Question: sending PDFs via HL7 v2

This question is a follow up to one asked on Stack Overflow

Question:

On stack overflow you asked me to look at MDM message type. My question is that I know some systems can’t handle MDM message types so if this is the case how could sending of a url for a pdf be handle in that case?

What is the best way(appropriate message/event type) to put a url for a pdf in an hl7 message(ie what are the message types and segment, etc.. that are appropriate)?

Also does the HL7 standard allow for the unsolicited pushing of pdf messages whether it be a url to a message or an actual pdf document encoded in hl7? For example if an ADT message came in and was successfully loaded into my system and I wanted to create an hl7 message to send out with the link or embeded pdf that i created. What hl7 message would i use to send?

Answer:

Most systems would have no concept of why they’d accept an unsolicited PDF – where would it go? what’s it’s workflow? If they do know the answer to that question, and they can accept it, then they should implement the MDM messages (T12, T14, T15 maybe), since that’s the correct message type for that functionality.

If the destination system doesn’t handle MDM messages, then it most likely doesn’t handle unsolicited PDF messages, but you’d have to ask (or consult the documentation if it exists). It’s going to be a per system thing – but it is anyway, since systems vary so much.

You can send an ORU message with an OBX segment with an RP data type in OBX-5 which is a reference to a PDF(or even an ED data type with the entire PDF in it). But whether systems can accept ORU messages like this, and whether they can correctly represent an RP/ED like this… again, that’s a question for each individual system.

4 Comments

  1. Don Cartegena says:

    Thanks Grahame! This is exactly what I was looking for.

    Overall an external application would generate a request to see data for a particular patient. The response would be the url for to the pdf. This would go to various systems so from my experience (mostly with ambulatory on outbound side and acute on inbound side) I recall all ambulatory systems can’t handle MDM.

    Which sometimes meant that we had to send ORU messages to. This is the reason I mentioned that.

    Hope this clarifies everything.

  2. Your answer denies the reality of the Australian standards which specifically support OBX segments with pdfs as an ED segment. This is supported by many systems in Australia.

    I am not sure that its the best way to deliver reports, as it tends to encourage non atomic data, but it will work with most GP systems.

    There is nothing about MDM that makes it a better solution, especially given the existing support in applications for ORU/REF messages.

  3. Eric Browne says:

    For encapsulating PDF files in ORU or REF messages as done in Australia and many other countries, further explanation is available at
    http://healthbase.info/blog/?p=376 .
    Healthbase Australia also provides a free online HL7 message viewer/interpreter/understand-a-scope for viewing such ORU/REF messages ( or MDM etcl, too )

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