^A03
ADT^A03 — Discharge/End Visit
Sent when a patient is discharged from the facility (inpatient) or ends a visit (outpatient). It signals downstream systems to close the patient's active encounter and release associated resources.
When Is This Sent?
When the admissions/discharge clerk processes the patient's discharge in the HIS/EHR, typically after the physician has entered a discharge order and the patient has physically left.
Real-World Usage
Every encounter that starts with an A01 or A04 should eventually end with an A03. Hospitals that don't properly configure A03 distribution end up with 'ghost patients' — patients who show as active in downstream systems (PACS, pharmacy, bed management) even after discharge. This inflates census counts and can cause medication safety issues.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with ADT^A03 in MSH.9 | R | — |
| 2 | EVN | Event type with A03 trigger and discharge timestamp | R | — |
| 3 | PID | Patient demographics | R | — |
| 4 | PV1 | Visit information with PV1.36 (discharge disposition) and PV1.45 (discharge date/time) | R | — |
| 5 | PV2 | Extended visit information | O | — |
| 6 | DG1 | Final discharge diagnosis | O | Yes |
| 7 | PR1 | Discharge procedures | O | Yes |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EPIC|HOSPITAL_A|MIRTH_PROD|PACS|20260311093000||ADT^A03^ADT_A03|MSG00003|P|2.5.1 2EVN||A03|20260311093000 3PID||1||123456^^^HOSP_A^MR||Smith^John^M^^Mr.||19850315|M 4PV1||1|I|4A^201^1^^^HOSP_A||||1234^Ahmed^Dr.^Khalid|||MED|||||01||||||||||||||||||||20260310143000|20260311093000
Troubleshooting Scenarios
Patient still showing as admitted in downstream system after discharge
Cause
A03 message is not reaching the downstream system. Either the interface is not configured to distribute A03 events, or there's a channel filter excluding A03.
Fix
Verify A03 is included in your interface engine's outbound channel filter for each downstream system. Also check whether A03 messages are in the dead-letter queue due to processing errors.
Discharge disposition not populating correctly
Cause
PV1.36 (discharge disposition code) is in a different format than the receiving system expects. Standard codes: 01=Home, 02=Short-term facility, 20=Expired, etc.
Fix
Map PV1.36 codes in your interface engine from the EHR's local codes to the receiving system's expected codes. Build a lookup table since disposition codes vary significantly between systems.
Common Confusions
ADT^A03 (Discharge) vs ADT^A13 (Cancel Discharge). A03 closes the visit. A13 reverses an A03 that was sent in error — useful when a patient is accidentally discharged but is still in the hospital. Downstream systems must handle A13 by re-opening the closed encounter.
Related Message Types
Segment Reference
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