CareOn qSOFA HL7 Integration Platform

Overview

The CareOn qSOFA HL7 Integration Platform is a sophisticated healthcare interoperability solution that enables seamless transmission of Soteria-generated sepsis prediction scores into the CareOn Electronic Medical Record (EMR) system. Using industry-standard HL7 messaging protocols, this integration platform ensures real-time delivery of critical clinical decision support data directly into clinician workflows.

How It Works

The integration platform functions as a bidirectional data bridge between the Soteria Sepsis Prediction Platform and CareOn EMR systems. It continuously monitors for new qSOFA predictions and automatically transforms them into standardized HL7 messages for immediate delivery to patient medical records.

Data Flow Architecture

Step 1: Score Generation

• Soteria analyzes patient vital signs and generates qSOFA probability scores
• Scores are calculated every 15 minutes during operational monitoring

Step 2: Message Transformation

• Sepsis scores are automatically converted into HL7 ORU^R01 (Unsolicited Observation Result) messages
• Each message includes patient location, observation timestamp, and risk score

Step 3: Message Transmission

• Messages are transmitted using MLLP (Minimal Lower Layer Protocol) over TCP/IP
• Intelligent retry logic ensures reliable delivery even during network disruptions

Step 4: CareOn Integration

• Messages are received by CareOn's device data interface
• Scores appear in observation charts, core banners, and patient journals
• Visual alerts trigger based on configurable risk thresholds

Technical Specifications

HL7 Message Structure

Message Type: ORU^R01 (Unsolicited Observation Result)
HL7 Version: 2.3
Character Encoding: ISO-8859-1
Transport Protocol: MLLP (Minimal Lower Layer Protocol)

Message Segments

MSH (Message Header)

• Identifies sending application (DATACAPTOR/Smartlinx)
• Includes unique message control ID for tracking
• Timestamp for message creation
• Processing mode (Production)

PID (Patient Identification)

• Patient demographic placeholder (handled by location-based routing)

PV1 (Patient Visit)

• Patient class indicator (Inpatient)
• Assigned patient location (ward/room identifier)

OBR (Observation Request)

• Observation timestamp
• Unique observation identifier (UUID-based)
• Location reference for result routing

OBX (Observation Result)

• Primary Score: qSOFA prediction score (0-100%)
• LOINC Code: 967919 (Quick Sequential Organ Failure Assessment)
• Value Type: Numeric (NM)
• Units: Percentage (%)
• Reference Range: 0-100
• Abnormal Flags: H (High), N (Normal) based on risk thresholds
• Result Status: F (Final)

Sample HL7 Message

MSH|^~\&|DATACAPTOR||||20241002075000||ORU^R01|4a02075000360003|P|2.3||||||8859/1|
PID|
PV1||I|GAU01R01D011|
OBR|||||||20241002075000|||GAU01R01D011|||GAU01R01D011|
OBX|1|NM|967919^qSOFA Score^LN||66.7|%|0-100|H||F|||20241002075000|
OBX|2|NM|TBD^Sepsis Probability^L||75|%|0-100|H||F|||20241002075000|

Key Features

Reliable Message Delivery

• Automatic Retry Logic: Failed transmissions retry up to 3 times with exponential backoff
• Connection Monitoring: Real-time socket connection health checks
• Acknowledgment Handling: Validates message receipt and processing
• Fallback Mechanisms: Multiple destination routing capabilities

Performance Optimization

• Connection Latency Tracking: Monitors and logs connection establishment times
• Total Response Time Logging: Tracks end-to-end message delivery performance
• Batch Processing: Handles multiple patient scores efficiently
• Minimal Overhead: Lightweight protocol ensures rapid transmission

Enterprise-Grade Logging

• Comprehensive Audit Trail: Winston-based logging to console and PostgreSQL
• Message Tracking: Full message content logging for troubleshooting
• Performance Metrics: Response time and latency monitoring
• Error Diagnostics: Detailed error logging with retry attempt tracking

Standards Compliance

• HL7 v2.3 Compliant: Industry-standard healthcare messaging format
• LOINC Coding: Uses standardized observation identifiers (LOINC 967919)
• ISO Character Encoding: ISO-8859-1 character set support
• Healthcare Interoperability: Compatible with standard EMR interfaces

CareOn Display Integration

Observation Chart Integration

• qSOFA scores display alongside vital signs
• 15-minute interval updates matching vital signs frequency
• Graphical trend visualization over 24-hour periods
• Color-coded risk indicators for rapid assessment

Core Banner Display

• Sepsis Risk Section: Prominent display in right-hand patient banner
• Current Score: Real-time qSOFA probability percentage
• 24-Hour Trend: Historical score trajectory visualization
• Alert Status: Visual indicators for risk level changes

Clinical Documentation

• Scores automatically injected into patient journal entries
• Comprehensive tracking of score history
• Documentation of alert acknowledgments
• Integration with clinical workflows

Network Configuration

Connection Endpoints

• Primary Interface: Configurable IP and port (e.g., 10.49.96.15:19100)
• Failover Support: Multiple destination routing capability
• Firewall Compatibility: Standard healthcare network protocols
• Secure Transmission: Private network channels

Deployment Architecture

• External Processing: HL7 transformation occurs outside CareOn environment
• Decoupled Design: Independent scaling and maintenance
• Location-Aware Routing: Facility-specific message routing logic
• Cross-Platform Support: Windows and Linux compatibility

Integration Benefits

Clinical Benefits

• Zero Workflow Disruption: Scores appear naturally within existing clinical interfaces
• Real-Time Availability: Immediate delivery of sepsis predictions to care teams
• Comprehensive Overview: Integrated display with all patient vital signs
• Trend Analysis: Historical scoring data supports clinical decision-making

Technical Benefits

• Standards-Based: Leverages existing CareOn device data interfaces
• Minimal Configuration: Integration requires only CareOn configuration changes
• Scalability: Supports up to 1,500 concurrent patients
• Maintainability: Clear separation between prediction and integration layers

Operational Benefits

• Reduced Development Overhead: No custom CareOn development required
• Familiar Interface: Uses standard unsolicited results integration pattern
• Flexible Deployment: Adaptable to facility-specific requirements
• Proven Technology: Based on widely-used HL7 healthcare standards

System Requirements

Network Requirements

• TCP/IP connectivity between Soteria platform and CareOn interface
• MLLP-capable HL7 receiving interface
• Configurable firewall rules for designated ports
• Low-latency network connections for real-time delivery

CareOn Configuration

• Device data interface enabled
• LOINC code 967919 configured in observation parameters
• Core banner customization for sepsis risk display
• Observation chart parameter mapping for qSOFA scores

Database Support

• PostgreSQL for message logging and audit trails
• Sufficient storage for comprehensive message archival
• Backup procedures for integration log data

Monitoring & Support

Real-Time Monitoring

• Connection status alerts via Telegram notifications
• Message transmission success/failure tracking
• Performance metrics dashboard
• Error rate monitoring and alerting

Diagnostic Capabilities

• Full message trace logging
• Connection latency reporting
• Retry attempt tracking
• Network health diagnostics

Support Resources

• Comprehensive message format documentation
• Sample HL7 messages for testing
• Integration troubleshooting guides
• Performance tuning recommendations

Getting Started

For implementation support, configuration guidance, or troubleshooting assistance with the CareOn qSOFA HL7 Integration Platform, please contact our technical support team.

The CareOn qSOFA HL7 Integration Platform is a component of the Soteria Sepsis Prediction Platform. All intellectual property rights are owned by CareExcel Inc.