
Referral Procedure ID	Optional		PR1-3
Referral Procedure Name	Optional		PR1-3

Sample REF (to Artera)

MSH|^~\&||SYSTEM|WELLAPP|WELLAPP|20200708093051||REF^I13|215009|P|2.3

RF1|AUTH|RT|Consult||INT|123456^SYSTEM|20200515|20210515|20200515|Specialty

ZF1|||Cardiology|||20200515

AUT|1143563^BCBS OUT OF STATE|100000|BCBS|20200515|20210515|||||20200522113426

PRD|RP|TEST^PROVIDER|1025 Chapala^STE 400^SANTA BARBARA^CA^93101|884747333^^^WBM1|(888)888-8888||844993332^NPI^NPI

PRD|RT|TEST2^PROVIDER|1025 Chapala^STE 400^SANTA BARBARA^CA^93101|884747333^^^WBM1|(888)888-8887||844993338^NPI^NPI

PID|1||8837444^^^^MRN||TEST^PATIENT||19910410|F

IN1|1|88443333^BCBS OUT OF STATE|2288333|BCBS||||300164|MARMON PPO PLAN - ACTIVE|||20190101||||TEST^PATIENT|Se|||||1|||YE|20190523|||||||||14541576|MNX8288777||||||Full|F|^^^^^US|||BOTH

DG1|1|I1|R07.9^Chest pain, unspecified^I10

DG1|2|I1|R00.2^Palpitations^I10

PR1|1|C4|REF12^AMB REFERRAL TO CARDIOLOGY^C4

Outgoing Integration (from Artera)

Patient Referral Acceptance Status updates

There is no standards-based mechanism for communicating a patient’s response to whether or not they would like to schedule their Referral. This information, however, can be critical to track within your EMR. To that end, Artera can provide the following data fields in a flat file or those data elements can be used to call an API or custom webservice.

Legend
Field	Notes
Patient ID	Matches the ID passed in the incoming HL7 message
Referral ID	Matches the ID passed in the incoming HL7 message
Referred by Provider ID	Matches the ID passed in the incoming HL7 message
Specialty ID	Matches the ID passed in the incoming HL7 message
Patient contacted date/time	When the patient was contacted
Patient response	How the patient replied (if at all) to their contact
Contact method	How the patient was contacted
Contact Status	The success of the patient contact attempt
Scheduling Status	Matches the scheduling status sent in the incoming HL7 message

specifications hl7 referral technical specifications ref feed

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