HL7 ADT_A03 Discharge/End Visit

The visit is over, and downstream systems need to stop treating it as active.
HL7 message structure ADT_A03 groups and segments from HL7 v2.5.1 Hide structure

These are the generated groups and segments for the version selected at the top of the page. The article explains the workflow, and this panel follows the chosen HL7 version.

Message Structure

SegmentNameRequiredRepeatable
MSH
 Message Header Yes No
SFT
 Software Segment No Yes
EVN
 Event Type Yes No
PID
 Patient Identification Yes No
PD1
 Patient Additional Demographic No No
ROL
 Role No Yes
NK1
 Next of Kin / Associated Parties No Yes
PV1
 Patient Visit Yes No
PV2
 Patient Visit - Additional Information No No
ROL
 Role No Yes
DB1
 Disability No Yes
AL1
 Patient Allergy Information No Yes
DG1
 Diagnosis No Yes
DRG
 Diagnosis Related Group No No
ADT_A03.PROCEDURE
 Procedure group No Yes
PR1
 Procedures Yes No
ROL
 Role No Yes
OBX
 Observation/Result No Yes
GT1
 Guarantor No Yes
ADT_A03.INSURANCE
 Insurance group No Yes
IN1
 Insurance Yes No
IN2
 Insurance Additional Information No No
IN3
 Insurance Additional Information, Certification No Yes
ROL
 Role No Yes
ACC
 Accident No No
PDA
 Patient Death and Autopsy No No

ADT_A03 closes the encounter. The patient has been discharged, the visit has ended, or the patient is no longer active for the workflow represented by that visit. Receivers use it to remove the patient from active lists, stop location-based routing, finalize billing workflows, update repositories, and prevent new orders from being placed against an encounter that is over.

Discharge sounds like a single event, but in real interfaces it often arrives late, gets corrected, or is held until coding or billing catches up. Treat it as an important state transition, not just a decorative timestamp.

A small A03 example

MSH|^~\&|ADT|CITYHOSP|EHR|CITYHOSP|20260717102000||ADT^A03^ADT_A03|ADT00003|P|2.5.1 EVN|A03|20260717101500 PID|1||123456^^^CITYHOSP^MR||Smith^Jane^Anne^^Ms^^L||19800314|F PV1|1|I|WARD2^205^1^CITYHOSP^^BED||||12345^Careful^Clara|||||||||||VN000345^^^CITYHOSP^VN|||||||||||||||||||01|20260715103000|20260717101500 DG1|1||R07.9^Chest pain, unspecified^I10|||F

What systems do with it

The sender is usually the PAS or EHR. Receivers close the current visit, release the bed, move the patient off active census, stop active-service worklists, and hand off to billing or record-completion workflows. Some systems allow late result posting after discharge; others block it unless the order already exists.

PID and PV1 are the core. Optional DG1, PR1, GT1, and insurance groups appear where discharge is tied to coding, billing, or claims preparation.

Discharge data that matters

Receivers usually care about discharge date and time, disposition, visit number, attending provider, account, and final diagnoses. The exact fields depend on the profile, but the important rule is stable identity: the A03 should close the same encounter opened by A01 and moved by any A02 messages.

If the patient is marked deceased, make sure death details are intentional and sourced correctly. Accidentally closing a visit is a nuisance; accidentally marking a person deceased can break clinical and administrative workflows far beyond the ADT receiver.

Implementation traps

A common trap is using A03 as a catch-all cleanup event. If the visit was cancelled before it happened, a cancellation event may be more accurate. If only the discharge time changed, use the local correction workflow agreed with the receiver rather than replaying a new clinical story.

Reference notes

HL7 patient administration material describes A03 as the discharge or end-visit event. The generated structure above shows why many A03 messages look bigger than transfers: discharge often carries diagnosis, procedure, guarantor, insurance, and accident context for accounting workflows.