HL7 message volume for Epic vs McKesson

Hi Jerry,

While I can’t speak to a McKesson to Epic conversion, I can say that Epic does generate a lot of ADT.

Also be aware that backloads can be done with a flag to not generate A31 messages.  I have had issues where they buried the engine when someone ran a backload of say 500K messages that triggered 500K A31 messages in a matter of minutes.  Make everyone who has this capability aware that they will cripple your engine and your organization if they don’t use the proper flags….

Keith,

Good point.

We went from GE to Epic and we noticed not only the amount of A31s but also the way that Epic creates encounters every time an inpatient has a procedure (eg. radiology) and sends out A04 and multiple A08s while that happens even though the patient is still an inpatient.  We also had to setup a function for some of our systems that generates A08s out of Bridges when it sends out A31s, so we really increased our volume, sorry I don’t know where the numbers went, but I think it was close to a double.

We also got bit a couple of times by the same backload issue, so we do two things to help alleviate the problem.  The first is that we create a temporary copy of our outgoing ADT interface in Bridges and have them run the load command with that AIP record as the target interface (so if they forget to set the suppress flag, it doesn’t affect other interfaces).  The second thing we do is that we still place a TPS proc at the top level where ADT hits Cloverleaf to block any messages with the EVN-5.1 of the username of the person running the job to keep anything out of the engine should we know about the load but the the other two checks were missed.

We eliminated many of the extraneous A31s by setting a profile variable to send visit account without additional A31s in the Outgoing ADT interface.  You can search Epic’s Nova notes for “Stop Sending Unnecessary A31s” to get the specifics of the profile variable and the settings.

Jim Cobane

Henry Ford Health

I would like second Jim’s suggestion. We followed the instructions in Epic’s Nova note “Stop Sending Unnecessary A31s [311982]” and instantly saw a 60% reduction in ADT message traffic. It was a quick and simple win for us and all our downstream systems.