IHE ITI Technical Framework
The Final Text ITI Technical Framework is published here in HTML format and is no longer published as PDF. Trial Implementation supplements are available from the Volume 1 Table of Contents.

5 National Extensions for IHE Germany

The national extensions documented in this section shall be used in conjunction with the definitions of integration profiles, actors and transactions provided in Volumes 1-3 of the IHE Technical Framework. This section includes extensions and restrictions to effectively support the regional practice of healthcare in Germany.

This national extension was authored under the sponsorship and supervision of IHE Germany and the IT Infrastructure Technical Committee. Comments should be directed to:

http://www.ihe.net/ITI_Public_Comments and ihe-d-pam-abgleich@googlegroups.com

5.1 Referenced Standards

German HL7 Edition 2.5, German HL7 Chapter (HL7-Benutzergruppe in Deutschland e. V.), http://www.hl7.de/

German National Message Profiles 2003 (Rel.1) to 2004 (Rel.2.1), http://www.hl7.de/download/documents/Profile_2.1.zip

5.2 HL7 v2 Conventions for Message Profiles

Implementations of [ITI-30] and [ITI-31] profiles that also claim support of the German National Extension shall conform to the requirements in this section and the information provided by the links.

5.2.1 HL7: Support for Character Sets

All actors with HL7 transactions shall support the value “8859/1” and “8859/15” for the field H/18 in the MSH segment.

5.2.2 Naming Conventions for Profiles

The term “profile” is used as defined by IHE and references “integration profiles” as specified by the different IHE Technical Frameworks.

In case where IHE integration profiles leverage HL7 v2 messages, they consist of one or more “HL7 message profiles” that are a specialization of the officially published HL7 v2 standard. When necessary extensions are defined. This is for example the case with the ZBE segment.

The “HL7 Message Profile Component” concept is used to specify fragments of messages, which can be used with different base messages. Such fragments are tables, data types, segments and segment groups. This way, a tedious repetition of specification details is prevented and helps to simplify and reduce development efforts.

5.3 [ITI-30] and [ITI-31]

Implementations of PAM and other profiles that use [ITI-30] and [ITI-31] that also claim support of the German National Extension shall conform to the requirements in this section.

The names of the HL7 fields shall be as defined in the German HL7 Edition 2.5.

IHE Germany has undertaken a three year project to align the National Message Profiles published in 2003 (Rel.1) to 2004 (Rel.2.1) with the Patient Administration Management Profile.

The overall project details can be found here:


The additional constraints can be roughly divided into the following categories:

  • data type enhancements (XPN, XAD)
  • profile support with MSH-21
  • software release verification
  • provision of specific table values
  • diagnosis and procedure related information

Some additional requirements have been crafted in the form of HL7 message profile components which can be combined with the HL7 base message profiles.

  • insurance information (payor data with smartcards)
  • DRG-related data
  • contact persons

5.3.1 Extension Requirements: Notation and Location

Most of the requirements are not documented directly in this document, but are instead included by reference in these tables below:

  • Table 5.3.2-1 Introductory Documents for German Message Profiles
  • Table 5.3.2-2 Detailed German Message Profiles for PAM
  • Table 5.3.3-1 Additional German Profile Components PAM
  • Table 5.3.4-1 Additional German Segment Definitions
  • Table 5.3.5-1 Additional German Data Type Definitions
  • Table 5.3.6-1 Additional German Table Definitions
  • Table 5.3.7-1 Additional German Profiles

Implementers are responsible for monitoring any changes to the linked tables hosted on the IHE/HL7 Germany wiki.

In the linked tables, the light blue highlights mark rows containing differences between the requirements in ITI TF-2 for [ITI-30] and [ITI-31] and German requirements.

The Verwendung (optionality) column shows the German requirements, and the requirements from ITI TF-2 have been preserved in parentheses, the Kard. (cardinality) column shows the German requirements, but the requirements from ITI TF-2 are not preserved.

All changes are SHALL-level implementation constraints for actors that want to comply with the German National Extensions.

For example:

Figure 5.3.1-1: Examples of Differences Between Requirements for [ITI-30] and [ITI-31] and German Requirements German Message Profile Architecture

Figure demonstrates the overall structure and relationship of the German Message Profiles as a specialization of ITI PAM:

Figure German Message Profiles as a National IHE Extension

The detailed architecture is depicted in Figure

Figure German Message Profile Architecture

5.3.2 German HL7 Message Profiles for PAM

The German HL7 Message Profiles were originally created in German but all relevant details have been translated into English and interleaved in the pages linked in this section.

Table 5.3.2-1 provides an overview of the details.

Table 5.3.2-1: Introductory Documents for German HL7 Message Profiles

Description Link
Document Overview


Communication Framework


Common Elements


Correction of Identifiers


To support German National Extensions, the PAM Patient Demographics Supplier, Patient Demographics Consumer, Patient Encounter Supplier, and Patient Encounter Consumer Actors shall support the messages listed in Table 5.3.2-2 and shall support the fields and associated behaviors described in the links in the Message Profile column. Note that some Events in the table are associated with options in the PAM Profile.

Table 5.3.2-2: Detailed German HL7 Message Profiles for PAM

Event German HL7 Message Profile

Admission: http://wiki.hl7.de/index.php/HL7v2-Profile_Aufnahme


Transfer: http://wiki.hl7.de/index.php/HL7v2-Profile_Verlegung


Discharge: http://wiki.hl7.de/index.php/HL7v2-Profile_Entlassung


Patient registration: http://wiki.hl7.de/index.php/HL7v2-Profile_Besuchsmeldung


Preadmit patient: http://wiki.hl7.de/index.php/HL7v2-Profile_Voraufnahme

A06, A07

Switch in-/outpatient: http://wiki.hl7.de/index.php/HL7v2-Profile_Fallartwechsel


Update: http://wiki.hl7.de/index.php/HL7v2-Profile_Aenderung_Patient

A09, A10

Patient tracking: http://wiki.hl7.de/index.php/HL7v2-Profile_Abwesenheiten_Einrichtung


Cancel Admission: http://wiki.hl7.de/index.php/HL7v2-Profile_Aufnahme_Storno


Cancel Transfer: http://wiki.hl7.de/index.php/HL7v2-Profile_Verlegung_Storno


Cancel Discharge: http://wiki.hl7.de/index.php/HL7v2-Profile_Entlassung_Storno

A21, A22

Leave of absence: http://wiki.hl7.de/index.php/HL7v2-Profile_Abwesenheiten_Urlaub


Update Person: http://wiki.hl7.de/index.php/HL7v2-Profile_Aenderung_Person

A24, A37

Link: http://wiki.hl7.de/index.php/HL7v2-Profile_Verknüpfung

A40, A47

Update Patient ID: http://wiki.hl7.de/index.php/HL7v2-Profile_Aenderung_Patienten-ID


Historic Movement: http://wiki.hl7.de/index.php/HL7v2-Profile_historische_Bewegung

5.3.3 Additional German HL7 Message Profile Components

Implementations may choose to support any of the message components listed in Table 5.3.3-1 but if supported shall support the fields and associated behaviors described in the links in the HL7 Message Profile Component column.

Table 5.3.3-1: Additional German HL7 Message Profile Components PAM

Description German HL7 Message Profile Component
Insurance smartcard data http://wiki.hl7.de/index.php?title=HL7v2-Profilkomponente_Kartendaten
Contact Persons http://wiki.hl7.de/index.php?title=HL7v2-Profilkomponente_Kontaktpersonen
Insurance http://wiki.hl7.de/index.php?title=HL7v2-Profilkomponente_Kostenträger
Transmission of DRG related data http://wiki.hl7.de/index.php?title=HL7v2-Profilkomponente_DRG-Rohdaten
Patient Photo (informative) http://wiki.hl7.de/index.php?title=HL7v2-Profilkomponente_Patient_Photo

5.3.4 Additional German Segment Definitions

Implementations shall support all the segments listed in Table 5.3.4-1 and shall support the fields and associated behaviors described in the links in the HL7 Message Profile Component column.

Table 5.3.4-1: Additional German Segment Definitions

Segment Description HL7 Message Profile Component
DG1 Diagnosis


ERR Error


EVN Event


FT1 Financial Transaction


MRG Merge


MSA Message Acknowledgement


MSH Message Header


IN1 Insurance


IN2 Insurance (Part 2)


IN3 Insurance (Part 3)


NK1 Next of Kin


OBR Observation Request


OBX Observations



PID Patient Identification


PR1 Procedures


PV1 Patient Visit



Patient Visit

(Addt. Inform.)


ROL Role


SFT Software


TXA Transcription Document Header


ZBE Movement


ZGK Card Data


5.3.5 Additional German Data Type Definitions

Implementations which send any of the data types listed in Table 5.3.5-1 shall support the fields and associated behaviors described in the links in the HL7 Message Profile Component column.

Table 5.3.5-1: Additional German Data Type Definitions

Data Type Description HL7 Message Profile Component
CE Coded Elements


CNE Coded No Exceptions


CWE Coded With Exceptions


CX Extended Composite ID Numbers


DT Date/Time


ED Encapsulated Data


EI Entity Identifier


FN Family Name (as part of XPN)


HD Hierarchic Designator


PPN Performing Person Time Stamp


SAD Street or Address (as part of XAD)


SI Sequence ID


ST String


TS Timestamp


XAD Extended Address


XCN Extended Composite ID Number and Name for Persons


XON Extended Composite Name and Identification Number for Organization


XPN Person Name


XTN Contact


Actors may choose to support any of the messages listed in Table 5.3.2-2 but if supported shall support the fields and associated behaviors described in the links in the HL7 Message Profile Component column.

5.3.6 Additional German Table Value Definitions

Table 5.3.6-1 provides an overview about nationally defined tables. Associated table values will be found at the end of the provided link.

Table 5.3.6-1: Additional German Table Definitions

Table Description German Descr. HL7 Message Profile Component
4902 Card Type Kartentyp

http://wiki.hl7.de/index.php/Tabelle_4902 (Kartentyp)

4903 WOP Indicator WOP-Kennzeichen

http://wiki.hl7.de/index.php/Tabelle_4903 (WOP-Kennzeichen)

4904 Sample Identification Stichproben­zuordnung

http://wiki.hl7.de/index.php/Tabelle_4904 (Stichprobenzuordnung)

4905 Location classification Rechtskreis

http://wiki.hl7.de/index.php/Tabelle_4905 (Rechtskreis)

4906 Inpatient Services Stationäre Leistungen

http://wiki.hl7.de/index.php/Tabelle_4906 (stationäre_Leistungen)

4907 Indication for specific person groups Kennzeichnung besondere Personen­gruppen

http://wiki.hl7.de/index.php/Tabelle_4907 (Kennzeichnung besondere Personengruppen)

4908 Disease management program indicator (eGK) DMP-Kennzeichen (eGK)

http://wiki.hl7.de/index.php/Tabelle_4908 (DMP-Kennzeichnung_eGK)

4909 Disease management program indicator (KVK) DMP-Kennzeichen (KVK)

http://wiki.hl7.de/index.php/Tabelle_4909 (DMP-Kennzeichnung_KVK)