An A03 event signals the end of a patient's stay in a healthcare facility. It signals that the patient's status has changed to "discharged" and that a discharge date has been recorded. The patient is no longer in the facility. The patient's location prior to discharge should be entered in PV1-3 - Assigned Patient Location.
An A03 event can be sent to notify: the pharmacy that the patient's stay has ended and that entitlement to drugs has changed accordingly; the nursing system that the patient has been discharged and that the care plan can be completed; the extended care or home health system that the patient has been discharged and that the new extended care or home health admission assessment can be scheduled; the finance system that the patient billing period has ended; and/or the clinical repository that discharge has taken place for the EMR.
For non-admitted patients, an A03 event signals the end of a patient's visit to a healthcare facility. It could be used to signal the end of a visit for a one-time or recurring outpatient who is not assigned to a bed. It could also be used to signal the end of a visit to the Emergency Room. PV1-45 - Discharge Date/Time can be used for the visit end date/time.
When an account's start and end dates span a period greater than any particular visit, the P06 (end account) event should be used to transmit information about the closing of an account. To indicate that a patient has expired, use an A03 event with the PID-29 - Patient Death Date and Time and PID-30 - Patient Death Indicator filled in.
The fields included when this message is sent should be the fields pertinent to communicate this event. The optional allergy, next-of-kin, insurance and guarantor fields should be sent when required to support advanced notification for pending extended care or home health admission requirements (such as scheduling of a nursing assessment in preparation for completion of the extended care plan). When other important fields change, it is recommended that the A08 (update patient information) event be used in addition.
The ROL segment has been deprecated and retained for backwards compatiblity purposes only as of v 2.9. The reader is referred to the PRT segment instead.
The PRT - Participation Segment is used in this message to communicate providers not specified elsewhere. Person level providers with an ongoing relationship are reported in the PRT segment following the PID/PD1 segments. Providers corresponding to the PV1 data are reported in the PRT segment following the PV1/PV2 segments. Providers related to a specific procedure are reported in the PRT segment following the PR1 segment. Providers related to a specific insurance are reported in the PRT segment following the IN1/IN2/IN3 segments. To communicate the begin date and end date of the provider, use the -PRT-11 - Begin Date/Time and the -PRT-12 - End Date/Time in the PRT segment, with the applicable PRT-4 - Role of Particpation. Refer to Chapter 7 for the definition of the PRT segment.
| Segment | Cardinality | Implement | Status |
|---|---|---|---|
 ADT^A03^ADT_A03 | |||
| [1..1] | SHALL | ||
| [0..1] | |||
| [1..1] | SHALL | ||
| [1..1] | SHALL | ||
| [0..1] | |||
| [0..1] | |||
| B | |||
| B | |||
 NEXT_OF_KIN |
|||
| [1..1] | SHALL | ||
| [0..1] | |||
| [1..1] | SHALL | ||
| [0..1] | |||
| B | |||
| B | |||
| [0..1] | |||
| PROCEDURE |
|||
| [1..1] | SHALL | ||
| B | |||
| OBSERVATION |
|||
| [1..1] | SHALL | ||
| INSURANCE |
|||
| [1..1] | SHALL | ||
| [0..1] | |||
| B | |||
 AUTHORIZATION |
|||
| [1..1] | SHALL | ||
 REFERRAL |
|||
| [1..1] | SHALL | ||
| [0..1] | |||
| [0..1] |
| MSH-15 | MSH-16 | Immediate ACK | Application Ack |
|---|---|---|---|
| Blank | Blank | - | ADT^A03^ADT_A03 |
| NE | NE | - | - |
| AL, SU, ER | NE | ACK^A03^ACK | - |
| NE | AL, SU, ER | - | ACK^A03^ACK |
| AL, SU, ER | AL, SU, ER | ACK^A03^ACK | ACK^A03^ACK |
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