Standard for Use of HL7 Version 2 in the UK

Request for Change

Request by (name) / Chris Smith
On behalf of (organisation ) / personal view / iSOFT Plc
e-mail address /
Telephone no. / 0776 495 2070
Date / 6 February 2003
RfC Identifier (Do not complete. This will be used for internal HL7UK tracking of RfCs) / 03 / 001
Section / Chapter, section or subsection number to which the request for change applies (all requests will be given an individual unique identifier)
Category / One of:M (Major) a serious disagreement with the approach taken or the terms of the standard
I (Minor)other disagreement with the approach taken or the terms of the standard
S (Suggest)suggestion for improvement not arising from a disagreement with the approach
Q (Query)uncertainty on meaning or a lack of clarity
T (Typo)technical, grammatical or typographical error
G (General)other general comments on the document
Details / A description of the request for change
Suggested Change / Either suggested wording to resolve the item or other suggested resolution of the request for change. Completion of this column will greatly enhance the process of resolving the items.

All Requests for Change must be in this format

Section / Category / Details / Suggested Change
AppendixA + Chapter 3 / S / Provide new Z segment to support special person matching requirements of NSTS on line service.
Unlike many healthcare systems, the NSTS – subscribing system is not ‘sealed’ and therefore changes can be made on either system without being reflected in the other thus allowing them to become out of step. In addition, the NHS number is a less reliable person identifier than most hospital numbering systems.
The NSTS notification service is required to send person detail updates to subscribing systems (typically hospital admin systems). Given the issues described in the previous paragraph, the NSTS allows their update record to be applied to an existing subscriber system based on a match on name, sex, DoB and NHS number. Current HL7 segments only provide current name, sex, DoB and NHS number therefore an additional segment is required to transport previous (NSTS) values in addition to the current person details included a PID segment / Create new Z segment for NSTS notification system.
Segment will contain:
NHS number as CX datatype
Previous NSTS Name as XPN datatype
Previous NSTS Sex as IS datatype
Previous NSTS DoB as TS datatype
This segment will be included in the A31 message.
This change will requires changes to:
Chapter 3 – amend A31 message definition
Appendix A – add ZU9 segment

HL7 UK Progress Tracking

Date / Action (HL7 UK recommended action /published for consultation / Adopted as Pre-Standard)
11/3/03 /

Chapter 3 changes – revised A31 message definition

Update person information (event code A31)

An A31 event occurs when person information is updated in the master patient administration system. Do not substitute this message for the A08 event used to update patient information. Since there are no specific trigger events relevant to person activity, the A31 message is used to communicate any and all changes to person information. The construct of this message relies on existing segments; it must be understood that any reference to <patient> is equally applicable to <person> as in PID:5 <Patient/Person Name>.
An A08 event occurs when any patient information not otherwise addressed by a unique trigger event is changed. As noted under A02, it may be necessary to supplement some event messages with an A08 message; particularly when the original trigger event allows changes to non-event specific information. The A08 event may occur in any system holding patient information and the message shall be broadcast to all interested systems.
A PID:3 (patient number) needs to be defined to trigger an A31 update person message.
ADT^A31 / ADT message / Chapter
MSH / Message Header / 2
EVN / Event Type / 3
PID / Patient Identification / 3
[PD1] / Additional Patient Identification / 3
[ { NK1 } ] / Next of Kin / 3
[ PV1 ] / Patient Visit / 3
[ PV2 ] / Patient Visit – Additional Information / 3
[ { OBX } ] / Observation/Result / 7
[ { AL1 } ] / Allergy Information / 3
[ { DG1 } ] / Diagnosis Information / 6
[ { PR1 } ] / Procedures / 6
“Z” segments added in this Standard / Chapter
[ ZU9 ] / UK Additional Data for NSTS matching / Appendix A

Appendix A changes – ZU9: NSTS matching segment

This segment shall be used to convey original person characteristics to enable receiving systems to match latest details (sent in a PID segment) with their own patient database.
Seq / HL7 UK data type / R/O/C / RP/# / Element name
1 / CX / R / Y / Patient Identifiers
2 / XPN / R / Y / Patient Name
3 / TS / R / Date/Time of Birth
4 / IS / R / Sex
Field notes
Patient Identifiers (CX)
Definition: This field shall be used to convey the person’s NHS number
Seq / Element name / HL7 data type / HL7 UK data type / R/O/C
1 / ID Number / ST / ST / R
2 / Check Digit (notsupportedintheUK)
3 / Code Identifying Check Digit Scheme (notsupportedintheUK)
4 / Assigning Authority / HD / HD / R
5 / Identifier Type Code / IS / IS / R
6 / Assigning Facility / HD / HD / O

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