Health Exchange MSH, OBR, and Z-Segs | Facilities (Z4A) + Providers (Z4D)

This article describes the specifications for the expectations for the custom Z-segments included within the HL7 ORU file. There is assumed knowledge about HL7 interfaces & connectivity, the purpose of this document is to provide specifications for the Z4A - Facility & Z4D - Provider segments. 

Unlike the common segment used for this value (PV1 or PV2), these custom segments are specific to the intended recipient within the practice receiving the Health Exchange document. 


Z4A Facility / Place of Service
The facility in which the services were performed is listed within this segment. This segment may repeat to indicate multiple POSs. The system will store each facility described in the Z4A segments. These segments should be located just before the last segments for Z4D. 

Z4A|GSMH|Grey, Meridith E||Grey-Sloan Memorial Hospital~123 W. Anywhere Street~Seattle, WA 98101|
Z4A|FacilityID|POSProviderLast, POSProviderFirst POSMiddle||FacilityName~Address1+2~City, ST Zip|

Z4D Provider / Recipient

The custom provider segments are expected at the very end of the Hl7 file, each segment will be accepted and processed into the client database using the externally defined Health Exchange Provider ID (HEProviderID). Multiple providers within the client database may be the recipient of a document. Each provider will need to be listed in their own Z4D segment.

Z4D|1|111^Grey^Meridith^E^^^^INHIE|Grey, Meridith E|
Z4D|SegmentCounter|HEProviderID^HEPLast^HEPFirst^HEPMiddle^^^^HEVendor|HEPLast, HEPFirst, HEPMiddle|
Specification DescriptionZ-Seg Location(s)Expected DataData Type
FacilityIDZ4A-1External Facility IDany
POSProviderLastZ4A.2.1Performing Provider Last Namestring
POSProviderFirstZ4A.2.2Performing Provider First Namestring
POSProviderMiddleZ4A.2.3Performing Provider Middle Namestring
FacilityNameZ4A.4.1(1) + ~Service Location Nameany
Address1+2Z4A.4.1(2) + ~Service Location Address 1 & 2any
City, ST ZipZ4A.4.1(3)Service Location City, ST, Zip{string}, {string} {integer}
Z4A.4.1 Service Location Address = Name~Address~City,ST Zip
HEProviderIDZ4D.2.1External Health Exchange Provider IDinteger
HEPLastZ4D.2.2Health Exchange Provider Last Namestring
HEPFirstZ4D.2.3Health Exchange Provider First Namestring
HEPMiddleZ4D.2.4Health Exchange Provider Middle Namestring
HEVendorZ4D.2.8External Health Exchange Vendor IDany
Prior to sending any files across the interface, please provide your iSalus Interface Specialist with the Health Exchange Vendor ID you have chosen for your company. ALL FILES MUST INCLUDE THIS ID

MSH.3 Segment / Header

Specification DescriptionMSH Location(s)Expected Data

Data Type

SendingFacilityMSH.3.1Sending Facility Namestring
DocumentSubTypeShortDescriptionMSH.3.3See Article


In the case where MSH3.3 is 'Discrete,' the specifications below will need to be placed in the OBR.4 segment. The ShortDescription (OBR.4.1) will be processed and display the LongDescription (OBR.4.2) in OfficeEMR.

OBR||||PR^Procedure Report|
Specification DescriptionOBR Location(s)Expected DataData Type
ShortDescriptionOBR.4.1See Article 
LongDescriptionOBR.4.2See Article