HL7 message volume for Epic vs McKesson

[Jerry Hendrickson]

Hi. We are converting from McKesson to Epic, with a go live next year.  We are in the process of starting the build for our interfaces.  I am wondering if there is a significant increase or decrease in HL7 message volume between the two systems.  I have read that Epic produces a lot of ADT messages.  If anyone has gone through a McKesson to Epic conversion, I would be very interested in your thoughts on this.  Any other good-to-knows would also be appreciated.  Thanks in advance for your input!

Topic

[James Cobane]

Hi Jerry,

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

[Keith McLeod]

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….

[Jerry Hendrickson]

James and Keith, thank you for the input.  That is good information to be aware of.  Have a great weekend.

Jerry.

[James Cobane]

Keith,

Good point.

[Jerry Hendrickson]

Which types of A31 messages did you decide to suppress?

[aaron kaufman-moore]

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.

[James Cobane]

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

[Mike Strout]

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.

[Author]

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