Inner Harbour Software

Question: How can I remove RXA-12, not just delete the value, but remove it so that RXA-13 becomes the new RXA-12?

To do this you can use the simple function below. They way it works is to go through all RXA segments and calls the RemoveAt(12) on the segment fields. This will remove the field causing all fields after RXA-12 to be offset by one.

public override void Run()
{
   HL7Message message = GetParsedMessage();
   foreach(HL7Segment segment in message.GetSegments("RXA"))
   {
     segment.Fields.RemoveAt(12);
   }
    
   this.SaveMessage(message,"RXA-12 Removed");
}

Question: How do I find the last A08/Visit not discharged.

This code searches through a message set, pulling the last A08 per visit/encounter. If the visit gets an A03 discharge message, then the visit is excluded from the final data set.

The final data set loads in a new tab and has only the last A08 for non-discharged encounters. If you want to include the A04s, see below for lines to comment out.

Note: that some of the A08 messages could still be for discharged patients. The PV1-45 discharge date/time may contain a value, but the original message set not have contained a corresponding A03.

Thank you to Scott Hall for contributing this code.

string _fileName = @"c:\_test.txt";
Dictionary<string,Encounter> _data = new Dictionary<string,Encounter>(10000);
Dictionary<string,Encounter> _discharged = new Dictionary<string,Encounter>(10000);

public class Encounter
{
   public Encounter(string encounterId)
   {
    EncounterId = encounterId;
   }

   public IMessageData Message;
   public string EncounterId;
}

public override void Run()
{
  // Get an HL7 Message in parsed format
  HL7Message message = GetParsedMessage();
  MSH msh = message.Segments.First<MSH>();
  if(msh==null || (msh.MessageType_09.TriggerEvent_02.Value!="A08" && msh.MessageType_09.TriggerEvent_02.Value!="A03"))
    return; // not an ADT^A08 message
  PID pid = message.Segments.First<PID>();
  if(pid==null)
    return; // no pid segment

  PV1 pv1 = message.Segments.First<PV1>();
  if(pv1==null)
    return; // no PV1 segment for encounter number
  string encounterId = pv1.VisitNumber_19.ToString(); //pid.PatientIdentifierList_03.First.ToString();
  Encounter CSN;

  // handle A03 Discharges
  if(msh.MessageType_09.TriggerEvent_02.Value=="A03")
  {
    if(!_discharged.TryGetValue(encounterId,out CSN)) // is patient already in the discharged dictionary?
    {
      _discharged.Add(encounterId,CSN);
    }

    // If you want A04 messages included for discharged patients, then comment out these two lines.
    // Otherwise, your dataset will be A08 messages for patients w/o an A04.
    // If you comment these lines, you might also want to change the tab name in the SaveMessage at the end.

    _data.Remove(encounterId);
    return;
  }

  // For A08 patient updates, check if the patient is already discharged.
  if(msh.MessageType_09.TriggerEvent_02.Value=="A08")
  {
    if(_discharged.TryGetValue(encounterId,out CSN)) // is patient in the discharged dictionary?
    {
      return;
    }
  }

  if(!_data.TryGetValue(encounterId,out CSN)) //CSN not found in dictionary?
  {
     CSN = new Encounter(encounterId);
     _data.Add(encounterId,CSN);
  } 

  CSN.Message = Message;
}

// Called once after the last message has been processed.
// It is a good place to perform cleanup and to report information.
// Always called from the UI thread.
public override void OnFinish()
{
   SaveMessage(_data.Values.Select(p=>p.Message),"Last A08/Visit not discharged A03");
}

Question:

I am working on a syndromic surveillance feed for the CDC and hope you can help me with an HL7 SQL question. The messages contain multiple OBX lines. In those lines, I need to pull: 

data in OBX-5
from the segment where OBX-3.1 = ‘SS003’

The order and number of OBX segments varies, so I can’t always specify a specific OBX segment.
Is there a way to do this in HL7 Spy? I’m including a set of OBX segments below as an example.

 OBX|1|NM|11289-6^BODY TEMPERATURE:TEMP:ENCTRFIRST:PATIENT:QN^LN||97.4|degF^FARENHEIT^UCUM|||||F
OBX|2|NM|59408-5^OXYGEN SATURATION:MFR:PT:BLDA:QN:PULSE OXIMETRY^LN||97|%^PERCENT^UCUM|||||F
OBX|3|CWE|8661-1^CHIEF COMPLAINT:FIND:PT:PATIENT:NOM:REPORTED^LN||||||||F
OBX|4|CWE|8661-1^CHIEF COMPLAINT:FIND:PT:PATIENT:NOM:REPORTED^LN||||||||F
OBX|5|NM|21612-7^AGE TIME PATIENT REPORTED^LN||60|a^YEAR^UCUM|||||F
OBX|6|CWE|SS003^FACILITY / VISIT TYPE^PHINQUESTION||225XN1300X||||||F
OBX|7|TX|44833-2^DIAGNOSIS.PRELIMINARY:IMP:PT:PATIENT:NOM:^LN||per ems pt with increased confusion. pt also presents with ulcers to bilateral feet||||||F
OBX|8|AD|SS002^TREATING FACILITY LOCATION^PHINQUESTION||701 10TH STREET SE||||||F

Answer:

The best way to accomplish this is to write a small amount of Custom Code. In the example below, all OBX-5 values where OBX-3.1 = ‘SS003’ will be placed in a file called obx5s.csv. Once all the messages have been processed the file will automatically be opened in excel, if it is installed on the computer.

private StreamWriter _writer;
private string _fileName = Path.Combine(Environment.GetFolderPath(System.Environment.SpecialFolder.Desktop),"ob5s.csv");

public override void OnStart()
{
  _writer = new StreamWriter(_fileName,false);
}

// Called once or many times based on RunTypeRequested
public override void Run()
{
  // Get an HL7 Message in parsed format
  HL7Message message = GetParsedMessage();
  foreach(var obx in message.OBXs)
  {
    if(obx[3,1,1] == "SS003")
    _writer.WriteLine("{0}", obx[5]);
   }
}
public override void OnFinish()
{
   if(_writer!=null)
   {
     _writer.Close();
     _writer = null;
     System.Diagnostics.Process.Start(_fileName);
   }
}

Question:

I am trying to pull data from multiple HL7 messages using the SQL query: SELECT *, PID-5.1 as ‘B Last Name’, PID-5.2 as ‘B First Name’, OBR-4.1 as ‘Order Number’, OBR-4.2 as ‘Order’ WHERE MSH-11 != ‘T’

The issue I’m having is messages with multiple OBRs. How can I get data all the data from the SQL statement and the data from each OBR on each message?

Answer: 

Unfortunately you cannot use the HL7 SQL tool for this. This tool returns at most 1 row per message. You would have to write some custom code to do this.

The code in the example below will create a file on the desktop called out.csv which will be a comma separated list of the fields

string _fileName = Path.Combine(Environment.GetFolderPath(Environment.SpecialFolder.Desktop),"out.csv");
StreamWriter _fileWriter;

public override void OnStart() 
{
   _fileWriter = new StreamWriter(_fileName,false);
}

public override void Run() 
{   
  // Get an HL7 Message in parsed format
  HL7Message message = GetParsedMessage();
  
  // skip any test messages
  if(message.MSH[10]=="T")
    return;
  
  PID pid = message.Segments.First<PID>();
  if(pid == null)
    return;
  
  // Get the first PID segment
  foreach(OBR obr in message.Segments.OfType<OBR>())
  {
     _fileWriter.Write(pid[5,1,1]);
     _fileWriter.Write(", ");
     _fileWriter.Write(pid[5,1,2]);
     _fileWriter.Write(", ");
     _fileWriter.Write(obr.Segment.Path.Repeat);
     _fileWriter.Write(", ");
     _fileWriter.Write(obr[2,1,1]);
     _fileWriter.Write(", ");
     _fileWriter.Write(obr[2,1,2]);
     _fileWriter.WriteLine();
  }
  
}

public override void OnFinish() 
{
  if(_fileWriter != null)
  {    
    _fileWriter.Close(); // close the file
    _fileWriter = null;
    // launch notepad to display the file.
    System.Diagnostics.Process.Start("Notepad",_fileName);
  }
}

Question:

Thanks for making such a great product. 🙂 Question, I have two tabs open with ADT messages. I need to do a query to see what patients are in the first tab and are not in the second. There is not select Join type function supported. My first tab is A04’s and the second is A14’s. Need to know which A04’s don’t have my patient in the A14’s list.

I send a quick registration (A14) to a system that returns a A05 (or it should).  I need to know when an A05 is not returned for an A14.  The field I am actually matching on is PV1-50 (we put special IDs there).

Answer:

private string _fileName = @"C:\temp\results.txt";
private class TrackedItem
{
   public int Index {get;set;}
   public string AlternateVisitNumber {get;set;}
   public string MessageControlId {get;set;}
}

Dictionary<string,TrackedItem> _a14s = new Dictionary<string,TrackedItem>(StringComparer.CurrentCultureIgnoreCase);
Dictionary<string,TrackedItem> _a05s = new Dictionary<string,TrackedItem>(StringComparer.CurrentCultureIgnoreCase);

public override void Run()
{
  // Get an HL7 Message in parsed format
  Hl7Message message = GetParsedMessage();
  var pv1 = message.GetFirstSegment<PV1>();
  if(pv1 == null)
    return; // no PV1 segment

  Dictionary<string,TrackedItem> collection=null;
  if(message.TriggerEvent=="A14")
  {
  collection = _a14s;
  } else if(message.TriggerEvent=="A05")
  {
    collection = _a05s;
  }

  if(collection == null)
    return; // not an A05, or A04 message

  TrackedItem item=null;
  if(!collection.TryGetValue(pv1.AlternateVisitID_50.IDNumber_01.Value, out item))
  {
    // remember information about the message
   item = new TrackedItem
          {
            Index = MessageIndex,
            AlternateVisitNumber = pv1.AlternateVisitID_50.IDNumber_01.Value,
            MessageControlId = message.MSH.MessageControlID_10.Value,
          };
    collection.Add(pv1.AlternateVisitID_50.IDNumber_01.Value, item);
  }
}

// this is called at the very end
public override void OnFinish()
{
  using(var stream = new System.IO.StreamWriter(_fileName))
  {
    stream.WriteLine("A14s without a matching A05");
    ExportDiff(stream, _a14s, _a05s);
    stream.WriteLine("A05s without a matching A14");
    ExportDiff(stream, _a05s, _a14s);
  }
  try{
    System.Diagnostics.Process.Start("Notepad",_fileName);
  } catch{}
 }

// show the difference between two collections
private void ExportDiff(StreamWriter writer, Dictionary<string,TrackedItem> collection1, Dictionary<string,TrackedItem> collection2)
{
  foreach(TrackedItem item in collection1.Values.OrderBy(i=>i.Index))
  {
    if(!collection2.ContainsKey(item.AlternateVisitNumber))
    {
      writer.Write(item.Index.ToString());
      writer.Write(" ");
      writer.Write(item.AlternateVisitNumber);
      writer.Write(" ");
      writer.WriteLine(item.MessageControlId);
   }
 }
}