Trigger - ANSWER-Serves as the integration point between the application workflow and Bridges
-generally an action in Hyperspace, like clicking a
... [Show More] button or closing an activity
-a single, clearly defined action that a user or process can take that results in an interface message being created and sent
An interface message contains.... - ANSWER-Data about an event (like a patient being admitted to the hospital)
MSH-11 and MSH-12 are... - ANSWER-the HL7 processing ID and version; Epic checks these values on an incoming message and rejects the message if they do not match the expected values
Segment Identifier - ANSWER-Three character code that identifies what kind of data that segment contains
PID-5 - ANSWER-patient name
NTE segment - ANSWER-can follow many different segments
Z-segment - ANSWER-custom segment for a specific implementation
Is it necessary to send empty fields following the last valued field? - ANSWER-No
Within a field do you need to send all components? - ANSWER-Only as many as are valued
Blank fields... - ANSWER-don't file anything
Delete character HL7 - ANSWER-double quotes " "--- tells the receiving system to delete a piece of info it has
FHIR - ANSWER-specifies RESTful exchange method via HTTPs to access data
Other standards supported by Bridges - ANSWER-X12, FHIR, NCPDP, DICOM, and Direct
Event (in context of outgoing message flow) - ANSWER-small set of values with the necessary info to build the message: patient ID, patient contact, type of message, and additional info
-contains directions for where the interface should pull the information it needs from the database
Queue - ANSWER-storage location outside of Chronicles database structure
Event Queue is procesed by... - ANSWER-the Event Daemon
Daemon (Outgoing Message Flow) - ANSWER-process that runs in the background without any direct user action
Event Daemon (Outgoing Message Flow) - ANSWER-pulls an event off the Event Queue, uses the information in the event to build the message and finally deletes the event from the event queue.
The event daemon puts the message it has built onto the data queue and adds an instruction to the Control Queue
builds an HL7 message based on data pulled from Chronicles
Data Queue (Outgoing Message Flow) - ANSWER-contains the full text of the message along with some additional metadata (i.e. timestamp) about message processing
Control Queue (Outgoing Message Flow) - ANSWER-a to-do list and contains very little data
-processed by the Communications Daemon
-maintains a list of messages waiting to be processed
Comm Deamon (Outgoing Message Flow) - ANSWER-reads an instruction from the Control Queue and copies the appropriate message off the Data Queue
-sends the message out of Epic and waits for an ACK to be reutrned
-deletes instruction from the Control Queue and proceeds to the next instruction
-sends or receives acknowledgments over a TCP/IP connection
Comm Daemon (Incoming Message Flow) - ANSWER--listens constantly for messages coming into the system
-validates MSH-11 and MSH-12 before accepting it, storing it in the data queue, and adding instruction to the control queue
-sends or receives acknowledgments over a TCP/IP connection
Control Queue (Incoming Message Flow) - ANSWER-processed by the Filer Daemon
Filer Daemon - ANSWER-pulls an instruction from the Control Queue, retrieves the corresponding message from the Data Queue, and then attempts to file the message.
Filing means that the Filer Daemon attempts to store the data in Chronicles.
If the filer daemon is successful, the data is added to the appropriate records in Chronicles.
When there is a problem, and the data in the message cannot be filed, an interface error message is logged
Translates HL7 data into something that can be stored to the database
When the filer daemon attempts to process a message, there are three things that can happen - ANSWER-1) it files the message into Chronicles, possibly with one or more warning or notification errors
2) its unable to file the entire message because there is something critically wrong with the message. This is indicated by a fatal or critical error
3) it's unable to file the message because part of the record to which the message needs to file is locked
Resequencing - ANSWER--a record is locked when a user or process is updating it
-IF a filer daemon receives a message for a patient, but that patient's record is already being updated with an active lock, then the Filer stores the instruction for that message on another queue- the Holding Queue.
-the message remains on the Holding Queue until the lock is released, so that the Filer Daemon can move onto the next message in the Control Queue for processing
The filer Daemon checks messages on the Holding Queue periodically to determine whether messages on the Holding Queue are ready to file
If the Filer Daemon encounters a message on the Control Queue that needs the same locks as a message already on the Holding Queue, that message is also added to the Holding Queue. This ensures that the messages always file into Chronicles in the same order they were received for a patient
Holding QUeue - ANSWER-Acts as a waiting area for messages that cannot get a lock to store information to the database
Interconnect - ANSWER-Epic's web services framework
-enables Epic applications to initiate and receive web service requests with an external application
-sometimes used as an alternate communication method to TCP/IP for interfaces
-communicates messages securely using an HTTPS framework
An interface requires interconnect if one or more of the following are true: - ANSWER-1) the message uses an XML framework
2) communication requires HTTPS (web) protocol to reach securely outside your firewall
3) the interface handles a job in a windows .NET framework, such as extracting an embedded PDF from an HL7 v2 message and storing it to a BLOB server
Common uses of interconnect include - ANSWER-e-Prescribing, Care Everywhere, Meaningful Use interfaces to state registries (i.e. immunizations, results and cancer reporting), Eligibility and X12 interfaces, EMFI and CHart Sunch interfaces, Research Protocol interfaces, Real Time Location System Tracking, IHE interfaces, country-speciifc interfaces
Outgoing Message Flow with Interconnect - ANSWER-Comm daemon sends the content of the data queue to Interconnect, wehre the message is packaged and sent
Incoming Message Flow with Interconnect - ANSWER--Exists within the firewall;
-constantly listening for messages coming into the system
-most incoming interconnect interfaces don't require a separate Comm Daemon, since the Interconnect server handles all of the communication in this direction.
Chronicles - ANSWER-contains all the information for a patient in the form of records
What are stored in the Event Queue, Data Queue, and Control Queue? - ANSWER-Event Queue: info needed to build a message (i.e. patient ID, encounter date, type of message, etc.)
Data Queue: text of HL7 message and additional metadata
Control Queue: to-do list with instructions to send or file messages stored in the Data Queue
What are two ways that interface messages are sent and received - ANSWER-TCP/IP with an interface engine is the most common.
Interconnect is used for HTTPS or other communication outside your local network
What does it mean for an interface to process a message? - ANSWER-the incoming interface's Filer Daemon tries to find the correct patient and file the data in the message into Chronicles
the outgoing interface's Event Daemon creates an HL7 message, based on information in Chronicles, and sends it out through the port defined in the Comm Daemon.
Are messages ever manually deleted from the Data Queue? - ANSWER-No, never. They are purged only by an automated purge job.
Communication Status (Interface Monitor Column) - ANSWER-whether the comm daemon is stopped or running
Total Recv'd/Sent (Interface Monitor Column) - ANSWER-total number of messages sent (outgoing) or received (incoming)
i.e. count
Last Recv'd/Sent (Interface Monitor Column) - ANSWER-Number of the Last message sent (outgoing) or received (incoming)
i.e. message number
Time since last message( Interface Monitor Column) - ANSWER-Elapsed time since a message was last sent (for an outgoing interface) or received (for an incoming interface)
Queued Messages (Interface Monitor Column) - ANSWER-number of messages waiting to be sent (outgoing) or processed (incoming) [Show Less]