HL7 Attachments handling

Question

For background, I have configured a channel that receives HL7 ORU^R01 messages from an external source. These messages include Base64-encoded DOCX and PDF reports, which significantly increase the overall message size and impact processing performance.

I would appreciate guidance on the following:

1. Converting Base64 to Attachments
   How can we extract the Base64-encoded DOCX and PDF content and convert them into message attachments so the main HL7 message size is reduced in memory and can be processed more efficiently?

2. Programmatic Access to Attachments
   Once converted, how can we access and retrieve these attachments programmatically within the channel (e.g., in scripting or transformations)?

3. Reattaching Files at Destination
   How can we configure the destination so that these attachments are re-embedded (converted back to Base64 and inserted into the appropriate OBX segment) before sending the outbound HL7 message?

Please let me know the recommended approach or best practices for handling this workflow.

Answer 1

For HL7 ORU^R01 with Base64 in OBX, the practical/typical QIE pattern is:

1. Extract Base64 from OBX → decode → write to file (or external object store)
2. Replace OBX-5 with a lightweight reference (UNC path, URL, document ID, etc.) so the HL7 message is small during processing
3. Before sending to the destination, either:
   • send the reference as-is (preferred), or
   • re-hydrate: read the file back, Base64-encode, and put it back into OBX-5 before sending.

However, how each of these steps is accomplished will vary based on your specific requirements and environment, so it would be best to reach out to us at support@qvera.com so we can take a look at your individual situation.