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Systems upstream or users downstream from the target system, or the target system itself, may produce generic ACKs (|ACK|). This is because other segments in the message may be unreadable because of errors or they are unavailable to the processing system. This type of ACK is informational, the confirmation of delivery to the target system relies on the application ACK. These additional ACKs are accept ACKs as defined by the international standard.


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Should delivery fail, faults that can be remedied are highlighted. These would have otherwise been unknown to the sender as the receiver would be unaware they should have received a message. This also allows systems to provide notification of human read acknowledgements of messages, mapping the sending application to the provider viewing the message contents.

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  1. Enter Original Message MSH-3(Sending Application) into ACK MSH-5(Receiving Application).
  2. Enter Original Message MSH-4(Sending Facility) into ACK MSH-6(Receiving Facility).
  3. Fill with software generating ACK into ACK MSH-3(Sending Application).
  4. Enter Original Message MSH-6(Receiving Facility) into ACK MSH-4(Sending Facility).
  5. Enter Original Message MSH-11(Processing ID) into ACK MSH-11(Processing ID).
  6. Enter Original Message MSH-10(Message control ID) into ACK MSA-2(Message control ID).
  7. ACK MSH-10(Message control ID) should be unique and unrelated to Original Message MSH-10(Message control ID).


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MSA segment details can be found here: https://confluence.hl7australia.com/display/OOADRM20181/2+Patient+Administration+for+Pathology#id-2PatientAdministrationforPathology-2.1.8MSA-messageacknowledgmentsegment

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  1. Sender to Receiver with application ACK.
    Image Added
    1. REF Examples 1.7 Level 1.zip Level 1 Example 1: https://confluence.hl7australia.com/display/OOADRM20181/Appendix+6+Example+Messages
      “MSH|^~\&|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID||JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|20170608223629+1000||REF^I12^REF_I12|MOE06082236987-957.1.4|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706-L1&&L|||AL|AL|AUS<cr>
      RF1…”
    2. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223642+1000||ACK|945375|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|CA|MOE06082236987-957.1.4
    3. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608224009+1000||RRI^I12^RRI _I12|AB19274|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706/RRI&&L|||NE|AL|AUS<cr>
      MSA|AA|MOE06082236987-957.1.4<cr>
      RF1|…<cr>
      PRD|…<cr>
      PID|…<cr>
  2. Sender to Intermediary with accept ACKs and later application ACK.
    Image Added
    1. REF Examples 1.7 Level 1.zip Level 1 Example 1: https://confluence.hl7australia.com/display/OOADRM20181/Appendix+6+Example+Messages
      “MSH|^~\&|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID||JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|20170608223629+1000||REF^I12^REF_I12|MOE06082236987-957.1.4|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706-L1&&L|||AL|AL|AUS<cr>
      RF1…”
    2. MSH|^~\&|MiddleWare^MiddleWare V2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223849+1000||ACK|945376|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|CA|MOE06082236987-957.1.4
    3. MSH|^~\&|SecondHopSoftware^ SecondHopSoftware Build 5.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223701+1000||ACK|8ajojeaha2|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|CA|MOE06082236987-957.1.4
    4. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223629+1000||RRI^I12^RRI _I12|AB19275|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706/RRI&&L|||NE|AL|AUS<cr>
      MSA|AA|MOE06082236987-957.1.4<cr>
      RF1|…<cr>
      PRD|…<cr>
      PID|…<cr>
  3. Sender to Intermediary with multiple ACKs including user reporting inability to view content read ACK.
    Image Added
    1. REF Examples 1.7 Level 1.zip Level 1 Example 1: https://confluence.hl7australia.com/display/OOADRM20181/Appendix+6+Example+Messages
      “MSH|^~\&|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID||JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|20170608223629+1000||REF^I12^REF_I12|MOE06082236987-957.1.4|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706-L1&&L|||AL|AL|AUS<cr>
      RF1…”
    2. MSH|^~\&|MiddleWare^MiddleWare V2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223849+1000||ACK|945376|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|CA|MOE06082236987-957.1.4
    3. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223852+1000||RRI^I12^ RRI _I12|AB19275|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706/RRI&&L|||NE|AL|AUS<cr>
      MSA|AA|MOE06082236987-957.1.4<cr>
      RF1|…<cr>
      PRD|…<cr>
      PID|…<cr>
    4. MSH|^~\&|DrJohnSmith^889119NF^AUSHICPR|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170609123701+1000||ACK|8ajojeaha2|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-READ-2020006&&L|||NE|AL|AUS<cr>
      MSA|AR|MOE06082236987-957.1.4|Report is unreadable.
      ERR|^^^EUserError&Report is unreadable&L
  4. Sender to Intermediary with Error/Reject ack from application/intermediary.
    Image Added
    1. REF Examples 1.7 Level 1.zip Level 1 Example 1: https://confluence.hl7australia.com/display/OOADRM20181/Appendix+6+Example+Messages
      “MSH|^~\&|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID||JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|20170608223629+1000||REF^I12^REF_I12|MOE06082236987-957.1.4|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-REF-SIMPLIFIED-201706-L1&&L|||AL|AL|AUS<cr>
      RF1…”
    2. MSH|^~\&|MiddleWare^MiddleWare V2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608223650+1000||ACK|945379|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|CA|MOE06082236987-957.1.4
    3. See point 1.
    4. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608224201+1000||ACK|8ajojeaha2|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|AE|MOE06082236987-957.1.4||||EHL7RelayAccessException^"Your user is not authorised to relay messages on this server. Access Denied"^L^EHL7RelayAccessException^^L
      ERR|^^^EHL7RelayAccessException&"Your user is not authorised is not authorised to relay messages on this server. Access Denied"
    5. MSH|^~\&|SomeSoftware^SomeSoftware V1.2^L|JD Medical^F144C1B5-56C7-43C1-80A4-83AD87D4FE5E^GUID|MERIDIAN^MERIDIAN:3.1.4 [win32-i386]^L|Buderim GE Centre Demo^0AE5C60C-A510-43B3-A509-C57F29B2D368^GUID|20170608224201+1000||ACK|8ajojeaha2|P|2.4^AUS&Australia&ISO3166_1^HL7AU-OO-ACK-201701&&L|||NE|AL|AUS<cr>
      MSA|AE|MOE06082236987-957.1.4||||EHL7RelayAccessException^"Your user is not authorised to relay messages on this server. Access Denied"^L^EHL7RelayAccessException^^L
      ERR|^^^EHL7RelayAccessException&Your user is not authorised is not authorised to relay messages on this server. Access Denied&L

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