MajwareMAJWARE
ADT
^A28
ADT3 required / 4 optional segments

ADT^A28Add Person Information

Sent to add a new person record to a Master Patient Index (MPI) or downstream system without creating a visit or encounter. It carries person-level demographic information only — there is no PV1 visit context.

When Is This Sent?

When a new patient is registered in the MPI for the first time, outside of any specific encounter. Common in enterprise MPI systems where patient demographics are maintained separately from visit records.

Real-World Usage

A28 is used by enterprise MPI and HIE systems to propagate new patient registrations. A new patient registered at one facility sends an A28 to the central MPI, which then distributes the identity to all connected systems. Unlike A01/A04 (which create visits), A28 creates only the patient identity record. Systems that rely exclusively on A01 for patient registration will not see patients until their first visit.

Message Structure

Segment names link to their field-level reference pages.

#SegmentPurpose in this messageReqRepeat
1MSHMessage header with ADT^A28 in MSH.9R
2EVNEvent type with A28 triggerR
3PIDFull patient demographics to be added to the MPIR
4PD1Additional demographics including primary care providerO
5NK1Next of kin and emergency contactsOYes
6AL1Known allergiesOYes
7IN1Insurance informationOYes

Example Message

Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.

HL7 v2.x Message
1MSH||^~\&|ENTERPRISE_MPI|HEALTH_SYSTEM|MIRTH_PROD|EPIC|20260310080000||ADT^A28^ADT_A28|MSG00090|P|2.5.1
2EVN||A28|20260310080000
3PID||1||567890^^^HOSP_A^MR~ENTID123^^^ENTERPRISE^PI||Davis^Margaret^E||19450318|F|||300 Pine St^^Springfield^IL^62705^US^H||2175553456^PRN^PH

Troubleshooting Scenarios

New patient not appearing in EHR after MPI registration

Cause

EHR is not subscribed to A28 events, or does not support A28 without a PV1 segment.

Fix

Check whether the EHR requires PV1 even for person-only messages. Some EHRs will not create a patient record without visit context — in that case, the MPI must either include a dummy PV1 or use a different mechanism such as A31 with a flag.

Common Confusions

ADT^A28 (Add Person) vs ADT^A01 (Admit). A28 creates only a person record in the MPI — no encounter is created. A01 creates a full visit/encounter. In systems that conflate person and encounter records, A28 may be processed identically to A01, but they are semantically different.

Related Message Types

Segment Reference

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