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CO - HL7 Issue from SR Results 8/12/24
Problem Statement
The ReportStream Support team received an email from CDPHE ELR on 8/12/24 regarding OBX2 and OBX5 issues.
What you need to know
Email text follows:
This is an automatic email from the CDPHE Electronic Lab Reporting (ELR) system. There was an issue with a file or message submitted by your organization.
Issue Report: Incorrect HL7 Conformance found in the OBX Segment.
Message ID:
7f04a816-85dd-431c-8502-7f606315ae7cReceived by: CDPHE ELR Onboarding Received on: 2024-08-12 10:40:37 File source: CDC PRIME File name:co-receiver-transform.yml-30eee79c-b9d2-4a00-bd6b-256803001f15-20240812194012.hl7Performing Org Name: High Plains Community Health Center INCPlease review OBX2 and OBX5 values, correct, and resubmit the file.
Acceptance Criteria
- [ ] Validate issue in OBX2 and OBX5 for these results.
- [ ] Determine steps to resolve - if the user needs to be contacted to resubmit, please advise the Support Team.
To Do
- Check HL7 message to determine the issue with the specified fields and correct.
Additional Comments
The results from the referenced message were submitted as manual entries in SimpleReport, the facility has not uploaded any data via CSV. We are currently unable to access the HL7 files through RS or Metabase.
@TaneaY You should be able to download the report by searching for this report id 30eee79c-b9d2-4a00-bd6b-256803001f15 in daily data. I looked at it and don't see any issues with the message. It has a valid OBX2 and OBX5. Did they give any more details on what the issue with those fields is?
@victor-chaparro I was able to download the HL7 and noticed most snomed and CLIA numbers formatted correctly even though some messages have more OBX fields then others populated. The OBX2 has populated that symptoms are present without further symptom information for most of the HIGH PLAINS COMMUNITY HEALTH reports. We will reach out to the user and see if there are specific Message ID's related to to this report that they are having issues with. Please take another look to confirm if Support is reviewing the file correctly. Specific Message ID noted 6fc86eb8-6cbc-435b-9e14-988ee6765731.
Follow up sent Hi Nancy,
We received the following error and want to confirm the Message ID's associated with High Plains Community Health Center INC. Can you please send response with specific Message ID's that are causing this error so that we can investigate further.
Response received: Here is the full MSH Segment from the file:
MSH|^~\&|CDC PRIME - Atlanta,^2.16.840.1.114222.4.1.237821^ISO|CDC PRIME^11D2030855^CLIA|CO-ELR|CO|20240812113057||ORU^R01^ORU_R01|7f04a816-85dd-431c-8502-7f606315ae7c|P|2.5.1|||NE|NE|USA|UNICODE UTF-8|ENG^English^ISO||PHLabReport-NoAck^ELR_Receiver^2.16.840.1.113883.9.11^ISO\r
This record was received on the "ONBOARDING" server, not the production server.
I believe the error was caused by the following OBX segment: OBX|4|CWE|76691-5^Gender identity^LN^^Gender identity||asked-declined^Asked But Declined||||||F|||20240812111557|06D0899456^High Plains Community Health Center INC^CLIA||||||||High Plains Community Health Center INC^L^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^06D0899456|201 Kendall Dr^^Lamar^CO^81052-3939^USA^^^Prowers||asked-declined^Asked But Declined\r
It is coded as a CWE but then the result value is not a SNOMED triplet.
Nancy
@TaneaY I've updated their settings so they will start receiving this instead: OBX|8|CWE|76691-5^Gender identity^LN^^^^^^Gender identity||ASKU^asked but unknown^NULLFL Can you confirm if that's ok with them and if we need to resend any messages that had this issue?
@victor-chaparro Thank you! I've reached out to the user with this information and requested feedback.
@victor-chaparro we received the following update from the user this morning:
I have tried to find a valid SNOMED for the Asked but declined answer and have not had any success. This report came in through our test server and the code on that server is checking for a valid SNOMED. This change will result in the same error.
Thank you for the work that you put in attempting to fix this, I am sorry that I do not have a solution to offer to you. Since this came through the test system, there is no need to resend anything.
Thank you!