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1. EMS Standard Scheduling Messaging

1.1. Document History

Version Date Who Comments
v0.1 - Draft 5th Dec 2017 Lee Dyson First draft.
v0.2 - Draft 3rd June 2021 Lee Dyson refreshed / typos
v1.0 - Release 28th June 2021 Robert McNaught Consistency updates
v1.1 - Release 16th Jul 2021 Robert McNaught Disclaimer
v1.2 - Release 29th Sept 2021 Robert McNaught Segment updates and formatting
v1.21 - Draft 26th Oct 2021 Lee Dyson Correct NTE definition
v1.22 - Release 25th July 2022 Robert McNaught PID note update

1.2. Introduction

EMS supports an HL7 scheduling workflow whereby a placer system (e.g. or PAS EPR) system sends EMS an SIU appointment message to book,cancel or re-schedule

As with all other EMS interfaces, messages received from another system are mapped into appropriate FHIR message types before being processsed by EMS. HL7 SIU scheduling messages are mapped into FHIR ServiceRequest messages.

EMS allows the placer system to book, update and cancel an appointment via the appropriate SIU scheduling messages. In many ways the scheduling message is handled like an order message in that it is expected to contain the mandatory details necessary to create an endoscopy booking in EMS.

A number of mandatory data-items must be provided by the scheduling system in order for EMS to accept the appointment automatically. If one or more of these data items is not provided, then the appointment request will wait in the EMS referrals triage queue, requiring manual intervention before being processed further.

1.3. Message Flow

Message Flow Diagram

1.4. Message Inbound to EMS

1.4.1. Messages Supported

Message Type Default Action
SIU^S12, S13, S14 Create / Update appointment
SIU^S15, S17 Cancel appointment

1.5. SIU Message Structure

[] - Optional

{} - Repeating

1.5.1. S12, S13, S14

MSH
SCH
{[NTE]}
PID
PD1
PV1
{[OBX]}
RGS
AIS
[AIG]
[AIL]
[AIP]

1.5.2. Sample SIU Message

MSH|^~\&|C0442|XXX|XXX_PAS|XXX|20190603122743||SIU^S12|Q322404250T350456824A1096|P|2.4||||||8859/1
SCH|18433082.000^HNAMSCHEVID||||||Endo Theatres^^^Endo Theatres||30|ZZ|^^30^20190604080000^20190604083000|||||^Young^Andy^^^^^^^PRSNL||||^Young^Andy^^^^^^^PRSNL|||||Confirmed
NTE|1|Public Surgical Comments|Public Surgical Comments
NTE|2|Scheduling Comments|Scheduling Comments
NTE|3|Preparations|\E\b Emergencies\E\b0\E\par\.br\\E\par\.br\\E\b If the hospital has an unexpected number of emergency cases we may have to postpone booked admissions.  We hope that this will not be the case but if this situation does arise we will contact you immediately\E\b0\E\par\.br\\E\par\.br\\E\b If you have not heard from us then please contact Admisssions on 020 8725 4520.\E\b0\E\par\.br\\E\b Emergencies\E\b0\E\par\.br\\E\par\.br\\E\b If the hospital has an unexpected number of emergency cases we may have to postpone booked admissions.  We hope that this will not be the case but if this situation does arise we will contact you immediately\E\b0\E\par\.br\\E\par\.br\\E\b If you have not heard from us then please contact Admisssions on 020 8725 4520.\E\b0\E\par\.br\\E\par\.br\\E\par\.br\\E\b What to Bring \E\b0\.br\\E\par \E\par\.br\I have enclosed a leaflet that should answer most of your questions. Please read it before you come into hospital. If the leaflet is not enclosed and you would like a copy or if there is anything further you would like to know please contact the Patient Pathway Co-ordinator on the above telephone number.\.br\\E\par \E\par\.br\\E\par\.br\\E\par\.br\\E\b What to Bring \E\b0\.br\\E\par \E\par\.br\I have enclosed a leaflet that should answer most of your questions. Please read it before you come into hospital. If the leaflet is not enclosed and you would like a copy or if there is anything further you would like to know please contact the Patient Pathway Co-ordinator on the above telephone number.\.br\\E\par \E\par\.br\this is surviellance and working\.br\\E\par\.br\There is a pre-admission club especially for children called the 'Safari Club', which starts at 11.00 hours every Saturday morning, except Bank Holiday weekends, on Jungle Ward, 1st Floor Lanesborough Wing.  This session is run by the Sister or Staff Nurse on the ward and is intended to reduce the anxiety of children coming into hospital by letting them know what to expect, and familiarising them with the hospital environment.  We strongly recommend that parents and children attend this informal discussion.\.br\\E\par
NTE|4|Scheduling Guidelines|This patient requires an interpreter. Please refer to the registration for patient's first language and then refer to the PALS intranet page under "interpreting and signing guidance" and book accordingly\.br\Patient must be assessed by the TAB Team.\.br\Please get patient to call TAB on 0208 725 0808\.br\This patient has information and/or communication needs documented under the Accessible Information Standard.  \.br\ \.br\Please review this information via the View Person Conversation\.br\This patient has information and/or communication needs documented under the Accessible Information Standard.  They have requested for information to be recorded in an electronic format.\.br\This patient has information and/or communication needs documented under the Accessible Information Standard.  They have requested for information to be printed in Braille.\.br\This patient has information and/or communication needs documented under the Accessible Information Standard.  They have requested for information to be printed in large font..
NTE|5|Action Comments|Comments
OBX|1||625676^Activate order at booking||Y||||||||Processing Option
OBX|2||625678^Create surgical case||Y||||||||Processing Option
OBX|33|ID|Interpreter required^interpreterrequired29126351||Y||||||||Event Detail
OBX|34|TS|Scheduling TCI Date/Time^Scheduling TCI Date/Time||20190604070000||||||||Action Detail
OBX|35|IS|TCI Location^TCI Location||Endoscopy Unit, Level 1, St James||||||||Action Detail
OBX|36|ID|HNAM ORDER_ID^Order ID|1|336002767||||||||Order Detail
OBX|52|TX|CD:110331227^Endo Priority|1|Routine (6 weeks)||||||||Order Detail
OBX|53|TX|CD:110484935^Transport Required?|1|Yes||||||||Order Detail
PID|1|2838606^^^RJ7 MRN^MRN|2838606^^^RJ7 MRN^MRN||STGTESTING^PATIENT-02^^^^^CURRENT||19700101|1|||St Georges Hospital^Blackshaw Road^LONDON^""^SW17 0QT^GBR^HOME^^""||||""|""|CHRCHCHRST|7621780^^^RJ7 Encounter Num^FINNBR||||A||""||""|""|""||""
PD1|""|""|THE GRAYSWOOD PRACTICE^^H85011|G9513114^MACKENZIE^SARAH^JANE^^^^^EXTID|""||""|""
PV1|1|WAITLIST|RJ7 Endos Cln^^^RJ7 St Georges^^AMB^St James Wing|""|||C4100760^GROVES^CHRISTOPHER^^^Dr^^^NHSCONSULTANTNUMBER^PRSNL^^^NONGP^""~902802735032^GROVES^CHRISTOPHER^^^Dr^^^DRNBR^PRSNL^^^ORGDR^""|C4100760^GROVES^CHRISTOPHER^^^Dr^^^NHSCONSULTANTNUMBER^PRSNL^^^NONGP^""~902802735032^GROVES^CHRISTOPHER^^^Dr^^^DRNBR^PRSNL^^^ORGDR^""||30101|""|""|""|""|""|""||DCWL|8389101^^^RJ7 Attendance Num^VISITID|""||""||||||||||||||""|""|""|RJ7 St Georges||ACTIVE
RGS|1
AIS|1||Colon|20190604080000|0|ZZ|30|ZZ||FUTURE
AIG|1||RJ7 Endo Suite 2^^^RJ7 Endo Suite 2|RJ7 Endoscopy Resource Role||||20190604080000|0|ZZ|30|ZZ||Confirmed
AIL|1||RJ7 Endoscopy^^^RJ7 St Georges^^S^St James Wing|APPOINTMENT
AIP|1||C4100760^GROVES^CHRISTOPHER^^^Dr^^^NHSCONSULTANTNUMBER^PRSNL^^^NONGP^""~902802735032^GROVES^CHRISTOPHER^^^Dr^^^DRNBR^PRSNL^^^ORGDR^""|Surgeon1||20190604080000|0|ZZ|30|ZZ||Confirmed

Note:

MSH|^~\&|MAXIMS ADT/OCS|IMS|EMS_ENDO|RLQ|20210825155520||SIU^S14|1629903320391|P|2.4|||AL|NE|GBR
SCH|14605||||||||||^^^20210827084000
PID|||RLQ9876543^^^^MRN^MAIN~9999999999^V^MAXIMS^^NHS^MAIN||Patient01^EMSTest^^^MR^^Current||19691125|M|||TestBuilding^TestStreet^TestTown^TestArea^TE5 7PC^^HOME^TestLocation||^MOB^MOB^^^^^^07000000000
PV1||OP|||14605||C4336880^Burdsall^Jake^^^DR^^^National Consultant Code^GMC~C4336880^Burdsall^Jake^^^DR^^^PAS^LOCAL|||||||Colonosocpy
RGS|||||
AIS|||H229^Colonoscopy
AIL|
AIP|||C4336880^Burdsall^Jake

1.6. Segment Definitions

1.6.1. MSH

Please Refer to EMS Standard Segment Definitions

1.6.2. SCH Segment

Field Description Notes
1 Appointment ID EMS will use this identifier, and return it as the placer’s order identifier for any report issued
8 Appointment Type ROU, Emergency see DefaultReferenceData
11.4 Appointment Start date/time (Localtime)  
11.5 Appointment End Date Time  

Note:

1.6.3. PID

Please Refer to EMS Standard Segment Definitions

Note:

1.6.4. PV1

The PV1 segment is used both inbound and outbound.

Field Name Required Example Notes
2 Patient Management     see DefaultReferenceData
3 Location Code     Clinic code or location code
3.1 Point of Care   RTT Room local code. Room must be setup in EMS. INBOUND
3.4 Facility   KEH Site local code. Site must be setup in EMS. INBOUND
7 Attending Doctor   C1234567 GMC Number from ODS or ISD list of Endoscopist (performer) being requested. INBOUND
9 Consulting Doctor     GMC code + Name of consultant
14 Admit Source   G Referral source. see DefaultReferenceData INBOUND
18 Patient Type N NHS,PRIVATE see DefaultReferenceData
19 Visit Number N   Round trip data item, not used in EMS but can be returned if requested. INBOUND

Note:

1.6.5. AIS

Field Description Notes
3 Procedure Code The Endoscopy procedure being booked

1.6.6. AIL

Field Description Notes
3 Site Code Room / Site in which procedure will take place

Note:

1.6.7. AIP

Field Description Notes
3 Performer Performing Endoscopist

Note:

1.6.8. NTE

By default. NTE segments are processed by the interface, and passed to EMS as Referral Notes which are visible on the pending referrals screen in EMS.

Field Description Notes
1 setId NTE segments will be parsed, and included as Notes in EMS Referral Text
3 Note Text / Comment as HL7 FT data type

1.6.9. OBX

OBX segments are used to carry ad-hoc data items which don’t have a more appropriate location elsewhere in the message. The big EPR systems (e.g. Lorenzo, Cerner Millennium) often include important user-defined or ad-hoc information in OBX flags. EMS can parse important items from the OBX flags if required. These OBX (or even ZBX) flags are by definition ad-hoc or non-standard, and their use should therefore be agreed with MEDILOGIK during the techincal specification phase of the project. There is no default mapping of values from OBX segments into the scheduling message.

Field Description Notes
1 set ID Sequent - not parsed
2 Data Type as per standard HL7 datatypes (TS, IS,TX,ID etc.)
3.1 Flag Code  
3.2 Flag Name  
5 Flag Value  

1.6.9.1. Example OBX flag

OBX|1|TX|URGENT^EMS||YES||||F