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13.2HL7 v2.x Support: Outbound Messaging (from Smile CDR)

 

The following diagram shows the processing path for Outbound HL7 v2.x Support.

Outbound Support

Getting Started

To enable Outbound HL7 v2.x Support, create a module of type HL7 v2.x Sending Endpoint. This module creates the endpoint that will transmit messages to an external system.

In order to enable automatic transmission of HL7 v2.x messages, a Subscription should be created in Smile CDR. This Subscription should resemble the following example:

{
  "resourceType": "Subscription",
  "id": "SUBSID",
  "status": "requested",
  "criteria": "DiagnosticReport?",
  "channel": {
    "extension": [
      {
        "url": "https://smilecdr.com/fhir/ns/StructureDefinition/subscription-channel-rest-delivery-class",
        "valueString": "ca.cdr.endpoint.hl7v2.out.deliverer.OutboundHl7V2SubscriptionDeliverer"
      },
      {
        "url": "https://smilecdr.com/fhir/ns/StructureDefinition/subscription-channel-hl7v2-sender-module-id",
        "valueString": "hl7_sender"
      },
      {
        "url": "https://smilecdr.com/fhir/ns/StructureDefinition/subscription-channel-hl7v2-target-message-type",
        "valueCode": "ORU^R01"
      }
    ],
    "type": "rest-hook"
  }
}

Note the following extensions:

Required Extensions

Optional Extensions

  • subscription-channel-hl7v2-target-message-type: (Optional) This extension supplies the HL7 v2.x message type that is created by this subscription. This may be omitted, in which case Smile CDR will attempt to use a sensible default for the resource type triggered by the Subscription.

13.2.1Enriching Message Conversion using Scripts

 

Smile CDR comes with a predefined conversion from FHIR resource models to HL7 v2.x. This conversion is intended to be sufficiently comprehensive to meet many use cases, but in many cases there are requirements to enrich the generated HL7 v2.x messages using other data. For example, a specific piece of data might be stored in a resource extension for a project, and that piece of data might be needed by recipients of the resulting HL7 v2.x messages.

In this case, a script may be used to enrich the message generation. The following functions are available.

13.2.2Function: onPostConvertFhirToHl7V2(theTriggerResource, theOutgoingMessage, theContext)

 

If present, this method is called once for each HL7 v2.x message that is generated. It is called after the built-in Smile CDR conversion has completed, but before the message is transmitted.

Parameters

This function takes the following parameters:

  • theTriggerResource – This parameter will contain the FHIR Resource that was the focus of this message generation.
  • theOutgoingMessage – This parameter will contain the HL7 v2,x Message that was generated as a result of the conversion.
  • theContext – This parameter is of type Hl7V2GeneratedMessageContext. It is not currently used but is provided for forwards compatibility.

Output

This function does not currently return a value, and any returned value will be ignored. It is possible however to modify the message that is passed in as an input parameter, making the parameter effectively an output as well.

Example: Copying Extension

The following example shows a field in the HL7 v2.x PID segment being copied using a value found in an extension within the FHIR resource.

/**
 * This function will be called any time that a new HL7 v2.x message is generated
 *
 * @param theTriggerResource The FHIR resource that was the focus of this conversion
 * @param theOutgoingMessage The generated HL7 v2.x message (may be modified)
 * @param theContext         The context object
 */
function onPostConvertFhirToHl7V2(theTriggerResource, theOutgoingMessage, theContext) {
   var nationalityCodeableConcept = theTriggerResource
      .getExtension('http://hl7.org/fhir/StructureDefinition/patient-nationality')
      .getExtension('code')
      .valueCodeableConcept;
   theOutgoingMessage['*/PID-28-1'] = nationalityCodeableConcept.coding.code;
   theOutgoingMessage['*/PID-28-2'] = nationalityCodeableConcept.coding.display;
   theOutgoingMessage['*/PID-28-3'] = nationalityCodeableConcept.coding.system;
}

13.2.3Using Persisted MessageHeader Resources

 

It is possible (but not required) to use stored MessageHeader resources in Smile CDR FHIR Storage as the source for several fields in the HL7 v2.x MSH header. These fields include the Sending Application, Receiving Facility, etc.

The use-persisted-messageheaders setting may be enabled on the HL7 v2.x Sender module. When this setting is enabled, each time a resource (e.g. a DiagnosticReport) triggers an outbound message (e.g. an ORU^R01), Smile CDR will search for a MessageHeader resource with the focus resource as a target. If one is found, it will be used to populate fields in the HL7 v2.x message that is generated.

The following example shows a MessageHeader resource stored in FHIR Storage:

{
  "resourceType": "MessageHeader",
  "id": "999122",
  "destination": [
    {
      "name": "Lab System"
    }
  ],
  "receiver": {
    "identifier": {
      "system": "http://acme.com",
      "value": "116344"
    }
  },
  "sender": {
    "identifier": {
      "system": "http://acme.com",
      "value": "9837666"
    }
  },
  "source": {
    "name": "Hospital CDR"
  },
  "focus": [
    {
      "reference": "ProcedureRequest/8634"
    }
  ]
}

This MessageHeader will result in an MSH segment similar to the following: MSH|^~</span>&|Hospital CDR|http://acme.com^9837666|Lab System|http://acme.com^116344|20180923190154.453+0330||ORU^R01^ORU_R01|8401|P|2.5