MDM rtf fun

[Gary Atkinson]

Hi-

I am looking for advise on how to interpret rtf data in OBX:5 of an MDM type message.  Our transcription system (SoftMed) has changed the header portion.  When the MDM is populated into Cerner (Our clinical system), the header portion of the result is not correct, ie) spacing and lines are off.  I have not worked with this type of data before was I wondering what others have used as resources of help.  Here is part of the message:

Code:

MSH|^~&|SOFTMED|NAH|HNAM||20080213151652||MDM^T02|080213151652468|P|2.3
EVN|T02|20080213151652
PID|||0001012555||TEST^AAH||19190909|M| |||||||||0804400002|111110749
PV1|||||||002623||||||||||002512|||||||||||||||||||||||||||200802130140|20080213
TXA|1|01^Discharge Summary|TX|20080213||200802131500|200802131515||2512^Kanu^Bai^^^^MD|002512|KD|00010125550804400002857626|||||U||||||2512^^A
OBX|1|TX|01^Discharge Summary||{Ertf1Eadeflang1025EansiEansicpg1252Euc1Eadeff0Edeff0Estshfdbch0Estshfloch0Estshfhich0Estshfbi0Edeflang1033Edeflangfe1033{Efonttbl{Ef0EfromanEfcharset0Efprq2{E*Epanose 02020603050405020304}Times New Roman{E*Efalt Times New Roman};}{Ef37EfromanEfcharset238Efprq2 Times New Roman CE{E*Efalt Times New Roman};}||||||P|||200802131500
OBX|2|TX|01^Discharge Summary||{Ef38EfromanEfcharset204Efprq2 Times New Roman Cyr{E*Efalt Times New Roman};}{Ef40EfromanEfcharset161Efprq2 Times New Roman Greek{E*Efalt Times New Roman};}{Ef41EfromanEfcharset162Efprq2 Times New Roman Tur{E*Efalt Times New Roman};}||||||P|||200802131500
OBX|3|TX|01^Discharge Summary||{Ef42Efbidi EfromanEfcharset177Efprq2 Times New Roman (Hebrew){E*Efalt Times New Roman};}{Ef43Efbidi EfromanEfcharset178Efprq2 Times New Roman (Arabic){E*Efalt Times New Roman};}||||||P|||200802131500
OBX|4|TX|01^Discharge Summary||{Ef44EfromanEfcharset186Efprq2 Times New Roman Baltic{E*Efalt Times New Roman};}{Ef45EfromanEfcharset163Efprq2 Times New Roman (Vietnamese){E*Efalt Times New Roman};}}{Ecolortbl;Ered0Egreen0Eblue0;Ered0Egreen0Eblue255;Ered0Egreen255Eblue255;||||||P|||200802131500
OBX|5|TX|01^Discharge Summary||Ered0Egreen255Eblue0;Ered255Egreen0Eblue255;Ered255Egreen0Eblue0;Ered255Egreen255Eblue0;Ered255Egreen255Eblue255;Ered0Egreen0Eblue128;Ered0Egreen128Eblue128;Ered0Egreen128Eblue0;Ered128Egreen0Eblue128;Ered128Egreen0Eblue0;Ered128Egreen128Eblue0;||||||P|||200802131500
OBX|6|TX|01^Discharge Summary||Ered128Egreen128Eblue128;Ered192Egreen192Eblue192;Ered255Egreen255Eblue255;}{Estylesheet{Eql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0||||||P|||200802131500
OBX|7|TX|01^Discharge Summary|| Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esnext0 Normal;}{Es1Eqc Eli0Eri0EkeepnEwidctlparEwrapdefaultEfaautoEoutlinelevel0EadjustrightErin0Elin0Eitap0 ErtlchEfcs1 EabEaf0Eafs24Ealang1025 EltrchEfcs0||||||P|||200802131500
OBX|8|TX|01^Discharge Summary|| EbEfs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext0 heading 1;}{Es2Eqc Eli0Eri0EkeepnEwidctlparEwrapdefaultEfaautoEoutlinelevel1EadjustrightErin0Elin0Eitap0 ErtlchEfcs1 EabEaf0Eafs16Ealang1025 EltrchEfcs0||||||P|||200802131500
OBX|9|TX|01^Discharge Summary|| EbEfs16Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext0 heading 2;}{Es3Eql Eli0Eri0EkeepnEwidctlparEwrapdefaultEfaautoEoutlinelevel2EadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0||||||P|||200802131500
OBX|10|TX|01^Discharge Summary|| EvEfs24Ecf6Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext0 heading 3;}{E*Ecs10 Eadditive Essemihidden Default Paragraph Font;}{E*||||||P|||200802131500
OBX|11|TX|01^Discharge Summary||Ets11EtsrowdEtrftsWidthB3Etrpaddl108Etrpaddr108Etrpaddfl3Etrpaddft3Etrpaddfb3Etrpaddfr3Etblind0Etblindtype3Etscellwidthfts0EtsvertaltEtsbrdrtEtsbrdrlEtsbrdrbEtsbrdrrEtsbrdrdglEtsbrdrdgrEtsbrdrhEtsbrdrv||||||P|||200802131500
OBX|12|TX|01^Discharge Summary|| Eql Eli0Eri0EwidctlparEwrapdefaultEaspalphaEaspnumEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs20 EltrchEfcs0 Efs20Elang1024Elangfe1024EcgridElangnp1024Elangfenp1024 Esnext11 Essemihidden Normal Table;}{Es15Eql Eli0Eri0Ewidctlpar||||||P|||200802131500
OBX|13|TX|01^Discharge Summary||EtqcEtx4320EtqrEtx8640EwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext15 header;}{Es16Eql Eli0Eri0Ewidctlpar||||||P|||200802131500
OBX|14|TX|01^Discharge Summary||EtqcEtx4320EtqrEtx8640EwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext16 footer;}{||||||P|||200802131500
OBX|15|TX|01^Discharge Summary||Es17Eql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 Esbasedon0 Esnext17 Plain Text;}}{E*ElatentstylesElsdstimax156Elsdlockeddef0}||||||P|||200802131500
OBX|16|TX|01^Discharge Summary||{E*Ersidtbl Ersid853299Ersid930863Ersid983886Ersid1574545Ersid1787694Ersid1909002Ersid2567837Ersid2961700Ersid3039669Ersid3431859Ersid3551110Ersid4545976Ersid4553060Ersid5196490Ersid5516929Ersid5775964Ersid5849597Ersid5906717Ersid5909611Ersid5976776||||||P|||200802131500
OBX|17|TX|01^Discharge Summary||Ersid6101088Ersid6448943Ersid6501359Ersid7028354Ersid7144050Ersid7166951Ersid7430513Ersid7433718Ersid7486572Ersid7632490Ersid7802618Ersid7949278Ersid8203039Ersid8472807Ersid8548850Ersid8929457Ersid9258028Ersid10027932Ersid10054733Ersid10183534||||||P|||200802131500
OBX|18|TX|01^Discharge Summary||Ersid10382602Ersid10560550Ersid10830804Ersid11173507Ersid11364081Ersid11428282Ersid12535729Ersid12918974Ersid12928093Ersid13048495Ersid13567838Ersid13580641Ersid13773277Ersid14239126Ersid14558345Ersid15302248Ersid16541548}{E*Egenerator Microsoft Word 11.||||||P|||200802131500
OBX|19|TX|01^Discharge Summary||0.8026;}{Einfo{Etitle North Arundel Hospital}{Eauthor NAH}{Eoperator katdun}{EcreatimEyr2008Emo2Edy13Ehr15Emin16}{ErevtimEyr2008Emo2Edy13Ehr15Emin16}{EprintimEyr2002Emo4Edy23Ehr14Emin29}{Eversion2}{Eedmins0}{Enofpages1}{Enofwords193}{Enofchars1105}||||||P|||200802131500
OBX|20|TX|01^Discharge Summary||{E*Ecompany North Arundel Hospital}{Enofcharsws1296}{Evern24609}{E*Epassword 00000000}}{E*Exmlnstbl {Exmlns1 urn:schemas-microsoft-com:office:smarttags}}Epaperw12240Epaperh15840Emargl1440Emargr720Emargt720Emargb720Egutter0Eltrsect||||||P|||200802131500
OBX|21|TX|01^Discharge Summary|| EwidowctrlEftnbjEaenddocEnoxlattoyenEexpshrtnEnoultrlspcEdntblnsbdbEnospaceforulEhyphcaps0EformshadeEhorzdocEdghspace120Edgvspace120Edghorigin1701Edgvorigin1984Edghshow0Edgvshow3||||||P|||200802131500
OBX|22|TX|01^Discharge Summary||EjcompressEviewkind1Eviewscale105EpgbrdrheadEpgbrdrfootEnolnhtadjtblErsidroot4545976 Efet0{E*Ewgrffmtfilter 013f}Eilfomacatclnup0{E*Edocvar {DOC_DESCRIPTION}{ChartScript Format File}}{E*Edocvar {scrScriptHandle}{655676}}||||||P|||200802131500
OBX|23|TX|01^Discharge Summary||{E*Edocvar {smChartScriptUIMode}{256}}{E*Eftnsep Eltrpar EpardEplain EltrparEql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 {||||||P|||200802131500
OBX|24|TX|01^Discharge Summary||ErtlchEfcs1 Eaf0 EltrchEfcs0 Einsrsid4545976 Echftnsep||||||P|||200802131500
OBX|25|TX|01^Discharge Summary|| Epar }}{E*Eftnsepc Eltrpar EpardEplain EltrparEql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 {ErtlchEfcs1 Eaf0 EltrchEfcs0||||||P|||200802131500
OBX|26|TX|01^Discharge Summary|| Einsrsid4545976 Echftnsepc||||||P|||200802131500
OBX|27|TX|01^Discharge Summary|| Epar }}{E*Eaftnsep Eltrpar EpardEplain EltrparEql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 {ErtlchEfcs1 Eaf0 EltrchEfcs0||||||P|||200802131500
OBX|28|TX|01^Discharge Summary|| Einsrsid4545976 Echftnsep||||||P|||200802131500
OBX|29|TX|01^Discharge Summary|| Epar }}{E*Eaftnsepc Eltrpar EpardEplain EltrparEql Eli0Eri0EwidctlparEwrapdefaultEfaautoEadjustrightErin0Elin0Eitap0 ErtlchEfcs1 Eaf0Eafs24Ealang1025 EltrchEfcs0 Efs24Elang1033Elangfe1033EcgridElangnp1033Elangfenp1033 {ErtlchEfcs1 Eaf0 EltrchEfcs0||||||P|||200802131500
OBX|30|TX|01^Discharge Summary|| Einsrsid4545976 Echftnsepc||||||P|||200802131500

Thanks in advance!

Gary

Topic

[Jim Kosloskey]

Gary,

I have some insight if you want it.

email me.

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Gary Atkinson]

On the way Jim…..

[Tom Rioux]

Share with the rest of the group.  That looks very interesting and I’d like to find out what the solution is, as I’m sure everyone else would as well.

Thanks…Tom

[Jim]

We are currently struggling with SoftMed RTF upload as well. How do you deal with the fact that the primary document is not sent from SoftMed as part of the message when it is an unsigned addendum?

Jim

Jim

[Jim Kosloskey]

Tom etal,

Since attachments here do not work very well and the information is formatted in a Word document which does not copy and paste well inside this message body it is impossible for me to post the insights.

If there are more than one of you that would like to discuss this, perhaps one of you can set up a conference call and I can review.

Otherwise, if there are just a couple who are interested, email me an I can send you what I have.

Thanks,

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Jim Kosloskey]

All,

Rob Abbott assures me attachments are working fine so I’ll give it a try.

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Rob Abbott]

Er, did this attachment work for anyone?  I am on my blackberry atm and it is not downloading properly.  If it’s an issue I will try to get it solved next week.

Jim I am not quite sure I assured you but I did say I *thought* attachments were in working order.

I don’t like bugs 😉

Rob Abbott
Cloverleaf Emeritus

[Robert Kersemakers]

Hi Rob,

Attachment worked fine: one Word-document downloaded.

Blackberry? That is soooo oldskool… 😉

Zuyderland Medisch Centrum; Heerlen/Sittard; The Netherlands

[Jim Kosloskey]

Rob,

Your positive thoughts are assurances to me  😆

It looks like it worked though.

Thanks,

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[John Hamilton]

I just downloaded the emails.doc file and It looks fine too me.

[Pete Gilbert]

wouldn’t you just base64 encode the document/payload before sending it and then have the recieving side un-encode it?

[Jim Kosloskey]

Pete,

Well you would need to decode the message in order for your acknowledgment proc to get the Control ID (MSH-10) at the very least in order to construct a valid acknowledgment. You do construct a valid acknowledgment ?

Also if you needed to get at any of the individual fields in the message that are not binary data (these tend to be results – and no one treats result messages commonly – so we almost always need to do something to the message), you would need to decode. Once decoded, separator issue potentials exist among others.

The HL/7 folks actually are a pretty smart group and their proposed solution is the best way to handle the situation. Of course, not many vendors understand the potentials let alone follow them.

I think the shotgun approach of encoding the entire mesage has limited potential but might be the only resolution if the respective vendors cannot do their part.

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Gary Atkinson]

A little update:

In troubleshooting with the receiving system (Cerner), it appears they are parsing the E.  In reading their specs they have the ability to decode, but sending system can not encode  🙄 At any rate, we think extra space is coming from a “line” in the header and are asking the sending system to remove it.  It’s been somewhat frustrating troubleshooting this issue, as I don’t have control over the rtf code, but I learned some new things.

Gary

[Gary Atkinson]

Update:

The sending system removed an additional horizontal line in their header and now the header displays correctly in Cerner.  Weird that it worked out this way  8)

Gary

[Pete Gilbert]

I wasn’t implying that you base 64 encode the entire hl7 v2.x message, just the rtf payload. The only time that I’ve base64 encode an entire hl7 v.x2 message, is when I am sending it wrapped in a soap envelope, and that was the best way to avoid inadvertently having a special xml character (like teh & or the > or the <) in the wrong place. And, yes, those folks sent me a base 64 encoded HL7 ack message wrapped in a soap envelope.

Jim Kosloskey wrote:

Pete,

Well you would need to decode the message in order for your acknowledgment proc to get the Control ID (MSH-10) at the very least in order to construct a valid acknowledgment. You do construct a valid acknowledgment ?

Also if you needed to get at any of the individual fields in the message that are not binary data (these tend to be results – and no one treats result messages commonly – so we almost always need to do something to the message), you would need to decode. Once decoded, separator issue potentials exist among others.

The HL/7 folks actually are a pretty smart group and their proposed solution is the best way to handle the situation. Of course, not many vendors understand the potentials let alone follow them.

I think the shotgun approach of encoding the entire mesage has limited potential but might be the only resolution if the respective vendors cannot do their part.

Jim Kosloskey

[Jim Kosloskey]

Pete,

I am sorry – I misread your post.

Jim Kosloskey

email: jim.kosloskey@jim-kosloskey.com 29+ years Cloverleaf, 59 years IT - old fart.

[Author]

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