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3.2.3 ADT/ACK - discharge/end visit (event A03)

An A03 event signals the end of a patient’s stay in a healthcare facility. It signals that the patient’s status has changed to "discharged" and that a discharge date has been recorded. The patient is no longer in the facility. The patient’s location prior to discharge should be entered in PV1-3-assigned patient location.

An A03 event can be sent to notify: the pharmacy that the patient’s stay has ended and that entitlement to drugs has changed accordingly; the nursing system that the patient has been discharged and that the care plan can be completed; the finance system that the patient billing period has ended; and/or the clinical repository that discharge has taken place for the EMR.

For non-admitted patients, an A03 event signals the end of a patient’s visit to a healthcare facility. It could be used to signal the end of a visit for a one-time or recurring outpatient who is not assigned to a bed. It could also be used to signal the end of a visit to the Emergency Room. PV1-45-discharge date/time can be used for the visit end date/time.

When an account’s start and end dates span a period greater than any particular visit, the P06 (end patient account) event should be used to transmit information about the closing of an account. To indicate that a patient has expired, use an A03 event with the PID-29-death date/time and PID-30-patient death indicator filled in.

The fields included when this message is sent should be the fields pertinent to communicate this event. When other important fields change, it is recommended that the A08 (update patient information) event be used instead.

ADT     ADT Message        Chapter
MSH     Message Header        2
EVN     Event Type         3
PID     Patient Identification      3
[PD1]    Additional Demographics      3
PV1     Patient Visit        3
[ PV2 ]    Patient Visit - Additional Info.    3
[ { DB1 } ]   Disability Information      3
[ { DG1 } ]   Diagnosis Information       6
[  DRG  ]   DRG Information        6
 [ { PR1    Procedures         6
  [{ROL}]  Role           12
 }]
[ { OBX } ]   Observation/Result       7
ACK     General Acknowledgment     Chapter
MSH     Message Header        2
MSA     Message Acknowledgment      2
[ ERR ]    Error           2

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