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3.2.19 QRY/ADR - patient query (event A19)

The following trigger event is served by QRY (a query from another system) and ADR (a response from an ADT system.)

Another application determines a need for ADT data about a patient and sends a query to the ADT system. The Who Filter in the QRD can identify the patient or account number upon which the query is defined and can contain a format code of "R" (record-oriented). If the query is based on the Patient ID and there are data associated with multiple accounts, the problem of which account data should be returned becomes an implementation issue. The ADT event-type segment, if included in the response, describes the last event for which the ADT system initiated an unsolicited update.

QRY     Patient Query       Chapter
MSH      Message Header        2
QRD     Query Definition        2
[ QRF ]     Query Filter         2
ADR     ADT Response        Chapter
MSH      Message Header        2
MSA      Message Acknowledgment       2
[ERR]    Error          2
QRD      Query Definition         2
 [ QRF ]   Query Filter         2
{ 
    [ EVN ]    Event Type          3
     PID    Patient Identification      3
 [PD1]   Additional Demographics      3
    [ {NK1} ]  Next of Kin / Associated Parties    3
PV1      Patient Visit         3
    [ PV2 ]   Patient Visit - Additional Info.    3
    [ { DB1 } ]  Disability Information      3
 [ {OBX} ]   Observation/Result      7
    [ {AL1} ]  Allergy Information        3
    [ {DG1} ]  Diagnosis Information       6
    [DRG]   DRG Information       6
      [ {PR1  Procedures         6
   [{ROL}] Role           12
  }]
    [ {GT1} ]  Guarantor Information       6
    [ 
      { 
       IN1   Insurance Information       6
       [ IN2 ]  Insurance Information - Addit. Info.   6
       [ IN3 ]    Insurance Information - Cert.     6
      } 
    ]
    [ ACC ]    Accident Information       6
    [ UB1 ]    Universal Bill Information     6
    [ UB2 ]   Universal Bill Information     6
 
}
[ DSC ]    Continuation Pointer        2

3.2.19.1 A19 usage notes

In addition to single-patient responses, the ADT record-oriented query/response needs to support responses containing multiple patients for the following query types (by subject filter): return census for a nursing unit (ANU), return patients matching a name search (APN), and return patients for a given physician (APP).

For multiple patient responses, additional values for QRD-3-R/U who subject definition may be used, such as:

IP

Inpatient

OP

Outpatient

DC

Discharged

For the ANU subject filter, the ADT systems response must have some method for conveying the fact that some beds are empty (as well as for returning the data for all patients in the occupied beds). This method will function as follows:

a) Bed Full

Regular { [EVN], PID, PV1 } segment group for each patient with PV1-40-bed status value of "O" occupied.

b) Bed Empty

In this case, all fields in the corresponding EVN, PID, and PV1 segments are null except for the following fields in the PV1 segment.

* PV1-3-assigned patient location contains the new bed location information

* PV1-40-bed status contains one of the following values: U (unoccupied), H (housekeeping), or C (closed).

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