Epic Interface Message Processing, Exams of Nursing

An overview of the integration between the application workflow and bridges, focusing on the processing of interface messages. It explains the role of the holding queue, control queue, and filer daemon in managing and processing these messages. The document also discusses the ability to resubmit and retrigger outgoing interface messages, as well as the various utilities available for message search, viewing, and editing. Additionally, it touches on best practices for conducting efficient message searches. The information presented in this document is likely relevant for university students studying topics related to healthcare information systems, enterprise application integration, and workflow management.

Typology: Exams

2023/2024

Available from 08/12/2024

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Epic Bridges Prep v1 Exam New 2025 Version with
All Questions from Actual Past Exam and 100%
Correct Answers
When is duplicate prevention performed? ----------- Correct Answer ---------- when an incoming interface
that can create patients does not find the patient by ID and ID type
What are the four possible outcomes of patient Identity Duplicate Checking and the recommended actions
for those outcomes? ----------- Correct Answer ---------- 1) no match- create a new patient and file
message
2)Low threshold matches- create a new patient and file messages
3) Single high threshold match- file message to existing patient
4) Multiple high threshold matches- log a fatal error
Is it necessary to send empty fields following the last valued field? ----------- Correct Answer ---------- No
Within a field do you need to send all components? ----------- Correct Answer ---------- Only as many as
are valued
Blank fields... ----------- Correct Answer ---------- don't file anything
Delete character HL7 ----------- Correct Answer ---------- double quotes " "--- tells the receiving system to
delete a piece of info it has
When is patient validation performed? ----------- Correct Answer ---------- when any patient-based
incoming interface finds the patient record by ID and ID type
What are the three types of validation an interface can use? ----------- Correct Answer ---------- Basic
Validation, Advanced Validation, Identity Duplicate Configuration (IDC)
Which Identity Duplicate Configuration (IDC) threshold is used for patient validation? ----------- Correct
Answer ---------- High Threshold
3 methods of migration for Bridges objects ----------- Correct Answer ---------- 1) data courier
2) pack/unpack database record utilities
3) manual migration
Data Courier ----------- Correct Answer ---------- tool that epic provides to facilitate the migration of
objects between environments
Trigger ----------- Correct Answer ---------- Serves as the integration point between the application
workflow and Bridges
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Epic Bridges Prep v1 Exam New 2025 Version with

All Questions from Actual Past Exam and 100%

Correct Answers

When is duplicate prevention performed? ----------- Correct Answer ---------- when an incoming interface that can create patients does not find the patient by ID and ID type What are the four possible outcomes of patient Identity Duplicate Checking and the recommended actions for those outcomes? ----------- Correct Answer ---------- 1) no match- create a new patient and file message 2)Low threshold matches- create a new patient and file messages

  1. Single high threshold match- file message to existing patient
  2. Multiple high threshold matches- log a fatal error Is it necessary to send empty fields following the last valued field? ----------- Correct Answer ---------- No Within a field do you need to send all components? ----------- Correct Answer ---------- Only as many as are valued Blank fields... ----------- Correct Answer ---------- don't file anything Delete character HL7 ----------- Correct Answer ---------- double quotes " "--- tells the receiving system to delete a piece of info it has When is patient validation performed? ----------- Correct Answer ---------- when any patient-based incoming interface finds the patient record by ID and ID type What are the three types of validation an interface can use? ----------- Correct Answer ---------- Basic Validation, Advanced Validation, Identity Duplicate Configuration (IDC) Which Identity Duplicate Configuration (IDC) threshold is used for patient validation? ----------- Correct Answer ---------- High Threshold 3 methods of migration for Bridges objects ----------- Correct Answer ---------- 1) data courier
  3. pack/unpack database record utilities
  4. manual migration Data Courier ----------- Correct Answer ---------- tool that epic provides to facilitate the migration of objects between environments Trigger ----------- Correct Answer ---------- Serves as the integration point between the application workflow and Bridges
  • generally an action in Hyperspace, like clicking a 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.... ----------- Correct Answer ---------- Data about an event (like a patient being admitted to the hospital) MSH-11 and MSH-12 are... ----------- Correct 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 ----------- Correct Answer ---------- Three character code that identifies what kind of data that segment contains PID- 5 ----------- Correct Answer ---------- patient name NTE segment ----------- Correct Answer ---------- can follow many different segments Z-segment ----------- Correct Answer ---------- custom segment for a specific implementation FHIR ----------- Correct Answer ---------- specifies RESTful exchange method via HTTPs to access data Other standards supported by Bridges ----------- Correct Answer ---------- X12, FHIR, NCPDP, DICOM, and Direct Event (in context of outgoing message flow) ----------- Correct 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 ----------- Correct Answer ---------- storage location outside of Chronicles database structure Event Queue is procesed by... ----------- Correct Answer ---------- the Event Daemon Daemon (Outgoing Message Flow) ----------- Correct Answer ---------- process that runs in the background without any direct user action Event Daemon (Outgoing Message Flow) ----------- Correct 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) ----------- Correct Answer ---------- contains the full text of the message along with some additional metadata (i.e. timestamp) about message 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 ----------- Correct Answer ---------- Acts as a waiting area for messages that cannot get a lock to store information to the database Interconnect ----------- Correct 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: ----------- Correct Answer ----- ----- 1) the message uses an XML framework
  1. communication requires HTTPS (web) protocol to reach securely outside your firewall
  2. 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 ----------- Correct 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 ----------- Correct Answer ---------- Comm daemon sends the content of the data queue to Interconnect, wehre the message is packaged and sent Incoming Message Flow with Interconnect ----------- Correct 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 ----------- Correct 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? ----------- Correct 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 ----------- Correct 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? ----------- Correct 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? ----------- Correct Answer ---------- No, never. They are purged only by an automated purge job. Communication Status (Interface Monitor Column) ----------- Correct Answer ---------- whether the comm daemon is stopped or running Total Recv'd/Sent (Interface Monitor Column) ----------- Correct Answer ---------- total number of messages sent (outgoing) or received (incoming) i.e. count Last Recv'd/Sent (Interface Monitor Column) ----------- Correct Answer ---------- Number of the Last message sent (outgoing) or received (incoming) i.e. message number Time since last message( Interface Monitor Column) ----------- Correct Answer ---------- Elapsed time since a message was last sent (for an outgoing interface) or received (for an incoming interface) Queued Messages (Interface Monitor Column) ----------- Correct Answer ---------- number of messages waiting to be sent (outgoing) or processed (incoming) Queued Events (Interface Monitor Column) ----------- Correct Answer ---------- number of events waiting to be processed from the Event Queue (outgoing only) Waiting Messages (Interface Monitor Column) ----------- Correct Answer ---------- Number of messages waiting to be processed from the Holding Queue Filer/Event Status (Interface Monitor Column) ----------- Correct Answer ---------- Whether the Event Daemon (outgoing) or Filer Daemon (incoming) is stopped or running Background Monitor ----------- Correct Answer ---------- takes care of many tasks including determining whether interfaces are running Interface Monitor Definition ----------- Correct Answer ---------- Allows you to specify which interfaces should be displayed in the Interface Monitor activity Interface Monitor ----------- Correct Answer ---------- displays the interfaces from the definition. There are several pieces of information available about each interface displayed:

  • AIP ID
  • Interface
  • Queue
  • Time since last message
  • Total recv;d/sent

Path: Epic>Admin>Interface Admin>Background Monitor Definition> Autostart Epic App for monitoring interfaces on mobile device ----------- Correct Answer ---------- Haiku With Haiku, you can access what details about an interface? ----------- Correct Answer ---------- - ID and name

  • Daemon status
  • Date and time of last message activity
  • Queue depth Data Queue ----------- Correct Answer ---------- used to store messages that are received by Bridges or that are created by Bridges to send out contains the full text of the message along with some additional metadata Message Viewer ----------- Correct Answer ---------- allows you to view the contents of an interface mesage in the Data Queue Path: Epic>Tools>Interface Utilities>View Messages Message Viewer Tree ----------- Correct Answer ---------- the interface message selected is displayed in a tree in the upper half of the Message Viewer. Each segment in the message is displayed in its own branch of the tree. Lower half of Message Viewer ----------- Correct Answer ---------- tabbed display window that can show you several things about the message (i.e. message text, logged errors, message submission details, and sesion history) Message Editor ----------- Correct Answer ---------- similar to the Message Viewer but has the additional power of allowing you to make changes to the message and subit your edited version path: Epic>Tools>Interface Utilities>Edit Message Create new message option ----------- Correct Answer ---------- only available for HL7 version 2 interfaces Resubmit feature ----------- Correct Answer ---------- creates a new message that is added to the data queue and the control queue to be processed
  • marks any errors on the original message as resolved. If an error still holds true on an incoming message, then a new instance of that error will be logged on the new message as it is processed by the Filer Daemon Resubmitting an Outgoing message ----------- Correct Answer ---------- sends the message directly out the Communications Daemon, and no additional validation is done on the message content. If a problem still exists on an outgoing message the error on the original message will be marked as resolved, but a new error will not reappear on the new message Resubmit feature ----------- Correct Answer ---------- submits your new copy of the interface message

Message Search ----------- Correct Answer ---------- allows you to specify an interface, a string to look for, and a time period. The activity then returns all messages that match that criteria

  • allows you to take action on messages that are returned in your search: edit, resubmit, save search path: epic>tools>interface utilities>message search Reasons to search for messages ----------- Correct Answer ---------- - if there is an error on a message for a patient
  • if there is a problem with a given procedure Detailed Message Report ----------- Correct Answer ---------- provides all the information related to a message in a single location
  • can also be viewed in the bottom report pane of the Message Search results
  • there are many links DMR to perform actions or jump to records, including the table associated with a table mapping error, or the patient to which the message is associated How to get the most out of Message Search ----------- Correct Answer ---------- - limit the time period of your search to as small of a window as possible
  • use unique identifiers like MRN, CSN, or order ID for your message content criteria as opposed to non- unique values like patient name
  • include multiple search values to limit your results even further Reasons why an interface daemon might stop unexpectedly ----------- Correct Answer ---------- 1) there is a major problem going on with the system in general 2)there is one unique message that the interface is unable to handle When a single message causes an interface daemon to stop unexpectedly... ----------- Correct Answer ----- ----- you are presented with two problems 1)the bad message cannot file 2)none of the messages after that message can file Skipping Messages ----------- Correct Answer ---------- Allows you to solve the problem of messages being blocked by one bad message by removing the bad message from the Control Queue so it will no longer be considered as a message to be processed and it logs a fatal error indicating which user skipped the message True/False: There is no action that a user can take to remove a message from the Data Queue ----------- Correct Answer ---------- True When can a message be skipped? ----------- Correct Answer ---------- If the Waiting? column has a "yes" value in the message search results Message Search "Waiting" Column ----------- Correct Answer ---------- indicates whether or not the message still exists on the Control or Hold Queue Reasons why a message might still exist on the Control Queue for an outgoing interface ----------- Correct Answer ---------- - the communication daemon is turned off
  • there are communication issues with the engine or external system

period searched

  • search for unique identifiers (CSN, MRN, order ID) as opposed to patient name
  • include multiple search values in your search criteria Bridges Error Codes ----------- Correct Answer ---------- Each error logged by bridges includes a discrete numeric error code that allows us to group multiple occurrences of the same problem Errors sharing the same error code also include additional information specific to the occurrence of that error Bridges Error Severities ----------- Correct Answer ---------- Epic supports five error severities: critical, fatal, warning, notification, and none Critical error ----------- Correct Answer ---------- indicates that the problem is serious enough to prevent the content from being processed Fatal error ----------- Correct Answer ---------- indicates that the problem is serious enough to prevent the content from being processed Notification error ----------- Correct Answer ---------- presents information that might be of interest; logs an error but content is still processed Warning error ----------- Correct Answer ---------- something went wrong, but not enough to prevent content from being processed Error Scope ----------- Correct Answer ---------- indicates the context of a given error. 3 levels at which an error can be logged:
  1. daemon,
  2. message
  3. local The majority of errors logged by interfaces are ______in scope ----------- Correct Answer ---------- message-scoped Local-scope error ----------- Correct Answer ---------- error applies only to part of the message, and the rest of the message might have been processed successfully daemon-scoped error ----------- Correct Answer ---------- indicates problem with the interface configuration, and might require that the interface be stopped so that the problem can be addressed Error Log Report ----------- Correct Answer ---------- allows you to search for logged errors, display them, and take actions to resolve them Path: Epic>Tools>Interface Utilties>Error Log PID- 7 ----------- Correct Answer ---------- patient date of birth Each type of error can be gathered into one of three possible actions: ----------- Correct Answer ----------
  4. Fix
  5. Work
  6. Suppress

"Fix" errors ----------- Correct Answer ---------- problems that can be eliminated by a change to the system to permanently elimnate the problem "Suppress" errors ----------- Correct Answer ---------- some errors are benign and require no further action, so those you can simply suppress "Work" errors ----------- Correct Answer ---------- errors you expect to happen periodically and will require manual intervention as part of the ongoing maintenance of the interface Possible steps one might take to resolve a "Fix" or "Work" error ----------- Correct Answer ---------- - correct a data mapping issue within Epic

  • resubmit or retrigger the message in Bridges
  • edit the message content in Bridges and then resubmit it
  • update a value or setting in the sending system and retrigger the message to Epic
  • change the handling of messages in your interface engine
  • manually change a data value in Chronicles
  • search for messages filed to the same patient Deleting an Error ----------- Correct Answer ---------- marks the error as resolved; happens if: you already made a change in the system to correct the issue, the error is innocuous
  • a later message has filed and rendered the message with the error obsolete Deleted error ----------- Correct Answer ---------- still exists in a resolved state can always access details about the error in Bridges, so long as the corresponding message exists in the Data Queue Error Workqueues ----------- Correct Answer ---------- tool for managing and assigning errors that fall into the ongoing maintenance category
  • each wq has a list of rules that describes the kinds of errors it should collect
  • whenever an interface logs an error that meets one of those rules, the error is automatically assigned to that wq
  • proactively collects all errors that meet criteria from pre-built rules path: epic>tools>interface utilities>workqueue list Collect an error workqueue if: ----------- Correct Answer ---------- 1) the error has a defined resolution path
  1. a user is assigned to fix the errors and has been trained on the defined resolution path
  2. the error doesn't already exist on another workqueue "Transfer" an error ----------- Correct Answer ---------- passes the error to another workqueue "Release" an error ----------- Correct Answer ---------- deletes the error only from your current workqueue "Delete" an error ----------- Correct Answer ---------- deletes the error at a system level Multiple rules in a wq will be evaluated with _______ logic ----------- Correct Answer ---------- OR

interfaces, system-wide profile variables, and system-wide error handling INTF_USER profile variable ----------- Correct Answer ---------- it is the user associated with the interface audit trail entries if no user is present in the message interface will not start without this pv added What must be done once you have made changes to a custom override to ensure the changes will take effect? ----------- Correct Answer ---------- Compile the custom override and restart the interface Profile variable usage report ----------- Correct Answer ---------- compares settings of profile variables across interfaces Profile variable audit report ----------- Correct Answer ---------- tracks the changes to a profile variable within a specific interface If you change a profile variable in one interface specification, does it affect the profile variable in other interfaces? ----------- Correct Answer ---------- No, just the one interface specification in which the change was made Editing the system definitions profile variables requires that you...... ----------- Correct Answer ---------- stop all interfaces that are listed in the Background Monitor Inherited profile variables ----------- Correct Answer ---------- profile variables that are in use by an interface that are defined in the system definitions one of the easiest types of custom overrides ----------- Correct Answer ---------- skipping a field T/F: A single custom override can be used across multiple interfaces of the same type ----------- Correct Answer ---------- T A custom override is created from... ----------- Correct Answer ---------- within the interface specification

  • click the green plus sign by the "message structure" tab When you run into an issue or have a question about an interface, the first place to look is.... ----------- Correct Answer ---------- the reference guide within the reference guide _____________section is most useful ----------- Correct Answer ---------- Supported Segments and Fields or Supported Elements, because it shows you every segment/field, element supported in that interface Profile Variable Validation ----------- Correct Answer ---------- - provides real time feedback as you make changes to a pv to see if that is appropriate based on your other settings. Error screening ----------- Correct Answer ---------- modifies properties of the error; place where you can enter code to change behavior of error
  • located in the Interface Spec HL7 Header Tab of Interface Spec ----------- Correct Answer ---------- controls what is sent in the MSH segment of the outgoing interface

for incoming interfaces, this is where you configure what you expect to receive in MSH-11 and MSH-12, which control whether a message will be acknowledged by the comm daemon If you need to dynamically populate some message header fields on an outgoing interface... ----------- Correct Answer ---------- there are profile variables that can override the values specified in the HL Header tab Epic's Enterprise Master Patient Index ----------- Correct Answer ---------- Identity Enterprise Master Patient Index ----------- Correct Answer ---------- lets you correctly identify records in a setting where each record may have more than one type of ID

  • can happen because your enterprise contains multiple locations and service areas, or because your enterprise is connected to outside systems Identity ----------- Correct Answer ---------- helps you to find the right record by maintaining an index of all the IDs associated with that record
  • supports maintenance of IDs for non patient entities such as procedures, immunizations and medications
  • Identity can be configured for a large number of Epic's master files Identity works by using what two elements ----------- Correct Answer ---------- 1) the ID itself and the institution that uses the ID, called the ID type
  • together, these uniquely determine the record being referred to, so the patient can be found using any of his or her ID or ID types Identity organizes external IDs by ----------- Correct Answer ---------- pairing them each with a corresponding ID type to provide context of what the ID represents 3 Master files that are the most prevalent users of Identity ----------- Correct Answer ---------- 1)EPT 2)SER 3)EAP ____________interface is the heaviest user of general tables ----------- Correct Answer ---------- Incoming Transcription A table with many-to-one mapping ----------- Correct Answer ---------- has multiple values which translate to the same result
  • valid if the values in the source column are a unique set with no duplicate values
  • applicable to tables that perform only incoming or outgoing mapping Record-level IDs (i.e. procedures, patients, providers, and medications) should be mapped using... --------- -- Correct Answer ---------- Identity Outgoing tables ----------- Correct Answer ---------- used to map data stored in Epic to values that are expected in an External system