Patient Registration

AdvaPACS supports the IHE Patient Registration [RAD-1] transaction for receiving patient demographic updates via HL7 ADT messages. These messages allow an external system, such as a RIS, HIS, or PAS, to create, update, or cancel patient records in AdvaPACS based on the supplied patient identifiers and demographics.

Supported Trigger Events

The following ADT trigger events are supported by AdvaPACS.

Trigger Event	Action
ADT^A01	Creates a new patient record if one does not already exist.
ADT^A04	Creates a new patient record if one does not already exist.
ADT^A05	Creates a new patient record if one does not already exist.
ADT^A08	Updates an existing patient record if a matching patient is found.
ADT^A11	Deletes the patient record if no associated resources exist.
ADT^A38	Deletes the patient record if no associated resources exist.
ADT^A40	Merge two patients by Patient ID.
ADT^A47	Update and replace a Patient ID.

Message Structure

Patient Registration messages use the standard ADT message structure. The following segments are supported:

Segment	Required	Description
MSH	Yes	Identifies the message type, sender and receiver.
EVN	Yes	Identifies the event that triggered the message.
PID	Yes	Contains the patient identifiers and demographics.
PV1	Conditional	Contains visit information where applicable.
MRG	Conditional	Contains patient merge information where applicable.

The following reference provides the supported fields for each HL7 segment used in this workflow. Unless otherwise stated, fields not listed are ignored during processing.

MSH

The MSH (Message Header) segment identifies the message type, sender, receiver, version and other information required to process an HL7 message. All patient registration messages sent to AdvaPACS must include a valid MSH segment.

FIELD	NAME	LENGTH	DATA TYPE	OPT.	TABLE
MSH-1	Field Separator	1	ST	R	-
MSH-2	Encoding Characters	4	ST	R	-
MSH-3	Sending Application	227	HD	R+	-
MSH-4	Sending Facility	227	HD	R+	-
MSH-5	Receiving Application	227	HD	R	-
MSH-6	Receiving Facility	227	HD	R+	-
MSH-7	Date/Time of Message	26	TS	R	-
MSH-9	Message Type	15	MSG	R	0076
MSH-10	Message Control ID	199	ST	R	-
MSH-11	Processing ID	3	PT	R	0103
MSH-12	Version ID	60	VID	R	0104
MSH-15	Accept Acknowledgment Type	2	ID	O	0155
MSH-16	Application Acknowledgment Type	2	ID	O	0155

EVN

The EVN segment identifies the event being reported and when that event was recorded by the sending system. For patient registration messages, AdvaPACS uses EVN to identify the ADT event type and record the event timestamp.

FIELD	NAME	LENGTH	DATA TYPE	OPT.	TABLE
EVN-1	Event Type Code	3	ID	O	0003
EVN-2	Recorded Date/Time	26	TS	R	-
EVN-3	Date/Time Planned Event	26	TS	O	-
EVN-4	Event Reason Code	3	IS	O	0062
EVN-5	Operator ID	250	XCN	O	0188
EVN-6	Event Occurred	26	TS	O	-
EVN-7	Event Facility	241	HD	O	-

Notes:

• If EVN-1 is populated, it should match the trigger event contained in MSH-9-2. For example, an ADT^A08 message should contain A08 in both MSH-9-2 and EVN-1.
• EVN-2 should contain the date and time the event was recorded by the sending system.

PID

The PID segment contains the patient identifiers and demographic information used to identify the patient associated with the report.

FIELD	NAME	LENGTH	DATA TYPE	OPT.	TABLE
PID-1	Set ID - PID	4	SI	O	-
PID-3	Patient Identifier List	20	CX	R	-
PID-5	Patient Name	48	XPN	R	-
PID-7	Date/Time of Birth	26	TS	R2	-
PID-8	Sex	1	IS	R	0001
PID-13	Phone Number - Home	40	XTN	O	-
PID-29	Patient Death Date and Time	26	TS	O	-
PID-30	Patient Death Indicator	1	ID	O	0136

Assigning Authorities

If the Assigning Authorities feature of AdvaPACS is enabled, Patient IDs must include Assigning Authority. The first subcomponent (namespace ID) of Assigning Authority shall be populated. If the second and third subcomponents (universal ID and universal ID type) are also populated, they shall reference the same entity as is referenced in the first subcomponent.

PV1

The PV1 (Patient Visit) segment describes the patient's encounter at the requesting facility. While many fields are optional for outpatient imaging, the segment can be used to communicate visit information, patient class, referring provider, and visit identifiers when available.

FIELD	NAME	LENGTH	DATA TYPE	OPT.	TABLE
PV1-1	Set ID - PV1	4	SI	O	-
PV1-2	Patient Class	1	IS	R	0004
PV1-8	Referring Doctor	60	XCN	C	0010
PV1-19	Visit Number	20	CX	C	-

MRG

The MRG (Merge Information) segment is used in patient merge and patient identifier update messages. It contains the patient's previous identifier information, allowing the receiving system to associate the incoming request with an existing patient record before performing the update.

FIELD	NAME	LENGTH	DATA TYPE	OPT.	TABLE
MRG-1	Prior Patient Identifier List	250	CX	R	-

Example Messages

The examples below illustrate typical HL7 messages used during patient registration. Use them as a reference when building, testing, or troubleshooting your integration with AdvaPACS.

Create a Patient

The following example uses an ADT^A04 message to register a new outpatient:

MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ADT^A04|MSG000001|P|2.5.1
EVN|A04|20260706103000+1200
PID|1||123456^^^HOSPITAL^MR||SMITH^JOHN^MICHAEL||19800115|M|||123 Example Street^^Auckland^^1010^NZ||0211234567^PRN^CP^+64|john.smith@example.com
PV1|1|O

Update a Patient ID

The following example uses an ADT^A47 message to update a patient's identifier, where:

• PID-3 contains the patient's new identifier.
• MRG-1 contains the patient's existing identifier, which will be replaced.

MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ADT^A47|MSG000002|P|2.5.1
EVN|A47|20260330120000
PID|1||NEWPID^^^HOSP^MR||DOE^JOHN
MRG|OLDPID^^^HOSP^MR

Merge Patients

The following example uses an ADT^A40 message to merge two patient records, where:

• PID-3 contains the surviving (correct) patient identifier.
• MRG-1 contains the patient identifier to be merged into the surviving patient record.

MSH|^~\&|RIS|HOSPITAL|ADVAPACS||20260706103000+1200||ADT^A40|MSG000001|P|2.5.1
EVN|A40|202604021030
PID|||12345^^^HOSP^MR||Doe^Jane||19800101|F
MRG|98765^^^HOSP^MR