Interfaces to EMR

 

When your practice sets out to find a new system, several decisions need to be made before you even start the process.  First, you need to decide if your existing billing application will meet the needs of your practice for at least the next four years.  If the answer to the question is “Yes”, then an interface will definitely be required with the new EMR system.

 

Next, if you decide the billing system should be replaced, you then have two options.  You can either purchase and EMR system that also has a built in billing system or you can choose the best EMR system and the best billing system and then have the two connect to each other via an HL7 interface.

 

HDS has implemented both types of systems and each has their pros and cons.  To make a better informed decision, you should first understand the details of how an interface works between an EMR and billing system.  The majority of all integration between two systems uses a standard which is called HL7.  The term HL7 actually stands for Health Language 7.  HL7 is not truly any kind of programming language but instead a specification of what format the data should be represented in.

 

The following text has come straight from www.hl7.org.  HL7 is defined by HL7.org as:

 

Health Level Seven is one of several American National Standards Institute (ANSI) -accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven’s domain is clinical and administrative data.

Headquartered in Ann Arbor, MI, Health Level Seven is like most of the other SDOs in that it is a not-for-profit volunteer organization. Its members-- providers, vendors, payers, consultants, government groups and others who have an interest in the development and advancement of clinical and administrative standards for healthcare—develop the standards. Like all ANSI-accredited SDOs, Health Level Seven adheres to a strict and well-defined set of operating procedures that ensures consensus, openness and balance of interest. A frequent misconception about Health Level Seven (and presumably about the other SDOs) is that it develops software. In reality, Health Level Seven develops specifications; the most widely used being a messaging standard that enables disparate healthcare applications to exchange keys sets of clinical and administrative data.

Members of Health Level Seven are known collectively as the Working Group, which is organized into technical committees and special interest groups. The technical committees are directly responsible for the content of the Standards. Special interest groups serve as a test bed for exploring new areas that may need coverage in HL7’s published standards. A list of the technical committees and special interest groups as well as their missions, scopes and current leadership is available on this web site (www.hl7.org).

The HL7 version that is most commonly used between EMR and Billing software vendors is 2.3.  While most vendors say they use version 2.3 many times you will discover that they may make minor changes to the specifications just to meet the needs of their application.  We will discuss that later in this article.  The HL7 2.3 specification is divided into what we called segments.  Each segment is used for a specific function by the application.  For this discussion, we will only cover a few of the segments that are typically used in a Billing to EMR interface.

The very first segment type is the MSH segment.  This is commonly known as the Message Header Segment.

The message header segment looks like this:

Typically, the vendor who sends the data will give the specification to the receiving vendor and then tell them what data to expect in what field.  Notice the first column is the sequence.  This is to ensure the every time a message is sent for example, field 4 will always contain the Sending Facilities name.  In this case, the vendor said the field is considered “O” or optional.  If there was data in field 4, then it could be up to 180 characters in length.

Also, notice in field 7 that in the Data Mapping Column the vendor tells the receiving vendor that that a date will be in the format of CCYYMMDDHHMM.  This allows the receiving vendor to know what to expect the date to look like when they read that field of data.

 

MSH - Message Header

 

seq

 

HL7 Field Name

R/O

 

Len

 

 

R/O

 

Len

Data Mapping

1

Field Separator

R

1

 

 

R

1

usually "|"

2

Encoding Characters

R

4

 

 

R

4

usually "^~\&"

3

Sending Application

O

180

 

 

O

7

'HDS'

4

Sending Facility

O

180

 

 

O

 

System Number

5

Receiving Application

O

180

 

 

O

 

 

6

Receiving Facility

O

180

 

 

O

11

NextGen

7

Date/time of Message

O

26

 

 

R

12

current date/time >

CCYYMMDDHHMM

8

Security

O

40

 

 

X

 

 

9

Message Type

R

7

 

 

R

7

message type^trigger event >

ORM^O01 - orders

ORU^R01 - results

ADT^A08 - Patient Info

ADT^A40 - Patient Merge

10

Message Control ID

R

20

 

 

R

15

unique message id > accession number-right justified,zero filled

11

Processing ID

R

3

 

 

R

1

'P'

12

Version ID

R

8

 

 

R

3

'2.3'

13

Sequence Number

O

15

 

 

X

 

 

14

Continuation Pointer

O

180

 

 

X

 

HL7 continuation pointer indicator

- not currently supported

15

Accept

Acknowledgment Type

O

2

 

 

X

 

"AL"

16

Application Acknowledgment Type

O

2

 

 

X

 

"NE"

17

Country Code

O

2

 

 

X

 

 

 

The next segment that is commonly used is the PID segment.  PID stands for Patient Identifier Information.  This segment has the following specification:

 

Typically, this table is used to communicate the two different Patient ID’s that exist in the billing system and the EMR system.  Usually fields 2 and 3 handle this requirement.  Notice in field 8 that the vendor is specifying how the sex field will contain data.  This is in case the billing system uses “M” to designate a Male and the EMR system may designate the number 1 for a Male. The EMR system may have to write some special program to make the conversion before the data is imported into their system.

 

PID - Patient Identification

seq

HL7 Field Name

R/O

Len

 

 

R/O

Len

Data Mapping

1

Set ID - Patient ID

O

4

 

 

X

 

 

2

Patient ID (External ID)

O

16

 

 

X

16

 

3

Patient ID (Internal ID)

R

20

 

 

R

11

Medical Record Number > Jacket Number

4

Alternate Patient ID

O

12

 

 

O

9

Social Security Number

5

Patient Name

   last name

   first name

   middle initial

R

48

 

 

R

 

 

6

Mother’s Maiden Name

O

30

 

 

X

 

 

7

Date of Birth

O

26

 

 

R

8

Date portion only (YYYYMMDD)

8

Sex

O

1

 

 

R

1

M - Male

F - Female

O - Other

U - Unknown

9

Patient Alias

O

48

 

 

X

 

 

10

Race

O

1

 

 

X

 

 

11

Patient Address

O

106

 

 

O

 

 

12

County Code

B

4

 

 

X

 

 

13

Phone Number - Home

O

40

 

 

O

10

aaapppssss

14

Phone Number - Business

O

40

 

 

O

10

aaapppssss

15

Language - Patient

O

25

 

 

X

 

 

16

Marital Status

O

1

 

 

O

 

 

17

Religion

O

3

 

 

O

 

 

18

Patient Account Number

O

20

 

 

O

11

Patient ID (Internal ID)

19

SSN Number - Patient

O

16

 

 

O

9

Alternate Patient ID

20

Driver’s Lic Num - Patient

O

25

 

 

X

 

 

21

Mother’s Identifier

O

20

 

 

X

 

 

22

Ethnic Group

O

1

 

 

X

 

 

23

Birth Place

O

25

 

 

X

 

 

24

Multiple Birth Indicator

O

2

 

 

X

 

 

25

Birth Order

O

2

 

 

X

 

 

26

Citizenship

O

3

 

 

X

 

 

27

Veterans Military Status

O

60

 

 

X

 

 

28

Nationality

O

80

 

 

X

 

 

29

Patient Death Date/Time

O

26

 

 

X

 

 

30

Patient Death Indicator

O

1

 

 

X

 

 

 

The next table that is typically used in the HL7 interface process is the Patient Visit table.  As you can see this table tell you who referred the patient, who the primary care physician is, where the service was performed and the admit and discharge date.

 

 

PV1 – Patient Visit

seq

HL7 Field Name

R/O

Len

 

 

R/O

Len

Data Mapping

1

Set ID - Patient Visit

O

4

 

 

X

 

 

2

Patient Class

R

1

 

 

R

1

O - Outpatient

 

3

Assigned Patient Location

   nurse unit

   room

   bed

   facility id

O

12

 

 

R

31

Site Name

4

Admission Type

O

2

 

 

X

 

 

5

Preadmit Number

O

20

 

 

X

 

 

6

Prior Patient Location

O

12

 

 

X

 

 

7

Attending Doctor

O

60

 

 

O

60

   Reading Physician -

   physician ID

   family name

   given name

   middle initial or name

   title

 

Referring Doctor

   physician id

   family name

   given name

   middle initial or name

O

60

 

 

R

60

  Referring Physician -

   physician ID

   family name

   given name

   middle initial or name

   title

9

Consulting Doctor

O

60

 

 

X

 

 

10

Hospital Service

O

3

 

 

X

 

 

11

Temporary Location

O

12

 

 

X

 

 

12

Preadmit Test Indicator

O

2

 

 

X

 

 

13

Readmission Indicator

O

2

 

 

X

 

 

14

Admit Source

O

3

 

 

X

 

 

15

Ambulatory Status

O

2

 

 

X

 

 

16

VIP Indicator

O

2

 

 

X

 

 

17

Admitting Doctor

 

O

60

 

 

X

 

 

18

Patient Type

O

2

 

 

X

 

 

19

Visit Number

O

15

 

 

R

8

Encounter Number > right justified,zero filled

20

Financial Class Eff. Date

O

50

 

 

X

 

 

21

Charge Price Indicator

O

2

 

 

X

 

 

22

Courtesy Code

O

2

 

 

X

 

 

23

Credit Rating

O

2

 

 

X

 

 

24

Contract Code

O

2

 

 

X

 

 

25

Contract Effective Date

O

8

 

 

X

 

 

26

Contract Amount

O

12

 

 

X

 

 

27

Contract Period

O

3

 

 

X

 

 

28

Interest Code

O

2

 

 

X

 

 

29

Transfer to Bad Debt Code

O

1

 

 

X

 

 

30

Transfer to Bad Debt Date

O

8

 

 

X

 

 

31

Bad Debt Agency Code

O

10

 

 

X

 

 

32

Bad Debt Transfer Amount

O

12

 

 

X

 

 

33

Bad Debt Recovery Amt

O

12

 

 

X

 

 

34

Delete Account Indicator

O

1

 

 

X

 

 

35

Delete Account Date

O

8

 

 

X

 

 

36

Discharge Disposition

O

3

 

 

X

 

 

37

Discharged to Location

O

25

 

 

X

 

 

38

Diet Type

O

2

 

 

X

 

 

39

Servicing Facility

O

2

 

 

X

 

 

40

Bed Status

B

1

 

 

X

 

 

41

Account Status

O

2

 

 

X

 

 

42

Pending Location

O

12

 

 

X

 

 

43

Prior Temporary Location

O

12

 

 

X

 

 

44

Admit Date/Time

O

26

 

 

O

12

Exam start date/time or scheduled date/time YYYYMMDDHHMM

45

Discharge Date/Time

O

26

 

 

X

 

 

46

Current Patient Balance

O

12

 

 

X

 

 

47

Total Charges

O

12

 

 

X

 

 

48

Total Adjustments

O

12

 

 

X

 

 

49

Total Payments

O

12

 

 

X

 

 

50

Alternate Visit ID

O

20

 

 

X

 

 

51

Visit Indicator

O

1

 

 

X

 

 

52

Other Healthcare Provider

O

60

 

 

X

 

 

 

At some point in time, your practice may choose to interface with either an external laboratory such as LabCorp or Quest or possibly a Radiology Group who will send their results directly into your EMR system.  Some EMR systems have the ability to create an electronic order and send it to the outside facility.  In order for that facility to understand what information is in the order, a segment that must be sent to them is the ORC segment which is called the Common Order Segment.  Notice, this order segment is designed for a Radiology Request.

ORC - Common Order

seq

HL7 Field Name

R/O

Len

 

 

R/O

Len

Data Mapping

1

Order Control

R

2

 

 

R

2

NW - New Order

CA - Cancel Order

SC - Change Order

ORU only:

RE - Report

 

 

 

 

 

 

 

 

 

2

 

 

Placer Order #

C

75

 

 

X

16

Order Entry System's

   Order Number

 

 

 

 

 

 

 

 

 

3

 

 

Filler Order #

C

75

 

 

R

15

Radiology System's

   Exam Identifier > accession number-right justified,zero filled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Placer Group #

O

75

 

 

X

 

 

5

Order Status

O

2

 

 

O

2

IP - Incomplete

CM - Completed

6

Response Flag

O

1

 

 

X

 

 

7

Quantity/Timing

   quantity

   interval

   duration

   start date/time

O

200

 

 

 

 

 

 

R

12

 

 

 

 

 

Scheduled Exam Date/Time

(YYYYMMDDHHMM)

 

   end date/time

 

 

 

 

X

 

 

 

 

   priority

   condition

   text

   conjunction

   order sequencing

 

 

 

 

X

 

HL7:

DICOM:

S - Stat                           

H-HIGH

A – ASAP

M- MED

R - Routine       

L-LOW

8

Parent

O

200

 

 

X

 

 

9

Date/Time of Transaction

O

26

 

 

X

 

 

10

Entered By

O

80

 

 

X

 

 

11

Verified By

O

80

 

 

X

 

 

12

Ordering Provider

   physician id

   family name

   given name

   middle initial or name

O

80

 

 

R

 

 

PACS Broker stores only the family name, given name, and middle initial (components 2,3,4)

 

 

13

Enterer’s Location

O

80

 

 

X

 

 

14

Call Back Phone Number

O

40

 

 

O

25

Referring Physician Phone #

Referring Physician Fax #

15

Order Effective Date/Time

O

26

 

 

X

 

 

16

Order Control Reason

O

200

 

 

X

 

 

17

Entering Organization

O

60

 

 

X

 

 

18

Entering Device

O

60

 

 

X

 

 

19

Action By

O

60

 

 

X

 

 

 

An additional message type that is seen with the order is called the Observation Request as seen in this specification:

 

OBR - Observation Request

seq

HL7 Field Name

R/O

Len

 

 

R/O

Len

Data Mapping

1

Set ID -

Observation Request

C

4

 

 

X

 

Used for multiple ORC/OBR pairs

 

2

 

Placer Order #

C

75

 

 

R

15

Radiology System's

   Exam Identifier > accession number-right justified,zero filled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

Filler Order #

C

75

 

 

R

15

Radiology System's

   Exam Identifier > accession number-right justified,zero filled

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Universal Service ID

   identifier

   text

R

200

 

 

R

10

36

Exam code

Exam description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Priority

B

2

 

 

X

 

 

6

Requested Date/Time

B

26

 

 

X

 

 

7

Observation Date/Time

C

26

 

 

O

 

Exam start date/time

YYYYMMDDHHMM

8

Obs End Date/Time

O

26

 

 

X

 

 

9

Collection Volume

O

20

 

 

X

 

 

10

Collector Identifier

O

60

 

 

X

 

 

11

Specimen Action Code

O

1

 

 

X

 

 

12

Danger Code

O

60

 

 

X

 

 

13

Relevant Clinical Inf.

O

300

 

 

O

 

Comment #1 ^

Comment #2 ^

Comment #3 ^

Comment #4

14

Specimen Rec'd Date/Time

C

26

 

 

X

 

 

15

Specimen Source

   Source Code

   Additives

   Source Description

   Body Site

O

300

 

 

X

 

 

16

Ordering Provider family

   physician ID

   family name

   given name

   middle initial or name

O

80

 

 

R

40

 

   physician ID

   family name

   given name

   middle initial or name

   title

17

Order Callback Phone No.

O

40

 

 

X

 

 

18

Placer Field 1

O

60

 

 

X

 

 

19

Placer Field 2

O

60

 

 

R

48

Facility name^

Modality description

20

Filler Field 1

O

60

 

 

X

 

 

21

Filler Field 2

O

60

 

 

X

 

 

22

Result Rpt/Status Change - Date/Time

C

26

 

 

X

 

 

23

Charge To Practice

O

40

 

 

X

 

 

24

Diagnostic Serv Sect Id

O

10

 

 

R

4

scheduled modality code

(or resource)

25

Result Status

C

1

 

 

R

1

ORU only:

D - Dictated

P - Preliminary

F - Final

C - Corrections to Final

A - Addendums

R - Revisions

 

 

 

 

 

 

X

 

HL7:      DICOM:

D           RECORDED

P              TRANSCRIBED

F            APPROVED

 

 

 

 

 

 

X

 

HL7:      DICOM:

P            READ

F            READ

26

Parent Result

O

200

 

 

X

 

 

27

Quantity/Timing

   quantity

   interval

   duration

   start date/time

O

200

 

 

 

 

 

 

X

 

 

 

 

8

6

 

 

   end date/time

 

 

 

 

X

8

6

 

 

   priority

   condition

   text

   conjunction

   order sequencing

 

 

 

 

X

 

HL7:                    DICOM:

S - STAT                         HIGH

A - ASAP                        MED

R - Routine        LOW

28

Result Copies To

O

150

 

 

X

 

 

29

Parent Number

O

150

 

 

X

 

 

30

Transportation Mode

O

20

 

 

X

 

 

31

Reason For Study

O

300

 

 

O

30

Reason for Visit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

32

Principal Result Interpreter

O

60

 

 

R

60

   physician ID

   family name

   given name

   middle initial or name

   title

33

Assistant Result Interpreter

O

60

 

 

X

 

Secondary Approver

34

Technician

O

60

 

 

O

26

ORU only

35

Transcriptionist

O

60

 

 

O

26

ORU only

36

Scheduled Date/Time

O

26

 

 

R

12

12

Scheduled date/time of exam ^ End date/time of exam

Used for prefetching of relevant prior exams and for building modality worklists

 

 

Typically the last type of segment you will work with in a results interface is known as the OBX message or Observation Result message.  This message will contain the lab results or the dictated results from the radiologist.

OBX - Observation/Result

seq

HL7 Field Name

R/O

Len

 

 

R/O

Len

Data Mapping

1

Set ID - Observation Simple

O

4

 

 

O

var

Line number

2

Value Type

C

2

 

 

O

2

'TX'

3

Observation Identifier

R

80

 

 

O

15

Accession number-right justified,zero filled

4

Observation Sub-ID

C

20

 

 

X

1

'1'

5

Observation Value

O

65K

 

 

R

var

 

Impressions can only be parsed if explicitly identified in OBX-3

6

Units

O

60

 

 

X

 

 

7

References Range

O

60

 

 

X

 

 

8

Abnormal Flags

O

10

 

 

X

 

 

9

Probability

O

5

 

 

X

 

 

10

Nature of Abnormal Test

O

5

 

 

X

 

 

11

Observe Result Status

R

2

 

 

R

1

Usually found in OBR-25

See OBR-25 for a  list of values

12

Date Of Last Obs

Normal Values

O

26

 

 

X

 

 

13

User Defined Access Chks

O

20

 

 

X

 

 

14

Date-Time of the Observation

O

26

 

 

R

12

Transcribed Date/Time

(YYYYMMDDHHMM)

15

Producer’s ID

O

60

 

 

X

 

 

16

Responsible Observer

O

60

 

 

X

 

 

 

Now that you have had the opportunity to see what the actual specification looks like, here is what a complete message will look like after it has been generate by a system.

 

MSH|^~\&|Texas Radiology|||Number 1 Dictation|200806041617||ORU^R01|001234330269714|P|2.3|

PID|||123152|123456789|MOUSE^MINI^||19430824|F|||42 CHEESE DR^^DISNEY WORLD^TX^78123||3611234567|||||123152|123456789|

PV1||O|THE BEST IMAGING CENTER IN TEXAS          ||||03^BEST^THE^^MD|11308^DEW^MOUNTAIN^E^MD|||||||||||1234151330269714|||||||||||||||||||||||||||

ORC|SC||123451330269714||CM||200806021420|||||11308^DEW^MOUNTAIN^E^MD ||3611234444^1234444|||||

OBR||5678901330269714|345671330269714|77057DBB^MAMMO DIGITAL SCREENING BILAT BREAST|||200806021509||||||RX RCVD 05/15/08 RAP^^CARE SCH RX FX SDI^   SCREEN|||83308^DEW^MOUNTAIN^E^MD ||| THE BEST IMAGING CENTER IN TEXAS ^MAMMOGRAPHY|||||MA01|F||||||SCREEN|03^BEST^THE^^MD |||JOHN SMITH|200806021420^200806021509|MOUSE.MINI.............._S1_20080602_0015539201|

OBX|1|TX|004151330269714|1|             MAMMOGRAM DIGITAL SCREENING BILAT ||||||F|||200806041505|||

OBX|2|TX|004151330269714|1|BREAST||||||F|||200806041505||

OBX|3|TX|004151330269714|1|||||||F|||200806041505|||

OBX|4|TX|004151330269714|1|HISTORY: 24 -year-old female for screening ||||||F|||200806041505|||

OBX|5|TX|004151330269714|1|examination||||||F|||200806041505||

OBX|6|TX|004151330269714|1|||||||F|||200806041505|||

OBX|7|TX|004151330269714|1|COMPARISON: 02/15/06||||||F|||200806041505|||

OBX|8|TX|004151330269714|1|||||||F|||200806041505|||

OBX|9|TX|004151330269714|1|TECHNIQUE: Bilateral digital screening mammogram ||||||F|||200806041505|||

OBX|10|TX|004151330269714|1|was obtained.  The study was reviewed using ||||||F|||200806041505|||

OBX|11|TX|004151330269714|1|computer-aided detection (CAD) system for ||||||F|||200806041505||

OBX|12|TX|004151330269714|1|mammography.||||||F|||200806041505||

OBX|13|TX|004151330269714|1|||||||F|||200806041505|||

OBX|14|TX|004151330269714|1|FINDINGS: MLO and CC images of each breast ||||||F|||200806041505|||

OBX|15|TX|004151330269714|1|demonstrate moderately dense fibroglandular ||||||F|||200806041505|||

OBX|16|TX|004151330269714|1|tissue present bilaterally.||||||F|||200806041505||

OBX|17|TX|004151330269714|1|||||||F|||200806041505|||

OBX|18|TX|004151330269714|1|RIGHT BREAST: There are no dominant masses, ||||||F|||200806041505|||

OBX|19|TX|004151330269714|1|suspicious clusters of micro- calcification or ||||||F|||200806041505|||

OBX|20|TX|004151330269714|1|areas of architectural distortion.  The current ||||||F|||200806041505||

OBX|21|TX|004151330269714|1|examination is stable when compared to the prior ||||||F|||200806041505|||

OBX|22|TX|004151330269714|1|study.||||||F|||200806041505||

OBX|23|TX|004151330269714|1|||||||F|||200806041505|||

OBX|24|TX|004151330269714|1|LEFT BREAST:  There are no dominant masses, ||||||F|||200806041505|||

OBX|25|TX|004151330269714|1|suspicious clusters of micro- calcification or ||||||F|||200806041505|||

OBX|26|TX|004151330269714|1|areas of architectural distortion.  The current ||||||F|||200806041505||

OBX|27|TX|004151330269714|1|examination is stable when compared to the prior ||||||F|||200806041505|||

OBX|28|TX|004151330269714|1|study.||||||F|||200806041505||

OBX|29|TX|004151330269714|1|||||||F|||200806041505|||

OBX|30|TX|004151330269714|1|OTHER: None.||||||F|||200806041505|||

OBX|31|TX|004151330269714|1|||||||F|||200806041505|||

OBX|32|TX|004151330269714|1|IMPRESSION:||||||F|||200806041505|||

OBX|33|TX|004151330269714|1|||||||F|||200806041505|||

OBX|34|TX|004151330269714|1|Stable bilateral examination.  Continued routine ||||||F|||200806041505|||

OBX|35|TX|004151330269714|1|follow-up is suggested.||||||F|||200806041505||

OBX|36|TX|004151330269714|1|||||||F|||200806041505|||

OBX|37|TX|004151330269714|1|BIRADS I: Negative Mammogram||||||F|||200806041505|||

OBX|38|TX|004151330269714|1|||||||F|||200806041505|||

OBX|39|TX|004151330269714|1|COMMENT: A negative mammogram report should not ||||||F|||200806041505|||

OBX|40|TX|004151330269714|1|delay biopsy if a dominant or clinically ||||||F|||200806041505|||

OBX|41|TX|004151330269714|1|suspicious mass is present.  Some cancers are not ||||||F|||200806041505||

OBX|42|TX|004151330269714|1|identified by mammography.  Dense breasts may ||||||F|||200806041505|||

OBX|43|TX|004151330269714|1|obscure and underlying neoplasm.||||||F|||200806041505||

OBX|44|TX|004151330269714|1|||||||F|||200806041505|||

OBX|45|TX|004151330269714|1|Thank you for choosing THE BEST IMAGING CENTER IN TEXAS of ||||||F|||200806041505|||

OBX|46|TX|004151330269714|1|Texas, L.L.P.||||||F|||200806041505||

OBX|47|TX|004151330269714|1|||||||F|||200806041505|||

OBX|48|TX|004151330269714|1|||||||F|||200806041505|||

OBX|49|TX|004151330269714|1|||||||F|||200806041505|||

OBX|50|TX|004151330269714|1|Approved by: R The Best MD||||||F|||200806041505|||

OBX|51|TX|004151330269714|1|Dictated By: R The Best MD||||||F|||200806041505|||

OBX|52|TX|004151330269714|1|BEA||||||F|||200806041505|||

OBX|53|TX|004151330269714|1|D: 6/4/2008 14:47||||||F|||200806041505|||

 

By this time, you should have a pretty good idea of what HL7 actually is.  The whole idea is for one vendor to send a HL7 message to another.  When that vendor receives the message, the data is imported into the system and processed accordingly to the type of message that was received.

 

With this knowledge in hand, you can now move to the next step in determining whether you want to purchase an EMR system that has a billing system already in it or to purchase what you feel is the best EMR and the best billing system.

 

HDS has evaluated many different EMR vendors in the market.  After each evaluation, we were always left with the following opinion.  The EMR portion of the software was excellent but the billing portion of the software was either just OK or not worth consideration.  Or, the billing portion was excellent but the EMR module was just OK or not worth consideration.  The only way to make the best decision is to use some type of evaluation form such as the one posted under the EMR Features section of this website.  HDS is currently working on a billing software evaluation form that will help with that process also.  By using these evaluation forms, it will become much easier to choose which vendor you should decide to use. 

 

Depending on the vendor, the interface process can either be an easy process or a nightmare.  If your practice chooses to go with the interface route, what is most critical is to obtain at least 5 to 10 references where that EMR vendor has interfaced with the exact billing application.  Just because the vendor tells you they have interfaced many times, do not take that to the bank.  Find out how long it took for the interface to be built, how much did it cost, and were there any cost overruns.

 

Typically, most interfaces will cost between $3000 and $5000 to build.  Some vendors will charge much more than this but this is the going rate for most interfaces.  The only time the price is much higher than this is if you choose to interface with some type of hospital information system.  If your practice feels a little overwhelmed with this process, HDS is happy to assist your team in making a smooth transition from your old system to your new one.  Good luck in your endeavors.

 

Hughes Data System ©2008