Moving images, documents, or rich text between systems via HL7 messaging (v 2.x) is possible using the HL7 ORU^R01 transaction. Historically, documents were moved as simple lines of ASCII text. With increased connectivity between hospitals, EMRs, labs, and imaging centers, there is a strong desire to move pretty text – HTML, PDF, Word, or other formatted text.
In a prior post about how HL7 2.X and the CCR compare, I described that HL7 2.X messages provide a view of data movement “right now.” Typically ADT, scheduling, order, result, and financial data are moved using HL7 2.X. The HL7 CDA standard is typically used to move documents. The catch is that CDA documents are typically marked up lines of ASCII text — XML tags with lots of clinical content rather than a pretty look-and-feel. So, neither standard solves the “moving pretty reports between systems” problem easily.
Enter the HL7 2.X Encapsulated Data (ED) type. In a prior post, I described how the magic ED data type inside an HL7 ORU message allows me to move a binary file between systems.
To make it clear:
- An image file — JPEG, GIF, DICOM — falls into the category of a binary file. I would use the ED data type inside of a ORU message to move that image.
- A “pretty document” – PDF, HTML, Word, RTF, etc. – is also a binary file and I would move it the same way.
As previously noted, the key is if the remote application supports the ED data type and the type of file that is being moved. Said another way, just because HL7 standard allows for the encoding of an image or formatted document, the receiving system may not support decoding.
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