IMPAX 6.0 HL7 Conformance Statement - Agfa HealthCare

HE/8558126 Page 1 of 29Document No. 8558126, Revision 2Agfa HealthCareAGFA HEALTHCAREHL7 Conformance StatementIMPAX 6.0Document No. 8558126Revision: 2Author: Agfa EngineeringWhen printed, this is NOT a controlled copy

HE/8558126 Page 2 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005Document InformationService-related contactinformation worldwideAll service-related contact informationis available on this URL!http://www.agfa.com/en/he/support/support_service/index.jspIssued by:Agfa HealthCare590 North Shore DriveHartland, WI 53029USAtel: 262-369-0900fax: 262-369-1530Agfa shall not be liable for errors contained herein or for incidental orconsequential damages in connection with the furnishing, performanceor use of this publication. Agfa reserves the right to revise thispublication and to make changes to its content at any time, withoutobligation to notify any person or entity of such revisions and changes.This publication may only be used in connection with the promotion,sales, installation and use of Agfa equipment by Agfa personnel.Copyright © October, 05Agfa HealthCareAll rights reserved

HE/8558126 Page 3 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005Table of ContentsDocument Information.............................................................................................................. 2Table of Contents..................................................................................................................... 31 Introduction..............................................................................................51.1 Revision Record ............................................................................................................. 51.2 Purpose and Intended Audience of this Document........................................................ 51.3 Acronyms and Abbreviations.......................................................................................... 51.4 Related Documents ........................................................................................................ 62 Inbound Messages ..................................................................................72.1 Supported Trigger Events............................................................................................... 72.1.1 Supported ADT Events................................................................................................ 72.1.1.1 ADT Segments Processed ....................................................................................... 82.1.2 Supported ORM Events............................................................................................... 92.1.2.1 ORM Messages : Supported Control Codes and Order Statuses............................ 92.1.2.2 ORM Segments Processed .................................................................................... 102.1.3 Supported ORU Events ............................................................................................. 102.1.3.1 ORU Segments Processed .................................................................................... 102.2 Supported HL7 Attributes ............................................................................................. 102.2.1 MSH Segment Mappings........................................................................................... 112.2.2 PID Segment Mappings............................................................................................. 122.2.3 PV1 Segment Mappings............................................................................................ 122.2.4 AL1 Segment Mappings ............................................................................................ 142.2.5 MRG Segment Mappings .......................................................................................... 142.2.6 ORC Segment Mappings........................................................................................... 152.2.7 OBR Segment Mappings........................................................................................... 162.2.8 OBX Segment Mappings ........................................................................................... 172.3 Acknowledgements ...................................................................................................... 183 Outbound Messages .............................................................................193.1 General Processing Rules............................................................................................ 193.2 Outbound Message Types Supported.......................................................................... 193.2.1 HL7 Message Type, Event Mappings........................................................................ 193.2.2 Segments Processed ................................................................................................ 193.3 ADT (Admission, Discharge, and Transfer).................................................................. 203.3.1 MSH Segment ........................................................................................................... 203.3.2 PID Segment ............................................................................................................. 213.3.3 PV1 Segment............................................................................................................. 223.3.4 AL1 Segment............................................................................................................. 233.3.5 MRG Segment........................................................................................................... 233.4 Order Entry ................................................................................................................... 243.4.1 Order Mappings ......................................................................................................... 243.4.2 ORC Segment ........................................................................................................... 243.4.3 OBR Segment............................................................................................................ 25

HE/8558126 Page 4 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20054 Queries..................................................................................................274.1 Query ............................................................................................................................ 274.1.1 Query–MSH Segment ............................................................................................... 274.1.2 Query–QRD Segment ............................................................................................... 274.2 Response to Query....................................................................................................... 274.2.1 Response to Query—MSH Segment ........................................................................ 274.2.2 Response to Query—QRD Segment ........................................................................ 284.2.3 Response to Query—PID Segment........................................................................... 284.2.4 Response to Query—PV1 Segment.......................................................................... 284.2.5 Response to Query—OBR Segment......................................................................... 284.2.6 Response to Query—NTE Segment ......................................................................... 294.2.7 Response to Query—ORC Segment ........................................................................ 294.2.8 Response to Query—OBX Segment......................................................................... 29

HE/8558126 Page 5 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20051 INTRODUCTION1.1 Revision RecordRevisionNumberDate2.0 September 8, 2005 Added Solution brandingReason for Change1.1 March 2, 2005 Changed in response to review comments.1.0 January 14, 2005 Initial version1.2 Purpose and Intended Audience of this DocumentThis document is a HL7 Conformance Statement for the HL7 Services of IMPAX 6.0.The user of this document is involved with system integration and/or software design. We assume that thereader is familiar with the terminology and concepts that are used in HL7 2.3.1 standard and the IHETechnical Framework.Readers not familiar with HL7 terminology should first read the appropriate parts of the HL7 standard itself,prior to reading this conformance statement.Although the use of this conformance statement in conjunction with the HL7 standard is intended to facilitatecommunication with IMPAX 6.0, it is not sufficient to guarantee, by itself, the inter-operation of the connectionbetween IMPAX 6.0 and the 3 rd party HL7-based system.The integration of any device into a system of interconnected devices goes beyond the scope of the HL7standard and this conformance statement when interoperability is desired. The responsibility for analyzingthe applications requirements and developing a solution that integrates the Agfa equipment with othervendors’ systems is the user’s responsibility and should not be underestimated.1.3 Acronyms and AbbreviationsDefinitions, terms and abbreviations used in this document, many of which are defined within the HL7standard. Abbreviations and terms are as follows:ADTAL1EVNAdmission, Discharge, and Transfer messagePatient Allergy Information segmentEvent Type segmentHL7 Health Level 7IHEMRGMSHNTEOBROBXORCORMIntegrating the Healthcare EnterpriseMerge Patient Information segmentMessage Header segmentNotes and comments segmentObservation Request segmentObservation/Result segmentCommon Order segmentOrder Request message

HE/8558126 Page 6 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005ORUPIDPV1QRDRISObservation Results - Unsolicited messagePatient ID segmentPatient Visit segmentQuery Definition segmentRadiology Information System1.4 Related Documents" HL7 Standard v2.3.1" IHE Radiology Technical Framework Revision 6.0 – Final Text, May 20, 2005

HE/8558126 Page 10 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20052.1.2.2 ORM Segments ProcessedThe following segments are processed when IMPAX 6.0 receives an ORM message:MSHPIDPV1[ AL1 ]ORCOBR2.1.3 Supported ORU EventsThe ORU^R01 is the only code supported for observation messages.Table 5 Supported ORU EventsFuncAreaEventCodeORU Trigger EventInboundSupportedORU R01 Unsolicited transmission of an observation message Y2.1.3.1 ORU Segments ProcessedThe following segments are processed when IMPAX 6.0 receives an ORU message:MSHPID[ PV1 ]{[ ORC ]OBR[ ZOS ]*{[ OBX ][ ZIR ]*}}* The ZOS and ZIR segments are used when receiving ORU messages from certain 3 rd party RIS systems.2.2 Supported HL7 AttributesThe following sections indicate the default mapping of HL7 attributes to internal IMPAX 6.0 data attributes.

HE/8558126 Page 11 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20052.2.1 MSH Segment MappingsSeq HL7 Field Name ValueRequiredby HL7Table 6 MSH Attribute Support in IMPAX 6.0Default Mapping toIMPAX Attribute(s)(Yes/No)1 Field Separator Yes Yes Usually "|"2 Encoding Characters Yes Yes Usually "^~\&"3 Sending Application No No4 Sending Facility No No5 Receiving Application No No6 Receiving Facility No No7 Date/time of Message No Yes8 Security No No9 Message Type Yes YesComments10 Message Control ID Yes Yes Generated by sending application11 Processing ID Yes Yes12 Version ID Yes Yes “2.1”, “2.2”, “2.3”, “2.3.1”13 Sequence Number No No14 Continuation Pointer No No15 AcceptAcknowledgement Type16 ApplicationAcknowledgement Type17 Country Code No NoNoNoNoNo18 Character Set No Yes If missing, will use character_encoding fromIMPAX 6.0 configuration19 Principal Language ofMessageNoNo

HE/8558126 Page 12 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20052.2.2 PID Segment MappingsSeq HL7 Field Name ValueRequiredTable 7 PID Attribute Support in IMPAX 6.0Default Mapping toIMPAX Attribute(s)(Yes/No)1 Set ID – Patient ID No No2 Patient ID (External ID) No Yes3 Patient ID (Internal ID) Yes Yes4 Alternate Patient ID No Yes5 Patient Name Yes Yes6 Mother’s Maiden Name No No7 Date of Birth No YesComments8 Sex No Yes M (Male), F (Female), O (Other), U (Unknown)9 Patient Alias No Yes10 Race No Yes Use PID 22 if absent11 Patient Address No Yes12 Country Code No No13 Phone Number – Home No Yes14 Phone Number –BusinessNoYes15 Primary Language No No16 Marital Status No Yes17 Religion No Yes18 Patient Account Number No Yes19 SSN Number – Patient No No20 Driver’s Lic Num –PatientNo21 Mother’s Identifier No No22 Ethnic Group No Yes Use if PID 10 is absent23 Birth Place No No24 Multiple Birth Indicator No No25 Birth Order No No26 Citizenship No No27 Veterans Military Status No No28 Nationality No No29 Patient DeathNoNoDate/Time30 Patient Death Indicator No NoNo2.2.3 PV1 Segment MappingsTable 8 PV1 Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)1 Set ID - Patient Visit No NoComments

HE/8558126 Page 13 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)Comments2 Patient Class Yes Yes I (Inpatient), O (Outpatient), E (Emergency ), P(Preadmit), R (Recurring), B (Obstetrics)3 Assigned PatientLocationNo Yes Use PV1 11 if absent4 Admission Type No No5 Pre-admit Number No No6 Prior Patient Location No No7 Attending Doctor No Yes8 Referring Doctor No Yes9 Consulting Doctor No Yes10 Hospital Service No No11 Temporary Location No Yes Used if PV1 3 is absent12 Pre-admit Test Indicator No No13 Readmission Indicator No No14 Admit Source No No15 Ambulatory Status No Yes B6 present16 VIP Indicator No No17 Admitting Doctor No Yes18 Patient Type No No19 Visit Number Yes Yes20 Financial Class Eff.Date21 Charge Price Indicator No No22 Courtesy Code No No23 Credit Rating No No24 Contract Code No No25 Contract Effective Date No No26 Contract Amount No No27 Contract Period No No28 Interest Code No No29 Transfer to Bad DebtCode30 Transfer to Bad DebtDate31 Bad Debt Agency Code No No32 Bad Debt TransferAmount33 Bad Debt Recovery Amt No No34 Delete Account Indicator No No35 Delete Account Date No No36 Discharge Disposition No No37 Discharged to Location No No38 Diet Type No No39 Servicing Facility No Yes40 Bed Status No No41 Account Status No NoNoNoNoNoNoNoNoNo

HE/8558126 Page 14 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)42 Pending Location No No43 Prior TemporaryLocation44 Admit Date/Time No Yes45 Discharge Date/Time No Yes46 Current Patient Balance No No47 Total Charges No No48 Total Adjustments No No49 Total Payments No No50 Alternate Visit ID No No51 Visit Indicator No No52 Other HealthcareProviderNoNoNoNoComments2.2.4 AL1 Segment MappingsTable 9 AL1 Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)1 Set ID - AL1 Yes Set to 1,2,3…2 Allergy Type No Yes3 AllergyCode/DescriptionYesYes4 Allergy Severity No Yes5 Allergy Reaction No Yes6 Identification Date No YesComments2.2.5 MRG Segment MappingsThis segment is only used in ADT Merge messages (A18, A30, A34, A40).Table 10 MRG Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequired1 Prior Patient ID -Internal2 Prior Alternate PatientID3 Prior Patient AcctNumber4 Prior Patient ID -ExternalYesNoDefault Mapping toIMPAX Attribute(s)(Yes/No)Yes5 Prior Visit Number No No6 Prior Alternate Visit ID No NoNoNoNoNoNoComments

HE/8558126 Page 15 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)7 Prior Patient Name No NoComments2.2.6 ORC Segment MappingsSeq HL7 Field Name ValueRequiredTable 11 ORC Attribute Support in IMPAX 6.0Default Mapping toIMPAX Attribute(s)(Yes/No)1 Order Control Yes Yes Refer to 2.1.2.1Comments2 Placer Order # Yes Yes ORC 2,1; if absent OBR 2,1.ORC 2,2 or OBR 2,2 or configuration setting:default_assigning_authority3 Filler Order # Yes Yes ORC 3,1 or OBR 3,1 if absentORC 3,2 or OBR 3,2 or configuration setting:default_assigning_authority4 Placer Group # No Yes ORC 4,1ORC 4,2 or configuration setting:default_assigning_authority5 Order Status Yes Yes Refer to 2.1.2.16 Response Flag No No7 Quantity/Timing No Yes Use OBR 27 if absent8 Parent No No9 Date/Time ofTransactionNo10 Entered By No Yes ORC 10,2-4 (name only)Yes11 Verified By No No12 Ordering Provider No Yes13 Enterer’s Location No Yes14 Call Back PhoneNumber15 Order EffectiveDate/TimeNoNoYesYes16 Order Control Reason No No17 Entering Organization No Yes18 Entering Device No No19 Action By No No

HE/8558126 Page 16 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20052.2.7 OBR Segment MappingsSeq HL7 Field Name ValueRequired1 Set ID - ObservationRequestTable 12 OBR Attribute Support in IMPAX 6.0NoDefault Mapping toIMPAX Attribute(s)(Yes/No)Set to 1,2,3…Comments2 Placer Order # Yes Yes OBR 2,1 if ORC 2,1 is absent;OBR 2,2 if ORC 2,2 is absent3 Filler Order # Yes Yes OBR 3,1 if ORC 3,1 is absent4 Universal Service ID Yes Yes Components 1,2,3 of OBR 45 Priority No Yes Used if OBR 27,6 is absent6 Requested Date/Time No Yes Used if OBR 27,4 is absent.7 Observation Date/Time No No8 Observation EndDate/TimeNoNo9 Collection Volume No No10 Collector Identifier No No11 Specimen Action Code No No12 Danger Code No Yes13 Relevant Clinical Inf. No Yes14 Specimen Rec'dDate/Time15 Specimen Source No NoNo16 Ordering Provider family No Yes Components 2,3,4 of OBR 1617 Order Callback PhoneNo.NoNoNo18 Placer Field 1 No Yes See NOTE 1IHE: OBR 18; if absent ORC 2,1; if absentOBR 2,119 Placer Field 2 No Yes Use if OBR 24 is absent (See NOTE 1)20 Filler Field 1 No Yes See NOTE 1IHE: OBR 20; if absent ORC 3,1; if absent OBR3,121 Filler Field 2 No No22 Result Rpt/StatusChange - Date/TimeNo Yes OBR 22,1.23 Charge To Practice No No24 Diagnostic Serv Sect Id No Yes Use OBR 19 if absent25 Result Status No Yes Use OBR 25,1 if OBX 11,1 is absent.TRANSCRIBED (R, P, C), APPROVED (F)26 Parent Result No No27 Quantity/Timing No Yes Used if ORC 7 is absent28 Result Copies To No No29 Parent Number No No30 Transportation Mode No Yes31 Reason For Study No Yes OBR 31,1

HE/8558126 Page 17 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005Seq HL7 Field Name ValueRequired32 Principal ResultInterpreter33 Assistant ResultInterpreterDefault Mapping toIMPAX Attribute(s)(Yes/No)CommentsNo Yes Components 2,3,4 or OBR 32.No34 Technician Yes Components 2,3,4 of OBR 3435 Transcriptionist No Yes OBR 35,136 Scheduled Date/Time No Yes Used if OBR 27,4 is absent.37 Number of SampleContainers38 Transport Logistics ofCollected Sample39 Collector's Comment No No40 Transport ArrangementResponsibility41 Transport Arranged No No42 Escort Required No NoNoNoNoNoNoNoNo43 Planned PatientNoNoTransport Comment(Note 1) IMPAX 6.0 maps certain attributes differently when configured for IHE compatibility. The itemsmarked with this note are IHE defaults that differ from non-IHE defaults.2.2.8 OBX Segment MappingsSeq HL7 Field Name ValueRequiredTable 13 OBX Attribute Support in IMPAX 6.0Default Mapping toIMPAX Attribute(s)(Yes/No)Comments1 Set ID – OBX No Set to 1,2,3…2 Value Type No No3 Observation identifier No Yes If OBX 3,2 is “IMP” use OBX 5,1 forimpressions. If OBX 3,2 is “GDT” use OBX 5,1for interpretation text. These attribute valuesgather across all of the OBX segments in amessage.4 Observation Sub-ID No No5 Observation Value No Yes6 Units No No7 References Range No No8 Abnormal Flags No No9 Probability No No10 Nature of Abnormal Test No No11 ObservationResult Status12 Date Last Obs NormalValues13 User Defined AccessChecksNo Yes OBX 11,1 or OBR 25,1 if absent.TRANSCRIBED (R, P, C), APPROVED (F)NoNoNoNo

HE/8558126 Page 18 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005Seq HL7 Field Name ValueRequired14 Date/Time of theObservationNoDefault Mapping toIMPAX Attribute(s)(Yes/No)Yes15 Producer’s ID No No16 Responsible Observer No Yes17 Observation Method No No2.3 AcknowledgementsCommentsThe HL7 mapping returns a NAK if the incoming message cannot be processed. If the reason is themessage type is not mapped, the Acknowledgment Code is set to “AR”. Any other parsing error returns anAcknowledgment Code of “AE”.

HE/8558126 Page 19 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20053 OUTBOUND MESSAGES3.1 General Processing RulesThe default outbound mapping is generally the inverse of the HL7 inbound mapping3.2 Outbound Message Types Supported3.2.1 HL7 Message Type, Event MappingsThe following table lists all of the default outbound HL7 messages supported. There is no single set ofmappings that will service all IMPAX 6.0 installations, so this table will likely be edited when the deviceis installed. The default mappings are the inverse of the inbound HL7 to IMPAX 6.0.Table 14 Outbound HL7 Message TypesHL7 message typeHL7 TriggerADTADTADTADTADTADTADTADTADTADTORMA01A02A03A05A08A11A18A23A33A38O013.2.2 Segments ProcessedThe following table lists the segments that are processed for each HL7 message type by the defaultHL7 outbound mappings.Table 15 HL7 Out Segments ProcessedHL7 Message TypeADTADT Merge messages add:ORMSegments ProducedMSHPIDPV1[ AL1 ]MRGMSHPIDPV1[AL1 ]ORCOBRBy default, all HL7 data elements correspond to HL7 v2.3.1.

HE/8558126 Page 20 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20053.3 ADT (Admission, Discharge, and Transfer)3.3.1 MSH SegmentTable 16 Outbound MSH Attribute Support in IMPAX 6.0SeqHL7 Field NameValueRequiredDefault Mapping fromIMPAX Attribute(s) (Yes/No)Comments1 Field Separator Yes Yes (1) Always "|"2 Encoding Characters Yes Yes (1) Always "^~\&"3 Sending Application No Yes (2) device configuration4 Sending Facility No Yes (2) device configuration5 Receiving Application No Yes (2) device configuration6 Receiving Facility No Yes (2) device configuration7 Date/time of Message No Yes Date/Time message sent8 Security No9 Message Type Yes Yes (3) See comment below10 Message Control ID Yes Yes (4) Generated number11 Processing ID Yes Yes (5) ‘P’12 Version ID Yes Yes (5) ‘2.3.1’13 Sequence Number No No14 Continuation Pointer No No15 AcceptAcknowledgment TypeNoNo16 ApplicationAcknowledgment Type17 Country Code No NoNo18 Character Set No Yes Uses lookup table19 Principal Language ofMessageNoNoNo(1) The field separator and encoding characters cannot be changed through script or grammar changes.(2) These attributes come from the configuration object and can be set when the device is configured using the service tool.(3) This field’s value comes from a lookup that maps an internal event type to the HL7 type and event code. If this lookup fails, nomore mapping occurs and no HL7 message is generated. If the lookup succeeds, the result is potentially refined by anotherlookup using a second internal attribute.(4) The message control ID is a sequential number. When the device starts, the initial value of the control ID is set to the numberof seconds since January 1, 1970.(5) These two values are constants found in the mapping table used to generate the MSH segment and can be changed byediting the grammar.

HE/8558126 Page 21 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20053.3.2 PID SegmentSeqHL7 Field NameTable 17 Outbound PID Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping fromIMPAX Attribute(s) (Yes/No)1 Set ID - Patient ID No No2 Patient ID (External ID) No No3 Patient ID (Internal ID) Yes Yes4 Alternate Patient ID No Yes5 Patient Name Yes Yes6 Mother’s Maiden Name No NoComments7 Date of Birth No Yes Date, time; right-filled with 0’s asneeded.8 Sex No Yes M (Male), F (Female),O (Other),U (Unknown)9 Patient Alias No Yes10 Race No Yes11 Patient Address No Yes12 County Code No No13 Phone Number - No Yes14 Phone Number -BusinessNoYes15 Primary Language No No16 Marital Status No Yes A (Separated),D (Divorced),M (Married),S (Single),W (Widowed)17 Religion No Yes18 Patient Account Number No Yes19 SSN Number - Patient No No20 Driver’s Lic Num -PatientNoNo21 Mother’s Identifier No No22 Ethnic Group No No23 Birth Place No No24 Multiple Birth Indicator No No25 Birth Order No No26 Citizenship No No27 Veterans Military Status No No28 Nationality No No29 Patient Death Date/Time No No30 Patient Death Indicator No No

HE/8558126 Page 22 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20053.3.3 PV1 SegmentSeqHL7 Field NameTable 18 PV1 Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping fromIMPAX Attribute(s) (Yes/No)1 Set ID - Patient Visit No NoComments2 Patient Class Yes Yes Required for ADTs, not ORMs.I (Inpatient),O (Outpatient),E (Emergency ),P (Preadmit),R (Recurring),B (Obstetrics)3 Assigned PatientLocationNoYes4 Admission Type No No5 Pre-admit Number No No6 Prior Patient Location No No7 Attending Doctor No Yes8 Referring Doctor No Yes9 Consulting Doctor No Yes10 Hospital Service No No11 Temporary Location No No12 Pre-admit Test Indicator No No13 Readmission Indicator No No14 Admit Source No No15 Ambulatory Status No Yes If and only if pregnancy_status is true,set to B6.16 VIP Indicator No No17 Admitting Doctor No Yes18 Patient Type No No19 Visit Number No Yes20 Financial Class Eff.Date21 Charge Price Indicator No No22 Courtesy Code No No23 Credit Rating No No24 Contract Code No No25 Contract Effective Date No No26 Contract Amount No No27 Contract Period No No28 Interest Code No No29 Transfer to Bad DebtCode30 Transfer to Bad DebtDate31 Bad Debt Agency Code No No32 Bad Debt TransferAmountNoNoNoNoNoNoNoNo

HE/8558126 Page 23 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005SeqHL7 Field NameValueRequiredDefault Mapping fromIMPAX Attribute(s) (Yes/No)33 Bad Debt Recovery Amt No No34 Delete Account Indicator No No35 Delete Account Date No No36 Discharge Disposition No No37 Discharged to Location No No38 Diet Type No No39 Servicing Facility No Yes40 Bed Status No No41 Account Status No No42 Pending Location No No43 Prior TemporaryLocationNoNoComments44 Admit Date/Time No Yes Date, time right filled with 0’s as needed.45 Discharge Date/Time No Yes Date, time right filled with 0’s as needed.46 Current Patient Balance No No47 Total Charges No No48 Total Adjustments No No49 Total Payments No No50 Alternate Visit ID No No51 Visit Indicator No No52 Other HealthcareProviderNoNo3.3.4 AL1 SegmentSeq HL7 Field Name Value RequiredTable 19 AL1 Attribute Support in IMPAX 6.0Default Mapping fromIMPAX Attribute(s) (Yes/No)1 Set ID - AL1 Yes Generated 1,2,3…2 Allergy Type No Yes3 AllergyCode/DescriptionYesYes4 Allergy Severity No Yes5 Allergy Reaction No Yes6 Identification Date No YesComments3.3.5 MRG SegmentTable 20 MRG Attribute Support in IMPAX 6.0SeqHL7 Field NameValueRequiredDefault Mapping fromIMPAX Attribute(s) (Yes/No)Comments1 Prior Patient ID -InternalYesYes2 Prior Alternate PatientIDNoNo

HE/8558126 Page 24 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005SeqHL7 Field Name3 Prior Patient AcctNumber4 Prior Patient ID -ExternalValueRequiredNoNoDefault Mapping fromIMPAX Attribute(s) (Yes/No)5 Prior Visit Number No No6 Prior Alternate Visit ID No No7 Prior Patient Name No NoNoNoCommentsThis segment is only used in Merge messages.3.4 Order Entry3.4.1 Order MappingsFor order messages, a lookup of the order control and order status values is attempted based oninternal order status attributes. The first lookup that produces a non-empty string is used for theORC(1,1) or ORC(5,1) value. If none of these lookups results in a non-empty string, no HL7 message isgenerated.3.4.2 ORC SegmentSeqHL7 Field NameTable 21 ORC Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping fromIMPAX Attribute(s)(Yes/No)1 Order Control Yes Yes Check first,see Section 3.4.12 Placer Order # No Yes3 Filler Order # No Yes4 Placer Group # No Yes5 Order Status No Yes6 Response Flag No No7 Quantity/Timing No Yes8 Parent No Yes9 Date/Timeof TransactionNo Yes Date, timeright filled with0’s as needed.10 Entered By No Yes11 Verified By No No12 Ordering Provider No Yes13 Enterer’s Location No Yes14 Call BackPhone NumberNoYes15 Order EffectiveDate/TimeNo Yes Date, timeright filled with0’s as needed.Comments

HE/8558126 Page 25 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 2005SeqHL7 Field Name16 Order ControlReason17 EnteringOrganizationValueRequiredNoNoDefault Mapping fromIMPAX Attribute(s)(Yes/No)NoYes18 Entering Device No No19 Action By No NoComments3.4.3 OBR SegmentSeqHL7 Field Name1 Set ID -ObservationRequestTable 22 OBR Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping fromIMPAX Attribute(s)(Yes/No)No No ‘1’2 Placer Order # No Yes3 Filler Order # No Yes4 UniversalService ID5 Priority No No6 RequestedDate/Time7 ObservationDate/Time8 Observation EndDate/Time9 Collection Volume No No10 Collector Identifier No No11 Specimen ActionCode12 Danger Code No Yes13 Relevant ClinicalInf.14 Specimen Rec'dDate/TimeCommentsYes No There are several sources for this field.This is the default in the outboundmapping and should be changed asneeded.NoNoNoNoNoNoNoNoNoNoYes15 Specimen Source No No16 Ordering Providerfamily17 Order CallbackPhone No.NoNoNoYes18 Placer Field 1 No No19 Placer Field 2 No No20 Filler Field 1 No NoNo

HE/8558126 Page 26 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 2005SeqHL7 Field NameValueRequiredDefault Mapping fromIMPAX Attribute(s)(Yes/No)21 Filler Field 2 No No22 Result Rpt/StatusChange -Date/Time23 Charge ToPractice24 Diagnostic ServSect IdNoNoNoNoNoYes25 Result Status No No26 Parent Result No No27 Quantity/Timing No Yes28 Result Copies To No No29 Parent Number No No30 TransportationModeNoYes31 Reason For Study No Yes32 Principal ResultInterpreter33 Assistant ResultInterpreter34 Technician No Yes35 Transcriptionist No No36 ScheduledDate/Time37 Number of SampleContainers38 Transport Logisticsof CollectedSample39 Collector'sComment40 TransportArrangementResponsibility41 TransportArranged42 Escort Required No No43 Planned PatientTransportCommentNoNoNoNoCommentsNo Yes Date, time right filled with 0’s as needed.NoNoNoNoNoNoNoNoNoNoNoNo

HE/8558126 Page 27 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20054 QUERIES4.1 QueryIMPAX 6.0 translates an internal report/ result query message into an HL7 QRY^Q01 message.4.1.1 Query–MSH SegmentIMPAX 6.0 creates the MSH segment of this message in the same manner as for other outbound messages.See 3.3.1, MSH Segment.4.1.2 Query–QRD SegmentThe following table describes how IMPAX 6.0 creates the QRD segment of the query message.Table 23 QRD Attribute Support in IMPAX 6.0SeqHL7 Field NameValueRequiredDefault Mapping from IMPAXAttribute(s) (Yes/No)Comments1 Query Date/Time Yes Yes Current date and time2 Query Format Code Yes Yes ‘R’ (record-oriented)3 Query Priority Yes Yes ‘I’ (immediate)4 Query ID Yes Yes Generated5 Deferred ResponseTypeNoNo6 Deferred ResponseDate/Time7 Quantity LimitedRequestNoNoYes Yes 99^RD (99 records)8 Who Subject Filter Yes Yes patient_id9 What Subject Filter Yes Yes RES (result)10 What DepartmentData Code11 What Data CodeValue Qual.12 Query Results Level No NoYes Yes accession_numberNo4.2 Response to QueryIMPAX 6.0 maps the query results into internal attributes as described in the following tables. Fields that arenot used have been omitted.No4.2.1 Response to Query—MSH SegmentTable 24 Response to Query--MSH Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments18 Character Set No Yes MSH 18,1; if absent usecharacter_encoding fromconfiguration

HE/8558126 Page 28 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October 20054.2.2 Response to Query—QRD SegmentSeqHL7 Field NameTable 25 Response to Query--QRD Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments10 What Department Data Code Yes Yes if ORC 3,1 absent and OBR 3,1absent4.2.3 Response to Query—PID SegmentSeqHL7 Field NameTable 26 Response to Query--PID Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments3 Patient ID (Internal ID) Yes Yes4 Alternate Patient ID No Yes5 Patient Name Yes Yes7 Date of Birth No Yes Date, right-filled with 0’s as needed.8 Sex No Yes9 Patient Alias No Yes4.2.4 Response to Query—PV1 SegmentTable 27 Response to Query--PV1 Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)8 Referring Doctor No YesComments4.2.5 Response to Query—OBR SegmentTable 28 Response to Query--OBR Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping toIMPAX Attribute(s)(Yes/No)Comments3 Filler Order # Yes Yes OBR 3,1 if ORC 3,1 is absentOBR 3,2 if ORC 3,2 is absent4 Universal Service ID Yes Yes OBR 4,213 Relevant Clinical Inf. No Yes If OBR 1,1 is absent then if OBR 13,1is not empty use OBR 13,1 + ‘-‘ + allNTE 3,1 where NTE 1,1 = ‘2’22 Result Rpt/StatusChange - Date/TimeNoYes25 Result Status No Yes Use OBR 25,1 if OBX 11,1 is absent.TRANSCRIBED (R, P, C),APPROVED (F)31 Reason For Study No Yes OBR 31,1; if absent see OBR 1332 Principal Result Interpreter No Yes35 Transcriptionist No Yes

HE/8558126 Page 29 of 29Document No. 8558126, Revision 2Agfa HealthCare 10 October, 20054.2.6 Response to Query—NTE SegmentTable 29 Response to Query--NTE Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments1 Set ID - NTE No Yes3 Comment No YesIf NTE 1,1 = ‘2’ then NTE 3,1 may bepart of reason_for_study. See OBR 13.4.2.7 Response to Query—ORC SegmentTable 30 Response to Query--ORC Attribute Support in IMPAX 6.0Seq HL7 Field Name ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments3 Filler Order # Yes Yes OBR 3,1 if ORC 3,1 is absentOBR 3,2 if ORC 3,2 is absent4.2.8 Response to Query—OBX SegmentSeqHL7 Field NameTable 31 Response to Query--OBX Attribute Support in IMPAX 6.0ValueRequiredDefault Mapping to IMPAXAttribute(s) (Yes/No)Comments3 Observation Identifier No Yesif OBX 3,2=’IMP’, use OBX 5,1 for5 Observation Value No Yesinterpretation_text; if absent use ZIR.11 Observation Result Status No Yes OBX 11,1; if absent OBR 25,114 Date/Time of theObservationNo Yes OBX 14,1, right-filled with zeroes asneeded.16 Responsible Observer No Yes OBX 16,1