HL7 File Processing
Introduction and FAQ
Table of Contents
•
•
•
•
•
•
Introduction
HL7 File Validation Process
Email Notifications
HL7 Reports
Common Error/Warning Messages
Frequently Asked Questions
2
HL7 File Processing
INTRODUCTION
3
Review of Accomplishments
So far in the HL7 on-boarding process, your organization has
accomplished the following:
Steps Completed
Purpose
•
Held a discovery call
•
Introduced the process and received highlevel explanation of what is required to move
forward with Stage 2 Meaningful Use.
•
Completed registration/renewal process
•
Added to ImmTrac (1st time registrants), or
updated site agreement in the system so that
an import code and FTP credentials could be
requested.
•
Obtained an Import Code
•
Provided a six-character code that will be
used as an identifier and must be included in
the name of all HL7 files submitted.
•
Received FTP credentials and completed
setup configuration for the Core FTP Client.
•
Required for the secure folders from which
HL7 files will be submitted or results received.
4
Test File Submission
The next step will be to submit test files to the FTP Folder. You will
be asked to submit multiple test files during this stage:
• First test file:
• should contain one message with one RXA segment.
• Must pass through the pre-validation process and be free of errors before
another file is requested.
• May contain warnings and still pass pre-validation
• Subsequent test files
• should contain the number of messages that is characteristic for your
organization to send on a weekly basis.
• May contain test or live data
• At least two error-free files containing live data are required before gaining
approval for Live status
• May contain warnings and still pass.
You will work with the Interop HL7 File Processing Team, who will
review the files and help answer any questions you have.
5
Pre-LIVE Status Training Considerations
• Is the staff familiar with the EHR already or do they need to be
trained?
• Who will review the results of each HL7 file submitted?
• How will messages with errors get fixed?
• How will they get resubmitted in the next weekly batch? Is the
EHR set up to support this?
• Who will the staff go to for questions? What kind of support can
they expect?
• Who will call the EHR vendor as questions/issues arise? Do they
know their main point of contact at the EHR vendor site?
• Is the site aware of the schedule date for when HL7 files will be
submitted to the state?
• Are there any technical considerations on the IT Services/Vendor
side that would prevent them from being promoted to live status?
6
Live File Submission
Once you complete the testing and your file submissions are
approved, your status in the system will be set to “Live”
• Only live data should be sent once the status has been set to
“Live”
• You may now resubmit any test files containing live data for
processing and importation into ImmTrac, provided this
information has not yet been submitted to ImmTrac
• You will be expected to submit live data on a weekly basis
• After live files have been processed, feedback report files for all
files submitted will be available in your DQA Reports folder for 90
days up to a 300 file maximum.
• Staff will need to be properly trained on any new processes put in
place.
7
Naming HL7 Files
Your HL7 immunization file must be prefixed with the import code
we assigned to your organization during your registration and onboarding process. If your file is not prefixed with your assigned
import code, it cannot be processed by the validation
engine. We will email the primary contact on file if this occurs. You
will need to correct the file name and resubmit it.
The import code, if possible, should be followed by the two digit
calendar year and the Julian Date, which is the three-digit day on
the Julian Calendar (see: http://www.fs.fed.us/fire/partners/fepp/juliandate.htm).
For example, if Provider ‘MYFILE’ is submitting a file on February
20, 2012, the file should be named MYFILE12051.HL7
8
HL7 File Processing
HL7 FILE VALIDATION PROCESS
9
HL7 Validation Process
• All HL7 files will be put through a 2-stage validation process
to validate the data prior to ImmTrac importation.
• Stage 1: DQA
• The DQA is a validation tool that is used to check the formatting and
measure the data quality in a HL7 file.
• DQA will go through the messages in your HL7 file and provide
feedback on the completeness and quality of the data submitted.
• An HL7 message must pass DQA validation without errors before it can
be submitted to ImmTrac.
• Stage 2: ImmTrac
• ImmTrac has its own set of validations that it performs. While DQA
validates the file for formatting and data quality, ImmTrac validates the
patient level data in the file.
• ImmTrac may ultimately be unable to import data that successfully
made it through DQA validation.
10
Examples of DQA and ImmTrac
Validation
• DQA validates CDC-level
information
• HL7 format
• Expired Vaccinations
• Mismatched manufacturers
and vaccination products
• ImmTrac validates
patient level information
• Consent on file
• Patient record match
• Patient data match
11
FTP File Share Structure
---- Your FTP Share Server will contain the following folders ----
12
HL7 Validation Process Flow
13
High-Level Validation Process
It may be helpful to look at the file validation process as four
discrete steps:
•
•
•
•
Submission
Pre-Processing
Error Notification (if applicable)
ImmTrac Processing and Importation
Each of these steps are detailed on the following slides
14
HL7 File Submissions
15
HL7 File Pre-Processing
16
HL7 Error Notification (if applicable)
17
ImmTrac Processing & Importation
18
HL7 File Processing
EMAIL NOTIFICATIONS
19
Email notifications during the HL7
file submission process
The following is a list of emails that Providers could potentially
receive during the HL7 file submission process. Each of the
bulleted items are detailed in the slides that follow:
• Email Acknowledgement of File Receipt
• Email Notification of Fatal Errors
• Email Notification of File Errors
• Error notifications are received only if the submitted HL7 file
contained errors.
• If your file contains no errors, the only email you will receive will
be the acknowledgement.
• While we do not recommend it, you may unsubscribe from the
automatic notifications.
20
Email Acknowledgement of File
Receipt
When our processing system discovers your submitted HL7 file,
we will automatically send an email acknowledgement to your
facility’s primary ImmTrac contact on file.
If your organization submits immunizations for multiple sites in a
single file, we will only send the acknowledgement to the
ImmTrac contact on record for the parent facility on record.
21
Email Notification of Fatal Errors
Notification of Fatal Errors are emailed error messages that
Providers receive upon submission of an erroneous HL7 file. The
reason for the fatal error is clearly stated in the email. These files
cannot be processed until the error is fixed.
Errors received upon submission are generally for HL7 files that:
• Were submitted with an invalid file name.
• Were already submitted on a previous date.
• Contained an invalid file type extension.
• Submitted files may only be of type .HL7, .TXT (IHQ files only), or
.IMP (AFFIRM files only).
Providers are urged to correct the file extension and resubmit.
22
Email Notification of File Errors
If we detect any errors in your HL7 immunization file during
DQA validation, we will send an email to your facility’s
primary ImmTrac contact. The email will tell you how many
errors and warnings were noted in your file.
We will allow your error-free HL7 messages to be
submitted to ImmTrac but messages with errors cannot be
submitted to ImmTrac. This error notification in conjunction
with our new feedback reports will allow you to correct the
errors we discovered and submit them in a future file.
23
HL7 File Processing
HL7 REPORTS
24
Feedback Report Files
Every time you submit an HL7 immunization file to ImmTrac, we will
generate four detailed feedback report files for you. These report
files are generated automatically when you file is pre-processed for
submission to ImmTrac.
These report files will be placed in your DQA-REPORT folder on our
secure FTP server. Please note that these report files will not
be emailed to you - they contain protected data and must be
downloaded from our secure FTP server just as you download the
return notification files from ImmTrac now.
The four feedback reports are listed below and will be detailed in the
HL7 Reports section of this slide deck:
•
•
•
•
Summary Report
Acknowledgement File
Log File
Error File
25
Download your Feedback Report
Files Within 90 Days
Your feedback report files will be kept in your DQA-REPORT
folder on our secure FTP server for 90 days. After 90 days they
will be deleted due to regulatory requirements.
There is a 300 file limit for the FTP folder. This limitation is
combined for all Provider folders on the FTP server.
26
What will I see after the validation
process is complete?
Four Generated Files will appear in your DQA Report Folder
after processing is complete. Each of these will be detailed
on the following slides.
Acknowledgement File
Error File
Summary Report
Log File
27
Error File
• Lists specific warnings and errors found in the segments of all
messages
• If there were no errors this file will be empty
• For troubleshooting assistance, refer to the Common
Error/Warning Messages section of this document
28
Log File
• Detailed information about each message received
• Includes detailed errors and warnings
29
Acknowledgement File
• A list of HL7 acknowledgements for each received
message
• States whether messages were accepted or rejected (A)
• Errors will be marked with an |e| and warnings with a |w| in
the 5th column. In this example, only warnings were
received (B)
30
Summary Report
• Gives a high level analysis of a file’s data quality
• Quantifiably measures the DQA submission in three areas:
•
•
•
Completeness- Are all required and recommended fields being sent as expected?
Quality- Are there errors or warnings in the received data?
Timeliness- Are reports of vaccination administration being received on time per CDC guidelines?
• A user guide for the DQA Summary Report can be found here:
http://openimmunizationsoftware.org/dataQuality/dqaReport.html
31
ImmTrac Return Notification Files
ImmTrac will continue to produce return notification files that will
be placed in your RECEIVE folder. Notification files let you know
that the patient for which the immunization was received:
• was matched in the registry
• had a consent on file to accept immunization data, and
• was imported into ImmTrac.
32
HL7 File Processing
COMMON ERROR/WARNING
MESSAGES
33
Error #1: Vaccination Product
Error:
+ Vaccination product is invalid
Description:
The vaccination product was recognized by DQA but was not accepted for submittal.
This error was received in a test file where an arbitrary manufacturer was listed as the
maker of the immunization product. DQA will mark a message as an error if the
manufacturer and lot number do not match the immunization product.
Resolution:
Update the manufacturer/lot information listed for the immunization product.
34
Error #2: Vaccination Admin Code
Error:
+ Vaccination admin code is invalid, Vaccination CPT Code = '90646'
Description:
The Vaccination Admin code was recognized by DQA but was not accepted for submittal.
This error was received in a test file where CPT Code 90646 was submitted for a patient
immunization that was administered 2012. CPT 90646 links to CVX Code 46, which CDC
rendered inactive on 5/28/10. DQA is set to error out any immunization administered
after the vaccination became inactive.
Resolution:
If the shot is historical, change the date to when the vaccination was administered.
Otherwise, use the current active code for the product (A list of cvx codes in our system is
embedded in the FAQ section of this document).
35
Error #3: Vaccination Facility ID
Error:
+Vaccination facility id is invalid
Description:
RXA-11 does not include the PFS number of the site that administered the
vaccination. This is a required field for all newly administered vaccinations.
Resolution:
Add the PFS number for RXA-11 (see blue text below). Refer to 3.5 RXA:
Pharmacy/Treatment Administration Segment Definition of the Implementation
Guide for more information.
RXA|0|1|20120518|20021214|48^Hib^CVX|0.5|ML||00^Administered^NIP0001||^
^^1234567890^^^^^3131 Briarpark Dr., Ste
108^^Dallas^TX^77042^US||||I2110SY||SKB^GlaxoSmithKline^MVX||||A|
36
Error #4: Vaccination Information
Source
Error:
+Vaccination information source is missing
Description:
ImmTrac is following the NCIRD’s guidelines by using this field to indicate whether the
immunization being reported was administered (new) or came from other records
(historical). It is not specified in the RXA segment whether this is a new or an historical
immunization record.
Resolution:
In RXA-9 (see blue text below), add the administration notes to indicate a new or
historical immunization.
•
•
New immunization: |00^New Immunization Record^NCIRD001|
Historical immunization: |01^Historical Information^NCIRD001|
RXA|0|999|20060817091022|20060817091022|20^DTaP^CVX|999|||
00^New Immunization Record^NCIRD001|
1008765^^^^^^^^TX^^^^MD|
^^^1234567890^^^^^321 Medical Dr.^Suite 325^Austin^TX^78756^US||||
X-1234||MSD^MERCK^MVX|<CR>
RXA|0|999|20040908|20040908|08^HepB^CVX^90744^HepB^C4|999|||
01^Historical information^NCIRD001|<CR>
37
Error #5: MSH Sending Facility
Error:
+ HL7 MSH sending facility is invalid
Description:
In the Message Header Segment (MSH), the PFS number for the Provider sending
the HL7 message is not included.
Resolution:
In MSH-4, (see blue text below), add 10 digit PFS number for the Parent Provider.
Refer to Section 3.1 MSH: Message Header Segment Definition in the
Implementation Guide for more information.
MSH|^~\&|ABC|1023456789|TxImmTrac|TxDSHS|20120518205126||VXU^V04^VXU_V04|TES
T 000|P|2.5.1
38
Error #6: Missing RXA Segment
Error:
+ HL7 RXA segment is missing, in repeat #4
Description:
A test document including three RXA segments got a message about the 4th RXA
segment missing. We discovered that the sender submitted the file with the
ORC segment, which is not required, but if it is sent it must be followed by an
RXA segment. The ORC came after the 3rd RXA segment, and therefore DQA
expected to find a 4th RXA segment after it. It didn’t, so this error was received.
Resolution:
If including the ORC segment, ensure that it appears before the RXA, not after.
ORC|RE||197023^DCS|||||||^Clerk^Myron|||||||DCS^Metro Clinic|
RXA|0|999|20060903|20060903|20^DTaP^CVX|999|
39
HL7 File Processing
FREQUENTLY ASKED QUESTIONS
(FAQS)
40
How will I know if there are any errors found in
my submitted file?
• Once DQA has completed validating your file, you will receive an
automated email message only if there were errors.
• If there are errors, the email will inform you of the number of errors and
warnings found and direct you to your DQA folder on our secure FTP
server.
• Based on the feedback received, you may choose to fix the
errors/warnings and resubmit only the messages that had errors. Do not
resubmit the entire file, as this will result in duplicate immunization
messages being submitted to ImmTrac.
41
What is the best way to manage who receives
the email notifications coming out of DQA?
The default is for the ImmTrac contact to be in receipt of the
acknowledgement and error notification emails. Anyone can
be added to this list, but if there are more than two, or if the
audience is expected to change often, it may be helpful to set
up a generic email list address on your end so that you can
move people in and out of that generic email list as needed.
42
I received a fatal error email on my file, but
when I went to the DQA Reports folder to
review the reports, the folder was empty.
Why?
Reports are placed in the DQA reports folder only after the file is
processed. When a file receives a fatal error, the system is
prevented from processing the file at all. Therefore, the DQA
Reports folder will be empty when a fatal error was found on a file .
43
How can I know when a code becomes
inactive? I’m having trouble determining
which codes are valid and which are not.
• The CDC has an email alert that you can sign up for to be
notified of updates to the CVX codes. You may sign up
here:
http://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.as
p?rpt=cvx
• In addition, the CVX/CPT codes and their status in our
system is embedded below. It lists the date that the
vaccination code became inactive, and indicates codes
Texas does not accept.
44
I tried to submit a file to the FTP
server, but got this error message:
452 Quota Exceeded: 90 files; 1096397 bytes
MYFILE12188b.HL7 – 0 bytes transferred
PASV
227 Entering Passive Mode(159,84,129,40,19,144)
LIST
Connect socket #1992 to 160.84.126,50, port4556…
Once the 300 file limit is reached you will have met your quota and will
not be able to do anything else until you reduce (delete or move files off
their subfolders) the number below 300.
The Accepted and DQA-Report folders are read only, so the only way to
delete files in these folders is to contact the DSHS Security Coordinator.
45
Not all of our Historical Immunizations will
have a date for when they were administered,
but the date is required. How do we report
these?
If a vaccination date is unavailable, do not send those
records. Since the date(s) of immunization are not known, the
age appropriate vaccination schedule should be utilized since
the individual would be considered as “susceptible”.
46
Who should I go to for Information?
We hope that all of these changes demonstrate that we
are serious about making things better and more
efficient for you.
The ImmTrac Interoperability Team is ready to assist you.
Role
Contact
Number
Primary Provider/Vendor Point-of-Contact
Marc Heymann 512-776-3015
ImmTrac Registrations and Renewals
Susan Keeler
512-776-3055
HL7 File Validation and Processing
Rachelle Zani
512-776-3066
Service Manager
Bill Carswell
512-776-7610
47