Admission, Discharge, and Transfer (ADT) messages are a critical component of electronic health record (EHR) maintenance and provide diffuse care teams with vital information about patients in real time, wherever they may be in the healthcare system.
EHR system features, including ADT messages, play a crucial role in patient administration within and between healthcare systems, and help healthcare providers focus on treating and forming ongoing relationships with their patients instead of tracking down their records.
What Are ADT Messages?
ADT messages indicate that a patient has entered or left a health care facility, and are a part of the larger Health Level 7 (HL7) standard for interoperability between health systems and care teams.
When an ADT message is sent, all members of the patient’s care team are updated on their patient’s status. Immediate, accurate identification of where and when a patient is admitted or discharged is critical for ensuring continuous care and for allowing providers to update or adjust care plans in real time.
The Role of ADT Messages in Improving Patient Care
Although ADT messages are important for tracking patients of all kinds, they are especially useful for receiving updates on patients receiving different types of care, such as those in long-term post-acute care (LTPAC) settings. Older adults and adults living with chronic conditions typically have expansive care teams and needs, including primary care physicians, multiple specialists, sporadic hospital stays, and regular diagnostic testing, all spread out across numerous different facilities.
When all members of the care team are aware of a new admission or discharge, it makes it easier to transfer necessary information between providers. Selecting the right EHR solution that incorporates ADT messages and other critical EHR features ensures continuity of care for each patient.
ADT Message Types: A Quick Reference Table
What are the various types of HL7 ADT messages? The ADT message types listed below summarize common ADT messages and their associated events:
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ADT Code
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Message Type
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Trigger Event
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Example Use Case
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A01
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Admit/visit notification
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Patient is admitted to the healthcare facility.
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Patient A presents at an emergency room with chest pains and is admitted to a bed.
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A02
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Transfer a patient
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Patient is transferred from one healthcare facility to another.
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Patient B’s symptoms require them to be transferred from their skilled nursing facility to the local hospital.
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A03
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Discharge or end visit
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Patient is discharged from the healthcare facility.
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Patient C has recovered and is released from the hospital to return home.
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A04
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Register a patient
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Patient that has arrived but not assigned a bed yet is registered in the system.
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Patient D is registered by the emergency room while they wait for a bed assignment.
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A05
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Pre-admit a patient
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Patient information is gathered prior to patient visit.
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Information is collected about Patient E prior to the patient’s admittance for an exam.
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A06
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Change an outpatient to an inpatient
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A non-admitted visit is changed to an admitted visit.
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At a routine exam, it was discovered Patient F had a serious condition that needed immediate patient admit.
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A07
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Change an inpatient to an outpatient
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An admitted visit is changed to a non-admitted visit.
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Patient G’s condition has improved and they are moved from the hospital back to a skilled nursing facility.
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A08
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Update patient information
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Patient information is out-of-date and needs to be updated.
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Patient H enrolled in Medicare and needs to update their insurance information.
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A11
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Cancel admit or visit notification
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An admitted patient visit is cancelled or was incorrectly admitted.
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Patient I was mistakenly entered as A01 but does not need to be admitted.
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A12
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Cancel transfer
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A planned patient transfer is cancelled.
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Patient J was scheduled to be transferred from a skilled nursing facility to a hospital but their condition improved and no longer requires a hospital stay.
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A13
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Cancel discharge or end visit
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A planned patient discharge is cancelled.
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Patient K requires continued follow-up and their discharge is cancelled.
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A31
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Update personal information
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Historical information (outside of current care episode) has to be updated for a patient.
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Patient L provided additional medical documents not previously shared and unrelated to their current treatment.
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A40
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Merge patient
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Combine records mistakenly filed under multiple patients to one patient.
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Patient A was mistakenly entered as Patient X and the records need to be merged.
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A Closer Look at ADT Message Types and When They Happen
ADT HL7 message types are crucial for smooth transitions in care between healthcare settings and for ensuring that care teams, family members, and patients are all on the same page. HL7 data types are flexible enough to offer alternate coding when required and allow for accurate EHR data transmission across disparate systems.
Clear distinctions between patient admittance, transfer, and discharge, especially for patients experiencing complex or chronic conditions, are key to ensuring that each stage of treatment is met with a prepared team that is ready to provide excellent care.
How ADT Messages Fit into LTPAC and SNF Workflows
Patients in LTPAC and skilled nursing facilities often require care provided by a wide team of healthcare professionals spread across different locations. EHR interoperability is crucial for ensuring that the patient receives appropriate care in each facility.
ADT messages can improve interoperability by:
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Alerting the pharmacy that the patient will need medication
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Notifying nursing staff that the patient is admitted and will require care
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Informing pathology to expect samples
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Alerting the primary care physician of the patient’s hospital visit
In addition to direct patient care, ADT messages also help facilities to account for care provided and bill insurance accurately. They are also useful for measuring Merit-based Payment Incentive System (MIPS) metrics for qualifying physicians.
Key Data Segments Found in ADT Messages
In addition to information about whether a patient has been admitted or discharged, ADT messages also include numerous segments that provide a clearer picture of the patient and their overall health.
Some key data segments found in ADT messages include:
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PID: information about patient identifiers
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PV1-3: assigned patient location and visit information
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IN1/IN2: patient’s insurance information
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AL1: information about any allergies the patient has
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DG1: information about the patient’s diagnosis
ChartPath: Supporting Smooth Care Transitions
Knowing in real-time where patients are and when they’re being moved is essential to providing continuous care, especially for patients transitioning from acute care to long-term management. ChartPath understands your need for accurate information about your patients as soon as it’s available. We can help you smooth transitions in care for your patients, allowing you to spend less time finding information and more time supporting your patients.
Our customizable charting with built-in AI tools and 24/7 support seamlessly integrates into existing healthcare workflows and enables you to keep track of your patients through every step of their treatment. Contact us today to discover how ChartPath can improve your EHR to ensure patients are cared for every step of the way.
