Healthcare facilities use the HL7 ADT interface (normally a module of the EHR system) as a mechanism to share patient census changes with many clinical systems. These patient census updates include changes to patient demographics and patient status.
Vocera can leverage a wide variety of this patient census and demographic information provided in the HL7 ADT messages and display the appropriate portions of this information in the clinician's peripheral view. Vocera can intelligently provide different portions of this contextual information based on the patient population or care unit. Vocera can also present relevant context to augment the delivery of a specific alert or notification (e.g., Bed Exit alert, Critical Lab result, or New Admission alert).
Vocera can process Admit/Discharge/Transfer/Update patient census and demographic information based upon the corresponding ADT trigger events listed below:
| ADT-A01 | Admit / Visit Notification |
| ADT-A02 | Transfer A Patient |
| ADT-A03 | Discharge/End Visit |
| ADT-A04 | Register A Patient |
| ADT-A05 | Pre-admit A Patient |
| ADT-A06 | Change An Outpatient To An Inpatient |
| ADT-A07 | Change An Inpatient To An Outpatient |
| ADT-A08 | Update Patient Information |
| ADT-A09 | Patient Departing - Tracking |
| ADT-A11 | Cancel Admit / Visit Notification |
| ADT-A12 | Cancel Transfer |
| ADT-A13 | Cancel Discharge/ End Visit |
Using an ADT-A08 Event
An ADT-A08 trigger event is used when any patient information has changed but when no other trigger event has occurred. For example, an A08 event can be used to notify the receiving systems of a change of address or a name change.
For example, a healthcare facility EHR may send ADT-A08 messages similar to this:
MSH|^~\&|ADT|1891799227^NH4L^|||20200303141148|1|ADT^A08|232023|T|2.5.1||||||||||| EVN|A08|20200303141148||REG_VIS_CHANGE|^EPIC^USER^^^^^^NHC^^^^^NPS|| PID|1|EP01715202^^^EPIC^MRN~ENTH0700756^^^NORTON^ENTH|EP01715202^^^EPIC^MRN~ENTH0700756^^^NORTON^ENTH||SQDOWNTOWN^MATT||19820109|M||WH|1567567^^LOUISVILLE^KY^40202^USA^P^^JEFFERSON|JEFFERSON|(502)123-1234^P^PH^^^502^1231234||SGN|S|CAT|200000386|888-82-4159|||NHS||N||||||N|| ZPD||MYCH~Mail~Phone||NOT USED|||N||||||||||||||| PD1|||NORTONHOSPITAL^^100031|1932217858^HEILMAN^STEVEN^J.^^^^^NPI^^^^NPI~HEIST^HEILMAN^STEVEN^J.^^^^^EPIC^^^^PROVID|||||||||||||| NK1|1|ROSEMARY^POVERMAN^^||1^^LOUISVILLE^KY^40202^USA|(502)123-1234^^PH^^^502^1231234||Emergency Contact 1||||||||||||||||||||||||||| NK1|2|||^^^^^USA|||Employer|||PILOT|||NOT EMPLOYED||||||||||||||||||||3100385|UN PV1|1|I|N.4L^N.4L03^4L031^NH^R^^^^^^DE|EM|||042435^PATEL^VIVEK^AMRAT^|||EMERGENCY ME^||||125|||043397^RAMINENI^JAYASREE^^||615829933|CHTY||||||||||||||||||||||^^^ R^^^^^^DE ^^^^^^^||20200303141136|||76583.84|||||||||||||242004^SEVEN N HOSPITALIST^7N HOS OBX|1|NM|1038^Weight||74^5|KG|||||F|||||||||||||| AL1|1||49773^NO ACTIVE ALLERGIES^||||||
The PID segment is used by all applications as the primary means of communicating patient identification information. This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently. In this example, the MRN displays in PID.2, and the patient name displays in PID.5.
This table describes many of the attributes shown in the code sample:
